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Tuesday, 11 October 2011
Page: 7020


Senator MOORE (Queensland) (18:09): I also want to make some remarks on the recommendations and the process we followed in this Community Affairs References Committee inquiry. Certainly this is a much reviewed process. The remote area Aboriginal health services program, which includes the section 100 supply program and also the section 100 pharmacy support allowances, has been reviewed a number of times since it was introduced in 1999. There was a clear need identified in 1999. It was shown that Aboriginal and Torres Strait Islander people, particularly but not exclu­sively those in remote areas, were not receiv­ing the benefit of our wonderful PBS system. At the time, 1999, the Centre for Remote Health noted that a review found that only 33c were spent on the PBS for Aboriginal and Torres Strait Islander people for each $1 spent on non-Indigenous people. This comparison made a benchmark about where we were moving in the process of allowing medication to be available for people who have great need. No-one denies the great need in remote Aboriginal and Islander communities and also in non-remote communities.

Through a number of submissions that came to the committee, we looked at the fact that since 1999 there have been extensive advances made in allowing medication to be available. The Department of Health and Ageing submission said, and I will put these figures on record, that from 1999 the remote area Aboriginal health service program:

… has grown from servicing 35 remote Aboriginal Health Services to 173 in 2011.

The supply of PBS items has increased from around 250,000 in 1999-2000 to more than 1.4 million in 2010-11.

In 2010-11, expenditure under the RAAHS Program had grown to $43 million from $3.9 million … in 1999.

Further, it is believed:

Around 170,000 Aboriginal and Torres Strait Islander people are estimated to benefit from the increased access to PBS medicines and better quality use of medicines …

So we do have that baseline data but, as Senator Siewert pointed out, we need to have more than just knowledge of how much medication is supplied. There is so much more that is needed. We need to look at the impact of the medication, and certainly one of the things we considered was: how do you actually see where people's chronic illness has been improved by this attention? We know it has. Intrinsically, we know that from 1999 until now, with the greater access to medication, of course people's health issues have been addressed, but we need to know that in greater detail.

We received very detailed information from people who wanted to do research in this area who said they had difficulty in getting the data. There is a good reason for that, but there is one issue that we should be able to respond to. What happens in areas of small populations is that the Privacy Act comes in and says that data cannot be released because of the possibility of individuals being able to be identified by the release of that data—a noble concern and one of which we should be aware. However, we need to be able to think and work smarter. There have got to be ways that the government and the stakeholders can work together effectively to see how we can understand on what this whole program is based—that is, clinical health improvements for people who most need it.

Certainly one of our recommendations is that we work together. It seems a sensible enough recommendation that we get together all the people who have such great goodwill in this area who are trying to ensure that people in remote areas get access to the appropriate medication and then that their health is improved. As we often say here, we need to have ways of assessing that. That was one of the things that were picked up most clearly by our report.

I note that Senator Siewert also referred to one of the more interesting recommendations I have seen from any of our committee reports, which is in fact that we should go back and check all the recommendations that have been made in this area and see what is happening to them—common sense. It happens so often that people have issues which need to be considered, they evolve, more information becomes available, needs are identified and then we go into a quite in-depth inquiry to find out that this work has been done before. Recommendations have been made but somehow the recommend­ations have been lost and we have not been able to pick up on the knowledge and the professionalism that we know is available. So I really like that recommendation. Certainly our community affairs committee has worked very hard in the past to ensure that we have this process, that we consider issues and that after a certain period of time we go back and see what has happened. This is because in areas of social welfare we consistently have incremental improvements. So rather than going back and identifying all the issues again, we see what work has been done, the kind of recommendations that have been made by various governments and various groups of public servants working in the area and what has happened. It is almost a standing recommendation so that we can understand that we are working effectively to ensure that remote health issues are moving forward in our community.

Another one—and I know Senator Siewert mentioned it—was to do with the basic things that we take for granted in our own medical processes in terms of medical aids. The pure stupidity of the process means that people cannot get the basic help they need to learn about their medication and to use it more effectively through such things as the small pill blister pack that we have available all the time and which have proved to be deeply effective. That is not actually part of the process. It is extra expenditure and, as we know, expenditure is so tight that that kind of process is not provided. Straightforward processes about things that we all know and understand can be translated effectively to make the system work better.

I also take the note about the labelling process. Having worked with pharmacies over many years, I know the need to have a standard process of labelling and clarity so that people can understand their medication is so important and is something that once again at this time we need to restate.

A lot of good work has been done. We have seen that there have been advances, but there needs to be further consideration. Basic understanding of the whole process is not wide in the community. There has got to be more education in the way that professionals can work more effectively with communities so that people, again, understand their medication and are able to get the best use out of it. It is not just about spending the dollar; it is about how the dollar is spent and how effectively the community can benefit from it.

This is a necessary report. It is one that will stimulate further discussion. I note that the government will be considering it. I share with Senator Siewert a commitment to follow up so that the recommendations are discussed openly and we see some change not just in this place but more effectively in communities.

There is also the issue that we discuss so often in this place, and which the Commun­ity Affairs References Committee will be picking up in another inquiry, of rural and remote workforces. There is a great need to have more professional work done in comm­unities and not just outside with people flying in and flying out. So I am looking forward to talking about that again in the future.

I commend the secretariat, who worked hard to prepare this particular report. We will be following up with all the people who have shown such great interest and goodwill in the process. I seek leave to continue my remarks later.

Leave granted; debate adjourned.