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House of Assembly - Fifty-First Parliament, Third Session (51-3)
2009-09-10 Daily Xml
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PREVENTATIVE HEALTH AGENCY

The Hon. R.B. SUCH (Fisher) (11:50): I move:

That this house congratulates the federal government on establishing the preventative health agency which will work with federal and state agencies to promote better health outcomes for all Australians.

I take the view that if a minister, irrespective of his or her party, has done or is doing good things they should be applauded. In this case it is Nicola Roxon (federal Minister for Health and Ageing) so when I congratulate the federal government I am really congratulating Nicola Roxon on what she is doing and seeking to do in relation to preventative health.

On 9 April 2008 the Hon. Nicola Roxon, Minister for Health and Ageing, established a preventative health task force which had a range of duties. I will not go into those, but the end result is that within the next week or so the minister will be introducing legislation to the federal parliament to establish a national preventative health agency, initially with administrative funding of $17.6 million and then additional money for specific advertising campaigns and other programs.

An amount of $17.6 million is literally peanuts but it is a first step and a great investment, not simply in terms of reducing the costs on our current health system for illnesses which are preventable but, more importantly, reducing the suffering of our fellow Australians.

I have been arguing for a long time that a lot more needs to be done in respect of preventative health. It is fair to say that in South Australia, under both the present government and previous governments, efforts have been made to improve the health of people and try to ensure they have a healthy lifestyle.

Mr Pengilly: Not with this mob in the country; they've been shutting them all down on us—

The Hon. R.B. SUCH: The member for Finniss points out that country people are suffering. Country people are suffering in a lot of ways, because they do not have access to the medical services they need and they have higher rates of cancer, for example. So, I agree that in that sense that country people are not getting a fair go, and one would hope that this agency will help to address that situation.

I have mentioned in this house before that some councils—the City of Marion and the City of Onkaparinga, to name two—operate preventative health programs for their employees, including assessment for cholesterol, blood sugar, blood pressure, body mass index, nutrition score, vision screening, stress profile, back fitness, care risk rating and cardiac risk rating. That is a fantastic initiative by local government, and it is funded through the Local Government Association Workers Compensation Scheme.

Other employers are doing good things. The ANZ Bank, Foster's brewery and the Victorian police also conduct workplace health checks. I recently spoke to our police commissioner and I asked him whether the police here receive in situ workplace checks. He said that they cannot afford to check all employees but they are trying to do that for some of them. I think that every government employee (and, indeed, private employees) should have the opportunity for what is a fundamental aspect of preventative health, and that is an in situ workplace assessment. Not only will it save lives and trauma but it will also save dollars at the end of the day.

Indeed, a recent study by Wesley Corporate Health found that if you reduce health risk factors by 2.9 per cent per employee in an organisation of 1,000 employees on an average salary of $50,000 a year, the productivity gains for that organisation would be equivalent to $3.48 million per year. If one looks at the situation for Australians in terms of their health, over one million Australians have diabetes but half do not even know that they have it, and over two million are at risk of developing diabetes. A health check was carried out on employees at the Abbotsford brewery in Melbourne (all of which were men, because of the nature of that industry, but that will change over time) and 35 per cent had high blood pressure, 10 per cent had high cholesterol, 11 per cent had mental health issues and 6 per cent had a high blood glucose reading.

If one looks at a study in any area of the population, one will find statistics that are quite alarming and, as I said before, the statistics are often worse for country people. What the federal agency can do (and, obviously, it is not the total answer, and no-one is suggesting it is) is make people aware of some of the risk factors leading to some of those illnesses to which I referred and also reduce, in some cases, the likelihood of people getting some of the cancers, of which there are many different types. The federal agency will be targeting, amongst other things, excessive alcohol consumption, obesity, the need for exercise—all the usual things—and will be promoting healthy eating and all of those related aspects.

At the local level, this week I had informal discussions with the minister responsible for work safety and the Minister for Health to see whether here the charter, if you like, of WorkSafe could include an educational focus on home safety, because the cost to our hospital system and medical system as a result of injuries and other activities in the home is enormous.

If we look at things such as do-it-yourself activities, at the moment people can go into one of the large hardware stores and buy a motorised chainsaw for $129. I know of two people who have had their throat cut and died as a result of inappropriate use of a chainsaw in a domestic situation, working around the home and unwisely cutting above their head. The chainsaw comes down and cuts their throat and that is the end of them. Another example is large angle grinders. A nine inch angle grinder is an incredibly dangerous tool. Employees at some workplaces are not allowed to use them now; they have been replaced by a reciprocating saw. However, do-it-yourself Joe Bloggs can go to Bunnings today and buy one for less than $100. A nine inch angle grinder will take off your leg in two seconds.

The point is that it is not only things like that. It is also children being scalded in the home and children drinking poisons. People have ladders at home that are dangerous—and one of our former colleagues has suffered significantly as a result of falling from a ladder. When people told me of his situation and what happened to him, the inference was that he had fallen from a two-storey building. However, he had fallen from only part-way up a ladder. Because of the way he fell, he snapped his leg and landed in the compost heap. His leg became infected and had to be amputated. His suffering is enormous, as is the cost to the medical system.

What I am saying is that, in terms of preventative health, we have to go beyond simply the conventional focus, and I am pleased by the initial reaction of the Hon. Paul Caica and the Hon. John Hill in relation to exploring this avenue of extending the charter of, say, SafeWork SA—not to be inspectorial or to have penalties but to educate people about risks to themselves and children and slippery bathroom floors, and so on, for the elderly in the domestic setting.

Some of the simple things that can be done in terms of preventative health would be to reduce the amount of salt, sugar and saturated fat in takeaway foods. On Monday night I was at the launch of Prostate Cancer Awareness for the month of September, at which the Premier officiated. I was talking to one of the female professors of medicine at the Adelaide University and she was telling me the amount of salt in what we eat is ridiculously high and quite unnecessary.

Other things such as proper labelling could help. We still do not have adequate labelling. If you go into a bakery you have no idea what they put in the product, and they do not have to tell you. You are sold things in Australia which, in other countries, are not allowed to be sold in terms of additives, and so on. It is only recently that one of the manufacturers of children's lollies has decided, after many years, that in Australia they will not use the artificial colourings that have been banned for a long time in the United Kingdom. So, there are a lot of things that can be done.

I mentioned before in situ workplace screening. I think it should happen in this place, also. We do it in a limited way in terms of flu injections, but we could go a lot further. I think the whole of the Public Service and large corporations should be doing it as well. I would like to see a return to regular health screening in the school environment. It used to happen and it is a good way of picking up problems. You do it, obviously, with regard to privacy and no embarrassment. Issues such as whether the spine is developing properly and whether the child is showing indications of mental illness (particularly at the secondary school level) all can be picked up. Some people say it is a big expense for picking up a few people who might have scoliosis, or some other thing, but I argue that it is effective.

We have a similar debate currently that young women should not get ready access to breast screening because the incidence of breast cancer is low amongst young women, and likewise with some cancers in young men. Apart from that being a pretty callous approach, it is important that we pick up these things early because, if you pick them up early, you can nearly always treat them much more effectively and, in some cases, you can cure them.

So, I am absolutely thrilled that the federal minister, Nicola Roxon, is doing this. The bill she has had developed, hopefully, will be introduced within the next week or so, as I indicated earlier. I would have thought you do not have to be a medical expert to realise that, if you can tackle some of these issues early on, you are less likely to have enormous pain, suffering and cost later in the health system. A lot of what happens in our hospitals and the costs imposed are preventable. What we will see in the very near future with the national preventative health agency is a small step, but I would like to see a situation where we see the fruits of that reflected in, importantly, less pain and suffering to people but, also importantly, less cost to the hospital system.

We cannot keep going with this open-ended approach to hospital and medical expenses and just say, 'Whatever the demand, we are going to meet it.' We cannot keep doing that. We have to tackle things at the front end, get people living in a healthy way, getting proper assessment, going to see their GP early on and getting children screened.

An initiative that the Hon. Lea Stevens brought in, which I commend her for, is the home-based visit for newborns, but I think that needs to be extended to two year olds, three year olds, and so on. If you get onto these things early, which is what preventative health is about, you can change outcomes and people's lives.

I was chatting to the head of one of our important government agencies, and I will not name him, and I asked, 'Do you have all your employees checked health-wise?' and he said, 'No,' and he had not been to a doctor for, I think, 30 years. That is tempting fate, and I know of too many sad cases where things have been picked up too late, for instance, cases of breast cancer. A guy living near me got onto a prostate cancer issue too late and he ended up committing suicide by driving into a truck near Murray Bridge and that truck driver has never worked since. That is the consequence of a failure to get onto issues early.

So, I commend what the federal minister Nicola Roxon is doing. I welcome the initiative of this national preventative health agency, and look forward to Australians having better health outcomes as a result.

Ms BEDFORD (Florey) (12:05): In light of my contribution yesterday extolling the virtues of broccoli, it will be no surprise to the house that I rise to support the honourable member's motion. The South Australian Health Care Plan recognises the importance of prevention of illness in order to improve the health of all South Australians, particularly those with the poorest health outcomes.

Ms Chapman: Watch out, Bob: you are going to have to eat broccoli. We will have to pass a private member's bill to make it compulsory for breakfast.

Ms BEDFORD: And this chamber is green: it is a very spooky place for me. Much of the burden of disease is preventable—conditions such as diabetes, cardiovascular disease, certain cancers and high blood pressure; and other common risk factors, including smoking, poor diet, physical inactivity, excess weight and alcohol misuse.

The National Partnership Agreement on Preventative Health involves an allocation by the Australian government of $448.1 million over four years and $872.1 million over six years from 2009-10 for 11 subprograms of activity. This includes major investment in supporting healthy children and healthy workers; extending to the Measure Up social marketing campaign and the national tobacco campaign; funding community programs for non-working adults; and conducting a national risk factor survey. Our South Australian allocation for healthy children will assist the rollout of the OPAL initiative to up to 20 communities.

One important new component is the allocation of $17.6 million for the establishment of the Australian national preventative health agency, which will:

have responsibility for providing evidence-based policy advice to health and other ministers interested in preventative health;

be tasked with administering social marketing programs and other national preventative health programs which it may be tasked with by health ministers;

be responsible for overseeing surveillance and research activities of a national nature; and

have responsibility for stakeholder consultation.

With the growth of effort in prevention, there is an important role for this type of national preventative agency that can support all jurisdictions to implement effective prevention-related policies and programs and, importantly, ensure that jurisdictions do not duplicate effort in research, data collection, social marketing and other prevention programs.

In running the national social marketing program, the agency will be able to implement campaigns without some of the delays incurred through government approval processes. The agency will also have a research funding pool of $13 million to commission or support research on key topics and to meet gaps in our knowledge. It will also be responsible for a workforce audit and workforce planning. Just as we need to plan for ensuring we have doctors and nurses to meet health care needs, we need to ensure we have sufficient numbers of types of workers in the right locations to support individuals and communities to promote good health and to prevent chronic disease.

Prevention requires efforts by a range of sectors and this agency is charged with the responsibility to provide independent advice to health ministers and other ministers with a role to improving health and wellbeing, such as education, sport and recreation, transport and local government ministers. In particular, the challenge posed by obesity to mobilise stakeholders and resources across jurisdictions, across portfolios within jurisdictions, and across the community and industry sectors, suggest the need for a new mechanism in commonwealth-state coordination.

The agency will assist all jurisdictional ministers in providing strategic leadership of the preventative health agenda, translating broad policy intent into evidence-based strategies and leveraging policy and practice changes such as through national companies that can support staff to be healthy and improve productivity at the same time. It should also assist in the implementation of interventions which are best delivered on a national capacity such as national risk factor surveys. It will complement our efforts in South Australia rather than duplicating them. The agency will:

be an independent statutory authority under its own enabling legislation and conforming with the Financial Management and Accountability Act 1997;

have a chief executive officer and an advisory council appointed by the commonwealth Minister for Health and Ageing, consulting with the AHMC;

task under triennial strategic and annual operating plans prepared by the CEO consulting with the advisory council and agreed by the AHMC; and

report to the AHMC on strategic matters and to the Australian government ministers on financial matters.

All in all, it is a marvellous initiative. I am sure everyone in this house commends it.

As broccoli is the first of at least 20 vegetables that will be served up in a super capacity, we can only look forward to improved health outcomes not only by people eating the super broccoli but by the awareness program that super broccoli will trigger in all forms of eating vegetables and fruit. So, the 2&5 program will receive a fillip from this as well. We commend the member and the motion.

Motion carried.

Mr VENNING: Madam Deputy Speaker, I draw your attention to the state of the house.

A quorum having been formed:

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