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Community Affairs Legislation Committee
25/07/2012

BALMER, Ms Liza, Deputy Co-ordinator, NPY Women's Council

WILLIAMSON, Ms Christine, Manager, Youth Program, NPY Women's Council

Committee met at 11:12.

CHAIR ( Senator Moore ): I declare open this public hearing and welcome everyone who is present today. Before we commence proceedings, naturally the committee acknowledges the traditional elders, past and present, on whose land we meet.

The Senate Community Affairs Legislation Committee is inquiring into the Low Aromatic Fuel Bill 2012. Today is the committee's second public hearing for this inquiry, after our first public hearing yesterday. These are public proceedings, although the committee may agree to a request to have evidence heard in camera or may determine that certain evidence should be heard in camera. I remind witnesses that in giving evidence to the committee you are protected by parliamentary privilege. It is unlawful for anyone to threaten or disadvantage a witness on account of evidence given to our committee and any such action may be treated by the Senate as contempt. It is also a contempt to give false or misleading evidence to the committee. If a witness objects to answering a question, the witness should state the grounds upon which the objection is taken and the committee will determine whether it will insist on an answer having regard to the grounds which are claimed. If the committee determines to insist on an answer, a witness may request that the answer be given in camera. Of course, such a request may be made at any other time.

I also want to acknowledge today that Mr Ian Tuxworth, a former chief minister of the Northern Territory, is with us today. Thank you, Mr Tuxworth, for joining us.

Our first witnesses are from the NPY Women's Council. We welcome you, as always. Your organisation has been wonderful in providing evidence and information to our committee over many years, so thank you. Take that back to the women in your community.

We have your submission. Thank you very much. If either or both of you would like to make some opening comments, then we will go to questions.

Ms Balmer : Would it be useful if I gave you a brief history of our involvement with Opal?

CHAIR: Go for it.

Ms Balmer : As you know, petrol sniffing in our NPY region, which is a cross-border region of central Australia, was huge. It was a massive problem. I started work with the council in 1996 and I can tell you that since then I have seen a major transformation in the lives of young people. The council lobbied for many years and was involved in many petrol sniffing programs, particularly the avgas scheme early on, and then later on the Comgas scheme. In 2005 we were part of the Opal Alliance that was formed with CAYLUS and with General Property Trust, which was lobbying for a broader roll-out of Opal fuel. As you would know, at the time in 2004 when Opal was rolled out it was only rolled out in the 33 communities where Comgas had been available. It was voluntary and was very ad hoc. Not every community had it and it was often up to the store manager rather than the community whether they had it or not. So we lobbied very strongly for an increased roll-out to cover the whole petrol sniffing region that we had identified. For many years we lobbied strongly and it took a long time. A lot of roadhouses and petrol stations in particular were resistant. But successfully over the last few years we have managed to get it to cover our region, the NPY region. That is not the entire mapping region that was presented, I think, at the last hearing but certainly it is covered in our NPY region, including Laverton, which has just come on in the last few months.

Laverton is a great example of what happens when Opal is introduced. Warburton has been our biggest concern for a number of years because the supply of sniffable petrol was coming in through Laverton and there were estimates of up to 60 to 70 per cent of young people under 25 sniffing, some occasionally and some regularly. Since the introduction of Opal fuel in Laverton there has been a significant decrease. It is still our community of concern, there is still a lot of sniffing there, but it is coming in from Kalgoorlie now. The APY Lands is a fantastic example of what happens with Opal fuel. In the 1990s there were estimates of up to 200 young people sniffing and in the last 12 months our data says that have been three incidents or episodes of petrol sniffing in the APY Lands. So the APY Lands is an example of the strongest Opal wrap-around. In WA clearly there is still access and supply. Another community in WA, in Kiwirrkurra, there is still petrol getting in there. Again the proximity to petrol means it is more available in Kiwirrkurra than it is in other communities.

The other interesting statistic that I would like to mention is that we had very low numbers of petrol sniffing in the Northern Territory and last year the Indigenous land Corporation bought the Voyagers resort at Yulara. The previous arrangement there at the Mobil petrol station was that premium fuel was locked and to access it you had to provide your registration details and your address. They kept a register of who was using it. When the Indigenous Land Corporation purchased the resort they took away those measures and in the last 12 months we have got seven episodes of petrol sniffing in the Northern Territory.

I suppose that is a brief history of Opal. We acknowledge that Opal itself is no silver bullet. It does not take away the problem of petrol sniffing or inhalant use in general but we can show, particularly in the APY Lands, when you provide a wrap-around comprehensive new service and you reduce the supply of petrol and replace it with Opal that the incidence almost disappears.

On those occasions where it is still happening, it is dealt with very quickly and the impact is very limited. On occasions the petrol does not even get past the dealer; it is picked up and confiscated.

CHAIR: Miss Williamson, did you want to add anything—in particular, from your work with the youth?

Miss Williamson : What I would add is that in the Northern Territory and South Australian areas we do have case management services. In the South Australian area there are youth diversion programs but there is also a dedicated resource around youth case management, which is really important in terms of working alongside the strategy of introducing Opal. In the WA lands, particularly Warburton at the moment, there are youth programs there. However, they are sport and rec and arts based programs; there is not a dedicated resource around case management for young people and their families. For us, having a look at that data, we would make that link that there needs to be some level of case management dedicated to young people and their families to offer that more intensive support around trying to target the base issues, the core issues, that lead young people to sniff petrol.

CHAIR: I am just going to jump right in. Where does your funding come from for the particular programs you have identified? As you well know, the history of the discussion around this area has been very much focused on the need to effective diversionary programs. That has come out of the two inquiries and all the work we have done. I am interested in the way you have discussed the different options being offered in three parts of the area in which you work and I am wanting to drill down for all of us as to where the money comes from and how it can be used?

Miss Williamson : At the moment we are funded by quite a few different bodies. We are funded through the Department of Health and Ageing to offer a young people's program in the South Australian and WA regions. We are funded by the Attorney-General's Department in Kiwirrkurra for two full-time youth workers there. In the Northern Territory we are funded through FaCHSIA for our Youth in Communities program in the four communities—that is, Finke, Imanpa, Docker River and Mutitjulu.

Senator SIEWERT: That is the Youth and Communities Program?

Miss Williamson : Yes, that is correct.

CHAIR: You did mention that in some cases there were diversionary programs around art and sport, with which we are very familiar, but you are looking at the real need for the case management and the family engagement. What particular funding goes to that and why, to the best of your knowledge, are you able to get that work in South Australia and the Northern Territory but not WA? Is that accurate?

Miss Williamson : That is correct. We had been providing a youth program in Warakurna, which is in WA. However, recently we lost our housing there so we do not have a resident youth worker there. In South Australia we are funded through the Department of Health and Ageing under supporting young people around substance misuse issues and under mental health as well. We are also funded through the Department of Health and Ageing to try and increase capacity building within our team and, with community members, trying to address substance abuse issues. In the Northern Territory, with the FaCHSIA funding, we are also funded to provide youth diversion through recreation halls but also general youth diversion in the community: bush trips, outings—that sort of stuff. We are also funded to provide case management there as well.

Ms Balmer : I think the point that Christine made earlier about the difference in WA, where there is very little case management and social support, is that we receive very little funding for Western Australia. So the other youth services that are offered and not run by us are run by sport and rec funding.

CHAIR: Which goes to someone else.

Senator SIEWERT: From the state.

Ms Balmer : It goes to the shire.

Senator SIEWERT: That is in the shire, is it?

Ms Balmer : Yes.

CHAIR: It goes to another provider.

Ms Balmer : We had one position in WA. That was the one that we had based in Warakurna. Because of the housing we do not have that person resident there anymore, so it is a visiting service and we really try not to double up where those other youth programs are.

CHAIR: But, from your observation, nobody is picking up the case management role.

Ms Balmer : No.

CHAIR: But you are doing both in South Australia and the Northern Territory for those Western Australian communities.

Ms Balmer : That is right.

CHAIR: With the obvious flack that that leads to.

Ms Balmer : That is right.

CHAIR: You are trying to get all of those boxes filled in.

Miss Williamson : Yes. There are case management services but they are specific around child protection or justice—that sort of thing. They are not just for youth programs.

Senator SIEWERT: Whenever we have been talking about the rollout of Opal, people have always said that you need youth diversionary services as well. So now we are seeing the expansion of the rollout of Opal, which is great, but there is not always complementary funding for youth diversionary services.

Ms Balmer : That is correct.

Senator SIEWERT: It has become delinked. You have three different pots of money, and there is another pot of money that is used separately in Western Australia. I am not necessarily having a go, because I think putting money in is good, but it does not seem to be coordinated.

Ms Balmer : Yes, the focus has to be around case management as well as diversionary activities. In Warburton there is a core group that the community can identify, so ideally you would have some really intensive work with that core group, complemented with diversionary activities. Just opening the rec hall every day is not enough.

Senator SIEWERT: You mentioned fuel is coming into Laverton from Kalgoorlie. Are people actually bringing it in in vehicles, or are they bringing it in jerry cans?

Ms Balmer : There is a bit of a trade. People will bring it from Kalgoorlie and sell it in those communities.

Senator SIEWERT: I would have thought it was a bit far to just fill up in Kalgoorlie.

Ms Balmer : From my knowledge, it is not coming out of cars. It is purposely brought in.

Senator SIEWERT: Have you held any discussions with DoHA or with the Western Australians about how to stop that?

Ms Balmer : Christine might like to answer that. We had a community meeting there recently around that.

Miss Williamson : We have been to Warburton twice now and the community have raised those concerns about petrol sniffing with us. Those concerns have been raised internally with our directors at NPY Women's Council but also with the Goldfields VSU working group. Their primary agenda is to look at volatile substance misuse.

In the discussions with that working group, and we have been sitting on that group for some time now, it was decided that there could be a core group of service providers who could come together and look at the issues in Warburton and how we could support the Warburton community to address them. That is only a recent development. We have met once since then. The people in that group are the Warburton police, NPY Women's Council, the health service there and the VSU Goldfields coordinator, Roland. We have met and discussed the areas of reporting, because reporting is really inconsistent.

When we met with the community, a lot of people in the community were very concerned about the issue. Then we met with lots of service providers and the feedback was very different, depending on which service provider it was and what role people played in that department. A lot of frontline workers are saying to us that that is a big issue. It is well known where people go to sniff. It is a common theme in the community.

Senator SIEWERT: If I interpret what you are saying correctly, some of the services are not necessarily recognising that there is a problem. Is that the way I should be interpreting that?

Miss Williamson : Some of the people in the Warburton community have been there for a really long time and they were around when petrol sniffing was very chronic, when young people were dying, when it was really at its worst. For people who have been there for quite some time now, it is not as bad as it used to be. So I think the assessment of the situation could be different depending on your length of time there.

Senator SIEWERT: Yes, I understand. Where is the petrol coming into Kiwirrkurra from?

Ms Balmer : It is coming in from the west. There is quite a bit of movement between Port Hedland and Kiwirrkurra. So it is coming all the way from Port Hedland into Kiwirrkurra.

Senator SIEWERT: Again it is being run in?

Ms Balmer : No, that is more about cars. That is the only fuel that they can get.

Senator SIEWERT: So they do not have access to Opal?

Ms Balmer : No. There is nowhere west of Kiwirrkurra that has Opal.

Senator SIEWERT: That has been an ongoing issue, hasn't it? There has been on-and-off discussion about what to do about that.

Ms Balmer : There has, yes.

Senator SIEWERT: Where is the discussion up to?

Ms Balmer : It has not really progressed since we last spoke about it. But, interestingly, when Christine and I were looking at the data, we found that there is probably a higher incidence of aerosol sniffing in Kiwirrkurra now than there is of petrol sniffing. So there has been a reduction in petrol sniffing.

Senator SIEWERT: Can I go back to this issue around data. Senator Moore laughs because we are a bit—

CHAIR: We are a bit data-phobic.

Senator SIEWERT: We did discuss yesterday with a number of witnesses—and a submission also addresses it—there being some dispute over prevalence data. I think you are a part of the process of feeding in data.

Ms Balmer : That is right.

Senator SIEWERT: As we understand it, the department has not released data since February. I forget the proper words, but it basically has some concerns about it. Where do you sit in terms of access to data and whether the prevalence data they have got at the moment is accurate?

Ms Balmer : I would have to agree that there are concerns about its accuracy because it relies on people reporting and, as Christine said earlier, there is a real inconsistency around reporting. Some people just say, 'Yes, I knew about that,' and other people are quick to file a report. I would suggest the prevalence is probably higher than is reported.

Miss Williamson : The other issue around the reporting is that in Western Australia it is a criminal activity and in the Northern Territory it is not. So when you go into a Northern Territory community most people will talk to you about the issue around petrol sniffing and be very open about it, but when we go to Western Australian communities, I think people want something done and they want to raise it as an issue but are worried in doing that.

Senator SIEWERT: About dobbing people in.

Miss Williamson : Yes, that is right, and being held responsible around people getting charged for doing it, with possible removal from the community to treatment services or to detention, depending on the situation.

Senator SIEWERT: In your estimate, how severely does that affect reporting? In other words, how much underestimating do you think that would result in?

Ms Balmer : I do not think we could answer that honestly. I do not think we have enough association, but from the reports that we have access to—people send them to us as well—they are mostly coming from police. They are not really coming from community members.

Senator SIEWERT: Can I ask how that compares with South Australia? In the NT you get reports from community—

Ms Balmer : We do. We get a lot more community reports, and from family members.

Senator SIEWERT: How does that tally with the police reports outside? In the NT and South Australia, do the community reports tally with police reports or do you get more of one than the other?

Ms Balmer : We get more reports in WA full stop.

Senator SIEWERT: I am trying to work out how much is being under-reported in WA if it is just the police, compared to other areas where it is community and police.

Ms Balmer : From observation, even with under-reporting it is fairly representative. There is virtually no sniffing in the Northern Territory and the APY Lands, except on occasions, and they are an outbreak, whereas in Warburton it is fairly frequent. The other thing about WA is that we will often get an informal report from a service provider and then we make the formal report.

Senator SIEWERT: So someone is not being dropped in it.

Miss Williamson : That is right. We have said that to Warburton community. Women's council will be the people who can report it if people are worried about putting their name to a report. One good example of people being reluctant to report, I suppose, is when we went out to Warburton recently—I think in May—we heard from the community, from front-line workers, that, as Lisa said before, 60 to 70 per cent of young people up to age 25 were involved with petrol sniffing on some level, and we spoke with the police.

The police had reported to me and my assistant manager that there was anywhere between two and 10 reports of sniffing per week. When I spoke with the Goldfields VSU Working Group coordinator, Roland, he had not received most of those reports.

Senator SIEWERT: Even though the police had reported them?

Miss Williamson : Yes. Well, he had not received any reports from any services. We have had an increase in reporting since that community visit. I do not know if that is an increase in sniffing incidents or just an increase in reporting.

Senator SIEWERT: Can you go through that figure again? What was it?

Miss Williamson : 60 to 70 per cent of young people under the age of 25.

Ms Balmer : That was a service provider who works with youth. That was her estimation of people coming to her service.

Senator SIEWERT: Still, now?

Miss Williamson : Yes.

Ms Balmer : Yes.

Senator SIEWERT: This is in WA?

Miss Williamson : Yes.

Senator SIEWERT: I want to get back to the bill. What are the reasons we are still seeing this in WA, when, as you just said, we have seen significant improvement in APY Lands?

Ms Balmer : I guess it is a combined problem. They were last on with Opal.

Senator SIEWERT: It has only just gone in.

Ms Balmer : Yes. Like we said, they do not have those really intensive youth services. They have youth activities but they do not have intensive youth support. It is a bigger community so, if there is going to be any sniffing, it is always going to be more there. We also understand that, often, when young people from other communities go there, they take up the activity as well. So APY Lands—and the Northern Territory to a lesser degree—got everything all at once: Opal, youth services, more rec halls, blah blah blah—it all went in at the same time, and that has not happened at Warburton.

Senator SIEWERT: Now we have established all that, I want to go to the bill.

CHAIR: I have just one question before we move away from this and then, Senator Smith, if you have any questions on data, we will knock data off.

Senator SMITH: No data ones.

CHAIR: A decision was made earlier this year by government not to release the data because the data could be not as accurate, or 'robust', as it needs to be. There was no change. The same data had been used before that. So the decision about it not being robust—we were using the data beforehand and now suddenly in February you cannot. There is nothing new happening? I am just trying to find out why the data was available—flawed and open to discussion as it could have been, and should be, because every data set should be analysed, debated and tested as much as it can be. February, it stopped coming on the basis that it could not be robust. But there was not particular thing that said—

Ms Balmer : There was no change in the way we were providing the data.

CHAIR: And you have nothing now.

Ms Balmer : No.

CHAIR: Okay.

Senator SIEWERT: Before I forget, I want to go back to this issue about Yulara. There is some confusion about what Yulara is or is not doing now. Kings Canyon, we understand, has gone back to sniffable fuel. We had heard that Yulara had. We understand they are still stocking Opal, but the issue, from what you have just said, is that they are not locking up the premium anymore.

CHAIR: There are guidelines around how premium was operating, yes.

Senator SIEWERT: I just want to make sure we are clear. It is the issue around premium at Yulara and at kings canyon and kings creek it is the fact that they are stopping stocking.

Ms Balmer : Yulara has always had premium, but it was very regulated.

Senator SIEWERT: Yes. I can remember long discussions we have had about the process for locking it up.

CHAIR: Were you given any reason for that, when you found that out?

Ms Balmer : No. It just seemed to appear. There was no discussion really.

CHAIR: Yulara is also part of the wider coverage area and is involved in reporting to the petrol sniffing task force—is that what they call them? The petrol sniffing group?

Ms Balmer : Petrol Sniffing Strategy Unit.

CHAIR: They report through to there, as the people in WA go. To the best of your knowledge, there was no exchange of information to the petrol sniffing task force about, 'We have changed our processes, and this is why'?

Ms Balmer : Not that I am aware of.

CHAIR: I will follow up on that, but I just wanted to know whether in your discussion you had heard about that.

Senator SIEWERT: How do you think the bill will help? You have said here that it is time to take that step. Can you articulate why you think it is important?

Ms Balmer : After seven years, we can all see the benefits of Opal very clearly. When it is left to an individual's decision, like what has happened at Yallara, the effects can be really detrimental. We have heard that people from Warburton are also now going to Yallara to get fuel. That has opened up their supply chain quite a lot. It has changed the stats in the Northern Territory. If people cannot do it voluntarily then the only solution is to mandate it to cover the region—not just the communities but any access points outside the region. That is really important. We have the proof to say that it works—we have seen it.

Senator SIEWERT: The access points outside the region seem to me to be important. We have the same issue in Lake Nash with sniffable fuel coming in from the two access points. It is not just about what is happening in the area but about other access points, isn't it?

Ms Balmer : It is. It depends on their proximity as well. Lake Nash is in a very unfortunate position in how close it is.

Senator SIEWERT: I know that it is a complicated one, but the issue for, for example, Warburton and Laverton is Kalgoorlie. Some people would say that that is a big city and quite a way away. It raises quite complicated issues, and it is the same with Port Hedland. How do we make sure that we are able to get some sort of level of control over access to fuel from those larger centres?

Ms Balmer : If Opal had been introduced to Laverton earlier we would have seen a change in the pattern of petrol sniffing behaviour. But it has become so well entrenched now, with young people identifying with that community. Everyone knows that that is where petrol sniffing still occurs—they talk about it even in South Australia. There has to be some kind of circuit breaker. Maybe then Kalgoorlie would not be a problem if we can put a stop to the practice in general.

Senator SIEWERT: This is similar to the situation that we heard about from Papunya yesterday, where the identity of some young people is associated with the can and it is cool to be sniffing. Do I understand you to be saying that that is still happening in Warburton to a certain extent?

Ms Balmer : That is right.

Senator SMITH: I am unclear: is it your opinion that the Western Australian government should be doing more to combat petrol sniffing within its jurisdiction?

Ms Balmer : More funding could be directed towards youth programs in general. Petrol sniffing is one of the areas.

Senator SMITH: That would be the case management and family support that you talked about.

Ms Balmer : Yes.

Senator SMITH: Yesterday, we heard that the petrol sniffing issue has been pretty successfully combated across the Northern Territory. But what I am hearing from you is that in Western Australia we might be seeing a bit of an explosion because not enough care and attention has been given to the issue in that part of the world.

Ms Balmer : Only in Warburton. In the Ngaanyatjarra region there are eight communities. Tjukurla is the community that is the furthest west, but Warburton is the biggest community closest to the fuel. The other communities in the Ngaanyatjarra lands are not facing the same issue. They have no access to fuel.

Senator SIEWERT: It is definitely the access to fuel.

Senator SMITH: What is the risk of the Warburton experience poisoning the success that has been achieved in other communities further east?

Ms Balmer : You would assume a risk, but interestingly it has not dribbled out to the other communities. If anything, young people go to that community rather than sniffing spreading to other communities.

Miss Williamson : We only had one example in terms of our reporting where petrol was taken over to Kiwirrkurra. That was once. It was dealt with very quickly. The fuel was confiscated and it was replaced with Opel. That is the only incident. We had one incident in Docker earlier in the year but we could not say for sure where the source of that was.

Senator SMITH: In your earlier evidence you talked about the core and base issues that might lead to petrol sniffing. Could you talk us through that a bit more?

Miss Williamson : Sure. Again, it is important to have a holistic strategy around looking at addressing the issue. When I went Warburton, so from my experience of being there, there are a lot of young people hanging around during the day and they are not engaged in a lot of activity. I do not know much about the school, but I did not see a lot of young people at the high school. Just from my general observation of being there for that visit, I would say that there was not happening for young people. Young people need to have some kind of vision and hope about where they are going to go in the future, and that requires a good education system, some good youth work in place and also some good support for family, to be able to work with family and with young people around the goals that they have for those young people.

In the Northern Territory, we have just sent a couple of young women off to boarding school. They are going to go and get a good education. We are working with the family to support those young women to stay there. I could not comment about what was happening in Warburton, because we do not run a youth program there; all I can comment on is my experience there, and that was my experience: there was not a lot happening for young people. I know that the youth diversion program runs sport and recreation type models after school and on weekends. The police there try to do a blue light disco every Friday night. They do try to engage young people, so I do not think it is for lack of trying after hours, but I would want to have a look at what is happening around schooling and employment for young people—what kinds of programs might be in place to link them back to employment or get them ready for employment.

Senator SMITH: How would you describe the mental health issues of young men in these communities? How much of that is a pre-determinant to utilising petrol to overcome poor self-esteem issues et cetera?

Ms Balmer : It is definitely an issue. Again, Kiwirrkurra is probably one of our communities of greatest concern around suicide and self-harming. It seems to be disproportionately higher in that community. On most occasions, particularly around self-harming, there is an association with sniffing or another form of substance abuse.

Senator SMITH: The Western Australian coroner issued a report with regard to suicide in one of the Kimberley communities. As a consequence of that report, have you seen any change in the attitude of the Western Australian government to those communities that are under your influence in Western Australia?

Ms Balmer : No, not really. Together with Nganampa Health—I think you are talking to them today—we asked the South Australian government for an urgent mental health response to Kiwirrkurra. At best we got a six-week visiting roster. We thought it really required no less than a six-month residential mental health program in that community.

Senator SIEWERT: I would like to clarify one thing. Does Kiwirrkurra have Opal?

Ms Balmer : Yes.

Senator SIEWERT: But the access point is coming in from the west and they only have sniffable, regular fuel?

Ms Balmer : Yes.

CHAIR: You said that people are bringing it in to Western Australia. How much does it cost? Do you know how much petrol is changing hands and at what cost?

Ms Balmer : I have never bought it myself, so I cannot tell you exactly, but I have heard reports of around $50 a litre.

CHAIR: That would last a lot of people a long time.

Ms Balmer : Yes, it would last a long time.

CHAIR: One of the things that we always talk about is how relatively cheap and easy to get petrol is in comparison to other things that people could use for whatever purpose. How much does petrol normally cost a litre in that area?

Ms Balmer : It varies from $2 to $2 80.

CHAIR: It is a particular business, then?

Ms Balmer : Absolutely.

CHAIR: Two dollars something a litre for your car and $50 on the market, so someone is making money.

Ms Balmer : Yes.

CHAIR: We did not warn you of this, but the other inquiry we are doing at the moment is on palliative care and this morning people gave evidence that talked particularly about the work that your organisation has done for palliative care. We were wondering whether we could ask some questions around that. If the person from the youth service in WA is here, the same thing is going to happen to you!

Senator SIEWERT: You may want to take some of these questions on notice.

Ms Balmer : I will do my best.

Senator SIEWERT: Your services were referenced this morning. Some witnesses said you have some dedicated resources to support palliative care. What is the level of those resources and who provides those resources?

Ms Balmer : It comes out of our age program. The person dedicated to that is our age advocacy worker. It was not an area that our members particularly identified as some kind of work that they wanted to do; it came out of need, really. It was that that advocacy work was increasingly about supporting people in palliative care. So we have really turned that into quite a specialist area. We also have funds for respite. We are able to support palliative care plans with brokerage from the respite money.

Senator SIEWERT: So you prepare care plans with your patients?

Ms Balmer : The care plan is usually done by the palliative care team, but we would have input into that because we know the community and we know what support is available. A great story is about a lady who was on dialysis here for 18 years. We supported her to return to community after 18 years on dialysis to pass away. That was a big effort because the community had to be prepared and supported and family had to be prepared. The palliative care team do not really have the resources to do that, whereas we do. So we are able to do the community based work.

Senator SIEWERT: So you work closely with the palliative care services?

Ms Balmer : That is right.

Senator SIEWERT: Central Australia palliative care?

Ms Balmer : Yes.

Senator SIEWERT: How long have you been running that service for your—

Ms Balmer : We have had the age advocacy program since 1998, but we have really just started doing quite particular palliative care in the last two years.

Senator SIEWERT: Where does the funding for the age service come from?

Ms Balmer : DoHA.

Senator SIEWERT: So out of that you then take out a bit for palliative care?

Ms Balmer : That is correct.

Senator SIEWERT: Do you specifically focus on people staying in community?

Ms Balmer : We support a whole range of things. Sometimes it is not possible for people to go, so we will support family coming in to town to be with them. Sometimes it is just a visit. They say, 'I just want to go home one more time.' Sometimes it is to go home to pass away. It really depends on the person and their particular health needs.

Senator SIEWERT: You determine that with the person, the family and palliative care services?

Ms Balmer : Yes, and the clinic in the community have to be an integral part of the plan.

Senator SIEWERT: This morning we were talking about some of the complex issues around developing care plans—working with families, in particular. How have you found that process?

Ms Balmer : I think, like many other things, it has been by example. People have seen it work and they are not so afraid of it anymore. In the case of the woman I talked about who went home after 18 years, that was particularly challenging because people get nervous around someone dying in their house. But we managed to find a very strong woman who was related to her who was prepared to take on the lead role and be responsible for her care. It was such an amazing experience. Everybody felt so happy afterwards. That spreads. Other people hear that story and they are not so afraid of it. They can see that it is okay.

Senator SIEWERT: I want to ask about access to drugs. It has come up around Australia but also specifically here, as have section 100 issues and being able to get access to section 8 drugs. Has that proved a problem for your work?

Ms Balmer : I am not sure about that. That is an area I would not be able to comment on, but I can get back to you if you like.

Senator SIEWERT: If you could take it on notice, that would be great.

CHAIR: And if there is anything else you would like to add on the palliative care process that would be great. Thank you very much, as always, to the NPY Women's Council. They have always given us strong support and information. We do value that.