Political roadblock stalls remote kidney disease treatment

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At the latest Senate Estimates hearings, the Department of Health was asked what progress was being made on dialysis in Central Australia.

Most would not know what this is about, but it goes to funding of $10 million set aside by the Commonwealth for the Northern Territory Government in 2011.

That funding was to be used to provide accommodation for dialysis patients from remote communities coming to Alice Springs and Tennant Creek. The Department of Health responded at the estimates hearing that it had just received a new proposal from the Northern Territory Government and that the funding allocated three years ago was still in the Commonwealth’s bank account.

This may appear to be good news, but it comes after sufferers of kidney disease and their families have had to endure more hardship and a community organisation established by Aboriginal people to help them has had had to divert much of its resources and time to advocate for a resolution.

The Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Corporation or Western Desert Dialysis was established by Pintupi people who raised one million dollars from auctioning their own art to establish the first 'on community' dialysis service in Kintore in 2004 so that sufferers of kidney disease and their families did not have to travel to Alice Springs with all the problems and costs that this entails.

Since then, Western Desert Dialysis has found a way to expand its services to other remote desert communities in Central Australia. This has been due to the incredible efforts of individuals like its CEO, Sarah Brown, and its partner, Caritas Australia, which provides funding through its First Australians Program, all raised from donations.

The $10 million from the Commonwealth, if spent in partnership with Western Desert Dialysis, could make a real difference. It should be spent in remote communities so that dialysis patients and their families do not have to travel into Alice Springs with all the challenges that this entails.

Western Dialysis’s model works. The fact that, after three years, there is no resolution of how the funding will be spent, including any knowledge of the proposal that the Territory Government has put to the Commonwealth, is a shocking response to the needs of one of the most vulnerable groups in Australia.

It is easy to blame the Territory Government. Its record on Indigenous Affairs, including its use of extra Commonwealth funding, is not good. But the Commonwealth also must take some responsibility for the delays. In the main – and noting some exceptions such as in the case of the Stronger Futures in the Northern Territory package – agencies in the Commonwealth treat the Northern Territory like a State.

It isn’t a state under our Constitution, and while its self-government legislation gives it state-like functions, it has very little capacity to fully enact policy, especially because it lacks a sufficient revenue base. It cannot act alone to meet long term challenges such as the reality that the Territory has the highest rate of kidney disease in the world.

It can’t be expected to accept a proposal from the Commonwealth to spend $10 million – welcome as it is – if it has significant implications for its own budget going forward. Importantly, the Commonwealth should not have allowed this to drift for so long, and it should have taken leadership well before now, including bringing the Territory Government and Western Dialysis together to work out the best way to spend its funding.

There is another aspect to this, and that is that it is time that the Catholic health system and the private health system as a whole, were engaged more in remote Australia, in order to achieve better health outcomes. Governments can’t do it all on their own, and neither can Aboriginal community controlled health organisations.

There is a role for others to bring their capacity to bear in remote Australia and in the way they do in mainstream Australia. This will ultimately help secure a sustainable response to challenges like kidney disease in the Northern Territory and the Commonwealth needs to consider financial incentives for this to happen.

In the meantime, the St Vincent de Paul Society and the Cabrini Health Foundation are thankfully contributing to a new dialysis home service at Santa Teresa, a former Catholic mission near Alice Springs. But there is no guarantee that the Commonwealth’s 2011 funding allocation will be spent any time soon, and in collaboration with community organisations such as Western Desert Dialysis. They care for sufferers and families every day.

Our system of government isn’t working if this is the result, and those preparing the White Paper on reform of the Federation ought to take note of this shocking example.


Brian StaceyBrian Stacey has worked for many years as a contributor to policy and programs for Indigenous Australians. He is seeking tax deductible donations on behalf of Western Desert Dialysis.

Image: Dialysis patient Hilary Tjapaltjari at home in Kintore (westerndesertdialysis.com)

 

Topic tags: Brian Stacey, Western Desert Dialysis, kidney disease, indigenous Australians, Caritas, vinnies

 

 

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Existing comments

Thanks Brian. Communities across the Western Desert have raised and continue to contribute millions of dollars into dialysis clinics in their communities. The self starter lift up by your bootstraps community action favoured by governments in Darwin and Canberra has already happened and it's time for government to help join all the sources of funds together for a cohesive and sustainable funding model.
Morgan Hitchcock | 17 March 2015


Excellent piece Brian, and coming from one with such a deep knowledge of the inner workings of bureaucracies in both the NT and Canberra, your criticisms are a true indictment on both governments. That people continue to suffer and be displaced to access dialysis is an absolute disgrace.I hope this is read widely. - Natasha
Natasha Robinson | 18 March 2015


OK as far as it goes. More ambulances at the bottom of the cliff. But what about prevention and especially the tsunami of obesity and type 2 diabetes that underlies most of this, in a population especially vulnerable to kidney disease.
Eugene | 18 March 2015


Thanks for bringing more attention to plight of dialysis patients in Central Australia.
Joe Martin-Jard | 18 March 2015


Well said Brian. I remember Peter Toyne [when in government] played a supportive role in facilitaing the Kintore art sale. Could it be that the the Northern Territory is a 'failed state'? While I see a role for Vinnies and Catholic agencies it is worrying that in taking up the slack these agencies are permitting the government[s] to avoid primary responsibility. It could even have been that in Toyne's case that his actions could cynically have been seen as part of this abrogation. I admired him and felt he had the interests of his electorate at heart but such is the nature of the improverished NT financial base that it will look everywhere for alternatives for funding. The funding fiasco emerging for Aboriginal programs in Central Australia [it is alleged that the iconic Institute for Aboriginal Development (IAD) might be forced to close] in this round indicates that more of the same is in the pipeline.
Mike Bowden | 18 March 2015


There's a new competition for inventor to find a cheaper, more accessible machine for dialysis. I came wait to see what this means for less accessible communities. It's always the ones who need the most help who get forgotten first
rachel | 20 March 2015


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