Jill Hall (Shortland, Australian Labor Party) Share this | Hansard source

Before I get to the substance of my contribution to the debate on the National Health Amendment (Continence Aids Payment Scheme) Bill 2010 the member for Cowper may like to hear what I have to say about the enhanced Medicare scheme and how it relates to the provision of service for people with chronic and complex dental health problems. I will set the record straight. It was in 1997 that the Howard government ended the Commonwealth dental program that helped many thousands of Australians throughout the country.

In relation to the program the member for Cowper spoke about I would like to give a real live example from the Cowper electorate. My mother lived in the Cowper electorate and I told her about the program. She had very complex health needs—in fact, she died because of the health problems she had. I gave her a handout on the program, and she went to talk to her doctor about it. The doctor said: ‘You wouldn’t qualify for this and, besides, there is no dentist within the vicinity that actually will utilise this program.’ I sent her back again and said, ‘Go and see your doctor, go and talk to your doctor. You would definitely qualify for this program. Surely there must be one dentist in the area. Try Coffs Harbour.’ She lived at Nambucca Heads. Her doctor eventually gave her the referral. Then she had to find a dentist that would provide the service for her under the Howard government’s wonderful scheme. There was no-one in Nambucca Heads, there was no-one in Macksville, there was no-one any closer than Sawtell. She finally found a dentist that would provide the service for her, and she got the dental treatment that she needed. She had quite a significant dental problem. She managed to have it done before she died, but only just.

If that scheme is held up as one that benefits Australians, and if that is something that the member for Cowper is proud of, then he needs to look a little more carefully at the number of people who need dental health treatment and cannot afford it. The Labor Party’s program is about providing dental health care to all those people that need it. I am very familiar with the health services in the Cowper electorate. I would encourage the member for Cowper to be quite honest with this House in relation to the services that are available there and in particular to that dental care program that he spoke at great length about and which his constituents have been unable to utilise. Having had my say on that particular program, I would like to turn to the legislation that we have before us today, which the member for Cowper only briefly mentioned as he concluded his contributions to this debate. This legislation will allow for the introduction of the Continence Aids Payment Scheme. I will refer to it as the CAP Scheme as opposed to the continence aid assistance scheme, which I will refer to as CAAS in my contribution to this debate.

This amendment allows for an instrument for the minister to change the way continence aids are paid for. It allows for the Commonwealth to make payments to people who are eligible under the CAP Scheme and ensures that there is an adequate process in place to facilitate the transfer of clients under the CAA Scheme, which has basically been provided by one provider, to the CAP Scheme, where people who use the scheme can choose their own provider of the continence aid. Obviously, this service will be provided by Medicare, which is a change to the way the first scheme operates.

Mr Speaker, you would be aware, I am sure, that an enormous amount of information has gone out to clients of the CAP Scheme. There are about 75,000 clients throughout Australia who are aware that the CAP Scheme will come into place. This will allow them to access continence aids at a time and in a way which is much more convenient for them. The current scheme provides $470 per person per annum for continence aids, which is what it costs the government, and I think that is indexed and due to go up to $489.95.

I thought it would be worth while having a look at the need for continence aids. Quite a few Australians have incontinence problems. I am referring here to the Australian incontinence data analysis and development report of March 2006. So, yes, the information is a little dated, but, if you look at the population today and make a correlation between the figures I am about to give to the House, you will find that it is pretty accurate, with 2.8 per cent of the Australian adult population experiencing severe incontinence. For 128,000 people living in cared accommodation who also need assistance with bladder and bowel control, this is handled differently.

This scheme relates to people living within the community. To give you the combination of how the 545,000 is made up, 240,800 people living in households experience very severe urinary incontinence and 202,100 people living in households experience frequent or very frequent faecal incontinence. Those figures show that there is a significant need for this program in the community. It is also important to know that there are 723,100 Australians who experience moderate urinary incontinence and another 2,877,500 Australians who have slight urinary incontinence problems. This really brings home the fact that this scheme needs to be in place.

People need to link in easily to the CAP Scheme. It is a flexible scheme which people who need continence aids can access locally. I am sure I am not the only member in this House who has a constituent with this problem—in my case it was a parent with an intellectually handicapped daughter who needed continence aids. There were problems accessing the aids and a delay receiving them because they were not provided in the area in which she lived—even within the Hunter area—and those aids were available from different sources. I think this is such a positive move.

Talking about the prevalence, it is worth while looking at the age factors associated with incontinence. Of the 284,000 Australians who always or sometimes need assistance with bladder or bowel management, 79 per cent are over 50 and 65 per cent are over 70. I bring those figures to the House because it is important for us to note that in a situation where we have an ageing population this is obviously going to become more prevalent. Since the 2006 report, there would have been an increase in the number of people needing continence aids simply because in those four years our population has aged further. It is important to note that females represent two-thirds of the people who are likely to experience severe incontinence and 45 per cent of the people live in cared accommodation. That means that 55 per cent of the people live in the community and these are the people who will benefit enormously from the scheme we are discussing, which will be covered by the legislation. Females represent 55 per cent of people living in households who need assistance with bladder or bowel control and 73 per cent of people living in cared accommodation. It is also interesting to note that 89 per cent of people living in care who are 70 to 84 years of age need assistance. There is a correlation between those people living in the community and an increase in their need for continence aids. So, by looking at these figures and at the fact that we are an ageing population, it is indisputable that a program like this is needed and it is also indisputable that people needing continence aids should be able to receive them close to where they live.

Disorders such as arthritis and related conditions often accompany people that have severe incontinence. Dementia is the most common health problem in relation to people that need continence aids. Based on the demographics and on the condition of incontinence, there can be strong support for having a scheme in place that is flexible and meets the needs of people who require continence aids.

It is interesting to note that the definition of incontinence that accompanies the scheme says that a person must suffer from a moderate to severe level of incontinence. For males, one of the diseases that have in the past led to incontinence has been prostate cancer. I know there have been enormous developments in treatment in that area, and operations and treatments that are now conducted are no longer leading to the problems they did in the past. The CAP Scheme is designed to help people with permanent—and I think that is important—and severe incontinence to meet some of their costs. Under the current scheme the government contribution—as it has always been—does not cover all the costs. It is similar with the CAP Scheme.

Clients who are currently receiving assistance under the CAA Scheme will receive a letter from the department about the changes to the scheme. I know from talking to people in my electorate that a number of clients have already received that information, and I know that there has been correspondence sent out to a number of constituents in Shortland electorate giving them advice about the new scheme. Cash payments made to people that need the continence aids can be made on either a yearly or six-monthly basis. Throughout the transition period the current provider will be in touch with clients of the CAA Scheme to provide information about the new CAP Scheme, and those clients will continue to access their subsidy until 30 June 2010, which is right about now.

It is important that this legislation gets through the parliament before the parliament rises, because it is legislation that will advantage so many Australians who need the continence aids that will become available through the CAP Scheme. The flexible provisions of the scheme will be enormously useful and beneficial to each and every person who needs to utilise continence aids.

There is one important change that is worth mentioning. Currently CAAS clients may be required to complete a CAPS transfer form. The important difference is that Medicare Australia will be the body funding this scheme. Completion of the CAPS transfer form will allow the payment to be made to the nominated bank account of the client.

This is, as I said, a vitally important scheme because it creates flexibility and gives some control to older Australians. As I have mentioned, we have an ageing population, so we need to make things happen easily. We need to be mindful of the quality of life that people enjoy. Through this CAPS program, we will be delivering a service to older Australians that will be extremely beneficial to them. I commend the legislation to the House.

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