Australian Association of Developmental Disability Medicine Inc.

8 May 2011

Productivity Commission Australian Government RE: Disability Care and Support Public inquiry

The Australian Association of Developmental Disability Medicine (AADDM) is a national organisation of medical practitioners who are committed to improving health outcomes for people with intellectual disability. The members of the association provide clinical medical services directly to people (children, adolescents and adults) with intellectual disability, as well as research, education and policy advice to government. We would like to provide the following submission to the productivity commission. Please also find as attachments a recent AADDM proposition of the Place of People with Intellectual Disability in Mental Health Reform and an AADDM position statement on the Health of People with Intellectual Disabilities. AADDM strongly supports a review of the long term disability care and support scheme. We agree that the current system is fragmented, underfunded and unpredictable. Parents and carers often feel frustrated and extremely concerned about the future welfare of their child. We commend the Australian Government on rising to the challenge of improving this system to better support people with intellectual disabilities.

We would like to emphasise the following issues and concerns; 1. The quality of life of people with intellectual disability is dependent on an acceptable level of general physical and mental health. Current evidence highlights major inequities in access to health services and health outcomes. 2. Improving health services is a cornerstone of improving health outcomes, and this system must involve an effectively integrated primary and specialist health care network for both physical and mental health. 3. People with disability and their carers must have confidence that the service systems will meet their needs throughout their lifespan, with capacity to respond to increased needs at major periods of transition, eg going to school, leaving school. 4. Carers must remain an important component of the “patient/client unit”. 5. Intervention, support and care services must be delivered to provide adequate ongoing support for severe lifelong disabilities, as well as to people who are likely to make significant gains and “normalise” with intervention. 6. Determination of eligibility for services must not be based on diagnosis alone, but coupled with a standardised measure of function, and careful consideration of the accumulation of risks, eg psychosocial adversity, mental health problems. 7. The principles that underpin distribution of funds to people with disability must be similar across the range of impairments, eg client centred. 8. The limitations in current research evidence should be a challenge to government to better fund research into this high risk population, with demonstrated poor health outcomes. This is a priority as funding of services must increasingly be based on evidence. 9. People with intellectual disability need the services of specialist medical practitioners to ensure the generic healthcare system has the ability and expertise to provide high quality healthcare.

Yours sincerely

Professor Nicholas Lennox President

ABN 61 039 294 522 Address: QCIDD, University of Queensland, Mater Hospital, Raymond Tce., South Brisbane, Q, 4101 Phone: (07) 3163 2412 Facsimile: (07) 3163 2445 President: Professor Nick Lennox Secretary: Dr Jacqueline Small

National and NSW Councils for Australian Association of Intellectual Disability Developmental Disability Medicine

POSITION STATEMENT ON THE HEALTH OF PEOPLE WITH INTELLECTUAL DISABILITIES

We call for concerted action to redress intellectual disabilities. The specialised the poor health status experienced by services would facilitate collaboration people with intellectual disabilities. We between local health and disability services make this call to the Australian, and State and undertake research. and Territory, Governments. We call on the Australian, and State and There are over 300,000 people with Territory, Governments to each and intellectual disabilities in Australia. They together work to redress the inequity in have very high rates of health problems health care experienced by people with and these problems are often not intellectual disabilities. In particular, we diagnosed or appropriately treated. Life call on the Governments to establish a expectancy is reduced by up to 20 years. national network of intellectual disability health services. There are many causes of this situation, ranging across communication barriers February 2009 between patients and health professionals, complexity of diagnosis, lack of general Contacts: and specialised skills in the health Jim Simpson, NSW CID workforce, and health promotion Ass Prof Nick Lennox, AADDM campaigns and research not focusing on people with intellectual disabilities. Endorsements As well as the human and financial cost of poor health for people with intellectual Michael Kidd disabilities and their families, there is President, Royal Australian College of General considerable financial cost to the health, Practitioners 2002-2006 social security and disability service Dean of Health Sciences, Flinders University systems. Stephen Leeder AO Governments need to take action to Director, Australian Health Policy Institute provide equity in health care for people Professor of Public Health and Community with intellectual disabilities. All health Medicine care planning should include specific consideration of how it will meet the Julian Gardner needs of people with intellectual Former Public Advocate, Victoria disabilities. Jeanette Moss AM There also needs to be a national network Parent advocate of health services specialising in the health care of people with intellectual disabilities. Peter Brooks Executive Dean of Health Sciences, University These services would be a consultancy of Queensland and training resource to the mainstream Professor of Medicine health system so as to enhance its capacity to meet the needs of people with Bruce Robinson

Dean of Medicine, University of Clinical Professor of Medicine Professor of Medicine Malcolm Schyvens Gwynnyth Llewellyn Past President, Law Society of Tasmania Dean of Health Sciences, Professor of Occupation and Leisure Sciences Roger West Former President, Guardianship Tribunal, and Kevin Cocks Community Services Commissioner NSW Director, Queensland Advocacy Inc Human Rights Medallist National Health and Hospitals Reform David Richmond AO Commission Interim report Former chief executive of agencies including NSW Health and the Olympic Coordination People with intellectual disabilities “face Authority stark health inequalities”. (p 55) Bill Carter QC Retired Supreme Court Judge and Royal Primary health care centres need “robust Commissioner links to specialist multidisciplinary health teams who are skilled in the management John Dwyer AO of people with intellectual disabilities”. (p 96) Professor of Medicine and Founding Chair, Australian Health Care Reform Alliance Pre-election promise Ron Mulock AO Former Health Minister and Deputy Premier, “Labor does recognise that people with NSW intellectual disabilities are disadvantaged in the health system. ….In many Robert Strike situations, GPs and other health President, Self Advocacy Sydney and professionals require access to specialist Chair, NSW Council for Intellectual Disability advice to provide the health services people with intellectual disabilities require. Kim Oates AM ….The health of people with disabilities Professor of Paediatrics and former chief executive, the Children’s Hospital at Westmead needs to be part of [our] reform plans.” (Shadow Ministers Roxon and McLucas, November

2007) Guy Hamilton AM Former head of intellectual disability services, Western Australia The NSW Government has recently spelt out the need for a multi tiered framework Trevor Parmenter AM of action on the health of people with Professor of Developmental Disability Studies intellectual disabilities including the and past President, International Association for establishment of a statewide network of the Scientific Study of Intellectual Disabilities specialised intellectual disability health services to back up mainstream services. Kevin Stone (NSW Health (2007), Development of a service Parent advocate and executive officer, Victorian framework to improve health care of people with Advocacy League for Individuals with Disability intellectual disabilities)

Michelle Howard The NSW Ombudsman, who review Public Advocate - Queensland deaths of people with disabilities, has said John Taplin that the proposed NSW framework “is Professor of Psychology, University of Adelaide critical to improve the health outcomes for this vulnerable community”. Eileen Baldry (NSW Ombudsman, Report of Reviewable Deaths Associate Professor and Associate Dean in 2007, Vol. 1, p.ix) School of Social Sciences and International Studies, University of NSW Helen Beange AM

National and NSW Australian Association of Councils for Developmental Disability Medicine Intellectual Disability

POSITION STATEMENT ON THE HEALTH OF PEOPLE WITH INTELLECTUAL DISABILITY

We call for concerted action to redress the We call on the Australian, and State and poor health status experienced by people Territory, Governments to each and together with intellectual disability. We make this work to redress the inequity in health care call to the Australian, and State and Territory, experienced by people with intellectual Governments. disability. In particular, we call on the Governments to establish a national There are over 300,000 people with network of intellectual disability health intellectual disability in Australia. They have services. very high rates of health problems and these problems are often not diagnosed or Contacts: appropriately treated. Life expectancy is Jim Simpson, NSW CID reduced by up to 20 years. Professor Nick Lennox, AADDM There are many causes of this situation, ranging across communication barriers between patients and health professionals, complexity of diagnosis, lack of general and Endorsements - individuals specialised skills in the health workforce, and Richard Larkins AO health promotion campaigns and research not Former Vice-Chancellor, Monash University & focusing on people with intellectual disability. President, Royal Australasian College of Physicians As well as the human and financial cost of poor health for people with intellectual Michael Kidd AM disability and their families, there is Dean of Health Sciences, Flinders University Former President, Royal Australian College of considerable financial cost to the health, General Practitioners & President-elect, social security and disability service systems. World Organisation of Family Doctors

Governments need to take action to provide Kevin Cocks AM equity in health care for people with Director, Queensland Advocacy Inc intellectual disability. All health care Human Rights Medallist planning should include specific consideration of how it will meet the Patrick McGorry AO needs of people with intellectual disability. Australian of the Year 2010 Director, Orygen Youth Health There also needs to be a national network of health services specialising in the health care Stephen Leeder AO of people with intellectual disability. These Director, Menzies Centre for Health Policy services would be a consultancy and training resource to the mainstream health system so Jeanette Moss AM as to enhance its capacity to meet the needs Parent advocate of people with intellectual disability. The Ron McCallum AO specialised services would facilitate Chair 2010, UN Committee on the Rights of collaboration between local health and Persons with Disabilities & disability services and undertake research. former Dean of Law, University of Sydney

Fiona Stanley AC Tony Fitzgerald AC Director, Telethon Institute for Child Health Former Royal Commissioner, Research, Australian of the Year 2003 President Queensland Court of Appeal & Justice NSW Court of Appeal Peter Baume AC Emeritus Professor of Community Medicine & Geoff Gallop AC former Federal Health Minister Former Premier, Western Australia & Director, Graduate School of Government, Ed Byrne AO University of Sydney Vice Chancellor, Monash University & former Vice Provost (Health), University College London Phillip Aspinall Primate of the Anglican Church of Australia Nicholas Saunders Vice Chancellor, University of Newcastle & former Errol Cocks Chair, National Health & Medical Research Director, Centre for Research into Disability and Council Society, Curtin University of Technology

Richard Bruggemann Professorial Fellow in Disability Studies & former List of individual endorsers continued at end of CEO, Intellectual Disability Services Council, SA document

Julian Gardner National Health and Hospitals Reform Former Public Advocate, Victoria Commission final report 2009

Robert Strike People with intellectual disability “face stark President, Self Advocacy Sydney, Lifelong Achievement Award, National Disability health inequalities”. Awards 2009 “Access to specialist medical services is a James Angus AO major gap to be addressed for people living Dean of Medicine, Dentistry and Health Sciences with an intellectual disability.” (p 82) University of Melbourne

Nicholas Fisk Dean of Health Sciences, University of “People with intellectual disability die Queensland prematurely and often have a number of unrecognised or poorly managed medical John Daly conditions as well as inadequate health Dean of Nursing, Midwifery & Health UTS, promotion and disease prevention." Chair, Global Alliance for Leadership in Nursing Education & Science, & Former Chair, Council of Primary Health Care Reform in Australia Deans of Nursing & Midwifery (Australia & NZ) Australian Government 2009

David Richmond AO Former chief executive of agencies including NSW Health & the Olympic Coordination Authority National Disability Strategy

John Dwyer AO “People with disability [will] attain the highest Professor of Medicine & Founding Chair, possible health outcomes throughout their Australian Health Care Reform Alliance lives.”

Tony Fowke AM “System changes flowing from [mainstream] President, World Federation for Mental Health & health reforms and initiatives across Australia Mental Health Carers Arafmi Australia provide important opportunities to improve

Paul Bauert, responses to the health needs of people with Director, Paediatric Services, Royal Darwin disability.” Hospital & President AMA NT Council of Australian Governments 2011

National organisations Professional Association of Nurses in Developmental Disability Australia Ability First Australia Public Health Association of Australia Association of Genetic Support of Australasia Royal Australasian College of Physicians Australian College of Rural and Remote Medicine Royal Australian and New Zealand College of Psychiatrists Australian Council of Social Service Royal Australian College of General Australian Federation of Disability Practitioners Organisations Rural Doctors Association of Australia Australian Healthcare & Hospitals Association Sexual Health & Family Planning Australia Australian Healthcare Reform Alliance St John of God Health Care Australian Physiotherapy Association St Vincent de Paul Society National Council Australian Society for Special Care in Dentistry The Smith Family

Australasian Society for Intellectual Disability UnitingCare Australia

Baptist Union of Australia Williams Syndrome Association

Best Buddies Australia Women With Disabilities Australia

Cancer Council Australia

Carers Australia Specialised resource services would greatly assist in addressing many of the health Children with Disability Australia inequality concerns identified in research and help Australia meet its commitment to Dietitians Association of Australia equal health outcomes arising from the UN

Convention on the Rights of Persons with Disability Advocacy Network Australia Disabilities.

Doctors Reform Society Graeme Innes Human Rights & Disability Discrimination Health Consumers of Rural & Remote Commissioner Australia

Life Without Barriers

Lifestyle Solutions Australia The need for Government, both Federal and State, to recognise and address the poor National Disability Services health status of people with intellectual disability is of prime importance, and I am National Ethnic Disability Alliance writing to confirm, on behalf of the College’s Executive Committee, endorsement of the National Primary Health Care Partnership Position Statement. National Rural Health Alliance Maria Tomasic, President, Royal People with Disability Australia Australian and New Zealand College of Psychiatrists Prader-Willi Syndrome Association of Australia

NSW organisations

The NSW Government has spelt out the Ability Incorporated Advocacy Service, need for a multi tiered framework of action Alstonville on the health of people with intellectual

disability including the establishment of a Ability Options, Western Sydney statewide network of specialised intellectual ACES Inc, Port Macquarie disability health services to back up mainstream services. Achieve Australia, NW Sydney (NSW Health (2007), Development of a service framework to improve health care of people with Action for People with Disability, Northern intellectual disabilities) Sydney The NSW Ombudsman, who review deaths Aftercare of people with disability, has said that the proposed NSW framework “is critical to ADSSI (Aged & Disability Support Services), improve the health outcomes for this Central Coast vulnerable community”. (NSW Ombudsman, Report of Reviewable Deaths in ANGLICARE Sydney 2007)

Association of Doctors in Developmental The NSW Opposition has supported a Disability current pilot of a new intellectual disability health service and states, “much more AFFORD (Australian Foundation for Disability) needs to be done in terms of meeting the

health needs of people with disabilities”. Biala Support Services, Ballina (Deputy Opposition Leader Jillian Skinner 2010)

Blue Mountains Disability Services

Council on the Ageing NSW Carers NSW

Council of Social Service of NSW CareWest, Central & Far West NSW

Cram Foundation, Illawarra Caringa Enterprises, Grafton

Currajong Disability Services, Parkes Catholic Care, SW and Inner West Sydney

Dare to Aspire, clinicians for community services CASS Care, Campsie

Disability Advocacy NSW Central Coast Disability Network

Disability & Aged Information Service, Lismore Central Coast Living Options

Disability Assistance for Shoalhaven Inc Central Sydney GP Network

Centre for Disability Studies Disability Enterprises, Leura

Challenge Disability Services, Tamworth & Disability Information Advocacy Service, north west NSW Bathurst

Checkpoint parent group, Eastern Sydney Down Syndrome NSW

Citizen Advocacy Western Sydney Essential Personnel, South East and South West Slopes, NSW Coffs Harbour Support Services Family Advocacy, NSW Community Links Wollondilly Family Planning NSW Community Options Illawarra Flintwood Disability Services, Western Sydney

Global Disability and Health Care Services

Greenacres Disability Services, Wollongong St George Migrant Resource Centre Hunter Carers for Intellectual Disability Shopfront Youth Legal Centre IDEAS Southlake Community Services Horizons Interaction Disability Services, Western Disability Services, Lake Macquarie Sydney SPOT on DD (Speech therapists, Intellectual Disability Rights Service Physiotherapists and Occupational Therapists on Developmental Disabilities) Jewish Care Sydney Sunnyfield Association Kurrajong Waratah, SW NSW Sylvanvale Foundation Lorna Hodgkinson Sunshine Home The Disability Trust, Illawarra Macarthur District Temporary Family Care The Housing Connection, Northern Sydney McCall Gardens Community, Western Sydney TNC Leisure Service Mai-Wel Group, Hunter Region Tweed Valley Respite Service Martin and Associates, Disability Clinicians UnitingCare Disability, NSW Mater Dei, Camden UnitingCare NSW ACT Motivate You, fitness and personal training Valley Industries, Taree Multicultural Disability Advocacy Association Valmar Support Services, South Western Slopes Nepean Area Disability Organisation Waverley Community Living Program Network of Alcohol and Drug Agencies Wesley Disability Services New Horizons Enterprises Western Sydney Intellectual Disability Support New IDAFE, Port Macquarie Group

Northcott Disability Services Windgap Foundation, Eastern Sydney

Northside Enterprises Youth Justice Coalition

NSW Bar Association Almost on a daily basis we experience how NSW Nurses Association deficient the existing health care system is when it comes to people with an intellectual On Track Community Programs, Tweed disability. I find it heartbreaking to find clients Heads being turned away as 'having a behaviour'

rather than being treated for an abscess, Parents without Partners NSW clients being treated for abdominal pain with Pathways Early Childhood Intervention, Inner Gaviscon only to find out later that they are Western Sydney having appendicitis, clients being dismissed as being difficult while suffering from moving PATH (Penrith Association for People with kidney stones. Disabilities) Vahida Berberovic, CEO, Windgap Public Interest Advocacy Centre Foundation

SEE Foundation, Western Sydney

St George & Sutherland Community College – Disability Options NSW Queensland organisations AEIOU Foundation for Children with Autism

ClinEdQ (Clinical Education & Training Orana Queensland) SHine (Sexual Health information networking & Endeavour Foundation education)

Guyrow SA Council on Intellectual Disability

Health and Community Services Workforce Council Tasmanian organisations Health Consumers Network Queensland Advocacy Tasmania

Integrated Family & Youth Service, Sunshine Nexus, Hobart Coast & Rockhampton Self Help Workplace, Launceston Mamre Association Speak Out Advocacy Tasmania Multicap Tascare Society for Children National Disability Services, Queensland The Parkside Foundation Parent to Parent Association of Queensland

Queensland Advocacy Victorian organisations Annecto – the people network Queensland Centre for Intellectual & Developmental Disability Carers Victoria

Queensland Nurses Union Central Access, northern Victoria

Queensland Parents for People with a Centre for Developmental Disability Health Disability Victoria

Queensland Support Services & Solutions Disability Advocacy & Information Service, Wodonga Sherwood House Medical Practice, Innisfail EW Tipping Foundation The Umbrella Group, Townsville Health Issues Centre Town & Country Community Options, Maryborough Karingal, Geelong

UnitingCare Queensland Mambourin Enterprises, Western Melbourne

Vulnerable Clients Program Initiative, McCallum Disability Services, Ballarat Queensland Ambulance Service

Warrina Services, Toowoomba Vatmi Industries

Victorian Advocacy League for Individuals with Disability SA organisations Barkuma Victorian Medicare Action Group

Bedford Group Villamanta Disability Rights Legal Service

Health Consumers Alliance

Interwork, Adelaide

Leveda

WA organisations Activ

Carers WA

Developmental Disability Council of WA

Down Syndrome WA

Health Consumers Council WA

Identitywa

Midway Community Care

Nulsen Association

People With Disabilities WA

SECCA (Sexuality Education Counselling and Consultancy Agency)

Valued Independent People

Western Australia Health Consumers’ Council

ACT organisations ACT Council of Social Service

Advocacy for Inclusion ACT

Community Connections

Community Living Association

L’Arche Genesaret

Sharing Places

NT organisations Carers NT

Down Syndrome Association NT

Integrated Disability Action

Endorsements – individuals (continued) Ian Wronski Pro-Vice Chancellor, Medicine, Health and Allan Fels AO Molecular Sciences, James Cook University Dean, Australian and New Zealand School of Government John Catford Dean of Health, Medicine, Nursing and Paul Stein AM Behavioural Sciences, Deakin University Chairman, Law & Justice Foundation NSW Former Justice, NSW Court of Appeal NSW Peter Dunkley

Pro Vice Chancellor Health, Bill Carter QC University of Newcastle Retired Supreme Court Judge & Royal

Commissioner Alison Jones

Dean of Medicine, University of Western Sydney Justice Sally Thomas AM

Supreme Court of the Northern Territory Elizabeth Farmer

Former Dean of Medicine, University of Michael Spence Wollongong Vice Chancellor, University of Sydney

Christopher Peck Paul Greenfield AO Dean of Dentistry, University of Sydney Vice Chancellor, University of Queensland

Janet Greeley Ian O'Connor Dean of Human Sciences, Vice Chancellor. Griffith University

Jill Downie Janice Reid AM Pro Vice-Chancellor, Health Sciences, Vice Chancellor, University of Western Curtin University of Technology Sydney

Margot Kearns Ross Milbourne Pro Vice Chancellor & Dean of Nursing, Vice Chancellor, University of Technology, University of Notre Dame Australia Sydney

Sandra Harding People with intellectual disability suffer Vice Chancellor, James Cook University untreated pain and disease due to a fundamental communication barrier with Justin Beilby doctors. It is time for the health system Dean of Health Sciences, University of to break down this barrier. Adelaide Kevin Cocks, Human Rights Medallist Nicholas Glasgow

Dean of Medicine and Health Sciences, ANU Philip Montgomery

Former President Royal Australasian College of Ian Puddey Medical Administrators & Director of Medical & Dean of Medicine, Dentistry & Health Health Services, Disability Services Sciences, University of WA Commission, WA

Bruce Robinson Sister Angela Mary Doyle AO Dean of Medicine, University of Sydney Former Administrator, Mater Hospitals &

Queenslander of the Year Gwynnyth Llewellyn

Dean of Health Sciences, University of Michael Stanford Sydney CEO St John of God Health Care &

WA Citizen of the Year 2010 Allan Cripps

Pro Vice Chancellor (Health) & Chris Sidoti Simon Broadley Former Australian Human Rights Commissioner Dean of Medicine, Griffith University

Michael McDaniel Peter Smith Adjunct Professor & former Dean of Indigenous Dean of Medicine, University of NSW Education, University of Western Sydney

Ron Mulock AO David Richmond AO Former Health Minister & Deputy Premier, Jane Fraser NSW Tony Ovadia Leonie Manns John Hannaford Andrew Buchanan Former Health & Community Services Being all surviving Chairpersons of the, Disability Minister, NSW Council of NSW 1985 - 2010

Jim Longley Former Community Services Minister, NSW The health status of people with intellectual disabilities is appallingly low. Their health Ann Sherry AO needs must take priority – by supporting Chief Executive Officer, Carnival Australia training for all health providers and Board member, Independent Panel, National Disability Strategy Project Team implementing specialist health services across Australia.

Bruce Tonge Gwynnyth Llewellyn Professor of Psychological Medicine & Head of Dean of Health Sciences the School of Psychology, Psychiatry and University of Sydney Psychological Medicine, Monash University

Philip Mitchell AM Professor and Head, School of Psychiatry, Guy Hamilton AM University of Former head of intellectual disability services, Western Australia Gordon Parker AO Professor of Psychiatry & Trevor Parmenter AM Executive Director, Black Dog Institute Professor of Developmental Disability Studies & former President, International Association for Stewart Einfeld the Scientific Study of Intellectual Disabilities Professor of Mental Health University of Sydney Phil Foreman Former Dean of Education, Julian Trollor University of Newcastle Chair in Intellectual Disability Mental Health University of NSW John Taplin Professor of Psychology, University of Adelaide Adrian Keller Chair, NSW Branch, Royal Australian & New Eileen Baldry Zealand College of Psychiatrists Justice Medallist & Professor of Criminology, University of NSW Margaret Ward Parent advocate & former Deputy Chair, Associate Professor Meg Smith OAM Disability Advisory Council of Australia School of Social Sciences, UWS

Faye Druett OAM Jeremy Ward Former Deputy Chair of People with Disability Parent advocate & former Director, Australia & Disability Council of NSW Queensland Advocacy Inc

Robin Banks Michelle Howard Anti Discrimination Commissioner, Tasmania Public Advocate Queensland

Malcolm Schyvens Graeme Smith Former President, Law Society of Tasmania Public Guardian NSW

Mark Ierace SC Margaret Colville AM Senior Public Defender, NSW Deputy Public Guardian of Tasmania

Roger West Kevin Stone Former President, Guardianship Tribunal, & Parent advocate & Executive Officer, Victorian Community Services Commissioner NSW Advocacy League for Individuals with Disability

Reverend Jim Colville AM Parent Advocate, Tasmania

Peter Brooks AM Jackie Softly Director, Australian Health Workforce Parent advocate and former Chair, Institute, University of Melbourne Ministerial Advisory Committee on Disability, WA

Leon Piterman AM John Entwistle Professor of General Practice Parent advocate, GP and former member, & Deputy Dean of Medicine, Nursing and National Disability Advisory Council Health Sciences, Monash University Grant Lindsay, Donna Rousham and Alison Kitson Esther Tan, Head of Nursing Parent advocates, Northern Territory University of Adelaide John Homan, Helen McCutcheon Parent advocate and inaugural Member, Head of Nursing & Midwifery, Disability Council of Queensland University of South Australia Maria Circuit Gerald Farrell Parent advocate and former Chair, NSW Council Head of Nursing, La Trobe University for Intellectual Disability

Denise Fassett Pam Morris Head of Nursing and Midwifery, Parent advocate University of Tasmania Antonia Scott Maxine Duke Former President, Down Syndrome NSW & Head of Nursing and Midwifery, Lecturer in Dentistry Deakin University Chris Cunneen Elaine Duffy Professor of Criminology, Cairns Institute & Head of Nursing, Midwifery & Indigenous School of Law Health, Charles Sturt University Neil Preston OAM Iain Graham CEO, Greenacres Disability Services, NSW Head of School of Health and Human Sciences, Southern Cross University Robert Yeoh AM Former President, Alzheimer’s Australia Andrew Cashin Professor of Nursing, Southern Cross Adrian Sleigh University Professor, National Centre for Epidemiology & Population Health, ANU Chris Mitchell Former President, Royal Australian College of Kim Oates AM General Practitioners Professor of Paediatrics & former CEO, Children’s Hospital at Westmead Susan Hayes AO Professor of Behavioural Sciences in John O’Donnell Medicine, University of Sydney CEO, Mater Health Services, Brisbane

Patricia O’Brien Helen Beange AM Professor of Disability Studies, University of Clinical Professor of Medicine Sydney & former Director, National Institute for Intellectual Disability, Trinity College, Brendan Crotty Dublin Head of School of Medicine, Deakin University

Tammy Jennings & Mark Parnell Haydn Walters Greens MLCs, South Australia Professor of Medicine, Universities of Tasmania & Notre Dame Australia Michelle Stagg and Dell Stagg, Parent advocate and President, SA Council Geoff Mitchell on Intellectual Disability Professor of General Practice & Head, MBBS Program Ipswich, University of Queensland Jan May OAM Parent advocate

Michael Field Associate Dean, Sydney Medical School

Bronwyn Hemsley Postdoctoral Fellow (Public Health), University of Queensland

Kathy Ellem Parent Advocate and Postdoctoral Research Fellow, University of Queensland

James Morton Haematologist & Oncologist,& Founder, AEIOU Foundation

Elona Lang OAM Disability service manager

Ian Dempsey Associate Professor of Education & Editor, Journal of Intellectual & Developmental Disability

Lita Mathews Disability service manager, Western NSW

Keith McVilly Associate Professor in psychology Deakin University

Sharon Friel Associate Professor in epidemiology, ANU & Former Director, Global Health Equity Group, University College London

Endorsements as at 7 March 2011