"We have been frustrated over plans to deliver world-class broadband to 97 per cent of the population," National Rural Health Alliance chairwoman Jennifer May has told an inquiry into the NBN.
"For us, the missing 3 per cent -- those who live in quite remote and poor reception areas -- provide the real test.
"If the small proportion of Australians to whom it is difficult to deliver fast broadband do not receive it, the relative disadvantage of those in rural and remote areas will be further enshrined."
Under the NBN Co proposal, fibre will be supplied to 93 per cent of Australians, 4 per cent will receive wireless services, and the remainder will get a satellite service.
The Indigenous Remote Communications Association said internet delivered by satellite in remote areas since 2002 initially had met community needs.
"However, the low speeds, regular technical problems, outages during heavy cloud or dust and small download limits mean these services are inadequate for present needs," it told the inquiry. "Satellite has been a good short-term solution while terrestrial infrastructure is established and will be useful as an emergency service."
The association said two-way streaming and key government and health applications did not work well over satellite services.
"We suggest regional 'node' communities be identified and linked with fibre-optic backhaul, with the surrounding clusters supplied via microwave links," it said. "While fibre-optic may be more expensive initially, the ongoing usage and significantly lower maintenance costs would easily offset that."
Dr May said the key principles should be universality and uniform pricing. "A standard retail price is essential, because affordability will govern usage, and need is greatest in small, isolated communities," she said. "Where cost is concerned, people in remote areas should be first, not last."
Dr May said the regional hospital in Tamworth, where she is based, had a web camera and fast-fibre links with an emergency department in Marble Bar, for example, so specialists could "see" patients and advise treating doctors. But it was not real-time; instead they were loading and sending images over the network.
"I can't get ADSL2+ in Tamworth," she said. "In the surgery, I have electronic medical records and clinical decision support, but not through the internet: it is standalone."
Alliance IT manager Michael Wearne said many e-health applications required a symmetric connection, or at least much faster upload speeds. "With ADSL2+, the speed drops dramatically with the distance from the exchange, and (you need) good exchanges, which many (remote) areas would not have," he said.
Australian Medical Association vice-president and north Brisbane GP Steve Hambleton told the inquiry his practice did not use electronic systems to communicate with local hospitals and specialists. "If we do send information to hospitals, it is by fax," he said. "At this stage, there are no protocols to allow us to do it securely (electronically)."
Health first assistant secretary, Medicare Benefits, Richard Bartlett said the department had not formed a view on the minimum speeds needed to support e-health services.
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Autor(en)/Author(s): Karen Dearne
Quelle/Source: Australian IT, 15.03.2011
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