Judith Adams (WA, Liberal Party) Share this | Hansard source

I rise to speak on the Senate Standing Committee on Community Affairs report Highway to health: better access for rural, regional and remote patients. I would like to sincerely thank my Senate colleagues for agreeing to the community affairs committee holding this inquiry. As the chair of the committee said at the start, certain members were a little dubious about whether this was a very important inquiry. But I think we have probably proven with this report that it was important. Those who read the report will certainly realise that there is a problem in rural and remote Australia. The committee members have certainly supported me very strongly, and I thank them for their remarks. I thank the committee secretariat, because it was no easy task. There were 196 public submissions and four confidential submissions. We held hearings in Canberra, Alice Springs, Melbourne, Perth, Launceston and Brisbane. That meant the secretariat had to leave their homes and travel and put in some rather horrific hours. When we went to Alice Springs we were able to look at the Aboriginal congress and also visit the hospital and speak to those people who are actively involved with policing the PATS. I think doing that gave everyone an idea of just how important the PATS is. I would like to quote from my first speech in this place on 11 August 2005. I said:

I firmly believe that the Patient Assistance Travel Schemes in each state need best-practice national guidelines to ensure rural patients have flexibility in accessing the best possible medical assistance. Since the Commonwealth handed the responsibility of the Patient Assistance Travel Scheme, PATS, over to the states in 1987, this issue has been reviewed many times. Recommendations from five recent parliamentary committee reports have highlighted the problems associated with these travel schemes. We have the evidence and data to tackle the problem, and I will be strongly recommending to the Senate Community Affairs References Committee—

as it was then called—

that the administration of PATS must be dealt with urgently. It is a complex issue, as it falls within the states’ jurisdiction, but something must be done.

So, after two years of really annoying my colleagues and pushing very hard, we have finally tabled our report—and that is no mean feat.

I thank the people who put forward submissions. We had support from many organisations. I was a member of the National Rural Health Alliance for six years, as a councillor representing the Australian Healthcare Association. That has 27 organisations, which include rural nurses, doctors, allied health groups, service providers such as the Royal Flying Doctor Service, consumer groups like CWA and academics. We had support from national bodies such as the AMA and the Australian General Practice Network, state governments, local governments, cancer groups, Aboriginal health organisations, teaching hospitals, consumers and health service boards. It goes to show that this really was a national inquiry. Everyone is concerned about it. As there are fewer and fewer of us living out in rural, regional and remote areas, I think we have done a service. We have the evidence now. It is there for someone at a higher plane to act on. There has to be coordination of all the states. At the moment we have—excuse the pun—a ‘dog’s breakfast’ as far as the different PATS areas go.

I was pleased to receive a flyer from the AMA called Bridging the gap, which we celebrated several days ago. The fifth item on their flyer is very good. It is about the Patient Assisted Travel Scheme. I think this is important, as it is coming from a body such as the AMA. It says:

The Australian healthcare system is based on the principle that all Australians are able to have access to the same level of health care regardless of where they live. Those who live in regional, rural and remote Australia should not be disadvantaged if they must travel to larger centres to access quality health care.

They go on to say, and this is one of our recommendations:

The AMA believes that the Commonwealth should work with the States and Territories to expand PATS to cover other treatments available under the Medical Benefits Schedule (MBS)—including access to allied health professionals where a doctor coordinates the patient’s overall care.

In this climate, PATS has become very much out of date since it was handed over to the states in 1987. We need to look at how we organise health. Primary health care is very important, but no longer is it just the bailiwick of the doctor, the GP or the specialist. It is the multidisciplinary team that sit behind them as their support. This might be with our remote area nurses. It is definitely with our allied health people.

I think it is important—and it is part of one of our recommendations—that the patient is not necessarily sent to the nearest specialist, who may not be the most appropriate specialist. If the patient has to go to someone that is not quite the person they should be seeing, they are probably going to create a much larger debt to the health system than they would have if they had been able to access the most appropriate specialist. So this has been one of my very strong pushes. That is contained in one of our recommendations.

I spoke in my first speech about the development of national standards. This is our recommendation:

Development of the national standards should include (but not be limited by) consideration of the following areas:

• patient escorts including approval for:
• psycho-social support;

At the moment it is only for medical support. Many people are sent to the city areas by themselves to undergo radiotherapy, chemotherapy and treatment for other symptoms. They are alone. This is completely unfair; it is cruel. It is not on at all. When we went to Alice Springs and spoke with our Indigenous people we heard some horrific stories. English is not the first language of a number of these patients. They are sent off to a city by themselves on an aircraft or in a bus, probably never having been in an aircraft before. Nobody meets them; nobody takes them anywhere. Where do they stay? What happens? There have been some dreadful instances. In the Northern Territory an elder, a very old gentleman, was dropped off at the airport very early in the morning and had nowhere to go. He was found deceased seven days later. These are the sorts of things that just cannot happen in this day and age. We have other instances, especially in my home state of Western Australia, where the bus will drop off a patient who is a mother with a baby at three in the morning, when she has another 400 kilometres to go and she is hoping someone will come and collect her. They do not come and collect her. These are the sorts of things that we just have to do something about. Patient escorts are very important.

The second problem is obstetric services in rural and regional areas being limited for safety’s sake to prevent litigation. You have to have an operating theatre and an anaesthetist standing by. I seek leave to continue my remarks at a later date.

Leave granted; debate adjourned.