” The AMA is calling on the Federal Government to significantly increase recurrent spending on health to properly meet current and future demand for quality care and services in the Australian health system.
Releasing the AMA’s Pre-Budget submission for the 2020-21 Federal Budget, AMA President, Dr Tony Bartone, said today that the AMA wants the Government to lift spending from its current level of 9.3 per cent to a level in line with comparable countries.
From Page 17
Over recent years, there have been some modest health gains for Aboriginal and Torres Strait Islander people, notably, the reductions in rates of child mortality and smoking. Despite this progress, the life expectancy gap between Aboriginal and Torres Strait Islander people and other Australians is still significant.
Chronic diseases are a primary contributor to the life expectancy gap between Indigenous and non-Indigenous Australians, many of which, stem from the social determinants of health
– poverty; unhygienic, overcrowded living conditions; poor food security and access to safe drinking water; lack of transport; as well as an absence of health services.
To make any significant progress in improving health and life outcomes for Aboriginal and Torres Strait Islander people, these social determinants must be addressed. This should be done through culturally appropriate programs that are responsive to the needs of Aboriginal and Torres Strait Islander communities.
From AMA 2020-21 Budget submission : Read Indigenous health support Page 17 or in full Part 1 Below
Download full AMA submission
” Major efforts have been undertaken in recent decades to improve Aboriginal and Torres Strait Islander people’s health. Life expectancy has increased notably, from levels well below those enjoyed by Australia’s non-Indigenous population.
There have been encouraging reductions in mortality rates from chronic diseases. Correspondingly, between 2012 and 2017 Aboriginal and Torres Strait Islander life expectancy at birth rose by over 2 years.
Nonetheless, it is vital that effort to maintain the increase in life expectancy is reinforced, as the gap in overall life expectancy between Aboriginal and Torres Strait Islander people and other Australians remains largely unchanged.
It is unacceptable that, according to the 2019 Closing the Gap report, “The target to close the gap in life expectancy by 2031 is not on track” (p122, emphasis added), and it is widely believed that the target cannot be achieved within the CTG timeframe.
It is urgent that the underlying causes of the gap are addressed. This must involve deliberate, coordinated and long-term commitments, developed and delivered with and by Aboriginal and Torres Strait Islander people.
Finally, noting the vital need for Aboriginal and Torres Strait Islander people to lead health and other initiatives central to their own health, PHAA supports the funding of programs that are initiated and run by Aboriginal and Torres Strait Islander people such as the National Aboriginal Community Controlled Health Organisation (NACCHO). “
From PHHA 2020-21 Budget submission : Read Indigenous health support Page 16 or in full Part 2 Below
Download the full PHAA Submission
Commonwealth Budget 2020-21 – pre-Budget directions
The 2020-21 Budget presents an opportunity for the Government to translate available knowledge into action, including identifying and filling service gaps, and directing Indigenous health funding according to need.
This is particularly important given that the burden of disease for the Aboriginal and Torres Strait Islander population is 2.3 times higher than for other Australians.
The AMA calls on the Government to:
- allocate Indigenous health funding in the 2019-20 budget based on the much higher health needs of Indigenous communities, recognising that chronic disease is inextricably connected to the social determinants of health; and
- implement the recommendations of the AMA’s recent Report Cards on Indigenous Health, in particular:
+ commit to achieving a minimum standard of 90 per cent population access to fluoridated water;
+ systematically identify, cost and fund unimplemented parts of the national Aboriginal and Torres Strait Islander Health Plan 2013-2023;
+ implement a coordinated national response to address chronic otitis media in Indigenous communities;
+ fund and implement a strategy to eradicate rheumatic heart disease from Australia; and
+ appropriately fund services that divert Aboriginal and Torres Strait Islander people from prison.
Serious health care challenges remain for Aboriginal and Torres Strait Islander Australians. Rheumatic heart disease remains a massive concern.
Alarmingly, mortality from cancer is actually rising, and the ‘gap’ in cancer mortality compared with the general population is actually growing. Rates of suicide remain far too high.
The health conditions of young Indigenous Australians should be a key focus. Aboriginal and Torres Strait Islander Australians have a younger age profile than the general population, having a median age of 23 compared with 38 (as at the 2016 Census). Over 60% of Indigenous people are aged under 30.
There are a number of current programs working to prevent illness in very young Aboriginal and Torres Strait Islanders people between 5 and 8 years old.
However, there is a major lack of targeted attention to people from the adolescent years through to around age 25.
This broad age group is formative of many lifelong health problems. Illnesses related to consumption habits (smoking, alcohol, sugar-added products and junk food) resulting in diabetes, cardiovascular disease, rheumatic heart disease, oral health problems, as well as mental health problems often have their genesis in this neglected period of adolescence and young adulthood.
Specifically, the evidence of a link between hearing loss in childhood and subsequent incarceration of Aboriginal people is overwhelming.
A program that has demonstrated the success of an Aboriginal controlled and led model is the Tackling Indigenous Smoking program.
The initiative to reduce smoking rates in Aboriginal and Torres Strait Islander people has made valuable progress but more is required to close the gap in smoking rates between Aboriginal and non-Aboriginal Australians.
Major initiatives in illness prevention are required to improve the wellbeing of adolescent Aboriginal and Torres Strait Islander people by:
- reducing the suicide rate
- reducing use of alcohol and other drugs
- reducing tobacco use, with targets including:
- reducing age 15-17 smoking rates from 19% to 9%
- increasing age 15-17 ‘never-smoked’ rates from 77% to 91%
- increasing annual health check for people aged 15-24
- reducing rates of juvenile incarceration, through programs such as justice reinvestment programs should aim to close the gap between Aboriginal and Torres Strait Islander People and the wider Australian population in all health metrics
Environmental factors also impact on health and wellbeing. Programs to improve environmental health help prevent eye and ear health problems which are more prevalent in Aboriginal and Torres Strait Islander communities.
Rheumatic heart disease, including acute rheumatic fever, is almost exclusively experienced within Australia by Aboriginal and Torres Strait Islander people and is also associated with poverty, poor and overcrowded living conditions and poor hygiene.
We note that the current National Aboriginal and Torres Strait Islander Health Plan, due to remain in effect until 2023, has not in fact been adequately funded to achieve its outputs.
One very obvious place for the Government to start in the coming Budget is to repair this defect. T
his would be consistent with the priorities, established by the COAG Joint Council on Closing the Gap co-chaired by the Pat Turner AM and the Hon Ken Wyatt MP, Minister for Indigenous Australians, to accelerate improvements in life outcomes of Aboriginal and Torres Strait Islander peoples by:
- developing and strengthening structures to ensure the full involvement of Aboriginal and Torres Strait Islander peoples in shared decision making at the national, state and local or regional level and embedding their ownership, responsibility and expertise to close the gap
- building the formal Aboriginal and Torres Strait Islander community-controlled services sector to deliver closing the gap services and programs in agreed priority areas
- ensuring all mainstream government agencies and institutions undertake systemic and structural transformation to contribute to Closing the
PHAA urges Government to adopt substantive and durable commitments aligned with the priorities identified by the National Health Leadership Forum (NHLF), the national representative body for Aboriginal and Torres Strait Islander peak organisations advocating for Indigenous health and wellbeing, which include:
- “Promote self-determination across national institutions, through Constitutional reform and the recommendations that arose from the Uluru Statement from the Heart;
- Close the gap in life expectancy and the disproportionate burden of disease that impacts Aboriginal and Torres Strait Islander people, through system-wide investment approach for the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan, with COAG Health Council;
- Prioritises and escalates actions under the National Aboriginal and Torres Strait Islander Health Workforce Plan – to address the massive shortfall in this workforce across all professions and levels, and is essential to improve Aboriginal and Torres Strait Islander health and wellbeing; and
- Acknowledge the adverse impact of racism on the health and wellbeing of Aboriginal and Torres Strait Islander people, and aspects of the health system that prevent people from accessing and receiving the health care they require – and to work with the NHLF and other Aboriginal and Torres Strait Islander health experts in embedding co-design and co-decision making processes to embed culturally safe and responsive health practices and ”
Finally, noting the vital need for Aboriginal and Torres Strait Islander people to lead health and other initiatives central to their own health, PHAA supports the funding of programs that are initiated and run by Aboriginal and Torres Strait Islander people such as the National Aboriginal Community Controlled Health Organisation (NACCHO).