NACCHO Media Release: Aboriginal health must remain the priority to close the gap

The peak Aboriginal health organisation today said Aboriginal health, commitment to programs that work, Aboriginal control and long-term funding were all necessary to close the ongoing gap between Aboriginal and other Australians.

The National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson Matthew Cooke said closing the gap was achievable.

“Closing the gap is about generational change and there are no quick fixes,” Mr Cooke said.

“Real gains, although small, are already being made in life expectancy and other key areas like maternal and child health.

“We need to see continued, long-term commitments from all levels of government in the programs that work. In health, it’s Aboriginal Community Controlled Health Services that are making the biggest inroads against the targets to close the gap.

“They are also contributing to other targets, such as in employment, as the largest employers of Aboriginal people.”

Mr Cooke said the Federal government’s focus on getting kids into school, adults into work and community safety, is welcomed, but cannot be achieved without a similar prioritisation of health issues.

“Put simply, sick kids can’t go to school, sick workers can’t work.

“Yet our health services continue to live with great uncertainty. The last funding allocation was for only twelve months and expires at the end of June this year. Without better funding certainty, we can’t provide certainty to our staff or to our patients.”

Mr Cooke said Aboriginal Community Controlled Health Services are the primary health care sector that delivers the best results for Aboriginal and Torres Strait Islander People but are the least funded.

“What we would like to see is a clever re-allocation of the Aboriginal health budget from mainstream services into community controlled health.

For example the government currently allocates Aboriginal health funding to Medicare Locals. We would like to see this redirected to our sector to ensure Aboriginal and Torres Strait Islander people continue to receive quality care during the transition to Primary Healthcare Networks.

“The Abbott Government supported establishment of the Closing the Gap targets while in opposition and must continue to honour these commitments in government if we are to meet the targets for overcoming Indigenous disadvantage by 2031.”

NACCHO welcomes new service to North West Queensland

Matt and Lizzie at Gidgee Normanton cropped

Pictured L to R: Matthew Cooke (Chair NACCHO), Elizabeth Adams (Chair QAIHC), Shaun Soloman (Chair Gidgee Healing) and Dallas Leon (CEO Gidgee Healing)

The peak Aboriginal health organisation today welcomed the opening of a new Aboriginal community controlled health centre in the community of Normanton in Queensland’s north west.

The National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson Matthew Cooke attended the opening and said the new Recovery and Community Wellbeing Centre was key to providing improved health services to Aboriginal people in the lower Gulf.

The new centre is a federally funded initiative which is operated by Gidgee Healing, an Aboriginal Medical Service, and The Salvation Army.

“Getting appropriate health and wellbeing services into remote parts of Australia is a huge challenge,” Mr Cooke said.

“It’s difficult for remote communities to get the quality health care they need.

“This centre will go a long way to helping many Aboriginal people get on the road to good health.”

Recovery and Wellbeing Centre Normanton cropped

Mr Cooke said the new Normanton Recovery and Community Wellbeing Service would be run by Aboriginal people for Aboriginal people.

“The population of Normanton and surrounding areas is overwhelmingly Aboriginal and they need access to culturally-appropriate health care.

“Having local people involved in this centre will be key to it’s success in attracting clients and improving the health of the community. It also has the potential to boost employment and training opportunities for local residents.

“This is a significant addition to the Gulf and we congratulate all involved in making it a reality.”

NACCHO Health Summit 2015: Call for Abstracts

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The 2015 NACCHO Health Summit will be held in the Gold Coast from the 16th to the 18th of June 2015. 

NACCHO invites abstracts submission from its members the Aboriginal Community Controlled Health Organisations, Affiliates and key stakeholder organisations to showcase policy frameworks, best practice and investment in Aboriginal Health. The delegates will be a representation from all over Australia in clinical practice, policy and research.

Learn more at: http://www.naccho.org.au/events/2015-naccho-summit/#sthash.hOruDVPa.dpuf

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Important Dates

  • Call for Abstracts Open – 2nd February
  • All Abstracts Due – 6th March 2015
  • Abstract Notifications – 6th April 2015
  • Early Bird Registration Open – 20th February 2015
  • Early Bird Registration Closes – 17th April 2015
  • Program Released – 6th April 2015
  • Summit Commences – 16th June 2015

NACCHO Media Release: Aboriginal community controlled health services are the key to reducing Hep C rates

22 January 2015

Aboriginal community controlled health services are the key to reducing Hep C rates

The peak Aboriginal health organisation will today tell a Senate inquiry today that more must be done to reduce the high rate of Hepatitis C infection among Aboriginal people.

National Aboriginal Community Controlled Health Organisation (NACCHO) CEO Lisa Briggs said the rate of new Hepatitis C infection continues to rise in Aboriginal populations even though it is falling for other Australians, and that Aboriginal Community Controlled Health Services are the are key to reducing infection rates.

“Mainstream services are clearly failing Aboriginal people, who are three times as likely to become infected with Hepatitis C as other Australians,” said Ms Briggs.

“It is clear that more prevention and treatment programs are needed that meet the needs of Aboriginal people,” said Ms Briggs.

She said the main contributors to the increased rate of infection for Aboriginal people are higher rates of unsafe injecting drug use and higher rates of incarceration, with the prevalence of the disease in prisoners who inject drugs above 50%.

“Aboriginal Community Controlled Health Services should play a bigger role in Hepatitis C prevention and treatment programs because they have proven to be the most effective providers of primary health care to Aboriginal people.

“These services need the funds and resources so they can provide prevention programs including needle exchange programs and opiate replacement therapy.

“A commitment to more outreach programs by Aboriginal Community Controlled Health Services into prisons will also help with infection rates in these populations.

“Hepatitis C rarely occurs in isolation.  Many patients are likely to have multiple health issues including mental illness, drug and alcohol addiction and type two diabetes. Aboriginal Community Controlled Health Services have proven time and time again to be the best model to provide comprehensive primary health care for these complex needs.

“Hepatitis C infections are decreasing among other Australians and we want to see them decreasing among Aboriginal people, too.

“We look forward to working with the Government to ensure our Aboriginal medical services have the funds and resources to make this happen.”

Aboriginal health services concerned about lack of transparency in GP co-payment discussions

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Aboriginal health services today called on the Federal Government to consult more widely on the impact of the GP co-payment before it is put to the Senate.

The National Aboriginal Community Controlled Health Organisation (NACCHO) Deputy Chairperson Matthew Cooke said the dealing apparently going on behind closed doors without input from the Aboriginal health sector was cause for concern.

“The fact is, the introduction of a GP co-payment is poor health policy for all Australians,” Mr Cooke said.

“Abolishing free universal health care will introduce a dangerous disincentive for people to seek the medical attention they need until their health conditions are advanced and need more invasive and costly attention.

“When applied to Aboriginal health its impact is likely to be magnified.

“We have made some gains in improving the health of Aboriginal people but we still have a long way to go to close the appalling health gap between Aboriginal and other Australians.

“We need our pregnant women to attend check ups, we need our children to be immunized, we need our young men to have access to mental health services.

“We simply can’t put any barriers in the way of Aboriginal people seeking health care or we risk the gains we are making in Aboriginal health. The GP co-payment is a significant barrier.”

Mr Cooke said speculation about exemptions from the GP co-payment for particular groups would only go part of the way to addressing the issues.

“Although we applaud the AMA’s efforts to work with the Federal Government to resolve the impact of a GP co-payment on vulnerable Australians, an exemption for Aboriginal Medical Services is not the silver bullet.

“The majority of our Services would have waived the co-payment for their patients, which would effectively have meant a cut in their funding, so in this regard it would be of benefit for our Services.”

“However, many Aboriginal people do not have access to Aboriginal Community Controlled Health Services because of where they live.

“There are 150 Aboriginal Community Controlled Health Services across Australia, providing primary health care to over half Australia’s Aboriginal population.

“But we don’t have national coverage so that would leave a lot of Aboriginal people using mainstream services still subject to the GP co-payment.”

Mr Cooke said he was also concerned about the additional pressures on Aboriginal Community Controlled Health Services if the exemption only applied to these Services.

“Demand for our Services is growing at a rate of about six per cent a year. Aboriginal people are already travelling large distances to seek out our Services as they prefer to be treated by someone who understands their culture and community.

“The co-payment exemption is likely to increase demand even further and would be a challenge for our Services to manage within their existing budgets and resources.”

COAG Reform Council speech NACCHO Summit: Health outcomes for Indigenous people

 

John Brumby

Indigenous Australians should enjoy the same health, education and employment outcomes as other Australians. But, instead there remains a persistent and terrible gap between the two in major areas.

Closing the gap between Indigenous and non-Indigenous Australians is a priority for all Australian governments. But closing the gap is a long-term challenge—one which requires enduring vigilance and resources”

John Brumby Chair NACCHO reform Council Speaking at the NACCHO SUMMIT

I would like to begin by acknowledging the traditional owners and custodians of the land on which we meet today, the Wurundjeri people of the Kulin nation. I pay my respects to their Elders both past and present.

It is my pleasure to be with you today to report on national progress in indigenous health.

As you know, the COAG Reform Council was established by COAG in 2006 to report on Australia’s national reform progress.

Our job is to hold all nine Australian governments accountable for implementing national reforms that began rolling out in 2008.

Importantly, we publicly report our findings to the Australian people.

In 2008, COAG agreed to goals on healthcare, education, skills and workforce development, disability, housing and closing the gap on Indigenous disadvantage.

That was six years ago.

Today I will be launching a supplement that focuses on the health outcomes for Indigenous people. The supplement draws on the findings we have made in two reports that we provide to the Council of Australian Governments (COAG) each year – the National Healthcare Agreement and the National Indigenous Reform Agreement.

DOWNLOAD HERE

Indigenous Australians should enjoy the same health, education and employment outcomes as other Australians. But, instead there remains a persistent and terrible gap between the two in major areas.

Closing the gap between Indigenous and non-Indigenous Australians is a priority for all Australian governments. But closing the gap is a long-term challenge—one which requires enduring vigilance and resources.

The Genesis of Closing the Gap

The genesis of the closing the gap campaign was a report in 2005 by Dr Tom Calma, the then Aboriginal and Torres Strait Islander Social Justice Commissioner.

The report called on the governments of Australia to commit to achieving health equality for Indigenous people within a generation.

This report sparked the National Indigenous Health Equality Campaign in 2006 that culminated in a formal launch of the close the gap campaign in Sydney in April 2007, where NACCHO was a leading voice calling for action.

NACCHO’s very name—National Aboriginal Community Controlled Health Organisation—reflects the campaign for self-determination … the wish of Indigenous Australians to have their own representative bodies.

On 20 December 2007, the Council of Australian Governments answered the call of NACCHO, ANTAR, Oxfam Australia and many other organisations and pledged to close the life expectancy gap between Indigenous and other Australians within a generation.

In March 2008, the Indigenous Health Equality Summit released a statement of intent which committed the Australian government, among other things, to achieve equality of health status and life expectancy between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians by 2030.

NACCHO was a signatory to that statement. The parties also agreed to use benchmarks and targets to measure, monitor and report.

COAG & Closing the Gap

In November 2008, our nation’s leaders committed to closing the gap within a generation (25 years) in the National Indigenous Reform Agreement (NIRA).

Importantly, COAG agreed to be accountable for closing these gaps and appointed the COAG Reform Council to monitor progress.

As you well know, COAG has six targets as part of its objective of closing the gap.

  1. To close the life expectancy gap within a generation, by 2031.
  2. To halve the gap in mortality rates for Indigenous children under five within a decade, by 2018.
  3. To provide access to early childhood education for all Indigenous four-year olds in remote communities within five years, by 2013.
  4. To halve the gap in reading, writing and numeracy within a decade, by 2018.
  5. To halve the gap in the rate of Year 12 or equivalent attainment, by 2020.
  6. And, finally, to halve the gap in employment outcomes within a decade by 2018.

For the past five years, the COAG Reform Council has dissected the data, measured progress and independently reported on whether Australian governments are achieving these targets in both our NIRA report and our report under the National Healthcare Agreement.

Indigenous Supplement to Healthcare in Australia 2012–13

What we have found under the NIRA report, the National Healthcare agreement and the supplement I am releasing today is that the health of Indigenous Australians continues to be poorer than non-Indigenous Australians.

We found that Indigenous life expectancy at birth was 69.1 years for men and 73.7 years for women. This equates to a gap between Indigenous and non-Indigenous life expectancy of 10.6 years for men and 9.5 years for women.

Although the national gap in life expectancy did slightly narrow over the last five years, it is extremely unlikely that governments will be able meet the target to close the life expectancy gap within a generation (that is, by 2031).

The life expectancy gap and potentially avoidable death

Closing the gap on life expectancy is complex and requires action on a range of fronts.

We report on a range of indicators and targets about many things that may help to achieve improvements in Indigenous health. These include indicators relating to preventative health, primary care, hospitals and the medical workforce.

I would like to focus today on the results we have found in regards to death from potentially avoidable causes – either through prevention, or through early intervention via primary or community care.

In regards to deaths from potentially avoidable causes – we measure according to whether they could have been potentially prevented or potentially treated.

Deaths from potentially preventable causes are avoidable through primary healthcare (such as the care provided by a GP or community care), health promotion (such as by improving healthy habits and behaviours) and preventative health (such as vaccination against some diseases or help to quit smoking).

Deaths from potentially treatable causes are avoidable through appropriate therapeutic interventions, such as surgery or medication, before a condition worsens. This is often the case where diseases are prevented early, such as through screening programs.

What we found was that Indigenous people were three times as likely to die of an avoidable cause. This means that three-quarters of deaths of Indigenous people aged under 75 were avoidable either through early prevention or treatment.

By way of comparison, two-thirds of all Australians died from avoidable causes.

It is a tragedy to think of all of those taken before their time purely because they did not receive care early enough, or did not make the lifestyle changes to prevent disease.

Early intervention is vital

This finding underlines two things that NACCHO well knows if we are to close this terrible gap in life expectancy:

  1. Good access to primary or community care is vital.
  2. Prevention is better than cure.

There have been large increases in the rates of indigenous people having health checks claimable from Medicare over time, and this was true of all age groups.

The rate of child health checks has more than doubled, from 87.9 per 1000 in 2009-10 to 193.0 per 1000 in 2012-13. This is an average annual increase of 35.7 checks per 1000 children aged 0 to 14 years.

In the 15-54 years age group, the rate of health checks more than doubled from 74.5 per 1000 in 2009-10 to 196.0 per 1000 in 2012-13. This equated to an average annual increase of 40.3 checks per 1000 people.

In the 55 years or over age group, the rate of health checks more than doubled from 137.5 checks per 1000 people in 2009-10 to 304.6 per 1000 indigenous people in 2012-13. This equates to an annual average increase of 54.8 checks per 100 people from 2009-10 to 2012-13.

In child health we have also seen some pleasing improvement.

The rate of Indigenous child deaths decreased by 35% to 164.7 deaths per 100,000 Indigenous children compared to 77.2 per 100,000 for non-Indigenous children, and death rates are falling more quickly.

This means that the gap in the child death rate between Indigenous and non-Indigenous children decreased by 38% from 1998 to 2012, and we are on track to reach the current 2018 target.

This is a resounding achievement and is partly due to increases in immunisation rates and health checks:

  • In 2012, immunisation rates for Indigenous children aged 2 years and 5 years were the same as for all children. However, rates at 1 year still lag behind.
  • And, the rate of child (0–14 years) health checks doubled between 2009–10 and 2012–13

These results in access to immunisation and health checks are very positive and reflect the hard work and what can be achieved when governments and community stakeholders, such as NACCHO and others work together.

We should ensure that these gains are not undone.

As you know, the cost of healthcare is very topical at the moment. Australians are being asked to consider what they would pay for access to a primary care physician.

What we found in our results for this report was that one in eight (12%) indigenous people already delayed or did not go to a GP as a result of cost. More than two out of five (43.9%) Indigenous people delayed or did not see a dental professional due to cost. And one-third (34.6%) delayed or did not fill a prescription also due to cost.

When people start to avoid going to their primary or community care provider because of cost or other reasons, they often end up in hospital.

And, what we found was that rates of potentially preventable hospitalisations for Indigenous people were already three to four times higher than rates for other Australians.

These results provide context for governments when they are considering policies around access to primary care. Governments should be careful that they do not put up barriers to healthcare access for Indigenous people as it may undo the good work that has been done in this space over five years and end up creating a different burden on the hospital system.

Prevention is better than cure

The other component that we will need focus on to close the gap in life expectancy is prevention – particularly prevention of circulatory diseases, endocrine disorders (like diabetes) and some cancers.

The results we found this year show significantly more work needs to be done.

The heart attack rate for Indigenous people in 2011 was two and a half times higher than that of other people.

And Indigenous Australians are more than five times more likely to die of endocrine diseases (like diabetes), and one and a half times as likely to die from a circulatory disease or cancer.

One of the primary drivers in rates of heart attacks and endocrine disorders are rates of excess body weight.

Around 70% of adult Indigenous Australians have excess body weight, meaning that they are either overweight or obese. The rate of obesity by itself was 42%.

This compares poorly to the broader Australian population, where 63% of all adults had excess body weight and 27% were obese.

This high rate is extremely concerning. Particularly when you consider the increased risks it poses for chronic diseases and early death.

Finally, I would like to turn to lung cancer. In 2010, the rates of lung cancer for Indigenous Australians was nearly double the rate for non-Indigenous Australians.

What is most tragic about lung cancer is how preventable it is. Lung cancer is very strongly linked with whether or not a person smokes. We found that the Indigenous adult smoking rate is more than double the non-Indigenous rate (41.1% vs 16.0%).

So, that is a brief summary of the health report.

Without a doubt, the results are still not good enough to close the gap in many of the health outcomes for indigenous people.

We continue to have too many Indigenous people dying before their time, of preventable diseases and conditions.

However, there are green shoots; we have seen increases in access to primary care, and most pleasingly we are on track to close the gap in child deaths.

The social determinants of health

I think it is important to recognise that these health outcomes will also be critically determined by non-health factors, what’s referred to as the ‘social determinants of health.’ The recognition of these social determinants has, in the words of the National Rural Health Alliance, become a ‘rejuvenated agenda.’

Our working conditions — whether that be our incomes, job stability, or workplace safety — and factors like education and housing among many others, each make meaningful contributions to our health.

To draw on the words of Dr Margaret Chan, the Director General of the World Health Organisation:

‘…the social conditions in which people are born, live, and work are the single most important determinant of good health or ill health, of a long and productive life, or a short and miserable one.’

So, I would also like to discuss some results from our latest National Indigenous Reform Agreement report with you – particularly the results from education and employment.

We launched our latest NIRA report on government’s achievement against these targets in May.

We found that in literacy, numeracy and year 12 education, outcomes for Indigenous Australians are catching up with those of non-Indigenous Australians.

Between 2008 and 2013, the gap in the proportion of Indigenous and non-Indigenous students who met the national minimum standard narrowed in reading in all years and in Years 3 and 5 in numeracy.

In reading, the gap reduced most, by over 10 percentage points in Years 3 and 5. There were smaller reductions in Years 7 and 9 (1 to 3 percentage points).

In numeracy, the gap narrowed by 2 to 3 percentage points in Years 3 and 5 but widened in Year 9 by 4 percentage points. The gap widened in Year 7 by less than 1%.

The gap in the proportion of Indigenous and non-Indigenous 20–24 year olds who attained Year 12 or equivalent decreased significantly—by 12.2 percentage points .

And, over the past four years, the proportion of Indigenous Australians with or working towards a post school qualification increased from 33.1% to 42.3 %.

More work needed on childhood education, school attendance and employment

While most of this is heartening, our report also found that better results are needed in early childhood education, school attendance and in employment to meet COAG targets.

Early childhood education is a critical time for development as a successful learner. In 2012, 88% of Indigenous children in remote communities were enrolled in a preschool program in the year before school compared to 70% in major cities.

Similarly, 77% of children in remote areas attended a preschool program compared to 67% in major cities.

Another area of real concern we highlight is the falling rate of school attendance by Indigenous students in most year levels.

It’s very disappointing that—over four years—falls in Indigenous students’ attendance have outstripped any improvements made.

The worst drops in attendance were in South Australia the ACT and the Northern Territory, where attendance fell as much as 14 percentage points.

Only New South Wales and Victoria saw attendance rates improve and the gap narrow overall but even so, improvements were small —1 percentage point for most year levels.

Regular school attendance is vital for developing core skills in literacy and numeracy, and for successfully completing secondary education.

A slump in school attendance rates in all jurisdictions in the later years of compulsory schooling is particularly concerning given its potential to impact long-term economic participation.

Which leads me to employment – Australia is not on track to halve the gap in employment outcomes by 2018.

Since 2008, the gap between Indigenous and non-Indigenous employment outcomes has widened over the past five years by almost seven percentage points.

To give you some examples, we found just over 60% of Indigenous Australians were participating in the labour force, compared to almost 80% of non-Indigenous Australians.

And the overall unemployment rate for Indigenous Australians was four times that of non-Indigenous Australians—almost 22% compared to 5%.

Lower Indigenous employment and workforce participation has an impact right across the reform agenda, and must be prioritised for attention by COAG.

We, at the council, are pleased to see some positive outcomes under the Indigenous Reform Agreement, but are wary that there is still hard work and monitoring to be done in key areas.

Performance reporting matters

As you may be aware, the COAG Reform Council is being wound up on June 30, so we will no longer be reporting on these outcomes in the future.

In response to the news of the COAG Reform Council being abolished, Mick Gooda said:

“If we don’t have decisions made on the basis of the best evidence that we have available to us, we might as well be just making up things on the back of beer coasters again.”

The reports we release on Indigenous outcomes have not only enabled governments to monitor their performance. They have also equipped the public, and organisations such as NACCHO and the other peak bodies that are here today, with the information they need to hold governments to account for promises they have made in regards to Indigenous Australians.

Our reporting has provided the impetus for more focused effort to improve Indigenous health, education and economic participation and has highlighted important progress – reassuring governments and the community that change is indeed possible.

And after five years of reporting on governments’ performance, our reports have shown that we are still only at the beginning of the change required over a generation to close the gap.

I’ve been fortunate in my public life to have served in both federal and state parliaments, in opposition and in government.

And after all these years, I can honestly say that accountability—keeping governments honest—and evidence-based reform are not simply important ingredients  – they are absolutely essential to getting results and keeping governments on track.

Although we do not know for sure who will be reporting on the targets to close the gap in the future, it has been suggested that the Prime Minister’s department will report on achievement of targets.

I have a great deal of respect for the Department of Prime Minister & Cabinet and I’m sure there are people with the skills to do that in PM&C.

However, what the COAG Reform Council did that was particularly special was hold governments to account on the promises they have made, but did so independently of any one government.

We report independently on the progress of all nine of Australia’s governments—the Commonwealth, the States and the Territories—in closing the gap.

That independence ensured that our reporting was impartial and objective.

Who will do this in the future?

We need to consider how to increase the effectiveness of our independent public reporting on government progress, such as improving the quality of indicators, and accessing better data.

It is important in the future that someone, or some organisation, will be there to properly measure what governments are achieving with the billions of dollars in taxpayers’ money they are spending.

Crucially, it is important that any future design of performance reporting frameworks and targets must involve indigenous stakeholders as equal partners.

Consultation with governments is required under the IGA. It should extend to key Indigenous stakeholders such as the Closing the Gap coalition.

With a tri-lateral coalition of the Commonwealth, State governments, and Indigenous representatives – we truly have a real chance of closing the gap.

So, in my last week as chairman of the COAG Reform Council, allow me to pay tribute to the work of NACCHO and extend my best wishes for the future of Indigenous health reform.

Your voice matters and I know it will shape a better future for Indigenous Australians. Thank you.

Media enquiries

All media enquiries can be directed to:

Julia Johnston
Phone: 02 8229 7368
Mobile: 0419 346 890
julia.johnston@coagreformcouncil.gov.au

Aboriginal Health Summit: ongoing investment needed to close the gap

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Successes in improving the health of Aboriginal people, to be showcased over the next three days at an Aboriginal health summit in Melbourne, will highlight the importance of ongoing investment in Aboriginal Community Controlled Health Services and programs.

Justin Mohamed, Chair of the National Aboriginal Community Controlled Health Organisation (NACCHO) said the 2014 NACCHO Health Summit will feature innovative and creative approaches to Aboriginal health, driven by Aboriginal people, which are achieving results.

“The Federal Budget has taken a huge chunk of funding out of Aboriginal health programs,” Mr Mohamed said.
“Given the incredible work being done by our sector to improve the lives of Aboriginal and Torres Strait Islander people, through prevention, early detection and health promotion, it simply doesn’t make economic sense to cut front line Aboriginal health programs.
“We still have a long way to go close the huge gap in life expectancy between Aboriginal and other Australians but we are on the right track to reaching our targets by 2031.
“It’s critical we maintain the momentum and continue to give Aboriginal people control over their own health – funding programs run by Aboriginal people – since that is where we will have the biggest effect.”
Mr Mohamed said some of the examples which will be shared at the 2014 NACCHO Health Summit include:
• The Victorian Aboriginal Health Services Healthy Lifestyles and Tackling Tobacco Team has implemented a range of different health promotion strategies to engage members of the community from children to elders in physical activity, quit and healthy lifestyles programs. Successful initiatives over the last 12 months include: fun runs, yoga, hypnotherapy, social marketing, a comedy show and more recently the VAHS Tram taking the Australian public along for the ride.
• Wuchopperen Health Service ‘Community Controlled Health Services have to prove their value contribution in an increasingly competitive landscape. Wuchopperen has survived three decades of funding uncertainty. Wuchopperen has enacted a multi-faceted strategy to ensure long term sustainability and self-determination – with self-sufficiency a possible endpoint within a decade. Leveraging MBS income streams Wuchopperen has facilitated an increase in staff numbers from 135 to 180 over three years, maintaining a proportion of 80 per cent Aboriginal and Torres Strait Islander Staff. All funds generated have been reinvested into further services to the community, including expanded allied health services and optometric care facilitating on-site eye-testing and dispensing of spectacles.’
• ABS presentation (funded by ABS/ Dept of Health/ National Heart Foundation) ‘The 2012-2013 Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) is the largest and most comprehensive survey of the Aboriginal and Torres Strait Islander community ever undertaken. This survey provides a platform for a range of new research into health determinants and patters, supporting assessment of of progress in closing the gap in health outcomes.’
• Walgett AMS Accreditation Experience, Fifteen Years and Still Going Strong ‘In 1987 the CEO and Board of WAMS became concerned about changes to AMS funding conditions. In order to prepare for the possibility WAMS investigated agencies which accredited health services. In 2013 WAMS gained it’s fifth round of accreditation and in 2014 will work to bring it’s Dental Clinic into the process. Accreditation assists in improving client services and also enables the service to stand as equals with other Health Services and Medicare Locals’.
• John Patterson AMSANT CQI ‘The life expectancy gap between Aboriginal and other Australians in the NT is the widest in the nation, but it is also closing at the fastest rate. NT is the only jurisdiction on track to close the life expectancy gap by 2031. AMSANT believe that the implementation of the CQI programs has been pivotal to improving the Aboriginal PHC contribution to closing the gap.’
Mr Mohamed said “The summit will be the Centre of Excellence in Aboriginal Community Controlled Health and the best demonstration of Aboriginal Health in Aboriginal Hands.”
Media contacts: Olivia Greentree 0439 411 774 / Jane Garcia 0434 489 533

Fears Tony Abbott will widen Indigenous health gap

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THE deputy chairman of Tony Abbott’s indigenous advisory council, doctor Ngiare Brown, has denounced budget cuts to indigenous affairs and says the $7 GP co-payment will hurt indigenous people and other vulnerable Australians who desperately need help to close the health gap.

Professor Brown will use next week’s meeting of the council to warn that the cuts to indigenous health will inevitably affect frontline services.

She told The Australian she would use her role on the council to push for reconsideration of the co-payment scheme and exemptions for vulnerable Australians and indigenous people based on income and burden of disease.

On overall cuts to the indigenous budget, she said she was determined to get detailed answers on where the cuts would come from and what they would affect.

“There have been anticipated cuts across the board for each portfolio and department,” Professor Brown said. “But what is most concerning is that there is talk about cuts to essential portfolios like health and education but currently there is no clarity on what this means.

“The Coalition claim they want to cut red tape, duplication and the bureaucracy, for example, but I’m concerned there are actually going to be cuts to frontline services, which we were promised would absolutely not be the case”.

On the cuts to preventative programs such as indigenous smoking campaigns, Professor Brown, one of the first group of Aboriginal medical graduates in Australia, said she considered this a frontline service.

“Public health and … prevention are absolutely frontline services, particularly in comprehensive primary care contexts like Aboriginal and Torres Strait Islander health,” she said. “So whether they are specific smoking programs or whether they are brief interventions delivered by our health workers, nurses and general practitioners, public health prevention programs are absolutely frontline services.

“How will departments define what a frontline service is, and then how will they make consistent determinations about what gets funded and what doesn’t.”

Indigenous Affairs Minister Nigel Scullion has vowed that the $239 million being cut from the general indigenous affairs budget will be achieved through “efficiencies” and less red tape and duplication — and not reductions to frontline services.

But with an additional $165m being cut from indigenous health, peak indigenous lobby groups fear that efforts to close the gap are being compromised.

Warren Mundine, chairman of the Prime Minister’s indigenous council, has said the Coalition originally intended to cut the portfolio’s budget by 10 per cent. The eventual 4.5 per cent cut announced in last week’s budget would come from ‘inefficiencies”, not frontline services, he said.

Professor Brown, who was previously the Australian Medical Association’s indigenous health adviser, said she was also concerned that the impact of the GP co-payment on indigenous people and closing the gap had not been taken into consideration.

“I don’t think there has been consideration of any kind for the financial, economic or social impacts or the intended and unintended consequences of co-payments,” she said. “Obviously the most vulnerable are going to be the ones that are hit the hardest: the young, the old and those with chronic diseases in particular. People needing multiple visits over long periods to manage their chronic disease or palliative care or children with special needs or disabilities for example — how are they going to afford multiple consultations at $7 a pop?

“One of my greatest concerns is not only that the most vulnerable will bear the brunt of a poorly conceived co-payment initiative, but that the health care system will not cope.

“The policy makers need to think very carefully about whether to go ahead with the co-payment and if they do, who will pay and who will have exemptions.

“It is already difficult enough for the Aboriginal community-controlled health sector to provide comprehensive care on the limited resources that we have. If you couple charging co-payments, which we may or may not collect, and getting less money in to the sector for public health and clinical care, then that is an extraordinary additional burden bear, particularly when we were promised that there would be no cuts to the frontline in health and education.”

Call out for Health Heroes!

healthheroes
The Department of Health are looking for ‘Health Heroes’ and are sending a call out to health professionals and students who would like to come down to the Careers Expos listed below to be a speaker and assist in promoting careers within indigenous health.

If you or know someone who would be interested in attending to be a speaker please contact

Jessica Lowe on 02 8354 0866     E: jessica.lowe@alltheperks.com.au

Further information available at : http://australia.gov.au/healthheroes

 

Dates & Locations

Brisbane, Convention and Exhibition Centre – 23 May between 9 and 3:30pm and 24 May 2014 between 10am and 4pm

Sydney, Moore Park – 29 May – 1 June between 10am and 3pm

Sydney, Olympic Park – 19 – 22 June between 9am and 3pm

Darwin, Convention Centre – 13 and 14 August times TBC

Alice Springs, Convention Centre – 21 and 22 August times TBC

 

Further information available at : http://australia.gov.au/healthheroes

NACCHO Aboriginal Health #IHmayday : Funding system for Aboriginal health in dire need of reform

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” The limited evidence available suggests that Aboriginal Community Controlled Health Services (ACCHS) outperforms mainstream services in terms of monitoring of risk factors, management of hypertension and implementation of systematic care for prevention and chronic disease.

Further, in terms of the broader government agenda of the Abbott government, ACCHS services are one of the largest employers of Aboriginal people in Australia, with clear benefits in terms of skill development, and a significant factor for regional development.”

Ian Ring is a professorial fellow at the Australian Health Services Research Institute at the University of Wollongong

 Published 23  April 2014 Canberra Times Illustration: Andrew Dyson

Declaring a Twitter MAY day (May 1) of action – and listening – for Aboriginal and Torres Strait Islander health

#IHmayday (see below for details)

There have been many significant developments in Aboriginal and Torres Strait island health in Australia in recent years, and perhaps the most significant has been the national Close the Gap initiative. A total of $1.6 billion has been directed to Aboriginal health in the four years ending June 2013, as part of a broader suite of initiatives also including employment, housing, education and remote services.

Progress however, as reported earlier in the year by Prime Minister Tony Abbott, has been patchy, and a new report, Economic Value of Aboriginal Community Controlled Health Services, launched recently at the National Press Club, highlights several funding issues that need urgent attention. Who would have thought that while funding for health services for Australians as a whole was uncapped and growing, funding for specific health services for Aboriginal people had been cut by the previous government in 2012-13, and was projected to fall further in real terms in the next four years?

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How do you “Close the Gap” by reducing funding for those with the worst health, while funding for the comparatively well-resourced majority of the population continues to increase with rising demand?

It turns out that funding for Aboriginal health services as a whole, almost uniquely among government programs, bears no relation to population size, the growth in the population, service demand or inflation

Worse, funding among states seems to have been driven largely by bid-driven processes, rather than any rational basis in terms of population size or health need, and on the face of it appears to be grossly inequitable – particularly for the majority of indigenous people who live in NSW and Queensland. Perhaps of even greater significance is the lack of any formal process for assessing which individual regions have poor indigenous health outcomes and a relative lack of services.

In short, the present funding system for indigenous health might be seen as somewhat amateurish and counterproductive in terms of closing the gap. This is not the fault of the administration, as the funding system seems to have been that way more or less from the start. But the administration has the opportunity, and the responsibility, to put the system on a rational basis – and in so doing, would reap big gains in terms of best use of public funds and in achieving the Close the Gap goals.

But why invest in specific services for Aboriginal people? Surely the mainstream services provided for the rest of the population would suffice?

Well, manifestly not. If they did, there would be no need for the Close the Gap initiative in the first place and indigenous health would be far better than it is. It is unrealistic to expect that mainstream treatment and preventative services for the rest of the population could deal adequately with the needs of a very small minority with particular health and cultural needs. Most GPs see no Aboriginal patients or, at most, a handful each year, whereas services designed by and for Aboriginal people promote better access to services and offer a much more comprehensive range of services for them, tailored specifically to their needs.

And the limited evidence available suggests that Aboriginal Community Controlled Health Services (ACCHS) outperforms mainstream services in terms of monitoring of risk factors, management of hypertension and implementation of systematic care for prevention and chronic disease.

Further, in terms of the broader government agenda of the Abbott government, ACCHS services are one of the largest employers of Aboriginal people in Australia, with clear benefits in terms of skill development, and a significant factor for regional development.

The report calls for fundamental reform of the funding mechanisms for Aboriginal health services so that in future funding is indexed to the size of the indigenous population, inflation, and demand for services. It wants funding in under-resourced states and territories to be brought up to an equitable level (but not by reducing funding to those states with more adequate funding), and for funding to be made available to provide the necessary services in areas which now have poor health outcomes and inadequate services. And of course, it is untenable national policy to cut funds for ACCHS services when such services produce the best results, are preferred by many Aboriginal people, provide a significant proportion of health services for them, but are now inadequately funded and poorly distributed.

There is nothing remarkable in these recommendations, which are long overdue, but addressing them would pay real dividends in terms of closing the gap and in terms of the broader government agendas of employment, education and regional development for Australia’s indigenous people.

 

Declaring a Twitter day of action – and listening – for Aboriginal and Torres Strait Islander health

The Twitterverse is an endless source of news and conversations about Aboriginal and Torres Strait Islander health.

In recognition of the vibrancy of the Indigenous health Twittersphere, Croakey is supporting an idea to declare May 1 as a day of Twitter action for Indigenous health.

The idea is the brainchild of Dr Lynore Geia, a Bwgcolman woman and nursing academic from James Cook University in Townsville and a former guest tweeter for @WePublicHealth. 

Dr Geia invites Croakey readers to follow the discussion at  #IHMayDay on May 1 – a timely event given widespread concern about expected federal budget cutbacks and funding uncertainty for Aboriginal Community Controlled Health Organisations.

It will be a day for Aboriginal and Torres Strait Islander people to tweet about health issues – whether they are patients, community members, students, health professionals, researchers, working in NGOs or government or elsewhere.

Thanks to Professor Marc Tennant from the University of Western Australia for suggesting that it also be a day of listening –  the idea being that non-Indigenous Australians can join in by listening and RT-ing.

Moderators

The discussions will be moderated around general themes during the day. These arrangements are still being confirmed but at this stage include:

• Journalist Amy McGuire will focus discussions on media coverage and health.

• Social worker Dameyon Bonson will guide discussions about the portrayal of Indigenous men in health/human service provision promotional materials, and the lack of positive/empowering imagery. Also, how “behavioural change” programs contribute to negative stereotype and assumptions, and how promoting programs as “behavioural enhancement” is more strengths based.  He will also talk about the Indigenous LGBQTI community.

(If you are interested in moderating some of the day’s discussions, please get in touch. Details of other moderators will be added here as they are confirmed…)

Thanks to Dr Geia for kicking off some of the discussions by previewing below some of the issues that she’d also like to see discussed:

• What have been the health impacts of the 2007 NTER/ Intervention? Has it led to any health gains – and what have been the social costs?

• Since the election of the Newman and Abbott governments, there has been upheaval and uncertainty in Indigenous health. The real gap in Indigenous health is the gap between the governments’ rhetoric about wanting to build Aboriginal health – versus the national Indigenous health discourse and the reality of on the ground service delivery.

• Models of care and service delivery are still being developed without genuine transparency and partnerships in communities.

• Health care services need to do so much more work around cultural competency, and governments need to recognise health outcomes in communities strongly related community control and delivered services;

• The proposed amendments to the RDA and the Constitution seems incongruent to closing the gap in health. The importance of tackling racism – and retaining the RDA – for improving health and wellbeing.

• Defining what health is using NACCHO definition – http://www.naccho.org.au/aboriginal-health/definitions/

• The Australian Indigenous population profile is opposite to the aging Australian mainstream population – health programs to meet the needs of Indigenous youth are paramount.

• Cyclone Ita highlighted that lack of road infrastructure is an issue for Indigenous communities like Wudjal Wudjal and Hopevale