Submission to the Productivity Commission

Inquiry into Disability Care and Support
Issues Paper

October 2010

Introduction
The Department of Broadband, Communications and the Digital Economy (the Department) welcomes the opportunity to provide a submission to the Productivity Commission in response to the Issues Paper on Disability Care and Support. 
The Department supports the consideration of broadband and other enabling technologies as a means of improving and managing more efficiently the current system of disability support services in Australia.
1.	Streamlining service delivery through broadband access
The Issues Paper sought comment on how the delivery of disability services could be streamlined, including economic and environmental efficiencies.  
The National Broadband Network (NBN) is an Australian Government Initiative which will deliver high speed broadband access to all Australians. The NBN will provide access to high speed broadband to 100 per cent of Australian premises. The Government’s objective is to connect 93 per cent of Australian homes, schools and businesses with fibre-to-the-premises technology providing broadband speeds of up to 100 megabits per second. All remaining premises will be served by a combination of next generation wireless and satellite technologies providing peak speeds of at least 12 megabits per second. 
Access to high speed broadband as a result of NBN will provide the opportunity to streamline services, increase efficiency, reduce environmental impacts and assist in delivering timely, high quality services to people with disability. 
The Department’s 21st Century Broadbandpolicy has identified the NBN as a key technology platform for delivering a range of benefits in relation to health care. 

High speed broadband can make a positive impact on health outcomes by improving the efficiency of the systems and processes used, allowing more dollars to be spent directly on patient care. The implementation of electronic health records, which can be transferred quickly, securely and reliably between GPs and specialists, is a good example. 
A high speed broadband network will also support access to specialist advice and second opinions through the secure electronic transfer of diagnostic information and test results, such as x-rays, enabling early diagnosis of diseases and treatment and potentially reducing hospital stay times. It can reduce the need for patient travel outside of rural and regional centres. 

The case for broadband as a more effective and efficient service delivery platform for health services has also been made in the Department of Health and Aging report, Building a 21st Century Primary Health Care System: A Draft of Australia’s First National Primary Health Care Strategy 2009.
The draft strategy stated that:
Electronic health records and new technologies support care integration, improve health outcomes, and deliver capacity, quailty and cost-effectiveness across the health system.
The report  also noted that:
eHealth and other technologies are key enablers of a sustainable health system and important building blocks for primary health care reform. eHealth can change the way health professionals interact with each other and with their patients, and support a more patient-centered health care system.
In the international arena, the social and economic benefits of broadband access have been highlighted in the Organisation for Economic Cooperation and Development (OECD) 2007 report, Broadband and the Economy.
Almost every aspect of economic activity and everyday life is already affected by broadband enabled ICTs, and with rapid technological developments and a continuous stream of new applications the pervasiveness of ICTs is likely to increase (pg 48).
The Report also stated that:
Broadband and very high-speed networks are also playing a wider and important role in enabling innovation, another factor contributing to the conditions for sustainable economic growth (pg 10).
Privacy principles, organisational capabilities and the accessibility of broadband services need to be considered when determining the most appropriate way to introduce online service delivery options into disability care and support services. These factors would be most appropriately considered as part of the joint implementation of the National Disability Strategy by government agencies.
2.	Increasing consumer engagement through broadband access
The Issues Paper sought comment on how to increase the participation of people with disability and their carers, as well as how to reach people in rural and remote areas of Australia more effectively.
Access to high speed broadband, through the rollout of the NBN, will assist Australians with a disability and their carers to connect with government and online services in new and innovative ways. For example, high speed broadband access can assist in reducing social isolation due to disability or location through online health services or remote appointments with health care professionals.
One example of broadband-enabled health services is the South Australian Digital Telehealth Network Project, funded through the Department’s Digital Regions Initiative. This project aims to use broadband-enabled services such as medical consultations via video-conferencing to bring medical facilities and services to areas that do not normally have such access. It is anticipated that the services delivered through this project will reduce patient travel time and improve patient care.
Online applications such as Skype and social networking websites also provide opportunities for people with disability to engage with friends, family and the local community in new and innovative ways which may help reduce social isolation. 
However, the design of online serve delivery or social tools needs to consider accessibility for people with disability, such as the need for screen reading software for the blind. In some cases, it may be necessary to include extensive outreach and education to support the uptake of online services by people with disability and their carers. 
The Australian Bureau of Statistics 2006 General Social Survey reported that 55.5 per cent of people aged 18-64 with a core activity restriction used the internet in their home during the previous 12 months, compared with 70 per cent of people without a disability. These figures indicate that without education and outreach the full benefits of online services are unlikely to be realised by people with disability.
3.	Accessibility of broadband and online services
In advancing any aspect of online disability care and support, consideration needs to be given to how access to services would be facilitated. 
The current arrangements for the supply of telecommunications disability equipment is provided for under the Telecommunications (Consumer Protection and Service Standards) Act 1999.  The Universal Service Obligation (USO), established through this legislation, guarantees access for all Australians, including people with disability, to a standard telephone service.
Furthermore, the Telecommunications (Equipment for the Disabled) Regulations 1998 specify the types of equipment that may be used to access a standard telephone service.  Equipment is provided through the Telstra Disability Equipment Program including teletypewriters (TTY), volume control handsets and specialised accessories.
The National Relay Service (NRS) is a telephone access solution for people who are deaf or have a hearing or speech impairment. The service is available 24 hours a day, seven days a week. In April 2010, the Minister for Broadband, Communications and the Digital Economy announced that the Department would undertake a review of the NRS. This review will consider how the NRS might be improved for the future, including consideration of new and emerging communication options.
Other communication aids, such as specialised equipment for people with complex communication needs, can be sourced through some state and territory aids and equipment programs. The eligibility, funding and types of equipment are determined at the state or territory level.  The current USO arrangements do not extend to internet access and broadband services.
The Department notes the move across governments towards international standards for accessibility in the provision of online services. The introduction of the Web Content Accessibility Guideline 2.0 (WCAG 2.0) sets an improved level of accessibility which is likely to result in a future online landscape where accessibility for people with disability is built in rather than bolted on. 
Australian governments at all levels have endorsed WCAG 2.0, and will be required to meet the new guidelines at the minimum compliance level (Single A) by the end of 2012. In addition, the Australian Government requires all federal websites to meet the medium conformance level (Double A) by the end of 2014.
Further Input
The Department would welcome the opportunity to make a further submission to the Commission’s inquiry at the release of the draft report in February2011.