Senate debates

Tuesday, 2 September 2014


Community Affairs References Committee; Report

5:36 pm

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

It is with great pleasure that I present the report of the Community Affairs References Committee on speech pathology services, together with the Hansard record of proceedings and documents presented to the committee.

Ordered that the report be printed.

by leave—I move:

That the Senate take note of the report.

This report would not have happened if it had not been for the particular work of Speech Pathology Australia, who were so dedicated in working with and briefing the Community Affairs References Committee on the issues that need to be looked at, and their dedication and concern for speech pathology services in Australia. I bet you many Australians just do not appreciate what speech pathology entails in this country and why it is so important. Through the committee process it has become an extremely apparent that speech pathology and communication and language disorders are absolutely critical to people's life outcomes—absolutely critical. I see this report as probably the matching pair to the report that the committee did on hearing services in Australia. Our report on hearing services highlighted the impact hearing impairment as deafness has on people's life outcomes, as do a person's ability to communicate verbally. It is absolutely fundamental to a person's development and wellbeing.

The committee report makes 10 recommendations. But before I start on outlining some of those recommendations and our findings, I want to make sure that I have time to acknowledge the work that Speech Pathology Australia has put into this inquiry and thank the many professionals in the speech pathology area that we spoke to, parents, older people and people suffering from aphasia who contributed, making sure that we had full access to information. I also want to thank those people who hosted us on various site visits, and I will come to that in a minute. I also protect the want to point out the committee secretariat, who, as per usual and once again went above and beyond the call of duty. In particular, our secretary, Janet Radcliffe, and also Richard Grant, who have done us proud in the work they have produced from the wealth very good quality submissions that we received, from people's personal experiences, and from the Hansard evidence—pulling out what were the main issues.

I cannot highlight enough how important it is that we do in this country address issues associated with speech pathology. In fact, recommendation 10 recommends to the federal government that they

… work with state and territory governments, consider the costs to the individual and to society of failing to intervene in a timely and effective way to address speech and language disorders in Australia and address these issues in the development of relevant policies and programs.

In other words, speech pathology and its implications and communication disorders need to be considered when the government is making policy decisions. It is that fundamentally important. Recommendation 10 also states:

The committee recommends that the federal government work with state and territory governments and stakeholders to ensure that parents and carers have access to information about the significance of speech and language disorders and the services that they can access to address them.

What became very apparent during our inquiry is that we need to ensure that we have early intervention services in place.

We visited the Australian Stuttering Research Centre, for example. We learned that if you can have early intervention for a child who is stuttering by the age of six, that child cannot only get over the stuttering but will actually never remember that they stuttered. We also learned about the severe impacts on emotional and social wellbeing and the mental illness that can result if people do not get the sorts of early intervention and treatment for the speech disorders. We learnt that if a child between six and nine can get assistance for their stuttering, for example, that the child is likely to be successful in completely overcoming their stutter. After that you can learn to manage your stutter, but you to practice every day and the longer they go without the support that they need, the more impact it can have for their life outcomes.

The Community Affairs Committee always focuses on the data, because it is so important. Our committee also found out that there is not a lot of data. Several of our recommendations are about the need for data. We do not have a good handle on the demand for speech pathology services in this country. We have made a series of recommendations around that. We also do not have a good handle on the supply of speech pathologists and we also need to be looking at that.

I would like to take a couple of moments to address the issues that we learned, particularly from site visits. We went to see Melbourne Youth Justice Centre in Parkville in Melbourne. I thank the principal of the school, which is an award-winning a school in that centre. We were told that over 50 per cent of the young people who are in that juvenile justice centre have some form of speech pathology, language learning and communication disorder that would actually qualify them for support. There was another group of people there that had some form of speech and language disorder that did not qualify them for support but that needed to be dealt with. If these numbers in the prevalence of the disorder in the juvenile justice system is the same in other juvenile justice centres—and we do not know, but we need to know—you have to think: what impact has that speech and learning disorder had on that young person's life outcomes?

We also learnt about the number of older workers in manual industries who have speech and language disorders and were never properly supported when they were young people. Imagine what their life outcomes could have been if they had actually had early intervention. The point that is raised through that is the number of people that are falling out of manual employment who have never had the support that they need for their speech pathology. It is really an extremely important issue that we need at a national level to be looking at—not only national, but at the state and territory level. So we have made a number of recommendations about the need to investigate people's access to speech pathology services.

We also looked at the availability of services in each state, and they varied. This is also a concerning thing: access varies and qualification varies. There are very long waiting lists for publicly available speech pathology services and, in many instances, very long waiting lists for privately available speech pathology services. Unfortunately, privately available speech pathology services are very expensive and that can be a barrier to people being able to access speech pathology services. We also went to—and I am sure Senator Moore will talk a bit more about this, because it is in her home state, the Glenleighden School—

Photo of Claire MooreClaire Moore (Queensland, Australian Labor Party, Shadow Minister for Women) Share this | | Hansard source

You're quite right.

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

For those listening, Senator Moore said, 'Quite right, she will be talking about it.' We saw what an excellent job that school does. We heard from the parents of the students who go to that school about the early intervention, the quality focus on early education and speech pathology services being integrated into their learning and what a difference that makes to people's life outcomes. Access to speech pathology services can change someone's life outcomes, and that is why the government needs to look at how these services can be provided, what the demand is and where people are able to access these services.

In our report, we also have a very interesting map, which maps access to speech pathology services against the early development index—and it is quite frightening. That map is just for Melbourne, not Victoria. We are recommending that that sort of information be gathered for all Australian states so that we do make sure that we are able to supply access to quality speech pathology services.

I really do encourage all senators and all members of parliament to read this report to get an understanding of the importance of these speech pathology services for communication and language disorders. It really is critical that we deal with this issue.

5:47 pm

Photo of Carol BrownCarol Brown (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Families and Payments) Share this | | Hansard source

I rise to speak on the Community Affairs References Committee report on the inquiry into the prevalence of different types of speech, language and communication disorders and speech pathology services in Australia. The inquiry looked at the dimensions of speech and swallowing disorders in Australia and the prevalence amongst specific groups as well as the demand for and the delivery of services. The committee report makes a total of 10 recommendations. The most significant of these recommendations is the last one, which states:

The committee recommends that the federal government working with state and territory governments, consider the costs to the individual and to society of failing to intervene in a timely and effective way to address speech and language disorders in Australia and address these issues in the development of relevant policies and programs.

The committee recommends that the federal government work with state and territory governments and stakeholders to ensure that parents and carers have access to information about the significance of speech and language disorders and the services that they can access to address them.

This recommendation reflects the evidence presented to the committee on the importance of verbal communication for a person's development and wellbeing. Evidence presented to the committee shows that a speech, language or communication disorder can have a significant impact on a person's health, wellbeing, education and employment outcomes.

In relation to my home state of Tasmania, the committee heard that the state government employs approximately 39.7 full-time equivalent speech pathologists. These employees work across the state. The Tasmanian Department of Health and Human Services gave evidence to the committee and identified a number of gaps in the provision of speech pathology services in Tasmania. Specifically, the department noted a significant gap in the lack of locally based services in the northern half of the east coast. The department added, however, that, in areas with limited access to speech pathology services, video and teleconferencing is utilised to improve timeliness of access to services. A significant service gap was also identified in the area of the juvenile justice system in Tasmania. The department stated:

Youth offenders are complex and challenging for policymakers and practitioners alike and face high risks for long-term disadvantage and social marginalisation

Other significant service gaps were noted in the aged care sector and in cancer care, Aboriginal services and community services in the north of the state.

As part of this inquiry the committee also had the opportunity to conduct several site visits. I had the opportunity to visit the Australian Stuttering Research Centre at the University of Sydney. Research at the ASRC is facilitated by close collaboration with the stuttering unit within the Bankstown health service, which is a specialist treatment facility located nearby. As well as collaborating in research, the ASRC and the stuttering unit, along with Macquarie University, conduct a program of continuing professional education in stuttering. The centre's director, Professor Mark Onslow, emphasised the importance of early intervention in addressing a child's stuttering. Professor Onslow spoke to the committee about the high success rate of early intervention and the long-term benefits of intervention. Professor Onslow explained that these interventions not only benefited the individual's health and wellbeing but society as a whole. Some of the most compelling evidence heard by the committee was from individuals diagnosed with and treated for speech language and communication disorders. The committee heard of the barriers that people face in employment, in education and in everyday life—the time, money and commitment needed to access vital services and supports.

I would encourage senators to read some of the evidence and submissions by people who experience language, speech and communication disorders. As a member of the committee, I particularly thank those people for their contribution to this inquiry. In her evidence to the committee, Georgia Cranko, a university student who lives with a communication disability, said:

Even though, to all intents and purposes, I am a successful communicator who has had access to a decent mainstream education, I still feel my opportunities and quality of life are impacted by the fact that I am non-verbal. But I am using this opportunity to ask for more support for communication specialists, including speech pathologists, who can help facilitate greater educational opportunities. That will give those of us who have little or no speech a greater opportunity to be heard, thus giving us agency over our lives and our ability to contribute to society at large.

That is exactly what this committee report is about. It is the first time that a federal parliamentary committee has focused on the availability and adequacy of speech pathology services in Australia. For the first time, we have heard about the barriers faced by people living with these disorders and the importance of intervention and supports. It was also the first time that many of the individuals living with these conditions, as well as their families and carers, have had the opportunity to have their voices heard by parliament and considered by the government.

I would also like to acknowledge the contribution of Speech Pathology Australia. Speech Pathology Australia has provided the committee with invaluable assistance and guidance throughout the inquiry process. The evidence to the committee from over 300 submissions and four days of public hearings made it clear that failing to treat childhood speech, language and communication disorders contributes to significant lifelong problems. The committee heard evidence of the range of problems that people living with these disorders face, including limited employment options often leading to periods of unemployment, a dependency on welfare, the psychological and emotional distress to the sufferer, their family and carers, and in many cases interactions with the justice system.

The committee also heard evidence about the lack of reliable data in the area. Access to data is vital for policy makers in government to understand the dimensions of the issue and frame an appropriate response. Policy developers are limited by the lack of reliable national data, including on the prevalence of speech and communication disorders and the demand for pathology services. The evidence has also made it clear that the demand for speech pathology services in Australia outstrips supply of these services. Many submitters identified the NDIS as a driver of increased demand for speech pathology services. Given the evidence on the impact, it is vital that the Commonwealth, state and territory governments work together with key stakeholders to address the issues identified in this report. I commend the report to the Senate and the government.

5:54 pm

Photo of Claire MooreClaire Moore (Queensland, Australian Labor Party, Shadow Minister for Women) Share this | | Hansard source

In June 2011, the Speech Pathology Australia National President Ms Christine Stone first contacted the Community Affairs References Committee. At that time, there was a request for more consideration of the need for speech pathology services across Australia. There was also a desperate plea for coordinated research into the need and location of speech therapy services so that our country can respond with an effective plan to address that need and to ensure that we maintain the highest quality of speech pathology in our nation.

I want to put on record my absolute admiration of and appreciation for the tenacious efforts of SPA, who never let up. From June 2011 to when we finally got this inquiry on the road in December 2013, there was regular contact. Case studies and information were forwarded by SPA to reassure the committee that there was a need for this work and also to highlight the professional qualities of the industry in Australia. Through the committee, we saw the fruits of that work. Over the period of the hearings, we saw the lifelong impact of the need for communication. The committee begins with an overview, and it states:

The capacity to communicate verbally is fundamental to a person's development and wellbeing. The ability to learn effectively, to form meaningful and supportive relationships, to influence others, and to obtain and maintain employment can be significantly affected if a person is unable to verbally communicate.

We tend to take that for granted but through the work that we did, through the submissions we received and as a result of the enthusiasm with which people came to see our committee as though they had been waiting for the opportunity to share their knowledge, to share their experience and to share their demands, it became clear that the need greatly outstrips the available services. Even more than the need, the accessibility of the services was highlighted consistently across evidence from all states and from the professionals working in the area. We have come away from this committee absolutely assured that there is a need for much more work.

Our committee usually has many recommendations. In this inquiry we had 10 recommendations, but I can assure the Senate that they are big ones. There is a great deal of detail in them, and they call for effective research into how we can establish what the needs of the community are, how we can best look at matching those needs to a professional workforce and how we can use resources across the country—both at the state and federal levels—to get the best knowledge and put in place a plan to meet the demand for effective communication support. One of the most confronting aspects of the inquiry was the fact that the need is so diverse and so great. We heard from schoolchildren, people who are looking for work and victims of illnesses such as stroke and acquired brain injury. All of them had quite specialised needs for the skills of trained speech pathologists. Their needs were different but there was a commonality.

Throughout the process, the services available in Australia, and when people could access them, were widely praised. There was genuine admiration and respect for the quality of speech pathologists across the country and for the services they provided, but the need was not being met because there was not sufficient service across the board. It was heartbreaking to see the terror with which people approached our committee, telling us that they had need, they knew they had need but they could not afford the services to make their lives and the lives of their families, the lives of their children, better. Their cries are a challenge for all of us that we cannot turn away from.

I want to mention the wonderful work of the Speech Pathology Australia. They shared information with us, they provided academic research to us and they gave us referrals so we could talk more closely with families and organisations where there was need.

Senator Siewert has pointed out that I will speak about Glenleighden School. I have spoken in this place several times before about this wonderful facility in Queensland. The sadness is that there is but one Glenleighden. There are no similar places anywhere else in the country that look at the particular needs of students with communication issues. The students who go to that school come from a wide range of backgrounds and have a wide range of conditions, but their core need is for effective support in communication through a range of therapies, led by a need for effective speech therapy.

We had a session at Glenleighden, and I want to put on record my continuing thanks to Ms Cae Ashton and her team at the school, who gathered together a number of parents who gave up their time to come and speak to us. These parents told us a little bit about what their lives entailed, their feelings about the desperate needs of their children and the difference that going to Glenleighden makes. I will never forget that session, and I am a pretty regular visitor to Glenleighden. We were given the opportunity to have mums and dads who expressed their desires for their children and also the sacrifices that they had made to ensure that their kids could receive the services provided at the school. People had actually moved states, they had moved homes, so that they could have the services of Glenleighden. I put on record my continuing thanks for that.

We also had the opportunity in Brisbane to have a public hearing. Again being quite parochial, Senator Siewert, I will mention some of my mates who gave evidence at that hearing, in particular, people from the Centre for Clinical Research Excellence in Aphasia Rehabilitation. Over the last few years, I have got to know a number of people who are members of Aphasia Queensland. These people have had, as a result mostly of stroke but sometimes of brain injury, severe communication issues, issues that have hindered their ability to rehabilitate and to re-communicate with family and friends. In particular, I thank Wendy and Paul Corp, a wonderful couple. Mrs Corp has had a stroke event, and her partner Paul has worked with her as she rebuilds her skills and her confidence. This couple was determined to come to our inquiry to talk to us about the value of effective therapy, the particular value of the LIFT program at the University of Queensland, which is an exhausting program over days of intensive work, at the end of which there is a real difference. People are able to communicate more freely and more confidently and are then able to rebuild to make the most of their lives.

Other senators have spoken about other site visits. We need to thank those people for coming to talk with us and to reinforce the need that Speech Pathology Australia shared with us in 2011. The services are extraordinary. The need is great. But we as a nation have a responsibility to ensure that the services that are available to some are available to all, because we know it makes a difference. I hope to be able to speak many times in this place and pick up on some of the issues that came out through the people we met. The important thing now is that this particular report is taken up by governments so that together they can identify the needs that they have to ensure that services are effectively identified and resourced. We need to continue to ensure that those communication needs are met, that the personal cost to individuals and society at large can be acknowledged and that we can respond to that need by having the strongest possible services across our nation.

This is the kind of work that the Senate committees do, Mr Deputy President. We have a chance to listen to people who want to talk to us, share their knowledge and then feed back into government policy development ways that we as a whole society can work together to improve what is going on in Australia. We know that people need to communicate effectively. We know that the earlier that people have the services of effective speech therapy the better their chance of becoming fluent and effective communicators. Then their opportunities for education and work will be enhanced.

6:04 pm

Photo of Zed SeseljaZed Seselja (ACT, Liberal Party) Share this | | Hansard source

I take the opportunity to add my voice to the debate on this report by the Senate Community Affairs References Committee. I thank my fellow senators. I think it was a good process. There was a bit of give and take, but it is important that we got to a point that the committee members could all agree on. The government should, therefore, take this report particularly seriously. I commend the report to the government. The report is a reflection of the importance of this issue and of the importance of getting solutions, of working together to do that. As has been touched on by other speakers, this is an issue that goes right across jurisdictions. States and territories have a very big part to play in this, but there is a view in the committee that the Commonwealth also has an important leadership role in this space. The inquiry came about largely due to the strong advocacy work of Speech Pathology Australia, so I take the opportunity to thank them and the many community organisations and individuals who took the time to share their experiences with the committee.

We all know that the ability to communicate orally is key to a person's development, to their wellbeing and to their connection with their community:

… a person who suffers from a speech or swallowing disorder is susceptible to poorer educational outcomes, reduced employment prospects and increased likelihood of social, emotional and mental health issues.

We do not want to see that. That is why speech pathology is so important. Evidence was submitted to the inquiry that adults aged 34 years:

… who had a language impairment at the age of five have up to seven times higher odds of poor reading, five times higher odds of mental health difficulties and three times higher odds of unemployment.

Many witnesses gave evidence of long waits for diagnosis and difficulty in accessing services in regional and remote areas. This is disheartening to hear when we know how important early intervention is. Access to speech pathology services is a complex issue. There is no one factor that would solve access issues. While the federal government does play a role in funding some services through particular programs, it is the states and territories—

6:07 pm

Photo of Gavin MarshallGavin Marshall (Victoria, Deputy-President) Share this | | Hansard source

Order! The time allotted for this debate has expired.