Mrs HICKEY - 2001-02-27
Reports commissioned as far back as 1997 by Territory health ministers, and by the Renal Committee in Tennant Creek and the Cooperative Research Centre for Aboriginal and Tropical Health, have all recommended that a renal dialysis unit be urgently established in Tennant Creek.
The Carney Report completed in March 2000 and provided to your department in May of the same year reveals that the Barkly region has the highest incidence of end stage renal failure in Australia.
According to your colleague, the Minister for Transport and Infrastructure Development, Mick Palmer, the construction of the Palmerston Health Precinct came in under budget to the tune of $700 000. In view of the evidence provided by reports on renal health in the Barkly, will you immediately direct the money saved on Palmerston to building a renal unit in Tennant Creek?
ANSWER
I welcome the question, Mr Speaker, on two counts. The first is it is my hope that it is genuinely seeking information which I can provide to this House about this very important issue. The second reason is that the opposition have been very quiet on matters relating to health and it is only this sittings that we have had questions since the June sittings of last year. So notwithstanding that the member for Barkly has appreciated the silence from her shadow for health, I would hope that this augers a change in the opposition and that they use this Parliament and ministerial Question Time to elicit answers to these important issues. It is important that the answer be given fully because there are several salient mistakes in the prelude to her question.
In the first place, the minister for health did not commission the 1997 report. The report that was done by Deakin University was commissioned by a senior departmental officer in Alice Springs and it contributed to the body of knowledge that we needed to know about end stage renal failure. The report that was done by Dr Carney, likewise, while it might have been provided as an early copy to the department, was given to the organisation which commissioned it, the Cooperative Research Centre for Aboriginal and Tropical Health, which considered it last week. So despite the fact that Dr Carney may have finished this body of knowledge last year, it was only being considered by its commissioning body last week.
It is important that the commissioning body look at it, not in the context of a singular report on the Barkly, but in the whole matter relating to end stage renal failure and dialysis, whether it be haemodialysis or peritoneal dialysis. Indeed, even whether we should be putting more effort into preventative strategies, what shape these might take, whether the two satellite services that we have offer some solutions that we may look at and whether the experience that we have learnt from those two satellite centres may well be deployed in Tennant.
It is not a matter – and this is a common failing of people who talk about matters relating to dialysis units, is that they tend to focus on the fact that there needs to be a building. That is correct. And that there needs to be machines. That is correct. That is the small part. The very difficult part is to make sure that those facilities meet the needs of the people who have to use it, that it is structured in such a way that if it is self-care, those people have the capacity to access it, and if it is to be articulated with outsourced programs, for instance, continuous peritoneal dialysis, whether that would also operate out of that service. So, it is not just a matter of writing off to an American company that makes haemodialysis machines, constructing a building and plugging it into the wall. This sort of facile description of a renal facility is the stuff that the opposition constantly engages in and says, ‘We want one of them, give me one’. You cannot actually do that.
If the source of the question goes to somehow show that this government is being tardy in being methodical about how we approach this matter, if it goes to whether the department is being somehow penny pinching in regards to this matter, I am happy to put a few data on the record which will demonstrate that that is patently not the case.
In the first place it was a health minister, I believe Health Minister Hanrahan, way back in the mid eighties, who looked at putting in our first haemodialysis machines. Since that time, we now spend $11m on dialysing people with end stage renal failure, and it should be remembered that there are not many options for these people. Option 1 is that they receive haemodialysis, or peritoneal dialysis; option 2 is that they get a transplant, and significant effort has been put into that, I will cover that later; or option 3 is that they die.
So the options available are very, very limited. If we are to progress with looking to dialyse people in their immediate community, medically that option exists and it is called continuous ambulatory peritoneal dialysis, or colloquially, ‘the bag’. Medical opinion in the Territory has been that this may be an inappropriate option for remote Territory Aborigines, notwithstanding that it is used extensively in our neighbouring states of Western Australian and Queensland. Our opinion is that it is probably best that these people move directly to haemodialysis and, in that case, we have limited options as to where those centres might be.
It has been my happy experience, in the short time of being health minister, to open two satellite centres. One in the Tiwi Islands, which I am sure has been visited by the member for Arafura on a number of occasions, and it is convenient that it is located there, not just for medical research and other reasons, but also to put a lie to this myth that has been peddled that somehow we allocate facilities such as this on the basis of how people vote, because that was indeed the first facility that was opened; the second was in Katherine.
We have lessons to learn from both these places, but it should be remembered that the Katherine facility, for instance, has been going less than a year, so I do not think that it is beyond reason that Northern Territory government officials, and indeed eventually the advice they provide to government, should be based on empirical, scientific and medical knowledge, and it should go through a variety of gateways to test this. When we talk about what it is we can do, in fact, all of us in this House can do something about this very serious question. Only last week, we were given the opportunity, through the media, to sign up for organ donation. And I bring it to the House’s attention again, because this is in fact the best option for people with end stage renal failure. A mere four or five years ago, we only had three recipients of kidneys in the course of a year, now that approaches 17 and it has been on that level for some time. These are 17 people who can go back to living a relatively normal life in their home communities, so it does provide the best solution for us. I would encourage those members of this House to look at organ donation.
I would also like to say that there is a significant body of evidence that says that the precursors to renal failure are becoming better known to us. They are issues relating to age; to diet; to assaults from a variety of parasitic burdens, including scabies; and there are some things we can do. I would put to the House that prevention is better than treatment. I put to the House again that there are things we can do, all of us. For instance, the member for Arnhem could become a role model for Aboriginal people, being an Aboriginal leader, and he could show people that the condition he finds himself in is a precursor to a variety of health problems. He could take more care of himself so that he demonstrates to the people who see him as a leader that there are options in all of our ...
Mr STIRLING: A point of order, Mr Speaker! Instead of the cheap attack on my colleague here, he was asked a specific question about money being saved at Palmerston and would it go to the Barkly for renal dialysis.
Mr SPEAKER: There is no point of order.
Mr DUNHAM: I turn now to the fact that some money was saved in Palmerston, and this is a good story. The facility was built on time and under budget and some monies were able to be deployed elsewhere. Unfortunately, they were not my monies. As health minister I would use every dollar that I am given. Unfortunately, these monies were not within my budget and I am unable to make a decision as to how they might be deployed.
[Editor’s Note: Question Time suspended to move Motion of Censure of Minister for Health, Family and Children’s Services]
The Carney Report completed in March 2000 and provided to your department in May of the same year reveals that the Barkly region has the highest incidence of end stage renal failure in Australia.
According to your colleague, the Minister for Transport and Infrastructure Development, Mick Palmer, the construction of the Palmerston Health Precinct came in under budget to the tune of $700 000. In view of the evidence provided by reports on renal health in the Barkly, will you immediately direct the money saved on Palmerston to building a renal unit in Tennant Creek?
ANSWER
I welcome the question, Mr Speaker, on two counts. The first is it is my hope that it is genuinely seeking information which I can provide to this House about this very important issue. The second reason is that the opposition have been very quiet on matters relating to health and it is only this sittings that we have had questions since the June sittings of last year. So notwithstanding that the member for Barkly has appreciated the silence from her shadow for health, I would hope that this augers a change in the opposition and that they use this Parliament and ministerial Question Time to elicit answers to these important issues. It is important that the answer be given fully because there are several salient mistakes in the prelude to her question.
In the first place, the minister for health did not commission the 1997 report. The report that was done by Deakin University was commissioned by a senior departmental officer in Alice Springs and it contributed to the body of knowledge that we needed to know about end stage renal failure. The report that was done by Dr Carney, likewise, while it might have been provided as an early copy to the department, was given to the organisation which commissioned it, the Cooperative Research Centre for Aboriginal and Tropical Health, which considered it last week. So despite the fact that Dr Carney may have finished this body of knowledge last year, it was only being considered by its commissioning body last week.
It is important that the commissioning body look at it, not in the context of a singular report on the Barkly, but in the whole matter relating to end stage renal failure and dialysis, whether it be haemodialysis or peritoneal dialysis. Indeed, even whether we should be putting more effort into preventative strategies, what shape these might take, whether the two satellite services that we have offer some solutions that we may look at and whether the experience that we have learnt from those two satellite centres may well be deployed in Tennant.
It is not a matter – and this is a common failing of people who talk about matters relating to dialysis units, is that they tend to focus on the fact that there needs to be a building. That is correct. And that there needs to be machines. That is correct. That is the small part. The very difficult part is to make sure that those facilities meet the needs of the people who have to use it, that it is structured in such a way that if it is self-care, those people have the capacity to access it, and if it is to be articulated with outsourced programs, for instance, continuous peritoneal dialysis, whether that would also operate out of that service. So, it is not just a matter of writing off to an American company that makes haemodialysis machines, constructing a building and plugging it into the wall. This sort of facile description of a renal facility is the stuff that the opposition constantly engages in and says, ‘We want one of them, give me one’. You cannot actually do that.
If the source of the question goes to somehow show that this government is being tardy in being methodical about how we approach this matter, if it goes to whether the department is being somehow penny pinching in regards to this matter, I am happy to put a few data on the record which will demonstrate that that is patently not the case.
In the first place it was a health minister, I believe Health Minister Hanrahan, way back in the mid eighties, who looked at putting in our first haemodialysis machines. Since that time, we now spend $11m on dialysing people with end stage renal failure, and it should be remembered that there are not many options for these people. Option 1 is that they receive haemodialysis, or peritoneal dialysis; option 2 is that they get a transplant, and significant effort has been put into that, I will cover that later; or option 3 is that they die.
So the options available are very, very limited. If we are to progress with looking to dialyse people in their immediate community, medically that option exists and it is called continuous ambulatory peritoneal dialysis, or colloquially, ‘the bag’. Medical opinion in the Territory has been that this may be an inappropriate option for remote Territory Aborigines, notwithstanding that it is used extensively in our neighbouring states of Western Australian and Queensland. Our opinion is that it is probably best that these people move directly to haemodialysis and, in that case, we have limited options as to where those centres might be.
It has been my happy experience, in the short time of being health minister, to open two satellite centres. One in the Tiwi Islands, which I am sure has been visited by the member for Arafura on a number of occasions, and it is convenient that it is located there, not just for medical research and other reasons, but also to put a lie to this myth that has been peddled that somehow we allocate facilities such as this on the basis of how people vote, because that was indeed the first facility that was opened; the second was in Katherine.
We have lessons to learn from both these places, but it should be remembered that the Katherine facility, for instance, has been going less than a year, so I do not think that it is beyond reason that Northern Territory government officials, and indeed eventually the advice they provide to government, should be based on empirical, scientific and medical knowledge, and it should go through a variety of gateways to test this. When we talk about what it is we can do, in fact, all of us in this House can do something about this very serious question. Only last week, we were given the opportunity, through the media, to sign up for organ donation. And I bring it to the House’s attention again, because this is in fact the best option for people with end stage renal failure. A mere four or five years ago, we only had three recipients of kidneys in the course of a year, now that approaches 17 and it has been on that level for some time. These are 17 people who can go back to living a relatively normal life in their home communities, so it does provide the best solution for us. I would encourage those members of this House to look at organ donation.
I would also like to say that there is a significant body of evidence that says that the precursors to renal failure are becoming better known to us. They are issues relating to age; to diet; to assaults from a variety of parasitic burdens, including scabies; and there are some things we can do. I would put to the House that prevention is better than treatment. I put to the House again that there are things we can do, all of us. For instance, the member for Arnhem could become a role model for Aboriginal people, being an Aboriginal leader, and he could show people that the condition he finds himself in is a precursor to a variety of health problems. He could take more care of himself so that he demonstrates to the people who see him as a leader that there are options in all of our ...
Mr STIRLING: A point of order, Mr Speaker! Instead of the cheap attack on my colleague here, he was asked a specific question about money being saved at Palmerston and would it go to the Barkly for renal dialysis.
Mr SPEAKER: There is no point of order.
Mr DUNHAM: I turn now to the fact that some money was saved in Palmerston, and this is a good story. The facility was built on time and under budget and some monies were able to be deployed elsewhere. Unfortunately, they were not my monies. As health minister I would use every dollar that I am given. Unfortunately, these monies were not within my budget and I am unable to make a decision as to how they might be deployed.
[Editor’s Note: Question Time suspended to move Motion of Censure of Minister for Health, Family and Children’s Services]
Last updated: 09 Aug 2016