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 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)