With #budget2017 cut backs to education announced this week , peak health bodies RACGP, Rural Doctors Association of Australia (RDAA), Vision 2020 and the  Australian Healthcare Reform Alliance (AHCRA) have released to NACCHO Aboriginal health investments and recommendations required to Close the Gap

” Aboriginal and Torres Strait Islander health leadership and authentic community engagement is crucial to achieving improved health outcomes.

The Aboriginal Community Controlled Health sector is of vital importance in delivering effective, culturally appropriate care to Australia’s First Peoples; and service development and provision should be led by Aboriginal and Torres Strait Islander health organisations where possible.

The sector must have long-term and secure funding to both retain and grow their capacity.

To address the inequity that exists between Aboriginal and Torres Strait Islander people and non-Indigenous Australians and improve access to care, continuing focus and appropriate funding is required.

The National Aboriginal and Torres Strait Islander Health Plan 2013-2023 (NATSIHP) Implementation Plan in 2015 has not been supported with sufficient, secure funding and resources, which is risking its success.

Funding uncertainty and changes creates significant issues for the continuity of services to patients and for organisations in retaining and building their capacity.”

Extract from  The Royal Australasian College of Physicians (RACP)  pre-budget submission for 2017-2018, Healthy people, Healthy Lives, which outlines key health funding recommendations for the Australian Government.Press Release 1 below

” Areas that RDAA has highlighted as needing further investment through this year’s Budget include: Better supports for rural and remote general practices and Aboriginal Community Controlled Health Services, to allow them to participate effectively in the first stage implementation of Health Care Homes.

It is essential that the higher costs associated with delivering high quality healthcare in rural and remote settings are realistically assessed, and that additional funds for practice support and infrastructure development are provided, to allow rural and remote general practices and Aboriginal Community Controlled Health Services to participate in the first stage implementation”

President of the Rural Doctors Association of Australia (RDAA), Dr Ewen McPhee. Press release 2 below

 ” Vision 2020 Australia and the eye health and vision care sector are calling on the Australian Government to reinforce its commitment to equitable eye health and vision care for Aboriginal and Torres Strait Islander people when the 2017-18 Budget is handed down on 9 May”

Carla Northam, CEO of Vision 2020 Australia, says: Focusing on eye health and vision care is an important part of closing the gap between Indigenous and non-Indigenous Australians. Press Release 3 below

Press Release 1 NACCHO Aboriginal Health and @TheRACP #Budget2017 submission : Healthy people, Healthy Lives

Download the full submission here :

healthy-people-healthy-lives-racp-pre-budget-submission-2017-18

The submission addresses various topics including child and adolescent health, Aboriginal and Torres Strait Islander health, preventive health, climate change and health, as well as health system reform.

The submission makes a range of recommendations including:

•  increased investment in early childhood development to give all Australians the best, healthiest start in life
•  concerted efforts to close the gap in health outcomes between Aboriginal and Torres Strait Islander people and non-Indigenous Australians
•  strong preventive health measures which will reduce preventable illness and disease, focusing in particular on reducing the harms of alcohol and increasing the availability of alcohol treatment services to those who need them
•  funding for a national campaign to encourage conversations about end-of-life care preferences, and the development of flexible models of care that enable people to receive palliative care at home.

Aboriginal and Torres Strait Islander Health :  Healthy People, Healthy Lives:

Aboriginal and Torres Strait Islander people continue to experience poorer health outcomes than non-Indigenous Australians. The latest ‘Closing the Gap’ report found that Australia is not currently on track to close the life expectancy gap by 2031 – with the gap remaining close to ten years for both men and women.

To address the inequity that exists between Aboriginal and Torres Strait Islander people and non-Indigenous Australians and improve access to care, continuing focus and appropriate funding is required.

The National Aboriginal and Torres Strait Islander Health Plan 2013-2023 (NATSIHP) Implementation Plan in 2015 has not been supported with sufficient, secure funding and resources, which is risking its success.

Funding uncertainty and changes creates significant issues for the continuity of services to patients and for organisations in retaining and building their capacity.

The RACP strongly supports existing programs to improve equitable access to specialist care, including the Rural Health Outreach Fund (RHOF) and Medical Outreach Indigenous Chronic Disease Program (MOICDP). The RACP recommends that the Australian Government continue its investment in these programs, undertaking evaluation to ensure the funding models are achieving positive health outcomes for Aboriginal and Torres Strait Islander peoples.

Given the recent focus by the Australian government on improving mental health and reducing suicide rates in Aboriginal and Torres Strait Islander communities, the RACP supports the analysis, reporting and implementation of evidence-based solutions, with input from and led by these communities, to improve the quality and delivery of mental health promotion and suicide prevention services. The RACP supports the establishment of clearinghouses which enable effective access to relevant, high quality information and resources to support these efforts.

The RACP recommends that the Australian government:

• Allocate secure long-term funding to progress the strategies and actions identified in the NATSIHP Implementation Plan.
• Provide secure, long-term funding for the Rural Health Outreach Fund (RHOF) and Medical Outreach Indigenous Chronic Disease Program (MOICDP).
• Allocate sufficient and secure long-term funding to the Aboriginal Community Controlled Health Sector to support the sector’s continued provision of Indigenous-led, culturally sensitive healthcare.
• Build and support the capacity of Indigenous health leaders by committing secure long-term funding to the Indigenous National Health Leadership Forum.
• Reinstate funding for a clearinghouse modelled on the previous Closing the Gap clearinghouse, as recommended in the latest draft of the Fifth National Mental Health Plan.

Healthy People, Healthy Lives:  Preventive Health

A clear, appropriately funded, nationally-coordinated strategy for preventive health must be prioritised in the Federal Budget.

Preventive health measures can have a powerful impact on the overall health of a population, particularly as the number of Australians living with chronic conditions continues to grow. Chronic illnesses such as heart disease, stroke, kidney disease, cancer, and type II diabetes account for 85 per cent of the burden of disease in Australia.

Investing in reducing the harms of alcohol

As a causal factor in more than 200 disease and injury conditions, it is clear that alcohol is a major risk factor for chronic disease, and efforts to reduce alcohol consumption must be central to preventive health measures. Alcohol-related harms create enormous social and economic costs to Australian society, with estimates putting the annual costs of alcohol misuse at between $15 billion and $36 billion.

 The RACP calls on the Australian government to increase funding for alcohol treatment and prevention services, with specific funding allocated towards making these services available outside major metropolitan centres and to groups at greatest risk, including young people, risky drinkers and Aboriginal and Torres Strait Islander people.

The RACP has long considered the WET and rebate to be particularly dangerous as they encourage the production and consumption of cheap wine, whose low price makes its attractive to underage and problem drinkers. The RACP is very disappointed that the Australian Government has watered down its proposed tightening of the WET rebate announced in the 2016-17 Federal Budget. The RACP considers this a backward step in efforts to reduce the harms of alcohol.

The RACP recommends that the Australian government:

• Develop a national preventive health strategy to address and lower risk factors for preventable illnesses and diseases.

• Increase funding for alcohol treatment including workforce development to address unmet demand for treatment.

• Increase funding for prevention services in order to reduce the incidence of alcohol use disorders.

• Reform alcohol taxation to introduce a volumetric taxation system for all alcohol products and abolish the Wine Equalisation Tax (WET) and rebate.

• Allocate a proportion of the increased revenue raised from volumetric taxation to funding alcohol treatment and prevention services.

Press Release 3 Rural Doctors Association of Australia (RDAA), 

Australia’s rural doctors are urging the Federal Government to use next week’s Budget to lay down realistic funding to help transform a number of “very promising” healthcare initiatives into reality.

President of the Rural Doctors Association of Australia (RDAA), Dr Ewen McPhee, said the Government has some “innovative and potentially game-changing healthcare initiatives” ready at the boarding gate, and with realistic funding allocated in the Budget they would be well on their way to lift-off.

“We’re not seeking any new measures in next week’s Budget” Dr McPhee said.

“What we are hoping for is realistic funding for the exciting new health policy initiatives that the Government has already announced and that are already in the pipeline.

“A number of ground-breaking initiatives have been announced by the Government — like the establishment of Health Care Homes, the National Rural Health Commissioner role and a National Rural Generalist

Program to deliver more of the next generation of doctors with advanced skills to rural Australia.

“Each of these initiatives have real potential to significantly improve the health outcomes of those living in the bush. A combined injection of focused planning and realistic funding will ensure they deliver to best effect in the unique settings of rural and remote medical practice.

“With the legislation for the National Rural Health Commissioner expected to soon pass the Senate, it will be important to ensure that the role has the financial and other resources required to effectively deliver on its key outcomes, and to enable it to start its important work as soon as possible.

“While the funding allocated to the role is a good start and is welcomed, we believe additional funding may be required to ensure the full success of the role.

“Likewise, the development and delivery of a National Rural Generalist Program — a key election promise by the Turnbull Government — will require adequate funding to underpin its establishment and ensure its success going forward.

“And while the Health Care Homes initiative shows real promise in delivering an innovative approach to healthcare delivery into the future, significant additional funding will be needed to ensure this initiative is successful, especially in rural and remote Australia.

“Expenditure on health is an investment in the future wellbeing and productivity of all Australians — this is particularly so in the primary healthcare sector, which forms the core of the Australian health system.

“It is great to see that the Government understands this — a key example is its welcome recent announcement to ensure that rural and remote patients benefit from increased access to psychology services via Medicare-funded video consults with distant psychologists.

“Providing realistic levels of investment to support health system reform and the transition to new healthcare delivery arrangements will be key to achieving change successfully, especially in the bush.”

Areas that RDAA has highlighted as needing further investment through this year’s Budget include:

• Providing base level funding to each state and territory to establish and maintain a Rural Generalist training pathway
• Recognition of the higher costs and complexity of rural practice, and of the advanced skills needed for Rural Generalist practice, through the Medicare Benefits Schedule (MBS)
• Removal of the Medicare indexation freeze, which continues to negatively impact on rural and remote patients and the viability of rural and remote practices
• Providing and prioritising rural and remote training options during initial medical training, to enable more medical students to sample the rewarding nature of rural and remote practice
• Expanding the Rural Junior Doctor Innovation Fund to include key pre-vocational terms, to facilitate a streamlined pathway for Rural Generalist trainees in all states and territories
• Supporting training programs and locations that have demonstrated post-Fellowship retention of medical trainees into rural and remote practice

Press release 3 .Budget must close the gap for vision

The Australian Government must help to close the gap for vision by supporting better eye health and vision care outcomes for Aboriginal and Torres Strait Islander Australians in this year’s Federal Budget.

Significant and troubling eye health inequities exist between Aboriginal and Torres Strait Islander people and non-Indigenous Australians.

Among these is the prevalence of vision impairment and blindness among Aboriginal and Torres Strait Islanders – three times that of non-Indigenous Australians.

Vision 2020 Australia and the eye health and vision care sector are calling on the Australian Government to reinforce its commitment to equitable eye health and vision care for Aboriginal and Torres Strait Islander people when the 2017-18 Budget is handed down on 9 May.

Carla Northam, CEO of Vision 2020 Australia, says: ‘Focusing on eye health and vision care is an important part of closing the gap between Indigenous and non-Indigenous Australians.

‘The eye health and vision care sector has a long history of collaboration and utilising its collective expertise to identify policy priorities in this area.

‘But, ultimately, the sector requires the support of the Australian Government to improve eye health and vision care outcomes for Aboriginal and Torres Strait Islander people.’

Despite poor eye health and vision care outcomes for Aboriginal and Torres Strait Islander people, around 90 per cent of vision impairment and blindness is preventable or treatable, highlighting the need for continued funding and policy support at a national level.

Jaki Adams-Barton, Chair of the Vision 2020 Australia Aboriginal and Torres Strait Islander Committee and Manager of The Fred Hollows Foundation’s Indigenous Australia Program, says there are a number of areas that require urgent attention.

‘Uncorrected refractive error causes almost two-thirds of vision impairment among Aboriginal and Torres Strait Islander people. Although spectacles are the easiest and most cost-effective solution, Australia is yet to implement a nationally consistent subsidised spectacles scheme, which would help improve access to prescription glasses in Aboriginal and Torres Strait Islander communities,’ Ms Adams-Barton says.

‘Cataracts are the leading cause of blindness among Aboriginal and Torres Strait Islander Australians, yet backlogs prevent access to surgeries that allow people to instantly see.

Equitable access to eye health care services is critical to reducing high rates of avoidable blindness, and systems need to immediately react, and also be reformed, to ensure this is sustainable in the future.

‘Australia is the only developed country in the world to still have active trachoma in remote Aboriginal communities. While the numbers are low, it unfortunately still exists. We need to implement the World Health Organisation’s SAFE strategy in its entirety, specifically focusing on the Environmental element, to eliminate trachoma by 2020 and ensure measures are sustainable into the future.’

Ms Northam says: ‘Coordination is key to the delivery of successful eye health services to Aboriginal and Torres Strait Islander communities, particularly those in regional and remote areas.

‘Vision 2020 Australia looks forward to seeing what the 2017-18 Federal Budget holds, and, beyond that, continuing to work with the sector and the Australian Government to improve eye health and vision care outcomes for Aboriginal and Torres Strait Islander Australians.’

 Press Release 4  : 7 BETTER WAYS TO SPEND $7 BILLION – MENTAL HEALTH

The Australian Healthcare Reform Alliance (AHCRA) today called on the Government to re-direct funding in the upcoming Budget from the $7 billion private health insurance (PHI) rebate to increase services for people with mental illnesses.

AHCRA is a coalition of peak health organisations working together to create a better and fairer health system for Australia’s future.

“In an environment of increasing demand and limited resources, AHCRA acknowledges the need to make tough choices. This means recognises the futility of continuing to subsidise wasteful and poorly targeted private health insurance rebates and directing the saved funding into an area of greater need, such as mental health services,” Dr Sebastian Rosenberg, AHCRA Spokesperson on Mental Health and Senior Lecturer in Mental Health Policy at the Brain and Mind Centre at the University of Sydney, said today.

“Abolishing the PHI rebate would free up around $7 billion in health funding, effectively permitting close to doubling the amount available in Australia to deliver mental health care. While representing 13% of the total burden of disease, mental health currently receives only around 5% of the health budget.

“We have better evidence than ever before about what works in mental health care but without adequate resources we have been fighting with one arm tied behind our backs. Choosing to end subsidies to the private health insurance industry frees Australia to finally develop a contemporary and community-based mental health system on which the community can rely.

“This new funding should not be used to replicate our existing bed-based system of mental health care. Instead, the new funding should be purposively directed towards early intervention and hospital avoidance. This would develop a new range of community-based services designed to fill the service void existing between the GP and the public hospital emergency department.

“A new system such as this would have massive positive impacts not only on individuals and their families but on the overall productivity of the Australian economy” Dr Rosenberg said.