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Wednesday, 22 August 2012
Page: 6138


Senator BOYCE (Queensland) (17:17): I would like firstly to congratulate Senator Nash for being the person who initially suggested this inquiry and, in particular, looking at the Australian Standard Geographical Classification Remoteness Areas, which clearly has not been working properly. But it was the entire Community Affairs References Committee which broadened this out into what has become a very meaningful assessment of the health services available in rural and remote Australia.

I was somewhat surprised to discover that the number of health professionals across Australia is spread evenly across the country on a per capita basis. Clearly, 'on a per capita basis' when you live in a town of 100 people is not quite as helpful as it might be when you live in a city of a million people. So we need to think about accessibility and many other issues at the same time as we are thinking about whether we have enough health professionals on a per capita basis. We have suggested not only that the Australian Standard Geographical Classification Remoteness Areas should be reassessed and changed to be far more flexible and to reflect much more the needs of people in remote areas and the incentives for doctors to actually go to those areas; we have suggested also that there should be a proper evaluation or assessment conducted at the same time as any new system is put in place. The problem for people who use the scheme is that whether you are in Gundagai or Newcastle, as Senator Nash said, or whether, in my state of Queensland, you are in Longreach or Townsville—both of which have the same classification—is clearly a significant factor in the ease with which you are going to get doctors to work in those areas.

One of the other things that came up, and I must congratulate Senator Moore on this, was the fact that there is a huge amount of data being collected, there is a huge amount of research going on and there are many good programs going on, but the communication of these, the sharing of information and the correct use of material are lacking in almost every area. You only have to look at the evidence from the Australia Bureau of Statistics about the geographical classification for remoteness areas, which said:

… it is well known that some policy makers use ABS definitions, both geographical and others, to directly target policy. For example, some organizations paid an additional allowance to staff stationed in 'rural' areas… The validity of using ASGC in this way depends entirely on the relevance of the geographical concept to the desired policy outcomes. It is vitally important that anyone developing policies, funding formulae or intervention strategies understands the alignment, or lack of alignment, between … classification and their business objective.

I think that unfortunately what we have discovered is that there really has been very poor alignment in the past on this topic.

As I said, the government, every government, is spending significant amounts of money to try and ensure adequate health services in regional Australia, but the evidence that we received as a committee during the inquiry has highlighted the deficiencies in both the development and evaluation of the programs. We have an urgent and fundamental need to better understand what works, where it works and where we have significant gaps in the system.

I would very much like to commend this report and, like Senator Moore, I would also like to acknowledge our former colleague the late Senator Judith Adams, who would have revelled in the opportunity to be involved in this inquiry and whose work in the Senate paved the way in many ways for the work that we have done in this inquiry.