NACCHO Chair Justin Mohamed speech – NACCHO Health Summit 2014

justin_speech

As a Goorang Goorang man from Bundaberg QLD I would like to commence by formally acknowledging the traditional owners and custodians of land upon which we meet today and pay my respects to elders both past and present. 

Today my topic is ‘investing in community controlled health makes economic sense.

I don’t need to tell most of you in the room here today that putting resources into community controlled health can have a great impact: not only in closing the health gap between Aboriginal and mainstream Australia, but also in providing employment and training opportunities and  giving an economic boost to Aboriginal and mainstream communities.

Indeed we heard many great examples of this in the presentations and workshops yesterday. There is some amazing work being done across many critical areas within local Communities and I am looking forward to hearing more success stories as the Summit continues over the next two days.

We have all known that Aboriginal Community Controlled Health Services have a flow effect into their communities – indeed most people in this room would have seen it in action.

But at times it has had its challenges for us to provide the definitive proof when asked by policy makers or funders.

Which is why last year NACCHO commissioned research into the economic benefits of Community Controlled Health Services.

We wanted to have something tangible, something that clearly articulated what we were seeing in individual services every day, was a reality across all our services and across the Nation.

So we bought in respected health economist Dr Katrina Alford, where she spent time analysing the statistics that are publicly available, reviewing the data, talking to our services and compiling a comprehensive report which we were fortunate to have been invited to launch earlier this year at the National Press Club.

Of course the report showed just what we had thought it would – that the multiplier effect of our services in terms of employment, training and improving participation of our people is significant.

Our services are large-scale employers of Aboriginal people and in fact the main source of employment in many of our communities.

Lets take a look at a service, one used as a case study in the report – Mulungu.

Mulungi is in Mareeba in far north Queensland, on the Atherton Tablelands about an hour west of Cairns. Mareeba has a population of around 10,000 people and about thirteen per cent of those are Australia’s First Peoples.

Mulungi provides employment for 41 people in this small town, thirty being Aboriginal and Torres Strait Islander people from the local community. Aboriginal employment at Mulngu accounts for more than 12 per cent of all the Aboriginal employment in the area and wages and salaries in excess of $2.6 million a year

That’s a huge economic contribution, not just to the local Aboriginal community, but to the broader community of Mareeba.

Mulngu is not alone. Our 150 Aboriginal Community Controlled Health Services employ more than 5,500 people across the country and more than 3,500 of those are Aboriginal and Torres Strait Islanders.

That’s a very high number of people who have meaningful, secure jobs – participating in the labour market and in many cases effectively breaking the welfare cycle that can persist in some of our communities.

Further, these jobs are predominantly skilled occupations – Aboriginal Health Workers, doctors, nurses, health professionals, finance, IT, medical transport and administrative staff.

They provide wages and salaries that are much higher than the average Aboriginal Australian income which is use to support their families, take into their communities and boost regional economies.

The ripple effect of this employment cannot be underestimated and so our services are providing a solution to one of the key challenges we need to address if we are to reduce the chronic unemployment rates of our people.

Dr Alford’s report also found that alongside employment, Aboriginal Community Controlled health services provide extensive education and training opportunities for Aboriginal people.

Many of us here today, including myself can testify of the opportunities and experiences that were made available to many of us as younger Aboriginal & Torres Strait Islander men and women starting out our careers were given through our local Aboriginal Community Controlled Health Organisations.

This includes being mentored by inspiring, incredible and visionary Aboriginal people  – that taught us the importance of “Aboriginal health in Aboriginal hands”.

Learning on the job, raising educational levels and earning our stripes along the way. I doubt whether we could have achieved so much if it hadn’t been for opportunities and privileges to learn and be developed in such a nurturing and culturally sensitive environment.

Sadly however, although we are slowly seeing some improvements, many of the Aboriginal and Torres Strait Islander health workforce suffer institutionalized racism in the mainstream system and many have their career paths stunted.

Yet, in an Aboriginal Community Controlled Health environment, the Aboriginal and Torres Strait Islander health workforce employees in the main flourish.

And as they do so they provide culturally appropriate, culturally safe, holistic health care which our people want to use.

They combine clinical know-how with culturally enriched local knowledge and wisdom.

We are seeing demand for our services rising at a rate of six per cent a year as more and more of our people seek our the care of the local services where they know they will be treated without judgment, but with respect and dignity.

People come to use our Services from far and wide – there are many examples of /Community members traveling many kilometres and considerable time to access our member services and in some cases by-passing mainstream health services on the way to our “culture centres of Comprehensive Primary Health Care”

 

Aboriginal Community Controlled Health Organisations

The trend toward Aboriginal people seeking check ups at their local Aboriginal Community Controlled Health service means we are starting to diagnose earlier, make real inroads into reducing risk taking behavior’s like smoking, and putting preventative health measures in place.

And as a result it is our services that are reducing child mortality by 66 per cent, and reducing overall Aboriginal and Torres Strait Islander mortality rates by 33 per cent.

This in turn is slowly reducing the pressure and costs at the chronic end of the scale, reducing the need for hospitalisation and acute care.

And so again we see that our services are ticking numerous boxes in the struggle to close the gap between Aboriginal and white Australia:

Health – tick
Employment – tick
Training – tick.

Indeed, a single investment in Aboriginal Community Control Health Organisations deals with all three of the main challenges in Aboriginal communities:

  • High unemployment
  • Low education levels
  • And poor health

It is hard, then, to argue against the proposition that investing in Aboriginal community controlled health makes economic sense.

And yet we are still fighting for that investment.

It’s true that ACCHOs funding was renewed for 12 months just prior to the Federal Budget and that was welcome given the climate of spending cuts in all areas and particularly across the board in Aboriginal affairs.

But let’s face it – this is a long way short of what is needed – long term surety and security for our services and the large numbers of people they employ.

Plus many of the programs we run outside of the core funding are still up in the air. Indigenous health spending was cut by millions in the Budget and we are still waiting to see what that will mean for us on the ground.

The introduction of the medicare co-payment will hurt our services and given most will absorb the cost rather than pass it on to their clients, it will effectively result in a cut to their operating budget.

The next twelve months will be telling.

At NACCHO we will be fighting for five-year funding agreements, such as are given to the pharmacy guild, alongside a reduction in the masses of administrative red tape which divert many of services from providing care.

We will also continue to argue at the national level for ACCHOs to be exempt from any co-payments. We simply can’t afford for there to be any barriers to Aboriginal people seeking medical advice and seeking it early.

Introducing the co-payment will take us one step backwards and in Aboriginal health we need to keep moving forward or our gains will be lost.

We have worked hard over the years to develop our multi-partisan relationships with key decision makers at the highest levels and I believe we are getting some traction.

I take it as a positive sign that the Assistant Minister for Health Fiona Nash took up the invitation to speak at the Summit yesterday. She also said on the public record in a recent press release, and I quote:

“The Government recognises that while some improvements in Indigenous health outcomes have been achieved over recent years, there is still a long way to go to close the gap between the health and life expectancy of Aboriginal and Torres Strait Islander people and non-Indigenous Australians.”

“The role that Aboriginal Community Controlled Health Organisations continue to play in the delivery of health services to Aboriginal and Torres Strait Islander people is therefore vital.”

She may be convinced, but we are yet to see how this may be realised by other politicians, our collective job is to make sure every other Member of Parliament is also convinced, so when it comes down to a decision by the Treasurer on where he puts his funding, every Member of Parliament is an advocate for our movement of Aboriginal Community Controlled Health Organisations Programs, run by our member services for diabetes, chronic disease, smoking, maternal health and there is more,  we need local, state and federal decision makers to physically see our best practice models.

We have a goal over the next 8-10 months to have every MP visit their local ACCHO – see first hand what goes on in our services, to get a better sense of the great work that is being done in electorates across the country, and to see for themselves the real social and economic benefit of community controlled health.

Together we are a strong and powerful entity unmatched by any group or sector in this Nation. We as Aboriginal Community Controlled Health Organisations is the door for MP’s to gain first hand experience, so in this NACCHO has created an MP kit to assist in guideing on how to engage with local MP’s. Many already have long-standing relationships, but there are a number of newly elected MP’s and many more who may never have stepped inside an ACCHO.

If there is ever a time for our us to think and act strategically “with one voice” it is now.

We have the structure across local, State and National levels, we have great support from other State and National health bodies.  The next 3-6 months will prove to be nothing short of extreme importance not only for our member services today but into future years.

Aboriginal Controlled Health has proven over 4 decades that we are the vehicle in addressing Aboriginal Health and the cultural connection between clinical and traditional healing of the physical, emotional and spiritual wellbeing our our people.