APPENDIX A.
Jurisdiction | Model | Additional state/territory funding? | Features |
---|---|---|---|
New South Wales [A40] | Usual care | No. |
|
Queensland14 [A35] | Designated provider | Yes – $10.4 million (~£6.7 million) over 3 years in 2006 to develop its own programme (the Queensland Bowel Cancer Screening Program). |
|
South Australia [A39] | Mixed | Yes – they pay the greater share of costs for pathway coordinators (the rest paid for by the Commonwealth). |
|
Tasmania [A38] | Usual care | No |
|
Victoria [A37] | Mixed | Yes – $14 million (~£9 million) over four years allocated in 2007. |
|
Western Australia [A36] | Usual care | No |
|
Australian Capital Territory (ACT) [A41] | Mixed | No |
|
Northern Territory (NT) [A42] | Opportunistic screeninga | No |
|
Usual care is not considered appropriate for the NT because it has a high proportion of Indigenous people (36.1%)39, the vast majority (81%) of whom live in remote or very remote areas.40 This raises both practical and cultural barriers. The practical issues include the absence of postal addresses in remote communities, where all mail is sent to the health clinic or community council. The kits themselves are often addressed incorrectly, as Aboriginal people may have several names over their lifetime. Moreover, most patients in the NT have several co-morbidities such as diabetes, renal failure and chronic obstructive pulmonary disease, and require more targeted invitational approaches. The cultural issues include the fact that faeces is considered shameful in Aboriginal culture, so clinical staff need to be involved in explaining the collection process, helping with the collection and returning the kits to the pathology lab [A42].