NACCHO 2013 budget alert: Aboriginal health spending: Where does the money go?

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NACCHO’s chairman Justin Mohamed is concerned state governments are waiting until tonights Budget announcement before making a call on Indigenous health funding.

“I would say at this stage, we haven’t had the confirmed numbers, and we do need every state and territory to come and recommit to closing the gap with their funding, to ensure the whole of Australia – every single Aboriginal and Torres Strait Islander person can have life expectancy similar to non-Aboriginal and Torres Strait Islander people.”

Source SBS

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With an election looming, the future of the government’s Closing the Gap policies remain uncertain. (AAP)

Building a clear picture of how the government spends money on Indigenous-specific programs is a problem so complex even seasoned economists struggle with it.
Part of the problem, as health researchers Dr Lesley Russell and Sebastian Rosenberg note in detail here, is the split in funding, delivery and administration between state and federal governments across more than 100 different initiatives.

There is also the question of funding announcements, which tend to dribble out throughout the year rather than forming a part of the federal budget.

Economist Jon Altman says he doesn’t expect to see “anything new” for Indigenous Australia in Wayne Swan’s budget announcement tomorrow.

“They’ve more or less fired all their fiscal bullets as far as  Indigenous Australia is concerned,” he says.
“They’ve made their forward  commitments to Stronger Futures, to Cape York, to Creative Australia to  Carbon Farming Initiative; it has all been sign-posted.”

Justin Mohamed, Chair of the National Aboriginal Community Controlled Health Organisation (NACCHO), agrees.

“On  previous budget nights and when the announcements are being made, you  know you sometimes walk out of there a little bit flat because  Aboriginal health or Aboriginal affairs probably doesn’t get the  concentrated attention it needs,” he says.

The federal government funds a number of Indigenous-specific programs under National Partnership Agreements (NPAs) in partnership with state and territory governments, based on six policy initiatives known as ‘Closing the Gap’.

These six measures were set down by Kevin Rudd in 2008 at the same time he gave a formal apology to the Stolen Generations. They cover the broad areas of health, education, infant mortality, life expectancy, literacy and employment.

Prime Minister Julia Gillard’s report on Closing the Gap issued in February this year noted that only three out of the six areas were on track for achievement.

This is despite funding for some key areas nearing their initial expiry date.

‘CRITICAL YEAR’ FOR INDIGENOUS HEALTH

In 2009, the federal government allocated $1.57 billion for Indigenous health initiatives. This funding agreement expires in June, although this has been buffered by a further commitment of $777 million over three years from the federal government — along with an expectation that state and territory governments will also contribute.

Victoria has already committed to $61.7 million over four years, and while other states have until June 30 to declare their funding commitments, none have so far declared their support.

The federal commitment, as Lesley Russell has written previously, is an increase in per annum expenditure, but because of a bump in funding for the year 2012-13, will actually result in a drop in funding for the year ahead.

“We await news of which programs will be cut, and where,” she wrote.

NACCHO’s Justin Mohamed is concerned state governments are waiting until tomorrow’s Budget announcement before making a call on Indigenous health funding.

“I would say at this stage, we haven’t had the confirmed numbers, and we do need every state and territory to come and recommit to closing the gap with their funding, to ensure the whole of Australia – every single Aboriginal and Torres Strait Islander person can have life expectancy similar to non-Aboriginal and Torres Strait Islander people.”

The total amount of funding has been increasing since Closing the Gap initiatives were first announced in 2008, but the dollar figure is also only one part of the story. How effectively the money is being used is a question raised repeatedly by those keeping a close eye on the government’s Indigenous expenditure.

“It’s really about how that money is administered, and where the money goes,”  says Mohamed.

WHERE TO FROM HERE?

With an election looming, the future of the government’s Closing the Gap policies remain uncertain.

The federal opposition has been vocally critical of current state and federal programs, with Shadow Indigenous Affairs Minister Nigel Scullion saying the efficiency and effectiveness of current programs needed to addressed.

A change of government could also clear out any partisan issues potentially hampering cooperation at state and federal levels, says Jon Altman.

“We’ve got to remember when we had multi-partisan agreement through COAG  on these National Partnership agreements, it was coast-to-coast Labor,  and since then we’ve had a change and a number of state governments and  territory governments are non-Labor, so the possibility of contested federalism has increased,” he says.

“Of course,  that could flip right round if you had a change of federal government,  and suddenly you might see a new cooperative federalism between an  Abbott government and at least those states and territories that are now  conservative.”

WHAT ARE THE NATIONAL PARTNERSHIP AGREEMENTS?

Indigenous early childhood development $564.6 over six years from July 2009 Remote service delivery $291.2 over six years from July 2009 Indigenous economic participation $228.8 over five years from July 2008 Remote indigenous housing $1.94 billion over ten years. New funding on top of $3.55 billion already committed, so total funding of $5.5. billion over ten years from Dec 08 Indigenous health outcomes $1.57 billion over four years from July 1, 2009 Remote Indigenous public internet access $6.967 million over four years

Q&A: What next for Indigenous funding?

Source SBS with thanks

With an election looming and some key Indigenous funding policies nearing expiry, is the pattern of government investment for Indigenous policies set to change?

Jon Altman of the Centre for Aboriginal Economic Policy Research at the Australian National University tells SBS reporter Rhiannon Elston why he doesn’t expect to see Indigenous spending on the agenda on budget night.

Q: To start with a broad picture, has funding been increasing for government-based ‘Closing the Gap’ initiatives since they were first drawn up in 2008? 

It most certainly has. There has been a series of a National Partnership Agreements (NPAs) that I think have certainly increased allocations to Indigenous policy, Indigenous Affairs. One of the problems, of course, that the government has is that the last census showed a greater than expected increase in Indigenous population. And so on a per capita basis, that puts some pressure on Indigenous funding. But nevertheless, the funding has increased. Paradoxically, perhaps, a lot of that funding is being allocated to remote Australia where need is seen to be the greatest.

And particularly, of course, the Northern Territory and Cape York are major beneficiaries. But the majority of the Indigenous population lives in non-remote Australia. Probably around 75 to 80 per cent live in non-remote Australia. So in a sense, the paradox is that government is… putting most of the money into remote Australia, where I think gaps are going to be the hardest to close.

And they’re assuming that mainstream provision of services will look after Indigenous people in non-remote Australia, where gaps are most likely to close. I think it’s a very brave assumption that people will get equitable needs-based access to services in non-remote Australia if they’re disadvantaged.

Q: That appears to be a recurring criticism; that the bulk of Indigenous funding lands in the Northern Territory and not enough is left for the other states. 

The first thing the government really needs to do, and it’s never done, is actually undertake some audit of what is needed. Because what we don’t hear a lot about in Indigenous policy making is the historical legacy. In some sense what happened post the 2007 intervention is the extent of the legacy in very visible remote Indigenous  communities was there for everybody to see, and the obvious government response to that was to try and band-aid what was very visible.

Poor housing, poor school facilities, poor community infrastructure. Poor medical centres. So the government has certainly tried to address some of that in those very visible places. But the truth is, to meet that historical legacy which has being growing exponentially for decades, is going to require very significant investments, very significant commitments, running into billions of dollars.

Q: With the Indigenous Health Outcomes NPA due to expire in June, we’ve seen the federal government recommit $777 million over three years with an expectation that the states and territories will also come to the table, and they have until June 30 to do that. So far, we haven’t seen broad state-based commitment. What kind of implications could that have?

I think it will depend on the next government. We’ve got to remember when we had multi-partisan agreement through COAG on these National Partnership agreements, it was coast-to-coast Labor, and since then we’ve had a change and a number of state governments and territory governments are non-Labor. So the possibility of contested federalism has increased, and of course that could flip right round if you had a change of federal government, and suddenly you might see a new cooperative federalism between an Abbott government and at least those states and territories that are now conservative.

Whatever the case, I think there will be some very hard questions asked about the National Partnership Agreements when they come up for renegotiation in terms of their effectiveness. And one of the things we’ve found with Closing the Gap in terms of their track record at least for the period 2006-2011, has been quite patchy. Some of the gaps are closing quite slowly. Some of the gaps are widening, and some of them are proving very difficult to shift. So in a sense, there might be scepticism about both the targets and about the efficacy of the national partnership agreements in helping to close them.

Q: Do you expect to see any major Indigenous funding announcements in next week’s budget?

I think the current government, it seems to be the new mode of operation, they’ve more or less fired all their fiscal bullets as far as Indigenous Australia is concerned. They’ve made their forward commitments to Stronger Futures, to Cape York, to Creative Australia to Carbon Farming Initiative; it has all been sign-posted so I actually don’t expect to see anything new for Indigenous Australia in the budget.

The question is, what will the government do to make sure that when we have new schemes like DisabilityCare Australia… what mechanisms do we have in place to make sure that those people who are most in need and I think it’s likely that even in relation to DC Indigenous People who will be most in need get the greatest access? And it seems to me that one of the problems we have with this notion of normalisation and needs-based equitable access to services including disability support, superannuation, jobs and so on, is that we assume the playing field is level, whereas clearly that’s not the case.

Not just in terms of historical legacy and the poor physical, psychological, emotional condition of many Indigenous people but also that our institutions aren’t very well tailored to respond to people from fundamentally different cultural backgrounds, and we just don’t want to recognise that racially based discrimination is still a problem when it comes to accessing services