Peter Lindsay (Herbert, Liberal Party, Shadow Parliamentary Secretary for Defence) Share this | Link to this | Hansard source

I move:

That the House:

(1)

supports the provision of the highest quality health services to Australians;

(2)

notes the continuing advances in medical science, making available new diagnostic tools; and

(3)

recognises the need to extend the availability of Positron Emission Tomography (PET) scanning to regional Australia.

I do not think there will be any disagreement in the House with the view that we support the provision of the highest quality health services to all Australians. It is a fundamental belief on both sides of the parliament that, as a modern country, we should look after our people and provide them with support. There is already marvellous support. Our health facilities are certainly very good indeed when you compare them to some of the other countries in the world. There are continuing advances in medical science making available a huge range of other opportunities for the medical profession to do its job even better. But of course that comes with a cost. Some of the latest drugs and technologies are hugely expensive.

Today I would like to address just one example of those technologies, and that is the PET/CT scanners that are now available. I would like to address that in the context of making them available universally. One of the fundamental tenets of Medicare is that there should be universal access across Australia. Access is not only about affordability; it is also about availability. I understand, as do other members of the House, that you cannot have hugely costly technology out the back of Bourke, but you have to be mindful about where you can have it. Currently, this modern marvel of PET/CT scanning, which is used particularly in the detection of cancers and their spread, is only available in the capital cities. In the whole of the state of Queensland there is only one PET/CT scanner, which is at the Wesley Hospital in Brisbane, to service—

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

The Howard government refused to license them.

Peter Lindsay (Herbert, Liberal Party, Shadow Parliamentary Secretary for Defence) Share this | Link to this | Hansard source

Thank you to the member for Shortland for being bitter and twisted. We had an election and now you are in control of the government and we will make sure that you address this issue. There is only one of these scanners in Queensland, and it is in Brisbane. That means, Mr Deputy Speaker Scott, that the people from your electorate have to travel to Brisbane, as do the people from my electorate. Some of our Queenslanders have to travel up to 2,000 kilometres to get a PET scan. Access should be about availability as well as affordability. Regional Australia does tend to have fewer health services available than our city and urban counterparts. I can understand that. That does not mean to say that we should not all be on guard to make sure that services are provided where they can be.

Differential access to specialist medical services for rural and remote Queenslanders is demonstrated by this information before the House today. We need a PET scanner in Townsville. We have nuclear medicine facilities which will run PET scanning in the city already. We have qualified doctors who can run it, and it can be provided in both the public and the private system. The member for Burdekin wrote a letter to the Townsville Bulletin this morning pointing out that the Townsville Cancer Centre at the Townsville Hospital purchased a new three-dimensional planning system 3½ years ago with PET scanning in mind. He also pointed out that the $300 million that was provided by the Queensland government for oncology in its ‘post-Patel’ reforms has not materialised as far as Townsville is concerned. What has happened to the money? Why have we not seen the Queensland government invest in such a vital technology for our region? The member for Burdekin makes a very valid point.

Queensland is not the only state with this issue, of course. Western Australia and South Australia have only one PET scanner each and Tasmania does not have one at all. We as a parliament need to be thinking about the availability of PET/CT scanners to regional areas. The Cancer Council of Australia in its submission to the inquiry of the Senate Standing Committee on Community Affairs, which resulted in the report Highway to health: better access for rural, regional and remote patients, pointed to poor outcomes for cancer patients in rural and remote areas. There is growing evidence that cancer mortality rates increase significantly with geographical isolation. That is a very worrying piece of evidence. Are my people in Townsville in a situation where, if they do not go to Brisbane for the use of this technology, their mortality rates will increase?

PET/CT scanning does a different job to an MRI or just a straight CT, and it provides our specialists with more information on the spread of cancer and how it can be managed. Dr Stuart Ramsay from Queensland X-Ray is certainly a strong supporter, having said that PET/CT scanning is long overdue in North Queensland. We have a population in the north which is close to 700,000 now. There is certainly a need, a demand and a client base for a scanner, but we do not have one.

We will be waiting to see what the Rudd government does in relation to PET scanning. Minister Nicola Roxon has said that she is considering the current situation. We have to do more than consider. I committed to my electorate that, if the Howard government were re-elected, we would have a PET scanner in Townsville. I would have delivered that. I ask the Rudd government to back my commitment and I ask the Rudd government to ensure that we do get a PET scanner in the city.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

Ms Hall interjecting

Peter Lindsay (Herbert, Liberal Party, Shadow Parliamentary Secretary for Defence) Share this | Link to this | Hansard source

You do what the people of North Queensland want, Member for Shortland. You get a PET scanner up in Townsville. We are the capital city of northern Australia. We do not deserve to be second-class citizens.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

You had 11 years to do it and you did nothing.

Peter Lindsay (Herbert, Liberal Party, Shadow Parliamentary Secretary for Defence) Share this | Link to this | Hansard source

You make sure that our people are looked after. I am going to make sure that we are looked after. Under the standing orders, stop interjecting!

Bruce Scott (Maranoa, National Party) Share this | Link to this | Hansard source

Member for Herbert, I will apply the standing orders.

Peter Lindsay (Herbert, Liberal Party, Shadow Parliamentary Secretary for Defence) Share this | Link to this | Hansard source

And you will do it in a very fine way, Mr Deputy Speaker. There is evidence now that you can assess people after one dose of chemotherapy using a PET/CT scanner to see if that chemo is going to work rather than having to wait for three or four doses. That is beneficial for the patients and for the professionals looking after them. Surely, in this modern day and age we can get a PET scanner in Townsville. PET scanners have applications for all sorts of cancers. We do really need to make sure that we get one in the city. I am advised by the professionals in Townsville that at present many people are simply not travelling to major cities for PET scans. If we had a local scanner then these patients would be more likely to get their medical conditions attended to.

PET scanning was first available on the Medical Benefits Schedule 10 years ago. It is now in all capital cities and it is time that it came to Townsville. The Minister for Health and Ageing also needs to look at the kinds of services that are available under the Medical Benefits Schedule. Currently, they are quite limited and that makes it uneconomical in a place like Townsville to install a machine. There is also not the customer base to fund the machine to make it economical for the city. I ask that the Medical Benefits Schedule be extended to include all of the conditions that could so well be treated by a PET/CT scanner in Townsville.

Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source

Is the motion seconded?

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

I second the motion due to the fact that there were no members from the opposition side in the House.

Peter Lindsay (Herbert, Liberal Party, Shadow Parliamentary Secretary for Defence) Share this | Link to this | Hansard source

Mr Deputy Speaker, I rise on a point of order. An opposition member was not required to second the motion in terms of the procedure. The seconder should have been called on at the end of my speech. The member for Shortland should get her facts right.

Bruce Scott (Maranoa, National Party) Share this | Link to this | Hansard source

Member for Herbert, I called the Government Whip to second it and she has done so.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

This motion before the House on health services raises some very important issues, none more important than the fact that licences for PET scanners under the previous government were very slow to be granted. It is interesting that the member for Herbert is in here arguing for a PET scanner for North Queensland. Under the last government there were numerous applications put in for the licensing of the PET scanner that was already at the Mater Hospital in Newcastle. The Mater Hospital is one of the leading hospitals in treating cancer in New South Wales, and for that matter throughout Australia.

I wrote letters to the previous health minister that were never answered. In consideration in detail of estimates last year I asked the minister if he could give me some information and give consideration to the licensing of the PET scanner in the Hunter. My question to the minister was never acknowledged or answered. The Minister for Ageing at the time summed up the debate and did not choose to deal with that part of the question. The opposition come with very dirty hands from the time that they were in government.

During the election campaign the Rudd government gave an undertaking that we would fund a PET scanner in the Hunter. That undertaking was given on 7 September. It will be no surprise to the House to learn that on 21 September the me-too member for Paterson gave an undertaking on behalf of the then Howard government that they would do the same. If there was ever an example of me-tooism, it was exhibited there. I am pleased to say that the people of the Hunter will have that PET machine licence at the Mater—something that is vital for the region that the Shortland electorate covers and vital for the people who are suffering from cancer.

I understand that this motion goes a lot further than just looking at PET scanners. Rather, it talks about a commitment to quality health care, something that we on this side of the House are totally committed to. It is not something that we have just discovered since the last election; it is something that we have been fighting for for many years. Unfortunately, under the previous government, quality health care was something that was delivered to just a few.

In the last parliament, I was a member of the Standing Committee on Health and Ageing at the time the report The blame game: report on the inquiry into health funding was tabled in parliament. I was deputy chair of that committee, which made a number of very important recommendations and identified a number of problems within the health system in Australia. That report was tabled in November 2006 and, believe it or not, by the time the last parliament—

Bob Baldwin (Paterson, Liberal Party, Shadow Minister Assisting the Shadow Minister for Defence) Share this | Link to this | Hansard source

On a point of order, Mr Deputy Speaker: the member for Shortland has just misrepresented my position.

Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source

That is not a point of order. There are other times to do that and the member for Paterson would know that.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

I understand that the member for Paterson is very sensitive about his failure to get the previous government to fund a PET machine in the Hunter until just before the last election. What I am talking about is the overall delivery of health services to people in Australia and the recommendations of The blame game. This report made a number of very important recommendations, which the government of the day, the Howard government, failed to respond to. It made a recommendation that this parliament develop and adopt a national health agenda. It made recommendations that we identify policy and funding principles and initiatives. It also identified the fact that there was a chronic shortage of health professionals and doctors in Australia.

While the Howard government refused to respond to this report, the Rudd government will. In the policy which it took to the last election, it gave an undertaking that it would invest $2 billion in a national health and hospital reform plan. This is quite different from what the Howard government did—they actually ripped money out of hospitals. This reform funding program will include additional funding to state and territory governments if they achieve agreed reform milestones, similar to the system of the competition policy payments designed to reward states and improve their performance.

This is a different approach to health. This is an approach that stops the blame game. This approach brings the states, territories and the Commonwealth together. So instead of standing up in this parliament and blaming the states for the problems, instead of standing up in state parliament and blaming the Commonwealth for the problems, we are joining together the states and the Commonwealth to work for the delivery of quality health services to the people of Australia.

I can speak with some authority on this, having previously been a member of the state government when there was a coalition government in power in Canberra. At that time, I made a speech stating where we identified problems at the Commonwealth level. I have sat here and heard speaker after speaker blame the states for all the problems that exist with health. What happens? Absolutely nothing. All that happens is that the member who stands up in whatever parliament feels good and puts out a media release, but the people of Australia, who we are representing in this parliament, miss out on the quality health services they need. We need more doctors. We need to ensure that the people of Australia get the type of health care they deserve. We do not need any more governments using weasel words to get away from the fact that they need to make sure that the money for health goes to the delivery of health services, rather than promoting their own health agenda.

Mal Washer (Moore, Liberal Party) Share this | Link to this | Hansard source

I must first apologise to the member for Herbert. I was not here in time to second the motion, so I apologise. Unfortunately, being the doctor here, I was treating someone and got distracted. They did not need a PET scan, fortunately.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

And treated them very well, I’m sure.

Mal Washer (Moore, Liberal Party) Share this | Link to this | Hansard source

Thank you. I rise to support the motion. It is essential that the highest quality health services be provided to Australians in a timely fashion. It is critical that the best diagnostic tools be made available to Australians. There is no doubt that accurate diagnosis in the early stages of a disease is vital for effective treatment and management. I want to talk about this machine. Bear with me—I do not want to make it too technical, but I think it is important that members understand what it is.

Positron emission tomography or PET scanning, which produces a three-dimensional image of the functional processes of the body, is one of the new diagnostic tools we have—new in only the last decade or so. The system produces pairs of gamma photons—that is, light—emitted indirectly by a positron-emitting radioisotope. It is interesting to note that a positron is the antimatter counterpart of an electron, making a PET scanner one of the significant applications of quantum physics.

This radioisotope is introduced into the body, usually via the blood circulation, on a metabolically active molecule like a sugar. The common sugar they use is called fluorodeoxyglucose—for the sake of simplicity, we will call it FDG. This then concentrates in the tissues of interest, like cancer cells, which rapidly take up the glucose because their mitochondria—that is, the powerhouses of the cells that make our cells work—need the glucose to be active. In these cells there is hyperactivity, overactivity, due to their rapid growth, and so it concentrates in the tumour cells.

The positron-emitting isotope is thereby concentrated in these tissues and the positron is eventually released. When it encounters an electron—electrons are in all of the cells surrounding it—it annihilates rapidly, producing a pair of photons—bursts of light—which move in opposition directions, allowing for localisation of where the event occurred. Thereby we are able to accurately show where the metastasis—the spread of the tumour—is positioned.

PET scans are increasingly read alongside computerised tomography, or CT, scans, the combination giving both anatomic and metabolic information on the illness. Limitations to the widespread use of PET scans arise from the high cost of the cyclotrons needed to produce these radioisotopes. Also, the chemical synthesis apparatus to produce the radiopharmaceuticals necessary for the procedure is complex. As the member for Herbert said, wider use would make this more cost-effective. The PET scanner is valuable for oncology because of the cancer’s mitochondrial forms—the powerhouse forms. This is of particular value in Hodgkin’s and non-Hodgkin’s lymphoma and lung cancer. It is proving very useful with cancers like breast and prostate, particularly if disease recurrence is suspected.

Oncology scans using this sugar, or FDG, make up over 90 per cent of all PET scans in current practice. PET scanning is used in neurology to indirectly measure blood flow in the brain and, for example, it can be used to differentiate Alzheimer’s disease from other dementing processes. It may also enable an early diagnosis of Alzheimer’s with new techniques that can visualise the amyloid plaques, which are the essential part of Alzheimer’s. PET is also used for localisation of seizure focus in epilepsy, which of course is necessary if we are going to treat epilepsy by applying surgery, which is a more common means of treating epilepsy. It is proving of increasing value in cardiology, neurophysiology, psychiatry and pharmacology. I can tell the House we will hear much more about this potentially magnificent tool for medicine in the future.

Damian Hale (Solomon, Australian Labor Party) Share this | Link to this | Hansard source

I congratulate you, Mr Deputy Speaker Scott, for your appointment to the Speaker’s panel. Today I would like to use my contribution to set out the Rudd government’s plan for improved health services for my electorate of Solomon. I certainly concur with the member for Herbert about the isolation people experience at times with our health services. I was pleased last September when I met with the then shadow minister for health to discuss the Rudd government’s commitment to a GP superclinic in Palmerston. The Rudd government’s commitment will see a contribution of up to $10 million towards the creation of a GP superclinic to provide better health services to Top End families. I have already met with the office of the Minister for Health and Ageing and indicated that I see the delivery of this commitment as a fundamental priority for the working families of Solomon. The minister has informed me that consultation will commence in April with the local community and local health professionals. I would also like to thank the Northern Territory Department of Health and Community Services for the preliminary work they have been undertaking on this important project.

Once completed, the Palmerston GP superclinic is expected to include: 24-hour GP services; chronic disease and complex care management services; outpatient services provided on an outreach basis from the Royal Darwin Hospital such as cancer and oncology support services, obstetrics, gynaecology and ophthalmology; a greater range of allied health services such as physiotherapy, dieticians and podiatry than is currently available; and dental services.

Speaking of dental services, I am pleased with two important commitments that the Rudd government has made to the community in this vital area. I was quite shocked to learn after my election that 3,957 Territorians are on dental waiting lists. Two important commitments outlined by the Rudd government will see, firstly, the establishment of the Commonwealth Dental Health Scheme, which will provide $290 million for up to one million additional treatments. Secondly, the government will introduce a teen dental plan that will provide a $150 tax rebate to help families in receipt of family tax benefit part A. These are both practical solutions to help families in the area of dental care. People’s teeth are so important to their overall self-confidence, and I think this investment is great news for families.

Federal Labor is committed to ending the blame game—I know that a lot of that happens with regard to health between the states and territories and the Commonwealth—and to improving health care for all Australians. I look forward to working with the Minister for Health and Ageing to deliver Labor’s $1.5 billion national health reform plan to improve health and hospital services around the country. Solomon is no different to other electorates. Basic health care for all Australians is vital. Probably one of the biggest issues that I have discovered while getting around in my electorate and talking to people is the lack of health services, especially in the Palmerston area. It is a growing area. Usually kids will get crook at the most inopportune times—and having to drive from Palmerston to the Darwin Hospital at 2 am is an issue for people. I look forward to working with the minister. I thank her for the way she has kept me informed of the progress of the plan and I look forward to delivering this for the people of Solomon.

Andrew Southcott (Boothby, Liberal Party, Shadow Minister for Employment Participation and Apprenticeships and Training) Share this | Link to this | Hansard source

Congratulations on your election to the Speaker’s panel, Mr Deputy Speaker Scott. I am very pleased to speak on the motion which has been moved by the member for Herbert. The first limb of the motion supports the provision of the highest quality health services to Australians. That is an aspiration that all members of this House would hold. Australia enjoys one of the best health systems in the world by any measure. We have amongst the highest life expectancy in the world. We are comparable with Sweden and Switzerland and ahead of comparable countries like the United States, the United Kingdom and New Zealand.

Our survival rates for many cancers are comparable with world’s best practice. We have specialised centres for the treatment of things like colorectal cancer and breast cancer, and our survival rates are extremely high there. We enjoy low child mortality, low infant mortality and low maternal mortality. Again, these are indicators of a very strong health system.

As the member for Herbert has correctly pointed out, our health is unequal. It was highlighted last week that we have a whole range of measures for Indigenous health and that this group has much lower health outcomes than the rest of the population. The Australian Institute of Health and Welfare, in a report in 2005, made the well-known point that people who live away from major cities and for whom access to health services is restricted may be disadvantaged as a result of different access to specialist surgery and medical care services. This has long been noted by organisations such as the Australian Medical Association and the National Rural Health Alliance.

PET technology is not applicable everywhere. Queensland is the most decentralised state and there are major population centres all up the coast in Queensland. There are very good arguments that can be made for the extension of PET technology. As previous members—most notably the member for Moore—have said, there is a whole range of applications for this technology. It is useful in diagnosis, it is valuable in treatment and it can be used to monitor the effect of surgery, radiation therapy and chemotherapy. So it is only going to be applicable in a larger centre. MSAC, the Medical Services Advisory Committee, is looking at the application of PET technology in a whole range of new areas stage by stage. It is looking at whether it can be extended to ovarian, melanoma and colorectal cancer, the second stages of oesophageal, gastric, head and neck cancer, third-stage lymphoma and fourth-stage sarcoma and glioma.

We do have evidence based medicine. We do have the Medical Services Advisory Committee. I believe we need to maintain the rigour of those bodies. Having said that, there has been quite a debate in the Medical Journal of Australia, most notably in 2004, that Australia does not have enough positron emission tomography machines. We need a much larger number. There are currently only eight eligible centres in Australia. As the member for Lyons said, there is not one in Tasmania, but I understand the Labor Party has committed to introducing one in Hobart.

I welcome the opportunity to speak on this motion. PET technology is a useful technology and, if supported by the evidence, it should be more widely available and should be available for a much greater number of indications.

Sid Sidebottom (Braddon, Australian Labor Party) Share this | Link to this | Hansard source

There is no doubt that health is an issue that dominates our kitchen table discussions, nowhere more so than in my electorate of Braddon. We are all aware of the growing demands on the provision of health services, and that is obviously for a variety of reasons. There is a growing demand and pressure on service delivery across the board—attracting, training and maintaining a sufficient workforce in particular, and nowhere more so than in rural and regional Australia—and also on the increasing equipment, material and capital costs associated with the provision of health services. Indeed, in relation to the latter, the provision of MRI equipment and PET scanners are special examples of this. Other speakers have highlighted this. I was very pleased that federal Labor, in its health and wellbeing policies for Tasmania in general and on the north-west coast in particular, honoured the MRI licensing commitment of the former government for the north-west coast.

A $3.5 million PET scanner is being set up in Hobart to service the state. It is a very valuable and very necessary service. In addition, federal Labor offered Tasmania a $50 million health and wellbeing package above and beyond the normal health agreement funding. I am very pleased to be able to put on the record some of those health initiatives, particularly for the north-west coast. Most important—and we share this with the rest of Australia—is Labor’s commitment to reduce elective surgery waiting lists. I was very pleased with the additional $8 million that was given to Tasmania for an additional 895 procedures to try and tackle these long waiting lists. That is something we do not need to be blaming each other for. We just need to do something about it.

I was very pleased with the Commonwealth’s reinvigoration of the dental health scheme, particularly for my electorate of Braddon, which, unfortunately, has one of the highest waiting lists for dental services, and the $81 million commitment to try to get more nurses back into the hospital system. More specifically, on the north-west coast I was very pleased to be part of a collective that lobbied federal Labor to provide services—for example, the $7.7 million commitment to a new cancer treatment unit, preferably on the north-west coast.

Peter Lindsay (Herbert, Liberal Party, Shadow Parliamentary Secretary for Defence) Share this | Link to this | Hansard source

Mr Deputy Speaker, I draw your attention to the state of the House.

Bruce Scott (Maranoa, National Party) Share this | Link to this | Hansard source

Order! In accordance with standing order 55(c), the House will be counted at the conclusion of the grievance debate if the member so desires at that time.

Sid Sidebottom (Braddon, Australian Labor Party) Share this | Link to this | Hansard source

I want to use this time for what it was meant for, and that is to raise issues that affect my electorate and this country. If you want to make a joke of it, mate, leave! Do us all a favour and get out of the system. There is $7.7 million for a new cancer treatment unit, preferably on the north-west coast. We have wonderful commitments of up to $5 million for a GP superclinic in Devonport and $2.5 million for an after hours doctors clinic in Burnie. Very importantly, there is a $60,000 contribution to a new Penguin Medical Centre. Of course, that will help particularly in its relationship to the nursing homes nearby.

I would also like to point out that the Mersey hospital was very much part and parcel of this election. Labor, I am proud to say, have made the decision to honour that commitment. We are working away to do that and I give our assurance that we want to make those services the best possible for the people in the Mersey region. (Time expired)

Bruce Scott (Maranoa, National Party) Share this | Link to this | Hansard source

Order! The time allotted for this debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.