” According to data from the 2016 National Eye Health Survey (NEHS), Aboriginal and Torres Strait Islander adults have a greater burden of eye disease, with three times the rate of blindness and three times the rate of vision loss than the non-Indigenous population.[1] Uncorrected refractive error causes almost two thirds of vision impairment, and cataract is the leading cause of blindness among Aboriginal and Torres Strait Islander people.
Vision 2020 Australia welcomes the opportunity to provide comment to the Productivity Commission (the Commission) regarding its Inquiry into introducing competition and informed user choice into human services (the Inquiry).
Download this full submission here :
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Vision 2020 Australia’s response to the Inquiry predominantly relates to improving outcomes in relation to eye health services provided in remote Aboriginal and Torres Strait Islander communities.
Additionally, almost 40 per cent of Aboriginal and Torres Strait Islander people who need cataract surgery have not accessed specialised treatment services (compared to 13 per cent of non-Indigenous Australians), and approximately half of Aboriginal and Torres Strait Islander participants with diabetes were found not to be having an eye examination at the frequency recommended by the National Health and Medical Research Council (NHMRC).
The eye health and vision care sector supports the principle put forward by the Australian Government that refers to introducing informed user choice in these communities. However, the sector has identified a number of challenges posed by the principle of introducing competition in the provision of eye health services in remote communities; due to issues such as the fragmented or duplicated delivery of these services.
In the following submission, Vision 2020 Australia outlines ten recommendations which, if implemented fully, would ensure that eye health and vision care outcomes for Aboriginal and Torres Strait Islander people are improved through better access to effective and reliable services.
Note all 10 recommendation are in this submissions
| Recommendation 8 |
| That ACCHOs are offered fair opportunities to compete with non-Indigenous health organisations during competitive tendering processes. |
Vision 2020 Australia notes that, in the context of eye health in remote Aboriginal and Torres Strait Islander communities, reforms intended to introduce greater user choice and competition do not necessarily result in positive outcomes. For example, in remote areas, increased competition when providing outreach services can in some cases lead to fragmented service coordination. Vision 2020 Australia therefore contends that mechanisms and approaches to introduce greater competition, contestability and user choice need to be carefully considered.
In remote Aboriginal and Torres Strait Islander communities delivering services collaboratively and in partnership with ACCHOs, and ensuring that the communities are consulted and involved in the design of policies and programs that impact them, is integral.
Furthermore, Vision 2020 Australia notes that the 2015 Senate Finance and Public Administration References Committee inquiry into the impact on service quality, efficiency and sustainability of the Commonwealth Indigenous Advancement Strategy tendering found that competitive tender processes disadvantage ACCHOs and do not fully take into account their value and expertise.[1] It is therefore vital that Aboriginal and Torres Strait Islander organisations are offered fair opportunities to compete with non-Indigenous organisations.
[1] “Commonwealth Indigenous Advancement Strategy tendering processes,” Parliament of Australia, accessed February 14, 2017. http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Finance_and_Public_Administration/Commonwealth_Indigenous.
Vision 2020 Australia
Vision 2020 Australia is the peak body for the eye health and vision care sector, representing around 50 member organisations involved in: local and global eye care; health promotion; low vision support; vision rehabilitation; eye research; professional assistance and community support.
This submission has been developed in collaboration with the Vision 2020 Australia Aboriginal and Torres Strait Islander Committee (the Committee).
The Committee provides a platform for members to collaborate and shape the direction of Vision 2020 Australia’s systemic advocacy related to Aboriginal and Torres Strait Islander eye health and vision care.
The Committee supports and promotes The Roadmap to Close the Gap for Vision (the Roadmap), developed by Indigenous Eye Health at the University of Melbourne, and works closely with the National Aboriginal and Community Controlled Health Organisation (NACCHO) and its affiliates to ensure its strategies are consistent with priorities identified by Aboriginal Medical Services providers in States and Territories.[2]
Vision 2020 Australia supports the submissions put forward by our member organisations, namely Indigenous Eye Health and The Fred Hollows Foundation.
Vision 2020 Australia notes that, in the context of eye health in remote Aboriginal and Torres Strait Islander communities, reforms intended to introduce greater user choice and competition do not necessarily result in positive outcomes
. For example, in remote areas, increased competition when providing outreach services can in some cases lead to fragmented service coordination. Vision 2020 Australia therefore contends that mechanisms and approaches to introduce greater competition, contestability and user choice need to be carefully considered.
In remote Aboriginal and Torres Strait Islander communities delivering services collaboratively and in partnership with ACCHOs, and ensuring that the communities are consulted and involved in the design of policies and programs that impact them, is integral.
Furthermore, Vision 2020 Australia notes that the 2015 Senate Finance and Public Administration References Committee inquiry into the impact on service quality, efficiency and sustainability of the Commonwealth Indigenous Advancement Strategy tendering found that competitive tender processes disadvantage ACCHOs and do not fully take into account their value and expertise.[1] It is therefore vital that Aboriginal and Torres Strait Islander organisations are offered fair opportunities to compete with non-Indigenous organisations.
[1] “Commonwealth Indigenous Advancement Strategy tendering processes,” Parliament of Australia, accessed February 14, 2017. http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Finance_and_Public_Administration/Commonwealth_Indigenous.
Summary of recommendations
Vision 2020 Australia has ten recommendations which, if implemented fully, would ensure that eye health and vision care outcomes for Aboriginal and Torres Strait Islander people are improved through the provision of better access to effective and reliable services.
| Recommendation 1 |
| That the Australian Government allocates additional funding to address existing barriers to accessing specialist eye health services in rural and remote areas. |
| Recommendation 2 |
| That the Australian Government undertakes capacity building for ophthalmic telehealth services. |
| Recommendation 3 |
| That the Australian Government modifies existing IT infrastructure in remote facilities catering to Aboriginal and Torres Strait Islander health to facilitate efficient and effective telehealth services. |
| Recommendation 4 |
| That the Australian Government facilitates the introduction of electronic patient record systems targeted for use in remote Aboriginal and Torres Strait Islander communities, with linkages to the broader health system. |
| Recommendation 5 |
| That the Australian Government provides funding for additional staff trained in the provision of eye health services for remote Aboriginal and Torres Strait Islander communities. |
| Recommendation 6 |
| That the Australian Government regularly reviews and provides ongoing funding to the Visiting Optometrists Scheme (VOS). |
| Recommendation 7 |
| That Aboriginal Community Controlled Health Organisations (ACCHOs) and Aboriginal and Torres Strait Islander communities are consulted and involved in the design of policies and programs that impact them. |
| Recommendation 8 |
| That ACCHOs are offered fair opportunities to compete with non-Indigenous health organisations during competitive tendering processes. |
| Recommendation 9 |
| That governments ensure that the Aboriginal community controlled sector is a key player in the delivery of culturally safe health services. |
| Recommendation 10 |
| That services provided to remote Aboriginal and Torres Strait Islander communities are integrated and coordinated so as to ensure an effective patient pathway where comorbidities can be effectively assessed and treated. |
[1] Foreman, J., et al, 2016, The National Eye Health Survey Report 2016, The Centre for Eye Research Australia and Vision 2020 Australia, Melbourne.
[2] Taylor HR, Anjou MD, Boudville AI, McNeil RJ, 2013, The Roadmap to Close the Gap for Vision, Indigenous Eye Health Unit, Melbourne School of Population Health,The University of Melbourne