Gordon Reid (Robertson, Australian Labor Party) Share this | Hansard source

I want to say how proud I am to be part of the Albanese Labor government alongside Minister Burney and other colleagues in talking about how we are investing in a better future for Aboriginal and Torres Strait Islander people right across our country, from my home electorate of Robertson to the Northern Territory, where the member for Lingiari is from, right across our vast country. In particular I want to focus on our investments in First Nations health care. In First Nations communities Aboriginal and Torres Strait Islander people suffer some of the worst rates of chronic illness, not just chronic illness but also exacerbations of those chronic illnesses that are leading to presentations to emergency departments and requiring broad-based care or, even worse, in intensive care and beyond. Some of those healthcare investments in the First Nations space include tripling the bulk-billing incentive, which I will touch on in a minute, and the support to deliver dialysis units for First Nations communities in regional and remote Australia for people with end-stage renal failure.

End-stage renal failure, for those in the chamber who do not know what it is and want more information, is a debilitating chronic illness that will inevitably require dialysis or renal replacement therapy. We're talking about patients with advanced chronic kidney disease, and in First Nations communities that is normally the result of uncontrolled hypertension or high blood pressure and also uncontrolled type 2 diabetes that has not been treated with lifestyle modification or oral antihyperglycemics, which are tablets, or insulin therapy. That leads to irreversible kidney damage then requiring renal replacement therapy or dialysis. Part of this investment is making sure that our First Nations communities can access this dialysis and these medical treatments.

If we have patients with advanced chronic kidney disease that's left untreated, particularly those who have end-stage renal failure, we start to see what are called uraemic symptoms and volume overload. To break that down, volume overload is where the body cannot get rid of the fluid and therefore the fluid will build up in the legs causing what we call oedema, which can then cause infected wound and like and can track up to the lungs and cause pulmonary oedema, essentially meaning the patient drowns if that is not treated. The other aspect is the uraemic symptoms. There are three big symptoms that we talk about in renal failure. One is pleurisy, an inflammation of the lining of the lungs. That not only causes severe, debilitating pain when the patient is breathing at rest but also pericarditis, which is an inflammation of the lining of the heart causing severe chronic chest pain that is often unable to be treated. Finally, and this is quite a severe silent symptom of end-stage renal failure where the patient has not undergone dialysis or renal replacement therapy, there's encephalopathy where the toxins build up in the blood and the body and then the patient becomes delirious, which can result in significant harm to the patient and their family as well as the healthcare staff supporting the patient through the illness.

These are just some of the examples as to why dialysis is necessary in our community but, in particular, why dialysis is important in our First Nations communities. With higher rates of high blood pressure, higher rates of high cholesterol, higher rates of type 2 diabetes where tablets, insulin and lifestyle modification just do not exist, that is why we need access to these vital medical services because, if we do not provide those medical services, there will be significant morbidity and, even worse, significant mortality. We know that macrovascular complications, including heart attack and stroke, result from end-stage renal failure and diabetes, which is part of that disease profile.

Also, to move to the bulk-billing incentive, this will have a positive impact for just over 300,000 First Nations people with concession cards. I don't have to tell those in the chamber the benefits of primary care and general practice. It's all about prevention. It prevents disease from becoming an acute, exacerbated illness where someone is going to require the highest level of care in our emergency departments or in our intensive care units. That is just one way that the Albanese government is assisting our First Nations communities. I want to thank the ministers for their hard work and support in this area and the Prime Minister for his work in First Nations support.

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