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

 

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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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NACCHO Aboriginal Health News : National Award in Indigenous Health Ethics goes to SA

photo

Research into health and wellbeing needs to be driven by and involve Aboriginal and Torres Strait Islander people, and provide a tangible benefit back to community and to develop an understanding of Aboriginal and Torres Strait Islander resilience, diversity and community needs.”

Dr Rosie King from the Aboriginal Health Council of South Australia

A project from South Australia has recently been recognised for forging ties between Indigenous and medical research communities for better health outcomes in Aboriginal Australians.

A National Award in Indigenous Health Ethics was presented to the joint project between the Aboriginal Health Council of South Australia and the Wardliparingga Aboriginal Research Unit within the South Australian Health and Medical Research Institute (SAHMRI).

The winning project is entitled “Next Steps for Aboriginal Health Research: How research can improve the health and wellbeing of Aboriginal people in South Australia.”

The tarrn doon nonin award – meaning ‘trust’ in the Woiwurrung language of central Victoria – comes from the Lowitja Institute, Australia’s National Institute for Aboriginal and Torres Straight Islander Health Research. The award recognizes excellence in Aboriginal and Torres Strait Islander health research ethics, and provides $10 000 towards project research funds.

“Research into health and wellbeing needs to be driven by and involve Aboriginal and Torres Strait Islander people.”

Dr Rosie King from the Aboriginal Health Council of South Australia said the philosophy underpinning the project was founded quite simply on asking the South Australian Aboriginal community what they thought research should focus on.

“People told us they want research to focus on their everyday health and wellbeing needs, but importantly they also want approaches that respect and engage with a view of life that is holistic and interconnected with cultural, spiritual, social and physical needs across the lifespan,” she said.

“Research into health and wellbeing needs to be driven by and involve Aboriginal and Torres Strait Islander people, and provide a tangible benefit back to community and to develop an understanding of Aboriginal and Torres Strait Islander resilience, diversity and community needs.”

The winning project was informed by an historic accord for negotiated health outcomes between Indigenous South Australians and medical health researchers, launched at SAHMRI in 2014.

SAHMRI also recently published details of its exemplar Closing the Gap health project ESSENCE to address cardiovascular health in Indigenous Australians based on a foundation of evidence and standards for equitable care.

Kim Morey, the manager for Knowledge Transition and Exchange in SAHMRI’s Aboriginal Research Unit, said that SAHMRI was thrilled to be recognised for the project.

“SAHMRI was most excited about this first partnership with ACHSA on the Next Steps project because it developed Aboriginal Community driven research priorities. SAHMRI welcomes recognition for Next Steps project, which refocuses the research agenda so that those issues most important to South Australian Aboriginal Communities begin to receive the attention that they deserve. Moreover, the majority of the researchers on the Next Steps team are Aboriginal.”

The online resource EthicsHub was also launched at the Indigenous Health Ethics award ceremony. This initiative will support individuals and organisations working or participating in Aboriginal and Torres Strait Islander health research.

NACCHO Health News : Indigenous children now able to access free flu vaccine in Australia.

 

WADEYE ABORIGINAL CLINIC NT

“For the first time, Indigenous children are able to access free flu vaccine in Australia

This is important because Aboriginal and Torres Strait Islander children are five times more likely to be hospitalised with flu and pneumonia than non-Indigenous children. Indigenous children are also 17 times more likely to die from flu or pneumonia than non-Indigenous children.”

Letter From Dept of Health Re Aboriginal Flu Vaccine_Page_1

DOWNLOAD important letter from Dept. of Health free flu vaccine in Australia ;Letter From Dept of Health Re Aboriginal Flu Vaccine

It’s that time of year again when scientists and doctors make predictions about the impending influenza (flu) season and we must decide whether to go out and get the flu vaccine.

The government-funded flu vaccine will be available from 20 April, a month later than most years, as the vaccine has been reformulated to cover a new strain. But some GPs may offer the vaccine privately before then.

So, who should consider getting the vaccine and who gets it for free? And are we really in for a bad flu season in Australia?

Aeron Hurt, WHO Collaborating Centre for Reference and Research on Influenza

How does the vaccine work?

The flu vaccine helps prevent us from getting the flu each season. It contains dead, broken-up bits of flu viruses that are expected to circulate during the upcoming season.

Once injected into our arms, the pieces of dead virus stimulate our body’s immune response to produce antibodies, which act as a defence that can rapidly swing into action when a live flu virus infects our nose and throat.

Because the viruses in the vaccine are dead, they can’t give us flu.

What’s new about flu vaccines in 2015?

For the first time, Indigenous children are able to access free flu vaccine in Australia.

For the first time, Indigenous children are able to access free flu vaccine in Australia.

This is important because Aboriginal and Torres Strait Islander children are five times more likely to be hospitalised with flu and pneumonia than non-Indigenous children. Indigenous children are also 17 times more likely to die from flu or pneumonia than non-Indigenous children.

This year a new flu vaccine, known as “quadrivalent”, will be available. This type of vaccine contains four flu viruses compared with three in the normal trivalent vaccine. The additional flu strain provides extra insurance that may be useful if unexpected viruses begin to circulate.

However, it’s likely that the standard trivalent vaccine will cover the great majority of the flu A and B strains expected to circulate in Australia this winter.

The quadrivalent vaccine won’t be available via the government’s free flu vaccine program and will be more expensive than the standard trivalent vaccine if purchasing it privately.

Who should get the flu vaccine?

For certain members of the community, catching flu can lead to severe illness or death. It is these “high-risk” groups (listed below) that should actively avoid catching it. Getting the flu vaccine is a major step towards achieving protection from flu.

Certain groups of individuals at high risk of developing severe illness or complications if infected with flu are eligible for free flu vaccine via the federal government. These are:

  • Anyone aged 65 years or over
  • Aboriginal and Torres Strait Islander people aged 15 years or over
  • Aboriginal and Torres Strait Islander children aged between six months and five years
  • Pregnant women

Anyone with with medical conditions that can lead to severe influenza, including people with heart disease, severe asthma and diabetes. A full list of eligible medical conditions can be found here.

Within the over-65 age group, a high proportion of people are vaccinated (more than 70%).

But although the flu vaccine is provided free of charge to vulnerable people, many still don’t get it. Less than 30% of pregnant women and Indigenous people receive the flu vaccine. Only half of those with medical conditions that can lead to severe influenza get vaccinated.

Although not included in the government’s free flu vaccine program, children under the age of two years are also highly susceptible to flu.

Once infected with flu, young kids are more likely to be hospitalised with severe illness than those in the over 65 age group. About half of young children who die from the flu are otherwise healthy with no underlying medical conditions or known risk factors.

Most children who die from flu are not vaccinated. Therefore the idea that fit, healthy infants can simply “fight off” a flu infection without any problem is not always true.

Another benefit of preventing flu in children is that it reduces the spread of infections to other vulnerable family members such as grandparents.

What’s in store for us this winter?

The one predictable thing about flu, is that it is unpredictable! However, we often look to the northern hemipshere’s winter flu season to give some insights into what might be expected here.

The recent flu season in the United States and most of Europe was dominated by the A(H3N2) strain of flu. This virus has historically been associated with increased severity in the elderly.

There has been a lot of media coverage about bad vaccine match in the northern hemisphere. This is because most of the serious influenza was caused by the A(H3N2) viruses which had changed over the five to six months when the vaccine producers were manufacturing the vaccine. But the other components of the vaccine were well matched.

Our vaccine has been updated to protect Australians against the new A(H3N2) viruses.

So, if you or a loved one fall within the high-risk groups described above, getting the vaccine remains the most effective way to avoid the inconvenience and potentially severe health risks of the flu – and passing it on.

Aeron Hurt is a Senior Scientist at the WHO Collaborating Centre for Reference and Research on Influenza, VIDRL based at the Peter Doherty Institute, Parkville, Melbourne. Aeron is also an honorary Principal Fellow at the University of Melbourne within the Melbourne School of Population and Global Healths The Melbourne WHO Collaborating Centre for Reference and Research on Influenza is supported by the Australian Government Department of Health and also receives funding from the IFPMA (International Federation of Pharmaceutical Manufacturers & Associations) and Novartis Vaccines under cooperative research agreements. AH holds shares in CSL Limited, a manufacturer of influenza vaccines.

Article by The Conversation

NACCHO Health News: AMA speech “Social Determinants and Aboriginal Health”

Brian

Investment in local health services is a must. Delivery of appropriate health services, particularly through Aboriginal community controlled health services, must be culturally safe, and delivered in the right locations by the right people. Spending on health is an investment. Investing in health must underpin our future policies to Close the Gap, and to address what is, for Australia, a prominent blight on our nation.

Governments and other groups that influence policy cannot do this work themselves. It must be a partnership with Indigenous Australians.

The AMA is committed to working, in partnership with our first peoples to Close the Gap in Indigenous health and disadvantage.”

AMA PRESIDENT A/PROF BRIAN OWLER (pictured above with Matthew Cooke NACCHO chair at recent Parliamentary event )

SPEECH TO BMA SYMPOSIUM The Role of Physicians and National Medical Associations in Addressing the Social Determinants of Health and Increasing Health Equity LONDON 24 MARCH 2015

The Social Determinants of Health: the Australian Perspective

The Australian connotation of the words ‘social determinants’ in relation to health immediately conjure images of the issues faced by Australia’s first people, our Australian Aborigines and Torres Strait Islanders.

And this is rightly so. The social determinants of health are major issues for Australia as a nation in its attempts to ‘close the gap’ for disadvantage of Indigenous people in relation to a range of outcomes, including health.

The implications of the social determinants are not bound by race, although race might be thought of as a social determinant in itself. Social determinants are important to health outcomes for all Australians.

The issues are much more complex than whether someone has a roof over the head, whether they have access to clean water and nutritious food. What I want to talk about, from the Australian perspective, are two issues.

First, there are deeper issues that underlay the social determinants of health. This comes from a sense of physical, social, and emotional wellbeing, the origins of which have deep spiritual roots for Australia’s Indigenous people.

The second is that the term ‘social determinants of health’ is somewhat misleading. While I know many here understand this, we must not forget that health is a determinant of social and other outcomes.

Australian Indigenous peoples represent about 3 per cent of the Australian population. Indigenous Australians experience poor health outcomes. We have a gap between Indigenous and non-Indigenous Australians in terms of health, but also in many other aspects of life. Indeed, the health outcomes are poorer compared to the Indigenous populations of other nations.

Life expectancy of Indigenous Australians is 10.6 years less for men, and 9.5 years for women. This gap in life expectancy is a serious blight on our nation, and remains unacceptable.

The AMA sees that addressing this issue is a core responsibility of the AMA and the medical profession.

While the gap in life expectancy remains unacceptable, there have been gains in Indigenous health. Life expectancy has increased by 1.6 years and 0.6 years for men and women respectively over the past five years. Mortality rates for Indigenous Australians declined by 9 per cent between 2001 and 2012.

So, what are the main contributors to the gap in life expectancy?  Chronic diseases are the main contributors to the mortality ‘gap’ between Indigenous and non-Indigenous Australians.

Four groups of chronic conditions account for about two-thirds of the gap in mortality: circulatory disease, endocrine, metabolic and nutritional disorders, cancer, and respiratory diseases.

Another major contributor to the gap in life expectancy is the Indigenous infant and child mortality rate. These rates remain well above that of the non-Indigenous population.

The infant mortality rate remains high at around five deaths per 1000 live births, compared to 3.3 per 1000 for non-Indigenous children.

External causes, such as injury and poisoning, account for around half of all deaths of children aged 1–4 years. External causes, mainly injury, are also the most common cause of death among Indigenous children aged 5–14, and account for half of the deaths in that age group.

The trend data for most States show a 57 per cent decline in the Indigenous infant mortality rate between 2001 and 2012, and a 26 per cent decline in the non-Indigenous rate.

There has been progress here, but clearly there is much more to do.

Suicide was the third leading cause of death among Indigenous males, at six per cent.

The rate of suicide is about two times higher for males and 1.9 for females, compared to non-Indigenous Australians. Suicide also occurs at a younger age. This is not consistent with Aboriginal culture, in which suicide was thought to be rare.

These sorts of reports highlight several important issues.

First, as is already known, non-communicable diseases, in particular circulatory disease and diabetes, remain very significant issues for the Australian Indigenous people.

Investment in local health services is a must. Delivery of appropriate health services, particularly through Aboriginal community controlled health services, must be culturally safe, and delivered in the right locations by the right people.

Second, the rate of suicide, particularly among young Indigenous males, is unacceptably high. This speaks to something much more difficult to address.

It is an issue of how we address mental health, the need to focus on drug and alcohol problems, but it also raises questions about why so many Indigenous people take their own lives.

Third, our child and infant mortality rates are too high, but are improving. What is disturbing is that many of the deaths remain preventable. That is, they are caused by trauma or injury. Some of these injuries will be non-accidental.

While those with chronic disease need to be cared for, prevention, particularly in the early part of life, is the key if we are going to see a generational change in health outcomes.

As a nation, Australia is conscious of the need to improve the health of Indigenous Australians – to Close the Gap.

Each year, the Prime Minister, in the first week that Federal Parliament sits, delivers a report on Closing the Gap.

In 2008, the Council of Australian Governments, or COAG, set six targets aimed at reducing Indigenous disadvantage in relation to health and education.

The Closing the Gap targets are to:

  • close the life expectancy gap within a generation (by 2031);
  • halve the gap in mortality rates for Indigenous children under five within a decade (by 2018);
  • ensure access to early childhood education for all Indigenous four year olds in remote communities within five years (by 2013);
  • halve the gap in reading, writing and numeracy achievements for children within a decade (by 2018);
  • halve the gap for Indigenous students in year 12 attainment rates (by 2020); and
  • halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade (by 2018).

Despite good intention and considerable investment by successive Governments, the disparity in outcomes remains.

As expressed in this year’s Closing the Gap statement by the Prime Minister: ‘It is profoundly disappointing that most Closing the Gap targets are not on track to be met’.

Closing the Gap is an incredibly difficult task, and it is fair to say that Australia and Australians have learnt much about how to Close the Gap over a number of decades.

There were many mistakes, not only in Closing the Gap, but also in how modern Australia has treated Indigenous Australians. These issues have had to be confronted in order to advance efforts to Close the Gap.

For example, from 1910 to 1970, it is estimated that 100,000 Indigenous children were taken from their families and raised in institutions or fostered to non-Indigenous families.

The ‘Stolen Generation’, as they are termed, was disastrous in its outcome, however well-intentioned it may have been – separating families, but also alienating individuals from their own culture and families.

There have been many examples of Governments trying to address the social determinants of health – but often they have failed. For example, the Australian Government attempted to improve the living conditions of Indigenous people by building houses.

The houses were often inappropriate for the location. The plumbing would block because of the hardness of the water. They would fall into disrepair, and they did not serve the needs of the communities. These initiatives were well meaning, but improvements in health outcomes were somewhat marginal.

We have learnt, unfortunately by mistake, but also through partnership with Indigenous Australians. When it comes to health, there is much more to improving Indigenous health than building houses and sending people to school.

The concept of health for Indigenous Australians is very different from that of Western culture. There is no word for health in many Aboriginal languages. Rather, health is more of a concept of social and emotional wellbeing than of physical health.

Even that statement is a generalisation.

Before the arrival of Europeans, Australia was inhabited not by a uniform nation of Aboriginal people, but rather hundreds of ‘Indigenous nations’, whose language varied tremendously, along with their culture and beliefs.

Despite this variation, a unifying theme in terms of that ‘social and emotional wellbeing’ is the connection of Indigenous people with their land.

Australia’s first peoples have been continuously sustained, both physically and spiritually, by their land for 50,000 years of more. They have a deep connection with the land, and it is an important component of maintaining their spiritual wellbeing.

The close connection with the land also means that Indigenous people often live in remote regions. These remote communities present challenges in delivering health care as well as infrastructure and services that improve the social determinants of health.

For Indigenous Australians, their very existence, let alone their lifestyle, was threatened by European settlement as late as 1788. For Indigenous Australians, the arrival of Captain Cook in 1770, and subsequently the First Fleet in 1788, is not seen as European settlement, but rather as a modern invasion.

It signified displacement, imprisonment, forced adoption and much worse. It has left both emotional and spiritual wounds open and unable to heal. Modern economic solutions will continue to fail until these much more deeply seated issues are confronted.

There have been important steps in our young nation’s history that have attempted to approach these issues.

As I mentioned, the attachment to land is an important part of Indigenous culture. For each Indigenous ‘nation’, certain places hold spiritual importance.

From the land stemmed the basis of Aboriginal ‘dreamtime’, the spiritual conceptualisation of the universe and the basis of human existence for Aboriginal peoples. One might say that their landscape was their religion.

Recognition of the longstanding connection to the land came through a series of legislative changes that largely started under the Whitlam Government in 1972. Whitlam established the Aboriginal Land Rights (or Woodward) Commission to examine the possibility of establishing land rights in the Northern Territory.

In 1975, the Whitlam Government purchased traditional land and handed it back to the Gurindji people. In a now famous gesture, Whitlam poured sand into the hands of Vincent Lingiari, an Elder of the Gurindji people.

The Aboriginal Land Rights Act was passed by the Fraser Government in 1976, and established land rights for traditional Aboriginal landowners in the Northern Territory.

In 1992, the doctrine of terra nullius was overruled by the High Court of Australia in Mabo v Queensland, which recognised the Meriam People of Murray Island in the Torres Strait as native title holders over part of their traditional lands.

The Native Title Act was legislated the following year, 1993, by the Keating Government.

Not only did this provide the legal acknowledgement that Indigenous Australians sought, it also provided a source of revenue. The use of land for mining purposes, for example, provided significant funding to Aboriginal people through regional land councils.

More has been done since, but these are important issues to address that underlay social and emotional wellbeing and, therefore, the health of Indigenous people.

In 2008, Prime Minister Kevin Rudd issued a formal apology to Indigenous people for the stolen generation. It had enormous symbolism for Indigenous Australians.

The next likely step is to recognise Australia’s first people in our Constitution.

Constitutional recognition is a vital step towards making Aboriginal and Torres Strait Islander people feel historically and integrally part of the modern Australian nation.

Recognising Indigenous people in the Constitution will improve their self-esteem, their wellbeing, and their physical and mental health.

The AMA is a proud supporter of the Recognise campaign, and is a Foundation Signatory of the campaign.

In 2013, the Abbott Government was elected. Prime Minister Abbott had spent significant amounts of time with Indigenous people, often living for a week at a time in Indigenous communities.

In Government, he ‘ran the country’ for a week from a remote Indigenous community in Arnhem Land of the Northern Territory.

Prime Minister Abbott also took over the responsibilities for many Indigenous policy areas. The coalescence of these responsibilities into the Department of Prime Minister and Cabinet coincided with the reduction of the number of Indigenous programs into five main areas.

The Indigenous Advancement Strategy, or IAS, that began on 1 July 2014 now embodies these aims. The IAS outlines a number of priority areas – getting children to school, adults to work, and making communities safer.

The IAS replaced more than 150 individual programs with five broad programs – Jobs, Land and Economy; Children and Schooling; Safety and Wellbeing; Culture and Capability; and Remote Australia Strategies.

These are all worthy aims. They remain important.

But what is missing from the core of the IAS is a focus on health.

Health, in a modern sense, underpins many of these outcomes. We need to get the balance right and we, the AMA, need to ensure that health is seen as a foundation to these outcomes.

So, what is our role as a national medical association? Our role is to guide politicians and their policies; to shape the national narrative and debate.

The AMA’s Indigenous Health Taskforce, which I chair, draws experts in Indigenous Health together. It highlights the AMA’s commitment to working, in partnership with Indigenous Australians, to improve the health of Indigenous Australians.

Not only do we highlight the problems, but the AMA works on solutions and to highlight the successes as well.

The AMA regularly publishes the AMA Indigenous Report Card.

Last year, we highlighted the importance of a healthy early start to life.

My predecessor, Dr Steve Hambleton stated that: “Robust and properly targeted and sustained investment in healthy early childhood development is one of the keys to breaking the cycle of ill health and premature death among Aboriginal peoples and Torres Strait Islanders.”

Gains can be made by focusing on antenatal care.

In the Pitinjarra lands of north western South Australia there have been major gains in antenatal care, with 75 per cent of all pregnant women seen in the first trimester.

The proportion of children under three years of age with significant growth failure has fallen from 25 per cent in the 1990s to less than 3 per cent today. Immunisation rates approach 100 per cent.

This year, the AMA Report Card will focus on the bigger picture of the importance of health in underpinning the outcomes of education, training, and employment.

We will also focus on the issues of Indigenous incarceration rates, which have continued to escalate.

Law and order policies and health policies are often interlinked. Incarceration leads to a multitude of poorer physical and emotional health outcomes.

Poor health, and a poor start to life, is likely to increase the chances of incarceration. The AMA will be working with the Law Council of Australia on this issue.

To change the health of an entire population is an enormously difficult task. It is too easy for Governments to ignore health, to focus on the economics. Education and economics alone are not sufficient. Health is the cornerstone on which education and economics are built.

If you can’t go to school because you or your family are sick, truancy officers won’t work. If you can’t hear because of otitis media, you won’t learn. If you miss training opportunities because of depression or ill health, you won’t progress to employment. You can’t hold down a job if you keep having sick days.

Spending on health is an investment. Investing in health must underpin our future policies to Close the Gap, and to address what is, for Australia, a prominent blight on our nation.

Governments and other groups that influence policy cannot do this work themselves. It must be a partnership with Indigenous Australians.

The AMA is committed to working, in partnership with our first peoples to Close the Gap in Indigenous health and disadvantage.

DOWNLOAD THE NACCHO HEALTHY FUTURES REPORT CARD HERE

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NACCHO $ Funding updates : Indigenous-controlled sector the clear loser of Indigenous Reform Agenda

IW

“The IAS has offered us nothing in terms of new imaginings of and engagement with Aboriginal people, communities and capabilities

One would think, given the inability of mainstream services to close the gap in indigenous disadvantage to date, that all funding for indigenous advancement outcomes would require “high standards of governance and accountability.Yet in reading between the lines, it is primarily the indigenous community-controlled sector that requires additional scrutiny and surveillance.These special measures of surveillance and exemption in indigenous affairs are all too familiar to indigenous Australians who have lived under the protectionist and assimilationist policies of the last century and beyond.”

Dr Chelsea Bond, a senior lecturer in the Oodgeroo Unit at Queensland University of Technology.

“Maningrida has not had a youth suicide in the past 3 years, has seen a decrease in youth crime, teen pregnancies and STI rates which can be attributed to the support given by the youth centre to the young people of the community. In addition, the youth centre through its weekly Mooditj program offers disengaged and referred youth the opportunity to learn about sexual health, safe sex, life skills and much more”

Story 2 Below:  Malabam Health Board Aboriginal Corporation (Maningrida NT ) oversees the “GREATS” Youth Services (GYS) which has been hit hard with an 80% cut to its annual $400k budget under the IAS cuts!

Picture above :The Inala Wangarra Sport and Recreation Program aims to provide sporting and recreational opportunities for local Aboriginal and Torres Strait Islander people. (see story Below)

According to the federal government, the Indigenous Advancement Strategy represents a“new relationship of engagement” with indigenous Australia. Yet it was just under a decade ago that we were inflicted with a “new paternalism” by our Prime Minister, then the federal health minister, in justifying a raft of indigenous social policy measures including the Northern Territory Emergency Response (the Intervention), the introduction of alcohol management plans in Aboriginal communities in Queensland and the mainstreaming of indigenous services in urban and regional centres, which was continued under successive Labor governments.

Perhaps the only new thing about this strategy is the $534 million funding cut from the Indigenous Affairs portfolio. This is despite what the PM deems the “profoundly disappointing” results outlined in the government’s own Closing the Gap report last month. The PM’s chief indigenous adviser, Warren Mundine, did warn us that the reform agenda would produce “winners” and “losers”, and certainly from the coverage over the past few weeks, many indigenous communities are feeling as though they are on the losing side. While a full list of the winners and losers has yet to be released, we can see that the indigenous community-controlled sector has been hit particularly hard — be they peak bodies or local grassroots organisations, from Tennant Creek to Inala (the community in which I live), a wide range of front-line services will no longer exist as a result of the IAS announcement.

The other less reported “new reform“ under the IAS introduced last year has been the requirement for indigenous organisations receiving “grants of $500,000 or more in a single financial year from funding administered by the Indigenous Affairs portfolio to incorporate under Commonwealth legislation under the Corporations (Aboriginal and Torres Strait Islander) Act 2006”.

Organisations may be exempt from this requirement if they don’t primarily service indigenous people, or alternatively indigenous organisations may be exempt if they “can demonstrate that they are well-governed and high-performing”. This strategy we are told is to “ensure organisations receiving Australian Government funding to deliver Indigenous programmes have high standards of governance and accountability”.

One would think, given the inability of mainstream services to close the gap in indigenous disadvantage to date, that all funding for indigenous advancement outcomes would require “high standards of governance and accountability”. Yet in reading between the lines, it is primarily the indigenous community-controlled sector that requires additional scrutiny and surveillance. These special measures of surveillance and exemption in indigenous affairs are all too familiar to indigenous Australians who have lived under the protectionist and assimilationist policies of the last century and beyond.

Ironically, the indigenous community-controlled sector already meets high standards of accountability —  accountability for outcomes within our own communities. These organisations are governed and largely staffed by local indigenous community members who are held accountable to our communities for delivering on outcomes, often well beyond what we are funded to deliver and beyond the usual hours of business. This is not in lieu of financial accountability requirements to funding providers, but rather in addition to — an additional burden not often faced by large NGOs staffed by people from outside of our community.

Take, for instance, the community organisation I’m a board member of: InalaWangarra, which was one of the losers under the IAS.

Recently our organisation was funded around $50,000 to deliver an outcome of 20 indigenous people into careers as security guards, which was well shy of the actual costs of the program. Just this week 20 local indigenous people in Inala graduated from the program with a certificate II in security, certificate III in hospitality, and received their blue cards, police checks and security licences and now are all embarking on careers with a security company in our region. For that small investment, the CEO is dealing with three different state and federal funding providers and writing grant applications and acquittals for each one, on top of regular visits and phone calls from funding providers just to check on how we are doing, with another requiring written monthly reports. Part of the funds for this program was provided after completion to ensure we delivered on the outcomes, thus requiring the organisation to resource program implementation from other funds.

This isn’t good governance surely? And this is despite our previous achievement under a federal government pilot program that placed 88 local indigenous community members into jobs, most of whom were long-term unemployed, and retained employment beyond 13 weeks. Despite demonstrating competency, indigenous community-controlled organisations are still deemed “too risky” to funding providers, and it is this “relationship of engagement” that demands reform.

The “new reforms” in indigenous social policy must include equal, if not greater scrutiny over the inability of mainstream services to deliver the outcomes they are funded to deliver in our communities. Their governance structure doesn’t enable local communities to hold them accountable, and every year we are surprised at the new NGO that has rolled into our suburb or received funding to service our community, despite having demonstrated little engagement with our community.

One such example is the federal funding in 2012 for indigenous men’s sheds across the country as a men’s health initiative. Within our local community, the Inala Police Citizens Youth Centre was funded to establish a men’s shed. Yet, one year later The Satellite newspaper reported: “The one-year-old building at the back of the Inala Police Citizens Youth Centre (PCYC) has every tool imaginable on its shelves, walls and benches and a pile of wood just waiting to be crafted.” There is, however, one problem. The shed is predominately empty due to a lack of members. Yet Inala Wangarra’s indigenous men’s group has never struggled with engaging local men in its activities — it has simply struggled to engage financial investment from state or federal funding providers. This is not an isolated case, and examples of poor engagement and poor service delivery can be found across critical areas of health, education, housing, employment and training, which explains much of the gap of inequality that our people suffer. It is often left to the under-resourced local indigenous community controlled organisation to fill the gaps of mainstream service delivery models.

This is the site where genuinely “new reform” could be demonstrated — ensuring that all funding (both indigenous-specific and mainstream) advances the interests of the indigenous community it services, both in terms of process and outcomes.

Indigenous people are more than consumers of social services; we have the skills and capabilities to drive the services within our community. Our model of service delivery requires us to employ local indigenous people and build the capacity of the workforce within our community and this is what makes the indigenous community controlled sector so critical to achieving the Closing the Gap targets.

Our model of service delivery doesn’t trade off old imaginings of indigenous incompetence, dysfunction or despair.

New reform” in indigenous social policy will only be realised through new imaginings of and engagement with Aboriginal people, communities and capabilities. Unfortunately the IAS has offered us nothing new in this regard.

Malabam Health Board Aboriginal Corporation (Maningrida) oversees the “GREATS” Youth Services (GYS) which has been hit hard with an 80% cut to its annual $400k budget under the IAS cuts!

Maningrida has not had a youth suicide in the past 3 years, has seen a decrease in youth crime, teen pregnancies and STI rates which can be attributed to the support given by the youth centre to the young people of the community. In addition, the youth centre through its weekly Mooditj program offers disengaged and referred youth the opportunity to learn about sexual health, safe sex, life skills and much more

Media Release Malabam Health Board Aboriginal Corporation

“GREATS” Youth Services

Greats

Another frontline community driven organisation has been hit hard by the recent release of the funding cuts made to Aboriginal community controlled organisations under the Federal Governments Indigenous Advancement Strategy.Malabam Health Board Aboriginal Corporation (Maningrida) oversees the “GREATS” Youth Services (GYS) which has been hit hard with an 80% cut to its annual $400k budget under the IAS cuts!

The Federal government has offered the youth services in Maningrida an annual budget of $80,000 to be involved in a children and schooling program which has little relevance to the extensive suite of services that it has been providing to the community over the past five years ; it currently services a youth population of 1500! Half of the population in Maningrida is under the age of 25 years and it is the biggest community in Arnhem Land with a population of 3500 people and 38 outstations.

GYS is the youth service that operates in Maningrida and offers a suite of activities, workshops, projects and community events and has done so since 2005. GYS currently employs 7 local indigenous staff and has a nightly head count of 75 youth at its drop-ins. GYS hosts a weekly community movie night and attracts an audience of 150 community families to enjoy social connections.

The monthly Friday night discos attract an audience of approx. 250 people and offer an alternative to boredom that can lead to crime, suicide and assaults.

Maningrida has not had a youth suicide in the past 3 years, has seen a decrease in youth crime, teen pregnancies and STI rates which can be attributed to the support given by the youth centre to the young people of the community. In addition, the youth centre through its weekly Mooditj program offers disengaged and referred youth the opportunity to learn about sexual health, safe sex, life skills and much more. GYS offers a weekly back to country bush trip with elders to re-engage the youth with culture! GYS also coordinates the NT police youth diversion program and focuses on restorative justice to keep youth out of jail!

The cuts through the IAS will force the seven local staff out of work and the youth centre to shut its doors 30th June, 2015. The youth centre will not be in a position to contiue its worthwhile service delivery primarily because the $80k on offer from the federal government has no connection with the services that have been on offer for the past nine years.

This will see the 1500 youth in the community without a service and a safe place to be at night. The community of Maningrida is in disbelief at the governments decision to cut its only youth service and are concerned with the impact of not having a reliable youth service beyond June

Youth Manager Noeletta McKenzie said “If GYS is to close I am concerned about the impact on the community and the probable rise in youth suicides and crime rates”, “We as a team at GYS have worked extremely hard to overcome the youth gang mentality and extended our hands out to the youth to ensure that suicide is not a thought”!. “I feel that youth services across the board through the IAS have been overlooked”!. “We are creating strong young leaders and all youth services play a vital role in the early lives of youth, especially in our communities”!

GYS was a community driven project when Mr. Millren (Dec) wrote a letter to the government 10 years ago seeking support as the youth were out of control and had no future! GYS is Mr. Millren’s legacy and it is now under threat, the decision by the government in relation to IAS funding for Maningrida is regrettable and has disheartened the many people who have travelled the journey since the innception of youth services in 2005 and observed the positive change that the service has had on the youth of

 

Having trouble with your IAS application ?

CAcI0jAUcAEb2Fd

The Minister Nigel Scullion advises that hotline has been setup to deal with funding inquiries 1 800 088 323 

 

NACCHO Health News: Free flu vaccines for Aboriginal children thru Aboriginal Medical Services

 

SL

Indigenous children will benefit from the Federal Government’s free flu vaccine program for the first time this year as authorities brace for a virulent strain of flu heading for Australia.

The Government announced at the NACCHO parliamentary breakfast in Canberra yesterday that  it would extend its free flu program to the children to help reduce flu deaths among the vulnerable group.

2015-03-17 07.34.41-1

Health Minister Sussan Ley speaking at the NACCHO event said five Indigenous children died from the flu each year.

PHOTO ABOVE 1.Federal Health Minister Sussan Ley with Indigenous children receiving free flu vaccinations in Broken Hill, NSW last weekend 2.Making announcement with NACCHO Chair Matthew Cooke and CEO Lisa Briggs

Under the National Immunisation Program (NIP), essential vaccines – including seasonal influenza vaccinations – are provided free of charge to at-risk groups within the community.

When the 2015 influenza vaccine is available in April, parents of Aboriginal and Torres Strait Islander children aged between six months and five years will be able to get their children vaccinated for free through general practitioners, community controlled Aboriginal Medical Services and immunisation clinics.

Free influenza vaccines are also available to Aboriginal and Torres Strait Islander people aged 15 years and over, people aged 65 years and over, pregnant women and people over six months who have specific medical conditions that increase their susceptibility to influenza.

The NIP is a joint initiative between the Australian Government and state and territory governments.

For more information,

Contact the Immunise Australia information line on 1800 671 811

Extra information below by ABC NEWS medical reporter Sophie Scott and Alison Branley

“The key objective I believe of every Federal Health Minister when it comes to Indigenous health must be closing the gap in life expectancy and that starts in childhood,” Ms Ley said.

“It’s vital we include children under five in as many health initiatives as possible and flu vaccination is one of them.”

Indigenous children will be able to get a flu vaccine through their GP, Aboriginal Medical Services and immunisation clinics.

Health experts said Aboriginal and Torres Strait Islander children were twice as likely to be hospitalised from the flu as non-Indigenous children.

Free flu vaccines are already provided for vulnerable groups such as people aged over 65, pregnant women and people with a range of chronic conditions who are at increased risk from flu complications.

The announcement comes as Australian doctors predict a killer flu season.      

In the northern hemisphere, flu rates were high and a deadly strain called H3N2 saw thousands of elderly people hospitalised.

More than 100 children have died in the United States.

“The objective is to be prepared,” Ms Ley said.

“You must take the flu seriously. As a nation, we’ll wait and see what happens with this year’s flu and hope it isn’t as bad as it was in the northern hemisphere.”

Flu vaccination program delayed to improve formula

This year’s Australian public flu immunisation program has been delayed so the flu vaccine can be reformulated from 2014 to replace two strains.

Australian Technical Advisory Group on Immunisation chairman Dr Ross Andrews said the flu vaccine would include the same strain that caused the pandemic in 2009 and two new strains from the northern hemisphere.

“It’s been delayed because of new strains that have been added to the vaccine,” he said.

“There’s been a delay to make sure we’ve got sufficient supplies, so two suppliers providing the vaccine to make sure we’re covered.

“It was a bad year in the northern hemisphere, it was a reasonably bad year last year for us as a flu season.

“It was the worst year … since 2009 and it’s possible we might be heading again to another severe flu season.”

The vaccine will be available from GPs from April 20, he said.

The US Centres for Disease Control and Prevention reported flu hospitalisation rates for people aged over 65 were the highest in 2014 since flu tracking began in 2005.

Doctors have urged vulnerable patients to be vaccinated as soon as the new vaccine is available.

Data from the Influenza Specialist Group shows almost 2,500 Australians have already had the flu this year, with the majority of cases in Queensland.