Australasian Health Complaints Commissioner’s Conference
Thank you Commissioner Durkin for your introduction.
I would like to acknowledge the Traditional Owners of the land on which we meet, the Ngunnawal people, and pay my respects to their Elders, past and present.
Thank you for the invitation to talk with you today. I think the work that you do in your roles as Health Complaints Commissioners can inform mine and perhaps vice versa.
I am really thrilled to be appointed as Parliamentary Secretary for Disabilities and Carers as I’ve been actively involved in the sector for many years.
As Shadow Minister responsible for Ageing, Disabilities and Carers, prior to the 2007 election, I had the privilege of meeting many people with disability and many of the diverse army of carers, and hearing their stories.
I learnt about the barriers and challenges they face.
It drove me to work hard for change.
In opposition, I chaired the Senate Community Affairs Committee’s inquiry into Quality and Equity into aged care.
The report led to the Council of Australian Governments (COAG) establishing the Young People in Residential Aged Care program to provide better living options for young people with disability who are – inappropriately in almost all cases – living in residential aged care.
I am also proud of the changes which have occurred following another Senate Inquiry where we examined the funding and operation of the Commonwealth State Territory Disability Agreement.
One of the recommendations of this Inquiry was to establish a National Disability Strategy, which is an achievement I am very proud that our Government has delivered.
Also, this work led to the development of the National Disability Agreement, which is delivering a significant funding increase for disability services and support across Australia.
Three years on, I feel I’ve come into this new role at an exciting time.
The Government has delivered significant improvements to disability services funding and the Disability Support Pension but there’s still a lot more work to be done.
My colleague, Minister Jenny Macklin, has identified disability reform as one of her top portfolio priorities for the current term.
I am looking forward to working closely with her to progress our reform agenda.
We want to improve the day to day lives of people with disability, promote participation, remove discrimination and create a more inclusive society.
National Disability Strategy
The National Disability Strategy sets out guiding principles, key policy directions and areas for future action in the disability sector.
It is the first time that Commonwealth, State and Territory Governments have agreed to a wide ranging set of directions for disability.
The Strategy adopts a bold vision – an inclusive Australian society that enables people with disability to fulfil their potential as equal citizens.
The one-and-a-half million Australians with a disability, and the 600,000 friends and family members who are their unpaid carers, deserve nothing less.
The draft Strategy has been developed by the Commonwealth, State and Territory Governments, and the Australian Local Government Association.
It will be taken to COAG for endorsement at the earliest opportunity.
We’ve also ensured the draft strategy reflects the views of people with disability, their families and carers.
Our National People with Disabilities and Carer Council led an extensive public consultation process, and ongoing community stakeholder engagement has taken place with disability and carer peak organisations and advocacy agencies.
The National Disability Strategy will set out a ten year national framework to drive future reforms for people with disability, their families and carers.
This includes mainstream systems, including health.
The Strategy recognises that people with disability have poor health outcomes, including aspects of health that are unrelated to the specific health conditions associated with their disability.
It also recognises that people with disability face discrimination in many areas of their lives.
More than 29 per cent of the submissions received for the initial consultation identified problems with health care, including a lack of understanding of the health needs of people with disability among many in the health and allied health sector.
It included comments such as:
“Regardless of age, people with intellectual disability have specific needs related to their disability which the aged care sector as a whole are presently not well trained to meet.”
“I experienced a nurse chastising a patient by saying ‘you have no idea how much you are costing this hospital’…”
“Those GPs who have myths about disability and sexuality may refuse to give a woman with a disability a pap smear”
“There’s a lot of ‘she’s in a wheelchair, take an aspirin and go home’ “
These comments show the need for a change in attitudes, and a need for better understanding of the needs of people with disability.
Two long-term goals of the new Strategy are:
- for people with disability to attain the highest possible health and wellbeing outcomes throughout their lives; and
- for people with disability to have their rights promoted, upheld and protected.
It includes areas for future action including improving the reach and effectiveness of all complaint procedures.
The Strategy covers six policy areas including health and wellbeing and identifies a range of areas for future action, ranging from actions to improve the responsiveness of the health system for people with disability, through to increasing the representation of people with disability on universal health advisory bodies.
In the first year of the Strategy, the focus will be on the development of an implementation plan that will include mainstream policy areas identified in the Strategy, including health and rights protection.
This will provide further opportunities for consultation and engagement with people with disabilities, their families and carers and key government and community stakeholders on the development of the Strategy.
I welcome your understandings and insights from handling complaints from people with disabilities, their families and carers and I would very much welcome your participation in the consultation process for developing the Strategy’s implementation plan.
Although the National Disability Strategy is a government commitment, it recognises that a whole-of-community effort is required to improve responses to people with disabilities and remove barriers to economic, civic and social life.
Disability Insurance Scheme
Alongside the development of the Strategy there has been much work undertaken to evaluate the appropriateness of bringing in a disability insurance scheme in some form.
People with disability, their families and carers have wanted a major rethink about how we fund and deliver services and support to people with disability.
One important initiative this Government has instigated is the Productivity Commission Inquiry into a national disability long-term care and support scheme.
It’s the first time any Australian government has looked at such a major change to the way we fund our disability system.
While Australia’s social security and universal health care systems provide an entitlement to payments and services based on need, there is currently no equivalent entitlement to disability care and support services.
And as you would well be aware, these services are under constant pressure.
That’s why we are seriously examining to see if a long-term care and support scheme is appropriate for Australia, complete with extensive modelling and analysis of interactions with existing service systems.
The Inquiry will consider costs, benefits, implementation and design issues, governance arrangements and administrative issues.
It will examine a social insurance model on a no‑fault basis, reflecting the shared risk of disability across the population, as well as other options that provide incentives to focus on early intervention.
The Commission will report its findings to Government by July 2011, and we will fully consider the report and its recommendations.
I am sure you are aware that we ratified the UN Convention on the Rights of Persons with Disabilities and entered into force for Australia on 16 August 2008.
Whilst the Convention does not create new rights, it specifically prohibits discrimination against people with disability in all areas of life.
The Convention aims to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms for all persons with disability, and to promote respect for their inherent dignity.
The National Disability Strategy will help Australia fulfil its obligations under the Convention.
Under the Convention, persons with disabilities have the right to the highest attainable standard of health without discrimination1.
They are to receive the same range, quality and standard of free or affordable health services as other persons, as well as health services needed because of their disabilities, and not to be discriminated against in the provision of health insurance.
Disability and Health
People with disability have considerably poorer health outcomes not all of which can be attributed to their disability.
Barriers to accessing quality health outcomes include:
- clinical knowledge of the health profession of the particular needs of people with disabilities;
- out of pocket costs of health care particularly relating to allied health and pharmaceuticals;
- accessibility issues including the physical environment and barriers to communication;
- interface issues between disability and mental health; and
- early ageing of people with certain disabilities.
There are a range of responses that can be pursued in order to remove barriers to quality health services.
Growing pressures on both the Health and Disability budgets of Commonwealth and State and Territory governments will continue as our population ages.
It is therefore timely that effort and energy is directed to ensuring that our health system understands and responds to the particular health needs of people with disability.
Ideally, responses to barriers to accessing good health outcomes should be developed in a systematic way, but individual policy responses are also welcome.
Last year it was brought to my predecessor, Bill Shorten’s attention that a survey conducted by the Physical Disability Council of New South Wales amongst people with disability found that over 80 per cent stated that their General Practitioner did not provide height adjustable examination beds.
The findings of that study were compiled into a report: Report on Access to Adjustable Height Tables by People with Disability and General Practitioners.
According to this report, people who cannot access height adjustable examination beds are more likely to not have access to either acute medical care or preventative medicine.
Furthermore, the report argues that these people are at increased risk of mis-diagnosis or non-detection of potentially serious conditions.
I am pleased to say, though I suspect that most of you already know, that following a number of correspondence between various parties, in the review of the 4th edition of their Standards for General Practice, the Australian College of General Practice has proposed that a height adjustable examination bed in each practice be a mandatory requirement of practice accreditation standards.
This example highlights that addressing one of a number of significant health access issues for people with disability can be achieved if we are all on the same page.
However, we still have a long way to go to ensure that access to health care by people with disability is sufficient to meet the needs of those with special needs.
One area which I believe will deliver much better health outcomes for people with disability is the introduction of the e-health program.
E-health is the electronic management of health information to deliver safer, more efficient, better quality healthcare.
Our Government is committed to e-health and is facilitating the transition of paper-based clinical record keeping to electronic means for better information exchange.
We are investing almost $470 million to introduce e-health across the health system – including the introduction of personally controlled electronic health records which will be rolled out from July 2012.
We know that the introduction of an e-health record will assist in avoiding medication errors; will decrease the number of pathology referrals; will allow the many treating professionals that people with disability use to share medical information with the approval of the individual concerned.
We expect that people with disability along with people with mental illness, will be significant beneficiaries of this program.
Although this Government has made many advances in the area and put disability on the political map, there is still much to be done before people with disability and carers are treated as equal citizens in this country.
Thank you again for the opportunity to speak with you today and I welcome the chance to have a discussion about issues that you would like to raise.