NACCHO Closing the Gap report: Analysis of provisions in the 2013-14 budget of the Indigenous Chronic Disease Package

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Total government expenditure on Indigenous health has risen significantly since the commencement of the National Partnership Agreement (NPA) on Closing the Gap in Indigenous Health Outcomes in 2009-10 and now represents about 5.1% of total government health expenditure.

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An analysis of provisions in the 2013‐14 Budget and implementation of the Indigenous Chronic Disease Package

Russell, Lesley
Menzies Centre for Health Policy

ABSTRACT and LINK

This paper presents the author’s analysis of the Indigenous provisions in the Australian Government’s 2013-14 Budget in the context of current and past strategies, policies, programs and funding support. It also looks at the implementation and impact of the Commonwealth’s Indigenous Chronic Disease Package. This work has been done using only materials and data that are publicly available. The opinions expressed are solely those of the author who takes responsibility for them and for any inadvertent errors. This work does not represent the official views of the Menzies Centre for Health Policy, the Australian Primary Health Care Research Institute (APHCRI) or the Commonwealth Department of Health and Ageing which funds APHCRI.

Report summary

This amounted to $4.7 billion in 2010-11; of this, the Commonwealth provided about one-third ($1.6 billion).

However while there is a significant effort underway to close the gap in Indigenous disadvantage and life expectancy, in most areas this effort has yet to show real returns on the investments. The disadvantages that have built up over more than 200 years will not disappear overnight, and sustained and concerted efforts are needed to redress them.

Chronicdiseases, which account for a major part of the life expectancy gap, take time to develop, and equally, it will take time to halt their progress and even longer to prevent their advent in the first place. Programs will need to be sustained over decades if they are to have an impact on improving health outcomes.

On this basis, it is worrying to see that continued funding for the NPA on Closing the Gap in Indigenous Health Outcomes, as announced in April, will be less over each of the next three years than in 2012-13.

At the same time, the Budget Papers show that expenses in the Aboriginal and Torres Strait Islander health sub-function will decline by 2.7% in real terms.

This comes as states such as Queensland and New South Wales have made damaging cuts to health services and Closing the Gap programs.

Education is a significant determinant of health status so it is also concerning to see a reduced level of funding provided for Indigenous education over the next six years, especiallywhen efforts to close the gap in education for indigenous students have stalled. These cuts inhealth and educations commitments cannot be justified by saying that Indigenous Australianscan access mainstream programs. In many cases these are absent, inappropriate, or perceived as culturally insensitive, despite recent efforts to improve these deficits.

It is a strength of the COAG commitment to close the gap on Indigenous disadvantage that it recognises that a whole-of-government approach is needed to deliver improvements in the lives of Indigenous Australians.

However tackling disadvantage is about more than building houses, providing job training, implementing welfare reform, community policing andincreasing access to health services; it requires that governments recognise and respect the complex social and cultural relationships that underlie the housing, economic, health and societal issues present in many Aboriginal

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