Apr 9 2013

NACCHO health news: AMA-Good mental health and wellbeing essential to close Indigenous health gap

By AMA President Dr Steve Hambleton

By AMA ( Australian Medical Association) President Dr Steve Hambleton

Edition :

Australian Medicine – 8 April 2013

In recent years, Australians have become increasingly aware that poor mental health can affect any of us at any time. Government health policy has also sought a more concerted focus on this area of health.

There is less awareness, though, of the distinctive needs and vulnerabilities of particular groups in Australia concerning mental health and wellbeing.

The factors that contribute to poor mental health and social and emotional wellbeing among Aboriginal peoples and Torres Strait Islanders are complex, and their effects cross generations.

The AMA believes that the mental health and social and emotional wellbeing of Aboriginal peoples and Torres Strait Islanders should be given greater priority in the nation’s health policy agenda.

According to the latest research, nearly one-third of Aboriginal and Torres Strait Islander adults report high to very high levels of psychological distress in their lives – two and a half times the rate reported by other Australians.

There were more than 990 reported suicides of Aboriginal people and Torres Strait Islanders between 2001 and 2010, which is twice the rate of other Australians.

The situation is even more dire among Stolen Generation survivors, who have mental health conditions at twice the rate of other Aboriginal people and Torres Strait Islanders who were not removed from their families.

Young Aboriginal people and Torres Strait Islanders are particularly at risk.

Those between 18 and 24 years of age are twice as likely as other Australians to have experienced high levels of psychological distress, and those between 12 and 24 years of age are more than three times more likely to be hospitalised for mental and behavioural disorders than other Australians of that age.

The suicide rates for young Aboriginal and Torres Strait Islander men between 15 and 19 years of age are nearly six times that of other Australian men of that age.

Poor social and emotional wellbeing and psychological distress is associated with exposure to major life stressors, such as illness, disability, exposure to violence, unemployment, the death of a family member or friend and persistent economic struggle. Aboriginal people and Torres Strait Islanders experience these major life stressors, and their associated levels of psychological distress, at higher rates than other Australians.

Research shows that there is an association between in utero stressors and a child’s developmental outcomes.

Children whose mothers experience more than three major stressors while they are in utero are at higher risk of exhibiting difficult behaviours in childhood.

The quality of a child’s early life can also affect their resilience and mental health later in life.

The AMA reported in 2008 on the problematic life circumstances and health risks of Aboriginal and Torres Strait Islander children, and will report on the evidence around healthy early development for Aboriginal and Torres Strait Islander children later this year.

For Aboriginal peoples and Torres Strait Islanders, mental health and social and emotional wellbeing are very much bound up with strength of their cultural identity, and the amount of control they have over their own lives. That’s why, among other things, the AMA has advocated for the formal recognition of Aboriginal peoples and Torres Strait Islanders in the Australian Constitution (see Recognition a step toward closing Indigenous health gap, px).

The AMA also believes that a national strategic approach to Aboriginal and Torres Strait Islander mental health is needed which, among other things, ensures that:

there are enough culturally specific mental health and wellbeing services in the right locations, and built into the comprehensive primary care provided by Aboriginal community-controlled health services;
child and maternal health services have the capacity to support healthy early childhood development for Aboriginal people and Torres Strait Islanders; and
mainstream mental health services and general practices are supported to provide culturally competent services for Aboriginal people and Torres Strait Islanders.

Importantly, Indigenous leadership must be preserved in the development and implementation of this strategic approach.

A positive state of mental health and happiness can be a buffer against adverse circumstances and health conditions. The physical health and mental health of Aboriginal people and Torres Strait Islanders are therefore intertwined.

This means that, in measuring what it will take to close the gap in Indigenous health, it is critical to include mental health and social and emotional wellbeing in the equation

Mar 28 2013

NACCHO political alert:Aboriginal Community Controlled Health can make a difference

Selwyn Button, CEO of the Queensland Aboriginal and Islander Health Council (QAIHC) has welcomed these weeks’ findings

The release of Queensland’s version of the National Aboriginal and Torres Strait Islander Health Performance Framework report, and the Coalition of Australian Governments (COAG) release of Closing the Gap targets, further proves that good quality and comprehensive primary health care services, through community controlled organisations, supports communities in addressing Indigenous health needs.

The Australian Institute for Health and Welfare this week released jurisdictional versions of data and information gathered over the period 2001 – 2010.

Stemming from a range of providers across the health care industry aimed at addressing health concerns for Aboriginal and Torres Strait Islander people, these impacts were measured predominantly relating to secondary and tertiary care in hospital settings.

Selwyn Button, CEO of the Queensland Aboriginal and Islander Health Council (QAIHC) has welcomed these weeks’ findings.

“This data and information clearly supports the notion that in order to make longlasting impacts upon the overall health of our communities, we must continue to focus our efforts in providing good quality comprehensive primary health care,” Mr Button said.

“Many of the issues identified, like Type 2 Diabetes, kidney disease and smoking related illnesses are all better managed when people are accessing care through their local community controlled service provider and getting access to early intervention, support and ongoing care.

“Although this data is now two years old, over the past three years there have been major improvements in the overall numbers of Aboriginal and Torres Strait Islander

people accessing services and undertaking comprehensive health assessments for health workers to know and understand what their ongoing care needs are,” Mr Button stated.

Although the report shows that there have been improvements in overall avoidable mortality rates, deaths relating to circulatory disease and infant mortality rates, there are still some concerns in ongoing management of chronic disease, smoking rates across communities and smoking during pregnancy.

“Importantly this data clearly demonstrates that in Queensland we are taking the issue of early detection, diagnosis and management very seriously,” Mr Button said.

“Recent Medicare data shows Queensland has accounted for more than one-third of national health checks for Aboriginal and Torres Strait Islander people in recent years.

“Queensland has the second largest population of Aboriginal and Torres Strait Islander people in the country.

“Approximately forty per cent of this population access regular care through community controlled services,” Mr Button stated.

“Undertaking this exercise annually and improving these numbers enables community controlled services to get a clear understanding of our communities, families and individuals health needs.

“We get a clear understanding of what is required to meet this growing demand for services to support better care and management of chronic diseases.

“Capturing baseline evidence will provide much clearer indication of our community’s needs and challenges that are ahead for us to address.

“This data must be used wisely to determine new investments and allocation of resources supporting quality care and improving outcomes for our people,” Mr Button advised.

More than sixty five percent of the COAG announcement of $1.6 billion towards Close the Gap went to non-Indigenous and mainstream services. This was based on data at the time showing that Aboriginal and Torres Strait Islander people were primarily receiving care through GP services and government-run facilities.

The evidence in Queensland shows otherwise.

“We are seeing significant improvements in accessing care through community controlled services and we must ensure that we address the funding imbalance to support this work.” Mr Button said.

Selwyn Button is the CEO of QAIHC, the peak body representing the Community Controlled Health Sector in Queensland at both a state and national level.

Media Enquiries: Judi Jabour, Campaign Capital, 0412 402 946.

Mar 25 2013

NACCHO Aboriginal Health News Alert:Download:Senate report on social determinants deserves cross-party support

Please note NACCHO is a member of the SDOHA

DOWNLOAD THE FULL REPORT FOR NACCHO SITE

The Social Determinants of Health Alliance (SDOHA), representing more than 25 organisations calling for urgent action on the social determinants of health, has applauded last night’s report from the Senate Community Affairs Committee on the social determinants, saying it represents a significant first step towards addressing the causes of health inequity in Australia – if all parties adopt the recommendations made by Labor, Liberal and Greens Senators.

“The establishment of the Senate Inquiry to investigate action on the social determinants was seen as the key that could unlock this debate, and if political parties follow their colleagues’ lead, that expectation will prove to be true,” SDOHA spokesman Martin Laverty said. “There is good reason to be optimistic that the Senate committee’s work will deliver real results for the people of Australia.”

SDOHA, representing health, social service and public policy organisations, said the fact the report’s five recommendations are almost lifted from its submission means the Senate report has the strong backing of many of the key groups working to bring about health equity.

“Our top priority was to have the Commonwealth, and hopefully other governments, ratify the World Health Organisation report Closing the gap in a generationand that’s the committee’s first recommendation,” Mr Laverty explained. “That will make governments accountable and also give them a roadmap for how to actually address the social determinants of health.”

Social Inclusion Minister Mark Butler spoke at last month’s SDOHA launch about the 600,000 Australians living with complex, multi-layered disadvantage that was often caused by social factors. “We know that the surest path out of that is fixing those health problems and giving them decent education and training to find employment,” the Minister said.

Mr Laverty said the Senate committee’s recommendation that governments particularly look at education, employment, housing, family and social security policy through a social determinants of health lens again has the potential to make a real difference.

“We know that the Senators recognise that all policies – transport, infrastructure environment and economic policy are a few other areas that could be added to the list – have an effect on people’s health, so we hope politicians don’t limit themselves to the specific, and pivotal, areas the committee mentioned.”

Mr Laverty pointed to the report by the National Centre for Social and Economic Modelling that last year outlined the financial benefits – in addition to the social advantages – that would be derived from government action on the determinants of health. Billions of dollars could be saved in health costs, including prescriptions, while billions more could be injected into the economy by helping Australians suffering from health conditions be made well and able to enter the workforce.

“At its core, addressing the social determinants of health is an issue of justice, of fairness, of equity; we’re supposed to be the country of the ‘fair go’,” Mr Laverty said. “But addressing the social determinants also makes sense economically, and would allow governments to save money and generate additional revenue.

“To the Alliance, this is a no-brainer. The multi-partisan Senate committee has offered a way forward. Let’s hope partisan politics – and an election campaign – doesn’t distract politicians from acting in Australians’ best interests.”

Mar 20 2013

NACCHO Press Release:Aboriginal Community Controlled Health vital to closing the gap

On National Close the Gap Day it’s critical political leaders around the country recognise the importance of supporting Aboriginal Community Controlled Health as the key mechanism for improving the health of Aboriginal and Torres Strait Islander people.

DOWNLOAD the full release here

Justin Mohamed, Chair of the National Aboriginal Community Controlled Health Organisation (NACCHO), said it was widely acknowledged that culturally appropriate healthcare services make a real difference.

“Healthcare services provided by Aboriginal people for Aboriginal people must continue to be supported and invested in if governments are serious about achieving health equality,” Mr Mohamed said.

“The latest Closing the Gap Report released by the Gillard Government last month highlighted the vital role of Aboriginal Community Controlled Health in improving health outcomes in life expectancy and child mortality.

“Any genuine effort to close the gap on Aboriginal health must have Aboriginal Community Controlled Health Organisations at its core.”

Mr Mohamed said Aboriginal people were concerned that political leaders had not renewed their funding commitment to the Close the Gap strategy – due to expire in June this year.

He said Aboriginal Community Controlled Health Organisations are the preferred provider in the delivery and are largely responsible for the health gains showcased in the Aboriginal and Torres Strait Islander National Performance Framework 2012.

“It is imperative that governments at state and national level recommit to the objectives of the Close the Gap strategy and renew their funding commitment through the National Partnership Agreements and ensure improved implementation of any new commitment is actioned immediately and into the future.

“There are many services and, more importantly, individuals and their families relying on programs that currently have no certainty past June 2013.

“We are urging the Government to make a significant announcement sooner rather than later.”

Close the Gap Day on 21 March is being celebrated by tens of thousands of people across Australia to highlight Aboriginal and Torres Strait Islander health and urge government action.

Feb 6 2013

Dear Prime Minister:Time for the health vision to be a reality :Todays Closing the Gap speech

“While all parties have voiced support for health equality, now is the time to demonstrate how promises will be turned into programs with accountable results.”

Source Canberra times 6 February

The Prime Minister will deliver her report to Parliament on Wednesday on progress towards closing the gap.

The speeches from Julia Gillard and Opposition Leader Tony Abbott offer an unparalleled opportunity for all political parties to restate their commitment to Aboriginal and Torres Strait Islander health equality.

In this election year, it is vital that all sides of politics at all levels strengthen their commitments to closing the gap by 2030. Long-term commitments to programs and services will provide surety and results that are literally a matter of life and death for our peoples.

While all parties have voiced support for health equality, now is the time to demonstrate how promises will be turned into programs with accountable results.

</iframWhy is commitment needed? Isn’t enough being done for first Australians? The efforts by government, non-government organisations, communities and individuals are to address simple facts such as babies born to Aboriginal mothers die at around twice the rate of other babies, and then children survive to experience higher rates of preventable illness such as heart disease, kidney disease and diabetes.

Now that the election has been set, and with the budget on the horizon, this fiscal commitment will most likely be announced in due course. These are nervous times because without this commitment by both sides, the prospect of closing the gap within a generation will be lost.

The health of Aboriginal and Torres Strait Islander Australians cannot fall victim to budget cuts or be propped up on short-term drip funding. All parties must support multi-decade commitments that will span policy cycles, funding agreements and governments.

Firstly, and perhaps most importantly, is a re-commitment to a National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. The current agreement expires in a few months.

This is the key funding that underpins all of the Aboriginal and Torres Strait Islander health programs and services provided by government, as well as by the Aboriginal community-controlled health organisations.

Secondly, the National Aboriginal and Torres Strait Islander Health Plan is due midyear. It is already off to a good start and will serve as a partnership between the government, our community and peak health bodies. The nation expects commitments to be maintained and crucial investment to continue, until we close the gap.

The government’s report will highlight some promising signs of health improvements. Those improvements are the core focus of our Close the Gap Campaign – a collaboration of health and human rights bodies. The campaign also publishes our ”shadow report” on the government’s progress.

Under-five mortality rates for first Australians are falling, and child health is improving – and a healthier child population means a healthier adult population.

Aboriginal and Torres Strait Islander peoples are also embracing increased personal control of our health, with the successful rollout of Tackling Smoking Initiatives and Chronic Disease Packages, along with increases in health checks.

Similar programs focused on improving diet and raising awareness about chronic disease will also take time and involve generational behaviour change. While these programs must be given the chance to succeed, there is no room for complacency.

We know that change can and does happen where collaboration between the community-controlled health sector and the government exists – where there’s genuine partnership.

There is an undeniable groundswell of good will from Australians, with more than 185,000 people supporting the Close the Gap campaign.

Tens of thousands of people are expected to take part in National Close the Gap Day events on March 21. As the day gets bigger each year, it provides hope that as a nation, we want to address this historical indictment.

This year is a critical juncture if we are to close the gap, and although there are many challenges and a long way to go, the finish line is within sight of a generation.

This is the year to hold to the vision of what can be achieved. Time to allow ourselves to be a nation inspired by it – Aboriginal and Torres Strait Islander health equality within our lifetimes, within our generation.

We look to the nation’s leaders to take the steps needed to realise this vision. It is also time to ask ourselves, what can I do to help close the gap by 2030?

Jody Broun and Mick Gooda are

co-chairs of the Close the Gap Campaign

The NACCHO chair Justin Mohamed is the Co Chair with Jody Broun on the National Health Leadership Forum

Jan 31 2013

2013 election:NACCHO recommendations for Aboriginal health:Dear Prime Minister

Dear Prime Minister

NACCHO recommendations for Aboriginal health in the 2013 election /2013-14 Budget

Now that you have called an election for September 14,NACCHO welcomes the opportunity to make this pre-budget/ pre election submission in order to support the government in implementing evidence-based and Aboriginal-community supported funding initiatives in the upcoming fiscal year.

As the peak national body for Aboriginal health in Australia, NACCHO looks forward to ongoing close collaboration with the Australian government as the budget is developed and implemented and calls on the Australian government to recognise the Aboriginal Community Controlled Health Service (ACCHS) movement as the most appropriate vehicle for health service delivery to our community of Aboriginal and Torres Strait Islander peoples.

In this submission, NACCHO makes recommendations on areas of key expenditure that are priorities for the ACCHS movement in the 2013-14 Australian budget

1.Closing the Gap: Continuation of funding $1.6

2. Continued Support for the Aboriginal Community Controllled Health movement:

3. Reintroduction of the Primary Health Care Access Program (PHCAP) or similar MBS redistributive program: $620m

4.Enhanced ACCHS access to the National Rural and Remote Health Infrastructure Program (NRRHIP) and other like initiatives: $17.25m

Full details are here our 14 page submission

These recommendations are designed to ensure the continuing viability, resilience and dynamism of the Aboriginal community-controlled model and philosophy; to formulate and propose ‘new ways of doing’ in the ACCHS movement; to promote a model of alignment between mainstream health services and those of the ACCHS movement; and, to ensure continuation of the “Closing the Gap” range of initiatives that are beginning to show signs of positive progress and outcome.

The overarching purpose of this submission is to promote Aboriginal community development and resilience through informed participation in person and Aboriginal community-centred health services, to posit financial models that advance and reinforce the human rights of Aboriginal people and address the disadvantage experienced by many Aboriginal and Torres Strait Islander people and communities.

It is recommended that, wherever practicable and reasonable to do so, the Australian government adopt multi-year funding commitments that will provide certainty and continuity of service provision for affected Aboriginal and Torres Strait Islander organisations and the communities they serve.

We thank you for your consideration of the attached submission

Justin Mohamed Chair of NACCHO

Download the 14 page submission here the Recommendations

Jan 24 2013

NACCHO’s 150+ members achieve great results in Federal health performance report

Aboriginal and Torres Strait Islander Health Performance Framework (HPF)

Download a copy of report here

Examples of our achievements

2/3 of all performance based outcomes where from the Aboriginal Community Controlled Health Sector
96% increase in episodes (1.22 mil – 2.5 mil) of care being delivered by the Aboriginal Community Controlled Health Sector
150,000 eligible Aboriginal and Torres Strait Islander patients have benefited from the CTG Pharmaceutical Benefits Scheme (PBS Co-pay)
Compared Immunisation coverage rate for 2yr old children are nearly at the same level to wider Australia Immunisation (Aboriginal children 92.3% compared to 92.6% of other children)

Executive summary

This is the fourth report against the Aboriginal and Torres Strait Islander Health Performance Framework (HPF) and the first report based on the revisions to the framework endorsed by the Australian Health Minister’s Advisory Council (AHMAC) in 2011

The HPF was designed to measure the impact of the National Strategic Framework for Aboriginal and Torres Strait Islander Health (NSFATSIH) AND WILL BE AN IMPORTANT TOOL FOR DEVELOPING THE NEW National Aboriginal and Torres Strait Islander Health Plan(NATSIHP)

See NACCHO recent 2013 submission to NATSIHP

The HPF monitors progress in Aboriginal and Torres Strait Islander health outcomes, health system performance and the broader determinants of health. The health of Aboriginal and Torres Strait Islander peoples is improving for a number of measures, although there remain many areas where further concerted effort will be needed to achieve improvements in health outcomes.

Data quality limitations hamper our ability to monitor Indigenous health and the performance of the health system (see technical Appendix).

Initiatives to improve data quality have been introduced in recent years and are yielding results. However, caution is still required in interpreting these findings. Note : this report includes revised mortality data for the period 2007,2008 and 2009 due to revisions in the WA mortality data for this period.

Council of Australian Governments (COAG)

Targets

In December 2007, COAG agreed to a partnership between all levels of government to work with Aboriginal and Torres Strait Islander peoples to close the gap in Aboriginal and Torres Strait Islander disadvantage.

During 2008 and 2009 new National Partnership Agreements were developed covering areas such as Indigenous early childhood, health, education and employment. The information in this report mainly relates to the period leading up to these agreements and for many of these initiatives it is still too early for the health outcome data to reflect the impact of this work.

Since the introduction of the Aboriginal and Torres Strait Islander Health Performance Framework (HPF) there has been a significant increase in health assessments and chronic disease management items claimed through Medicare.

Given that two thirds of the current gap in health outcomes is due to chronic disease, these improvements in the detection and management of chronic disease are important.

COAG set six targets in 2008 including :

Closing the life expectancy gap within a generation

The gap in life expectancy at birth between Aboriginal and Torres Strait Islander peoples and other Australians for 2005-07 was estimated at 11.5 years for males and 9.7 years for females.
In the absence of new data on life expectancy (due to be released in late 2013), mortality rates provide an indication of progress. The graph below shows mortality rates from 1998 to 2010 and an indicative trajectory of mortality rates required to reach the target by 2031. This graph shows there has been a significant decline in Indigenous mortality rates in the last decade, however Indigenous rates are currently twice the non-Indigenous rate and this decline would need to accelerate to reach the target.

Halving the gap in mortality rates for Indigenous children under five within a decade

In 2008, the Aboriginal and Torres Strait Islander child mortality rate was 213 per 100,000 compared to 101 per 100,000 for non-Indigenous children. This makes the baseline gap 112 per 100,000. Note : the 2008 baseline has been revised since the last report due to revisions in the WA mortality data.
The graph below shows child mortality rates from 1998 to 2010 and indicative trajectories required to meet the target by 2018. The 2009 and 2010 rates are within the range required to meet the target.

To read the full 227 page report

Download a copy of report here

Nov 12 2012

Medicare Locals and the Aboriginal Community Controlled Health Sector: Where are we? Where are we going?

Published in CROAKEY 12 November 2012: Melissa Sweet editor

The National Primary Health Care Conference has just wrapped up in Adelaide, and you can get an idea of some of the wide-ranging discussions from the #nphcc Twitter stream.(refer NACCHOAustralia TWITTER)

One of the obvious implications is that we must hope Medicare Locals are skilled in the art and science of setting and implementing priorities, given the smorgasbord of expectations upon them.

Engaging with the Aboriginal community controlled health sector should be a priority, suggests NACCHO’s senior policy officer on health reform, James Lamerton.

In the article below, he has some practical suggestions for how Medicare Locals can go about this.

Medicare Locals and the Aboriginal Community Controlled Health Sector: Where are we? Where are we going?

James Lamerton writes:

At the National Primary Health Care Conference in Adelaide last week the daunting terrain that Medicare Locals are expected to navigate was on display.

Medicare Local CEOs and directors must be tearing their hair or turning to drink after hearing, on the first day, from the Department of Health and Ageing’s David Butt and, on the final day, from the Coalition’s Andrew Southcott; both confirmed that the ML ground will be not only rugged but continually shifting.

One thing, however, does offer the Medicare Locals some degree of certainty and considerable promise; the ongoing presence, in the primary health care environment, of the Aboriginal Community Controlled Health Service (ACCHS) sector that has been providing comprehensive primary health care, based on the social determinants of health thinking, for forty years.

Though Aboriginal health was not a theme at the conference, those representatives of the sector present made it clear that partnerships between Aboriginal Community Controlled Health Service and Medicare Locals are not only possible but highly desirable.

From population health planning, through treatment of chronic conditions to primary mental health care initiatives like the Access to Allied Psychological Services and Partners in Recovery programs, the Aboriginal Community Controlled Health Service sector will be an essential, effective and enduring partner for Medicare Locals.

Examples of high functioning partnerships between Aboriginal Community Controlled Health Services and Medicare Locals abound.

From the Pilbara to the NT; from Brisbane to NSW’s northern rivers and Sydney’s western suburbs, these two crucial players in the primary health care environment have carved out partnerships that are not only rolling out Aboriginal health programs and initiatives together but are also building respect and trust between and within communities.

Meanwhile, many Medicare Local CEOs at the conference, whose organisations do not have formal partnerships with the Aboriginal Community Controlled Health Service within their footprint, showed that they were open to partnering but may need support and guidance.

Tips for engagement

So is there a sure-fire, foolproof recipe that Medicare Local CEOs and their teams can follow that will lead to a successful partnership?

The short answer is no – or, at least, not that I know of – but following are some basic tips that should help.

Research the Aboriginal Community Controlled Health Service in your area and get your head around its operating environment – in other words, show an interest.

Have a look at the constitution, find out who the board members are and where they come from. What programs/projects does the Aboriginal Community Controlled Health Service run, and what is it really good at? What are its pressure points? Maybe in those pressure points there’s a potential partnering opportunity.

Ensure that your local Aboriginal Community Controlled Health Service is a member of your Medicare Local. Why not even look at Aboriginality and experience in the community controlled sector as essential skills for at least one of your directors?

Meet. Get a knock down to the Aboriginal Community Controlled Health Service CEO this week and follow it up, as soon as possible, with a Chair & CEO to Chair & CEO meeting.

Is it possible for the two boards to come together? Not only can this be an excellent trust-building opportunity but it’ll also allow your board members to hear the voice of the Aboriginal community directly (NB be prepared to hear some confronting messages).

Don’t rush it. If you’re building a new relationship or repairing an old one, it’ll most likely take time.

To you and your team, it might seem that things move at a glacial pace within your local Aboriginal Community Controlled Health Service, but this is usually because it is using its community feedback loops to see what people think.

It might be frustrating but this is where the strength of the Aboriginal Community Controlled Health Service lies; see what you can learn from it and extrapolate to your relationships with your traditional and emerging constituencies. (NB: These feedback loops will invariably appear idiosyncratic and puzzlingly opaque: stay cool, they’ve been in place and working pretty well for 60,000 years).

Remember Grandma’s advice: you were born with two ears and one mouth – there’s a reason for that. Active and appreciative listening to a problem will often produce the seeds of a solution. In the Aboriginal Community Controlled Health Service environment, silence not only implies consent but also shows respect.

Start with something small and achievable. We’re not going to close the gap in one fell swoop; agree a project that you can work on together (truly ‘work on together’), even if there are some residual trust issues, and see it through to its conclusion – come hell or high water.

Jointly evaluate it, pick the eyes out of it and carry the characteristics of the relationship into something new. Initial success may prove to be sub-optimal but cast your mind back to when you were learning to swim. That’s right, you started out simply trying not to drown and eventually ended up swimming to Rottnest Island.

Meet 2. Arrange informal but regular meetings between your clinicians and those of the Aboriginal Community Controlled Health Service. It’s amazing what can be shared and learned by both groups in an environment of enquiry.

Own what’s yours but respect what isn’t. Enough said.

The mixed Medicare Local messages coming from Government and Opposition are certainly testing the patience and resolve of the Medicare Local movement; it’s hard to plan when the map is redrawn regularly.

However, the opening whistle’s blown and it’s game-on.

This reform agenda presents us with a potentially epoch-altering opportunity to make serious inroads into comprehensive primary health care and public health thinking based on a ‘rights’ ethos.

To the politicians, the future of Medicare Locals may appear uncertain but the only infallible way for us to predict the future is for us to create it.

More reading: Mark Metherell’s report for Croakey from day one of the conference on the need to shift the funding imbalance between hospitals and primary health care.

Nov 12 2012

National Primary Health Care Conference:Speech National Congress Co Chair Jody Broun:

From transition to action: Integrating primary health and social care

Picture above: Jody Broun recently meeting with Minister Snowdon and NACCHO chair Justin Mohamed

Keynote address to the National Primary Health Care Conference

Jody Broun – Co-Chair National Congress of Australia’s First Peoples

8 November 2012

DOWNLOAD THE FULL SPEECH HERE

Brief Extract

It’s a real pleasure to be invited as a keynote speaker at your conference. Integration in service delivery has been identified continuously as a barrier to improving outcomes, and as such a very valid topic for your discussions.

The 2010 Department of Finance review of Indigenous Expenditure concluded that “whole of government coordination remains a major challenge – Program management and service delivery remains fragmented rather than coordinated, with weak linkages even within agencies, let alone across them…Communication between agencies is too often poor, even where their responsibilities and interests are closely related.”

I would hope that you can resolve some of those issues through your work at this conference and in practice when you get back to your roles in the communities and organisations, and that the current health reforms provide the platform for making change.

Health was identified as the highest priority by members of Congress and I have taken it on as my portfolio – this means I am also co-chair of the National Health Leadership Forum, co-chair of the Close the Gap Steering Committee, and co-chair of the Stakeholder Advisory group driving the development of the new National ATSI health plan

Nov 1 2012

Press release NACCHO and Medicare Locals at the table to Close the Gap

Picture above NACCHO Chair, Mr Justin Mohamed, stated it was very important that as respective national peak bodies both NACCHO and AML Alliance need to demonstrate sound leadership and model collaboration if genuine partnership is to be achieved.

Australia’s Medicare Locals and the National Aboriginal Community Controlled Health Organisation (NACCHO) will draw on their respective strengths in primary health care to share in the best way forward to achieve improved health outcomes for Aboriginal and Torres Strait Islander Peoples from the National Health Care Reforms.

In the lead up to a Close the Gap symposium at the National Primary Health Care Conference, AML Alliance Chair, Dr Arn Sprogis said it’s national sessions like these that enable organisations to work cooperatively to develop tangible opportunities for the Close the Gap agenda.

“This session will convene some of the best thinkers and advocates for primary health care in the Aboriginal and Torres Strait Islander health sector to generate the big ideas,” Dr Sprogis said.

“We want the ripple effect: to see good policy lead to better service delivery.

There is a well-earned respect between the two sectors and what they can do for Aboriginal and Torres Strait Islander people, however integrating their systems and thinking is what will expand the opportunities immeasurably.

“We’re determined to pursue the best possible outcomes for Aboriginal and Torres Strait Island Peoples from the National Health Care Reforms,” Dr Sprogis said.

NACCHO Chair, Mr Justin Mohamed, stated it was very important that as respective national peak bodies both NACCHO and AML Alliance need to demonstrate sound leadership and model collaboration if genuine partnership is to be achieved.

“This symposium will allow a full and open discussion of how our sectors view the future and for both to explore and forge new ways of working together as we strive towards true and meaningful partnerships,” Mr. Mohamed added.

“Both sectors independently face challenging futures, so this will be an opportunity for both NACCHO and our members and the AML Alliance to begin to lay stable foundations as we work towards improved collaborative relationships.

Through improved partnerships and Aboriginal leadership there is a real opportunity to produce realistic and achievable policy recommendations to government,” Mr. Mohamed said.

Mr Mohamed encouraged all attendees to approach the symposium as a blank sheet where we can map a way forward that ensures the best possible health outcomes are achieved for our people and their communities.

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