NACCHO 2013 budget alert: Aboriginal health spending: Where does the money go?

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NACCHO’s chairman Justin Mohamed is concerned state governments are waiting until tonights Budget announcement before making a call on Indigenous health funding.

“I would say at this stage, we haven’t had the confirmed numbers, and we do need every state and territory to come and recommit to closing the gap with their funding, to ensure the whole of Australia – every single Aboriginal and Torres Strait Islander person can have life expectancy similar to non-Aboriginal and Torres Strait Islander people.”

Source SBS

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With an election looming, the future of the government’s Closing the Gap policies remain uncertain. (AAP)

Building a clear picture of how the government spends money on Indigenous-specific programs is a problem so complex even seasoned economists struggle with it.
Part of the problem, as health researchers Dr Lesley Russell and Sebastian Rosenberg note in detail here, is the split in funding, delivery and administration between state and federal governments across more than 100 different initiatives.

There is also the question of funding announcements, which tend to dribble out throughout the year rather than forming a part of the federal budget.

Economist Jon Altman says he doesn’t expect to see “anything new” for Indigenous Australia in Wayne Swan’s budget announcement tomorrow.

“They’ve more or less fired all their fiscal bullets as far as  Indigenous Australia is concerned,” he says.
“They’ve made their forward  commitments to Stronger Futures, to Cape York, to Creative Australia to  Carbon Farming Initiative; it has all been sign-posted.”

Justin Mohamed, Chair of the National Aboriginal Community Controlled Health Organisation (NACCHO), agrees.

“On  previous budget nights and when the announcements are being made, you  know you sometimes walk out of there a little bit flat because  Aboriginal health or Aboriginal affairs probably doesn’t get the  concentrated attention it needs,” he says.

The federal government funds a number of Indigenous-specific programs under National Partnership Agreements (NPAs) in partnership with state and territory governments, based on six policy initiatives known as ‘Closing the Gap’.

These six measures were set down by Kevin Rudd in 2008 at the same time he gave a formal apology to the Stolen Generations. They cover the broad areas of health, education, infant mortality, life expectancy, literacy and employment.

Prime Minister Julia Gillard’s report on Closing the Gap issued in February this year noted that only three out of the six areas were on track for achievement.

This is despite funding for some key areas nearing their initial expiry date.

‘CRITICAL YEAR’ FOR INDIGENOUS HEALTH

In 2009, the federal government allocated $1.57 billion for Indigenous health initiatives. This funding agreement expires in June, although this has been buffered by a further commitment of $777 million over three years from the federal government — along with an expectation that state and territory governments will also contribute.

Victoria has already committed to $61.7 million over four years, and while other states have until June 30 to declare their funding commitments, none have so far declared their support.

The federal commitment, as Lesley Russell has written previously, is an increase in per annum expenditure, but because of a bump in funding for the year 2012-13, will actually result in a drop in funding for the year ahead.

“We await news of which programs will be cut, and where,” she wrote.

NACCHO’s Justin Mohamed is concerned state governments are waiting until tomorrow’s Budget announcement before making a call on Indigenous health funding.

“I would say at this stage, we haven’t had the confirmed numbers, and we do need every state and territory to come and recommit to closing the gap with their funding, to ensure the whole of Australia – every single Aboriginal and Torres Strait Islander person can have life expectancy similar to non-Aboriginal and Torres Strait Islander people.”

The total amount of funding has been increasing since Closing the Gap initiatives were first announced in 2008, but the dollar figure is also only one part of the story. How effectively the money is being used is a question raised repeatedly by those keeping a close eye on the government’s Indigenous expenditure.

“It’s really about how that money is administered, and where the money goes,”  says Mohamed.

WHERE TO FROM HERE?

With an election looming, the future of the government’s Closing the Gap policies remain uncertain.

The federal opposition has been vocally critical of current state and federal programs, with Shadow Indigenous Affairs Minister Nigel Scullion saying the efficiency and effectiveness of current programs needed to addressed.

A change of government could also clear out any partisan issues potentially hampering cooperation at state and federal levels, says Jon Altman.

“We’ve got to remember when we had multi-partisan agreement through COAG  on these National Partnership agreements, it was coast-to-coast Labor,  and since then we’ve had a change and a number of state governments and  territory governments are non-Labor, so the possibility of contested federalism has increased,” he says.

“Of course,  that could flip right round if you had a change of federal government,  and suddenly you might see a new cooperative federalism between an  Abbott government and at least those states and territories that are now  conservative.”

WHAT ARE THE NATIONAL PARTNERSHIP AGREEMENTS?

Indigenous early childhood development $564.6 over six years from July 2009 Remote service delivery $291.2 over six years from July 2009 Indigenous economic participation $228.8 over five years from July 2008 Remote indigenous housing $1.94 billion over ten years. New funding on top of $3.55 billion already committed, so total funding of $5.5. billion over ten years from Dec 08 Indigenous health outcomes $1.57 billion over four years from July 1, 2009 Remote Indigenous public internet access $6.967 million over four years

Q&A: What next for Indigenous funding?

Source SBS with thanks

With an election looming and some key Indigenous funding policies nearing expiry, is the pattern of government investment for Indigenous policies set to change?

Jon Altman of the Centre for Aboriginal Economic Policy Research at the Australian National University tells SBS reporter Rhiannon Elston why he doesn’t expect to see Indigenous spending on the agenda on budget night.

Q: To start with a broad picture, has funding been increasing for government-based ‘Closing the Gap’ initiatives since they were first drawn up in 2008? 

It most certainly has. There has been a series of a National Partnership Agreements (NPAs) that I think have certainly increased allocations to Indigenous policy, Indigenous Affairs. One of the problems, of course, that the government has is that the last census showed a greater than expected increase in Indigenous population. And so on a per capita basis, that puts some pressure on Indigenous funding. But nevertheless, the funding has increased. Paradoxically, perhaps, a lot of that funding is being allocated to remote Australia where need is seen to be the greatest.

And particularly, of course, the Northern Territory and Cape York are major beneficiaries. But the majority of the Indigenous population lives in non-remote Australia. Probably around 75 to 80 per cent live in non-remote Australia. So in a sense, the paradox is that government is… putting most of the money into remote Australia, where I think gaps are going to be the hardest to close.

And they’re assuming that mainstream provision of services will look after Indigenous people in non-remote Australia, where gaps are most likely to close. I think it’s a very brave assumption that people will get equitable needs-based access to services in non-remote Australia if they’re disadvantaged.

Q: That appears to be a recurring criticism; that the bulk of Indigenous funding lands in the Northern Territory and not enough is left for the other states. 

The first thing the government really needs to do, and it’s never done, is actually undertake some audit of what is needed. Because what we don’t hear a lot about in Indigenous policy making is the historical legacy. In some sense what happened post the 2007 intervention is the extent of the legacy in very visible remote Indigenous  communities was there for everybody to see, and the obvious government response to that was to try and band-aid what was very visible.

Poor housing, poor school facilities, poor community infrastructure. Poor medical centres. So the government has certainly tried to address some of that in those very visible places. But the truth is, to meet that historical legacy which has being growing exponentially for decades, is going to require very significant investments, very significant commitments, running into billions of dollars.

Q: With the Indigenous Health Outcomes NPA due to expire in June, we’ve seen the federal government recommit $777 million over three years with an expectation that the states and territories will also come to the table, and they have until June 30 to do that. So far, we haven’t seen broad state-based commitment. What kind of implications could that have?

I think it will depend on the next government. We’ve got to remember when we had multi-partisan agreement through COAG on these National Partnership agreements, it was coast-to-coast Labor, and since then we’ve had a change and a number of state governments and territory governments are non-Labor. So the possibility of contested federalism has increased, and of course that could flip right round if you had a change of federal government, and suddenly you might see a new cooperative federalism between an Abbott government and at least those states and territories that are now conservative.

Whatever the case, I think there will be some very hard questions asked about the National Partnership Agreements when they come up for renegotiation in terms of their effectiveness. And one of the things we’ve found with Closing the Gap in terms of their track record at least for the period 2006-2011, has been quite patchy. Some of the gaps are closing quite slowly. Some of the gaps are widening, and some of them are proving very difficult to shift. So in a sense, there might be scepticism about both the targets and about the efficacy of the national partnership agreements in helping to close them.

Q: Do you expect to see any major Indigenous funding announcements in next week’s budget?

I think the current government, it seems to be the new mode of operation, they’ve more or less fired all their fiscal bullets as far as Indigenous Australia is concerned. They’ve made their forward commitments to Stronger Futures, to Cape York, to Creative Australia to Carbon Farming Initiative; it has all been sign-posted so I actually don’t expect to see anything new for Indigenous Australia in the budget.

The question is, what will the government do to make sure that when we have new schemes like DisabilityCare Australia… what mechanisms do we have in place to make sure that those people who are most in need and I think it’s likely that even in relation to DC Indigenous People who will be most in need get the greatest access? And it seems to me that one of the problems we have with this notion of normalisation and needs-based equitable access to services including disability support, superannuation, jobs and so on, is that we assume the playing field is level, whereas clearly that’s not the case.

Not just in terms of historical legacy and the poor physical, psychological, emotional condition of many Indigenous people but also that our institutions aren’t very well tailored to respond to people from fundamentally different cultural backgrounds, and we just don’t want to recognise that racially based discrimination is still a problem when it comes to accessing services

NACCHO chair welcomes Professor Kerry Arabena as the newly appointed Chair of Indigenous Health

Kerry Arabena _Leadership-opt-620x349

Mr Justin Mohamed, Chair of NACCHO representing over 150 Aboriginal Community Controlled Health Organisations throughout Australia today welcomed the annoucement that Professor Kerry Arabena  has been appointed Chair of Indigenous Health at the  Melbourne School of Population and Global Health

Our thanks to the Melbourne AGE for sharing photo  (Photo: Sarah Anderson) and story in which Kerry spoke about the challenges  facing Indigenous Australians, and why local and global leadership is critical  for Indigenous affairs

Strong, charismatic and decisive leadership within Aboriginal and Torres  Strait Islander communities is something Kerry Arabena identifies as crucial to  improving Indigenous health outcomes in Australia.

“Since 1970, Aboriginal and Torres Strait Islander people have taken our  rightful place in discussions about health service delivery, the health and  wellbeing of families and the positive transformation of our communities,” she  says.

“Our role as leaders has been to learn to navigate and operate in complex  health service, government and community systems to represent the issues we’ve  heard from people in our communities.”

A descendant of the Meriam People of the Torres Strait, Professor Arabena is  the first Torres Strait Islander woman to achieve and receive a professorial  position. She has had many senior appointments: as well as recently being  appointed Chair of Indigenous Health at the Melbourne School of Population and  Global Health, it was announced in April that Professor Arabena would be taking  on the role of Chair of the National Aboriginal and Torres Strait Islander  Health Equality Council.

A social worker by profession, Professor Arabena began her career in  community services and case management in the Northern Territory over 20 years  ago, where she worked in one of the most remote Aboriginal medical services in  Australia at Kintore, 600km west of Alice Springs.

“I think I’m the only Torres Strait Islander woman who’s ever lived out in  the desert like that,” she says.

She transitioned from social work into human ecology, community-controlled  health organisations, co-ordination of national public health initiatives and  finally into academia. At the University of Melbourne her role involves  community engagement and capacity-building.

She notes that the role of leadership within the Aboriginal and Torres Strait  Islander community is constantly changing.

“Some of us have been in our fields for at least 20 years and are in  positions to mentor others. We are modern intellectuals with ancestral and  cultural connection to country. This type of leadership is now critical for all  our affairs.

“Our role is to look to the next generation, to ensure we are supporting and  creating spaces for them. We need to unify on matters affecting us all, and  engage in conversations about our affairs on a local and global scale.”

These conversations are much needed. Many disparities still exist between  Indigenous and non-Indigenous population health status and outcomes,  determinants of health and health system performance.

While Professor Arabena is wary of “simplifying, stereotyping and amplifying”  the difficulties of life for people in some Aboriginal and Torres Strait  Islander communities, she says “The reality of life is grim” for many of  them.

“Life is such that some children would choose to end their lives before they  get a chance to live it. Life is such that we have young people who have  completed year 12 but who are unable to read or write.”

Professor Arabena believes negatively framed discussion of Indigenous issues  in policy environments is, however, deeply problematic, directly impacting  health outcomes for Aboriginal and Torres Strait Island people.

In many public conversations, Indigenous people are viewed as “disadvantaged”  and “in poverty” and all of these other terms we use so loosely.

“What we forget to see and know is that people can change, people can empower  themselves, and that given information and opportunity, people can transform  their lives from what might have been incredibly difficult circumstances.”

Professor Arabena identifies several strategies she will focus on during her  time at the University, including helping build recognition of the rights of  Indigenous families and communities to live self-determining lives, free from  discrimination; and creating and advancing knowledge of the contributions  Indigenous Australians have made, and continue to make, to Australian  society.

“I get excited about what we can do together. Despite difficult  circumstances, there have been eight Aboriginal and Torres Strait Islander  Australians of the Year, and I think That’s something we can all be proud  of.

“We get described as “disadvantaged” and not able to do things: actually we  can, and we are, and we will. Whether people recognise that or not ” we know  what we do, we know what we can achieve. And to me, that is worth  celebrating.”

www.pgh.unimelb.edu.au

Read more:

NACCHO accreditation resource:RACGP Standards set to assist Aboriginal community controlled health services

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Pictured Sarah Paterson (left) and Aislinn Martin (right) presenting the first copy of RACGP Standards to NACCHO CEO Lisa Briggs here in Canberra

The Royal Australian College of General Practitioners (RACGP) and the National Aboriginal Community Controlled Health Organisation (NACCHO) are proud to launch the

New Interpretive guide to the RACGP Standards set to assist Aboriginal community controlled health services Interpretive guide to the RACGP Standards for general practice (4th edition) for Aboriginal community controlled health services (‘Interpretive guide’).

DOWNLOAD PDF

A companion document to the RACGP’s current Standards for General Practices (4th edition) (‘the Standards’), the Interpretive guide aims to assist Aboriginal community controlled health services to meet the requirements for accreditation against the RACGP standards and to apply quality measures to their everyday practice.

The RACGP and NACCHO acknowledge the efforts made by the Aboriginal Community Controlled Health Services (ACCHS), across Australia, to obtain RACGP accreditation, an important step towards achieving the best possible health outcomes for patients.

The Interpretive guide explains the Standards in a meaningful way for Aboriginal community controlled health services by taking into account their context, culture and service delivery models.

Associate Professor Brad Murphy, Chair of the RACGP National Faculty of Aboriginal and Torres Strait Islander Health, acknowledges that Aboriginal community controlled health services are committed to achieving RACGP and other forms of accreditation, and this new resource aims to assist in identifying the relevance of the Standards to their own health services and communities.

“Thanks to the highly effective collaboration that took place between the RACGP and NACCHO, as well as its state and territory affiliates, we are proud to jointly launch a significant piece of work that will contribute to ongoing quality and safety improvements in the health services delivered to Aboriginal and Torres Strait Islander communities,” A/Prof Murphy said.

By applying the Standards to individual practices, GPs, Aboriginal Health Workers and their practice teams ensure the provision of high quality, safe and contemporary primary healthcare is delivered to all Australians.

“Achieving accreditation demonstrates that a practice has been assessed as having reached defined standards of excellence in safety and quality in primary healthcare. This should be a matter of great pride to the practice itself, its patients and the community,” said A/Prof Murphy.

Justin Mohamed the Chair of NACCHO on behalf of all the 150 members throughout Australia thanked the RACGP for the highly effective collaboration that has taken place between the two peak bodies to produce such an important resource

Both the Interpretive guide and Standards are available to all College stakeholders

as either a downloadable PDF

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Trish Jean NACCHO National Quality and Accreditation Officer (left) checking out the new site

and also via an interactive and topic searchable web resource on the RACGP website

About the RACGP

The Royal Australian College of General Practitioners (RACGP) is Australia’s largest professional general practice organisation and represents urban and rural general practitioners. We represent over 21,500 members working in or towards a career in general practice and are proud that over 19,300 Australian-registered general practitioners have chosen to be a member of the College. There are over 125 million general practice consultations taking place annually in Australia. Visit

http://www.racgp.org.au. The RACGP recognises the traditional custodians of land and sea, on whose lands we work and live. We wish to pay our respects to all Traditional Owners and Elders past, present and future.

NACCHO health news: Local health mob summit in Central Australia to identify positive solutions to local problems

Stop_the_Violence_March_-_Alice_Springs_-_2010

 

Listen to Me: Summit to unite bush voices for change

Kurunna Mwarre: Making my spirit inside me good,

A summit in Central Australia will bring Aboriginal people together to identify positive solutions to local problems faced in their home communities and the wider community of Alice Springs.

Around 200 delegates will travel from communities and town camps to Ross River to take part in the summit, Kurunna Mwarre: Making my spirit inside me good, which is being held from 14-16 May 2013.

Photo above previous Congress Alice springs community action 2010 to Stop the Violence

“The summit gives people the opportunity to talk about violence and anti-social behaviour,” explained John Liddle, Ingkintja Male Health Manager (picture below) at Congress and one of the summit organisers.

John_Liddle_-_Male_Health_Summit_2008

“People genuinely want to see change and they want to be empowered to be part of that change.

“This summit is about taking responsibility for the past and taking local ownership to bring about and sustain positive change and healing of spirits.”

The summit is co-facilitated by health service, Central Australian Aboriginal Congress and Creating a Safe Supportive Environment Inc. (CASSE) and follows on from previous summits facilitated by Congress’ Ingkintja male health branch, held in 2008 and 2010, where hundreds of Aboriginal males came together to address issues of violence and hurt in Aboriginal communities.

From the initial 2008 summit came the momentous ‘Inteyerrkwe Statement’, which gave a decisive proclamation that Aboriginal males from Central Australia were committed to ensuring safe and happy community environment for their families:

Arrernte Dancers

We the Aboriginal males from Central Australia and our visitor brothers from around Australia gathered at Inteyerrkwe in July 2008 to develop strategies to ensure our future roles as grandfathers, fathers, uncles, nephews, brothers, grandsons, and sons in caring for our children in a safe family environment that will lead to a happier, longer life that reflects opportunities experienced by the wider community.

“We acknowledge and say sorry for the hurt, pain and suffering caused by Aboriginal males to our wives, to our children, to our mothers, to our grandmothers, to our granddaughters, to our aunties, to our nieces and to our sisters.“We also acknowledge that we need the love and support of our Aboriginal women to help us move forward.”

Now, in 2013, both males and females will gather together to put forward positive solutions to help facilitate change.

“We talk a lot about what the problems are,” Mr Liddle said. “Now we want to focus on the solutions.”

“We want our voices to be heard.”

***ENDS***

ADDITIONAL INFORMATION:

The Kurunna mwarre: Making my spirit inside me good Summit will be held at Ross River from Tuesday 14 to Thursday 16 May 2013. It is for Aboriginal people only.

A Summit Open Day will be held on Thursday 16 May for politicians, media and stakeholders to attend and be presented with the solutions emanating from the summit. (See details below)

Media contact:

Emma Ringer, Communications Officer, Central Australian Aboriginal Congress

Ph: 0408 741 691 / 08 8958 3664

Email: emma.ringer@caac.org.au

Summit contact:

Bruce Loomes

Ph: 0439 594 724

Email: bruce_loomes@bigpond.com

Summit spokespeople:

Mr John Liddle, Ingkintja Male Health Branch Manager, Central Australian Aboriginal Congress

Ms Donna Ah Chee, CEO, Central Australian Aboriginal Congress

Kurunna Mwarre Summit Open Day:

When:                  Thursday 16 May, 2013

Time:                     11:00am to 12:30pm

Where:                 Ross River Resort, via Alice Springs NT

Who:                     Federal and NT politicians

Federal and NT government departments

Aboriginal organisations and service providers

Indigenous and non-Indigenous leaders in Central Australia

Media and relevant stakeholders

Interested persons from Central Australia

Media release, images, further information:

http://www.caac.org.au/media-publications/media-releases/listen-to-me-summit-to-unite-bush-voices-for-change/

Event details:

http://www.caac.org.au/how-we-help/events/kurunna-mwarre-summit-making-my-spirit-inside-me-good/

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NACCHO press release:Julia Gillard to announce that the federal contribution for a renewed Aboriginal health deal will be $777 million until June 2016

Closing the gap now in the hands of state and territory governments

 See Page 5 todays April 18 The Australian for the CTG/NACCHO campaign half page ad

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The National Community Controlled Health Organisation (NACCHO) today welcomed the Gillard Government’s commitment to the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes and called on state and territory leaders to urgently do the same.

According to AAP reports this morning Prime Minister Julia Gillard will announce  that the federal contribution for a renewed deal will be $777 million until June 2016.

Ms Gillard will ask the states and territory government to chip in the remainder, although the issue will not be on the agenda of the Council of Australian Governments (COAG) meeting on Friday.

“As a result of our investments in indigenous health, we are seeing improvements,” Ms Gillard said in a statement.

“We know there is more to be done.”

The original national partnership deal struck in 2008 was worth $1.58 billion over four years and the federal contribution was $805.5 million.

Ms Gillard said the renewed federal contribution would be an increase over previous per annum expenditure.

Following former prime minister Kevin Rudd’s apology to the stolen generations in 2008, federal, state and territory governments agreed on six ambitious Close the Gap targets to tackle indigenous disadvantage.

 NACCHO Chair, Justin Mohamed said the National Partnership Agreement was due to expire at the end of June, putting critical Aboriginal health programs at risk.

 “Improving the appalling state of Aboriginal health must be a priority for all levels of government and Aboriginal people will be relieved to finally have a commitment from the Gillard Government today.

 “The pressure is now squarely on the states and territories as signatories of the 2008 Close the Gap Statement of Intent in which they committed to work together to close the disgraceful seventeen year gap in life expectancy between Aboriginal and non-Aboriginal Australians by 2030.

 “The states and territories need to uphold their commitment to this important goal and sign up to continue the National Partnership Agreement which is due to expire in less than two months.”

Mr Mohamed said it was imperative the Agreement was given priority at the COAG meeting tomorrow.

 “Improving Aboriginal health is not a quick fix – it requires a long-term commitment above party politics.

 “This is not just a matter for the Federal Government. It has been proven that only by all levels of government working together will we see improvements in Aboriginal health.

 “There have been five years of good work on Closing the Gap programs and must maintain the momentum.

 “We must maintain our commitment and build on the inroads the 150 Aboriginal community controlled health organisations (ACCHOs) are making in their communities.

 “Aboriginal comprehensive primary health care provided by Aboriginal communities is the key to making a difference to Aboriginal health outcomes.”

 Mr Mohamed said the Federal Government’s ongoing commitment to Aboriginal health in a challenging fiscal environment was a testament to many in the sector who had worked tirelessly to keep Aboriginal health on the national agenda.

 Press release from the CTG campaign group

Aboriginal and Torres Strait Islander health must be placed on the agenda for this Friday’s COAG meeting if there is to be any hope of closing the life expectancy gap by 2030, the Close the Gap Campaign said today.

 “Five years ago all sides of politics agreed to do something about the national disgrace that sees Aboriginal and Torres Strait Islander people die more than 10 years younger than the broader Australian community,” Campaign Co- Chair Mick Gooda said.

 “While the 2008 COAG meeting saw federal, state and territory governments commit to long term funding for services and programs though the National Partnership Agreement, Aboriginal and Torres Strait Islander health is absent from this Friday’s COAG meeting agenda.

 “We know that the policies and programs resulting from these 2008 COAG commitments are starting to bear fruit and make a real difference on the ground, for example, mortality rates for under five year old Aboriginal and Torres Strait Islander children are falling,” he said.

 “But the life expectancy gap remains just as unacceptable today as it was back then and I know that most of those attending COAG this Friday agree with me,” Mr Gooda said.

 The National Partnership Agreement which has driven efforts to close the gap in Aboriginal and Torres Strait Islander health outcomes is set to expire at the end of June 2013. Despite Federal Government indications that it will continue funding its share of the Agreement, State and Territory governments have not yet signed up to the Agreement  leaving some services and programs in real doubt as to whether they can continue to provide badly needed services beyond 30 June.

 Campaign Co Chair Jody Broun said governments of all persuasions owed it to the rest of the country to maintain their efforts to close the life expectancy gap by 2030.

 “There’s no doubt that nothing short of ongoing funding and commitment to working with Aboriginal and Torres Strait Islander peoples from all levels of government is what’s needed to keep on track,” Ms Broun said.

 “State, territory and federal governments need to continue working together to fund more services and programs that make a real difference to health outcomes for Aboriginal and Torres Strait Islander peoples.

 “We have to maintain our efforts to improve access to critical chronic disease services and to deliver anti-smoking measures, more affordable medicines and healthy lifestyle programs. We need to support and build capacity in our Aboriginal Community Controlled Health Services and we need to build on the inroads already made by our child and maternal health services,” she said.

 “We need more Aboriginal health workers, allied health professionals, doctors, nurses and health promotion workers.

 “A recommitment from state, territory and federal governments at this Friday’s COAG meeting is needed to quite literally save lives.”

 Who is the CLOSE the Gap campaign mob

 Australia’s peak Aboriginal and Torres Strait Islander and non-Indigenous health bodies, health professional bodies and human rights organisations operate the Close the Gap Campaign.

 The Campaign’s goal is to raise the health and life expectancy of Aboriginal and Torres Strait Islander peoples to that of the non-Indigenous population within a generation : to close the gap by 2030.

 It aims to do this through the implementation of a human rights based approach set out in the Aboriginal and Torres Strait Islander Social Justice Commissioner’s Social Justice Report 2005.

 The Campaign’s Steering Committee first met in March 2006. Our patrons, Catherine Freeman OAM and Ian Thorpe OAM launched the campaign in April 2007. To date 176,000 Australians have formally pledged their support. In August 2010 and 2011, the National Rugby League dedicated an annual round of matches as a Close the Gap round, reaching around 3 million Australians per round. 840 community events involving 130,000 Australians were held on National Close the Gap Day in 2011.

How can you ask your state Premier or territory Chief Minister to support Close the Gap?

All Australian governments have committed to Close the Gap through the COAG process and the National Indigenous Reform Agreement.
 
The development of the Closing the Gap policy platform to back up this commitment set the foundations to meet this generational target.Ask your State Premier or Chief Minister to publicly commit to renewing investment in Aboriginal and Torres Strait Islander health equality.
 

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 AMA COAG Must make ‘Closing the Gap’ a National Priority

AMA President, Dr Steve Hambleton, said today that it would be a disgrace if the long-term health needs of Aboriginal people and Torres Strait Islanders were not discussed at this Friday’s Council of Australian Governments (COAG) meeting in Canberra.

Dr Hambleton said it would be irresponsible if Australia’s political leaders came away from the meeting without an agreement to continue long-term funding for the COAG National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes.

“Closing the gap and achieving health equality between Aboriginal people and Torres Strait Islanders and other Australians must be a priority for all our governments,” Dr Hambleton said.

“It is a worthy goal that requires long-term funding and genuine political commitment.

“It requires action, not just words.

“Five years ago, our governments signed up in good faith to the National Partnership Agreement, and it has delivered some positive health outcomes.

“Now is not the time to be complacent – we must build on these good results.

“The current Agreement expires in a matter of months.

“We are calling on COAG leaders to this Friday agree to the long-term continuation of the National Partnership Agreement with at least the same level of funding for another five years initially.

“This would send a very strong message to the community that our governments are serious about closing the gap,” Dr Hambleton said.

Since 2008, the Agreement has achieved a number of successes in improving Indigenous health and wellbeing, including:

  • being on track to halve the mortality rates for children under five;
  • significantly increasing Aboriginal and Torres Strait Islander peoples’ access to health services for chronic disease – which underlies much of the gap in health outcomes;
  • having work underway in partnership with Aboriginal and Torres Strait Islander peoples to develop a long term health plan; and
  • meeting the target for early childhood education access in remote communities.

NACCHO COAG press release:Aboriginal health relies on COAG this Friday to Close the Gap

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The ability to improve shocking Aboriginal life expectancy rates is at risk while COAG delays discussions on the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes, said the peak Aboriginal health organisation today.

 Justin Mohamed, Chair of the National Aboriginal Community Controlled Health Organisation (NACCHO) the national authority in comprehensive health care, said COAG must include the Agreement on the agenda for Friday’s meeting. 

DOWNLOAD NACCHO press release here

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Please note :How can you ask your state Premier or territory Chief Minister to support Close the Gap SEE LINK BELOW

 “To close the gap in life expectancy of 17 years was the core commitment of the Australian Government and Opposition in the Close the Gap Statement of Intent.” Mr Mohamed said.

 “Five years ago all state and territory governments also signed up to the Close the Gap statement of intent which would see this appalling statistic reduced by 2030

“Since then we have made some advances and invested in Aboriginal community controlled health services (ACCHO,s)which is starting to have an impact.

“But we can’t stop now. Aboriginal health is not a quick fix – it requires a long-term commitment by all levels of government.

“We must continue to build on the great work being done by the 150 Aboriginal community controlled health services around the country that are making inroads in our communities and making a real difference to their health.

“ACCHO’s  are best placed to provide culturally appropriate primary health care and need support to continue and expand their service delivery. 

“COAG must make the National Partnership Agreement a priority at Friday’s meeting”

Mr Mohamed said many quality and effective programs were at risk if COAG delayed any longer.

“It is unacceptable that Aboriginal people who rely on health programs funded through the agreement don’t know if they will still be there come July,” Mr Mohammed said.

NACCHO is calling on COAG to show continued commitment to the Close the GAP agreement

How can you ask your state Premier or territory Chief Minister to support Close the Gap?

All Australian governments have committed to Close the Gap through the COAG process and the National Indigenous Reform Agreement.
 
The development of the Closing the Gap policy platform to back up this commitment set the foundations to meet this generational target.Ask your State Premier or Chief Minister to publicly commit to renewing investment in Aboriginal and Torres Strait Islander health equality.
 

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Dear Premier

The commitment to close the life expectancy gap between Indigenous and non-Indigenous people by 2030 was a watershed moment for the nation.

All Australian governments have committed to this important national priority through the COAG process and the National Indigenous Reform Agreement. The development of the Closing the Gap policy platform to back up this commitment set the foundations to meet this generational target.  Thank you for your government’s commitment to this national priority.

More than 185,000 Australians, have signed the close the gap pledge and last year alone more than 130,000 Australians attended 850 events on National Close the Gap Day. In a country as wealthy as Australia, it is unacceptable that a baby born to an Indigenous mother can expect to live between 10 and 17 years less than a baby born to a non-Indigenous mother, or die before the age of four at between two  and three times the rate of non-Indigenous children.
That is why I believe that now is the time to build on the foundations in place and continue the necessary investment to close the gap.

I therefore ask that you publicly commit to renewing investment in Aboriginal and Torres Strait Islander health equality through:

- Committing to invest in the renewal of the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes which expires on June 30, with your state funding maintained at least at the level allocated to the current Agreement
- Committing to invest in the delivery of the National Aboriginal and Torres Strait Islander Health Plan due for completion later this year

This year the number of National Close the Gap Day (March 21st) events has again grown to over 900 right around Australia; these events show continuing and growing support for the goal of closing the life expectancy gap by 2030. The message at these events was that it is critical to continue to invest in closing the gap programs.

I trust that you and your government will continue to play your part in this national effort and look forward to your response to my letter.

NACCHO political alert:AIHW report:Spending on Indigenous health reaches $4.6 billion

 AIHW

In 2010-11, 3.7% of Australia’s total health expenditure, or $4.6 billion, was spent on Aboriginal and Torres Strait Islander people, who make up 2.5% of the Australian population, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

DOWNLOAD THE REPORT HERE

The report, Expenditure on health for Aboriginal and Torres Strait Islander people 2010-11, shows that $4.6 billion was spent on the health of Aboriginal and Torres Strait Islander people in 2010-11, equating to $7,995 per Indigenous Australian.

‘For non-Indigenous Australians, $5,437 was spent per person,’ said AIHW spokesperson Teresa Dickinson.

‘This is an Indigenous per person ratio of 1.47-that is, $1.47 was spent per Indigenous Australian for every $1.00 spent per non-Indigenous Australian.’

This ratio was an increase from the 2008-09 figure of 1.39.

In 2010-11, publicly-provided services such as public hospital and community health services were the highest expenditure areas for the Indigenous population.

‘The average per person expenditure on public hospital services for Indigenous Australians was more than double that for non-Indigenous Australians-$3,631 compared with $1,683,’ Ms Dickinson said.

Conversely, for health services that have greater out-of-pocket expenses, such as pharmaceutical and dental services, Indigenous expenditure is generally lower relative to the non-Indigenous population.

‘The average per person expenditure on dental services was $149 for Indigenous Australians, compared with $355 for non-Indigenous Australians,’ Ms Dickinson said.

‘These differences reflect different patterns of service usage.’

Most health expenditure on Indigenous Australians in 2010-11 (91.4%) was government-funded-46.6% by state and territory governments and 44.8% by the Australian Government. For non-Indigenous Australians, 68.1% of total health expenditure was government-funded.

Between 2008-09 and 2010-11, expenditure by all governments on Aboriginal and Torres Strait Islander people rose by $847 per person. This represents an average annual growth rate of 6.1%, compared with 2.6% for non-Indigenous Australians.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.

Canberra, 28 March 2013

Further information: Ms Teresa Dickinson, AIHW, tel. 02 6249 5104 mob. 0439 430 577

NACCHO member good news alert:A new beginning for Dubbo Aboriginal Community Controlled Health

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Aboriginal health services return to Aboriginal Community control with the opening of the Interim Dubbo Aboriginal Medical Service

27 March 2012 – Sydney: The Aboriginal Health and Medical Research Council of New South Wales (AH&MRC) and the Bila Muuji Aboriginal Health Service have formed a Coalition to support the re-establishment of Aboriginal health services in Dubbo following the closure of Thubbo Aboriginal Medical Co-op Ltd (Thubbo AMS) in 2012.

 Aboriginal Community Controlled Health Services (ACCHSs) in the region are concerned about the Dubbo Aboriginal Community’s ability to access culturally appropriate primary health care.

The Coalition was formed to provide interim services to Aboriginal people in Dubbo while also working with the Community towards the long-term goal of establishing a viable ACCHS in Dubbo that is dedicated to improving the health and wellbeing of the local Aboriginal Community.

 The Interim Dubbo Aboriginal Medical Service (AMS) will open at 211 Brisbane Street in coming weeks and will soon be taking bookings for GPs to start providing clinics three days per week.

 “Restoring access to high-quality, culturally appropriate primary health care in Dubbo, which is delivered by Aboriginal health services from the region, has been our first priority,” said Ms Sandra Bailey, CEO of the AH&MRC.

 “The AH&MRC is leading this Coalition to assist the Community with the eventual development of a new Community Controlled Health Service and will coordinate ongoing services in the interim. Bila Muuji has already responded quickly to restore access and primary health care services in the area,” Ms Bailey said.

 The Interim Dubbo AMS is located right in the centre of Dubbo and is close to public transport. A toll free hotline has been set up to assist with patient enquires, bookings and concerns. The hotline can be reached on 1800 999 444.

 The Interim Dubbo AMS will be open to new clients as well as people who previously attended Thubbo AMS. Thubbo AMS patients who do not wish to access the new service can choose to have their medical records transferred to a health service of their choice by contacting the hotline number listed above.

 The establishment of the Interim Dubbo AMS has been supported at Community meetings of the Dubbo Aboriginal Community and also has the endorsement of the Dubbo Aboriginal Community Working Party (DACWP).

 The Department of Health and Ageing (DoHA) also supports this strategy to re-establish culturally appropriate services in Dubbo. “The Government is committed to the concept of Aboriginal community control for the provision of health services to Aboriginal and Torres Strait Islander people wherever possible,” said a spokesperson from DoHA.

 The AH&MRC will continue to provide information about the ongoing development of the Interim Dubbo AMS as the service gets up and running and grows to meet the local Aboriginal Community’s health needs. Further consultation will take place to ensure there are opportunities for Community input.

 “We are committed to working together as a team to support the ultimate goal of re-establishing Aboriginal Community Controlled Health Services in Dubbo as a matter of priority,” said Ms Bailey.

 The Interim Dubbo Aboriginal Medical Service can contacted on 1800 999 444 for clinic appointments and health enquiries.

For all media enquiries please contact Adam Stuart on (02) 9212 4777.

 About the Aboriginal Health & Medical Research Council of NSW

The Aboriginal Health & Medical Research Council of New South Wales (AH&MRC) is the peak representative body and voice of Aboriginal communities on health in NSW. The AH&MRC represents its members, Aboriginal Community Controlled Health Services (ACCHSs), which deliver culturally appropriate comprehensive primary health care to their communities.

 Aboriginal Community Control has its origins in Aboriginal people’s right to self-determination. The AH&MRC is governed by a Board of Directors who are Aboriginal people elected by our members on a regional basis and represents, supports and advocates for our members and their communities on Aboriginal health issues at state and national levels.

 For more information about the AH&MRC please visit our website at www.ahmrc.org.au or contact Matthew Rodgers, Media and Communications Officer, at mrodgers@ahmrc.org.au or (02) 9212 4777.

  Acknowledging the traditional custodians of the land on which the Aboriginal Health & Medical Research Council operates and respecting all Elders past and present.

 

NACCHO health news alert:Preventing disease and dialysis in the younger generations

 

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Recently Donna Ah Chee, CEO , Central Australian Aboriginal Congress in Alice Springs , gave a speech at the launch of the Kidney Action Network, examining progress in managing this major health threat to indigenous communities and the work still ahead.

Members of  the network who also spoke at the launch Left to right: John Paterson (CEO AMSANT), Donna Ah Chee (CEO Central Australian Aboriginal Congress), Preston Thomas (Deputy Chair of Ngaanyatjarra Health / Director of Western Desert Dialysis), Sarah Brown (CEO Western Desert Dialysis), Andrea Mason (Coordinator, NPY Women’s Council)

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The following article is reproduced from our friends at CROAKEY

 

In 2011 the AIHW published the Chronic Kidney Disease in Aboriginal and Torres Strait Islander People (AIHW, 2011) report which contained some alarming statistics about the renal health of Indigenous Australians.

The report found that Indigenous Australians develop end stage kidney disease (ESKD) at over six times the rate of non-Indigenous Australians and that Indigenous Australians were four times more likely to have chronic kidney disease as a cause of death.

Further, 70% of ESKD cases in indigenous Australians occurred before the age of 60. At the time of that report diabetic neuropathy was the most commonly attributed cause of ESKD present in 60% of cases.

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Many thanks to Donna for allowing us to provide the full transcript of her speech below:

The stark reality of the numbers of Aboriginal people on dialysis here in Alice Springs is a constant and real daily reminder of the work that still needs to be done to address Aboriginal health disadvantage and Close the Gap in our life expectancy.

However, at the outset I think it is vital to acknowledge the very real health improvements that are now being seen in the prevention and treatment of chronic illnesses, the very diseases that have created this kidney disease crisis.

Since the beginning of the Primary Health Care Access Program (PHCAP) in the NT back in 2001, there has been a continuing improvement in life expectancy amongst Aboriginal people in the Northern Territory, primarily because of a decline in premature deaths in midlife caused by chronic illnesses.

The NT is currently the only jurisdiction on track to Close the Gap by 2031, if the current trend continues.

There is now much better access to evidence-based treatments, including medicines, than was previously the case. We have many more health professionals on the ground now. This has helped to detect renal disease early and slow its progression.

However it is vital that we do much more in terms of the primary prevention of renal disease in the first place, and this requires action to prevent the epidemic of obesity and diabetes.

I have just been to a national forum in Canberra on this issue, organised by Diabetes Australia. Congress made four key policy proposals to address the prevention of the obesity and diabetes epidemic:

  1. To re-establish the Primary Health Care Access Program, or PHCAP, so that the expanded primary health care core services model can be fully funded and so make further improvements in access to primary health care.
  2. To fund the key early childhood programs (ante-natal and for the first three years of childhood) that will help to ensure that all young people have good self-regulation and impulse control and will be more resistant to the development of addictions including fat and sugar
  3. To introduce an alcohol floor price, as cheap alcohol consumption is a major contributor to obesity and the inability to self-manage chronic disease
  4. The introduction of a 20% tax on glucose—especially on the glucose in sugary soft drinks—and fat, with hypothecation of the tax to ensure that the tax is used as a subsidy for fresh fruit and vegetables

We must get much more serious on the prevention of renal disease than we have been up to now.

However, there are now some early signs that for the first time the rate of increase in End Stage Renal Disease may have at least plateaued, as the number of new patients coming on to dialysis in the NT has declined slightly for the first time.

There are many reasons for this, but it is at least partly due to the real improvements that have been made in the NT health system, where a large injection of new resources have been allocated over the last decade in a planned way, according to need.

Unfortunately, in recent years many new resources have been allocated through competitive tendering. This form of funding allocation has been fragmenting the health system, and has the potential to slow down the gains that we have made up to now.

Also, the way that renal dialysis services are being delivered has not been part of this change process. We are largely stuck in the same “centre-based” approach that we have had for decades, with patients being given little option other than to move to Alice Springs and other major centres to go on to dialysis.

It should be acknowledged that there have been efforts to get some dialysis patients home on ‘self-care’ home haemodialysis, but only a very small proportion of our people are currently capable of achieving this.

Congress has advocated for many years for the option of nurse-assisted home-based haemodialysis for all of the reasons outlined in the Central Australian Renal Study, which was completed in 2010.

Congress recognises the work being done by the Western Desert people to help themselves deal with the high levels of kidney problems in their communities. They have led the way in taking initiatives to ensure that there are better options, including nurse-assisted home haemodialysis. Where government have failed to deliver, Aboriginal people have had to try to fill the void with their own funds.

The Western Desert Nganampa Walytja Palyantjaku Tjukaku remote area dialysis services organisation has shown that nurse-assisted home haemodialysis is not only possible, but also very highly valued by the community. This vision needs to be built on by using existing government resources differently; dialysis needs to be decentralised, and provided out bush where people live. It is very likely that this option is not only better but also cheaper. It is not acceptable that in the absence of this option some of our people are choosing to die at home without life-saving dialysis treatment.

There have also been some encouraging signs recently in terms of improved access to renal transplantation for Aboriginal people, with more than 20 transplants in the NT last year. There is still a lot more improvement needed in this area because renal transplantation is the definitive treatment for End Stage Renal Failure, and allows people to live a full, active and healthy life once more. We know that a lot of dedicated people are working hard on this issue.

There has been a lot of work done to bring kidney disease in remote communities to the attention of governments. This work was distilled in the 2010 Central Australian Renal Planning Study.

Congress is very concerned by the refusal of the state and Territory governments to engage with the key recommendations of the Renal Planning Study. This is why we need stronger advocacy and political action. This is why we need the new Kidney Action Network.

There has been a failure to recognise and act on the fact that Alice Springs has to be the hub centre for delivery of services to people in most of the tri-state (NT-SA-WA) cross border desert areas, which rely on Alice as their natural, geographic, social and cultural regional centre.

The failure to provide serious support to the ‘Alice Springs hub centre’ concept means that many patients are still forced to move to Adelaide and Perth, which are too far from their families, communities, social life and cultural necessities.

Congress fully recognises the impact these planning and infrastructure failures have on individuals, their families and their communities. Congress also recognises that tri-state planning is not something that has ever been done well. This is a big challenge for our complex, federated system.

For the sake of the End Stage Renal Patients across the whole of central Australia, we have to get this tri-state planning right and ensure people are provided the right type of renal replacement treatment in their home communities. This must include nurse-assisted home haemodialysis. We also have to address the obesity and diabetes epidemic through effective prevention. We need to all join together through this new Network and make sure all the necessary changes are achieved.