With a team at the University of Melbourne, we have researched and consulted widely over the past five years to come up with a plan to “Close the Gap” in Indigenous eye health. ‘The Roadmap to Close the Gap for Vision’ presents an opportunity for another ‘small victory’ by eliminating preventable vision loss for Indigenous people over the next five years
Professor Hugh Taylor (pictured centre above)
Early this year, then Prime Minister Julia Gillard spoke to Parliament about some of the positive trends that are emerging in the long-term goal of the Government to “Close the Gap” for Australian Indigenous disadvantage.
She described Closing the Gap as ‘an accumulation of small victories’ which can provide ‘the basic public services…delivered at the standard that every Australian expects’.
The general theme is that some things are improving, albeit slowly, and others need to get a wriggle on.
With a team at the University of Melbourne, we have researched and consulted widely over the past five years to come up with a plan to “Close the Gap” in Indigenous eye health. ‘The Roadmap to Close the Gap for Vision’ presents an opportunity for another ‘small victory’ by eliminating preventable vision loss for Indigenous people over the next five years.
This is the first time Indigenous eye health has been comprehensively researched to identify the problems, needs and solutions.
Previous reports on Indigenous eye care have been limited to reviews and the findings have been implemented incompletely at best. ‘The Roadmap to Close the Gap for Vision’ has drawn on successful examples and practices from around the country and extensive community and stakeholder consultation. Best of all, it is feasible and doable, but each component is essential for success.
The key to the Roadmap is the comprehensive approach that will improve the provision and utilisation of eye services by the application of additional resources to increase the availability of eye care and provide good co-ordination and case management of patients.
Indigenous Australians experience six times the rate of blindness compared with the rest of Australia. Vision loss causes 11 per cent of the Gap in health – it is equal third with trauma, following heart disease and diabetes but ahead of stroke and alcoholism. The provision of good quality eye care is fundamental to improving the health of Indigenous Australians and unlike many other conditions, most vision loss can be eliminated overnight.
The Roadmap provides policy recommendations to eliminate unnecessary vision loss through 42 interlocking strategies. The recommendations build on previous reports from the Indigenous Eye Health Unit at the University of Melbourne and an extensive consultation process with the community-controlled sector, eye health professionals, governments and other stakeholders.
The Roadmap addresses primary eye care, refractive services, cataract, diabetic eye disease and trachoma. It includes cost estimates for the Commonwealth, state and territory governments. It builds on community consultation and control, the regional delivery of services and the National Health Reforms. It stresses the assessment of population-based needs, strong co-ordination, monitoring of performance and national accountability.
A recent Victorian initiative is one example of the difference a co-ordinated approach that involves all the key partners and addresses one of the concerns raised as a barrier can make. The Victorian Eyecare Service was augmented in 2010 by the Victorian Government with funds to allow Aboriginal Victorians access to a specifically designed pair of spectacles for $10. The scheme is available from optometrists working in Aboriginal Health Services and through a network of private optometrists in rural Victoria.
There is no requirement for a health care card or pensioner status to be eligible for access to the scheme. The introduction of this scheme in 2010 has been followed by a more than twofold increase in demand. Cost is identified as the most common reason Indigenous people do not go to a health professional when needed. However, rather than cost, we found that cost-certainty was the more important issue. Cost-uncertainty for spectacles was commonly reported to the research team as the reason for not visiting the optometrist and not having eyes tested. The Victorian scheme demonstrates that when good quality spectacles are provided at a low and certain cost, the service is rapidly accepted and taken up.
All Australians reasonably expect to see clearly and comfortably and to have healthy eyes. We all fear vision loss and blindness given its considerable potential impact on the quality of our lives. The Roadmap to Close the Gap for Vision provides opportunity to accumulate yet another small victory to reduce Indigenous disadvantage. We have the evidence, the strategy and the capacity to close the gap for vision – the time is right to take this next “small step”.
The Indigenous Eye Health Unit would like to acknowledge support from the following donors; The Harold Mitchell Foundation, The Ian Potter Foundation, Mr Greg Poche AO, the University of Melbourne, Dr David Middleton, Mr Peter Anastasiou, Mr Rob Bowen, Dr Vera Bowen, Mr Noel Andresen, Dr Mark & Alla Medownick, Gandel Philanthropy, CBM Australia, The Cybec Foundation, The Aspen Foundation and “K” Line Logistics. Funding for work on the Implementation of the Roadmap to Close the Gap for Vision has been provided by the Department of Health for 2013 – 2014.
Read more about Hugh Taylor at: www.medicine150.mdhs.unimelb.edu.au/taylor
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