NACCHO #CTG10 Reports : NT intervention ‘fails on human rights’ and closing the gap

NT

“There have been some improvements to Indigenous child mortality with this target on track to be met by 2018. However, despite narrowing the gap in life expectancy, the rate of improvement is far too slow to close the gap. The situation is particularly bad for Indigenous people living in the Northern Territory, whose life expectancy is nearly 15 years shorter than non-Indigenous Australians

SEE HEALTH AND LIFE EXPECTANCY REPORT CARD

The Northern Territory intervention has failed to deliver substantial reform in any of the areas covered by the Close the Gap goals and has also failed to meet Australia’s international human rights obligations, an independent report has found.

 in The Guardian reports

Nearly a decade after the Northern Territory intervention, residents of Indigenous town camps in Alice Springs are fighting to regain control of their lives as they wrestle with longstanding social problems

Photo above: Aboriginal children playing at one of the town camps in Alice Springs when the intervention started in 2007. An independent report shows the strategy has failed to deliver substantial reform in any target area. Photograph: Anoek de Groot/AFP/Getty Images

The report, by the Castan Centre for Human Rights at Monash University, rated the intervention, which was rebadged in 2012 and now operates as the “stronger futures” policy, four out of 10 for its general human rights performance and failed it against seven other human rights measures, including the right to self-determination.

It also gave fail marks to every Close the Gap measure except education – which it scored at five out of 10 for improvements in primary school attendance – and urged the government to include incarceration rates as a new Close the Gap target, pointing to an “increasing and inordinate amount of Indigenous Australians being incarcerated”.

Malcolm Turnbull is set to deliver his first update on the Closing the Gap targets on Wednesday.

The national targets were set by the Council of Australian Governments in 2008, a year after the NT intervention began, and, according to the most recent update delivered by the then prime minister Tony Abbott in February 2015, most are not on track to be met.

The target of getting all Indigenous four-year-olds in remote communities into early childhood education was missed in 2013, with just 85% instead of the target of 95% enrolled.

The 2015 update, which Abbott described as “profoundly disappointing”, said the targets of closing the life expectancy gap between Indigenous and non-Indigenous Australians within a generation, halving the gap in literacy and numeracy by 2018, and halving the gap in employment outcomes by 2018 were not on track. Literacy and numeracy rates had not improved since 2008 and Indigenous employment had fallen.

Two more targets, to halve the gap in child mortality rates by 2018 and to halve the gap in year 12 completion rates by 2020, were listed as on track.

However, the author of the Castan Centre report said it appeared unlikely that any of the targets would be met in the Territory.

Close the Gap and Closing the Gap – what’s the difference?

Two similarly named programs are working towards the same goal of reducing inequality between Indigenous and non-Indigenous Australians

“The intervention was meant to improve the lives of Indigenous people in the Northern Territory, but at this rate the gap between Indigenous and non-Indigenous people may never close in many areas,” Dr Stephen Gray said.

He urged the government to adopt a new target of reducing Indigenous incarceration rates, as was recommended by the Close the Gap steering committee in 2014.

According to the latest Australian Bureau of Statistics data, Indigenous people made up 3% of the population but 27% of the prison population, and 52% of all young people in detention. In the NT, Aboriginal and Torres Strait Islander peoples make up 86% of the adult prisoner population and 96.9% of young people in detention. Incarceration rates are up 41% since the start of the intervention.

In November, the Australian Medical Association called rates of Indigenous imprisonment a “health and justice crisis”.

“I think there’s a perception that because family violence is such a crisis, because assault rates and child abuse are at such a crisis, we should not be always going on about Aboriginal imprisonment rates,” Gray said. “That sense that you can’t improve one without worsening the other is false.”

Amnesty International agreed, telling Guardian Australia that “any efforts at Closing the Gap cannot ignore these areas of massive inequality and the role that law and justice policy play in disadvantage.”

Reports of child abuse in the NT have decreased since 2010, but there has been a 500% increase in reports of self harm or suicide by Indigenous children and a sharp rise in the number of Indigenous children in care.

Gray said it was difficult to unpick the complicated mass of policy that governed the lives of Indigenous people in the NT, and that made it difficult to evaluate.

The intervention began with bipartisan support under the Howard government in 2007 as a response to a report about horrific levels of child sexual abuse in some Aboriginal communities, and was delivered as a complex suite of laws that altered everything from welfare payments to land tenure.

There was this presumption of rampant child sexual abuse in Aboriginal communities,” Gray told Guardian Australia. “It has been the excuse for a large number of other reforms that don’t really relate to child sexual abuse or family violence at all, like land reforms. It’s got very little to do with the original goals of the intervention.”

In 2008, the Rudd government reshaped it to focus on the new Closing the Gap targets but punitive measures remained, including more police, the removal of customary law and cultural practices from consideration in sentencing, quarantining welfare payments of those judged to have “neglected” their children, and tough penalties for possessing alcohol or pornography, as did the suspension of the Racial Discrimination Act.

The Northern Territory National Emergency Response Act expired in 2012 and was extended by the Gillard government until 2022, under the new name of the Stronger Futures in the Northern Territory Act. The Racial Discrimination Act was reintroduced but the percentage of an individual’s welfare payments that could be quarantined under the BasicsCard increased to 70%, and penalties for possessing porn or alcohol in dry communities, including a single can of beer, increased to six months’ jail.

By then the government had produced 98 reports and seven parliamentary inquiries into the intervention, a weight of information Gray said obscured its negative effects, particularly the impact on human rights.

“There’s a danger that things get out of check because of the swift pace of apparent change,” he said. “Because wheels keep turning, another policy gets rebadged, funding gets moved, but the real pace of life in Aboriginal communities remains the same.”

The result, the report said, was that many of Australia’s international human rights obligations, including the right of Indigenous peoples to self-determination, continued to be “directly and knowingly violated or ignored”.

Prof Jon Altman, from the Alfred Deakin Centre for Citizenship and Globalisation, said the Castan Centre’s evaluation of the intervention was too generous. The government deserved a zero out of 10, he said, for its attempts to improve education, and a negative score on employment rates which had gone backwards since the decision to abolish the community development employment projects (CDEP) program, which employed about 33,000 Indigenous people, particularly in remote communities.

Altman, who has spent 40 years working in Aboriginal communities in the NT in particular, said the services previously delivered by community-led CDEP organisations were now being done by non-Indigenous organisations, while many who had worked under CDEP remained on “passive welfare”.

Aboriginal people are exceptional. When we can all acknowledge that, the gap will close

Chris Sarra

 

Despite the dire outcomes of the Closing the Gap report, there is great potential in Indigenous communities. Our greatest challenge might be in believing that

“The state needs to admit that it’s actually doing worse than Aboriginal community-based organisations,” he said

Altman argued the Close the Gap program should be abolished, saying it was assimilationist, had alienated Aboriginal and Torres Strait Islander people and had produced no significant benefits.

“It’s all based on a policy, an ideology, that progress in closing the gap will require people to adopt western norms,” he told Guardian Australia. “And that’s a pretty hard line. It really doesn’t leave people much wiggle room if they don’t want to be changed.

“My advice to the prime minister is to stop talking about closing the gap and start talking about improving people’s wellbeing and livelihoods, because those things are taking a hammering.”

 

 

NACCHO Aboriginal Health: Indigenous doctor striving to break the obesity cycle

Doctor Keevers

“Coming from an indigenous family and seeing that all of my uncles­ and aunties have been overweight for most of their lives and have concurrent illnesses with Type 2 diabetes is definitely a factor,”

“I’ve always been into fitness myself but I’ve seen others in the community who haven’t had the same health and obesity education and how it gets locked into low-socio-economic cycles.”

Medicine graduate Justin Keevers might become the first indigenous doctor to specialise in obesity-related­ surgery.

“There is an emphasis for surgeons not to be super-specialised but I like the idea of becoming an upper-gastrointestinal surgeon with an interest in obesity after seeing how it affects the indigenous community and general popul­ation,” Dr Keevers said.

From The Australian

The 29-year-old former electrician was one of eight indigenous doctors who graduated from Sydney’s University of NSW medicine faculty last week after receiving scholarships from The Balnaves Foundation.

Dr Keevers moved to Sydney from the far north coast of NSW in 2007 and was soon fed up trying to make ends meet as a sparky, so ­applied for medicine through the university’s Nura Gili Pre-Medicine Program.

The program gave him the support base he needed to settle into university life and stick at the ­degree. “I think half of us hadn’t been to school in over five years so that initial stuff about how to write essay­s and assignments, those integ­ral skills that they expect you to have out of high school, was very helpful,” said Dr Keevers, who started as an intern at Prince of Wales Hospital this week.

The six years of study included a year alongside a bariatric surgeon in Port Macquarie, on the NSW mid-north coast, where he formed a plan to tackle the obesity-related diseases that plagued his community back in Byron Bay.

“Coming from an indigenous family and seeing that all of my uncles­ and aunties have been overweight for most of their lives and have concurrent illnesses with Type 2 diabetes is definitely a factor,” he said.

“I’ve always been into fitness myself but I’ve seen others in the community who haven’t had the same health and obesity education and how it gets locked into low-socio-economic cycles.”

Philanthropist Neil Balnaves said Australia was “crying out” for more indigenous doctors and the scholarships were a way of responding to the call. The number of indigenous doctors across the country has doubled in a decade to 204, but for population parity Australia needs 3000.

“We wanted to … dramatically the drop-off rate of students and that was simply about housing the students in the university and surrounding them with mentors and emotional support,” Mr Balnaves said. “Not only are they all graduating but the dropout rate is less than non-indigenous students … (these) young men and women will graduate as doctors and go back with an understanding of their heritage and medicine and … the language and culture.”

NACCHO News Alert : Communique from the COAG Health Council Meeting August 2015

 

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The Federal and State and Territory Health Ministers recently met in Darwin at the COAG Health Council to discuss a range of national health issues. The meeting was chaired by Jack Snelling, Minister for Health, South Australia.

More information can be found on the COAG website

Major items discussed included:

1.Reform of the Federation
Council discussed the progress of work on the Reform of the Federation and the outcome of the consideration of health issues at the Leaders’ Retreat in July. Noting that further work for COAG’s consideration later in the year will be led by Tasmania and Victoria, Ministers agreed to work co-operatively in considering options for improving the efficiency of the health system, particularly in the provision of care for people with chronic disease and extending Medicare benefit arrangements to hospitals based on efficient pricing. Council noted that future arrangements for health financing would be considered in the context of the Reform of the Federation.

2.Impact of discontinued National Partnership Agreements (NPAs) on states and territories
Ministers noted that between 2008–09 and 2013–14 the Commonwealth provided an average of $1.7 billion per year to States and Territories under a range of National Partnership Agreements which are now concluded.
The Council agreed that, in consultation with all jurisdictions, they would explore new models for sufficient health and hospital funding as part of the broader discussion around the reform of federation.

3.Changes to eHealth Records
Ministers discussed proposed changes by the Australian Government to eHealth legislation to support delivery of the My Health Record and the establishment of the eHealth Commission. The amendments are aimed at bringing forward the benefits of a connected national eHealth system, aimed at providing improved health outcomes for consumers through national sharing of information and a more efficient health system.
Included in the draft legislation will be the implementation of the opt-out trials, to be conducted in some states and territories where participants will automatically receive an eHealth record unless they choose to opt out if they do not wish to have one. Under present arrangements, people have to specifically enrol to receive an eHealth record. Ministers were invited to nominate potential trial sites.

4. ICE – An opportunity for national collaboration
Noting the scope of the National Ice Taskforce, Health Ministers discussed the impact of this drug on the community and health workers confronting the aggressive behaviours associated with Ice.  Ministers discussed other issues of shared interest and identified opportunities for health departments to enhance the effectiveness of responses to the harms associated with ice use amongst individuals, families and communities.
It was agreed that the Australian Health Ministers’ Advisory Council (AHMAC) would progress where appropriate, joint work and sharing of resources such as clinical guidelines, tools, training and local strategies to strengthen current health responses.

5.Healthy, Safe and Thriving: National Strategic Framework for Child and Youth Health
Ministers endorsed the Healthy, Safe and Thriving: National Strategic Framework for Child and Youth Health (the Framework) and its two supporting reference documents. Building on the achievements in child and youth health over the past 20 years, the Framework identifies continuing and emerging health issues for children and young people from preconception to 24 years of age. The Framework articulates a shared national vision with five key strategic priorities to improve health and wellbeing outcomes for children and youth in Australia over the next ten years.

6.National Framework for Action on Dementia
Ministers endorsed the National Framework for Action on Dementia 2015-2019, which aims to guide the development and implementation of policies, plans and actions to reduce the risk of dementia and improve the outcomes for people with dementia and their carers. The Framework will support ongoing policy development and action for governments, peak bodies, service providers, and the broader community, to work together in order to make a positive difference in the lives of people with dementia, their carers and families.

7.National Oral Health Plan 2015–2024
Oral health is an important part of general health, affecting not only the individual, but also the broader health system and economy.
Ministers considered and endorsed the new National Oral Health Plan 2015-2024, which provides strategic direction and a framework for collaborative action over the next ten years. Translation of the plan into practice requires jurisdictions and sectors to work together, with the Oral Health Monitoring Group reporting on progress of the National Oral Health Plan every two years.

8.National Bowel Cancer Screening Program 
Ministers discussed the Commonwealth Government’s commitment to full implementation of the National Bowel Cancer Screening Program for people age 50-74 by 2020.
Ministers discussed their ongoing commitment to the National Bowel Cancer Screening Program, the importance of continually improving the effectiveness of the Program; the Commonwealth’s new investments in the national Cancer Screening Register; the importance of improving Program participation; the role of endoscopy in early diagnosis and the clear benefits of early treatment to patients and the health system as whole.

9.The relationship between welfare reform and health outcomes
In discussing this issue the Council noted the concern that the Northern Territory (NT) has in relation to the direct health effects that passive welfare has on Territorians.
The Ministers agreed that the NT would endeavour to provide further evidence of any possible link between passive welfare and poor health outcome to a future meeting.

10.Inclusion of Paramedics in the National Registration and Accreditation Scheme
In the Australian Health Workforce Ministerial Council today Ministers discussed the potential registration of paramedics under a national scheme. This issue has been referred back to AHMAC for further work and advice back to Ministers.

 

NACCHO Aboriginal Health News : Is the solution to grog on the cards

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“What responsibility should we have over how welfare is delivered to those in need? Since the introduction of federal unemployment benefits in 1944, the government has provided welfare in cash. The reason is expedience: dropping cash into an account is simpler and cheaper than the traditional church welfare of providing clothes, food or vouchers.

But what happens if the cash is wasted on drugs, alcohol and gambling, leading to catastrophic social consequences?

Our view is the debit card could reduce the social harm welfare-fuelled abuse can cause, while still providing as much individual freedom as possible to welfare recipients.

The government believes this concept is worth trialling and today I will be introducing legislation to implement the idea in two or three regions.”

Federal Parliamentary Secretary to the Prime Minister The Hon. Alan Tudge MP (above right)

Wednesday, 19 August 2015 Opinion

DOWNLOAD and read full transcript of Alan Tudge Interview in Ceduna

Interview Alan Tudge

SEE ALSO PREVIOUS NACCHO REPORT : More communities support Healthy Welfare Card

This is the question the Abbott government has been grappling with following the recommendation in Andrew Forrest’s Creating Parity report to introduce a cashless debit card for welfare recipients in vulnerable areas.

The logic is inescapable. We have places where welfare is a major part of the local economy and the welfare dollar is fuelling gambling, alcohol and drug abuse.

It’s not just that individuals are wasting welfare payments but welfare abuse is destroying the lives of women and children.

In a place such as Kununurra, the hospitalisation rate from assaults is 68 times the national average. Across the Northern Territory, indigenous women are being bashed every year at a rate of 11 assaults per 100 women. These are just the reported cases. Two-thirds are related to alcohol, nearly all of which is paid for by welfare cash. It is not uncommon for kids to go hungry because there is no food on the table. Not because of poverty — an unemployed couple with three young children could have $800 in welfare cash a week after housing costs — but because the money is wasted in the first few days after “payday”. The National Crime Commission says towns of high welfare dependence are being targeted by criminals selling ice.

Most of the measures taken in the face of such evidence have been on the supply side, tough rules about what can be sold at pubs and what can be imported into a community. Such restrictions typically have halved the rate of violence in those places. But even in remote communities it’s hard to sustain initial gains and stop the grog runners and drug dealers. In urban areas, restricting supply (other than through hours of sale) is nearly impossible.

Forrest’s proposal is to work on the demand side. He argues that in certain areas, all welfare payments — except old age and veterans’ pensions — be placed on an ordinary bank debit card that could be used anywhere to purchase anything, but simply cannot be used at liquor stores or gambling venues. Because cash would be limited, illicit drugs could not be bought.

The government believes this concept is worth trialling and today I will be introducing legislation to implement the idea in two or three regions. These regions will be chosen on the basis of (a) high welfare dependence and social harm caused by welfare-fuelled alcohol and drug abuse, and (b) willingness of community leaders to participate in the trial. The Ceduna region will be the first trial site and we are in discussions with East Kimberley leaders about that region being the second. Our view is the debit card could reduce the social harm welfare-fuelled abuse can cause, while still providing as much individual freedom as possible to welfare recipients.

We have been negotiating with banks and community leaders over how the card could be designed and implemented. How a card would be issued, how online transactions would occur, how people could get account balances and how fees would be structured to minimise or eliminate costs to the user are issues being worked through. The intent is for the card to look as much as possible like the ordinary debit card most people carry in their pocket daily. Eighty per cent of payments will be placed on the card, with the other 20 per cent continuing to go into the recipient’s bank account.

Where there is a desire to do so, we will implement a local board that will have control over the settings of the card. This board would have power to lift the amount of welfare placed into an individual’s cash account. Key additional services such as alcohol counselling and financial management assistance may need to be introduced.

This proposal is not income management. There will be no compulsion for anyone to spend their payments in a particular way, although of course people will be encouraged to establish a budget. There will be complete freedom, with the exception of two restricted products.

I acknowledge that for some people, using a card rather than cash to pay for everyday items will be an initial inconvenience. The potential upside, however, is a transformed community where women are safer and more money is available for children’s needs. If successful, this will represent a radical new positive approach to the distribution of welfare.

 

 

NACCHO Aboriginal Health Alert : Suicide prevention information SURVEY and leaders meeting update

ATSISPEP

“The focus of the roundtable will be on how we can best reduce the incidence of mental health conditions and suicide, and improve social and emotional wellbeing among Aboriginal and Torres Strait Islander people, Indigenous health remains this nation’s most confronting health challenge, with mental health issues in need of urgent attention. We want this meeting to develop some clear, positive strategic direction,”

Senator Scullion speaking on behalf of the three federal government ministers who will sit down with Indigenous leaders and mental health advocates today ( Wednesday)  to tackle Indigenous mental health, which they say is the nation’s “most confronting health challenge”. See full story below

SURVEY INFO

Welcome to the Aboriginal and Torres Strait Islander suicide prevention information survey.

This survey is being conducted for the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) – a national research project at the University of Western Australia (UWA) in partnership with Telethon Kids Institute that is responding to the high levels of suicide in Aboriginal and Torres Strait Islander communities.

COMPLETE SURVEY HERE

ATSISPEP is developing a strong evidence base on effective programs, services, resources, training and other initiatives directed at Aboriginal and Torres Strait Islander suicide prevention across Australia. This survey seeks your feedback, responses, and insights about any experiences you may have had with a range of suicide prevention programs, services, training and resources– either personally or in your professional capacity. The information you provide will help guide and further inform our project and strengthen its findings.

The survey takes around 10 minutes to complete and is completely anonymous. Please contact the team at Telethon Kids Institute if you have any queries about the survey, or if you would like to discuss anything further with the ATSISPEP team. Thank you for your interest and participation in what we hope will be a valuable information gathering exercise.

 Indigenous mental health: leaders to tackle ‘most confronting challenge’

Three federal government ministers will sit down with Indigenous leaders and mental health advocates on Wednesday to tackle Indigenous mental health, which they say is the nation’s “most confronting health challenge”. 

From Sarah Whyte SMH :

Health Minister Sussan Ley, Assistant Health Minister Fiona Nash and Indigenous Affairs Minister Nigel Scullion will meet 17 mental health advocates and seven respected Indigenous health leaders at Parliament House to discuss reducing the suicide rates of Indigenous people and associated mental health issues.

“The focus of the roundtable will be on how we can best reduce the incidence of mental health conditions and suicide, and improve social and emotional wellbeing among Aboriginal and Torres Strait Islander people,” Senator Scullion said.

“Indigenous health remains this nation’s most confronting health challenge, with mental health issues in need of urgent attention. We want this meeting to develop some clear, positive strategic direction,” he said.

Suicide death rates among Indigenous and Torres Strait Islanders are more than double those of non-Indigenous people living in the same areas.

For people aged 25 to 34, the suicide rate almost triples compared with non-Indigenous people.

“Successive governments have invested heavily in culturally appropriate health programs for Indigenous Australians and, while we have had some success with improvements in life expectancy, especially with the decline in child death rates, the incidence of suicide is a continued concern and we must all work toward a coherent, national approach that more rapidly tackles these issues,” Ms Ley said.

For help or information call Lifeline 131 114 or beyondblue 1300 224 636

 COMPLETE SURVEY HERE

NACCHO Health News: Remote Aboriginal leaders in bid to avert ice crisis

FNQ ICE

 

An indigenous-led coalition of leaders and frontline health workers has launched a pre-­emptive strike to avert a socially catastrophic explosion of ice use in remote communities.

Mounting evidence of the increasing use of ice and related “psychotic episodes” in the past six months has sparked fears of a reversal of a decade of social improvements under alcohol bans.

PHOTO :Concerned about the ice threat are Jaidyn Yeatman, left, Jayden Kynuna and Thaddeaus Johnson at Yarrabah near Cairns. Picture: Brian Cassey Source: News Corp Australia (see their interview below)

PLEASE NOTE : NACCHO is in the process of organising a National Ice Forum here in Canberra during August : Details to be announced shortly

Forget jobs and land, ice is our big issue: MP Billy Gordon (see article Below)

Queensland’s Aboriginal mayors and indigenous-led health and social services are pushing for a zero-tolerance response to suppliers and are alread­y funding grassroots anti-ice campaigns.

Lockhardt River Mayor Wayne Butcher, the chairman of the Indigenous Leaders Forum, put the drugs threat on the top of the agenda at a meeting of mayors last month to ramp up the fight in collaboration with police, government and social services.

“We know the threat: it would destroy us, to be honest,” Mr Butcher said after a meeting. “There were 17 mayors of indigenous communities sitting around the table and I asked for a show of hands if they knew that ice was in their community, and nearly everyone put up their hand. It’s happened so quick. It seemed like a city problem but it has been sneaking into the communities.”

Several mayors are flagging a proposal to evict convicted suppliers of ice from public housing, with reports of at least one suspected dealer recently “chased out’’ of a community.

Queensland Police Commissioner Ian Stewart said vulnerable indigenous communities were at a social “tipping point” in a war on ice that he believes can only be won through “true collaboration” between communities, politicians and law enforcement.

“I am not saying it is epidemic yet but it has the potential,” Mr Stewart said. “If we don’t cover off before it starts we are all going to be in strife.”

Mr Stewart said he had been encouraged by the indigenous leadership in moving to face the threat. “We have actually got, in my humble opinion, some of the best thinkers and some of the most passionate mayors that we have had in our history,’’ he said.

Mr Stewart warned that the push against drug use also had to involve all members of the communities abandoning a traditional reticence to inform police of criminal activity in the tight-knit communities.

“Their responsibility is not just to talk about this … if they know stuff within their communities it will only work if they let us know, so we can go out and snuff these things out.’’

After a decade of leading the fight against indigenous social dysfunction, including the use of alcohol bans and tough welfare measures pushed by Noel Pearson, Cape York could set the model in the nationwide battle against ice.

Grassroots health groups such as the Apunipima Cape York Health Council are funding front-foot social-media and public-awareness campaigns.

Apunipima chief medical officer Mark Wenitong said: “We don’t actually get any substance-abuse funding or anything. We thought: ‘Well, we could sit around and wait for some funding to come through, wait for somebody else to do it, but let’s just start doing it.’ ”

The Queensland Aboriginal and Islander Health Council has reported a “surge in demand’’ for ice-rehabilitation services, which have been cut in recent years.

The number of dedicated Aboriginal drug and alcohol services had been cut from 11 in 2011 to just five, with reduced state and federal funding.

QAIHC general manager of policy innovation and service development Sandy Gillies said governments needed to boost funding and support for her staff, who were “largely doing it alone’’. “There’s been a history of governments waiting for health crises to develop before responding and we are determined to be proactive this time,” she said.

“We have little experience and knowledge of this drug and are only just beginning to see the impact it is having on already high rates of family violence and incarceration.’’ Ms Gillies said QAIHC and its affiliate, the Queensland Indigenous Substance Misuse Council, would submit a policy paper to the state government that included a call for more training of its workers and increased rehabilitation funding.

Increased drug use, particularly with cannabis, appears to have been an unintended consequence of the introduction of alcohol management plans, from 2002.

Under AMPs, alcohol-related violence and injury fell to historically low levels within a few years. School attendance also jumped — helped along with more punitive measures against parents and guardians who failed to get their kids to class — and the chaotic scenes of public drunkenness subsided.

New research shows that in three AMP communities, two-thirds of males aged 14-47 and 30 per cent of females smoke marijuana on at least a weekly basis, with a large proportion dependent. Epidemiologist Alan Clough, who has been evaluating the impact of AMPs, said researchers found that cannabis use in the Northern Territory and far north Queensland communities became endemic within four years.

“A similar four-year window of opportunity may therefore be all that is available to reduce the impacts of ice if a demand for it increases,’’ Associate Professor Clough said. “The narrow window could be further reduced given the unknown impacts of this highly addictive drug.’’

In February, Yarrabah Mayor Errol Neal brought in ice experts for a special meeting he convened in the 2000-strong community, about 60km from Cairns, to “educate and warn’’ people about the drug. “We have to expose people early,” he said.

“Most people don’t know what it is or what it looks like but we have been told by our health workers and young people that it is here.

“We think it has had an effect, it seems to have died down a bit and there is a feeling of zero tolerance about (ice).’’

Mr Neal said various mayors had been discussing tough measures, including a proposal to evict anyone caught supplying the drug from public housing.

Forget jobs and land, ice is our big issue: MP Billy Gordon

Balance-of-power MP Billy Gordon is demanding the Palaszczuk minority government ramp up effor­ts to stem the spread of ice across Queensland’s Aboriginal communities.

The independent MP, who has supported the Labor government on most legislation, said increased rehabilitation and mental health funding and the need for an anti-ice campaign targeted specifically at indigenous youths was at the top of his policy agenda.

Mr Gordon, an indigenous MP with a sprawling electorate that covers Cape York Peninsula, said he met Health Minister Cameron Dick over his concerns after suspected ice-fuelled suicides in an Aboriginal community last month.

Queensland police, mayors and social workers have reported a spike in the use of ice throughout most of the state’s Aboriginal communities in the past year.

In a report in The Weekend Australian on the emerging threat of ice in the communities, Police Commissioner Ian Stewart and the Queensland Aboriginal and ­Islander Health Council called on state and federal governments to increase education and rehabilit­ation services.

The number of dedicated Aboriginal drug and alcohol services has been cut from 11 in 2011 to just five, with reduced state and federal funding.

Mr Gordon feared government would ignore the potential dangers of ice in isolated indigenous communities, which are already struggling with unemployment, welfare dependency and substance abuse.

“Drugs like ice that have such profound psychological effects on the user could destroy Aboriginal communities,’’ he said.

“It would chew them up and spit them out — it’s very scary and we have to do something now.

“Forget native title, forget employm­ent — the single biggest issue that I am worried about in communities is mental health and if ice really spreads then it will be devastating.’’

In a statement, Mr Dick said the state government was working on strategies to tackle ice across Queensland.

“The federal government has established a taskforce on ice and we want to make sure that there is no duplication of services between the state and federal government,” he said.

“This is also a matter which require­s a whole-of-govern­ment response, with other agencies such as the police and education and training authorities involved.’’

The 19 mayors of Queensland’s indigenous communities have also called for government to ramp up its efforts.

Errol Neal, Mayor of the 2000-strong community of Yarrabah, east of Cairns, said indigenous mayors had been discussing tough measures, including a proposal to evict from public housing anyone caught supplying the drug.

Yarrabah youths Jayden ­Kynuna, 22, Jaidyn Yeatman, 21, and Thaddeaus Johnson, 19 — who were educated outside their community but returned to work in local health and social services — said education about the dangers of the drug and “zero tolerance’’ could work. Mr Kynuna said many young people didn’t want a return to the “social dysfunction’’ that existed when the grog was flowing.

“It’s showing up at parties, ­people are bringing it from Cairns and (it’s) getting more popular, it’s scary,’’ he said.

“Some people who have been smoking the ganja say it’s no big deal, but they don’t know what they are talking about.

“We need to educate people, everyone, especially the schools, kids and people my age about what this drug can do.’’

 

NACCHO 2015-16 Federal Budget Analysis Report : Aboriginal Community Controlled Health Sector

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DOWNLOAD the POST 2015-2016 Budget Analysis HERE

Aboriginal Community Controlled Health Sector

Core Funding

The Australia Government has made a re-commitment to the Sector:

  • $1.4bn over 3 years or $448m / per year. This will include a 1.5% CPI increase over a 3 year period.
  • The Government has confirmed NACCHO and Affiliate funding for 18 months in the amount of $18m, with the Department of Health commencing a review of role and function.

In 2015-16, the Government will implement a National Continuous Quality Improvement Framework for Aboriginal and Torres Strait Islander primary health care, through the expansion of the Healthy for Life activity.

Funding methodology

From 1 July 2015, the Government will progressively implement a new funding approach for the Indigenous Australian’s Health Programme.

The new approach will support the targeted use of funds in regions whose populations experience high health need and population growth.

The Budget papers explicitly mention NACCHO and Affiliates as being engaged as the nominated community stakeholders along with States/Territories in the development of this mechanism.

Indigenous Chronic Disease Package

The Budget has not provided any clear answers regarding the future of the Indigenous Chronic Disease package, outside of a stated commitment to “focus on improving the prevention, detection and management of chronic disease to improve health outcomes”.

Tackling Indigenous Smoking Program – a redesigned program will be implemented arising from the review undertaken in 2014-15. No detailed announcements were made in the Budget as the Minister is yet to sign off on the outcomes of the review.

Australian Nurse Family Partnership Program and New Directions: Mothers and Babies Services – the Australian Nurse Family Partnership Program will grow from three to five sites and New Directions: Mothers and Babies Services will reach an additional 25 services in 2015-16, bringing the total to 110 service, with an enhanced capacity to identify and manage Fetal Alcohol Spectrum Disorder in affected communities.

Close the Gap PBS Co-payment – expected to be an ongoing measure worth $85m, however there were no announcements in the Budget. NACCHO will look to identify this funding in a more detailed analysis.

MBS Practice Incentive Payments – expected to be ongoing funding and will form part of the MBS Review, with an intention to enhancing the program.

Indigenous Australians’ Health Programme

Initiatives funded under the Indigenous Australians’ Health Programme include primary health care services (including eye and ear health), maternal and child health activities, medical outreach to rural and remote areas, and targeted initiatives to improve prevention and primary health care management of chronic diseases.

The Budget papers outline the Department of Health’s commitment to a joint approach to the development of the Indigenous Australians’ Health Programme.

This provides an opportunity for ACCHSs to discuss the development of the Programme and funding methodology with local MPs.

National Aboriginal and Torres Strait Islander Health Plan Implementation Plan

In 2015, the Government will release the National Aboriginal and Torres Strait Islander Health Plan (2013-2023) Implementation Plan which is being developed in partnership with the National Health Leadership Forum (NHLF).

In 2015-16, the Government will commence the actions outlined in the Implementation Plan and will continue working with the NHLF to monitor and review progress.

Workforce

Focus on rural and remote shortages. A new geographical classification system will ensure incentive payments are targeted to doctors and dentists who choose to practice in areas of greatest need.

A range of medical, nursing and allied health scholarships will be consolidated.

Expansion of GP training places to 1,500 commencing places every year under the Australian General Practice Training Program.

The Remote Vocational Training Scheme supports doctors practicing in some of Australia’s most remote locations to undertake vocational general practice training.

The Scheme supports 22 new training places each year. In 2015, a new cohort of 10 registrars training in Aboriginal Community Controlled Health Services commenced training under this scheme.

Health Budget Announcements

MBS

The Government has announced a review of Medicare. This will include a comprehensive review of all 5500 MBS items.

This process will also oversee the establishment of a Primary Health Care Advisory Group to focus on innovative ways to deliver primary care, especially chronic disease.

The Government has committed $34.3m over two years to undertake this process. The Taskforce is expected to report back with key priority areas for action late in 2015.

NACCHO has already initiated discussions with the Department of Health to influence the consultation process and ensure the Sector has a seat at the table in these processes.

In addition, NACCHO has secured confirmation of an extension of the Section 19.2 ACT which expires on 30th June 2015, which enables ACCHSs to receive financial benefit from Medicare rebates in addition to Government funding. Confirmation letters will be sent to member services confirming an extension of the exemption until 30th June 2018.

The Government remains committed to the freeze on MBS rebate indexation. This will cost the Sector critical funding to support services outside of grant funding. NACCHO will work with the Department to address gaps in MBS revenue.

Healthy Kids Check

The Budget cut Medicare funding for the “Healthy Kids Check”, a consultation with a nurse or GP to assess a child’s health and development before they start school.

Funding for the program will stop in November. This measure is considered a duplication with existing state and territory based programs.

This change does not impact ACCHS or Aboriginal and Torres Strait Islander children to the same degree. ACCHSs can continue to bill health assessments through a separate item (715) which is eligible to be billed at any age.

PBS

The Budget provides additional spending of $1.6b over five years, with a further $2.5b in recommendations which are in the final stage of negotiations.

Listings include:

    • Breast cancer
    • Melanoma
    • Eye disease
    • Shingles vaccine for people 70-79.

The benefits for some of the measures, such as the cancer drugs, are undermined by others such as the fee reduction for the shingles vaccine. This covers an age cohort which largely excludes Aboriginal and Torres Strait Islander people, who have lower life expectancy. NACCHO is working with the Department to address this.

Sixth Pharmacy Agreement

The 6th Community Pharmacy Agreement (CPA) has reached the final stages of negotiation. NACCHO and the Pharmacy Guild of Australia have been negotiating 1 year transition funding of QUMAX to enable development of an Implementation Plan under the 6th CPA.

NACCHO will seek to expand QUMAX from 76 services to 134 services who currently receive funding from the Department rather than directly.

This Agreement introduces pilot trials for pharmacists to undertake basic functions usually undertaken by Doctors and Nurses, for example vaccinations, wound care and chronic disease management. This could be seen as money being taken out of the primary care sector and re-directed to pharmacists.

PHN Funding

Current funding allocated to Medicare Locals will transfer to the PHNs. The 2015-16 Health Budget papers indicate that “identified primary mental health care services will [also] be transitioned to Primary Health Networks”. Additionally, the Minister for Health has advised in writing to NACCHO that funding for Complementary Care and Supplementary Services will transition from Medicare Locals to the PHNs.

This decision was based on notion that this would ensure greater access for Aboriginal and Torres Strait Islander people, regardless of where they access their primary health care. This position implies that Medicare Locals were providing universal care to Aboriginal and Torres Strait Islander people, despite a lack of evidence to support this.

NACCHO will continue to lobby the Minister and the Department to re-allocate Aboriginal Medicare Local funding to the Sector, rather than to PHNs.

Flexible Funding

Last year’s Budget foreshadowed $197.1m in cuts to the ‘Health Flexible Funds’ over three years.

This year, that figure has increased to $500m worth of cuts over four years, according to the Secretary of the Department of Health. There is still no clarity in relation to how these savings are to be achieved.

Among the 16 Flexible Funds which could be affected are those supporting the provision of essential services in rural, regional and remote Australia; working to Close the Gap in health outcomes for Indigenous Australians; managing vital responses to communicable diseases; and delivering substance use treatment services around the country.

NACCHO is currently working with the Public Health Association of Australia on a public campaign opposing these cuts.

Mental Health

There were no measures announced in response to the Mental Health Commission’s recent review of programs and services.

Instead, the Government has committed to develop and implement options for policy and program changes. This process will be driven through an expert reference group, which will develop short, medium and long-term implementation strategies based on reviews findings:

    • Suicide prevention
    • promotion, prevention and early intervention of mental health and illness;
    • the role of primary care in treatment of mental health, including better targeting of services; and
    • national leadership, including regional service integration.

NACCHO will monitor announcements for Mental Health in relation to the Federal Budget and the commencement of the Expert Reference Group. It is expected these announcements will be linked to the development of the Federation White Paper.

Medical Research Future Fund (MRFF)

The MRFF has been revived in this year’s budget. Funding for the MRFF will be derived from savings found in the Health budget. The MRFF will receive $400m over the next four years, starting with $10m in this financial year.

Last year NACCHO lobbied for the reinvestment of $121m in savings from the Aboriginal health budget, rather than its inclusion in the MRFF funding bucket. NACCHO will closely monitor which money is allocated to the fund and how it is used to promote research that benefits Aboriginal people.

Ice Campaign

This Budget commits $20 million over two years for a new stage of the National Drugs Campaign primarily aimed at the use of ice. No consultation has been undertaken in the lead up to the announcement of this health promotion campaign. It almost certainly will not achieve tangible outcomes for Aboriginal people.

In addition, it is unclear how this complements the recent development of a National Ice Taskforce, under the leadership of the Prime Minister, which is currently undertaking public consultations around the country. It is expected that reporting for this process will not commence until mid-year.

NACCHO is currently developing a response to the National Ice Taskforce and considering alternate strategies to progress development of a Sector-led response to Ice in Aboriginal and Torres Strait islander communities.

General Budget Announcements

Income Management — two year extension

The Government will provide $146.7 million over two years to extend existing income management arrangements in all current locations until 30 June 2017, despite evidence to the contrary that this approach is effective.

Income management will continue in: Perth Metropolitan, Peel and Kimberley regions, Laverton, Kiwirrkurra and Ngaanyatjarra Lands in Western Australia; Anangu Pitjantjatjara Yankunytjatjara Lands, Ceduna and Playford in South Australia; Cape York, Rockhampton, Livingstone and Logan in Queensland; Bankstown in New South Wales; Greater Shepparton in Victoria; and in the Northern Territory.

Youth Employment Strategy

The Government will provide over $330 million to implement a Youth Employment Strategy. This provides targeted support for groups of young people who are more susceptible to long term unemployment or are at risk of welfare dependence.

The Government will reverse the 2014-15 Budget measure Stronger Participation Incentives for Job Seekers under 30 and instead require young people under 25 years of age to actively seek work for a four week waiting period before receiving income support payments.

NACCHO will continue to lobby for an exemption for Aboriginal and Torres Strait Islander youth, who are disproportionately affected by unemployment.

Small Business Package  

The Government has introduced a raft of tax measures and incentives that may be applicable to some ACCHSs.

The Government is reducing the tax rate for the more than 90 per cent of incorporated businesses with annual turnover under $2 million. The tax cut will apply from 1 July 2015.

The Government will also provide a 5 per cent tax discount to unincorporated businesses with annual turnover less than $2 million from 1 July 2015.

All small businesses will get an immediate tax deduction for any individual assets they buy costing less than $20,000. (Currently, the threshold sits at $1,000).

This $20,000 limit applies to each individual item. Small businesses can apply this $20,000 rule to as many individual items as they wish. These arrangements start Budget night and continue until the end of June 2017.

NACCHO will develop a paper which outlines entitlements for the sector through these measures.

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NACCHO 2015 budget update : Aboriginal groups question budget strategy

photoCongress

“Priorities identified in the Indigenous Advancement Strategy (IAS) guidelines were too limited to address disadvantage in a holistic way.  Additionally, the delivery of the IAS is devoid of decision-making procedures for Aboriginal and Torres Strait Islander Peoples, and appropriate definition for community wellbeing.The current policy of overcoming disadvantage is limited in its application and does not take account of significant disadvantage faced by Aboriginal and Torres Strait Islander Peoples, e.g. rates of incarceration and detention.“

 National Congress of Australia’s First Peoples (‘Congress’)

The Budget confirms that more than $145 million will be cut from Indigenous programs and services in 2015-16, including $46 million from Indigenous health”

Shadow Minister for Indigenous Affairs, Shayne Neumann

Budget 2015-16: information of relevance to Indigenous health

NACCHO 2015 Federal Budget Update : How the budget could Close the Aboriginal Health Gap ?

Report from Probono Australia

Picture above Press Conference Parliament HOUSE :LIVE on SKYNEWS

The Federal Government says Indigenous Australians will be the beneficiaries of fresh Budget shakeups in housing and jobs, but Aboriginal and Torres Strait Islander representatives have criticised the Government’s approach.

The 2015 Federal Budget includes $4.9 billion for the Government’s Indigenous Advancement Strategy, including the negotiation of a new Remote Indigenous Housing Strategy to replace the National Partnership Agreement on Remote Indigenous Housing.

According to the Government, the change will provide greater flexibility to respond to the housing needs of remote Indigenous communities and ensure that Government investment improves the condition of housing in those communities.

“The Government is reforming Indigenous Affairs to get adults into work, children to school and make communities safer,” Budget papers said.

“Under new arrangements, housing works will drive Indigenous training and employment and the states and the Northern Territory will be required to deliver positive outcomes in property and tenancy management, home ownership and land tenure.”

“These reforms will put in place practical change on the ground, supported by the Department of the Prime Minister and Cabinet regional network of staff who are located in the communities they serve and deliver on this Government’s priorities to provide better outcomes for First Australians.”

However, the National Congress of Australia’s First Peoples (‘Congress’) said priorities identified in the Indigenous Advancement Strategy (IAS) guidelines were too limited to address disadvantage in a holistic way.

“Additionally, the delivery of the IAS is devoid of decision-making procedures for Aboriginal and Torres Strait Islander Peoples, and appropriate definition for community wellbeing,” the organisation said.

“The current policy of overcoming disadvantage is limited in its application and does not take account of significant disadvantage faced by Aboriginal and Torres Strait Islander Peoples, e.g. rates of incarceration and detention.“

A jobs package in the Budget will also aim to boost Indigenous economic participation, with the Government promising that “clear and accountable targets will significantly increase the number of Indigenous employees in the Australian public sector”.

WM

Graphic from Warren Mundine tweets

“The Government is focused on achieving positive results and a number of key reforms which will improve employment outcomes for First Australians are set to commence,” according to Budget papers.

“From 1 July 2015, reforms to remote employment services will start to transform the economic life of remote communities. The majority of remote job seekers will be active and engaged in meaningful work-like activities that contribute to communities and build real-life work skills and experience. A key aim will be to provide each individual with a real pathway to employment.”

“Through the Employment Parity Initiative, the largest companies in Australia will be supported to increase the number of Indigenous Australians in their workforce to levels which reflect the size of the Indigenous population, approximately three per cent. This initiative will see 20,000 more Indigenous job seekers into work by 2020.”

Congress said the package was too focused on subsidies for business.

“A major portion of the Budget for Aboriginal and Torres Strait Islander Peoples is delivered to the private sector as jobs providers and trainers. However, the huge subsidies to major businesses are not providing real jobs and have not been successful in avoiding sustained high unemployment for Aboriginal and Torres Strait Islander Peoples,” Congress said.

“Grants should not be available to subsidise temporary employment in industries.  The employment programs should be linked to job creation through effective recruitment procedures and skills training provided whilst in permanent employment.”

Congress said the almost half a billion dollars worth of cuts from Aboriginal and Torres Strait Islander programs in the last Budget (2014-15) could still not be accounted for.

“The there is no evidence that significant savings were made and at the same time a number of community-based organisations were rejected in their applications under the Indigenous Advancement Strategy (IAS), on the basis that there were insufficient funds available.

“The cuts made in the last Budget should be restored until evidence of savings in the delivery of programs is available.”

Aboriginal and Torres Strait Islander rights advocacy organisation ANTaR said the Budget “failed the test of addressing the uncertainty, upheaval and cuts in Indigenous Affairs from the past 12 months.”

National Director Andrew Meehan said that last year’s Budget cut of $534 million to Indigenous Affairs, followed by an open competitive tendering process as part of the Indigenous Advancement Strategy (IAS), had left Indigenous Affairs in disarray.

“This last year has been one of real anxiety for many Aboriginal and Torres Strait Islander organisations and communities , and the Budget missed the opportunity to put that right,” he said.

The Shadow Minister for Indigenous Affairs, Shayne Neumann, said the “unfairness” of last year’s Budget continued, given “massive” cuts gutting Indigenous programs and frontline services.

“The Budget confirms that more than $145 million will be cut from Indigenous programs and services in 2015-16, including $46 million from Indigenous health.

“This Budget provides no relief for the hundreds of Indigenous organisations still reeling from the massive cuts delivered through the Government’s disastrous Indigenous Advancement Strategy in the last Budget.

“This year’s Budget rips $95 million from the National Partnership Agreement on Remote Indigenous Housing, in spite of serious overcrowding.

“We still don’t know where the cuts will fall, with many services facing an uncertain future.”

Congress said Indigenous engagement with the entire Budget process remained a concern.

“Since the demise of the Aboriginal and Torres Strait Islander Commission (ATSIC), Aboriginal and Torres Strait Islander Peoples have little or no capacity to monitor the Budget announcements, or to assess or innovate and improve as part of the Budget cycle.

“Expenditure in the Budget cycle on Aboriginal and Torres Strait Islander Peoples is difficult to gauge, as related Budget information is dispersed throughout portfolios and difficult to overview, including comparisons to previous reports on expenditures.  This complexity effectively prevents transparency and accountability and generates misinformation and controversy.”

Andrew Meehan agreed that it was time to elevate the importance of Indigenous Affairs in putting together the Budget.

“Across almost every social and economic measure, Aboriginal and Torres Strait Islander people are the most disadvantaged and are far more likely to experience poverty than other Australians,” he said.

“A Budget that doesn’t put addressing this front and centre is not a fair budget. Nor does it demonstrate that Indigenous Affairs is at the heart of this government, as the Prime Minister has previously proclaimed.”

Download Budget Papers 2015 HERE

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NACCHO Funding News :Most groups funded under Indigenous advancement strategy non-Indigenous

Mick

Respectful engagement with Aboriginal and Torres Strait Islander peoples regarding these significant changes was conspicuous by its absence.If Aboriginal and Torres Strait Islander peoples are to have confidence in these outcomes, we must be able to understand the process,” 

The Aboriginal and Torres Strait Islander social justice commissioner, Mick Gooda

More than half the organisations granted funding under the Indigenous advancement strategy are non-Indigenous, a Senate inquiry has been told.

NACCHO thanks  Follow on Twitter @heldavidson

from The Guardian for permission to publish ORGINAL HERE

Of the $4.9bn available, “about half” had already been allocated to existing programs before the first IAS application round opened, the Department of Prime Minister and Cabinet told the inquiry.

The Senate standing committee is examining the “impact on service quality, efficiency and sustainability” of the IAS after widespread confusion and dissatisfaction at the announcement of successful applications in March. The inquiry has received and published 58 submissions, with varying views.

In its submission the department defended the tender process and provided funding breakdowns, including that 45% of the organisations granted funding were Indigenous.

The Greens senator Rachel Siewert said it added “insult to injury” after the confusing process.

“The clear message from community members and stakeholders was that they wanted genuine conversations with the government, they want to run their own services and decide their own fate,” Siewert said.

The department also revealed while $4.9bn was allocated in the federal budget over four years, “approximately half” was already tied up in “dedicated funding arrangements” before the tender process began.

These included contracts which predated IAS such as the remote jobs and communities program and working on country programs.

Extending the assessment process owing to the overwhelming response also took further money from the pool as the government continued to fund more than 900 services which had been set to expire in the interim, leaving $2bn eventually available for applications.

Of that, $860m was committed in the first year, and some funding was set aside for demand-driven applications and to fill gaps identified during negotiations. The IAS has since allocated $20.5m to youth services in the Northern Territory.

In its submission the department acknowledged the IAS was a “significant shift for government” but said its introduction was “an opportunity to better target investment to three key government priorities of getting children to school, adults into work and making communities safer”.

“While the IAS funding round has been a significant undertaking particularly for Indigenous communities and the service sector, it has for the first time in at least a decade enabled government to look holistically at the suite of activities being delivered at both a sectorial and regional level.”

The department said it offered certainty to service providers as more than half the successful applicants had been offered funding contracts for two years or longer.

The Aboriginal and Torres Strait Islander social justice commissioner, Mick Gooda, said in his submission “respectful engagement with Aboriginal and Torres Strait Islander peoples regarding these significant changes was conspicuous by its absence”.

He said many questions remain unanswered, including the amount of funding to each organisation, how it compared with what was requested, the period of contract granted, and which organisations lost funding altogether.

Gooda said the IAS “marked a shift to a competitive tender process” for unsuspecting organisations, and suggested it could have a negative impact on Indigenous-controlled organisations.

“If Aboriginal and Torres Strait Islander peoples are to have confidence in these outcomes, we must be able to understand the process,” he wrote.

Having got “many calls” after the announcement of the process, Gooda said some organisations did not have the capacity to put together the complicated applications, a suggestion also made by the – otherwise largely supportive – North Australian Aboriginal Family Violence Legal Service.

Other organisations hired expensive consultants, and uncertainty led others to believe they did not fit the criteria, said Gooda.

The Community Council for Australia said it did not support historical funding models but criticised the IAS process for limited consultation, “top-down imposition of requirements” and apparent disregard or lack of knowledge about the realities of running services.

It said the IAS’s attempt to improve the “dog’s breakfast” of human service contracting was “undermined by the way this task was approached” including failing to heed recommendations from the productivity commission.

Using drastically reduced federal funding, the IAS sought to streamline myriad Indigenous funding arrangements into five key programs: jobs, land and economy; children and schooling, which received a third of funding; safety and wellbeing, which received nearly half ; culture and capability; and remote Australia strategies.

Geographically, the largest share went to eastern New South Wales (18%), which has a quarter of Australia’s Indigenous population, followed by greater Western Australia (13%) and the Top End and Tiwi Islands region (11%). A 10th of the funding went to central Australia.

“Regions in more remote areas attracted a greater share of IAS funding than their share of the Indigenous population reflecting relative need,” the submission said.

The department is continuing negotiations with applicants and will have 14 days to publish the final details once each is completed.

 

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NACCHO Good News: Home grown Derby girl to be towns first Aboriginal doctor

 

Inspire 2

If I could inspire one person to become a doctor, or to finish high school, to go on to higher education regardless of whether it’s medicine or not, then that’s amazing.”

Vinka Barunga was one of those kids who always wanted to put on Band-Aids and take temperatures. She doesn’t remember a time when she didn’t want to be a doctor.

For the past four years, Vinka has been studying medicine at the University of Western Australia in Perth. This year, she’s back in Derby for a 12-month placement with the Rural Clinical School. Living with two other medical students, she’ll divide her time between the local Hospital and the Derby Aboriginal Health Service.

For Vinka, her patients are more than names on a chart. In many cases, they’re family and friends. The young doctor-in-training is lucky to walk through the waiting room without being held up by at least one relative eager for a chat.

Derby has never had a full-time Aboriginal doctor, and many of the locals are excited to see a home-town girl on her way to graduating from medicine.

Derby’s health services cater primarily for Indigenous patients. Diabetes, kidney disease and heart disease are among the most common health issues. Children are often treated for ear or skin infections.

These conditions are largely caused, or complicated by, substance abuse, poverty and overcrowding. For visiting doctors, the reality can be confronting. For Vinka, it’s all too familiar.

Vinka’s story is featured on Living Black: Kimberley Healing this week.  Tuesday at 9PM on NITV. Story by :  Ella Archibald-Binge

WATCH VIDEO and more info here

She’s a capable netballer, a volunteer fire fighter with a weakness for mango ice-cream, a reluctant fisher-woman who hates throwing a line but loves eating the catch. She laughs easily, watches Grey’s Anatomy and reads Women’s Health.

“I think I was always a little bit medically-inclined,” Vinka says, smiling as she casts her mind back to the day her mother bought her a plastic stethoscope as a toy.

“I was always that kid who wanted to put bandaids on and take someone’s temperature when they’re sick.”

The 26-year-old is perched cross-legged on a dining room chair. Her tribe’s name is etched along her foot in bold, slanted black ink: Worora. Her long brown hair is swept back into a ponytail, which hangs over one shoulder. Head tilted, she gazes upwards as she reminisces about her childhood days, spent running with the neighbourhood kids, usually wearing nothing but underpants.

“Everyone knows everyone in Derby,” Vinka says. “There would be someone that knew where you were and who you were with, so you were always quite safe.”

&Dr Isaac Hohaia shows Vinka and two other medical students how to react in an emergency.

Dr Isaac Hohaia shows Vinka and two other medical students how to react in an emergency.

Derby is a small town sitting at the gateway to the Kimberley region of Western Australia. About a two hour drive from Broome, the town greets you with blue sky, red dirt and an unrelenting sun. There’s no such thing as winter in Derby – only wet and dry seasons. The temperature generally hovers just shy of 40 degrees. The 5000-strong town draws many visitors from the surrounding Aboriginal communities. The closest community, about 10 kilometres out of town, is Mowanjum, where Vinka was raised.

Most of her early memories involve water: running through sprinklers, mud sliding on the marshlands, swimming in the river (the locals are quick to shrug off warnings about crocodile country).

<img height=”525″ width=”700″ alt=”Mowanjum locals fish for Barramundi at May River, near Derby. Vinka spent much of her childhood splashing in the water at May River.” title=”Mowanjum locals fish for Barramundi at May River, near Derby. Vinka spent much of her childhood splashing in the water at May River.” class=”media-element file-body-content” src=”http://www.sbs.com.au/news/sites/sbs.com.au.news/files/styles/body_image/public/edos_fishing_pic.jpg?itok=si3Dn58V&mtime=1430702601″ itemprop=”image” />Mowanjum locals fish for Barramundi at May River, near Derby. Vinka spent much of her childhood splashing in the water at May River.

Mowanjum locals fish for Barramundi at May River, near Derby. Vinka spent much of her childhood splashing in the water at May River.

But Vinka has other, not-so-fond memories, too: little ears irreparably damaged by chronic infections, bodies and minds ruined by alcohol, young lives taken too soon…  It’s a combination of the happy and sad memories that have brought her back to her home town – this time as a medical student.

For the past four years, Vinka has been studying medicine at the University of Western Australia in Perth. This year, she’s back in Derby for a 12-month placement with the Rural Clinical School. Living with two other medical students, she’ll divide her time between the local Hospital and the Derby Aboriginal Health Service.

For Vinka, her patients are more than names on a chart. In many cases, they’re family and friends. The young doctor-in-training is lucky to walk through the waiting room without being held up by at least one relative eager for a chat.

Derby has never had a full-time Aboriginal doctor, and many of the locals are excited to see a home-town girl on her way to graduating from medicine.

“I hope it makes them think ‘oh she’s done it, I can tell my grandchildren that I went to hospital and saw an Aboriginal doctor’,” Vinka says.

Derby’s health services cater primarily for Indigenous patients. Diabetes, kidney disease and heart disease are among the most common health issues. Children are often treated for ear or skin infections. These conditions are largely caused, or complicated by, substance abuse, poverty and overcrowding. For visiting doctors, the reality can be confronting. For Vinka, it’s all too familiar.

“We learn a lot about Aboriginal health issues and we learn about the really high alcohol and drug use and we learn about the domestic violence,” she says, her voice soft and serious.

“We learn about the chronic ear infections in children and hearing problems in later life and mental health issues as a result of forced removal of children and forced removal from country.

“I guess it’s something that everyone can learn in theory, but to go and see it is a completely different story.”

Vinka has fond memories of playing with her cousins at Mowanjum.

Vinka’s seen a lot in her 26 years. In 2012, her community of Mowanjum reached crisis point after a spate of youth suicides.

“You grow up in a community where you see domestic violence and you see people drinking and you think that that’s the way of life”

“You grow up in a community where you see domestic violence and you see people drinking and you think that that’s the way of life,” she says.

“There have been moments when I’ve felt that as well.”

The past few years haven’t been easy for Vinka. During her time at university, she’s lost both parents to illness. But she hasn’t lost sight of her goal, and she finds daily inspiration in her patients.

“You learn a lot from people in medicine… talking to them about what they’ve done and the struggles they’ve had,” Vinka says.

“I guess I think that everyone’s life is hard.”

In medicine, Vinka has found something to aim for – and now she hopes to inspire other young people in her community to set goals of their own. She believes it’s crucial to empower the next generation to create a healthy community. A community free from chronic disease; a community where people have a steady income, and a solid purpose – rather than “just existing”. A community where projects are developed by the people, for the people. A community that celebrates culture, cares for country and builds opportunities. It’s a vision shared by many at Mowanjum, and Vinka is determined to turn it into a reality.

“If I could inspire one person to become a doctor, or to finish high school, to go onto higher education – regardless of whether it’s medicine or not – then tat’s amazing,” she says.

It’s this passion for her culture and community that keeps the young doctor-in-training so driven. When I ask Vinka how her culture influenced her upbringing, she laughs and takes a big breath.

“I always struggle answering this question,” she replies with a smile that says she’s been asked the same thing a thousand times.

“It’s really hard to remove myself from it and say how it’s impacted my life, because I guess it impacts every aspect of my life.”

I curse myself for my clumsily-worded question, but generously Vinka gives me an answer, and a powerful one at that.

“I think my culture has instilled an immense pride in myself and in my people, so that makes up a lot of who I am and why I want to do what I’m doing, and become a doctor and give back to the people who have taught me so much about who I am and where I belong.”

Vinka Barunga is many things: a student, a role model, a natural-born swimmer. But above all, she’s a proud Worora woman, determined to be the first Aboriginal doctor in her community – but definitely not the last.

Vinka’s story is featured on Living Black: Kimberley Healing this week. Watch it on Mo Tuesday May 5 at 9PM on NITV.

 

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