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Wednesday, 25 September 2002
Page: 4946

Senator Allison asked the Minister for Health and Ageing, upon notice, on 27 August 2002:

With reference to the 1998 study by S. Hollins (et al), Mortality in people with learning disability: risks, causes, and death certification findings in London, which indicates that people with moderate and more severe levels of developmental disability die 20 to 30 years younger than the general population and are 58 times more likely to die before the age of 50:

(1) Has any such study been undertaken in Australia; if so, did the findings match those of the United Kingdom (UK) study; if so, does the Government consider that such early death and high levels of unrecognised and poorly managed disease are acceptable.

(2) Is the Government aware that a 1996 survey of Australian General Practitioners (GPs) indicated that 89 per cent of GPs felt it was difficult to gain a complete history from people with a developmental disability and that over 75 per cent of GPs considered themselves inadequately trained to care for people with a developmental disability.

(3) Will the Government establish and fund national medical training schemes for specialised practice in developmental disability.

(4) Will the Government consider adopting the World Health Organisation's health targets for this population.

(5) Will the Government consider recognising this group as people who have chronic and complex health needs by using the health assessment descriptors under the Enhanced Primary Care Initiatives for General Practice, and by including them in generic health promotion research and campaigns.

(6) Will the Government consider setting up a national register of people with intellectual disabilities, as the UK has done.

Senator Patterson (Minister for Health and Ageing) —The answer to the honourable senator's question is as follows:

(1) Yes, the Government is aware that a small study has been undertaken in Australia, although due to its size this may not be directly compararable to the study done in the United Kingdom. Morbidity and mortality from any condition due to lack of recognition and poor management by health professionals would be considered as unacceptable to the Government.

(2) The findings of this study were reported in the Journal of Intellectual Disability Research in 1997.

(3) It is not clear that the establishment of separate specialised practice in developmental disability would be the most effective method for ensuring better health care of people with developmental disabilities. A core unit of general paediatrics is training in community child health. Training in this unit includes comprehensive exposure to developmental disability, including skills in assessment and early intervention. Increasingly, paediatric trainees are working in the community with general practitioners, psychologists, other allied health professionals and care providers to design and manage appropriate programs for children and adolescents presenting with a range of disabilities.

(4) There are currently no ratified World Health Organisation (WHO) health targets for people with disabilities. The Government is aware that draft health targets have been proposed to the WHO.

(5) The Enhanced Primary Care (EPC) health assessment items are designed to encourage and enable more preventive care for older Australians, including people who may be in good health. These items are available to people who are aged 75 years and over (or 55 years and over for Aboriginal and Torres Strait Islander people). Health assessments are not suitable for younger people with chronic conditions and complex health needs.

The EPC Medicare items also include multi-disciplinary care planning and case conferencing items which are available for people of any age, with a chronic or terminal condition and complex needs, requiring care from a multi-disciplinary team. People with developmental disabilities are eligible for care planning and case conferencing services, when they have complex needs requiring care from a GP and at least two other care providers. Care planning enables the total care of the person, including preventive care, to be planned and coordinated by, or in consultation with, a GP. This provides a better mechanism for ensuring total care than the health assessment, which has been designed for older Australians.

The Government is aware of research undertaken by organisations such as the University of Sydney's Centre for Developmental Disability Studies, the University of Queensland's Centre for Primary Health Care and the Spastic Centre in New South Wales into the health care of people with developmental disabilities.

(6) The Government is not considering setting up a national register for people with intellectual disabilities at this stage.