Access to dialysis services, and particularly community-based services, has been an issue which the Anangu Lands Paper Tracker has advocated for over many years in response to a need expressed by renal patients living on the APY Lands in the North-West of South Australia. This important issue has been championed by the Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Corporation (the Purple House), the Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Women’s Council Aboriginal Corporation, other community-controlled organisations and leaders from many remote communities.
Setting up a Medicare Benefits Schedule (MBS) Review Taskforce
On 22 April 2015, the then Minister of Health and Sport Sussan Ley announced that a Medicare Benefits Schedule (MBS) Review Taskforce would be established. The aim of the taskforce was to consider how the more than 5,700 items on the MBS could contribute to improving health outcomes for patients.
As part of this Review, the Renal Clinical Committee was established in April 2016 to make recommendations to the Taskforce about renal-related items on the MBS.
The Committee was assigned seven items to review, all relating to the provision of haemodialysis and peritoneal dialysis. Amongst its other recommendations, it recommended that a new item should be created for dialysis in very remote areas.
The Anangu Lands Paper Tracker made a submission to the Renal Clinical Committee in support of including an MBS item for remote dialysis. You can read our submission here. In our submission, we strongly supported Recommendation 4.1 (Very remote dialysis item) as its implementation would enable more renal patients to remain on country with their families and contribute to community life.
We also said that enabling dialysis treatments and services to be administered by a renal nurse, Aboriginal and Torres Strait Islander health practitioner or Aboriginal health worker would significantly enhance access to dialysis treatment in remote communities and that the inclusion of a very remote dialysis MBS item would enable an increase in the provision of community-based dialysis services, with a likely increase in patient attendance, and subsequent improvement in clinical outcomes as well as a reduced hospitalisation rate, with fewer dialysis patients risking their lives to return to the community without treatment, thereby putting a strain on primary health care services.
Outcomes of the recommendation to the Taskforce
An important outcome of the work of the MBS Review Taskforce is that the Federal government has added dialysis services to the Medicare Benefits Schedule (MBS) to provide better access to lifesaving treatment for Aboriginal and Torres Strait Islander people living in remote communities. You can read the Renal Clinical Committee’s Report here and the Department of Health’s summary document here.
The renal health MBS item, amongst other new additions to the scheme, means that from 1st November 2018, Medicare will cover some of the costs of dialysis delivered in remote areas, ‘in a primary care setting’.
Without this MBS item for remote dialysis, organisations like the Purple House would have to continue to rely on private donations and fundraising to cover the costs of providing dialysis treatments in remote communities. The new MBS item will mean that more Anangu tjuta can access dialysis treatment in their communities, resulting in better health outcomes and happier patients.
If you would like to listen to an Anangu Lands Paper Tracker radio interview with Sarah Brown from the Purple House about these developments with the Medicare Benefits Scheme, you can listen to it here.