NACCHO Aboriginal Health and our Workforce #IAHAConf19 #ClosingTheGap : Read John Paterson’s CEO @AMSANTaus Keynote Speech :The importance of collaboration , partnerships and the role of leadership vital in supporting and expanding our Aboriginal health workforce.

 

” Allied health professionals play a very important role in the health system and our services increasingly employ a range of allied health professionals as part of providing holistic, comprehensive primary health care: podiatrists, diabetes educators, dieticians, optometrists, audiologists, dental workers and physiotherapists.

Some areas have received increasing recognition and associated resourcing. For example, better understanding of the issues associated with social and emotional wellbeing, the impact of trauma and the need to address the tragic loss of so many of our people to suicide, has resulted in increased resourcing and employment of allied health professionals, particularly within the multi-disciplinary teams of our health services.

IAHA’s role, as is AMSANT’s, is to build our Aboriginal and Torres Strait Islander health workforce that is critical to improving health outcomes.”

John Paterson CEO AMSANT Keynote Speech IAHA Conference Darwin 25 September

I would like to begin by acknowledging the traditional owners on whose land we gather upon today, the Larrakia people – and to honour their leaders past, present and emerging.

My name is John Paterson and I am the Chief Executive Officer of Aboriginal Medical Services Alliance NT, or more commonly known as AMSANT. AMSANT is the peak body for Aboriginal community controlled health services (ACCHSs) in the Northern Territory and we are an affiliate of the National Aboriginal Community Controlled Organisation, NACCHO. We provide a range of support to our members including workforce, public health, policy, digital health, continuous quality improvement and trauma informed care.

I’d like to thank the Indigenous Allied Health Association for inviting me to present this morning at this important conference.

I’d also like to acknowledge my colleague, Donna Ah Chee, who gave an inspiring keynote speech yesterday.  In her presentation, Donna outlined the characteristics and importance of the comprehensive model of primary health care, delivered through Aboriginal community controlled health services, and so I won’t go over the same ground here today.

Instead I’d like to focus on the importance of collaboration and partnership that in many ways have come to define the way we work in Aboriginal health; and also to reflect on the role of leadership that is so vital in supporting and expanding our Aboriginal health workforce.

Can I firstly congratulate IAHA on celebrating their first 10 years—hopefully the first decade of many more to come—and to acknowledge their hard work across the nation to build and support quality Indigenous Allied Health professionals for our mob.

I would also like to acknowledge IAHA’s CEO, Donna Murray, their board and its members for the hard work you continue to do to build IAHA to where it is today.  We look forward to seeing where your future takes you.

We know how important it is to have our own Aboriginal and Torres Strait Islander national and peak organisations to advocate for our mob. We have to be there, in the tent, at the negotiating table, making our case.

And we’ve got to be working together.

One of my other hats is as one of the governing group of CEOs of the Aboriginal Peak Organisations NT, or APO NT, along with the CEOs of the Northern Land Council and Central Land Council. The APO NT alliance was formed in 2010 to provide coordinated Aboriginal leadership in the Territory in the wake of the NT Intervention, although we have also worked effectively at the national level.

APO NT is a member of the National Indigenous Coalition of Peaks, within which IAHA is also represented as a member. The work of the Coalition of Peaks and the outcomes we are achieving in relation to a renegotiation of Closing the Gap is an important example of why working together in partnership is so vital to the future of Aboriginal health. This is a theme I will return to later in my presentation.

The other critical element, of course, is the frontline workers at the health service and community levels, who care for our mob.  I want to acknowledge and thank all of the Aboriginal and Torres Strait Islander Allied Health Professionals and students in the room today and across the nation who do such an exceptional job in their chosen fields to help make a difference in health.

Find a a job in an ACCHO with NACCHO Job Alerts

You are an essential part of the health system and we thank you for your tireless efforts in everything that you do.

Allied health professionals play a very important role in the health system and our services increasingly employ a range of allied health professionals as part of providing holistic, comprehensive primary health care: podiatrists, diabetes educators, dieticians, optometrists, audiologists, dental workers and physiotherapists.

Some areas have received increasing recognition and associated resourcing. For example, better understanding of the issues associated with social and emotional wellbeing, the impact of trauma and the need to address the tragic loss of so many of our people to suicide, has resulted in increased resourcing and employment of allied health professionals, particularly within the multi-disciplinary teams of our health services.

IAHA’s role, as is AMSANT’s, is to build our Aboriginal and Torres Strait Islander health workforce that is critical to improving health outcomes.

The untapped potential is huge. Collectively, the Aboriginal community controlled health sector employs about 6,000 staff, 56 per cent whom are Aboriginal and Torres Strait Islander people. This makes us the single largest employer of Aboriginal and Torres Strait Islander people in the country.

But there is still such a long way to go.

One of the areas requiring attention is the need to be advocating for more allied health positions within our sector. Many Aboriginal community controlled health services are not sufficiently funded to employ the multi-disciplinary workforce required to deliver the full range of core comprehensive primary health care services. Expanding and increasing the resourcing of Aboriginal community-controlled comprehensive primary health care services is a key strategy in developing our Indigenous workforce, particularly in allied health positions.

Further potential is provided by the opportunities to expand services in regional and remote areas in aged care and through the NDIS.

The lack of aged care and disability services in regional and remote areas is a major problem that needs to be addressed in ways that take account of the lack of economies of scale and difficulty in attracting health professionals to such areas, as well the need for culturally responsive service delivery. This requires consideration of regional hub models and opportunities for joint initiatives in workforce development, capacity building and the employment of specialist and other allied health professionals.

Some ACCHSs already provide aged care and disability services, sometimes by default due to the failure or lack of service providers. There is further potential for ACCHSs to employ staff who can provide aged care and disability services.

Our vision is for people with disabilities in remote and regional areas to be able to access the services they need and to lead active and fulfilling lives. And for our old people to be able to live out their days in dignity on country and pass away surrounded by family.

We have such a long way to go to achieve this vision and we hope that the current Royal Commissions into these areas will provide a catalyst for action.

Increasingly, building our Indigenous workforce requires collaboration between providers and sectors. AMSANT works in collaboration with a wide range of key stakeholders to create career opportunities for our next generation coming through, and to build initiatives and opportunities for our existing Aboriginal health workforce in developing career pathways, whether it be as community workers, health workers or in management.

An important initiative for AMSANT has been our involvement in the Lowitja Institute-funded Career Pathways Project. This is an Aboriginal-led national research project to provide insights and guidance to enhance the capacity of the health system to retain and support the development and careers of Aboriginal and Torres Strait Islander people in the health workforce. The project partners include Aboriginal health services in NSW and the NT along with university and peak organisation partners.

This project was important to us. We wanted to give our Aboriginal health professionals a voice that was evidence-based. To be able to provide solutions from the ground up that we could advocate for at local, regional and national platforms. To demonstrate with evidence where the need for investment is and emphasise how critical our Aboriginal health workforce is to improve health outcomes for our mob.

Other significant collaborations include working with Indigenous workforce bodies, such as IAHA and the National Aboriginal and Torres Strait Islander Health Workers Association, or NATSIHWA, on expanding Indigenous workforce in key areas.

You may have heard yesterday that AMSANT has been working in partnership with IAHA for the past 2-3 years to develop and implement a VET in schools pathway for high school students here in Darwin. This will provide students an opportunity to gain a qualification in allied health support and consider a career in health.

This has been a priority for AMSANT for many years, to source opportunities in many health disciplines for the next generation of our kids to start a journey in health. We have known for too long here in the NT that there are simply not enough opportunities for our kids to start that journey. A journey that is supported, nurtured and led by the Aboriginal health sector.

We have also successfully advocated alongside IAHA and other key organisations to the Council of Australian Governments (COAG) at a meeting in Alice Springs, for the development of an Aboriginal health workforce plan.

The important message from this is that we can’t do workforce strategy, or broader health strategy for that matter, alone.

Partnerships are vital. We need them to help bridge the gap between the too-often siloed mentality of governments and funders and the reality that health is holistic and demands focus on the big picture.

Partnerships enable us to work together to push the health agenda and encourage investment in the areas our communities so desperately need.

This means following the evidence and advocating on it.

For example, it’s now commonly understood that health services only account for approximately a third of health outcomes, with the other two thirds accounted for by the social and cultural determinants of health.

Increasingly, AMSANT’s partnerships have focused on health determinants, following the evidence and responding to the issues raised by our membership and the community. Our sector’s model of comprehensive primary health care encourages cross sectoral action on the social determinants.

Housing has been at the forefront of community concern, with high levels of overcrowded and inadequate housing and homelessness. We know the health and wellbeing impacts that poor housing and homelessness causes. This includes impacts on the Aboriginal health workforce who struggle with living in inadequate or overcrowded houses while maintaining their responsibilities to their work in health. Strong Aboriginal advocacy on housing is needed.

As a member of APO NT, AMSANT has contributed to the development of a Northern Territory Aboriginal peak housing body, Aboriginal Housing NT or AHNT. The new body will provide a strong Aboriginal voice on housing as well as a mechanism for government to engage with in increasing the involvement of Aboriginal organisations in housing provision and management.

I use this example to illustrate the importance of taking a role in advocating on the social determinants as a means of improving health outcomes as opposed to focusing exclusively on health service or disease specific strategies.

However, it also illustrates the point that I began this presentation with—the importance of Aboriginal leadership and having our own Aboriginal and Torres Strait Islander organisations to advocate for our mob and to deliver services to our communities that are culturally responsive and effective.

I want to return briefly to my earlier mention of Closing the Gap and the membership of APO NT and IAHA as members of the National Indigenous Coalition of Peaks.

 

The Coalition of Peaks emerged as a result of a group of national Indigenous organisations writing to the Prime Minister in relation to the exclusion of our mob from the decision-making process for the Closing the Gap Refresh.

After ten years of failed progress under Closing the Gap we weren’t about to submit to another top-down, government-imposed process on our communities.

The letter sparked a meeting with the Prime Minister and subsequently, negotiations with the Council of Australian Governments, or COAG, that have resulted in a formal Partnership Agreement on Closing the Gap with the Coalition of Peaks, and the establishment of a Joint Council on Closing the Gap with the Coalition of Peaks represented as a Council member—the first time that a non-governmental body has been represented within a COAG structure.

Importantly, the central ask of the Coalition of Peaks, is not around new indicators—although these are important tools to get right—but for a fundamental change in the way governments work with our people and the full involvement of our people in shared decision-making at all levels.

This includes a commitment to building, strengthening and expanding the formal Aboriginal and Torres Strait Islander community controlled sector to deliver Closing the Gap services and programs.

We are also calling for the new Closing the Gap strategy to be properly funded, at least matching the ten-year funding of the original Closing the Gap.

The potential for this new national partnership with government is that support for the expansion of the Aboriginal community controlled service delivery sector and with it the Indigenous health workforce could be a game-changer.

While nothing is certain in this world, this is one development that gives me real hope that fundamental change is possible.

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And it started with Aboriginal leadership.

Of course, Aboriginal leadership is just as important at the sector and service level if we are to be true to our commitment to the aspirations and standards of community control.

AMSANT has been committed to building leadership capacity within the health sector in the NT and has been delivering leadership workshops for over 11 years now. We have recently developed a formal partnership with the Australian Indigenous Leadership Centre which will further build our capacity in leadership support within the NT. We look forward to seeing this partnership develop and deliver for our sector.

We especially need to acknowledge our elders—our leaders and mentors who have or still work tirelessly to keep doing what they do to give our communities the best possible chance of improving health outcomes. Too often they are the unsung heroes that have paved the way for the next generations to keep building on the hard work that’s been done.

Leadership is vital at every level, not least in supporting our Aboriginal workforce. We know the many challenges that our workforce face, dealing with burnout, the vicarious trauma they experience, as well as day to day stress—and we know that we have to have in place effective strategies to support them. We know there is much still to do in supporting career pathways. And we know that there are many issues of equity, such as addressing the lack of housing for local workers.

The Aboriginal health sectors and its workforce has decades of knowledge, know-how and lived experience to know what we need by way of services and ways to improve health outcomes.

AMSANT recently celebrated our 25th anniversary and our oldest member service, the Central Australia Aboriginal Congress, has now been in existence for 45 years. They, along with other pioneers such as the Redfern Medical Service, paved the way for the more than 150 Aboriginal community controlled health services that are currently working for our communities across the country.

Here in the Territory, AMSANT is a member of the Northern Territory Aboriginal Health Forum along with the Northern Territory and Commonwealth governments, and the NT Primary Health Network. The Forum is a high level Aboriginal health planning body that assures us a seat at the table.

Our sector today continues the mission it took on 45 years ago to provide Aboriginal community controlled holistic, comprehensive primary health care to our people. We have continued to grow our place in the health system, currently providing around two thirds of all primary health care services to our communities. And we are supported to continue to transfer government run services to community control over time.

I hope that the students amongst the audience today can take encouragement from this history of our sector, that you have a secure future in Aboriginal health and that you have a welcome place in our services.

Believe me, as a former bureaucrat and ATSIC Commissioner, there is not much that survives the relentlessly changing priorities of government. That we continue to prevail is a true success story!

And I hope you can take the courage to dream big as our leaders did all those years ago.

Today we have a new vision to follow: the Uluru Statement from the Heart, adopted by the First Nations National Constitutional Convention at Uluru in May 2017.

Treaty, truth, voice!

We have support and as Indigenous peoples we are persistent and patient.

But keep that fire in your belly!

I hope you enjoy the rest of the conference and I wish you all the very best for your futures.

Thank you.

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