Providing a Remote Health Service and the Price of Fuel

Alice has 2nd highest fuel prices in country was the headline of an ABC article on Monday. Fuel in the Alice costs $1.48 a litre. I assume this is unleaded though diesel would be sold far more frequently than in most other centres.

The Australian average regional price according to the Australian Institute of Petroleum was $1.31 week ending 21st November. (It looks like this page is updated each week so click on the picture for the figures I am comparing).

click for full picture

I live in remote Western Australia. The average regional WA price for diesel in this time period was 135.6 cents a litre.

In Broome fuel is apparently $1.49 a litre.

Out bush in remote WA I am paying $2.00 a litre for diesel.

Let’s briefly put this into a remote health/Indigenous Health context.

Expenditures on health for Aboriginal and Torres Strait Islander peoples 2004-05

The expenditure on health for those in remote and very remote areas is higher than all other areas. But as I demonstrated, fuel costs by themselves can be a third higher. This impacts as an example on what tradies charge to maintain and repair infrastructure, the cost of attending a motor vehicle accident and freighting out medical supplies.

I do wonder what the direct spend on staff and equipment per population in remote areas to that in other parts of Australia would be. My feeling that stripping out the costs (essential to provide a service, but not the service itself) would see less paid on direct patient care for a population group with a higher amount of illness in whatever disease you want to look at.

References:
Australian Institute of Petroleum website accessed 28 Nov 2011
AIHW Expenditures on health for Aboriginal and Torres Strait Islander peoples 2004-05

Clinical Pharmacist Practitioner in Indigenous Health, Remote South Australia

There aren’t many pharmacist jobs in Indigenous Health in Australia. Remote, rural or urban. Here is a great Pharmacist job with an Aboriginal Health Service in Port Augusta that has a long and beneficial relationship with pharmacists.

Download (PDF, 169KB)

(Disclaimer: I did some work with Pika Wiya Health and the pharmacy that services it in 2001 or 2)

Status Report on the PBS Medicine Supply Arrangements for Remote Area Aboriginal Health Services

Special arrangements for the supply of Pharmaceutical Benefits Scheme (PBS) medicines to patients of eligible Remote Area Aboriginal Health Services (AHSs) were introduced in 1999 under Section 100 of the National Health Act 1953. These patients can obtain PBS medications without charge and without a PBS prescription

Currently 166 remote area AHSs, both community controlled and remote health services operated by the States and Territories, have access to S100 medications through these arrangements.

Numerous evaluations and reports have been performed over the years including a formal evaluation in July 2004 and and a consultants report in 2009.

As well as ensuring supply of pharmaceuticals the S100 program is also supposed to collect data, monitor the program in response to the 2004 evaluation. This “Status Report on action in response to the evaluation” is apparently a living document. It was last updated on 9th October 2007. So the document is dead or they are not really monitoring the program. I’m tempted to believe the latter alternative.

I have placed the document here as a slideshow with a link to the government website and document below.

Over the next few months I will look at some of the activities they are supposed to be reviewing.

Status Report on action in response to the evaluation

Walgan Tilly – Redesigning Aboriginal Health Programs in NSW

In NSW the Redesign Project Walgan Tilly produced a number of recommendations which in June 2008 led to changes in the way programs for chronic disease in Indigenous Australians was handled.

This means that all existing and new initiatives designed for Aboriginal people with a chronic disease are now under the strategic program direction of Chronic Care for Aboriginal People – CCAP. This portfolio is managed and monitored by the Health Service Performance Improvement Branch with a Memorandum of Understanding with the Centre for Aboriginal Health.

This presentation by James Dunne Assistant State-wide Program Director NSW Health gave at the recent Redesigning Healthcare Summit (held early May in Melbourne) describes the journey. I look forward to a presentation in a few years showing us the improvement

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