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House of Assembly - Fifty-Second Parliament, First Session (52-1)
2011-09-29 Daily Xml
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HEALTH CHECKS, SCHOOL CHILDREN

The Hon. R.B. SUCH (Fisher) (11:43): I move:

That this house calls on the state government to introduce comprehensive health checks for all primary and secondary school children.

I am not suggesting that there needs to be a health check every year at junior primary, primary or secondary school level, but certainly throughout those stages there should be some health checks. We used to do it as a community. The government, years ago did it, and I believe it was very productive in terms of reducing long-term suffering and medical problems for citizens. I will give some examples: young people used to be checked for scoliosis, and they were checked for hearing and things like hernias. Subsequently, when that program was disbanded, people who were not picked up by the system simply slipped through the net, and it is time that health checks at primary and secondary school level were introduced.

Throughout Australia, we have a mixed bag: the Northern Territory has a program in the early years, Victoria has a primary school nursing program, New South Wales does not, nor do Western Australia, Queensland or Tasmania. However, other places in the world do: in Singapore, all secondary school students are screened for vision, spinal screening and a whole range of other aspects; in parts of the UK and in Scandinavian countries, they have extensive health checks as well.

I think the emphasis should be on what is sometimes called 'preventative health or wellbeing' because if we do not address some of these issues now there is no way in the future that we will be able to cope with the medical demands on our system and hospitalisation. I appreciate that the government has been supporting the OPAL program to try to bring about a healthier population, and some of the focus of programs which are directed at early signs of obesity are good, but I think they should be part of a more comprehensive health check. It would be less likely to cause distress to a child if it were a total health assessment, rather than focusing on the single issue of obesity.

The checks can be done in a way which respects the privacy and dignity of the child. The argument that is sometimes trotted out is that parents can take their children to the local doctor. The reality is that not everyone does, and sometimes medical issues are not picked up. Someone might take their child to the doctor for a particular thing like flu or something like that, but it does not mean the doctor is going to check them for a whole range of other possible conditions.

One of the good things that former minister for health, Lea Stevens, brought in was checks for newborns and those in the early infant years. I think that was an excellent initiative, but it needs to be extended because we should be seeing what is happening in terms of the physical and mental development of children over a wider span than that. Children, particularly at the early secondary years, should be checked out for possible psychological and mental health issues.

If that was done, I could just about guarantee that you would have fewer problems with truancy and behavioural issues in schools, and there would be fewer problems for the police and others dealing with young people, particularly those in their teen years, many of whom are exhibiting early signs of mental illness. But you will not pick up those children with the current ad hoc arrangement—you may, but there is no guarantee that you will pick them up without a coordinated approach.

Sure, a scheme of health checks will cost money. Diagnosis is one thing, treatment is another, but it you do not diagnose, and you do not treat, then ultimately you will wear the consequences down the system. The individual will, and so will the system as a whole, and the community and the taxpayer will increasingly be forced to pay for a health system which is going to dramatically rise in cost over time. If you got onto some of those issues earlier and dealt with some of the aspects which affect learning and behaviour generally, and certainly lifestyle and wellbeing, the benefits that would accrue to the individual and the community would be enormous.

As I have mentioned in here, some companies and councils offer health checks to their staff, and I think that is fantastic. The City of Onkaparinga do it, Marion do it, I believe the ANZ bank do it, and others as well. I pose the question: why is it that Scandinavian countries and Singapore can have health checks at various stages through school years, but we cannot or do not and do not want to do it? To me it is a good investment. As I say, apart from saving money down the track in terms of hospitalisation and medical treatment, more importantly to me is that you improve the wellbeing of individuals.

I know of cases of people with serious physical impairments, where those issues have been picked up in the school system, and others where they did not have a school screening system and those individuals have suffered throughout their life. I know of someone who is unable to have children now, because of a very simple process that could have identified a problem, was not identified; therefore, no remedial action was taken. That person as an adult cannot have children, when, if it had been picked up as a child it could have been addressed, and that person might have had the pleasure and the privilege of being able to have children.

That is just one example. There are many others relating to hearing, sight and behaviour that could and should have been picked up. So, the emphasis in my view should be on what is called preventative health, with health checks through the school system, not every year, but every few years at junior primary, primary and at the secondary level.

Mrs VLAHOS (Taylor) (11:52): I rise to oppose the motion. South Australia has a long and strong commitment to early childhood development, and parents are supported in a range of ways along a child's developmental journey. I know this first-hand, being the mother of a five year old and a seven year old, who has gone through many of these screening processes over the recent years, with screening for development issues on a regular basis as part of the component for a preventative health-care strategy for very young children in our state.

All South Australian families are provided with a copy of My Health Record (the blue book) when a child is born. Following the birth, this provides advice on safety and positive parenting advice for children, and as it serves as the parents' first guide to the child's development. The Universal Contact Visit, which the member for Fisher mentioned, was introduced by the Hon. Lea Stevens (who used to be a member in this place), and offers all parents the opportunity to have this first contact visit and have contact with a nurse. Introduced as a result of the Every Chance for Every Child framework in 2003, it includes a one to four week health/development check.

Hearing screening is also offered to all families through the Universal Neonatal Hearing Screening program. Often, that happens when you have the birth of your child in hospital. Families can also access, via their general practitioner and obstetrician, a six-week maternal and baby health check that goes in line with the blue book. Targeted screening for developmental delay is carried out at a six to nine month and at a 18 to 24 month period, with screening also provided around the age of four years when children go to see a child and family health services nurse in preparation for preschool. Again, the issues that the member for Fisher raised are dealt with at those checks.

Aboriginal children can access annual health checks through their general practitioner or Aboriginal Community Controlled Health Centre. Children who are under the guardianship of the minister have access to the rapid response health checks as they need them. All children can access their general practitioner to have the issues raised in the health checks, including developmental things such as ongoing asthma care plans, dealt with on a regular basis through the federal government health program.

The member for Fisher raised the many other health-care systems outside of Australia, and each one varies in its own complexity. Just because something works in another country it does not mean that it applies and is relevant for our state or country. We used to provide milk to children in schools. We no longer do that, for a variety of reasons. That does not mean that we go back to the old ways of having health checks, as he recommends.

The National Health and Medical Research Council Review's report, Child Health Screening and Surveillance: a Critical Review of the Evidence (2002), concludes that for conditions such as scoliosis there is no evidence for the benefits of introducing new screening programs or for the continuation of existing programs that would assess this thing. In relation to hearing screening for such conditions as otitis media in older children, there is strong evidence that the benefits are minimal given the fluctuating nature of these conditions. Therefore, a general practitioner on a child's presentation, if they know there is a hearing problem, will monitor this as an ongoing program, just as asthma is monitored.

The evidence from medical research over the past decade indicates that there is limited health gain to be obtained by one-off screening of children on a particular day for specific conditions. The focus of health care surveillance and screening has therefore moved to prevention, early detection and early intervention for preschoolers rather than identifying problems once children commence school randomly on a particular day, as proposed by the member for Fisher.

Debate adjourned on motion of Mr Pederick.

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