House debates

Tuesday, 4 June 2013

Bills

Appropriation Bill (No. 1) 2013-2014; Consideration in Detail

1:25 pm

Photo of Andrew LamingAndrew Laming (Bowman, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services and Indigenous Health) Share this | Hansard source

I have some questions for the Minister for Indigenous Health. I will be covering renal issues, dental issues and the Mason review, but first of all I want to focus on the budget announcement in particular: the $777 million that has been announced as a three-year commitment by the federal government. Firstly, Minister, breaking down that commitment into the three financial years would be very helpful. Secondly, was there any discussion with state governments on your contribution prior to the budget announcement and, if so, which states and what was the nature of that correspondence? Thirdly, what is the intended contribution by state governments to match your $777 million commitment? Do you have an implementation plan in place? Will it be similar to previous implementation plans, or is it going to diverge somewhat from the previous implementation plan for the NPA?

More specifically then to renal disease and the recent breakdown in negotiations with the Territory government over chronic renal disease funding. Minister, could I ask for your assessment of the state of play as of today? We understand that late last week there was some communication between your office and stakeholders indicating that the remaining $10 million that had been set aside for a post Alan Cass solution to chronic renal disease was in limbo. I appreciate that they have been difficult negotiations, but what exactly has happened to that $10 million? Is it still on the table? And will there be a coordinated and carefully planned announcement? Or are we at risk of seeing this money either dribbled out, as election commitments around Central Australia, or, worse, removed from dental care or from Indigenous health altogether and back to consolidated revenue? I know you would agree that this would be an adverse outcome.

I wanted to ask specifically about the post-CDDS environment. The CDDS was cruelly and viciously cut off in November last year, leaving the sickest adults in particular vulnerable, and many Indigenous Australians have now become utterly reliant on what was not looking after them before—that is, state dental services. That is another debate. But, specifically, Minister, have you made an assessment of the degree of access and availability to dental care for Indigenous Australians in 2013 and since the termination of the CDDS? In particular, have you looked at the states that have the lowest per capita dental investment—those eastern seaboard states in particular—and have you looked specifically at AMSs around the country? And those that do have dental agreements, are they actually, year on year and month on month, still treating as many Indigenous Australians with chronic and complex dental disease as they were this time last year? That would be a fair assessment. Has the number of people receiving treatment fallen away and, if so, do you have a view on that?

I particularly draw your attention to large provincial cities up the eastern seaboard that have large AMSs that provide dental care, but are no longer able to access the CDDS, which effectively cuts out 90 per cent of Australia's 12,000 dentists from being able to provide any service at all to an Indigenous Australian. Can you help me with the commitment of state hospital funding for dental? How will that work in a practical way: if you are an Indigenous Australian presenting to an AMS and you are told that there is no longer a CDDS arrangement, does this entail a trip to the public hospital? Does this entail being put onto a long waiting list—often 2½ years or longer? Is there a process where state public hospitals are now forced to pick through a waiting list trying to identify the Indigenous Australians? And are we reaching a point where vouchers, for instance, are being provided and then these Indigenous Australians have to then travel back to the dental service and have a second go at turning up for treatment?

If vouchers are being provided, just how large are those vouchers—$300 or $3,000? Or do we have this invidious situation where Indigenous Australians have to turn up for a second voucher when the first one runs out? These are very practical issues facing Indigenous families who are hoping for timely dental treatment.

Lastly, I have two small matters. Firstly, there is a service by the name of Murri Medical, which exists in Caboolture. It is my understanding that they are doing very promising work, including doing 68 per cent of all of the Indigenous 715 items for their region. That is quite a considerable achievement for a service that only began a couple of years ago. Minister, have you visited Murri Medical, particularly in Caboolture, and seen their service? If not, have you ever been invited to? You might be able to check your records and see if you have received an invitation to visit Murri Medical that perhaps has not been taken up. Secondly, as the Jenny Mason review tells us, do you finally concede that the rural classification scheme of your government is flawed? (Time expired)

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