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Tuesday, 29 May 2012
Page: 6189


Dr WASHER (Moore) (20:12): I agree with the comments of my colleague Judi Moylan, the member for Pearce, in her budget response speech on 23 May, when she described the budget as an opportunity lost. I support her sentiment and make a further observation on the desperate scramble to achieve a pathetic, smoke-and-mirrors excuse for a surplus that totally dismisses Australia's responsibility to halt the enormity of the diabetes epidemic that is set to engulf this country and, potentially, ultimately bankrupt it.

The 2005 Australian diabetes, obesity and lifestyle study (AusDiab) follow-up study showed that 1.7 million Australians have diabetes. Up to half of the cases of type 2 diabetes remain undiagnosed. By 2031 it is estimated that 3.3 million Australians will have type 2 diabetes. The total financial cost in this country of type 2 diabetes is estimated at $10.3 billion per annum. Of this, productivity losses make up $4.1 billion. People with this disease who can no longer work effectively become statistics in terms of the cost of treatment of this sinister disease.

One leading Australian expert, Professor Stephen Colagiuri, has published the prediction that the cost of diabetes in Australia will exceed $23 billion within 20 years. Another Australian world expert, Professor Paul Zimmet, in commenting on this budget, stated that the diabetes epidemic will become the fastest growing non-infectious disease epidemic in human history. He has expressed his deep disappointment at the Gillard government's decision to reduce funding for a major four-year, $200 million program for the prevention of type 2 diabetes.

The health appropriations are principally directed at so-called 'prevention', and it was disappointing that the budget did not contain any detail of planning or strategies to reduce the death rate from diabetes and/or the comorbidities that contribute to it. I did expect in the appropriations a mention of funding for Indigenous Australian citizens for the dialysis that is needed desperately in the Northern Territory, including Alice Springs. Indigenous Australian citizens from Alice Springs are lining up for treatment after contracting diabetes at a rate about three times that of the rest of us. Alice Springs has the largest kidney failure dialysis unit in the Southern Hemisphere, with over 2,000 patients on dialysis. The main focus should be to prevent the diabetes epidemic that will overwhelm this country's economy progressively over the next 25-40 years if these funds are not increased. This budget does nothing to address the problem. The Gillard government is actually going to reduce the expenditure on dialysis and you can find a reference on page 172 of Budget Paper No. 2. Why is it doing this? The Treasurer, Mr Swan, says this measure will save a miserable $12.3 million by cutting the dialysis grant component with the 2007-08 budget measure entitled COAG, reducing the risk of type II diabetes. Compare that with the $23 billion he would have to find in 20 years to pay for the cost of doing nothing today. Type II diabetes is preventable. The government claims to be spending big in the budget on preventive measures, so they cut diabetes spending. What completely irresponsible, indefensible nonsense. How, one might be entitled to ask, can this government stand there and tell us that one of its key priorities is not diabetes?

Like my colleague the member for Pearce, Judi Moylan, I too had the privilege of being a guest of Novo Nordisk at the European Diabetes Leadership Forum held under the auspices of the OECD. Novo Nordisk, the world's largest insulin manufacturer is internationally recognised as a leader in diabetes research and is responsible for many of the breakthroughs giving diabetes sufferers a better life free of costly complications. Australia as a member of the OECD was invited to attend this international forum attended by some 700 leading health policy experts and government representatives. While the Treasurer, Mr Swan, is ever ready to accept the accolades of the OECD when it comes to being recognised as a responsible Treasurer, there was no-one from this government at this important OECD meeting. The outcome of that meeting is of vital interest to this government if it is serious about doing anything effective and meaningful about diabetes. Slashing spending on diabetes prevention, as the Treasurer has done, is utterly contrary to the OECD agreed needs to staunch the epidemic and its cost to treasuries around the world. The Copenhagen roadmap takes in United Nations resolution 61/225 on diabetes. This country was a signatory to the recent declaration of the UN 2011 meeting on the prevention and control of non-communicable diseases. A statement released proposed that the health of countries' citizens equated to wealth. Further, without strong national policies addressing diabetes and associated non-communicable diseases the inevitable results are increasing debt burdens that will engulf developed and developing economies.

Put simply, the cost of diabetes intervention is nothing compared to the cost of treating it. The Copenhagen meeting called on all member countries of the OECD to adopt a diabetes national action plan. There is no diabetes national action plan in Australia despite calls from stakeholder, community and health professional groups over the years. It is a sad fact that one in three of today's generation Ys will join the ranks of persons with type II diabetes during their lifetime. A new report has been released by the partnership of Baker IDI Heart and Diabetes Institute, Diabetes Australia, JDRF and Novo Nordisk called Diabetes: the silent pandemic and its impact on Australia. This report presents in the clearest terms a frightening assessment of the rapid growth of diabetes and its impact on Australians. As an immediate priority we need to recommit to the development of a formal national action plan in keeping with the UN resolution 61/225 on diabetes which is demanded by health consumer groups, a strategic plan that recommends countries review and strengthen critical activities to contain the growth and burden of disease. The CEO of Diabetes Australia, Lewis Kaplan, says of the report that 'time is of the essence because unlike other developed nations, despite agreeing with these global recommendations, Australia has failed to take comprehensive action and implement change'. This report underscores the fact, that in the absence of taking preventive measures, type 2 diabetes will triple in prevalence and affect three million Australians in just over a decade. This is a tragic prediction, especially given that type 2 diabetes is potentially preventable in a substantial percentage of people.

In addition to this dramatic growth in type 2 diabetes, the report highlights a continuing rise in the occurrence of type 1 diabetes—particularly in very young children, from zero to four years of age. In contrast to type 2 diabetes, type 1 is unpreventable and the cause for the rise is, worryingly, unknown. Prevalence of type 1 diabetes in Australia is one of the highest in the world and is increasing by approximately three per cent annually. The result is that significantly more young children and their families are burdened with a lifelong incurable disease, requiring effective and consistent self-management to control the condition—typically multiple daily insulin injections.

Other OECD countries like Denmark have increased regulation and introduced taxes on what their experts, like our own, have labelled as 'risky food'. These funds are applied to programs to reach and educate at-risk groups and type 2 diabetes patients to adopt healthy lifestyles and diets. More importantly, these strategies are interwoven with intervention techniques based on early diagnosis and early commencement of treatment. Treatment can take the form of maternal and adult lifestyle modification, medications or even, more recently, adoption of bariatric surgical measures as outlined in the International Diabetes Federation Consensus Statement released in February last year.

This government is taking a short-term view with an eye towards showing a paltry $1 billion budget surplus today that will cost the country billions in the future. Short-term thinking about short-term gains mean long-term problems. AusDiab, a world-recognised groundbreaking study funded by the Howard government in 2000, proved that Australians at high risk for diabetes can be identified, and cost-effective lifestyle interventions implemented which effectively delay and prevent the onset and insidious development of diabetes. There is proof positive that over 10 years, the costs of an intensive lifestyle intervention for high risk individuals are almost entirely offset by the savings arising from averting diabetes and its complications. Those complications—amputations, blindness, heart attacks and kidney failure—require costly management from allied health professionals and carers as well as general practitioners and endocrine specialists.

OECD meeting in Copenhagen reaffirmed a directive to all member nations, including Australia, that nations must deal with diabetes by early diagnosis and intervention as a matter of extreme urgency. The Copenhagen Roadmap will be published online on June 4 and sets the benchmark for all OECD member countries to meet if this battle is to be won.

There is an urgent need for Australia to re-formulate and re-state its commitment to a national diabetes plan, and for that plan to be properly resourced so the increase in diabetes prevalence and its costs in the Australian population can be averted. Almost 40 percent of Australia's adult population is already 'touched' by diabetes in some way. The diabetes monster, if unchecked and untreated, not only threatens our quality of life; it threatens to demolish the wealth of individuals and families, leaving them no alternative but to turn to the government for support.

I am also concerned that this budget makes provision for a number of 'expected savings' on the Pharmaceutical Benefits Scheme. Buried in its language are references to what are falsely described as reviews of therapeutic categories by the Pharmaceutical Benefits Advisory Committee. The PBAC has, until recently, stood on its record as an independent, expert body in determining what cost-effective medicines it should recommend to the minister to be funded by the government and introduced to the PBS.

Patient groups were outraged when this government decided to embark on a savage, thoughtless assault on the PBS by introducing a policy under which cabinet effectively second-guessed the PBAC and decided which medicines it would fund. A Senate enquiry blew the whistle on this stupidity, as a result of which the then health minister backed down and gave an undertaking to revert to the previous coalition government policy which allowed medicines costing less than $10 million per annum to be signed off by the health minister. Regrettably, this policy, again in the name of senseless penny pinching, will be re-introduced in October unless savings are found. This is despite almost $2.3 billion in savings the government has already milked from the scheme. It is widely feared that this is another naked cash grab dressed up as what the government disingenuously refers to in the budget as PBAC 'reviews' of prescribing costs of drug categories, including diabetes.

It is imperative we take action now on diabetes. Just consider that in the 15 minutes allotted to me to make this speech, two more Australians have been diagnosed with diabetes and there are another two who have the disease but are undiagnosed.