Jane Prentice (Ryan, Liberal Party) Share this | Link to this | Hansard source

I move:

That this House:

(1) recognises that BUSHkids is a non government, not for profit community organisation which offers a range of free allied health services to children and families living in rural Queensland;

(2) notes that in 2015, BUSHkids celebrates its 80th year of service to the people of rural Queensland;

(3) acknowledges that BUSHkids relies on generous donations from the general public in order to be able to continue its valuable work;

(4) notes the launch of Friends of BUSHkids, an initiative to reinvigorate community involvement in promoting and fundraising for BUSHkids services; and

(5) encourages all Queensland Members to support the Friends of BUSHkids initiative in their electorate.

My electorate of Ryan is full of good people doing good things for others. Today I want to thank, congratulate and acknowledge a wonderful group of people who spend a lot of their lives trying to make things better for young children and their families in regional Queensland. The Royal Queensland Bush Children's Health Scheme, otherwise known as BUSHkids, started in 1935 because the Governor of Queensland was worried about the health and wellbeing of sick children in the bush during the Great Depression and a long drought. It has continued because good people recognised future generations would suffer more complex and pressing medical conditions unless something was done to provide bush kids with better access to similar primary health services to those available in our cities.

BUSHkids is a not-for-profit organisation that for 80 years has provided better access to primary health care for children and their families in regional and rural areas right across Queensland. It is supported by a wonderful group of community spirited healthcare professionals and administration staff located in the heart of my electorate, in Toowong.

The scope of practice for BUSHkids was slightly different in its early days because the needs of sick children in rural and regional areas and the model of care available to them was found wanting. In its early days, for example, BUSHkids dealt with physical problems—like heart defects, lazy eyes, cleft palates, malnutrition, dentures and prosthetic limbs—because access to primary health care in remote areas of Queensland was limited or non-existent and sick children had to travel long distances for the care they needed. Sadly, for those in faraway pockets of Queensland, the time required for travel to get to major regional health centres and the disruption this caused to a struggling family business often meant a sick child did not get the care they needed. We know that a lack of access to primary healthcare services will result in poorer health outcomes, unnecessary and potentially avoidable complications and increased hospital admissions. Put simply, people with limited access to primary health care are also significantly disadvantaged in relation to preventative health care.

Chronic disease is not just an issue for old people, because the development and impact of chronic diseases and their risk factors is a lifelong process. Chronic disease is a major cause of loss of life and disability in all age groups, varying from more than 70 per cent in children up to the age of 14 and up to 95 per cent for elderly people over 65 years of age. The prevention of chronic disease requires the implementation of interventions that target young people as well as broader interventions for the whole population, wherever they live and work. Importantly, health systems that include strong primary health care are more efficient and have lower rates of hospitalisation, less health inequality and better health outcomes, including lower mortality.

In effect, we now know that establishing stronger personal and community links to primary healthcare information and services in regional and rural Queensland will reduce preventable illness and its cumulative impact on a person's health and wellbeing, as well as hospital demand. That more and better primary healthcare services are now accessible to sick children and their families in rural and remote Queensland is in part due to the pioneering spirit of the BUSHkids early health practitioners, their patients and their supporters. They have a long record of distinguished service to rural and remote communities in Queensland. For example, BUSHkids has played a vital role in helping sick and troubled children get better and keeping families and communities together. BUSHkids has helped nearly 45,000 sick children in remote and rural Queensland get the health care that they need. This is a truly remarkable achievement.

While access to better primary healthcare services for children in regional and remote Queensland has improved greatly over the past 80 years, there is still a need for better access to allied health services. And BUSHkids relies on generous donations from members of the public in order to be able to continue its valuable work.

Health care itself is on a journey where the emphasis of care is shifting to extending wellness and improving health. The link between health and education runs both ways and is far more complex than simple cause and effect. Poor health impacts on children's ability to learn and vice versa. This is evidenced by the high levels of ear disease and permanent hearing damage experienced by young Indigenous children, with hearing loss leading to linguistic, social and learning difficulties as well as behavioural problems in schools. This in turn reduces educational outcomes, which will have lifelong consequences for employment, income and social success. Through greater responsibility for and ownership and understanding of the importance of personal health management at a younger age, a much better long-term health outcome for young people and their families, as well as the taxpayer, is achievable. Put simply, prevention of disease or early intervention so an illness does not grow into an acute episode is the best outcome for the patient, their family and the taxpayer.

BUSHkids is uniquely placed to continue its crucial role in early identification, prevention and intervention in respect of health, education and social issues that affect children and their families in rural communities. In rural and remote Queensland today, for example, there is a growing trend in early childhood development and behavioural issues associated with broader family and community challenges such as fly-in fly-out work, ongoing drought, family break-ups and drug and alcohol related social issues. In responding to this challenge and recognising the range of primary health services available, BUSHkids now offers early intervention strategies that include parents, family and community education.

Complementary models of care that include allied health and other primary healthcare management alternatives are effective in improving clinical management of patients and freeing up specialist appointments. BUSHkids now has fully supported centres based in Emerald, Dalby, Bundaberg, Mount Isa and Warwick and a sixth centre at Inglewood serviced by a family healthcare support worker. Dedicated allied health professionals in regional Queensland provide early intervention, development and therapy services to improve the health and wellbeing of children with, or at risk of, developmental and other difficulties. The BUSHkids speech language pathologist reduces the incidence and impact of communication and eating difficulties through assessment, diagnosis and treatment of children with speech, language, voice fluency, literacy and eating difficulties. BUSHkids occupational therapists assess the skills which can impact on a child's participation in their self-care, play and school activities. BUSHkids psychologists help reduce the incidence and impact of emotional, social, academic and behavioural difficulties. And BUSHkids family health support workers support allied health professionals by providing a range of education and school development programs to children and their parents and/or caregivers. And, with early intervention facilitators located in Agnes Water/Miriam Vale, Kingaroy/Nanango and Stanthorpe, BUSHkids provide even more rural and regional Queensland children and their families with better access to allied health professionals in partnership with other government and non-government healthcare providers.

Madam Deputy Speaker, the need for our BUSHkids programs is compelling, and I am sure your own electorate of Durack would benefit from these services. Increasing evidence shows we should front-load early intervention and innovative primary care management options to when and where people need them, instead of moving a very expensive ambulance to the bottom of a cliff. Indeed, the World Health Organization has long argued 'resource allocation clusters around curative services at great cost', thereby 'neglecting the potential of primary prevention and health promotion to prevent' the vast majority of the disease burden.

I am honoured to be the patron of Friends of BUSHkids in Brisbane, which is a crucial link between city and country. I applaud BUSHkids for its 80-year record of service, for putting the changing health and wellness needs of rural kids at the centre of its scope of practice and for remaining true to the timeless principle of Hippocrates:

The function of protecting and developing health must rank even above that of restoring it when it is impaired.

Friends of BUSHkids is a community based group designed to promote engagement with the services BUSHkids provide, so it is at the forefront of emerging health issues and is the best possible advocate for improving the health and welfare of rural children. I encourage all members, particularly Queenslanders, to support the Friends of BUSHkids in their electorates, and I commend this motion to the House.

Melissa Price (Durack, Liberal Party) Share this | Link to this | Hansard source

Is the motion seconded?

David Coleman (Banks, Liberal Party) Share this | Link to this | Hansard source

I second the motion and reserve my right to speak.

Stephen Jones (Throsby, Australian Labor Party, Shadow Parliamentary Secretary for Regional Development and Infrastructure) Share this | Link to this | Hansard source

I thank the member for Ryan from bringing this matter before the House and congratulate her on her advocacy for this important organisation providing services to people in rural and regional Queensland. I cannot be as kind to the policies of her government when it comes to providing services to people who live in the bush—but more of that shortly.

I want to touch on some of the problems that are confronting people who are living in rural and regional Australia, particularly the healthcare problems, because the further you get from the capital cities the shorter is the average lifespan. In fact, compared with major cities, life expectancy in all regional areas is one to two years shorter, while in remote areas it is a whopping seven years shorter. People in the bush are more likely to engage in the sorts of behaviours that are associated with poor health. There are higher rates of smoking, for example, and, because of the great distances that need to be travelled between towns, often less physical activity. People living outside of major cities are also more likely to be admitted to hospitals for conditions that could have been prevented through access to non-hospital services and care services such as the primary care services that the member for Ryan spoke about in her contribution.

When you look at the incidence of chronic disease in regional and remote areas, females are 1.3 times—that is, 30 per cent—more likely to be reporting suffering from diabetes. The prevalence of asthma in inner regional areas is significantly higher than in major cities. Males in regional and remote areas are 1.4 times more likely and females just as likely to be reporting dangerous levels of bronchitis than those who are living in major cities. In regional and remote areas, males and females are 1.3 and 1.2 times, respectively, more likely to be reporting suffering from arthritis than people within capital cities. When it comes to cancer, compared with major cities the incidence of cancer is significantly higher in all regional areas. Melanoma is responsible for the large proportion of the excess new cases of cancer in regional areas. Its prevalence is 60 per cent greater, in fact, followed by colorectal cancer at 16 per cent, lip cancers at 15 per cent and lung cancers at 12 per cent. So there is a gap.

If we go to the area of mental health, we can see we have a significant problem in regional and rural Australia as well. Males in outer regional and remote areas are significantly more likely, 1.2 times more likely, to show high to very high levels of psychological distress when compared to their counterparts living in the major cities. Nationally, in 2012 over 2½ thousand people died from suicide, almost double the national road toll. Tragically, the suicide rate is 66 per cent higher in regional areas than in our cities.

When you look at dental care and children, six-year-old children in some remote areas have much higher rates—between 30 and 60 per cent higher rates—of decayed, missing or filled teeth than their counterparts in areas with much higher access to dental care. Twelve-year-old children in moderately accessible areas and very remote areas also tend to have more decayed, missing or filled teeth than their counterparts in highly accessible areas—in this instance, between 20 and 30 per cent higher rates.

Madam Deputy Speaker Price, against this backdrop—this whopping gap between health outcomes in areas such as your own and in areas such as parts of my electorate and health outcomes enjoyed by people in metropolitan cities—you wonder: why would any sane government introduce policies which were designed to make it harder for people to access their health professionals, particularly in the primary care setting? But that is exactly what this government has done in its first 2½ years.

Consider Medicare Locals. We created 61 Medicare Locals when Labor was in government. Their objective was to look at the areas where there were chronic health issues or gaps in health service delivery and to ensure we could put in place the sorts of services that were needed to close those gaps. They put in place the coordination of local services. They undertook independent reviews to ensure that, where new services were put in place, they were doing exactly what they were designed to do. But the former health minister never really understood what Medicare Locals were all about. He promised to abolish them, then he promised not to abolish them and then, after getting into government, he did abolish all of them and replaced them with new Primary Health Networks—about 31 around the country.

Those Primary Health Networks have significant problems. Some of them are far too big. For example, there is one Primary Health Network for the entirety of North Queensland—an area of greater size than the whole of Victoria. One PHN in your state, Deputy Speaker, covers 99 per cent of the state. There are only two PHNs covering the whole of South Australia, and there are significant problems with the design and the borders in a lot of those areas. In Albury-Wodonga, two rival state governments have managed to put in place a single health district spanning both states—and the Medicare Locals that were put in place mimicked that arrangement. The minister did not like it. He split it up and replaced it with two Primary Health Networks. It is opposed by everyone in those areas and it is creating more barriers to delivering and accessing healthcare. It was a folly, a massive waste of time and a massive waste of resources—again making it harder for people in rural and regional Australia to access the services they need.

Next I point to hospital cuts. The Liberal-National government ripped more than $57 billion in funding from public hospitals. They axed the national funding agreement with the states. State premiers of whatever political flavour are now warning that these cuts are unsustainable—leading to the closure of beds and putting many rural and regional hospitals, and hospital based services, at risk.

Then of course we have the GP tax and the GP tax by stealth—by which I mean the rebate freeze. They are hell-bent—these are harsh words towards your government, Madam Deputy Speaker—on destroying the Medicare system and, importantly, the GP practices that are the mainstay of healthcare provision within rural and regional Australia. The Medicare rebate freeze has been described by the Australia Medical Association as likely to see less bulk-billing and the possibility of a co-payment by stealth. It is going to drive the costs of medical services up in rural and regional Australia—once again making it harder for those people who most need those services to find access to them. I could add to this the $800 million that has been cut from the Health Flexible Funds. Importantly, these funds are funding regional health programs and remote health programs, along with a range of other services, including Aboriginal and Torres Strait Islander health services.

Against the backdrop of all of these cuts, I welcome the fact that the member for Ryan has put the issue of bush kids on the parliamentary agenda, but I have to be harshly critical of the policies of her government for what they are doing in attacking healthcare services in the bush for people of all ages. We understand the critical importance of allied health services for people in the bush. It is sometimes very difficult, for love or money, to get an audiologist, a dietician, a psychologist or occupational health services in a remote area, because there is not much of a private market for those services—I would add to that physiotherapy services in remote Australia. The role of the hospital based services, the role of the Primary Health Networks and the role of those services funded by the Health Flexible Funds are absolutely critical.

I use the opportunity of this parliamentary debate, which goes to rural and regional healthcare provision, to again challenge the minister. I have done this on several occasions. I ask you to guarantee that not one dollar of the $800 million worth of cuts to the Health Flexible Funds will fall upon those services that are currently being provided to rural and regional Australia. That would be a good outcome.

Lisa Chesters (Bendigo, Australian Labor Party) Share this | Link to this | Hansard source

I have to say, it is a little bit shocking that the member for Ryan has not even been able to get the members of those electorates which benefit from BUSHkids to even come in here and speak to this motion. It is a good motion. It is important to acknowledge the great work that this organisation does in ensuring that the most vulnerable in our regional communities receive the medical help and the care that they need, when they need it. It is pretty shocking that the government members of parliament are not here to stand up and say that they agree with the member for Ryan and that they support this motion that she has put forward to acknowledge the hard work that BUSHkids does in their own communities. Perhaps it is because they are a little bit embarrassed at this government's record when it comes to regional health; a record that the previous speaker has outlined. On coming to office, this government cut billions—absolutely billions— from the health portfolio in their first budget. Through various measures, they have basically made it very hard for regional health services to deliver help and support when people most need it. In regional communities, we are starting to see the real impact of those cuts starting to be felt on a day-to-day basis.

Firstly though, let us take a moment to acknowledge the great work that BUSHkids does. They are in the core business of providing allied health services. They focus on children's development. They believe in early intervention. They are a not-for-profit organisation providing primary health care to children and their families in rural Queensland communities. I grew up in regional Queensland, and I know the distances that people would quite often travel to seek allied health services. BUSHkids do an amazing job of education, in making sure that, where children might be at risk of poor health, educational or social outcomes, they engage the schools and they engage the local community. They make sure that children most at risk receive the help that they need. As I have said, their core business is allied health. They focus on speech-language pathology, they focus on occupational therapy, they focus on psychology, and they focus on family health support workers. As a previous speaker has said, these kinds of support services would be welcome in Victoria. The not-for-profit based model that we have in Queensland is something that my own state could benefit from—because, right now, regional communities in Victoria are struggling, and they are struggling as a direct result of policies that this government has introduced.

The most shocking attack has been on Medicare. The impact of this government's attack on Medicare is being felt throughout regional Victoria. The freeze to the indexation of the Medicare rebate is having a big impact on allied health services. In my own electorate just recently, a couple of clients of Burra Consulting Services have been in touch to say that they received a letter asking them to pay $165 up-front to access services—yes, they would receive the Medicare rebate, but they would have to pay up-front and then receive the rebate afterwards. To a young person who might be accessing these services, or to a family that has a young person needing these services, it is hard to find that $165 to pay up-front. But this is what some regional services are doing—because this government has frozen the Medicare rebate. We know that CPI is going up by 1.3 per cent, that the Wage Price Index—even though it is at the lowest rate it has been for a while—is still at 2.3 per cent, and that the ABS reports an increase in hospital and medical costs of 6.5 per cent. So the costs of running these services are going up, yet this government has cruelly frozen the Medicare rebate indexation, meaning that GPs, allied health services, and health services in regional areas are having to put up their costs. If we really want to see help for BUSHkids then this government needs to reverse its shocking track record on health. It needs to be investing and not cutting funding to rural health services.

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the motion put forward by the member for Ryan about supporting BUSHkids. I note the member for Ryan is my next-door neighbour in an inner city electorate, but I also note the contribution from the member for Bendigo—a Queenslander by birth but representing the seat of Bendigo in Victoria—and also the contribution from the member for Throsby from regional New South Wales. It is great to have people from the Labor Party supporting this motion. It is sad to see the silence from the LNP from Queensland when it comes to this great motion put forward by the member for Ryan. Obviously with an inner city electorate I do not have as many bush kids, but I know that many of them receive services in my electorate with the PA Hospital right across the road from the electorate of Moreton, but also QEII hospital and many other services that I will touch on.

BUSHkids do a great service. Having grown up in St George, I know that they do not do outreach programs to St George, but they are only just down the road in Warwick, Inglewood and Dalby, and they service all of Queensland. If we take our minds back to 1935 when we had a slightly different Queensland—it is still a very decentralised state, the most decentralised state—the difficulties of living in these far-flung areas when you have a child that needs medical attention were a problem recognised by the Governor of Queensland at the time, Sir Leslie Orme Wilson, and he sought a solution. He could see that children with increasingly complex medical needs would become a particular challenge in the bush, so at the request of Leslie Wilson—a former British soldier and Governor of Queensland from 1932 to 1946—in 1935 a meeting was convened by the Labor Lord Mayor, Alfred Jones, for the purpose of commencing the BUSHkids program to provide intervention and prevention for medical conditions suffered by children living in remote areas. Initially this program offered access to city medical and surgical services for children who live in the bush. It provided homes near the beach for the children to recuperate with their families. The first home opened in Scarborough, just north of Brisbane. Other homes were established in Yeppoon, Hervey Bay, Rowes Bay and Townsville. Eventually these homes progressed and became registered as hospitals, and the Red Cross provided travel for the children from their country towns. The service provided help even during the difficulties of World War II, when the society's resources were stressed. The polio epidemic provided even more challenges for the service, but despite all of the obstacles the BUSHkids service has continued for 80 years.

Currently BUSHkids operate centres in Brisbane, Bundaberg, Dalby, Emerald, Inglewood, Mount Isa and Warwick. The current program aims to build the capacity of the local rural communities to be able to respond appropriately to children who are at risk. This might include children with poor health or even education or social outcome concerns. Having grown up in Western Queensland, I understand the challenges that come with children who live in isolated areas. Also, having taught in Toowoomba and in Babinda in North Queensland, I understand the challenges that come with having a very decentralised state. I understand the importance of early intervention for children in these communities to access health and educational professionals. Early intervention can make an enormous difference to children, rather than having them moving in a direction that is going to create challenges down the track. If we can have early intervention, guidance and support for parents, a stitch in time saves nine later on.

BUSHkids provides early intervention for allied health for children and families in rural communities who would not otherwise receive the medical or educational care they need. The services provided to children through the BUSHkids program are delivered through a range of facilities across Queensland. One is disability services at Oxley, which is easy to access, particularly for those kids coming in from Warwick, Inglewood, Dalby and all points west.

I commend the member for Ryan for putting this motion to the House. I am disappointed that her Liberal Party and National Party colleagues were not around to support it. Too often they can take the support they have in the bush for granted, whereas we really need to make sure with a decentralised state such as Queensland, with major centres like Townsville, Toowoomba, Rockhampton, Mackay, Mount Isa et cetera, that we focus on the resources that are there.

Debate adjourned.