Monday, 19 October 2009
Australian National Preventive Health Agency Bill 2009
I rise tonight to speak in support of the Australian National Preventive Health Agency Bill 2009. The rate of growth in the cost of health in Australia is significant and exponential. Every year in real terms we spend more and more money on health. As the technology and expertise grows, so do the costs, but a significant contributor to the cost of health is the lifestyle choices that we as individuals and as a community make. It seems to me that it does not take much insight to know that this sort of exponential growth in health costs will be unsustainable in the long term. Prevention of ill health and disease is the best way of tackling the ever-increasing health costs in Australia.
In Australia, one-third of the burden on our health system relates to the health behaviour and lifestyle factors of individuals. These behaviours and factors can be modified. When we encourage individuals to make different choices about their health habits and their behaviour, we start to make inroads on the costs of health as well as making for a healthier and happier community.
The Australian Institute of Health and Welfare has identified the seven risk factors that contribute the most to the burden of disease. They are tobacco, high blood pressure, obesity, lack of physical activity, cholesterol, alcohol and the low intake of fruit and vegetables. It is difficult to overstate the risks that these factors pose to the level of ill health in our community. Obesity and tobacco alone, at seven per cent each, constitute 14 per cent of the contribution to the burden of disease, while lack of physical activity contributes 6.6 per cent. The financial cost that these factors pose to our health system is significant, while the cost to our community in terms of mortality and morbidity is considerable.
For instance, in the 2004-05 financial year, the health costs associated with tobacco were estimated at $31 billion. We know that we spent $1.9 billion on health in relation to the harmful consumption of alcohol in 2004-05. Also associated with the overconsumption of alcohol is the loss of workplace productivity, estimated to be worth $3.5 billion, according to the Australian Institute of Health and Welfare. While there have been significant reductions in tobacco usage in Australia, we know that it is still too high and far too many people are still smoking. The message has not got through as well as we would like. We know that we can and should do more to prevent young men and women taking up the habit of smoking, as well as to help existing smokers quit.
The National Heart Foundation has conducted studies in the last few years and has found a clear upward trend towards greater obesity. We know that obesity is already a significant health issue in our community, and it is only set to grow if we do not do something about it now. Earlier this year, the OECD predicted that in the next decade almost two-thirds of our population would be either overweight or obese, while the World Health Organisation has labelled obesity a worldwide epidemic.
In 2006 the Australian Institute of Health and Welfare found that half of all adults in Australia are not undertaking enough physical activity. This issue, combined with our inadequate consumption of fresh fruit and vegetables, makes for a very serious problem. The National Preventative Health Strategy: the roadmap for action says that by 2032 the leading cause of disease for males and the second leading cause of disease for females will be type 2 diabetes. This will result in an increase in direct healthcare costs for type 2 diabetes to $8 billion annually from the current $1.3 billion. As we just heard the member for Dobell describe, these costs are magnified many times when you take into account the effects on other sections of the community.
The rise in diabetes rates is mainly because of the significant increase in rates of obesity in our community—again, mostly related to poor nutrition and lack of physical activity. I know that at Monash Medical Centre, located in the south-east of Melbourne, the Nutrition and Dietetics Unit are seeing children as young as 10 and 12 who have been diagnosed with type 2 diabetes. This is a very disturbing anecdote about what is a lifelong disease. Similarly, there are particular workplaces where type 2 diabetes is prevalent. The one that springs to my mind in particular is the construction industry, where workers on building sites quite often make very poor choices of meals and consequently have a higher rate of type 2 diabetes. We need to make healthier choices easier for people to make, not have available only junk food but have healthy food that is good for you today and helps you to live a longer and healthier life.
There is good reason to do so. We know that prevention works and we know that prevention makes sense socially and economically. Deaths from cardiovascular disease have dropped dramatically since the 1960s and 1970s because as a community we are more aware of the harmful effects of high blood cholesterol and poor nutrition. The incidence of HIV-AIDS has decreased in regions—mostly western, to the great detriment of poorer communities around the globe—where prevention programs have been conducted. The rate of immunisation has increased over the last few decades, resulting in a decrease in the incidence of preventable illnesses such as measles, mumps, polio and tetanus. Reports estimate that we prevented 400,000 deaths and saved $8.4 billion due to the 30 per cent decline in tobacco consumption between 1975 and 2005. Tellingly, studies in the United States indicate that the return on investment is $5.60 for every dollar spent on community based disease prevention, including things such as encouraging a better diet and increasing physical activity.
The establishment of the Australian National Preventative Health Agency is a recommendation of the National Health and Hospitals Reform Commission. Its main aim will be to provide national leadership on health promotion as well as conduct relevant research in these vital areas. A key role of the Australian National Preventative Health Agency, as has already been outlined by the Minister for Health and Ageing, will be to provide the leadership and coordination required to support the implementation of the National Partnership Agreement on Preventative Health, an agreement with the Council of Australian Governments. This agreement between the state, territory and federal governments recognises that greater coordination is required in our efforts to tackle preventable chronic conditions.
Initially, the Australian National Preventative Health Agency will focus its efforts on social marketing campaigns to reduce the risks posed by tobacco consumption, alcohol consumption and obesity. The Rudd government are committing $102 million to those campaigns. We are also committing $13 million for a preventative health research fund. Overall we are funding this new agency to the tune of $133 million over four years, a clear indication that the Rudd government are serious about tackling the risk factors of preventable chronic illness and disease in our community. Given that the evidence shows the role that lifestyle and behavioural factors play in individual health outcomes and it has been known for some time now, the question that could well be asked is why previous governments have not done anything about it. When you think about it, it is a wise investment: spend now to prevent greater expenditure in the future. But that was not a goal of previous governments.
In contrast, the Rudd Labor government are in the business of taking action on preventative health. We will listen to the experts like the people involved in the National Health and Hospitals Reform Commission and like the practitioners on the ground, and we will look seriously at the recommendations given to us. We will take the necessary action to bring about change in our community. We all have stories of someone known to us or close to us who has suffered the effects of a chronic illness that might have otherwise been prevented. I am sure that we all know someone who might benefit from preventative health measures in our local communities. Sometimes that person may even be us.
Health choices should be easy choices. While it is never the role of government to make decisions for people, it is the role of government to facilitate the opportunity for the decision to be made. We need to make the healthy choice the easy choice. It is my hope that the leadership that will be provided by the Australian National Preventative Health Agency will help maximise the opportunities we have in our local communities to make healthy decisions and that not only the young but also those of us who are older will all benefit from these ventures. I commend this bill to the House.