Executive Summary and Recommendations

The Commonwealth Government's decision to develop a Men's Health Policy, announced on 8 June 2008, is an acknowledgement that men's health requires specific attention. A program of consultation throughout Australia is currently underway and it is expected that the policy will be completed by the end of 2009.

This committee believes that the issues raised in evidence to it and the contents of this report will make an important and constructive contribution both to the debate on men's health and to the final content of the policy.

Recommendation 1

The committee recommends that the Commonwealth Government give due consideration to the findings of this committee and to the evidence gathered by it in the course of this inquiry in developing the National Men's Health Policy.

Chapter 1

Health is generally defined as much more than the simple absence of a particular disease. To the (WHO) World Health Organisation it is a "...complete state of physical, mental and social wellbeing and not merely the absence of disease or infirmity". While not universally accepted, this definition draws attention to the wide range of social and cultural determinants which may contribute to men's health status; attitudes to masculinity, employment and income for example.

The need to consider men's health as a distinct subject is made clear by the statistics for the morbidity (incidence of disease) and mortality of men in Australia, which are considered in Chapter 1. Australian men are long-lived by world standards but their health status exhibits distinct differences from that of Australian women and is, by most measures, worse.

Chapter 2

The committee received a number of proposals for the creation of an agency to promote men's interests in government, an 'office of the status of men'. The committee does not believe that this is necessary but it does support the view that the impact of legislation and policies on men should be considered by government.

Recommendation 2

The committee recommends that legislative drafting instructions and administrative procedures applying in all Commonwealth Government departments and agencies include a mandatory requirement that they consider the impact of legislation and policies on men as well as women. (2.11)

The lack of a detailed understanding of the various factors which contribute to men's health status have given rise to a demand for a longitudinal study of men's health. A longitudinal study of women's health was established in 1995 and much of the preliminary work for a men's study has already been undertaken under the auspices of Andrology Australia.

Recommendation 3

The committee strongly recommends that a Longitudinal Study of Men's Health building on the work already undertaken by Andrology Australia and other stakeholders be established and funded by the Commonwealth Government. (2.23)

There is a common perception that men are either not interested in their health or careless in managing it. The committee does not accept this. Men do in fact use health services in high numbers and respond positively to education and awareness campaigns. However services need to be provided in ways that acknowledge men's social and economic circumstances and take account of their distinctive attitudes. In addition, boys should be informed about healthy behaviours at an early age.

Recommendation 4

The committee recommends that the Commonwealth Government investigate the feasibility of introducing a structured, comprehensive annual health check for men. The proposed health check should be designed to be carried out in a range of contexts - general practice, the workplace and through community health programs. Consideration should also be given to providing a specific Medicare item which provides adequate time for the consultation and minimises the cost to the patient. (2.43)

Recommendation 5

The committee recommends that the feasibility of offering incentives to nurses to undertake training as men's nurse practitioners be investigated by the Commonwealth Government. (2.43)

Recommendation 6

The committee recommends that the Commonwealth Government initiate discussions with its State and Territory counterparts with the object of introducing, as appropriate, programs that encourage boys to take responsibility for their health and wellbeing. (2.55)

Indigenous men exhibit the worst health outcomes of all groups in Australian society. Many of these problems are the product of broad social, economic and cultural issues beyond the scope of this inquiry. However some specific steps can be taken to improve the situation.

Recommendation 7

The committee recommends that the Commonwealth Government take the initiative in conjunction with the States and Territories in examining strategies for improving trauma treatment in Central Australia. (2.80)

Recommendation 8

The committee recommends that the Commonwealth Government take the initiative, in cooperation with the States and Territories, to reduce complexity and simplify the application process for health related grants. (2.84)

Chapter 3

Depression and other mental illnesses are significant and often poorly recognised problems in Australia. Overcoming the stigma which still attaches to mental illness is a major issue. Depression is a significant problem in its own right. It is also closely linked to alcohol and drug abuse and can also be present as a co-morbidity with major physical health problems such as prostate cancer. It is important that this interconnectedness be recognised in the provision and conduct of treatment services.

Recommendation 9

The committee recommends that the integration of health service provision to recognise the interconnectedness of men's health issues be made a central part of the forthcoming national men's health policy. (3.55)

Recommendation 10

The committee recommends that the Commonwealth Government investigate standardised service models for mental health to facilitate a uniform standard of care throughout Australia. (3.55)

Chapter 4

Prostate cancer is the most commonly diagnosed cancer in Australia. It ranks alongside breast cancer in terms of mortality. The incidence of prostate cancer will increase as the population ages. It is also a highly complicated cancer which requires an increased research effort and greater resources dedicated to treatment. At present the information available to those with prostate cancer and the services to support them are not adequate.

Recommendation 11

The committee recommends that the Commonwealth Government ensure that the Australian Prostate Cancer BioResource is provided with sustainable funding at a level that would enable it to complete its tissue collection and carry out the necessary work in support of prostate cancer research outlined in chapter 4. (4.30)

Recommendation 12

The committee recommends that the Commonwealth Government provide funding to the Prostate Cancer Foundation to ensure that the Prostate Cancer Information Pack program proceeds. (4.53)

Recommendation 13

The committee recommends that the Commonwealth Government expedite funding for the provision of specialist prostate cancer nurses, particularly in rural and regional Australia. (4.58)

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