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House of Assembly - Fifty-First Parliament, Third Session (51-3)
2009-06-04 Daily Xml
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MEN'S HEALTH POLICY

The Hon. R.B. SUCH (Fisher) (12:21): I move:

That this house welcomes the strong commitment of the federal and state governments in developing a men's health policy, but acknowledges that much more needs to be done in regard to men's health issues, including awareness, research and treatment.

As members would be aware, I am quite passionate about this issue, as I am about women's health, and have been for a long time. Back in 1992, I tried to get a men's health policy adopted in this very place—sadly, without success.

It is appropriate that we focus on men's health this month because this is Men's Health Month, and 15 to 21 June is Men's Health Week. When men's health was first discussed, many years ago, it was often thought that if you were for men's health then you must be against women's health, but nothing could be further from the truth. As I said earlier, I am passionate about women's health as well as men's health, and it saddens me when I hear of people experiencing trauma or dying unnecessarily and far too early—often because of a lack of proper diagnosis or lack of awareness, or lack of treatment. Only two weeks ago I farewelled a friend, a woman with breast cancer, at the age of 54—tragically, far too young. Sadly, she was not properly diagnosed when she was about 49; she was told that it was a muscle issue, and by the time it was properly diagnosed it was too late.

The same thing is happening with men. Too many men are dying far too early. We heard recently of the case of Richard Pratt who, sadly, died from prostate cancer. He was one of the wealthiest people in country but, tragically, that did not save him; unless you get onto these things early, and get them diagnosed and treated, all the money in the world will not save you. Bud Tingwell also died recently from prostate cancer; people may say that he was getting on a bit, but he may well have lived quite a lot longer.

Men's health is not just about prostate cancer, important as that is, and I acknowledge the role of the Prostate Cancer Foundation of Australia and the federal government's Department of Health and Ageing and pay tribute to the federal Minister for Health, Nicola Roxon, as well as our local minister. However, crossing party lines, I recently made a submission to a senate Select Committee on Men's Health that was chaired by Cory Bernardi. I must say that I was very impressed not only by Mr Bernardi but also by the other members of that committee, which has, in the last few weeks, released its report. That report can be accessed through the web, and I commend it to members.

We are now seeing progress in terms of men's health awareness because of the important work of the Prostate Cancer Foundation and the federal Department of Health and Ageing, as well as the Freemason's Foundation. This foundation is based at the University of Adelaide but it also works in with other universities, and is generously supported by the Freemasons. It is a wonderful gesture on their part to support research and awareness into men's health.

A study on men's health was undertaken in Victoria not too long ago by Foundation 49, which specialises in men's health issues, and we know, from research done by the Freemasons Foundation Centre for Men's Health in the north-eastern suburbs here in South Australia, that the statistics are similar for this state. In the Victorian study, 35 per cent of men in the workplace had high blood pressure, 10 per cent had high cholesterol, 4 per cent had erectile issues, 11 per cent had mental health issues, and 6 per cent had high blood glucose readings—and so it went on. When you look at the statistics in detail you will also see that the health of country men is even worse than men in the city, which is appalling; when you look at Aboriginal men you will see that their average life expectancy is 51 years, and that is also an appalling statistic.

We have a long way to go in terms of addressing these issues as well as, as I said before, addressing issues that affect women. Cancer is not the biggest killer of men, nor is it the biggest killer of women; that place is taken by cardiovascular diseases. As I said at the start, while it is important to focus on prostate and other cancers in men and breast, ovarian, cervical cancer and so on in women, we should not overlook other key health issues, including things such as cardiovascular diseases.

Currently, an average of something like 2,900 men die from prostate cancer each year in Australia—in fact, in 2005 2,900 men died from prostate cancer and in 2006 it is estimated that there were 18,700 new cases diagnosed. It is important to remember that prostate cancer does not necessarily have any symptoms in the early stages, so people can have the disease and not know they have it. I mentioned the figures for rural and regional Australia earlier, and when you look at them you will see that country men have a 21 per cent higher mortality rate from prostate cancer than do men in capital cities. That is an outrageous situation, and it is because they often do not get the medical facilities or the awareness programs necessary for early detection and treatment.

As I said there are a lot of other issues relating to men's health, which also apply to women. Another huge issue—for not just older men but for men in general, as a result of accidents and other issues—is the problem of incontinence. That is being dealt with through significant resourcing from the federal Department of Health and Ageing.

It is not all gloom and doom; there are a lot of things that can be done. I have just had the privilege of being trained as a men's health ambassador, although I do not get a white flag in front of my car and I do not know whether or not the Speaker will give me morning tea here as he does the other ambassadors. As a men's health ambassador I have been trained to talk to Rotary and other groups like that to help spread the message. One of the interesting things in that training program—and this applies to women as well—are ways in which you can reduce the likelihood of cancer: aerobic exercise; strength and resistance training; obviously, regular check-ups from your GP; reduce negative stress; reduce red meat and animal fat intake; increase fish intake; increase fruit and vegetables.

One thing that is quite surprising is that people need to include selenium-rich foods in their diet. I do not know whether many people realise it but, in Australia, our soils tend to be deficient in selenium which means that the fruit and vegetables we eat here tend to be deficient in selenium. The advice, and this is from top experts in Australia commissioned by the Australian Department of Health and Ageing, is a recommendation to ensure that we have a proper intake of selenium. We do not want too much because it is toxic but we need some because it is a proven anti-cancer agent. Likewise, men in particular should have lycopene, which is found in cooked tomatoes—cooked tomatoes are better for you than uncooked ones.

The other part of this program that I undertook recently strongly emphasised eating broccoli, green tea, and drinking—

Mr Piccolo interjecting:

The Hon. R.B. SUCH: My pronunciation of 'broccoli' has been corrected.

Mr Piccolo interjecting:

The Hon. R.B. SUCH: I would not describe you as that; you should be proud of your Italian heritage. The list also includes drinking green tea, increasing soy content in your diet and, as I said, talking to your GP and having regular check-ups. By doing that we can reduce the number of people who are getting illnesses of any kind and often not getting them treated promptly enough.

One of the statistics that really shattered me at this training program was the prevalence of incontinence in Australian men. It was estimated that up to 13 per cent of men have a problem with urinary incontinence and up to 20 per cent have a problem with faecal incontinence. They may not be dinner party topics but they are very important. The good news is that a lot of these problems can be treated.

One of the issues for men with prostate cancer is that they are fearful of becoming incontinent, and the other one they are even more fearful of is becoming impotent. With early intervention those issues can usually be treated in a way which certainly reduces the risk of either incontinence or impotence but, even where people may end up with those conditions, the treatments including implants that are designed now are fantastic.

At this conference there was a guy who admitted to us that he was impotent but he had had a penile implant and he said his sex life had never been better. Sexual dysfunction, in his case, was as a result of a medical condition. We take these things for granted. Men do not like talking about them but they should, because there are some fly-by-night people making a fortune from this. People have probably seen billboards and other ads for nasal sprays, which are just a con because there is no evidence that they work.

Another person on this training program had lost both testicles through testicular cancer but, with modern treatment, he is still able to lead a normal life by using a patch. Many people who cannot leave their homes because of an incontinence issue can be helped quite promptly and easily with some of the latest technology available. The point is that we need to tackle some of these issues. We need to tackle them with early intervention. I am a great advocate of workplace screening. I believe that, in schools, we should go back to screening children discreetly and appropriately for things like obesity, scoliosis and so on.

The same applies to women's health. We should be talking about girls' health and, if we are talking about men's health, we need to focus on boys' health, as well. For a lot of teenage boys, in particular, there are issues of depression—likewise for teenage girls. One of the great things which Jeff Kennett is involved in is the beyondblue program which targets men and women. Depression and other mental health issues are very serious in our community and need to be addressed.

I think the message is quite clear for men and women: have a regular checkup. A lot of men are reluctant to have a check for prostate cancer because they do not like the idea of a digital rectal examination. Well, get over it—it is not all that difficult or uncomfortable. If it saves your life, it is well worth doing.

The point I touched on earlier was that people believe prostate cancer is an old man's disease. Some men in their 30s, although they are in the minority, suffer from prostate cancer. Certainly, by the age of 40, if someone has a family history of prostate cancer, they should see their doctor. Every male by the age of 50 should have a proper prostate check and that involves a digital rectal examination, a prostate-specific antigen blood test and further investigation if necessary. The symptoms can be hidden and you can have prostate cancer without being aware of it.

The message is for men and women is to get a check-up. Get a check-up early, be vigilant in terms of your health, and it may well save your life because a lot of these health issues that befall us need not be life threatening if you get onto them early and deal with them appropriately. I commend that message to all members and suggest that through their newsletter they communicate this to their electors.

Mr PICCOLO (Light) (12:37): I rise to speak in partial support this motion in the sense that I wish to move an amendment to the motion, as follows:

That this house welcomes the strong commitment of the federal and state governments in developing a men's health policy and acknowledges the need to continue working on men's health issues, including awareness, research and treatment.

The DEPUTY SPEAKER: That amendment is in order.

Mr PICCOLO: In speaking in support of my amended motion, as a society, it is good to see that we are becoming increasingly aware of the importance of raising the profile of men's health and men's health issues. I am pleased to be able to report on the strong commitment from both the state and federal governments in this area. In fact, last week the federal parliament handed down its Senate report into men's health policy, and I will speak about that a little later.

Having said that, it is fair to say that, in comparison to other people in the world, men in our society are generally in good health, but that is not to say that improvements cannot be made. In some areas, we can make significant improvements. As I said, there are variations in health outcomes depending on the work you do, where you live and also a range of other factors; for example, Aboriginal men in society are faring the poorest when compared with the rest of the male population.

Heart disease, lung cancer and suicide were the three leading causes of premature death among men in South Australia between 2004 and 2006. The leading three contributors to health loss—that is, premature death and illness—among males in South Australia between 2004 and 2006 were heart disease, type 2 diabetes, and anxiety and depression, which are slowly getting more attention with beyondblue and other programs.

South Australia has become increasingly proactive in addressing men's health issues. For South Australia, the South Australian Men's Health Strategic Framework (the 2008-2012 plan), which was published last year in June, provides some policy and planning framework to respond to men's health needs in the planning and delivery of health services.

The framework supports the development and coordination of research to develop our understanding of men's health and health service issues, as well as the development of programs and health services that are appropriate for men. The framework recognises that the increasing awareness of men's health needs is consistent with the recognition of the need to address preventable illnesses and injuries across all sectors.

South Australian Health is also involved in a number of men's health initiatives, including providing funding to the Freemasons Foundation Centre for Men's Health, a centre established by the Freemasons Foundation in conjunction with the University of Adelaide. I am proud to say that I am a member of the foundation's Patrons Board along with my colleague here, and I have attended some of their local events in Gawler. The Freemasons are doing a wonderful job in promoting men's health right across the country.

One of the centre's aims is to build a pool of researchers and practitioners with an interest in various aspects of men's health to generate knowledge related to men's health and wellbeing. Again, it is important that, if we introduce new programs, they are based on research and are effective.

SA Health is also currently funding or contributing to the funding of several men's health projects, including the Florey Adelaide Male Ageing Study, which is a longitudinal study of chronic disease among 1,200 men aged between 35 and 80 and living in the northwest regions of Adelaide. If my memory serves me correctly, this is the first longitudinal study of men's health in this state. SA Health is also involved in the development of a training resource for primary health care workers working with men and it also provides research around improving men's access to primary health care, in particular, investigating men's use of health call centres.

As I have mentioned, the federal parliament established a Senate select committee to look at men's health. This has provided our state government with an excellent opportunity to put forward our position on areas of interest to the inquiry, including: the level of funding to address men's health; the adequacy of existing education and awareness programs; the prevailing attitudes of men towards their own health and sense of wellbeing; the adequacy of treatment services; and general support programs for men's health in metropolitan, rural, regional and remote areas.

The Select Committee on Men's Health handed down its report last Thursday, I think. I will highlight a couple of the recommendations and findings, because I think it is relevant to the particular motion before us. Recommendation 2 of the committee states:

The committee recommends that legislative drafting instructions and administrative procedures applying in all commonwealth government departments and agencies include a mandatory requirement that they consider the impact of legislation and policies on men as well as women.

This recommendation supports the comments made by the member for Fisher. More importantly, there is a growing awareness that, in trying to improve men's health, you do not have to do it at the expense of addressing men's health issues. Both can and should be addressed. Another finding in the report states:

There is a common perception that men are either not interested in their health or careless in managing it. The committee does not accept this. Men do in fact use health services in high numbers and respond positively to education and awareness campaigns. However services need to be provided in ways that acknowledge men's social and economic circumstances and take account of their distinctive attitudes.

I would add to that their distinctive circumstances and situations because of work and a whole range of other factors. The report continues, 'In addition, boys should be informed about healthy behaviours at an early age.' I could not agree more. The final recommendation that I would like to draw to the house's attention deals with depression. The report states:

Depression and other mental illnesses are significant and often poorly recognised problems in Australia. Overcoming the stigma which still attaches to mental illness is a major issue. Depression is a significant problem in its own right.

I would like to acknowledge the work done by beyondblue to improve that. The report continues:

It is also closely linked to alcohol and drug abuse and can also be present as a co-morbidity with major physical health problems such as prostate cancer. It is important that this interconnectedness be recognised in the provision and conduct of treatment services.

That supports the position of this government. SA Health and the government are doing research to make sure that our policies are appropriate.

The Australian government has also undertaken an extensive consultation process for the development of a national men's policy, which is continuing. The national men's health policy forums held in South Australia were valuable in informing and providing representatives from South Australian men's health groups and those individuals with an interest in the area of men's health with an opportunity to have an input in the development of a national policy. South Australia has long recognised the need for improvement in the area of men's health and applauds the federal government's national consultation in the development of its national men's health policy. The government looks forward to the outcomes of that national policy to improve men's health.

At this point I acknowledge the contribution of a number of people in my own community in addressing men's health issues. I was involved in a men's health group in Gawler which has led to the creation of a men's shed, and the men's shed is one of those vehicles where men can meet and discuss a whole range of health and related issues and, through the local health service, is very proactive in promoting men's health. With those comments, I ask the house to support my amendment.

Mr PENGILLY (Finniss) (12:46): I am pleased to support this motion. It is an important motion because it is critical that we get men's health further up on the agenda and restore some of the balance after what has happened over the last few years. I do not criticise the fact that women's health has been to the fore. However, I think that men's health programs have suffered as a result of women pushing their health issues more successfully than have men, Australian men in particular being rather reticent about getting too involved in looking after their own health.

My generation of baby boomers was of the view that we were going to live forever and not have anything wrong with us. There are a fair few of us around the place at the moment who know that is not correct, and the fact is that we need to promote the issue of men's health and to get men responsible for looking after their own issues. I know the member for Fisher shares my views on that. We only have to look at the veterans, particularly the Vietnam veterans, and their health issues, and I see a lot of them regularly. If I go into my own career of farming, there is a number of farmers of my generation who have neglected to look after their health and have now been caught up with by things such as prostate cancer, smoking-related illnesses, high blood pressure and cholesterol—all those things that none of us were ever going to have happen to us—and we need to do a lot more to promote health issues.

I had a number of years on the regional health board and the KI health board, and I was always very pleased to support some of these issues. In particular, one of the things that has been widely adopted across regional South Australia is the pit stops at field days where you encourage men to go in and have a check-up and get all sorts of things checked out. It has been most successful. Some men are a bit reticent to go in but, with a bit of encouragement from their peers, they go in.

However, the reality is that, through government (whether it be federal, state or even local government), we must do much more to push men's health matters and to get them further up on the agenda. This side of the house is very much aware that it needs pushing, and I know the shadow minister for health wants to keep her man alive as long as possible, so she will be putting forward some very good policies on that particular aspect of health.

So, I am pleased to support this motion. I do not want to see any male particularly suffer as a result of neglecting their health. I encourage my friends to go regularly. I tell people as young as their late 30s to get their prostate, cholesterol and blood pressure checked—the whole gamut of these things—and get in and get it done. I had it a few years ago and had the daylights frightened out of me, and it did me the world of good, and look at me now. I am going to live forever (so I think). I support the motion and I encourage the house to get behind it.

Ms CHAPMAN (Bragg—Deputy Leader of the Opposition) (12:50): I rise to welcome the motion moved by the member for Fisher. I congratulate him on his appointment as a men's health ambassador. I look forward to his new svelte figure, and I suppose lycra pants will be given out in his new role. There is no question that many governments, in this case both the state and federal governments, are considering the development of men's health policies, and that is to be welcomed. Even with the foreshadowed amendment, which shows a little churlishness on behalf of the member of this government who is anxious about the word 'but' and has to add in 'and', we will not take issue.

The most important thing here is that the work is done to ensure that there is a men's health policy. We have had one for women for decades. It has translated into better health services and understanding for women, who have the more peculiar aspects in relation to child bearing and, further, ensured that areas such as breast cancer have received attention for research and understanding, awareness and ultimately treatment. That has been a fantastic initiative, and it is time men's health followed, so we welcome that.

The identification of the importance of men coming forward to recognise their own health issues is part of this. Women, perhaps, are used to being prescribed for, poked at and exposed to health procedures early in life and, because of child-bearing responsibilities, seem to have more than their fair share than the other sex. However, it does not mean that men should escape or in some way be quarantined from an understanding of their own health needs. Obviously, the development of wellbeing policies to promote an understanding that we need to eat, drink and smoke less and walk, run and swim more are obviously important initiatives but, unless men understand that they are exposed to risk of serious maladies and even death if they do not have regular check-ups and do not take the initiative, that will continue.

The stats have been referred to this morning. Life expectancy for men is 4.8 years less than for women; men represent 78 per cent of suicides in Australia and 73 per cent of road deaths; one in nine men in Australia will develop prostate cancer during their lifetime; and already 3,000 men a year in this country die from prostate cancer. My husband died at the age of 50 from cancer—not prostate cancer. Perhaps if he had had regular check-ups he would be with us today, but it is a sobering reminder of the importance of coming forward.

An early program that I remember Dean Brown established when he was minister for health was to have men's health conferences out in the regional parts of South Australia. They did bring men out of the woodwork, so to speak, and they were able to be informed. One of the contributors here this morning referred to the importance of men's health initiatives at rural field days, but now even at metropolitan occasions, such as one at Unley I attended recently, charitable service groups provide for testing men's blood pressure and the like. It is all part of the process of raising awareness, but I say this: we can call for more research, and that is clearly happening, but treatment is also important.

Much has been said today about indigenous men also having access to health services. Just this week I had a call from a former employee of my family who is in his 80s and who is indigenous. He is in an aged care facility near the member for Light's electorate, and he has had a disability since he was the age of 12. He is now in his 80s and is obviously mature aged. He has been given the Order of Australia for his services to the indigenous community, and he is seeking access to an electric wheelchair. They say that he is going blind, he is losing his sight and that it may be a danger to put someone in operation of an electric wheelchair while they are blind. Here is someone who has come forward and said, 'I'm not blind yet. I might have deteriorating eyesight, but in the meantime surely I need access to services to support my disability, ill health and aged circumstances.'

Let us not just talk about pamphlets, awareness, programs, conferences and advertisements in the newspaper: let us talk about understanding that when men come forward we have to be prepared with treatments, resources, support, understanding and preparedness to accept that a level of treatment will need to be undertaken to ensure that, as men have the courage to come forward, they are actually diagnosed and assessed and that they have facilities for treatment. There is little to be achieved in being told that it is important to check regularly if there is nothing to ensure that they have attention to the condition that is identified.

So, I remind the house that the last words of the motion are an important addition—identification, education and assessment. They are all great things, and they all have to be in place as a preliminary. However, we have to understand that we must make a commitment if we want men to live and not be sentenced to some malady. We must also provide the treatment and the resources.

Mr GOLDSWORTHY (Kavel) (12:56): I, too, would like to make some comments on the motion moved by the member for Fisher, particularly in relation to the latter part, which states 'that much more needs to be done in regard to men's health issues, including awareness, research and treatment'. I have listened to the debate and to the contributions, particularly to that of the member for Fisher. He gave some quite comprehensive statistics on some of the different illnesses and diseases that can be suffered by the male population of our community.

It is important that men are really aware of their health needs. There has been an increased level of campaigning and public awareness with respect to prostate cancer. I have some personal experience of that cancer, as my father suffered from it but, fortunately, he was able to receive treatment fairly early on after diagnosis and was cured. Unfortunately, I cannot say the same for my grandfather, who was diagnosed fairly late after its onset; eventually, he passed away as a consequence of prostate cancer, and the same set of circumstances prevailed in relation to my uncle's death

So, I have a pretty clear understanding of prostate cancer, and the statistics show us that its prevalence is about the same as breast cancer in women. We are all certainly very aware of and keenly campaign for breast cancer to be dealt with as a very serious health issue in our community. Prostate cancer is not the only serious condition or disease faced by men; obviously there is a whole range of health conditions and problems, such as heart disease brought on by high cholesterol levels and blood pressure, cerebral haemorrhage and strokes.

The need for awareness, diagnosis and treatment is very important because a certain percentage of men may feel unwell or have symptoms they tend to brush off and disregard. Unfortunately, in some instances, those symptoms develop into something far more serious, so it is important that we deal with these issues at what is referred to as a 'primary' level of health care, where those conditions are diagnosed and treatment is implemented.

Debated adjourned.


[Sitting suspended from 13:00 to 14:00]


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