“Aboriginal self-determination must be front and centre in any decision making processes if we are to truly see major gains to Close the Gap in Indigenous health and social and economic wellbeing.
The importance of the ACCHO sector is widely and formally acknowledged across the Australian health and social sectors – from GPs to hospital emergency facilities. ACCHOs are Australia’s largest, single national and preferred primary health care system for Aboriginal people.
In 2015 all major political parties supported the 10 year Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan (2013 – 2023).
NACCHO will persevere in its efforts to turn positive talk into positive action no matter which party or parties form the next government.”
Matthew Cooke NACCHO chair opinion article
The Productivity Commission’s November 2015 progress report on the implementation of the National Indigenous Reform Agreement (NIRA) made two relevant statements.
First, inadequate progress is being made in Closing the Gap. Second, more than 80 per cent of investments under the NIRA implementation have gone to non-Indigenous organisations.
It’s clear then that unless investments under the NIRA – and in all Indigenous-focused programs – support Aboriginal self-determination, and that those investments are channeled through reputable Aboriginal organisations, whoever is Prime Minister after 2 July 2016 will have to present yet another report to Parliament that confirms again our continuing failure to Close the Gap.
Better progress is being made in the area of Aboriginal health than in the other five NIRA target areas because successive Australian Governments have been obliged to channel some of their Aboriginal grant funds through Aboriginal Community Controlled Health Organisations (ACCHOs)– often referred to as Aboriginal Medical Services.
There are around 150 ACCHOs across Australia – 134 funded by the Australian Government, There are more than 300 fixed, outreach and mobile clinics in the ACCHO sector and more are opening all the time.
New data will be published in the third quarter of 2016, but data from 2012 published by the Australian Institute for Health and Welfare show that ACCHOs provided 2.1 million episodes of care. The same data show the number of Aboriginal clients is increasing at six per cent a year.
Importantly, the ACCHO sector is held accountable to national key performance indicators – which means it can demonstrate that it’s the model showing the most health gains. For example, ACCHOs increased the proportion of clients who received care in 10 out of 16 indicators. The sector also made the biggest contribution to achieving a 66% reduction in child mortality rates and a 33% reduction in overall mortality rates. ACCHO are living evidence of the benefits of Aboriginal self-determination.
The ACCHO sector is also the only nation-wide network of service providers accountable back to Aboriginal communities. ACCHO Directors are elected Aboriginal people from communities in urban, rural and remote locations from all over Australia.
In 2015 all major political parties supported the 10 year Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan (2013 – 2023). The Plan highlights the central role that ACCHO will play in more than 30 areas to improve the health and wellbeing of Aboriginal people.
The ACCHO sector welcomed the Plan but we’ve yet to see any outline of how it will be fully funded. Concerns have also been expressed about the scope and role of the government’s newly formed Primary Health Networks (PHN), and how these large mainstream nation-wide funding entities will actively support ACCHO to continue to grow and deliver further health and social benefits to their communities.
The National Health Plan communicates the integral role of the ACCHO sector, both as a principle and priority – yet the sector was not part of the government’s decision making regarding Aboriginal health programs which are now to be commissioned by the 31 PHNs.
Currently, ACCHO funding is still tied to conditional three-year service agreements. The scope of Aboriginal health and wellbeing services and policy already encompasses at least six separate Divisions of the Australian Government’s Department of Health; the Department of the Prime Minister and Cabinet (Indigenous Advancement Strategy); and the Department of Social Services (National Disability Insurance Scheme).
To have this complex set of policy and funding relationships not acknowledged in a permanent and secure partnership contradicts the glowing statements from current and former government ministers about the performance and value of the ACCHO sector.
NACCHO will persevere in its efforts to turn positive talk into positive action no matter which party or parties form the next government.
NACCHO will continue to articulate evidence-based policies, frameworks and programs from within the ACCHO sector that achieve both self-determination and close the gap in health and wellbeing for Aboriginal Australians – one cannot be achieved without the other. NACCHO will do this in collaboration with mainstream national health organisations.
Investing in non-Aboriginal services and organisations to deliver Aboriginal health and social services is widely acknowledged as failed policy. NACCHO will keep building the capacity and responsiveness of the ACCHO Sector, and work to further demonstrate that investing in self-determination, and empowering Aboriginal people delivers better health outcomes and value for money.
Chairman, National Aboriginal Community Controlled Health Organisation
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