Warren Snowdon (Lingiari, Australian Labor Party, Shadow Assistant Minister for External Territories) Share this | Hansard source

I want to thank the government for allowing me to speak now, because I'm supposed to be at the Privileges Committee—not as a subject! So I give my apologies. I won't be long. It gives me great pleasure to support this legislation, the Health Insurance Amendment (Continuing the Office of the National Rural Health Commissioner) Bill 2020. As the shadow minister pointed out, we're pleased to do so despite the fact that it's a belated arrival at this point by the government. I think that the position of this Rural Health Commissioner is extremely important and note the changes that have been made in the context of the functions of the commissioner under this legislation.

It's worth actually reflecting upon them. I won't go through all of them, but some are as follows: to provide advice to the rural health minister; to develop, align and implement Commonwealth strategies—as you'd expect; to develop and promote innovative and integrated approaches to the delivery of health services; to identify opportunities to strengthen and align health workforce training; to strengthen and promote regionally based, patient-centred approaches to the delivery of health services to those areas that take into account the needs of communities, families and individuals in those areas; to undertake research and collect, analyse, interpret and share information about a process for improving the quality and sustainability of access to health services; and to consult with the following persons and groups: health professionals, state and territory government bodies, industry, non-profit and other community groups and other health stakeholders.

I want to make some observations about that because, in the context of my own electorate, and given my own knowledge and understanding of Aboriginal health and the role of Aboriginal community based health organisations in the delivery of primary healthcare services across this country, most particularly to regional and remote communities, it is important that we see the priority that should be given to ensuring that the consultation, which is referred to here, includes working with Aboriginal community controlled health organisations and their communities. I say that for a range of reasons, the most important being that they're the fundamental drivers of change in the delivery of primary health care in the bush. In my own communities, we're talking not about one or two health services; we're talking about a range of health services that work across the Northern Territory.

I was actually driven to write a few of these organisations down today just to check how many of them there are, but it is quite a large number if you include Nganampa Health Council, which is the community based health organisation that works in the APY Lands of South Australia, and if you then go to the primary healthcare delivery organisations in the Northern Territory working not only in Alice Springs but also in Darwin, Katherine and Tennant Creek. There are organisations such as Danila Dilba in Darwin, Central Australian Aboriginal Congress in Alice Springs, Anyinginyi Health Aboriginal Corporation in Tennant Creek and Wurli Wurlinjang in Katherine. There are organisations such as Miwatj Health, which provides primary healthcare services to all the major communities of large areas of north-east Arnhem Land. Then, if you look at the work that is being done by other health services, there is Ampilatwatja Health Service, the Utopia health service, the Pintupi Homelands Health Service, Katherine West Health Board and Sunrise Health Service, and the list goes on.

If you had any understanding of these organisations, what you would note about them is that they are fundamental to changing lives and to making sure that the life outcomes for Aboriginal and Torres Strait Islander people are a lot better than they have been. But it requires dedicated purpose. It requires ensuring that investments are being made in rural and remote health. In the context of this legislation, it requires looking at the role of the Rural Health Commissioner to reinforce the value of the role and make sure the commissioner has the resources that are required.

I say that in the context of the COVID pandemic and the issues that have confronted people right across this country. And I point out that, given the role of these Aboriginal health services, working in conjunction with the public health officials of the Northern Territory government, and the work of the Northern Territory government's own health clinics in remote parts of this country and the work that is being done in a policy sense by closing the Northern Territory borders and working with the federal government, using the Biosecurity Act to prevent travel into remote communities, it has been 72 days since there has been a COVID case in the Northern Territory and 28 days since the last patient recovered in the Northern Territory. That's phenomenal when you think about the potential impact of this virus on remote communities. The member for Durack would understand what I'm talking about. I know, Madam Deputy Speaker Claydon, you'd be fully aware of what I'm talking about. Given the poverty that strikes at the heart of many of these communities—the overcrowding in housing et cetera—it was anticipated that there would be, and there was contingency planning done around, a very, very dramatic impact of this virus on the bush. In fact, in the Northern Territory, I'm not sure that we've had any case of an Aboriginal person getting COVID.

I know of the enormous amount of work that is being done by the health services—not only the Northern Territory government's own health services but also, most importantly, the Aboriginal primary healthcare providers, the ACCHOs—to ensure that there are proper pandemic plans for every community. I've seen some of these pandemic plans, and they involve the communities integrally. When we look at those, and we know how much we rely upon these Aboriginal community controlled organisations and indeed public health generally in the bush, we are taken to the question of ensuring we've got the health workforce able to deliver the services.

One of the issues that has bedevilled remote communities in rural health in this country for many years has been the capacity to attract and retain public health professionals. I want to point out that the dedication and longevity of the Aboriginal community controlled health organisations and some of the public health offices in the Northern Territory that I am aware of have been really important in achieving the outcomes across the public health domain. But when we acknowledge the importance of the work which is being done in the COVID space, we've got to appreciate that this is effectively a partnership between the Commonwealth government, in this case, and the Aboriginal community controlled health organisations to achieve this outcome, and it's to their great credit.

The work which is being done by the Northern Territory government—by the Chief Minister, Michael Gunner, in his leadership and by the minister, Natasha Fyles, and her public health officials—with the NT Commissioner of Police in getting these plans put in place and protecting the Northern Territory community is monumental. To think that we haven't had a case in 72 days is monumental and really important. I understand there are people in this place who are bemoaning the fact that the Northern Territory government still has its borders closed. I can tell you that it's very strongly supported by a large section of the Northern Territory population. They can see the merit in ensuring there are not a lot of people coming into the Territory, and it's one of the reasons that we've been so successful. Of course that will change, I'm anticipating, over the next month or so. But lessons have been learned here.

We need to be understanding that, even though we haven't had a case in 72 days, there is contingency planning in the case that there may be an outbreak in the future. It's important, again, to understand that the people who have ventilated the views about this and developed the contingency planning are those very same organisations in partnership with the Northern Territory government public health officials, and this contingency planning is really important.

I've been regularly briefed by Northern Territory government officials, Aboriginal health services and public health around what's been happening. It's taken them quite a while, but it's very clear that they've developed very comprehensive contingency planning for the possible sad eventuality—and we hope it will never happen—of an outbreak of cases in one or two Aboriginal communities or a number of Aboriginal communities and how they might deal with that. Their response relies upon, as I say again, the professionalism and the expertise of the public health officers who have done all this work. We need to say thank you to them for continuing that work.

I'd say that the health commissioner, as he goes about his work over the next little while, appreciates and understands that we can learn a great deal from what's happened and what's worked. But his role, as I see it, is in part to advise the government of the need to make sure that we have a comprehensive plan for rural and regional health—something we don't yet have. But, if we did have such a plan, and if we were developing such a plan, it would need to understand, comprehend and accommodate the issues around Aboriginal primary health care and the Aboriginal community controlled health service organisations, who provide, in my view, the best examples of comprehensive primary health care in the country. We need to make sure they have the resources they require to be able to undertake their work effectively. So I say to the government: 'Here's an opportunity for you. You've done the right thing about this health commissioner. What we want you to do now is sit down with the health commissioner and with the community generally—the health professionals, the doctors, the nurses, the Aboriginal health workers and the allied health professionals across the country, all of whom are in great demand in the bush—and work with them and the community to develop a comprehensive rural and regional healthcare plan.' Of course, that should also include the Royal Flying Doctor Service.

It's been a privilege to be able to speak in this debate and, more importantly, to be able to highlight the importance of the Aboriginal health services. Most importantly, we need to understand the priority we should be giving to making sure we've got appropriately skilled and appropriately trained health officials in the bush, whether they're doctors, nurses, allied health professionals or, most particularly, Aboriginal primary healthcare workers, including Aboriginal health practitioners, who are fundamental to the operation of the Aboriginal Community Controlled Health Organisation. And we need to reinforce the value of training people in the bush. I know it's something which has had the attention of this place in the past, but, if we can make sure that we train people in the bush, I can guarantee you we'll get more people who are trained as professionals staying in the bush. I want to commend the work that's being done in that space at Alice Springs Hospital, for example, and at Charles Darwin University, in training medical practitioners.

It's been a privilege to offer a contribution here, and I apologise again to my colleague the member for Mallee for jumping in her place.

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