With the Federal election looming, mivision is keen to know exactly where the parties stand when it comes to the very important and costly issue of eye health.Previously, we asked the Minister for Health and Ageing, the Hon. Nicola Roxon, about the Federal Government’s policies and intentions when it comes to the eye health of Australians. Recently, we posed the same questions to the Shadow Minister for Health and Ageing, the Hon. Peter Dutton in an attempt to learn the Coalition’s views on the topic. Here is his exclusive response to mivision…
We all know that there are huge challenges that still need to be tackled in regard to eye disease and vision loss and that there is an unacceptable disparity in the distribution of eye disease across the Australian population.
Whilst the role of Government is important whether it be local, State or Federal, it is true that Governments, particularly in areas of health and clinical care, cannot solve everything in isolation.
Issues such as eye health do not always get the attention they deserve. Many worthy and important causes are often drowned out by other issues in media and political cycles.
Of all the health issues facing Australia, trachoma is surely one of the most concerning
We know that loss of vision has such a dramatic impact on quality of life, independence, employment and social circumstances.
With over 500,000 Australians with vision loss and some 66,000 being blind, the impact on our society is significant.
It is our challenge to ensure the health debate and health reform isn’t always just about hospital care, as important as that is. Similarly, preventative health is about more than tobacco, alcohol and obesity.
If we are genuine about wanting to improve the health outcomes for Australians we do need to broaden our thinking and tackle some of the big issues which can place such a heavy burden on the lives of affected individuals.
The total economic cost of vision disorders in Australia is estimated to be in the order AUD$16 billion. It is a staggering figure that takes into account health system costs, early entry into residential care and home and community care, building modifications, carer costs and lost employment amongst others.
However, it assists us to understand the devastating impact loss or impairment of sight can have on so many facets of a person’s life. It is personally devastating, personally costly and costly to society.
There is a greater need to examine the linkages, the causes and co-morbidities of health conditions at a policy level. Whilst our budgetary processes examine health issues in insolation, it rarely reflects reality.
This was a key area of contention within the recent cataract debate.
Reducing funding for the Medicare rebate had a direct budgetary impact and seemingly provided savings.
However, there was no modelling or account given to the increased costs to the public system, additional hospital admissions for falls and fractures, early entry to residential care and home care and the impact on general health and wellbeing. It creates a false economy to look at these issues in insolation.
There was no thought whatsoever for patients – those who need vital cataract surgery. The Rudd, now Gillard Government, was prepared to force mostly older Australians, the ones who can least afford the extra costs, to pay more or forgo surgery.
It didn’t seem to matter that patients were faced with that terrible choice, the government was determined to press ahead with rebate cut, changing it several times to subvert the Senate decision that it should not be allowed to proceed.
While no thought was given to patients, no input was sought from the medical profession and the government actively worked to exclude ophthalmologists refusing to negotiate with them.
Working with stakeholders, and through what may be considered a complex and tumultuous process, the Coalition was able to force the government to the negotiating table and eventually secure what I would regard as a much better outcome for patients requiring access to a common, but very important procedure.
It is unfortunate that some eye health services to remote areas were lost in the three months it took to finally resolve the cataract rebate issue.
I hope that these services can be restored going forward.
It is a frustration of Opposition in not being able to implement policy, but as the cataract debate showed we intervened forcefully, drove public debate and achieved better results for patients.
Another prime example of the Coalition working strongly on eye health was the government’s moves last year to change the Extended Medicare Safety Net.
It brought forward legislation to controversially cap the Safety Net for a range of procedures.
In its original form the legislation would have affected injections into the eye and in turn treatment of macular degeneration. Given the limited treatment options available, many stakeholders raised compelling concerns for the effect on patients. Through strident negotiations, we were able to exempt the item number from the legislation. This was a big win for the many older patients on fixed incomes whose sight depends on regular treatment.
Despite the resources of a country as fortunate as Australia, and investments by Governments of both political persuasions, there are certain areas in health where the outcome for patients requires much more focussed policy attention.
The lack of positive health outcomes for people in some indigenous communities rightly remains a focus for political parties and policy makers.
While the emergency intervention in the Northern Territory may have been contentious, it shone a much needed light on the dire health and social situation of many people in remote indigenous communities.
It was important to push aside the talk, the staggering bureaucracy and put people on the ground who were equipped and qualified to render direct assistance to those in need.
Of all the health issues facing Australia, trachoma is surely one of the most concerning. It is important that we maintain the focus on this battle.
It is a condition of poverty and Australia sits amongst countries such as Ethiopia, Afghanistan and Cambodia with continuing incidence of active cases.
It is a condition that has long since disappeared from urban Australia, but recent studies have shown that its prevalence is still up to 23 percent for children living in remote indigenous communities.
This stark reality provides a strong impetus for all sides of politics to continue the fight on this front.
More broadly, it is one example of the considerable challenge that lies ahead in reducing the disparity of health outcomes in this country. We should not be discouraged, but emboldened to do more.
Doing more does not mean more bureaucracy or greater waste, it means more targeted and evidence based policy and interventions. It means collecting and using reliable data for decision making.
Advances have been made in this regard. Tony Abbott, as Health Minister initiated funding for training and implementation of the Trachoma Guidelines.
In addition, funding was also provided for the National Trachoma Surveillance and Reporting Unit. These measures enabled a systemic approach to target, treat and control trachoma in Aboriginal and Torres Strait Islander Communities.
On the issue of Trachoma, to the credit of the current Minister, efforts have continued under the current government and there is broad political support for additional investments made.
Under Tony Abbott’s leadership, the National Eye Health Initiative was also delivered. The May 2006 Budget included funding for a range of activities to promote and strengthen services.
The promotion and commitment to eye health was consolidated through the National Health and Medical Research Council with funding for 95 new and continuing vision grants in 2006 alone.
Further, the Coalition expanded the Visiting Optometrists Scheme in the May 2007 Budget. This important scheme aims to improve access to services in rural and remote communities. It is through schemes such as this that we are able to work to address the maldistribution of health services and patient outcomes in Australia.
The announcement expanded geographic coverage of services in remote areas and reduced financial disincentives incurred by optometrists in providing outreach services.
It ensured optometrists were more appropriately remunerated and provided more flexible and cost effective service delivery. Significantly, it improves early intervention and provides for better long term eye health care.
I mention these initiatives because the Coalition does have a positive story to tell on health and in particular, eye health.
We have supported the Government in the continuation of a range of measures and intervened when Budget cuts would have been detrimental.
We remain committed to building on the work of all governments and are optimistic as to what can be achieved working with those on the frontline of clinical care, with high risk communities and key stakeholders.
Vision 2020 recently celebrated a decade of successful work since its inspection in 2000. The Coalition supports its mission to eliminate avoidable blindness and vision loss by 2020.
The Coalition will release our health policies as we proceed to the coming Federal election.