Claire Moore (Queensland, Australian Labor Party) Share this | Hansard source

I was really pleased when I saw this matter of public importance on dialysis services for discussion this afternoon because I knew that the people who were going to be involved in this debate shared a common cause and a common interest. I am disappointed with the last speaker, Senator Scullion, who does share this interest. I have worked with him many times in these areas and I understand the deep commitment he has to the people of the Northern Territory, particularly the Indigenous people. When you have a look at the speakers list for this afternoon, the senators it includes share a lot of experience working on a number of senate committees and have had the privilege to visit the areas to which this motion refers—that is, the central and western part of the Northern Territory—and there is a common goodwill. It is important that we have the ability to discuss the issues.

The media has been covering the recent process in the Northern Territory around Alice Springs, but it is not new. I included a similar, but perhaps a little less passionate, discussion about trachoma and the issues around kidney dialysis in a speech I made about 2½ years ago in this chamber. Perhaps it did not have the same degree of emotion, but it did look at what was happening in Aboriginal communities, the issue of renal dialysis and the real need for governments at all levels—state, federal and local—to work together effectively with the local communities to come up with the necessary local responses.

One of the things that a number of us did share was the opportunity to visit what Senator Siewert referred to as the Purple House. I forget the address but everyone knows the house—and Senator Evans has been there as well—because you have such a sense of welcome and achievement when you are able to go there and visit with Sarah, who I am very proud to say is a Queenslander. She is on loan to the Northern Territory for a while; nonetheless, she is a Queensland nurse who is working there on a most inspirational project to do specifically with the issues of renal failure and the necessary care for people in that area.

I think we made that visit 18 months ago and we were talking about these same issues. We acknowledge that within the Aboriginal community, particularly in this part of the world but also, as we heard from Senator Crossin, across many parts of Australia, there is a horrific degree of illness around renal failure. That is on record and that has been processed through many years. I am not saying it is a good thing that we have known about this for a long time, but it is the reality. It is a reality that the issues around lifestyle, life circumstances, lack of treatment and lack of professional advice in those areas because of workforce shortages have all combined to mean that way too many men and women suffer from severe renal failure. Anyone who walks through any of the dialysis areas in any of our hospitals can talk with people who will tell you immediately what impact being linked to machines, being unable to move freely and being unable to react effectively with their families has on their lives. Tragically, there is too high an incidence of this condition in the Aboriginal communities about which we are speaking.

Certainly the focus of this discussion and the focus of a lot of the treatment has been Alice Springs. Years ago they were acknowledging that there needed to be a rapid increase in services being provided there, not only because of the people who currently live in the Northern Territory but also because Alice Springs is the centre for a whole range of regions around that part of Australia. All you have got to do is look at the map to see that it is the focus of transit routes from a whole range of areas that happen to be in Western Australia and in South Australia. Even some parts of western Queensland relate more effectively and more traditionally to Alice Springs as their centre. It is quicker, it is easier and there are distinct cultural links. So the focus has been on people needing to seek services in Alice Springs. That automatically means that there has got to be cooperation between the various state governments. I cannot say that it would be a good thing to draw the maps differently—a number of people would have objections to that—but when it comes to medical services, education and a whole range of other things this government has been saying that we need to have cooperation between the various states to acknowledge commitment, to acknowledge responsibility and to put together a plan to which they are committed and from which they can work into the future to provide effective services.

Clearly that must be a priority in what is happening in Alice Springs, and that has been the reaction of our government through the Minister for Indigenous Health, Rural and Regional Health and Regional Service Delivery, Warren Snowdon, who probably knows this better than anybody in this chamber, because he lives there and knows the Alice Springs community. Minister Snowdon and the governments of the Northern Territory, South Australia and Western Australia acknowledge that they have to work together on this issue and that there is an immediate crisis. We are waiting for some new facilities to be built in Alice Springs, and it would have been better if they had been built more quickly, but in the short time before these new facilities can be brought on line—putting together these beds, the machinery and, most importantly, the personnel who can effectively work these machines is complex and we have heard that you can often have the infrastructure but you do not have the trained professionals, particularly the dedicated nurses who have the skills to work with the people—we have to share resources. Of course, the first decision was that the first clients that need to be serviced are those who are currently receiving the service because, as we know and as Senator Siewert pointed out, once you start on the dialysis program you cannot withdraw. So the current patients need to have the immediate priority. They need to have their times secure and they need to have their work plans and their life plans linked to the process.

Over the last couple of months, in terms of the medical planning process, it has been determined that, as a short-term measure—I know it may not seem short for the people who are involved—new patients who are not residents of the Northern Territory will be referred to their own home states. That is not such a difficult thing to understand. It actually looks at people taking responsibility. The states acknowledge that it is urgent. They are going to get together in the next couple of weeks to ensure that they work effectively on what is going to happen and continue this carry-on process until enough services are available in the Northern Territory. They will take into account the kinds of tragic personal circumstances to which Senator Siewert referred.

Those circumstances will be taken into account. The people who work in this field know the area. They are in pain as much as many of their patients because they do not want to deny service. They want to acknowledge the personal circumstances of each of the patients, to work with them through that process and ensure that they come up with a result that is personal and effective and causes the least disruption—and that is going to be difficult.

In terms of what this government has done, we immediately acknowledged when we came into government the absolute need in this area. And in terms of delivery of primary care in a whole range of areas in chronic disease management we acknowledged, particularly in this part of the world, the chronic need for kidney support. There have been large amounts of money given—Senator Crossin has gone through it—including $5.3 million, which was immediately committed to the Northern Territory government to look specifically at the area of dialysis and support. That money is being spent but it takes time to build the permanent portals.

Nonetheless, other services are being trialled. This is a difficult area, because it is not easy to find the best way. There are special circumstances around letting people have home dialysis—particularly the need for effective water and sanitary services, and knowledge and support locally in the community. That is in train, and more of those services are going to take place, particularly in areas such as Maningrida, Lake Nash and Burunga, which are areas which feed into the area. We are going to have renal ready rooms that will be collocated with the community health centres. It is really important that people can have their service at their own community and not have to travel as much. We are also looking at the drop-in-care dialysis facilities in Alice Springs and Darwin. Once again, they will be making people feel welcome, making people feel secure and letting them access the services locally.

We all know—and I make this statement unashamedly on behalf of all the senators who are taking part in this debate—that there is a need. We are all committed to finding the best way of responding to this need. This government is part of that response. We need to work effectively with the state governments who have primary responsibility in this area. But it is no good just standing here and throwing grenades across the chamber when the important thing is to find out what must be done and how we can work together. And we must look to the future because if we look back at the past we will be talking about who did what since 1935 and people will not be around long enough to talk about what their futures will be. There is a crisis at the moment in looking after the patients. There is a process in train. We must make sure it works.