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Transcript of Minister for Health, Greg Hunt's National Women's Health Summit remarks.

The Hon Greg Hunt MP
Former Minister for Health and Aged Care

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So if we look at women’s health, what I want to do today is to set out the past and the present and the future and vision for women’s health to include a pathway going forward over the next decade out to 2030. And let me begin with the landscape, so the journey from past to where we are now and we know that as we look around Australia and we look back to the early 1960s in life expectancy there have been extraordinary developments.

We’ve gone from an average of 74 years life expectancy for women to 84 and a half in 2015. That’s the eighth best in the word, perhaps not as good as it could be and I say that in particular, we know that our Indigenous women have catastrophically low rates of treatment for many chronic diseases, their life expectancy rates are lower, so we’ve got areas of great progress and areas where we need to address the challenges.

But having said that as my wife pointed out to me with a certain degree of relish, the life expectancy for males is 80.5, the life expectancy for women is 84.5. She said she looked forward to her golden years.

However, there are other important areas of success as well. In particular, we look at breast cancer and what we’ve been able to do since introducing breast screening. We’ve gone from a rate of loss of life from about 74 per 100,000 in 1991, down to 50 deaths per 100,000 and that’s still too high and there’s still more to be done.

But to make that sort of reduction is something which has had bipartisan support by acknowledging to commend the foresight of all of those, including potentially many in this room who were involved in the introduction of those screening programs and processes. More to be done but enormous progress so far.

Similarly in terms of cervical cancer, since we’ve introduced the pap smear and screening program which has been updated only as of 1 December last year. What we have seen is a 50 per cent reduction over two and half decades, a 50 per cent reduction in the mortality of cervical cancer. Still a catastrophic situation but the avoidance, the treatment, the care is dramatically a step forward from where it was.

This then brings me to the challenges from past that we have all inherited today. We start with chronic disease. In terms of chronic disease we know that approximately 56 per cent of women have some degree of obesity and that has impact in terms of the chronic heart condition, it has impacts in terms of mental health, it means it’s not the ability to exercise.

There are many, many challenges on that front. The cardiovascular as I mentioned, that’s the number one killer. Now, something over time will lead to the end of each of our journeys but cardiovascular disease is an avoidable condition and in many cases if you have the right lifestyle, the right treatment, and the right monitoring.

Ovarian cancer is still a catastrophic diagnosis and a friend of mine lost her battle just before Christmas, and it was a harrowing year. And the other friend of mine who was with her at the time described this as one of the worst and most agonising outcomes he has seen and his doctor, who worked 40 years in the space. So, I’ll come back to that in a minute.

We also note mental health remains a major challenge. Over the course of all of our lives, we know that about 40 per cent of men and women will experience some form of mental health challenge. It could be chronic or episodic, it could anxiety or depression.

In any one year, it could be, it’s about four million people, or it could be even more challenging and serious in terms of bipolar or manic depression, eating disorders, which I’ll address shortly, or suicidality. So, these are great existing challenges that we need to acknowledge in full.

And then there are particular groups of women at risk. Women in rural and remote Australia have less access to care because of distance, and so the importance and evolution, of telehealth is something that’s fundamental.

The involvement and the ability to get more doctors into rural Australia, which is at the moment one of the top priorities that Bridget McKenzie and I are working on, is fundamental, and I am very hopeful that through a combination of teaching, training, and attraction and retention, will be able to improve those numbers in the short, medium and long-term.

We also know that migrant women have challenges. Whether it’s cultural barriers at the one end, whether it is linguistic or whether it is a soft unintended prejudice on different occasions. Not direct, not structured, but an inability to recognise some of the challenges.

Which is why I am pleased that we’re supporting the Migration Council. I welcome the Migration Council here today. But I mentioned at the outset, and I’m delighted that Julia acknowledged Indigenous Australians. Indigenous women have a life expectancy a full 10 years less than the Australian average for women.

So, in my mind, if there is one great national failing over the last 40 years, it has been the failure to fully close that gap. Yes, there’s been progress, but at the end of the day, the differences in Indigenous health, and in particular women’s Indigenous health, are stark and clear and dividing and unless we call it out, we won’t be successful in closing that gap properly.

So that then brings me to the present, and here I really want to deal with three elements of particular relevance to today. The long-term research, maternal health initiatives and also to acknowledge, in particular, the women’s health challenge, which has been largely unaddressed in the public health debate. That’s not about the specialists and GPs, that’s about the public health debate and that’s endometriosis and to announce the next step on that front.

In terms of the long-term health, we are engaged in continuing on the decade’s long project, which has been the longitudinal study and we only recently announced $8 million to continue and extend the longitudinal study, its tremendous work.

And my expectation and belief is, it doesn’t matter who’s in government, in 10, 20 and 30 and 40 years, that will continue and we are seeking to have the premier women’s health long term study and database over any advanced nation in the world.

I think that that’s a legitimate aspiration and I’m confident that whether it’s myself or Catherine, whether it’s successors unknown long-term into the future,  that will be maintained and investment will continue.

Related to that is the work of Jean Hailes, with their ongoing studies and assistance in women’s health. They have been tremendous leaders. We’ve recently allocated an additional $7 million to the Jean Hailes Foundation. I just want to acknowledge and commend what they are doing. And then of course, there are the screening programs.

I mentioned breast cancer and the role at the outset. With cervical cancer, we’ve just switched over, on 1 December, to the new test, and so the results of this means that women will be able to go from two years to five year testing, after their next test. And in particular, it will allow us to make significant reductions, coupled with the introduction of Gardasil 9.

My little girl, who is in year seven, has just been amongst the first cohort to be immunised with Gardasil 9. These two initiatives together are expected to see us take the 50 per cent reduction in cervical cancer from 1991 to now and reduce it by 50 per cent again by 2035.

Again, that’s a long-term, bipartisan commitment and there are people on all sides of Parliament, and all sides of policy, who have been involved. And this has been one of the successes of the women’s health area, policy and movement. So I want to acknowledge the important work of each and every one of you in this room who have been involved.

That then brings me to the issue of maternal and child health. Now, an extremely important thing here is in relation to pregnancy and pregnancy guidelines. The guidelines to work with our brilliant obstetricians, some of whom I’ve met this morning.

And today, we are releasing the new National Pregnancy Guidelines. There’s guidelines both for expectant mothers and for clinicians, whether it’s the midwives, the doctors, general nurses involved in their treatment.

The most obvious thing, and I do think we have to call this out, is that it identifies that the obesity and pregnancy can impact upon women’s health and, of course, in extreme circumstances can impact upon the child’s health. So, this is a monitoring task and an information task for all of us going forwards.

Of course, fetal alcohol syndrome is a catastrophe, and it’s an avoidable catastrophe. When I was asked what was amongst my absolute priorities in this space, working on Indigenous fetal alcohol syndrome. I know that the numbers are too high and we need to be open and honest about it.

But to work constructively because there’s so much inherent disadvantage that in that circumstance the environment is such that there’s a lack of information, a lack of support, and a lack of awareness, and so we put those things together and the new National Guidelines will be very, very important.

At the same time, we have the Pregnancy, Birth and Babies direct health website, and that program has over 3 million interactions a year. And it’s incredibly important, both the website, its Facebook, and it’s a telephone service. And this is providing direct assistance to mothers, expectant mothers and to those in the family who are supporting the expectant and new mothers. A very important service.

Then we’ve also released and commenced, today, the National Approach to Maternity Services, working in particular with the midwives and the obstetricians and gynaecologists. An important step going forwards.

Now, another issue that I want to address is endometriosis. The figures are that at least one in 10 women suffer some form of endometriosis over the course of their life. And in a way it’s largely been an unacknowledged issue within the public domain.

We’ve had a very brave group of parliamentary leaders, Nola Marino, and Nicolle Flint, and Gai Brodtmann, and Maria Vamvakinou. I know that Catherine and Janet have been important spokeswomen in this role.

So, recently the Parliamentary Friends of Endometriosis was launched. But at that meeting, we announced that there would be a National Action Plan for Endometriosis. And I also issued an apology on behalf of all previous governments for a failure to properly acknowledge, address, and to provide funding and support in this space. I think it’s been an area of oversight, and I think it’s time to acknowledge that.

So, on that front, what I’m announcing today is that there will be $2.5 million allocated through The Medical Research Future Fund to directly address endometriosis in terms of studying treatment. In particular, I want to ensure that there is the early, the capacity to assist with early diagnosis and early treatment. And if we can do that, then we can assist our brilliant GPs, obstetricians, and gynaecologists, in their work.

So, then this brings me to the future and as we look forward, again, here there are three things that I want to address, preventative health, mental health, and research. In terms of preventative health, one of the most important initiatives is the TRACEBACK program for ovarian cancer, where we can identify the BRCA1 and BRCA2 gene that affects not just breast cancer but also ovarian cancer. And if we’re able to take the samples, we think that there’s over 1000 lives that can be saved over the course of the next decade, just a fundamentally important program.

Two, in terms of mental health, whilst we do get an enormous amount, there’s one particular area that I want to address and that is eating disorders. It can happen to men, it can happen to women but statistically there is no doubt it is most common amongst younger women. And it’s one of the hardest areas of mental health to address.

And so, what I have done is requested that the MBS Taskforce consider extended eating disorder treatment, a new item of Medicare. I can inform the room that only yesterday the Medicare Task Force Clinical Committee met, this was the first of their meetings, they’ll keep me updated as they go. But they have my commitment and my support that if they propose we will announce this funding that that will be a very, very important step forward.

Then there’s generalised research. And within the recent Medical Research Future Fund rounds I’m really delighted that we’re able to allocate a significant amount, just over $1.2 million, to a study into pregnancy and health, and in particular some of the impacts that are risking gestational health. That’s coupled with the focus on rare diseases and rare cancers.

And we’ll soon be opening a new round under that. And within the National Health and Medical Research Council, Anne Kelso, the brilliant, brilliant CEO, has, with my agreement, launched a focus on ensuring that there are more lead clinical researchers who are women. That’s an historic gap, and that’s a shared passion that we have.

The last point that I want to make, before Julia rings the bell a second time, is that in 2010, there was a national women’s health strategy announced, and I commend all of those involved. It was an initiative of the previous government, and I think it was a positive initiative.

But I think it is time to commence the process of a second national women’s health strategy. And I’d like that to run from 2020 to 2030, and to work over the course of the next 12 months, and to think of today as the kick off day, in establishing a national women’s health strategy from 2020 to 2030, a second national women’s health strategy.

And I think that is a good place to finish with a sense of vision and sense of task and a thank you to all of you for your leadership in this space. I thank you and I acknowledge you.


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