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

New Microsoft Publisher Document (3)

Follow the AMA Media on Twitter: http://twitter.com/ama_media Follow the AMA President on Twitter: http://twitter.com/amapresident Follow Australian Medicine on Twitter:  https://twitter.com/amaausmed Like the AMA on Facebook https://www.facebook.com/AustralianMedicalAssociation

 

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.

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

Slide1

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

Abstract-2015-2-1024x736

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

Print

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

summit-2014-banner

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