Renal Dialysis Services on the APY Lands

The Hon. K.L. VINCENT: I seek leave to make an explanation before asking the Minister for Aboriginal Affairs and Reconciliation questions about the availability of renal dialysis services on the APY lands.

Leave granted.

An honourable member interjecting:

The Hon. K.L. VINCENT: Renal dialysis services on the APY. Chronic kidney disease is an extremely serious health issue for many Indigenous Australians. While figures vary considerably between different studies, statistics constantly point to a higher rate of chronic kidney disease in the Indigenous community and indicate that it is especially prevalent in remote areas. At present I understand that 21 Anangu people with end stage kidney disease living on the APY lands require renal dialysis to stay alive, the majority of whom receive treatment in the Northern Territory.

Chronic disease is a systemic issue in remote communities and is exacerbated by a range of unique risk factors such as the poor availability of fresh fruit and vegetables, unreliable access to clean drinking water and isolation from essential health services. Given all of this, I was very disappointed to read news reports on Monday that the state’s Minister for Health, the Hon. Jack Snelling MP, had turned down the offer of federal funding to establish a renal dialysis unit in Pukatja due to concerns about the costs of running that unit.
This is a service that could significantly improve the quality of life of people with end stage kidney disease on the APY lands. The refusal to even consult with the community regarding the establishment of services represents nothing less than a complete failure by this government to address this systemic health issue head on.

There is far more to this issue than a simple question of dollars. The cost and disruption of sending dialysis patients to Alice Springs or Adelaide for treatment was highlighted by every service I spoke to during my trip to the APY lands last year as a major obstacle in the delivery of primary health services on the lands.
Without the Minister for Health having undertaken the consultation requested by the federal government, I would be interested to know how the Minister for Health has determined that flying all of those on the APY lands who require dialysis to Alice Springs or Adelaide and paying to keep them in hospital is more cost effective than providing a local service in Pukatja. Even if this is in fact the case, I regard making a decision on this matter based solely on the financial cost, without giving proper regard to the social and cultural life of Anangu people to be a grave error.

Given the choice, Anangu people overwhelmingly prefer to receive whatever services they can on their lands. The time is long overdue that we should respect their relationship with the land and facilitate people with chronic illness or disability to remain on their land as long as possible. My questions to the minister are:

1.Given that chronic kidney disease is a serious systemic issue on the APY lands, will the minister intervene to ensure that the consultation regarding the establishment of a renal dialysis service on the APY lands is undertaken?

2.Does the minister believe that a renal dialysis service on the APY lands could significantly improve the lives of many Anangu people living with end stage kidney disease?

3.Does the minister believe, as does the Minister for Health, that the social and health benefits of such a service would be outweighed by the financial costs of running the service?

4.Will the minister undertake to make available to the parliament the exact costings upon which this belief is based?

5.Was the minister aware of the Minister for Health’s decision to refuse to consult the community and turn down federal funding for renal dialysis services?
The CHAIR: Before I call the Minister for Aboriginal Affairs and Reconciliation, please ignore the opinion and the debate, and also parts of that question should be directed to the minister in the other place.

The Hon. I.K. HUNTER (Minister for Sustainability, Environment and Conservation, Minister for Water and the River Murray, Minister for Aboriginal Affairs and Reconciliation): Well, indeed, and that would have been my opening remark. I thank the honourable member for her most important question and her ongoing and significant support for these issues. As you have commented, sir, the matter does fall under the portfolio responsibilities of the Minister for Health and Ageing in the other place, and I think I have answered part of this question at least in the past, so I can reiterate a few points.

Members will probably be aware that, in 2011, the Central Australia Renal Study was released by the Australian government. The study recommended a hub and spoke model of service delivery for dialysis patients from central Australia, with Alice Springs as the hub. Members may also be aware that the Northern Territory government has decided not to progress the development of an accommodation centre for renal dialysis patients in Alice Springs as they are unable to meet the ongoing operational costs of the centre. They handed back $13 million to the Australian government because of that decision.

I am advised that an estimated 12 people from the APY lands are currently receiving dialysis in Alice Springs and a further nine people from the APY lands are receiving dialysis in South Australia. The decision made by the Northern Territory government to not progress the accommodation centre is unfortunate because it puts pressure on that community, but I am advised that it will not impact the 12 patients currently receiving dialysis in Alice Springs.

I understand that SA Health currently provides payment for South Australian residents treated in the Northern Territory in line with agreed cross-border agreements. I am further advised that there has been no formal offer, although I need to check that given the article in the paper from the Australian government, but I will refer that part of the question the honourable member poses to the minister in the other place and seek a response on her behalf.