Rachel Siewert (WA, Australian Greens) Share this | Hansard source

I would also like to speak on this matter of public importance: the failure of the Rudd Labor government to ensure adequate provision of health services and rural infrastructure for regional communities. I would like to point out that we have had years of neglect and failure of governments to provide adequate health services in regional areas. Not that I am here to defend the government, because I have a whole lot of my own criticisms, but to expect them to have fixed in the last nine months the problems that rural communities have faced is really a big ask. What we should be looking at are some of the longstanding issues that are affecting rural and regional health and infrastructure in our communities. I would not put the focus on road infrastructure, particularly in this day and age with greenhouse effects and climate change coming down at us; I would be looking at the broader infrastructure needs of the rural and regional communities and looking at what we need to do to face the impact of climate change in rural communities. I suggest the focus of this matter of public importance would actually be targeted better at that, rather than just looking at roads.

While I am on the issue of infrastructure, we note today the release of the discussion paper by Infrastructure Australia, which fortunately has picked up on those arguments that my colleague Senator Milne made very strongly in this place when debating a particular piece of legislation. I notice that one of the goals in the paper that was released today is about environmental sustainability and reduced greenhouse gas emissions. We are very pleased to see that as a goal in this paper—a goal to look at the strategic priorities to reduce greenhouse emissions. The Greens believe that this will, if it is in fact achieved and implemented, strongly address the needs of regional and rural communities.

However, I would like to move on to the issues around health. The Greens are very well aware of the very major issues that are facing rural and regional Australia, particularly when you look at some of the absolutely appalling health statistics. We know for a start that health outcomes for those suffering from cancer in rural areas are much poorer compared to their city counterparts. Overall, we also know that rural males have higher rates of disease burdens due to cardiovascular disease, cancer, neurological and sense disorders, chronic respiratory diseases, musculoskeletal diseases and other injuries compared to their metropolitan counterparts. Overall for rural females, we know that there are higher rates of disease burden due to cardiovascular disease, cancer and, again, neurological diseases and sense disorders. They have much higher rates compared to their city counterparts. When you look at psychiatric services, there are approximately 113 Medicare funded psychiatric services per thousand people in major cities and 19 per thousand people in very remote areas. That is a very significant difference. It is now documented that rurality, which is ‘living in a rural or remote location’, creates a higher risk of suicide. Suicide rates for males in rural and remote communities have increased steadily over the past 20 years and the rates for young males are consistently higher in small, rural communities than in metro and regional areas. In fact, rural Australia has one of the highest rates of youth suicide in the world.

Hypertension is a major disease burden in regional and remote areas. Its incidence is significantly higher in these areas. The average life expectancy of people living in rural and remote areas is generally up to five years less than for people living in major cities. The list of health issues related to living in rural and remote Australia is very extensive. There is also the lack of access to regional hospitals, doctors, GPs, nurses, dental services and mental health services and there is the state of Indigenous health—which I will come back to in a minute. Services in those areas are all suffering compared to metropolitan services. In addition, it is very hard to get let alone keep staff. All these issues are affecting rural and regional services. Having lived in the bush, and having experienced lack of access to doctors and medical services, I can testify to the problems that are caused in regional communities when you do not have access to good medical services. On many occasions my family and I had to travel hours and hours from where we lived just to see the doctor. Just to see the GP for a 10- to 15-minute appointment you had to spend two hours in a car. These are significant issues that I think people in the city just do not understand.

Of particular concern to us is mental health in regional communities. Data recently released by the Australian Institute of Health and Welfare highlighted the lack of mental health services in country areas. The Greens have long argued for increased funding for these services and for education in the prevention and early detection of mental illness. There is a very large shortfall in mental health support in regional areas that definitely needs to be addressed. Early last month the National Rural Health Alliance said:

We need to build sustainable primary health care systems for the bush that include mental health services. These will be different from those in the city and different between rural areas and remote areas.

We believe it is an essential priority for the government to address.

We are also deeply concerned about Indigenous health. People in this place will be in no doubt as to how the Greens, and I in particular, feel about the issues around Indigenous health. I have spoken on that issue numerous times in this place. Just to remind people: there is a gap of 17 years in life expectancy between Indigenous and non-Indigenous Australians. That is one of the worst gaps in the world and Australia is one of the only First World nations that is not significantly closing that gap. We have a lot that we need to achieve, including providing primary healthcare services, providing a significant injection of funding and providing better access to Medicare benefits and the Pharmaceutical Benefits Scheme—not to mention addressing overcrowded housing.

Then we need to look at dental care. If you are living in regional or rural Australia and you are not on a dentist’s or a GP’s list, you can whistle Dixie if you need to get some treatment. You do not just roll up at a GP’s office—or at a dentist’s office, for that matter—or ring and make an appointment. If you are not on their appointments schedule, you just do not get a look-in. We need to significantly improve the dental care system in this country. We need to look at the significant workforce issues that continue to impact on health care in the metropolitan areas let alone in the regional areas, where it is extremely difficult to get trained staff.

I have not even touched on the issues that are facing those living with a disability, carers and older Australians. Older Australians need access to aged care and carers need access to services and respite. In many areas that is non-existent. We need to look at what we can do with training. We need to look at better ways of providing healthcare services to regional Australians, including, for example, establishing multipurpose community healthcare centres with a holistic approach to health where people can get fast and efficient service. Then we can start addressing the huge disparity between rural and city health. Of course, that will take a commitment by government, and that is a commitment that has not been given by past governments either. These poor health stats did not come overnight. They did not suddenly develop in the last nine months. I still find it rather intriguing when the coalition put up matters of public importance like this seeking to address these issues. They were in government for 11 years and these issues went unaddressed. Some issues—for example, mental health—no doubt deteriorated over that period of time.

This is not something that, admittedly, can be changed overnight. But we do expect this government to make a much more significant contribution. For example, how about getting rid of the private health insurance rebate? You would have $3.6 billion right there and then. People living in rural Australia often cannot use their private health insurance. I know in my home state of Western Australia you would be struggling to find a private hospital outside of the metropolitan area. (Time expired)