Legislative Council Tuesday 21 August, 2018

QUESTION UPON NOTICE

The following answer was given to a question upon notice:

 Ms FORREST  asked the Acting Leader of Government Business in the Legislative Council -

With regard to Tasmania's outreach services:

(1)       Does the table accurately reflect the number of services that have been committed to under the various funding streams?

(2)       For each of the services listed in the table -  

(a)   What services have been provided?

(b)   How many visits to each location have been provided per annum?

(c)   What dates were these services provided?

(d)   At what locations were the services delivered - for example, in clients' homes, council offices, local hospitals or other health facilities, or at other locations?

(3)       Are any other service providers providing allied health services to rural areas in the north west?  If so, which services and to which locations?

(4)       How do these numbers per capita compare with the north and south of the state?

Mrs HISCUTT replied -

(1)       All services listed on the table accurately reflect what was delivered in 2017-18, with the following exceptions, and I will seek leave shortly to table all the tables -

•        A new visiting psychiatrist was recruited for King Island to increase the annual number of clinics available, which resulted in a temporary reduction in service levels while recruitment was completed.

•        The provider of the Neuropsychology Early Onset Dementia service decided to cease delivery.  Funding for the Neuropsychology Early Onset Dementia service was reallocated to increase services for people with Huntington's disease in Devonport and Launceston.

•        Recruitment of a service provider for community-based health promotion activities on King Island resulted in a temporary reduction in service levels while the recruitment process was completed.

From time to time service providers decide to move away from Tasmania, retire or for other reasons cease providing outreach services.  TAZREACH has no control over these decisions but will always work to ensure the best possible outcomes for affected communities.

(2)       (a)    Please refer to attachment 1, which is a full list of services and frequency.  All services in the table were operational through 2017-18 and with the exceptions noted in the answer to question one have been delivering their planned level of service.  In addition seven services received one or two additional visits in order to meet ongoing high demand.

            (b)    The final number of visits provided during 2017-18 will not be known until all service claim forms are submitted to TAZREACH by service providers.  Available service data indicates that over 90 per cent of services will complete their full allocation of visits in 2018-19.  It is not unusual for at least some services to not complete one or two of their allocated visits, due usually to holiday breaks, family leave or personal illnesses.

            (c)    Please refer to attachment 1.

            (d)    Services are mainly delivered at Tasmanian Health Service - THS - rural hospitals and community health centres.  Aboriginal health services are delivered at Circular Head Aboriginal Corporation and the Tasmanian Aboriginal Centre in Burnie.  A small number of services are delivered at Rural Health Tasmania in Ulverstone, at Devonport GP Superclinic and at the Ochre Health medical practice in Strahan.  No TAZREACH services were delivered in the home. However, professional guidelines and governance process to ensure the safety and quality of home visits have recently been developed for TAZREACH services in the event this occurs in the future.

(3)       The Tasmanian Health Service provides a range of allied health services across the north west of Tasmania and the west coast, including occupational therapy and physiotherapy clinics in the west coast, Circular Head and King Island.  These are a mixture of regular clinics that vary from weekly to quarterly depending on the nature of the clinic and the number of people waiting for the consultations.  Some of these services may be provided in clients' homes if necessary, otherwise they are provided at THS facilities. 

            Primary Health Tasmania - PHT - funds a range of organisations including the Royal Flying Doctor Service Tasmania to provide allied health services for people with diabetes, mental illness, chronic conditions and geriatric conditions.

            PHT also funds Rural Health Tasmania, a non-government organisation located in north west Tasmania, to deliver services for people with mental illnesses, cancer and other chronic conditions.  Other known service providers that are located in the north-west or visit the north-west for provision of allied health-type services additional to TAZREACH funding include St Giles, Rural Alive and Well, Youth, Family  and Community Connections (youth drug and alcohol service in Burnie) and Australian Hearing.

            The Government, through TAZREACH and other agencies attempts to collect information about existing services from known service provider organisations such as RFDS Tasmania and PHT; however, these organisations are under no obligation to provide or proactively update this information when a service profile changes.  As such the Government does not currently possess completely comprehensive information about the level and frequency of allied health services provided by all organisations in the north-west.

              HealthWest Queenstown and the King Island Hospital and Community Health Centre employ some allied health staff, the nature of which changes from time to time depending on workforce availability.  For example, this may be a mental health worker or social worker.  These positions are typically part-time only.  There has also been a nurse practitioner position on the west coast. 

              There are also privately practising optometrists, physiotherapists, podiatrists, dieticians and social workers at Devonport and Burnie, some of whom may provide visiting services to other parts of the north-west and west coast from time to time.

             The location and frequency of all of these services can vary at any time according to provider availability and the organisation's decision-making around service priorities.  For example, Diabetes Tasmania may provide a service to locations in the north-west if that is requested directly, but will typically only schedule an outreach visit when there is a sufficient number of referrals waiting.

(4)         All rural and remote parts of the state - and Australia generally - are subject to the same variables and indeterminacies in levels of service provision and service profiles, largely as a result of workforce shortages in areas of low population density and consequent relatively low demand compared to urban centres.  For reasons of these variables, it is not possible to determine the overall level of service per capita in the north-west or to compare service levels in the north-west with other parts of the state.

               An analysis of 2017-18 TAZREACH service data shows the following -

•        North-west Tasmania and the west coast have so far been provided with 684 clinics across 92 services.  Of those 92 services, 25 are Aboriginal health services and 67 are mainstream health services.

•        Northern Tasmania has so far been provided with 644 clinics for 81 services.  Of those 81 services, 31 are Aboriginal health services and 50 are mainstream health services.

•        Southern Tasmania has so far been provided with 406 clinics and 48 services.  Of those 48 services, 25 are Aboriginal health services and 23 are mainstream health services.

Importantly, this service distribution reflects population data for Aboriginal Tasmanians. 

With the rollout of the National Disability Insurance Scheme, there are likely to be improved market prospects for private providers in regions, particularly for disciplines that did not have much of a prospect of operating privately in the past, such as occupational therapy and speech pathology.

Mrs HISCUTT (Montgomery - Leader of the Government in the Legislative Council) -

Mr President, I seek leave to move that the attachments be incorporated into Hansard.

Leave granted.

Attachment 1: Table of TAZREACH Services 2017-2018 as at 21 June 2017