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Wednesday, 29 March 2006
Page: 128

Mr HARTSUYKER (6:16 PM) —The Cancer Australia Bill 2006 sets up a new national agency to oversee and coordinate all aspects of government policy on cancer. I welcome this measure. There are few families in this country which have not been affected by cancer. It does not respect age, race, colour, creed or status.

We all know that there are steps that can be taken to minimise the likelihood of contracting the disease, but, sadly, that provides no guarantee. One in three men and one in four women are likely to contract some form of cancer before the age of 75. If you play rugby union, look around the field next time you play. Five of your team-mates are likely at some stage to suffer from cancer. If you play netball, two or three of your squad may ultimately contract the disease.

This year alone, it is expected that more than 462,000 new cases of cancer will be diagnosed in Australia. The most common form of cancer in Australia is non-melanoma skin cancer, with 374,000 cases annually. More than half of us will develop at least one of these cancers, which can be fatal. There are more than 36,000 deaths from all kinds of cancer each year. Age standardised cancer incidence and mortality are falling in Australia. Australia is one of a small number of countries in which this is true. The age standardised mortality rate for men has been falling by about one per cent per year since 1990.

While survival rates are improving, there is still a particular sense of dread connected with this terrible disease. As a community we believe that cancer patients deserve our support and that we should minimise the impact of cancer on any sufferer. However, there is an added burden for those living outside major centres of population if they contract the disease. They and their families are often faced with long and expensive journeys to receive treatment, with long periods away from home at a time when they most need the support of their nearest and dearest and things familiar. Coping with this needs a certain kind of fortitude on the part of the individual and his or her family. It also needs resources. Many families, I know, worry about the money when all they should have to concern themselves with is the health problem and the survival of a loved one. Sadly, as a result, too many people in regional and rural areas are not receiving the treatment that would be typically received if they were in a metropolitan area. This result can, regrettably, be fatal.

I welcomed the release of the Baume report on radiation oncology, A vision for radiotherapy, which examined a range of issues relating to the provision of radiotherapy services, an important element in the fight against cancer. The report noted that only 80 per cent of the desirable numbers of people with a new diagnosis of cancer are receiving radiotherapy. It further noted that the waiting times to receive treatment are too long and that in Australia there are shortages of critical staff and modern radiotherapy machines. The report stated:

Cost shifting between levels of government is occurring. Many formerly public patients are being reclassified as private to gain Medicare benefits. Some of this money is being used to cover capital costs of equipment. Some is going into the pockets of people or institutions.

The report went on to note that in many places extra money is required and that governments must work together to ensure that things change for the better.

I was delighted to see that when the Baume report was released the need for radiotherapy services on the North Coast of New South Wales was recognised. The report noted that, according to the research conducted, radiotherapy usage by patients from the North Coast of New South Wales was low compared to other areas, including other regional areas. The North Coast of New South Wales is an area where many senior Australians have chosen to spend their retirement years. Age being a major risk factor for cancer, the resultant demand for radiation oncology services by this large, growing and aged population is obvious.

I welcomed the decision of the New South Wales government to locate two new radiotherapy units on the North Coast of that state. One was located at Port Macquarie and the other at Coffs Harbour. These facilities will be financially supported by the federal government through the provision of the Medicare rebate. The people of the North Coast are eagerly anticipating the opening of the radiotherapy units next year. That will mean that many patients will be spared the need to spend six or eight weeks in Sydney, Newcastle or Brisbane while they receive treatment. This will make a significant difference to those patients and their families.

Also of significance is the way in which the community has rallied behind this project to provide a patients and carers lodge next to the radiotherapy unit on the Coffs Harbour Health Campus to assist those travelling to the unit at Coffs Harbour from the surrounding region. I pay tribute to the Rotary Club of Coffs Harbour, which was the driving force behind this $1.4 million project. With local Lions clubs, it raised the bulk of the money, with some help from the federal government’s Regional Partnerships program. There were other contributions from organisations such as the New South Wales Cancer Council, the North Coast CWA clubs, the Quota Club and the Pink Ladies. There were also a number of substantial private donations. I would like to commend Mr Allen Hogbin and Mr Colin Scully for their substantial personal contributions. We have a priceless asset in the energy, enthusiasm and commitment shown by these local groups and individuals in supporting the work of fighting cancer.

I would like to take a moment to highlight another vital issue relating to the provision of cancer treatment—that is, the training and education of health professionals and specifically radiation therapists. This is another issue that was highlighted in the Baume report. In the report Professor Baume notes that Australian educated radiation therapists are amongst the best trained in the world. However, the professor highlights that our workforce in this area is not large enough to meet the needs of the Australian community. Recruitment is increasingly difficult, and high attrition rates are creating an ongoing problem. Indeed, Professor Baume makes the point that the size of the radiation therapy workforce is restricting our capacity to deliver improved and expanded services across the nation.

The report notes the following five key recommendations in relation to the radiation therapy workforce: the workforce must be highly trained and qualified; it must be of sufficient number, quite obviously, to operate machines and perform services to an optimal level and standard; the workforce must have high morale and be offered appropriate remuneration and career opportunities; it must be able to meet the needs for ongoing study and professional development; and it must be able to treat 50 per cent of people newly diagnosed as having cancer and to treat them without undue delay.

Professor Baume acknowledged at the time of handing down his report that there were enough radiation oncologists to meet current needs but that an ageing workforce was going to mean real challenges in the workforce over the next decade. However, in relation to radiation therapists the workforce shortage was more acute. The rate of attrition, an increase in the number of cancer treatment facilities and issues relating to remuneration, recognition and overseas opportunities had caused significant challenges and had led to a vacancy rate in that occupation of around 10 per cent.

Following the tabling of the Baume report, the coalition government provided a positive response to a number of these recommendations. Importantly, the Australian government committed to increase the number of radiation therapists by supporting additional training places. Whilst these measures are to be commended, I would like to note that the challenges associated with having an adequate workforce are ongoing. In addition to the challenges in relation to radiation therapists, there are challenges in relation to other health professionals that also require attention. We have a workforce shortage in relation to pathology. Pathologists are vital in the diagnosis of such diseases as cancer and provide invaluable information which monitors the effects of treatment.

I am sure all members of the House understand that, when it comes to cancer, the diagnosis and the subsequent treatment are the two fundamental elements to managing the disease in an effective manner. In that sense, the current workplace shortage in pathology is very relevant to cancer treatment. There is a serious shortage of pathologists in Australia, and they are in an ageing demographic also—as is the case with many other professionals. And that shortage is not only in Australia; it is also worldwide. If this trend continues, it is highly possible that pathology services may become a limiting factor in the capacity to undertake a range of clinical activities.

In 2003, the Australian Medical Workforce Advisory Committee recommended that an additional 100 registrar positions needed to be created in Australia each year in order to address this shortfall. This is a large number, particularly when you consider there are only 260 trainees presently training in Australia. As all members would be aware, the responsibility for funding training positions rests with state and territory governments. Whilst the lack of training by most of our state governments is a source of tremendous regret, I believe this is an issue which goes beyond highlighting the inadequacies of our state governments. It is essential that the Commonwealth works with the states to ensure these workplace shortfalls are addressed. The number of people who will be diagnosed and treated for such diseases as cancer is unlikely to decrease, so it is essential that we start working towards a solution now.

When we consider the impact that cancer has on hundreds of thousands of Australian families, it is important that governments at all levels work together to ensure there is an integrated strategy towards cancer treatment. The example which I have just mentioned in relation to pathology and radiation therapists highlights why there is a need for a more coordinated approach to cancer treatment. I therefore welcome the establishment of Cancer Australia, taking in research, support for carers, palliative care, prevention, policy recommendations and support for health professionals. I hope prevention and education will figure prominently in the agency’s work.

In light of the figures I quoted earlier on the incidence of skin cancer, it is clear that we need to go some way further than our current campaigns. I note that one of the initiatives in which the agency will be involved is a national awareness campaign on this issue. Clearly, the major cultural shift involved in changing Australians’ relationship with the sun and the outdoors still has some way to go. Organisations currently working in this area have, I understand, strongly supported the establishment of Cancer Australia, and greater coordination and communication can only enhance the good work done to date.

The advisory council of the new body has an impressive membership with a wide range of expertise. However, I hope it will be possible for the views of cancer sufferers themselves to be heard. The views of those directly affected may not differ from those of the health professionals, but they can often give us a different perspective, a different sense of priority and perhaps a deeper insight. Despite the recent advances in medical technology, there is still much work to be done in the fight against cancer and Cancer Australia has a major role to play. I commend the bill to the House.