Read into Hansard on Thursday 26th May 2016
MOTION
Consider and Note – Report of the Joint Select Committee on Preventative Health Care
[5.11 p.m.]
Ms FORREST (Murchison) – Mr President, I know I have had a few little turns up today, but I thought I would use this opportunity to welcome the member for Apsley back to the Chamber. It is great to have her back. I know she works very hard in her electorate and they have recognised that. That is an endorsement of the effort she makes in that area. I was pleased to hear her acknowledge the support she had in her campaign in achieving that return to this place. I look forward to her ongoing contributions.
I welcome to the new member for Elwick. Welcome to the Chamber. I am sure you will find it fascinating, frustrating, and hopefully rewarding as well over time. All jobs have good and bad parts and I am sure you will find that the case here but we hope you enjoy your time with us. I am sure all of us will be willing to help in any way we can in that transition.
I also acknowledge the contribution of the former member for Elwick, Adriana Taylor, who was a member of the Preventative Health committee. She made a contribution in that role as well as many other roles she took in this place. I acknowledge the effort she put in and the work she did. I have a lasting memento of her. I bought the desk that her husband made for her, a standing desk. It is a lovely piece of art. I am really enjoying using it. It is nice to have it still here and as a reminder of her and her contribution to this place.
Mr President, I move –
That the Council note the report of the Joint Select Committee on Preventative Health Care.
This took nearly a whole length of parliament to undertake, the length of a term of a Legislative Councillor almost. That was because a lower House election got in the way.
…
[5.47 p.m.]
Mr VALENTINE (Hobart) – Mr President, I thank the member for Murchison for her chairmanship of the committee. It was a longwinded affair, no question about that, but it was an interesting committee to be a part of. I, too, acknowledge the work of the secretary of the committee, Jenny Mannering. She was so stressed by it all she went off and was married in the middle of it to be able to cope. Allison Waddington, Jill Mann and Hansard officers who were involved all played their part in the administration of the inquiry. Congratulations and thanks to them.
I, too, acknowledge all those people in organisations that made submissions to this inquiry. You cannot have much of an inquiry if you do not have people submitting. There are a lot of people out there – I am not sure if it was 87 – but it was quite a significant number who took time to put pen to paper and to let us know what their thoughts and feelings were on various aspects of this particular inquiry.
As always with these inquiries you learn such a lot. That is what I like about the role that we play. It is the opportunity to learn as well as sit in judgment on various things. I thank everybody who put in their submission on this.
There are a number of areas of particular interest to me and the member for Murchison has covered most of those. That equality/equity diagram was a really good diagram to have on the front page. I used that when I was giving a lesson to a grade 5 class on parliament and what we do here and why parliaments exist, and I was able to grab hold of that and draw it on the board. I did not hand them the picture because as you know they are interested as you draw and you could see that they got it. A picture is worth a thousand words. That little diagram says so much.
A couple of things I wanted to focus on are that long-term planning that was brought out, and shared or agreed goals between all parties. It is being able to get everybody to agree that this is where we want to be and we want to be there in 2020 or 2025, whatever it happens to be. We have all heard that proper planning prevents poor performance and so we need to plan properly. That is brought out in the executive summary – ‘such a strategy should set short, medium and long-term goals’. Would it not be great to be able to see every party in this parliament agreeing with that and signing off on it, not arguing about what the goals are but maybe arguing about how best to achieve those goals. That would be very good to see, from my perspective. The report does not say that every party should sign off on it but it is obvious that to have a long‑term strategy you have to have good agreement around the Chambers when you are dealing with these things.
Another point that is brought out in the executive summary is that there is a fundamental relationship and statistical correlation between the health of Tasmanians and the social determinants of health – socio-economic status, housing, education and employment. They are all basic things and the guiding principles and the basis for the key recommendations of the report. As it says in the executive summary, ‘Continuous improvement in addressing these determinants must be the highest long-term priority of the current and successive governments’. That is why you need the agreement. It is not just a four-year exercise; these things take a long time. You do not want to de‑focus from one government to the next and that is why it is important to get agreement on what those goals are.
Another point which is obvious to me, a basic thing, is that you are not going to go anywhere without proper education, as the member for Murchison said. Page 1 of the executive summary says: ‘Improving the health literacy of Tasmanians will empower individuals to improve their own health and the health of their families.’ It is education, education, education. The other point that is so good here is the ‘health in all policies’ approach. It is a whole‑of‑government exercise; it is not just the Department of Health and Human Services or aspects of an exercise that might be brought forward by other departments. Participation in sports, Sport and Recreation – it is not just those two departments, it is every aspect of government business that has a health component to it. It is a matter of every government department not just playing lip service to it but really doing the homework on their whole agency or agencies and ticking this off and saying, ‘Yes, we can have a health outcome with regard to this, if it is planning’ – and it is mentioned in here about the importance of proper planning in the community – ‘then let us do it and sign off on it. Let us report on it.’ – and not just in a cursory way but in a very detailed way and make sure we see government departments picking up that challenge and seeing it properly addressed.
I talked about planning and one of the components in the executive summary on page 2 says:
The committee recognises the link between health and the built environment. Liveability principles must be embedded in all government policy decisions relating to the built environment, including but not limited to transport, infrastructure and land use planning.
In local government we used to talk about designing out crime. There are things you can do in your built environment to make it harder for people to commit crime, whether it is the trees you are planting in the street and making sure they do not have low-level branches so people cannot hide behind them – simple things. You can manufacture your environment to be able to improve health outcomes and that is what is being suggested here – the liveability principles, and whether it is cycle-ways or every time you put a road in that we make sure we are making it easier for pedestrians or cyclists to negotiate. It makes people want to get out there and be in their environment in those ways.
The other aspect is data. The member for Murchison was right, that is a specific interest of mine. In my ICT career in the Department of Health and Human Services we came across a lot of datasets in some of those older systems. We were changing those systems and making sure they complied with the national minimum dataset.
There is not much point in collecting data that is not comparable between states. It is important we get the base data correct – what we are collecting, making sure it is measurable and comparable between other jurisdictions so we can see how we are performing in relation to other states, as well as providing the opportunity for the nation to get a snapshot at any particular time on how we are doing as a nation.
The value of the arts – we have so many opportunities in this city to experience live theatre, to visit exhibitions and the like. We need to be providing those opportunities in the regional areas as well. We need to do what we can to be able to give people the opportunity to participate in the arts. It helps people to feel they belong.
I remember going to a play put on by people with Down syndrome. It was amazing to see the way they embraced that opportunity. You could see how delighted they were to be involved in demonstrating to others, in a certain way, in live theatre. It was terrific. What does that do for their lives? It is terrific stuff. There is a lot that can be done with the performing arts, with the visual arts for that matter, and we need to concentrate on seeing how we can improve people’s access to those sorts of things.
e-health has great potential to improve people’s access to health services. Imagine yourself being on Flinders Island out in the backblocks somewhere. Without e-health services you have to fly to the mainland to go to your appointment. Sometimes you turn up at your appointment and it has been cancelled. I do not know how they feel when that happens.
I have been to hospitals quite a few times. You are sitting waiting for your turn and you hear somebody say I received this letter that said such and such. Oh, I am sorry, doctor such and such is not available today. You think about that. If they have come from the country, they have probably booked a room for the night to attend that appointment, they arrive there and find it has been cancelled. The opportunity for e-health to play a part, electronic communication, where they might even go to their local GP and there might be a specialist on the other end of the line who can diagnose with the GP present. There are all sorts of ways that electronic health services can be delivered. I encourage greater levels of participation in that way. If we can possibly get the NBN working properly it might happen.
The last one was a finding because we did not have the evidence to demonstrate the safety, quality and efficacy of electronic cigarettes as a less harmful alternative to smoking tobacco products. In a way it was disappointing to me because I think e‑cigarettes are the next device we are going to find causes significant health issues in our community if they are not regulated in some way in terms of the liquid that can be put in these. You can still buy them; you just cannot buy nicotine-based liquids to put in them. Obviously people are going to do that across the net. It is just the exposure of younger people to that. I do not know what the answer is but I think e-cigarettes are a bit of an issue.
I support this motion and the report. I thank all those involved and hopefully, as has already been expressed, the Government will take up many of these recommendations in the report, if they are not already doing so. They are probably already working on some of those areas, but it would be great to see some of the basic stuff addressed. I note the report.