Senator HUMPHRIES (10:57 AM) —I present the report of the Community Affairs Committee, Highway to health: better access for rural, regional and remote patients, together with the Hansard record of proceedings and documents presented to the committee.

Ordered that the report be printed.

Senator HUMPHRIES —I seek leave to move a motion in relation to the report.

Leave granted.

Senator HUMPHRIES —I move:

This report is reporting on the various patient assisted travel schemes which operate around Australia. In 1978, the federal Patient Assisted Travel Scheme was established and, at that point, it was operated by the Commonwealth government. In 1986, that scheme was devolved to the various states and territories of Australia, and this inquiry was intended to establish how well those schemes serve the needs of Australians living in rural and remote Australia.

The inquiry found that there were serious inadequacies in the various schemes: that the subsidy levels were unrealistically low in many cases, that the thresholds that people had to travel before they qualified for assistance were often too high, that the schemes themselves were complex and obscure, that access to them was difficult, and that there were marked inconsistencies between the way these schemes operated from one jurisdiction to another. And, when so many people were, in effect, crossing state boundaries, by virtue of these schemes, to access services, those inconsistencies became a matter of some vexation to the users of the schemes. What was also disturbing was that, in conjunction with those facts, there was clear evidence of poorer health outcomes for people living in rural and remote Australia—for example, more depression for people in remote Australia, higher rates of communicable disease, a greater incidence of very low birth-weight babies, and, generally, lower levels of life expectancy.

We might expect that there would be a certain degree of lower or worse health outcomes by virtue of people living a long way from health services, but the question is whether the various PAT schemes are able to mitigate the effect of that distance. Real questions remain as a result of this inquiry as to whether they effectively do that. PAT schemes certainly alleviate some of the financial burden associated with having to travel for medical assistance but only a relatively small proportion of that. Something like one-fifth to one-tenth of the costs usually entailed in travelling long distances for medical assistance is the level of reimbursement that people can expect. That leaves many Australians with significant financial hardship associated with medical illness. Most disturbingly, perhaps, is the fact that the cost of travel actually dissuades some people from seeking medical attention. It actually dampens demands for certain preventative services—for example, breast cancer screening—and it leads others to choose not to be treated or to be treated too late for intervention to be effective. That has led the committee to make a number of recommendations, key among which are: firstly, that there should be a building-in to the next Australian Health Care Agreement of attention to this issue so that it becomes one of the measures whereby Australia gauges the effectiveness of its health and hospital related services; and, secondly, that the Australian Health Ministers Advisory Council establish a task force to look at a range of issues affecting the operation of the PAT schemes, including obviating the differences between jurisdictions and establishing national standards to ensure that a certain amount of consistency can be achieved and the standards applicable in these schemes can be raised across the nation.

I do not propose to speak for any longer than that. I simply want to thank the committee secretariat for its very hard work in putting together this report. I thank the other members of the committee. I particularly thank the senator who was the driving force and inspiration for this inquiry, Senator Judith Adams. It is true that the committee began the task of this inquiry with a certain reluctance based on some view that this might not be an issue of great substance. I have to say that by the end of the inquiry we were convinced that this was an issue affecting very substantially all people who live in rural and remote areas of Australia and did need very serious public policy attention.