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Thursday, 12 August 2004
Page: 26593

Senator Allison asked the Minister representing the Minister for Health and Ageing, upon notice, on 17 June 2004:

Given that the preliminary findings of the Australian Longitudinal Study on Women's Health indicate that: (a) partial incontinence affects 13 per cent of young women and more than a third of middle aged and older women; and (b) risk factors for incontinence severity include heavy smoking in young women, hysterectomy in middle-aged women, use of hormone replacement therapy in older women and being overweight in all three age groups:

(1) What measures are being put in place by the Government to warn women about these risk factors.

(2) What, if any, economic analysis has been done of the potential health services and aged care savings that might be achieved by reducing incontinence rates through prevention.

(3) Given the causal relationship between caesarian section and the need for hysterectomy in later life, what efforts are being made to reduce rates of caesarian section in childbirth, particularly in the private hospital sector.

Senator Ian Campbell (Minister for the Environment and Heritage) —The Minister for Health and Ageing has provided the following answer to the honourable senator's question:

(1) In relation to smoking, the Australian Government funds national population-based measures to alert people to its adverse health effects and encourage them to quit. The National Tobacco Campaign initiated in 1997 is one of the most intensive of its type ever seen in Australia. It is intended to alert people aged over 18, both male and female, to a range of health effects and encourages use of the national Quitline. The Australian Government also maintains national bans on tobacco advertising and health warnings on tobacco packaging, which are one of the most direct ways of advising smokers about the dangers they face. The Government has indicated its commitment to update these warnings, including the use of graphic images. It should be noted that the direct delivery of smoking cessation services is a matter for State and Territory Governments through their various Quit organisations.

The Australian Government provides funding of $500,000 per year until the end of June 2006 to the Jean Hailes Foundation. These funds support professional development for clinicians, and community education, primarily focused on the health and wellbeing of women aged between 35 and 65 years.

The Foundation provides education on a range of health issues that affect women, including incontinence. Their educational material on incontinence includes information on the types of incontinence, causes, prevention and treatment, and suggests that, in some women, incontinence may become worse after menopause because of the lack of the hormone oestrogen. Hence, the Foundation suggests that these women may be helped by oestrogen treatment—particularly a local oestrogen treatment such as a cream. The Foundation also suggests that these women also do pelvic floor exercises and bladder retraining exercises.

The Foundation suggests women seek further advice from their doctor or the National Continence Helpline, a service that is also funded by the Australian Government.

Researchers with the Women's Longitudinal Study are debating whether there is a relationship between hormone replacement therapy and urinary incontinence, once other factors have been taken into consideration.

Further evidence is required before prevention methods can be considered.

(2) Health economists from the University of New South Wales are currently engaged in a research project to develop a framework for the economic and cost evaluation of continence conditions. The project commenced in June 2001, with funds from the National Continence Management Strategy. The final report is expected to be completed and published in late 2004. The purpose of the project is to develop a framework for evaluating the cost of treatment and management of urinary and faecal incontinence for different target groups, service and treatment settings.

This research will inform further work looking at potential health, aged care and community savings by reducing the incidence of incontinence through preventative measures.

(3) The Department is not aware of any work in this area.

However, the Department has undertaken other work researching the correlation between different childbirth factors and the risk of incontinence. Key factors that were identified include head circumference, birth weight and length of stage two labour.