Warren Snowdon (Lingiari, Australian Labor Party, Shadow Assistant Minister for External Territories) Share this | Hansard source

My question is to the Minister for Indigenous Health. I note the Minister for Health referred to the MBS item number for remote renal dialysis. I want to thank the minister and the government for introducing this new schedule, but I do want to ask about the price that's been agreed. The budget didn't detail the MBS item price, but I understand the schedule is for $590. The national efficient price cost each year for the healthcare services provided by the Independent Hospital Pricing Authority for remote renal dialysis is approximately $690. The amount announced, and that I understand was agreed to, is somewhat less—$100 less, in fact. I understand that currently the amount per delivery of dialysis treatment at the national efficient price going to the NT government, as per the IHPA, is $671.27 for Flynn Drive in Alice Springs. For Nhulunbuy in the Northern Territory, it's $731.83. Dr Paul Lawton, whom you will know, Minister, has been working as a nephrologist across the Northern Territory since 1999. He believes that anything less than $690 per episode of care will not cover the cost needed to provide the Medicare schedule item.

I wonder, therefore, Minister, if you could tell us how you arrived at the scheduled fee of $590. Why is it less than the national efficient price and why is it less than the amount of money being given for renal dialysis services in urban centres, like Flynn Drive in Alice Springs and Nhulunbuy in the north-east of the Northern Territory, when remote dialysis will cost more?

Secondly, if you wouldn't mind, Minister, could you comment on the proposed primary care funding model that you've announced in the budget? I understand the budget papers tell us that the new model will gradually be implemented from 1 July 2019 in consultation with the Indigenous health sector to ensure resources are directed to areas of need. The new funding model will be based on patient numbers, episodes of care, remoteness and need. Are you in a position now to detail what the model will be, how it will operate and who will be disadvantaged by it?

I understand that what the government is proposing may result in a massive disincentive to Aboriginal medical services to increase their uptake of MBS item 715. Higher performing Aboriginal medical services, like the Institute for Urban Indigenous Health and others around Australia, are deeply concerned that they are going to lose out with this model. So I would appreciate it, Minister, if you could tell us what considerations have been given to this possible disincentive and what you'll be doing to address the issue when you provide us with the details of the new funding model.

See this speech in context