Tuesday 29 October 2013

Hansard of the Legislative Council


Hospital & Canteen Food

Mr FINCH (Rosevears) - Mr President, I move -

That this House calls upon the government to order a review of foods prepared, and/or sold in hospitals, including their canteens, kitchens, or vending machines, with a view to considering similar legislation which has been enacted in South Australia controlling the sale of 'junk' food in hospitals.

Mr President, a number of factors provided momentum for this motion. One was my newfound interest in Tasmania's excessive consumption of sugar and another was the revelation when I was in hospital when I was told that I was consuming the equivalent of poison for breakfast. As I explained in my special interest speech a few months ago, the Launceston orthopaedic surgeon, Gary Fettke, views fructose as one of the main contributing factors to numerous ailments that are overly represented in Tasmania, particularly diabetes, heart disease and many illnesses that are brought about by obesity. Since that moment of revelation over my hospital breakfast tray, the subjects of fructose consumption, excessive seed oils in our diet and numerous other problems associated with processed foods have received massive publicity virtually every day in the paper, on television and on radio. It is a subject of great concern to the Australian community.

It is indeed a big problem, but we need to start somewhere to try to correct it in Tasmania and that is what is behind this motion. I keep to the front of my mind our Launceston General Hospital Central Auxiliary. One of my favourite people of all time would be the president, Mrs Margaret Moore, and the secretary, Dianne Lawson and treasurer Janet Knowles. They have 90 volunteers who work there and they have been going for 80 years. This year they contributed $500 000 in medical equipment to the LGH.

Mr Valentine - Are they going to provide you with a cake as a result of that?

Members laughing.

Mr FINCH - Without sugar - but certainly they are all the time looking for those opportunities to provide the healthy options to people at the canteen.

In 2011, the South Australian Public Health Act gave the minister the ability to make policies regarding the regulation of food offered for sale and consumed in public hospitals. The relevant policy is titled 'Healthy Food and Drink Choices for Staff and Visitors in South Australian Health Facilities'. That Department of Health website notes, and I will quote:

As part of the South Australian Government's commitment to preventing overweight and obesity, a policy has been released to ensure healthy food is available for staff and visitors in all South Australian Government health services and facilities, including central and regional offices.

The policy is mandatory and applies to all situations where food and drinks are provided including cafeterias, kiosks, cafes, shops, vending machines, catering for functions, meetings and client education programs as well as fund raising, advertising and sponsorship.

The new Royal Adelaide Hospital precinct is due to open in 2016, and the Health minister, John Hill, has said categorically that junk food outlets will be banned. I quote Mr Hill:

There will not be any junk food outlets in the new RAH or any other hospital in South Australia. The new hospital will have a wide range of food outlets for patients, visitors and staff and these will have to comply with the existing policies on healthy eating.

The policy aims to increase the range and availability of healthier food and drink options, and to decrease the availability of energy-dense, nutrient-poor food and drinks.

That is the South Australian Health minister quoted in the Adelaide Advertiser on 17 July 2009. I will also selectively quote from the minister's second reading speech and I will try to keep it relevant and brief. He states:

This bill is about public health, the health of all of us. As a piece of legislation it is the latest in a long line of public health law stretching back to colonial times in South Australia.

And later he points out:

There are now more far reaching and insidious public health challenges facing us this century. These threats are not produced by any external agent, bacteria or virus.

These threats emerge from the way we live our lives.

There has been an explosion in chronic, non-communicable diseases, so much so, that some public health experts predict that in societies like ours, children being born today may be the first generation in over 200 years to face the prospect of reduced life expectancy.

That is the South Australian Minister for Health and he could have been speaking about Tasmania.

I tend towards the view that it is up to individuals to make choices about their lifestyle and health outcomes. Legislation should be the last resort but that was not working in South Australia and it is not working in Tasmania. Public education is an important factor and I will speak more about that later/ We have to start somewhere, and perhaps legislation along the lines of that in South Australia is the key but that is up to the government which needs to look long and hard at the deteriorating health of Tasmanians. One final quote from the South Australian Health minister which nails the argument for some regulation and enforcement:

Chronic, non-communicable diseases do not happen by accident. Not so long ago, many people attributed this explosion of disease to the lifestyle choices that individuals made. Whatever the correctness of this view, it was not and is not the entire picture. We now understand that people's choices are heavily influenced and constrained by the circumstances they find themselves in. This is commonly referred to as the social determinants of health.

The World Health Organisation's Commission into the Social Determinants of Health reported in 2008. It called for sustained government and community action at all levels - local, state, regional and global - to attack the 'causes of the causes of illness', that is, to attack the social determinants of health.

This bill in part provides for South Australia's response to this challenge.

It is from the South Australian Minister for Health's second reading speech on the 2011 Health Bill. I hope that we see a speedy and similar response from Tasmania.

I touched earlier on the subject of public education about nutrition. We need to do much more. South Australia's legislation was accompanied by numerous initiatives and one was the Start Right Eat Right Award scheme which required child-care centre staff, the director and cook, to be trained in menu planning, childhood nutrition and food hygiene. Awarded Start Right Eat Right centres provide a menu which meets 50 per cent of a child's recommended dietary intake. Other initiatives included posters and fact sheets such as a food and drinks guide, recommended supply of food and drinks, a summary of nutrient criteria, healthy catering ideas for meetings, functions and events, and food and drink advice for Aboriginal groups. That is just part of the South Australian public health education campaign.

Getting food right in hospitals and health services should be just the beginning of a similar campaign in Tasmania. The problem is vast and reaches every part of our communities and our lives and it is becoming worse, not better.

Researchers from the Baker IDI Heart and Diabetes Institute and Monash University presented data to a Melbourne conference two weeks ago suggesting that more than 40 per cent of Australians had waist circumferences that placed them in the obese category. That is 40 per cent of Australians. The former chairman of the Rudd Government's Preventative Health Taskforce, Professor Rob Moodie, is quoted in The Age newspaper:

We're yet to do the hard things that are more likely to create healthy environments. Much responsibility lay with the companies that manufactured and served junk foods. These industries are modern day vectors of disease, just as mosquitoes might be for malaria.

A global report on sugar compiled by the research institute of the investment bank, Credit Suisse last week, highlights the need for the food and beverage industry to tackle the focus on obesity head-on by joining a diversification into new, healthier products. It pointed out that sugar consumption in Australia is around double the world's average. Australians consume chocolates and sweets each year worth $6.2 billion and we drink $3.5 billion' worth of soft drinks. I quote from the Credit Suisse report, as published in The Age:

The potential for a surge in negative public opinion and the looming threat of regulation and taxation are issues that the food and beverage industry clearly must address, though the extent to which they can do so without hurting their current business models is up for question', said the report's authors, Giles Keating, Credit Suisse's research head for Private Banking and Wealth Management, and Stefano Natella, the financial services firm's co-head of Global Securities Research.

The Age report continues:

Australians are among the world's biggest sugar consumers, joining the US, Brazil and Argentina in taking in more than double the world's average of 17 teaspoons a day, the report said. In comparison, the American Heart Association recommends six teaspoons of added sugar for women and nine for men.

'I think people don't understand that when they or their child drink one glass of sugary soft drink, it would be equivalent to watching your child put six scoops of sugar in a cup of tea, which none of us would tolerate', Public Health Association of Australia's chief executive Michael Moore said.

Mr Moore said unlike the health fears around tobacco and alcohol, which involved a product people do not have to consume, food is something we need, so tackling the obesity problem and people's daily sugar intake would be more complex.

The Age story goes on to say:

General medical practitioners across the US, Europe and Asia were surveyed and it was found 90 per cent believed the growth in type 2 diabetes and the current obesity epidemic was strongly linked to excess sugar consumption.

The World Health Organisation is projecting that diabetes will be the seventh leading cause of death in 2030. The global body estimates about 347 million people worldwide currently have diabetes, with more than 80 per cent of diabetes deaths occurring in low- to middle-income countries.

That was quoted from The Age online for 25 October 2013.

Many argue that public education about food choices should start in primary school, if not earlier. I agree. Initiatives like that of chef and food writer, Stephanie Alexander, to promote kitchen gardens in schools, and preparation of the produce, are having an effect and are being initiated, or imitated, in Tasmania. I know of an initiative at Beaconsfield Child and Family Centre. The once quite small garden that the groundsman developed has been expanded. It is now fairly big. Inside the Beaconsfield Child and Family Centre is a cooking area par excellence and they are encouraging people to come into the Beaconsfield Child and Family Centre - adults - to cook and prepare food. I have been there once to make a couple of recipes of mine - a spinach and a pasta dish. Everyone consumed a lot, so it went down very well.

The Beaconsfield Child and Family Centre is leading the way here with a beautiful garden and that food is being cooked by the students and the adults in the community who come in for cooking lessons to savour that. The powerful thing about teaching children to recognise healthy food is that they often go home and convert their parents. If we fail to educate our children about healthy eating, they become victims of the food manufacturers' so-called bliss point. This was defined in 1991 by Australian psychologist Robert McBride, who addressed a food industry gathering saying:

The bliss point is a powerful phenomenon and dictates what we eat and drink more than we realise. Nutrition is not foremost in people's minds when they choose their food.

That was quoted in The Age newspaper on 22 October 2013. Robert McBride and others have explained that the bliss point is 'the perfect amount of sugar added to processed food to maximise their appeal.' That is an idea of the 1970s because 'sugar is a human weakness and irresistible and innate craving'. In his book, Salt, Sugar, Fat: How the food giants hooked us, journalist Michael Moss says convenience food manufacturers use the salt-sugar-fat trio to create products with the maximum appeal for the cheapest price. Michael Moss singles out the potato chip as America's number one contributor to obesity, explaining how science goes into increasing its appeal - from how the salt is applied to the mouth feel of the fat. Moss and others say it is interesting how our bodies calibrate to the existing dietary environment: the sweeter your diet the sweeter you want things. As a writer in the Epicure section of The Age 22 October 2013 said:

The next time you see a product marketed as using less salt, sugar or fat, read the fine print. When food manufacturers reduce one dietary bogeyman, they generally ramp up another to compensate in taste terms.

That brings me to food labelling, which is totally inadequate. Some of us cannot even read the fine print, let alone understand it.  One  example, what is L-cysteine? It is an amino acid that prolongs shelf life and is made from human hair or duck feathers, and it is in some foods.

I will return to my motion, which admittedly is quite narrow in the context of some things I have been speaking about, but it is a start. There can be only benefits from the government ordering a review of foods prepared and/or sold in hospitals including their canteens, kitchens or vending machines. Depending on the outcome, similar legislation to that enacted in South Australia may well be appropriate for Tasmania, but we must act. We cannot continue the way we are going. It is partly up to individuals to take control but they need a lot of help, especially if they are on their backs in a hospital bed without much of a healthy choice on their breakfast trays. I come back to Dr Gary Fettke looking at my breakfast tray and saying to me, 'sugar is poison'. I said, 'But does it matter?' and he said, 'You want to die good looking, don't you?' and I said, 'Yes'.

Members laughing.

Mr FINCH - That is what instigated this motion and I hope for some interesting debate. I hope people support the motion.



Mrs HISCUTT (Montgomery) - Mr President, I have been told to read fast, so excuse me if I gabble.

I do not believe that there is a need for the government to order a review of foods prepared and/or sold in our hospitals at this point in time. There are already several programs working in this area, taking a carrot approach to healthier eating in our community and not a stick. There is already a healthy workers advisory service under the auspices of WorkCover Tasmania's Work Health and Wellbeing Advisory Service with a 1300 telephone number that provides advice to employers on how to introduce healthier eating in the workplace.

The honourable member may be aware of the HOVER program, started in 2010. HOVER is an acronym for Healthier Options in Vending - an Employer Resource, with details available on the Eat Well Tasmania website.

I am reliably informed that we are already years ahead of South Australia with our Eat Well Tasmania projects. This would appear to be a more holistic approach to tackle obesity and diet-related health issues than a narrow concentration on health care workers who work in public hospitals. The cost-benefit analysis of such a restricted program does not really stack up.

We are all concerned with the raised obesity epidemic and its associated health complications but obesity does not start or end with hospital canteens and food prepared for patients in hospital premises. Indeed, it should start, as was alluded to by the honourable member, in the grassroots of our community, well before a person goes into hospital. I am sure that there are other, better targeted and more efficient approaches, such as HOVER and Eat Well Tasmania that could address such health concerns more effectively.

It may also be a bit premature to talk about the healthy food and drink choices for staff and visitors in the South Australian health facilities, mandatory policy that the South Australian government introduced in 2009. The motion's proponent, Mr Gary Fettke, believes from discussions that the policy has been a successful venture in South Australia and his letter, dated 28 September to all honourable members, says:

I have written to the Premier and Health Minister regarding the adoption of the South Australian practice of removing 'junk' food from the hospital and health facility environments. The South Australian Policy has been in place for the last few years and requires mandatory compliance. I understand from discussions that it has been a successful venture.

But where is the evidence? I can find no reviews of the policy's implementation or compliance that are available publicly. We do not know if it is successful or not. The project is not due for completion until 2016, so it is unlikely we will find out anything before then.

Eat Well Tasmania has the infrastructure in place to work with private and public workplaces to improve the number of healthy options available to staff and visitors. Instead of instituting another review or another level of bureaucracy to monitor if our workplaces have healthy vending machines, why do we not let Eat Well Tasmania do its job? Additionally, the State of Public Health report released this year suggests that the Tasmanian food and nutrition policy from 2004 is due to be redeveloped next year anyway. Could this not be considered then?

Further, the Joint Parliamentary Committee into Preventative Health Care has only just begun and perhaps the honourable member could refer the subject of vending machines to that committee rather than seek another review which would possibly duplicate this work.

Page 31 of the State of Public Health Report 2013 from the Department of Health and Human Services says:

In 2004 the Tasmanian Government adopted the Tasmanian Food and Nutrition Policy, which lays out a 10-year plan for improving food and nutrition in Tasmania. The policy covers key focus areas of environment, food safety, promoting healthy eating, breastfeeding, food security, primary production, distribution, retail and wholesale, food service, labelling -

and indeed they are small labels -

media, marketing and advertising, technology and workforce development. This policy provides a rather unique (in Australian terms) platform for action across a wide range of sectors from producer to plate that has guided a number of successful strategies - some mentioned below.

Those I have mentioned.

The policy is necessarily ambitious in its scope but provides Tasmania with an opportunity to improve population health in a sustainable manner involving partnership with industry. There is an intention to redevelop the policy in 2014.

To order a review at this time would seem to be a duplication of what is already underway.

While I commend and support the honourable member's concern for the health and wellbeing of Tasmanians, to order such a review may take funds from the good projects in operation that are tackling obesity already and therefore I do not support this well-intentioned motion.

[5.56 p.m.]

Ms RATTRAY (Apsley) - Mr President, I am of a mind to support the honourable member's motion. I appreciated the contribution from the member for Montgomery in relation to her information about some existing programs and the fact that one of them will be reviewed in 2014, which is just around the corner. There is probably an opportunity, when that review takes place, to consider the well put forward aspirations of the member for Rosevears in his motion.

I almost have to declare an interest here because I have been a patient of Mr Fettke's in the past and I have had to stand in front of Mr Fettke and hold the large carton of alcohol, and then he stacked two books on top of it, and proceeded to ask me, 'How did that feel?' and I said, 'Quite heavy'. He took the two books off and said, 'How does that feel?' and I said, 'Much better', and he said, 'That's what will happen if you get rid of some weight, your knees will feel a lot better'. He was quite blunt but it was absolutely true.

Mr Finch - He has had that carton of beer in his office for quite some time.

Ms RATTRAY - And those two large medical journals, I suspect.

He was absolutely right, my knees would feel a lot better if there was not as much of me to carry around. I thankfully do not spend a lot of time in hospitals but I know that there are many people in our communities who do, unfortunately, need to spend quite a deal of time in hospitals. You would hope that the hospitals would have good eating plans in place, would have high quality nutritional meals. When you come back from an operation, and have not had anything to eat for, say, 24 hours, and are coming out of recovery, you are usually quite hungry - and it might be at 7 or 8 o'clock at night and a lot of the domestic staff have finished for the day - all they can offer is a plate of sandwiches, and you are very grateful. It does not usually come with any chocolate but we hear that there is sugar in so much of the food that we intake. That can be fine for people who have the physique of the member for Windermere and have never had to worry about an ounce of weight in their lives - I am envious of every one of those people who do not have to have that consideration. But there are so many more of us - and I am sure I fit into the 40 per cent of Tasmanians bracket -

Mr Finch - You do not have to look at me.

Ms RATTRAY - I am trying not to look at anyone because I fit into that bracket myself so I am not shying away from that and it has been a constant struggle for my entire adult life, and a bit before that, that my weight fluctuates and sometimes I wish I had much better eating habits. I get them for a while and then they go by the wayside and then come back again - it is a roller-coaster, and I will try to be encouraged more, particularly with the summer months coming.

This notion has been put to me previously. A good friend and relation of mine who lives outside Ross had suggested this is a very worthwhile opportunity for the parliament to support and the government and the health department to look at reducing the type of goods that are for sale and made available, particularly in our hospital situations. Already many schools try to avoid having a lot of sweets, and particularly chocolates, given that so many of the students seem to have nut allergies now. That concept is being looked at, I believe, right around the state. There are already some aspects of the work being done. It is always having that coordinated approach which seems to be the real key to making some inroads into this situation.

I very much appreciated the direct letter from Mr Fettke. I am not sure whether he recalled on writing his letter that I was also a patient of his last year to have the annual grease and oil change on a knee as a result of playing netball many years ago. It probably will need some more attention in the future. I have sympathy and support generally the notion of having healthier food options and fewer of those sugar-related products in our hospitals, schools and wherever.

I also take on board some of the comments that were made. They are terrific fundraisers and I am mindful that some of those fundraising events are going to be hard to replace, but I am sure we can come up with some very good replacement ideas for what can be provided instead of the chocolates, et cetera. We could do something else more related to dried fruits and the like. It is not as likable to some people but they are fairly healthy. I note that sometimes when you are recovering from surgery and the like some of those other healthier foods are not as palatable as we have known in the past.

I believe there is an opportunity to work together in that 2014 review period to concentrate on what is already taking place and what Mr Fettke has suggested with his proposal. I am not sure whether we will be able to implement all of that but we need support from the department, the government and the minister. Receiving that support would be the first step. Support generally from this Chamber would also lend a strong argument towards moving any review process and looking at what programs are being undertaken.

The television program, Catalyst, last week talked about toxic sugar and the relationship of sucrose in the diet to coronary heart disease. It was an interesting program that gave me a level of understanding about how sugar can potentially impact on coronary heart disease. If it is proven to be correct, that is a huge revelation. It is a huge finding if that is so. It also talked about the fact that general community members have been taking cholesterol tablets believing they were the be-all and end-all of reducing cholesterol. That is next week's episode - how potentially those cholesterol tablets many, many people take regularly, and have done for many years, may not be doing the work they say they are doing. There are always a lot of studies in medicine, and research focusing on different tablets and cures for different aspects of your health, so we should have a better look at it. I truly believe this is an opportunity to have a better look at it, and get a better understanding of whether we can make some changes in the health facilities around the state.

Most schools are already moving towards implementing restrictions on sweets in their canteens. The Education department could well be a step ahead of the health facilities around the state, although most of us would have seen students come home with boxes of fundraising chocolates, and schools facilitate those types of fundraising events. We have a way to go, and I appreciated the honourable member's special interest contribution a month or so ago, when he talked about obesity issues and the effects of fructose. I was interested then and I am interested now.

I am not going to oppose the motion because I think it is not necessary, but I understand we already have some good programs in place, and we should be working in a cooperative manner with those programs that are already being undertaken to get better outcomes and to achieve more. I appreciate the honourable member making this a part of today's private members' day, and I very much appreciate the work that Mr Fettke continues to do in the interests of the broader community, because he is really committed to it. You do not get in and out of his rooms without getting a reasonable discussion about your own personal wellbeing and what you might be able to do to support your communities and make them a healthier place to live and work.

I am going to support the motion because it is important we show that level of support. If the government wants to make some changes they will ask the Health department and say that this has been 'at the will of the parliament'. In my mind, that will add some weight to the argument.

[6.08 p.m.]

Mrs ARMITAGE (Launceston) - Mr President, I, too, commend Mr Gary Fettke for all the work he has been doing. I am not a patient of his but I am a friend and I regularly get his emails where he points out what I should be doing.

We all know that the cost of health is increasing and the fact is we have to be a healthier society. The whole state budget could go on health if we do not start to be healthier in ourselves. As has been mentioned by the honourable member for Apsley, most schools have healthy canteens. My boys are now in their late twenties and thirties but I can remember when they were in primary school - that far back - the canteens were changing to make them healthier, taking out sweets and a lot of things we would consider to be very nice. If you put something in your child's lunch box you would get into terrible trouble because they would swap it for something else, because someone who did not have it would want something really nice. Personally, I would always choose chocolate over something like a muesli bar, if it was available so I can understand that if it is not there you have to eat more healthily.

Ms Rattray - If you can afford to have a chocolate occasionally.

Mrs ARMITAGE - No, I cannot. I do three kilometres every morning so that I can eat what I please but I would rather not do it.

We have to ask ourselves why it is that one‑third of adults worldwide have high blood pressure when in 1900 only 5 per cent had high pressure. Why did 153 million people have diabetes in 1980 and now we are up to 347 million? Sugar, we believe, is one of the culprits if not the major culprit.

The primary reason they give for obesity is sugar, and in particular fructose. Sucrose or table sugar is composed of equal amounts of glucose and fructose, the latter being the kind of sugar you find naturally in fruit. I always thought if you eat fruit that is fine but of course many fruits are also full of fructose. High-fructose corn syrup, or HFC as it is called, is also a mixture of fructose and glucose, about 55 per cent and 45 per cent in soft drinks. The impact on health of sucrose and the HFCs appears to be similar. Although glucose is metabolised by cells all through your body, fructose is processed primarily in the liver, and if you eat too much in quickly digested forms like soft drinks and candy, your liver breaks down the fructose and produces fats called triglycerides and I think that is part of our problem.

Some of these fats stay in the liver, which over long exposure can turn fatty and dysfunctional, but a lot of the triglycerides are pushed out into the blood too. Over time, blood pressure goes up and tissues become progressively more resistant to insulin. The pancreas responds by pouring out more insulin trying to keep things in check. Eventually, a condition known as metabolic syndrome kicks in, characterised by obesity, especially around the waist. High blood pressure and other metabolic changes, if not checked, can lead to type 2 diabetes with a heightened danger of heart attack thrown in for good measure. As much as one-third of the American adult population - and I am sure it would be the same for the Australian population - could meet the criteria for metabolic syndrome set by the National Institute of Health.

Recently the American Heart Association added its voice to the warnings against too much added sugar in the diet but its rationale is that sugar provides calories with no nutritional benefit. Excessive sugar is not just empty calories, it is toxic.

I am going to read you a little bit of interesting background on sugar because I do not think the honourable member for Rosevears knows it. It is called 'In the beginning was the fruit'.

If sugar is so bad for us, why do we crave it? The short answer is that an injection of sugar into the bloodstream stimulates the same pleasure centres of the brain that respond to heroin and cocaine. All tasty foods do this to some extent - that's why they're tasty! - but sugar has a sharply pronounced effect. In this sense it is literally an addictive drug.

This raises the question, however, of why our brains would evolve to respond pleasurably to a potentially toxic compound. The answer lies deep in our simian past, when a craving for fructose would be just the thing our ancestors needed to survive.

Some 22 million years ago, so far back it might as well be the beginning, apes filled the canopy of the African rain forest. They survived on the fruit of the trees, sweet with natural sugar, which they ate year‑round - a summer without end.

One day, perhaps 5 million years later, a cold wind blew through this Eden. The seas receded, the ice caps expanded. A spit of land emerged from the tides, a bridge that a few adventurous apes followed out of Africa. Nomads, wanderers, they settled in the rain forests that blanketed Eurasia. But the cooling continued, replacing tropical groves of fruit with deciduous forests, where the leaves flame in autumn, then die. A time of famine followed. The woods filled with starving apes. At some point a mutation occurred in one of those apes. It made that ape a wildly efficient processor of fructose. Even small amounts were stored as fat, a huge survival advantage in months when winter lay upon the land and food was scarce.

Then one day that ape, with its mutant gene and healthy craving for rare, precious fruit sugar, returned to its home in Africa and begot the apes we see today, including the one that has spread its sugar‑loving progeny across the globe. The mutation was such a powerful survival factor that only animals that had it survived, so today all apes have that mutation, including humans. It got our ancestors through the lean years. But when sugar hit the West in a big way, we had a big problem. Our world is flooded with fructose, but our bodies have evolved to get by on very, very little of it. It's a great irony: The very thing that saved us, could kill us in the end.

I support your motion.

[6.15 p.m.]

Mr HALL (Western Tiers) - Mr President, I spoke to one of the minister's advisers to get their view on your motion and I appreciate that you put this motion forward, but I did not get anything back, but I suppose the honourable leader has that advice rather than me. No doubt she will get it from the honourable leader shortly.

It is an interesting subject. Sugar, the white death, has become a very big health issue. I do not know whether other members saw the Catalyst program the other night on ABC television and we have round two next week. That started to dispel, quite a bit, the issues of the great demon of animal fats causing cholesterol problems and -

Ms Rattray - Coronary heart disease.

Mr HALL - Yes, and all of that. Apparently they almost talked about that as being a great con, one of the great cons of our time -

Mrs Taylor - The member for Apsley does not have to turn into a vegan after all?

Mr HALL - No. She can eat a great big feed of pork chops tonight, it will not matter. But it did point to sugar, in that program, that is what they were aiming at, as being the great demon and the cause of inflammatory diseases and diabetes and everything else. I have Gary Fettke's stuff here and he makes some very good points. Maybe he is a bit radical with it. He is very enthusiastic. I know some young cyclists who have taken his advice, but sometimes it gets a bit hard to follow that strict regime, particularly when you are hungry and you want to eat a hamburger after you have ridden for 100 kilometres or so.

Not focusing on the honourable member's motion at the moment, but with the hospital issues, diet is really about moderation. The food does not have to be organic, it does not have to be GE-free, it does not have to be conventional. But it does have to be unprocessed food which is what we should be trying to eat rather than processed food and that is so important. You only have to look at how our diets have changed. Even if any honourable member in this Chamber looks around at old school photos, we virtually had no fat kids back in those days.

We had very little in the way of processed foods and fast foods. You only have to go to second and third world countries now, particularly into Asia, and it is changing and it is starting to change rather rapidly. In general in the rural areas and in the poorer areas where there is no access to fast foods and processed foods, people are as they ought to be and they are healthy and they are eating plenty of fish, vegies and all that stuff. It is changing.

I can support the motion. It sends the right message and that is what it is about. We all weaken now and again. I do not drink soft drinks and I have given up sugar in tea and coffee but I have a shocking fetish for chocolate. Every now and again I need a sugar fix and that is the way it is. Even the honourable member for Rosevears would admit that, now and again, Maccas at Bridgewater is alluring.

Mr Finch - I thought this might come up. I purposely took home the member for Windermere last week to observe my habits on the road and it didn't include the golden arches at Bridgewater.

Mr HALL - No, but I did hear that you stopped at Mood Food back up the road a bit.

Mr Finch - But you were referring to Bridgewater.

Mr HALL - And what is more, whilst he is talking about the honourable member for Windermere, we did observe the honourable member for Rosevears recently over at Harbour Lights with his mouth open like a barracuda on the biggest cottage pie you would ever see. Two bites and it was gone.

Members laughing.

Mr Finch - It was a blue-tongue process.

Mr HALL - But he is doing well. He is going to the gym most mornings.

[6.21 p.m.]

Mr VALENTINE (Hobart) - Mr President, I support this motion of the honourable member. It is very good to see these sorts of issues addressed. Obviously that visit to the doctor made all the difference to him and we can expect to see great things over the coming years from the honourable member for Rosevears.

Mr Finch - Particularly in the non-drinking year.

Mr VALENTINE - That is right. One realises that alcohol is one molecule away from being sugar. Going back to my early days, I remember that sugar was C6H12O6 and I think alcohol is C5H11 whatever - and the carbon dioxide that is given off gives you bubbly alcohol. It is sugar when you put it all back together, so drinking or non-drinking is a very important issue when it comes to the opportunity for sugars to form in your body.

Mr Finch - I will sort that out next year.

Mr VALENTINE - Yes, you sort that out in your off-year.

It was mentioned - and I think it was by the honourable member for Launceston - that the health budget could take up the whole of the state government's budget in years to come if we do not do something to bring public health under control. I believe it was during the preventative health committee that we heard it could be as early as in 10 years' time. That is scary when you think about that. We must move to improve our position as a community in our health if only for economic reasons. This is not being brought forward for economic reasons; it is being brought forward because the honourable member for Rosevears cares about his community. It should be extended to encompass schools but it makes it a much bigger issue. I know a lot of schools are doing something to improve what they are selling in their canteens and the like but I still think there is a way to go. Some schools I believe still have deep-fried products available and that would be something that should be attended to, at least in public schools, and encouraged in the private school system.

I believe if we do not grab hold of this today, we are going to be in a parlous state. Some may say that to limit the options is a bit too draconian but I do not think it is. You might say, 'Hospitals serve you breakfast and give you fruit juice', but we have heard about fructose and how that can be damaging. If you have a look at the content of the sugar in some of those fruit juices, it is not just some of the sugary carbonated drinks that you buy from the shop that have lots of sugar in them. If you look at the content of sugar in reconstituted fruit juices particularly, it is at significant levels. It is not just what you might consider to be normal junk food that we have to be careful of.

Obesity is a significant issue in teenage children and in the general community. It is when people are young when they are putting on the weight. I remember being told once that if you can get to the age of 15 and have a reasonably trim figure you will not have as much problem in the latter years of your life with maintaining a reasonable weight level. You put on fat cells and those fat cells have the capacity to expand prior to puberty so it is a point that needs to be carefully looked at with regard to our children. If we can keep the weight off children up until at least puberty then we are going to be doing them a service further into the future.

I went to the web, as one does, to have a bit of a look at obesity itself and how much of an issue it is for our nation. I found on the Monash University site that Australia is one of the fattest nations in the developed world, which is a bit of a concern. Fourteen million people in Australia are either overweight or obese. Now what does that mean? A body mass index of greater than 25 means you are overweight. If you have a body mass index greater than 30 then you are obese. That site told me that 5 million Australians were obese, so that means that about 9 million people are overweight and when you put the two together you have a significant problem for Australia.

This particular site at Monash told us that if we continue at the present rate, by 2025 just under 80 per cent of all adults and a third of children will be overweight or obese. I do not think we can allow that to happen as a community. Obesity is a leading cause of premature death and illness, having overtaken smoking.

Mr Finch - The member for Windermere did not hear that.

Mr Dean - I heard it.

Mr VALENTINE - I do not think the member for Windermere smokes, does he?

Mr Dean - Never.

Mr VALENTINE - We are told there that obesity is the single biggest threat to public health in Australia. The secondary complications that flow from it are of concern. More than 900 000 Australians suffer from diabetes and, of course, obesity is a major issue with regard to that. Australians reporting heart, stroke and vascular diseases aged 15 and over were much more likely to be classified as overweight or obese than those without heart, stroke and vascular disease - 65 per cent compared with 51 per cent - so obviously there is a significant issue there. If you are obese or you are overweight then your chances of having those issues and problems is much greater.

I am overweight. I do not know what my body mass index is at the moment but I know that I am going to have to take some considered action to make sure that I am fit and healthy in my coming years. I am looking at trying to eat less, trying to reduce the meal sizes that I have and, hopefully, reducing my weight, but also looking at the type of food that I am eating as well and steering away from some of these sugary foods. You take the fast food option occasionally and you take those chips and think, 'Gee, they taste good', but I have been told that those chips before they are fried have been dipped in a solution of sugar. I do not have the hard evidence but I have been told that. It would be interesting to know whether that is fact but that is what increases your desire to have more of them. The buns have sugar in them as well so you are getting it from two sides there and it is not just one producer, it is across quite a number of them. We need to pay attention to what we do because as a nation we are heading for a significant health problem.

I congratulate the member for Rosevears for bringing this on. It is a very important motion and I will support it. I believe his intent is that the government consider it. I do not think he is ordering the government to do it, as it might seem in the motion. I commend him for it and I will be doing my bit.

[6.30 p.m.]

Mr DEAN (Windermere) - Mr President, I will support the motion. It is a good motion and anything to do with health is something we ought to be supporting in this place.

Mr Harriss - What about salt?

Mr DEAN - I was going to get onto that. Very clearly I do not have longevity; in fact, I have 'shortivity', if there is such a word, in this world because I love my sugar and salt, so I am destined for some problems later on. I am trying to wean myself away from sugar but I am finding it very hard. I talk about people weaning themselves off smoking so if they can do that I can probably do this. It is something I need to concentrate on.

I want to talk a little about the kiosk in the hospital. The member for Rosevears mentioned the kiosk, that they are all volunteers who work in that establishment. Anne works there as a volunteer and loves it. She gets some enjoyment out of it. Interestingly, that kiosk - and I have a copy of their profit sheet here - makes a lot of money. Their takings for July‑August‑September this year was $183 582.95. Their profit was $157 454.87. That is a lot of money over a three-month period. They have junk food but that is not what they concentrate on selling. They sell sandwiches and other lines but, unfortunately, they need to make some changes or ought to consider it. Those profits go back into the hospital, and some probably go back into Clifford Craig, and are used to keep the hospital running.

Mr Finch - I mentioned earlier that they contributed $500 000 towards medical facilities for the hospital in the last 12 months.

Mr DEAN - I know they have a very healthy bank account and they were waiting for the hospital to come forward and request another purchase. Much of that, unfortunately, is through the sale of junk food. The cafeteria did a promotion recently. They put out a bottle of Coke and a bottle of water and listed the ingredients in the Coke and the damage it does to your system. As a result of that, Coke sales dropped tremendously and water sales picked up that equivalent amount. It was a matter of bringing to the attention of people the damage they were causing to themselves through drinking Coke.

Most of the kiosk customers are staff and visitors, not so much the patients. Because there are shops across the street, I suspect if they could not get their junk food, they would go across there. You are right, hospitals should be setting the example. They were able to do that with smoking and even in the psychiatric ward of that hospital they stopped smoking. That is done for the purposes of improving health. Anything that can be done to that end is a great thing and I will be supporting the member's motion.

[6.35 p.m.]



Mr FINCH (Rosevears) - Mr President, I thank honourable members for contributing to the debate. That was the idea - to stimulate the conversation and to build a motion that may suggest to the government that we are concerned, and we are talking about this issue.

I am not 'ordering' the government. I want the government to consider having that review and it was good that the member for Montgomery mentioned the programs that are in place, and highlighted them. But we must not rest on our laurels. We must keep generating those conversations that mean we are focusing on this issue because, as has been highlighted, the problem is only getting worse. We must make sure, too, that we give our kids the best opportunity to learn about healthy food and the correct eating habits.

The member for Hobart talked about schools, and I mentioned that briefly in my presentation - that is where the work starts. That is where the education needs to take place. The kids then go home and talk to their parents, and can change their habits somewhat, or we hope so.

For those who are reading this debate on Hansard and may be watching it when it is put on Twitter and Facebook, if I might just explain that mention of the year on and the year off. From midnight on New Year's Eve, I have a year drinking alcohol - some would say to excess - followed by a year where no alcohol passes my lips for any reason. I am in the thirty-first year of doing that and I have not transgressed for any reason. The member for Windermere might be interested that the reason for my strong willpower in respect of that comes from having to give up smoking. I was a 60 a day person and because of the effects on my health, I realised a change had to come. Going cold turkey has enabled me to develop -

Mrs Taylor - It's very hard to go cold turkey on eating.

Mr FINCH - The point is that challenge - that Everest in my life of giving up smoking cold turkey - enables me to have control, in a willpower sense, of the things I do. I was waiting for that epiphany, that moment when something said, 'You have to take control of sugar'. Because I was having 10 cups of tea a day, all with two well-heaped sugars or plenty of honey, as well as the other sugar intake I had. I knew that something had to happen. Gary Fettke highlighting that to me in hospital meant that from that moment, I have not added sugar to anything in my food. That was August last year.

I am on a roll here. Having watched the eating habits of the member for Windermere in the dining room and realising the damage salt can do to a person, my New Year's Eve resolution was not to add salt to any of my food, and I have not done that since New Year's Eve.

Mrs Taylor - When you have sausages, eggs and chips, there is no salt?

Mr FINCH - There is plenty in there. I do not need to add it. The point is that the added stuff were addictions for me. I was addicted to salt and addicted to sugar. Now it is about taking control of that, and the alcohol. I really enjoy alcohol but I am in control of alcohol - or half and half - in my life. But cigarettes - I was addicted to cigarettes, a huge nicotine addiction.

I will move on because this motion is not about me. It is about alerting the government to the issue, for its consideration. I noticed a couple of agency people were here to listen to the debate and the idea is to keep stimulating that conversation and for us all to be thinking about the issue of health and how we can assist this burgeoning issue of the drain on our budget every year that is increasing.

I cannot see any possible argument that Tasmanians do not need help and support to make those healthy food choices. I suggest that the government in looking at this situation might think about other public institutions as well. I have focused here on hospitals but other public institutions as well may come into consideration.

Ms Rattray - The parliament?

Mr FINCH - Some are suggesting the parliament and far be it from me to order the government to take notice of that. However, I will conclude and thank members for their support.

Motion agreed to.