Cancer Awareness

About this Item
Speakers - Kirkby The Hon Elisabeth; Pezzutti The Hon Dr Brian; Sham-Ho The Hon Helen; Evans The Hon Beryl
Business - Matter of Public Importance

CANCER AWARENESS

Matter of Public Interest

Debate resumed from an earlier hour.

The Hon. ELISABETH KIRKBY [2.32]: Earlier I was dealing with the problems faced by women who did not have regular screening for breast cancer and I pointed to the fact that regular screening was necessary for older women. I said also that the leader of my Party, Senator Janine Haine, had made strong representations to the Federal Minister for Health for this screening procedure to be available on Medicare. It is still not available. The cost of the screening procedure is about $176, and therefore women in the lower socio-economic groups who are most at risk will not be able to afford it. I urge the Minister for Health and Community Services to make representations to the Federal Minister for Health to ensure that this necessary form of screening is freely available under normal Medicare conditions. Screening is the only way to get the necessary message across to women from non-English speaking backgrounds. Any government action to help to prevent cancer must include quality control and accountability of screening laboratories; and the education of doctors to deal better with pathological samples and testing results. A recent survey of medical students and interns showed that less than half believed that they had received adequate instruction in cancer matters, and only half had ever visited cancer screening clinics.

There should be accountability of industry to report on measures implemented in the workplace for the safe handling of carcinogenic substances and to reduce exposure to such substances. A public education campaign which effectively reaches those at greatest risk, particularly migrants and the less privileged, should be implemented. There should be a wholehearted campaign to reduce smoking and the excessive consumption of alcohol throughout the community. A timetable for the cessation of public promotion and advertising of tobacco should be drawn up, and, in the interim, a harder line taken with promotion of tobacco and alcohol advertising aimed at young people. The problems of passive smoking should be thoroughly and urgently addressed. Studies indicate an increased risk of lung cancer for non-smokers who are regularly exposed to passive
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smoking. As has been said by other members in this debate, the current "slap it on" campaign to avoid skin cancers, which is particularly targeted at young people in schools, must be strengthened. With the climatic changes and the hole in the ozone layer, children are greatly at risk if they are exposed to dangerous ultraviolet rays for long periods of time. The southern hemisphere has the highest rate of melanoma in the world. This has been emphasised strongly by surgeons who are specialists in this field. I congratulate the Hon. Beryl Evans for moving the motion and it gives me great pleasure to support it.

The Hon. Dr B. P. V. PEZZUTTI [2.35]: I support the motion of the Hon. Beryl Evans, who is not a woman to merely talk about an issue; she does something about it. I, together with health professionals, attended one of the honourable member's regular meetings when this issue arose. She co-opted a number of people to become voluntary committee members. The work of her committee was acknowledged by the former Minister for Health, the Hon. Peter Collins, who set in train support for the committee and professional help to promote what the Hon. Beryl Evans justifiably and accurately saw was a great need in the community. In speaking to this motion one must also address the broader issues. The Government has moved, and properly so, with the support of the former Minister for Health and the present Minister for Health Services Management, to establish a public health unit in each health region and area health service. Those public health units have a raft of interests, including the promotion of a real assessment of the risks people run in their everyday lives and what they can do about them. The units encourage the necessary research with the assistance of epidemiology teams when necessary.

More importantly, the Government has encouraged proper medical research in this State. I remember some years ago the Premier discovered that almost 80 per cent of the National Health and Medical Research Centre grants were going to institutions in Victoria. He could not understand why New South Wales was not attracting that type of funding for research into illnesses, diseases and cancer. He has moved to remedy that situation, so that New South Wales has first-class research institutions. The research is not merely to ensure that people who have cancer receive better treatment but also the early diagnosis of cancer and its prevention. The medical profession and scientists round the world are working hard to find a more accurate method of diagnosis. The results of the research have enabled the community to be better informed of the nature of cancer, how it develops and how it changes over time. As the community ages there will be more incidence of cancer. The new forms of cancer treatment have proved to be most successful. When I was a medical student there was no treatment for leukemia in children. Every child who had leukemia died. With the irradiation of their own marrow and marrow replacement, and other forms of therapy, children with leukaemia now have almost a 60 per cent chance of living. There has been an enormous turnaround in the successful treatment of leukaemia.

Though it is important that methods of treatment improve, it is important also that treatment is sought early to increase one's chances of arresting the illness. If better and more improved treatment is available, the community will be encouraged to avail themselves of it. Often the early treatment of cancers provides answers with regard to how they can be prevented in the first place. The Department of Health has been involved in spreading to people's homes the message about cancers. The approach adopted by the Hon. Beryl Evans to spread the message in the workplace was clever. I am sure it will bear fruit. People spend a vast amount of their time at their workplaces. Employers, employers and the union movement should become involved. The greatest asset that a company has is its work force. By looking after that asset, companies are demonstrating a commitment to the welfare of workers, and the result will be improved
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morale and increased productivity. Employees should not only be concerned about the health of their employees in an occupational health and safety way. They should seek to identify those high mortality cancers, namely breast cancer and cancer of the cervix. Women should conduct self-examination and focus their attention on whether any female members of their family have had breast cancer. That increases one's chances of contracting the disease. They should have regard to the high-risk age groups. People should be informed that if the disease is treated at an early stage, survival rates of those with breast cancer will improve in the long term. This is the earnest hope of every professional and every community leader in Australia.

Much has been said about the breast screening process, mammography. The Commonwealth Government has adopted a responsible approach to the process, but of late the approach has become somewhat tardy. It is not just a matter of screening women at risk or women generally or making available the process at reasonable cost. We must look at what is behind the process. Lismore has been chosen as the country demonstration centre for breast cancer surveys. That has come about as a result of the enormous efforts of Beth Trevan, the Cancer Council's field officer for the North Coast. She is a woman of tireless energy and great capacity who has spread the message of others and messages of her own to the community. An excellent video cassette of the process has been produced with the assistance of the Lions Club at Lismore. Local community women were engaged for the filming of the video, which was scripted by Miss Trevan. It is a highly professional video on breast self-examination that informs women about the process of mammography. It advises women approaching menopause and women who have had sexual intercourse at any time in their lives to have regular pap smears. The efforts of Beth Trevan have been quite remarkable. She has brought together a team of people to counteract cancer on the North Coast. The protocol of the Commonwealth to achieve funding is most rigorous. Local surgeons and hospitals have also played a key role. Dr Bill Buddee from Lismore has worked closely with Beth Trevan and the regional director, Andrea Larkin, on an excellent proposal and protocol. Screening in country areas must be assessed to ensure that adequate results are achieved.

The PRESIDENT: Order! The honourable member has exhausted his time for speaking.

The Hon. HELEN SHAM-HO [2.45]: I support the motion of the Hon. Beryl Evans and congratulate her on bringing this matter to the attention of honourable members. I am pleased to have the opportunity to participate in the debate. I shall focus my attention on the needs of the residents of the western suburbs of Sydney, people from non-English speaking backgrounds and blue collar workers. In 1979 the Thirty-second World Health Assembly launched the global strategy entitled "Health for All by the Year 2000". The objective was the attainment by all of a level of health adequate to work productively and participate actively in the social life of the community. Inherent in this objective was access for every person to primary care and, through it, all levels of a comprehensive health system. Last year, I hosted a successful conference in Parliament House on women's health in industry. The theme of the conference was the prevention of women's cancer in the workplace. It made an important contribution to the greater initiative of the World Health Assembly.

The health and social problems characteristic of the western suburbs of Sydney mirror, to a large extent, the health and social problems of blue collar workers. There is a preponderance of the low socio-economic groups, non-English speaking migrants, young families, single parent households, and Aborigines. Western Sydney has been the
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place where young working-class families and socially disadvantaged groups have settled in disproportionate numbers. There are problems associated with language: about 34 language groups are represented in the region. During the past 10 years many of the inadequacies in health care delivery to the western suburbs of Sydney have been addressed. Westmead hospital has been brought to full capacity and facilities at hospitals in Liverpool, Campbelltown and Fairfield have been expanded and modernised. Age adjusted hospital morbidity data indicates that blue collar workers and their families have a higher risk of illness than the general population. For example, they have approximately a 20 per cent greater risk of contracting malignant neoplasms of the respiratory organs, diabetes mellitus and ischaemic heart disease. The female blue collar worker is at even greater risk. According to the report on "Health for all Australians" the overall mortality of female blue collar workers is 44 per cent greater than that of female white collar workers. Other indices of social misfortune such as death from traffic accidents, death from myocardial infarction before the age of 65, conviction for petty crime and drink-driving, divorce, dependence on government housing, and convictions for drug offences also tell us that people living in the blue collar worker suburbs of Sydney are disadvantaged compared with other Australians.

In the context of the World Health Organization's "Health for all by the year 2000" program and the New South Wales Government's program to bring a more equitable distribution of the health care dollar to those who are relatively disadvantaged, I welcome the Government's initiatives to establish cancer screening services as outlined by the Minister. Indeed, New South Wales is leading Australia in that respect. Moreover, it is appropriate that this initiative target migrant women, who are one of the most disadvantaged groups of all recipients of health care in Australia. Immigrants represent 29 per cent of those engaged in manufacturing compared with 16 per cent Australian-born. Moreover, immigrants are disproportionately represented in occupations with the worst working conditions. For example, a survey of 225 factories involved in the clothing trade found that 77 per cent of female workers were foreign-born. Problems of language and culture, as the Hon. Beryl Evans has said, may often be additional barriers to female blue collar workers obtaining equitable health care.

Other barriers are logistical and emotional. Factory work often means long hours of boring, repetitive work. A woman is simply too tired after a day's work in a factory to wait for hours in a doctor's surgery. Then there are her additional roles as mother and wife and her interminable home duties. Lack of child care facilities or lack of transport after work may be additional barriers. Ignorance and fear are barriers also. Cancers account for more than 20 per cent of female mortality and morbidity, but the important fact is that these cancers are usually highly preventable. For example, up to 60 per cent of women with invasive cervical cancer have never had a single pap smear. It is estimated that regular pap smears would eliminate up to 90 per cent of all cervical cancers. Breast cancer is the leading cause of cancer mortality in western women. The Minister said that one in 15 women have breast cancer. Early detection vastly improves the chances of survival. Women should be aware of two other cancers that are also highly preventable. Prevention in these cases, however, is through awareness rather than by screening tests. First is lung cancer, which is perhaps the most ominous for women. It is well established that smoking contributes to the risk of cancer, in particular lung cancer, and cardiovascular disease. Young people, women in particular, are the group most prone to begin smoking. The department is conducting a "Quit for Life" program aimed at young people who smoke. Part of the campaign is the "Hooked" television commercial aimed at this target group. It has won international advertising awards and has been evaluated highly.

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Research has shown that the commercial achieved high levels of awareness and accurate message interpretation by the target group. In conjunction with the campaign the department assists in sponsoring the rock eisteddfod - a musical event aimed at high school students and containing a very strong anti-smoking message. A more recent approach taken by the department in its attempt to cut the numbers of young people taking up smoking during their formative teenage years is to be found in the Public Health Act, which came into effect on 18th November. As members would be aware, tobacco products can now be sold only to those over the age of 18 years. It is also necessary for retailers to display a sign at the point of sale of tobacco products. The sign advises that it is a criminal offence to sell tobacco products to those under 18 years of age and that the maximum penalty is $5,000. The sign also provides a telephone number for people to call if they think the regulation is being infringed. The department has undertaken an extensive campaign to inform the community of this change in regulation. This week an extensive radio and newspaper information campaign was launched. The radio campaign, which will run for the whole of this week, is aimed at young people. Metropolitan and rural radio stations have been targeted. The 30-second radio advertisements for 2EA - the ethnic radio station - will run for six weeks and cover 15 community languages.

The PRESIDENT: Order! Pursuant to sessional orders the time for this debate has expired. Does the mover wish to exercise her right of reply?

The Hon. BERYL EVANS [2.55], in reply: I thank the members of the House for supporting the motion. I thank them also for their congratulations - not to me but to all those who took part in the programs and continue to participate. Cancer is a serious affliction that affects each and every one of us at some point in our lives. Cancer is a most horrible creeping disease. The Minister mentioned overseas experience. Women in Sweden have been educated to have regular tests every year. That is what we have set out to achieve. The same can be achieved through education to enable people to understand the need for regular testing. All men and women should select a date of personal significance, their birth date or the birth date of their spouse or child, on which to visit a doctor or clinic for a test. It is noteworthy that penalties in other areas encourage people to submit to testing. At one time holders of flying licences, who wished to retain them, were required to pass a medical every 12 months, but that period has been extended to two years.

Children should be taught the benefit of annual testing to keep their good health. People lose their good health without even realising what is happening, and should be encouraged to visit a specialist, local general practitioner or health clinic to be tested. They should seek the best advice from those most able to give it. Last year the former Minister for Health gave me permission to visit clinics in Europe. I visited the main clinic in Edinburgh and was fascinated with the way it was run. I am delighted that the Government intends to adopt similar services with the establishment of assessment centres. Medical practitioners in Edinburgh recommend to their patients a visit to the main clinic, if that is necessary. An appointment is made, the patient goes to the clinic and is attended by the best advisers, surgeons and mammography experts. All necessary tests are completed in one day.

That experience is vastly different from the trauma of a person being told by a doctor of a lump in the breast, being referred after a week's delay to a specialist, waiting for the results and then being sent on to another specialist. The trauma to a person being
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tested and retested in that way is severe and unnecessary. The Minister has said that two assessment centres are to be established and three more are to be in place in l992. If that occurs, I shall be delighted. Everything possible must be done to treat all diseases, especially cancer. Women must be able to obtain the best advice from experts. Women must not continue to be mutilated, as has happened unnecessarily in most cases for the past 20 years.

The Minister's advisory committee on women's health consists of doctors and nurses chosen at random from throughout the State. At the last meeting I attended, one of Sydney's leading cancer specialists said to me that he was delighted because over the past two years he had not removed a lump greater than two millimetres from a woman's breast. He put that down entirely to early detection. It is wonderful that some people are getting the message and having tests. As honourable members know, each year the Family Planning Association has run clinics in Parliament House for parliamentary staff and ministerial staff in the surrounding area so that they may have tests. I was distressed, but nonetheless satisfied, that last year the pap smears of two relieving dining room staff were found to contain abnormal cells. Those abnormal cells would not have been found if the clinic had not been held in Parliament House, because those women had not had a medical check-up. This week I was equally distressed when a staff member told me that one of the chefs has developed cancer and is going away for treatment. These abnormalities are being found early, which means that the worry goes because the people will be cured and survive.

The Hon. I. M. Macdonald spoke about skin cancer, several other forms of cancer and the bronzed Aussie. I do not know when Australians will lose the image of the bronzed Aussie. Men seem to think it is masculine to appear tanned and healthy looking. They should remember that white is also beautiful. This week my hairdresser told me that her 18-year-old son said he was going to town to buy a hat. She said: "Whatever for? I never thought I would see you with a hat on". He said, "Well Mum, with all this talk about skin cancer I think it is time we young people did something about it and set an example". Perhaps the message is getting through. It is my hope that educating people and making them think will be good for the individual and the economy. Illness is an enormous cost to any country, and we pay for that. One's health comes first. I ask every member in this Chamber and their friends and families to have regular tests. I have become a problem to most of my friends. I have given them guilty consciences. I receive telephone calls from some of my friends who say, "I want to tell you that I have just been down to have a medical".

I love the story of one lady who was asked what stirred her to have a mammogram. She said, "Because Beryl Evans told me to". Dr Croll, who is on my committee, said: "Where is this woman who is here because Beryl Evans said she had to come? I will look after her personally". My friend said, "That is the best thing the Liberal Party has ever done for me". I thank honourable members for supporting the motion. In closing I should say that our campaign will be held next year in September. The campaign will be held at a set time every year. I should like to ask each and every member whether they have had a medical this year. If not, will they go and have one?

Discussion of matter of public interest concluded.

Last modified 05/12/2007 16:36:25 : Update this page