Andrew Laming (Bowman, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services and Indigenous Health) Share this | Link to this | Hansard source

Three of the great killers around the world—endemic TB, malaria and HIV—come no closer to Australia's continent than the Torres Strait. TB, with a prevalence of around two per cent, afflicts tens of thousands of Papua New Guinea nationals. Torres Strait Island residents who live in these beautiful northern islands require world-class health facilities to maintain adequate biosurveillance. So it is with great alarm that, over the last six months, that community has seen the bickering between state and federal Labor over who will fund the continued TB screening on those islands.

Looking after PNG nationals is a very important role for AusAID, but nothing is more important for an Australian government than to look after Australian citizens—and Torres Strait Islanders are just that. We would like to see a federal government that acknowledges its important role in treating tuberculosis and monitoring the Torres Strait Islands, which is marked by up to 50,000 border crossings each year, for the arrival of this disease from Papua New Guinea—particularly for drug resistant TB, which is incredibly hard to treat and monitor.

We have seen correspondence emanating from the Queensland government, which is greatly concerned that it can no longer afford to provide these TB services in Boigu and Saibai. We have seen a response from the Prime Minister which effectively refers to some project assistance, which is of course code for AusAID and its underspent budget, to bail out Queensland Health and the federal government's own health responsibilities in the Torres Strait.

The decision last Friday, when the Queensland and federal agencies met and decided to move the Thursday Island clinics into Papua New Guinea, came as a shock. It all seems reasonable on the surface, except that the obvious will now occur: extremely sick PNG nationals will no longer be evacuated to receive better levels of care. More importantly, the biosurveillance that we have always counted on in the Torres Strait Islands will disappear entirely. To expect Thursday Island and its committed clinicians to keep an eye on infectious TB, particularly partially or fully drug resistant TB, is simply impossible. There is a hierarchy of policy approaches: we must first look after Australian citizens. We must make that pledge from both sides of the chamber in this place.

At a second level we must also do everything we can to help Papua New Guinea and, while we do not mind extra money being deployed, it is utterly ridiculous to have transitional meetings about screening for tuberculosis when you have actually shut down all of the clinics and then talk about restarting those clinics in October, when they finally roll out to Daru in Western Province. It is unacceptable to ignore people with tuberculosis but say, 'We are currently recruiting a TB doctor for Papa New Guinea; we are currently looking for a TB vessel to travel down the coast and treat.' It is ridiculous not to even have a TB coordinator in place. Incredible as it is, AusAID is months away from delivering these services on the PNG mainland. So it makes the decision doubly abhorrent that this federal government and the Department of Health and Ageing would fail, in the interim, to continue these TB clinics. All local clinicians ask for—and most of them have been gagged by their government—is a chance to hand over these patients who are already partially treated. It is ridiculous that, up until last Wednesday, patients could travel those three kilometres by sea to Boigu and Saibai and receive treatment but there are no plans to continue the care of those 50 PNG citizens.

Worse still, people are crossing every day of every week, of every year, from Papua New Guinea and we no longer have these TB clinicians, these specialists, who are able to prescribe secondary treatments and tertiary evacuations where required. They are no longer going to be deployed in the Torres Strait Islands at all. To simply think that you can move Australian doctors to Daru, in Papua New Guinea, where they are neither registered nor accredited and expect them to work in conditions like those in Daru in providing support when, the moment those clinicians leave, these patients will of course be left with what is there at the moment. That is, with very few ways of recovering patients and very few ways of continuing care. There is one very important thing to remember about TB and that is that partially treated TB is more dangerous than non-treated TB. The reality is that, once patients become resistant to certain treatments, not only are they almost impossible to treat with the most advanced modern-day treatments but they are also infectious and lead to other people falling ill with the same extremely hard to treat varieties. To expect that treatments like Amykacin, prothionamide and Pasa will be available continuously in Papua New Guinea is simply beyond belief.

We will never, in the next generation at least, see the eradication of TB in PNG. More will always need to be done. But let us remember one thing: we must put Australian citizens first. TI residents are Australian citizens and, above all, they deserve not the penny-pinching and the nickel and diming of federal health, but care, coverage and biosurveillance for tuberculosis.