“The primary health care sector that delivers the best results for Aboriginal and Torres Strait Islander People is the least funded. Funding for ACCHSs is unrelated to population size or need, is not indexed for inflation or service demand and is not distributed equitably within and between the States and Territories.

NACCHO advocates for a change in the way healthcare funding is allocated, which re-distributes an appropriate share of mainstream health funds to ACCHSs, taking into consideration expected population growth, indexation and health need.”

Mathew Cooke NACCHO Chair

EXECUTIVE SUMMARY-NACCHO 2015-16 BUDGET SUBMISSION:

In June 2011, the Australian Bureau of Statistics estimated that 3 percent (669,881) of the Australian population, identified as Aboriginal and Torres Strait Islander People.

Aboriginal and Torres Strait Islander People fare much worse than other Australians against all health indicators. Life expectancy is estimated to be ten to seventeen years less than the Australian national average.

The incidence of preventable illnesses such as diabetes, heart disease and kidney disease is considerably higher. Suicide rates have increased due to high levels of psychological distress, where hospitalisations due to self-harming have increased forty-eight percent in less than a decade. Child and maternal health outcomes are poorer, with birth weights lower and infant mortality higher.

These facts highlights the importance of making primary health care as culturally appropriate and accessible as possible.

In this submission, NACCHO makes recommendations on priority areas of expenditure and re-allocation to ACCHSs.

These recommendations aim to maintain a sustainable and viable model of service delivery and to ensure the Commonwealth Government continues to support initiatives aimed at improving health outcomes for Aboriginal and Torres Strait Islander People.

The primary health care sector that delivers the best results for Aboriginal and Torres Strait Islander People is the least funded. Funding for ACCHSs is unrelated to population size or need, is not indexed for inflation or service demand and is not distributed equitably within and between the States and Territories.

NACCHO advocates for a change in the way healthcare funding is allocated, which re-distributes an appropriate share of mainstream health funds to ACCHSs, taking into consideration expected population growth, indexation and health need.

In the 2015-16 budget, NACCHO seeks stronger commitments and national oversight from the Commonwealth Government towards achieving the CtG targets. To build on current progress, the Commonwealth Government must renew its commitment to the programs that are working and their expanded delivery through health services that are culturally appropriate and economically effective.

NACCHO recommends funds allocated to CtG initiatives and programs be quarantined from cuts. Expanded and enhanced access to program funds for ACCHSs and the launch of the National Aboriginal and Torres Strait Islander Health Plan Implementation Plan (NATSIHP IP) also support progress towards Closing the Gap and require appropriate and targeted funding.

The transition to the Community Controlled Health model is consistent with broader government objectives regarding Aboriginal service and funding reforms, including improvements in access to services, coordinating services and partnerships between communities and government.

To ensure that Aboriginal and Torres Strait Islander People continue to receive services and continuity of care while changes to the health system take place, such as the establishment of the Primary Health Network (PHNs), the Government should consider allocating Aboriginal-specific money in Medicare Locals to ACCHSs.

To ensure continued support for ACCHSs, NACCHO believes that the Commonwealth Government fund for the National Peak Body separately to that of Affiliates. This approach will reduce overlap between the different jurisdictions and achieve even greater outcomes for our Member Services.

Infrastructure and workforce programs are also essential elements to ensuring that ACCHSs improve the capacity to deliver the core elements of Comprehensive Primary Health Care. Infrastructure needs include accommodating staff, transport, furniture, computers and equipment. Failures of the market to deliver jobs to those in need can be addressed via a demand-driven employment model, delivered through ACCHSs. This achieves the Government’s stated objective, to “boost Indigenous employment and support Indigenous Australians to get ahead”.

Long term funding arrangements for ACCHSs and NACCHO (4 to 5 years) are critical to ensure that the long term goals of the CtG framework are met and to ensure consistency and job security.

Increased investment in ACCHSs does not require additional or new money. NACCHO advocates the Government go down the path of a clever re-allocation of the health budget to address anomalies in spending which favours allocation to mainstream services and hospitals that do not deliver the same level of returns as ACCHSs.

Underpinning these recommendations, NACCHO advocates the Government adopt measures that encourage Aboriginal and Torres Strait Islander People’s participation in their own community development and reinforce the human rights of Aboriginal and Torres Strait Islander People. The Community Controlled sector embodies these aspirations, combining the best of clinical know-how with culturally enriched local knowledge and wisdom.

If we Close the Gap between health and life expectancy of Aboriginal and Torres Strait Islander People, Australia will be a stronger nation. Australians can be prouder and all Australians and, especially Aboriginal and Torres Strait Islander children, families and communities will be healthier.

The benefits to Australia are far reaching and will deliver significant economic and productivity improvements.

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