” Participants agreed that Aboriginal and Torres Strait Islander peoples faced persistent and acute barriers to health equity and therefore must remain a top priority. Many of these barriers, like racism, are structural, evident both within the health system andmore widely.
In response, Indigenous health leaders and other participants called for governments to re-commit to Indigenous self-determination, which also acknowledges the importance of the cultural determinants of health.
Aboriginal and Torres Strait Islander peoples and communities should be supported in leading the design and delivery of health policy and services in partnership with governments and other stakeholders.”
From Tackling health inequality and other whole-of-government challenges 22/40
See relevant Aboriginal and Torres Strait Islander Health extracts below or
Download the 8 page Document Here
Please note NACCHO welcomes health policy documents and press releases from all parties
” The communiqué includes an appropriate focus on equity and socio-economic disadvantage. The specific issue of Aboriginal and Torres Strait Islander disadvantage was raised by Bill Shorten in his opening speech and discussed in several sessions.
As was also to be expected, problems with Commonwealth-state relations – or the need to improve coordination between the different spheres of government – were raised in a several sessions
STEPHEN DUCKETT Review . Labor charts a health policy rethink see Article 2 below
At the roundtable discussions in Canberra NACCHO was represented by chair Matthew Cooke pictured at the summit with MP Stephen Jones
Watch Interview with Matthew CroakeyTV
Walking the talk in Indigenous health
National Aboriginal Community Controlled Health Organisation (NACCHO) chair Matthew Cooke put Labor on notice to address racism in the health system, which Lowitja Institute CEO Romlie Mokak said was the “burning issue” in Indigenous health.
Cooke said the problem is not just in the way Indigenous people are treated in the system but also in how governments and their agencies exclude Indigenous organisations that should be involved “at every level of decision-making”.
He said NACCHO members had been “spearheading” self-determination for more than 40 years – a principle now being adopted by non-Indigenous people wanting to make community decisions about their health care and about health services and systems in communities.
“But Labor forgot us with Medicare Locals and the Liberals forgot us with the PHN (Primary Health Networks) transition… We were left out in the makeup of governance structures, clinical councils and community networks.
“We face a lot of arrogance, a lot of racism in the health system,” he said.
Cooke said a statement this week by Indigenous Health Minister Ken Wyatt, calling on PHNs to work with ACCOs was “very welcome”.
The Report : Protection, prevention and promotion
4. Participants highlighted the chronic disease crisis, noting that at least one-third of these diseases are preventable. They also emphasised the main risk factors that contribute to this crisis, such as weight gain, unhealthy foods, lack of physical activity, tobacco use, and alcohol. Participants noted that these were national challenges and would require system-wide responses to promote health and wellbeing across all age groups.
5. A common theme was the impact of inequity on health. It was recognised that some groups faced particular challenges and would benefit from more targeted government support – such as Aboriginal and Torres Strait Islander peoples, people in remote Australia, mothers and infants, and people with disability. However, the broad range of social determinants impact heavily on health. Participants also recognised that mental health and suicide are key issues affecting Australian families and communities, particularly affecting young people and LGBTIQ people, and these require national, coordinated strategies.
6. Participants called on governments to focus on implementation and action, not reviews. They felt that the evidence was already quite clear in most areas, although they noted that ongoing support for national surveys and data collection is required to monitor progress, for example through the National Health Survey. Participants argued that the Commonwealth could improve implementation by partnering more closely with communities, states and territories, the public health sector and industry. They also called for stronger public health messaging from governments, to improve Australians’ understanding of how people’s health is strongly influenced by surrounding environments and how people can be empowered to manage their own health. Participants felt that establishing environments that facilitate making the healthy choice the easy choice is an important role of government.
7. Participants also called on governments to adopt a ‘health in all policies’ approach. This would recognise that a wide range of factors – like education, housing, employment and economic inequality – affect health. Such an approach would help to break down silos within government. For example, the group argued that governments should address climate change and its impacts on health, and better integrate health and disability policy.
As well as this overall approach, participants called for targeted interventions on some issues – like mass media campaigns on tobacco, restrictions on marketing of junk food and alcohol (particularly to children), breaking the nexus between these unhealthy products and sport, as well as implementing taxation measures to mitigate the harmful consumption of alcohol and junk food – in particular sugar-laden soft drinks
Mental health and suicide prevention
18. Participants agreed that more needed to be done in the short term to address Australia’s mental health burden and the growing rate of suicide. There was an agreed view that the National Mental Health Commission’s review and recommendations were a solid framework for reform and it was time to implement this plan.
19. There was agreement mental health should be given a higher priority, substantially more funding, and that it was a weak point of the health system given it is 20 per cent of the health burden. It was also established that mental health should be an important part of the economics agenda within an ‘invest to save’ context. Participants highlighted a range of challenges and issues including the urgent need to address service delivery gaps, particularly in psychosocial support and between the GP and the ED, investment to be made in services and at a community level, and an emphasis to build the evidence base as well as building resilience across communities.
20. In relation to suicide prevention challenges, participants highlighted the need to address trauma in Aboriginal and Torres Strait Islander communities, develop a national suicide prevention strategy including a standalone strategy for children and young people, build workforce capacity, improve and better co-ordinate data collection and provide community connections in hospital systems. Suicide Prevention Australia raised its view there is a need to establish a National Office for Suicide Prevention and put before Parliament a National Suicide Prevention Bill.
21. Participants also emphasised the need for the Commonwealth to lead state and territory collaboration on issues around funding and service delivery. There was also agreement from participants that long-term national leadership was urgently required to address mental health and suicide prevention. This would involve establishing clear national targets for action, and supporting timely and transparent reporting on progress.
Ensuring universal access for all Australians
26. Participants agreed that Australians have a right to universal access to world-class health care. But they emphasised that rising out-of-pocket costs have become a critical barrier to access. They also highlighted that barriers to access are higher for some people (including Indigenous Australians), in some areas (including regional, rural and remote Australia), and for some services (including mental health, allied health and dental services).
STEPHEN DUCKETT Review .
Labor charts a health policy rethink :
Stephen Duckett is Director, Health Program, Grattan Institute
The Labor Party has released a summary of the proceedings of its ‘National Health Policy Summit’, held in Canberra on 3rd March. Good on the ALP for holding the summit. Trouble is, the ‘communique’, while summarising the views of the quite diverse range of participants, gives no clear indication of where Labor might be heading.
The summit process
First, some background. The summit was initiated by federal Labor’s Shadow Health Minister, Catherine King, together with Shadow Minister for Ageing and Mental Health, Julie Collins. It was held in Parliament House with about 180 attendees, including more than 20 Labor MPs. Labor Leader Bill Shorten was present for the whole day. Attendees included consumer organisation representatives; past and present presidents of the Australian Medical Association; private-sector lobbyists including from private hospitals and insurers, and from the pharmacy and devices industries; academics; and a scattering of clinicians.
There were eight ‘round table’ sessions: Protection, prevention and promotion; Primary, secondary and community care; Hospitals; Mental health and suicide prevention; Tackling health inequality and other whole-of-government challenges; Ensuring universal access for all Australians; Innovation across the health system; and Equipping Australia’s health workforce for the future. Session chairs gave feedback at the end of the day, before concluding comments from Bill Shorten.
The summit themes
The communiqué includes an appropriate focus on equity and socio-economic disadvantage. The specific issue of Aboriginal and Torres Strait Islander disadvantage was raised by Bill Shorten in his opening speech and discussed in several sessions.
As was also to be expected, problems with Commonwealth-state relations – or the need to improve coordination between the different spheres of government – were raised in a several sessions.
Less expected was a pervasive call for better data, and access to data. Data recommendations were made by six of the eight round tables: Protection, prevention and promotion (where there was support for national surveys to monitor progress); Primary, secondary and community care (support for indicators of results); Hospitals (where improved data and data sharing could improve the quality and efficiency of patient care); Ensuring universal access (better use of data in primary care); Innovation (data to improve efficiency); and Equipping Australia’s health workforce for the future (better workforce data).
Several round tables saw opportunities to improve the efficiency of the health care systems by investing in primary care; using the workforce more effectively; and creating better links between hospitals and other facilities (for example, some people who present at hospital emergency departments which could be treated in primary care or in the resident’s aged-care facility).
Another common theme was the need for health-sector policymakers to build on the strengths of Medicare and keep in touch with local communities (‘decision-making is too centralised in the hands of insiders in Canberra’; and that there needs to be a ‘stronger narrative from governments on the purpose of health policies and programs’).
The next steps
The Summit communiqué commits Labor to work with participants (and others) to ‘refine and develop its policies over this term of Parliament’ and that it have more detailed discussions around the Summit priority issues.
I co-chaired one of the round table sessions, so any evaluation I make of the summit is from that ‘insider’ perspective. What struck me was the openness and energy of the summiteers. The media were allowed in. There were lots of new ideas. Summiteers were not at all the ‘usual suspects’. They came with views from across the political spectrum, the common theme being a desire to influence the policy process.
And it truly was a ‘listening’ exercise. For example, Bill Shorten sat in one of the sessions I attended and took copious notes but did not attempt to articulate existing policy. Likewise, the Shadow Minister for Families and Social Services, Jenny Macklin, who co-chaired my session, essentially listened and took notes.
The challenge for Labor, though, is what it does next. The communiqué commits the ALP to working with summit participants (and others) to ‘refine and develop its policies over this term of Parliament’. The communiqué is a mix of problem statements and broad policy directions. The devil will be in the detail, as the alternative government seeks to balance pragmatic political reality, fiscal responsibility, and the policy aspirations articulated by the summiteers.
Time will tell whether unleashing the enthusiasm of summiteers pays off in better health policy for patients and taxpayers.
Comment: It is interesting that there was little or no discussion on the role of private health insurance. This is the ‘elephant in the room’ which is eroding Medicare. John Menadue