NACCHO Aboriginal Health #AIDAconf2017 @AMApresident speech #Indigenous health – Turning words into action

 ” At every opportunity, the AMA highlights the issues of housing, clean water, transport, food security, access to allied medical services, and other social determinants that contribute to chronic disease and act as barriers to treatment and prevention.

The AMA has said time and again that it is simply unacceptable that Australia cannot manage the health care of the first peoples, who make up just three per cent of our population.

When it comes to Indigenous health, the Federal Government needs to broaden its thinking.”

Dr Michael Gannon AMA President speaking at Australian Indigenous Doctors #AIDAconf207 21 September

Please note we hope to publish todays #AIDAconf2017 speech from Minister Indigenous Health Ken Wyatt on  Monday

I acknowledge the Wonnarua People – the traditional owners and custodians of the land, and pay respects to their elders, past and present.

My thanks to the Australian Indigenous Doctors’ Association for the invitation to speak here today. It is a great privilege.

Congratulations on your 20th Anniversary. You have come a long way.

Aboriginal and Torres Strait Islander people face adversity in many aspects of their lives.

There is arguably no greater indicator of disadvantage than the appalling state of Indigenous health.

Aboriginal and Torres Strait Islander people are needlessly sicker, and are dying much younger than their non-Indigenous peers.

What is even more disturbing is that many of these health problems and deaths stem from preventable causes.

The battle to gain meaningful and lasting improvements has been long and hard, and it continues.

I sit on the Western Australian State Perinatal and Infant Mortality Committee. Aboriginality is a depressingly regular theme in these Stillbirths and Neonatal Deaths.

I am proud to be President of an organisation that has for decades highlighted the deficiencies in Indigenous health services and advocated for improvements.

While there has been some success in reducing childhood mortality and smoking rates, the high levels of chronic disease among Indigenous people continue to be of considerable concern.

For the AMA, Aboriginal and Torres Strait Islander health is a key priority. It is core business.

It is a responsibility of the entire medical profession to ensure that Aboriginal and Torres Strait Islander people have the best possible health.

It is the responsibility of doctors to ensure that patients – all patients – are able to live their lives to the fullest.

Many of you will know that the AMA has a Taskforce on Indigenous Health, which I Chair.

The Taskforce develops and recommends Indigenous health policy and strategies for the AMA to champion with governments and other agencies.

Along with AMA leadership, the Taskforce has representatives from AIDA, NACCHO, the Royal Australian College of General Practitioners, and the Australian Medical Students’ Association.

The Taskforce has been working since 2000. The Taskforce helps the AMA develop its annual Report Card on Indigenous Health.

Download here


These Report Cards comment on topical issues in Aboriginal and Torres Strait Islander health, and recommend solutions that we urge governments to embrace.

The consistent message in all of these Report Cards is that the health of Aboriginal and Torres Strait Islander people will not improve until the factors that contribute to poor health, the social determinants of health, are addressed.

This year, the AMA’s Report Card on Indigenous Health – to be released in November – will focus on ear health and hearing loss.

Aboriginal and Torres Strait Islander people in Australia suffer from some of the highest levels of ear disease in the world, and experience hearing problems at up to ten times the rate of non-Indigenous people across nearly all age groups.

Hearing loss has health and social implications, particularly in relation to educational difficulties, low self-esteem, and contact with the criminal justice system.

To address ear health issues among Aboriginal and Torres Strait Islander people, it will be necessary to continue raising awareness, improving strategies for prevention, providing funds for further research, and improving access to services.

The AMA hopes the Report Card will be a catalyst for government action to improve ear health among Aboriginal and Torres Strait Islander people.

All our governments must address the broader social determinants of health, which contribute to the development of ear disease.

At every opportunity, the AMA highlights the issues of housing, clean water, transport, food security, access to allied medical services, and other social determinants that contribute to chronic disease and act as barriers to treatment and prevention.

The AMA has said time and again that it is simply unacceptable that Australia cannot manage the health care of the first peoples, who make up just three per cent of our population.

When it comes to Indigenous health, the Federal Government needs to broaden its thinking.

For too long now, people working in Indigenous health have called for action to address the social issues that affect the health of Aboriginal and Torres Strait Islander people.

Education, housing, employment, sanitation, clean water, and transport – these all affect health too.

This is clearly recognised in the Government’s own National Aboriginal and Torres Strait Health Plan 2013-2023, yet we continue to see insufficient action on addressing social determinants.

One message is clear – the evidence of what needs to be done is with us.

There is a huge volume of research, frameworks, strategies, action plans and the like sitting with governments – and yet we are not seeing these being properly resourced and funded. We do not need more paper documents. We need action.

The AMA recognises that Indigenous doctors are critical to improving health outcomes for their Aboriginal and Torres Strait Islander patients.

Aboriginal and Torres Strait Islander doctors have a unique ability to align their clinical and cultural expertise to improve access to services, and provide culturally appropriate care for Indigenous patients.

But there are too few Aboriginal and Torres Strait Islander doctors and medical students in Australia.

My father grew up in Dowerin in rural WA. He had long lost the title of its best ever footballer before Lance ‘Buddy’ Franklin was born.

I grew up in Perth and went to primary school with Aboriginal kids. The same was true at high school.

Later in my University training and as a Doctor-in-training, I had regular exposure to a high proportion of Aboriginal patients at Royal Perth Hospital and King Edward Memorial Hospital.

But at University, I had little contact with Indigenous people.

In 2017, there are just 281 medical practitioners employed in Australia who identify as Aboriginal and/or Torres Strait Islander – representing only 0.3 per cent of the workforce.

In 2016, around 286 Indigenous students were known to be studying medicine. It is, as you in this room know, slowly changing.

The Indigenous medical workforce must grow significantly to achieve overall improvements in Indigenous health.

To help boost the number of Indigenous medical students, and ultimately doctors, the AMA has offered a scholarship to an Indigenous medical student each year since 1994.

Over the years, our Scholarship has helped support more than 20 Indigenous men and women to complete their medical degrees.

Our most recent Scholarship recipient, James Chapman, understands the importance of family, culture, and education.

At a young age, James saw both of his parents endure health problems, and unfortunately lost his father to acute myeloid leukaemia after a short battle with the disease.

While he did not realise it at the time, James has said his father was a victim of the gap that exists between Indigenous and non-Indigenous Australians.

His father’s death made him realise his potential to contribute to his fellow Indigenous populations by providing access to health services.

James now has a purpose to study medicine so that he can practise in rural and remote Australia, offering Indigenous people access to equal health care, and addressing a major socio-economic inequality in Australia.

He realises that closing the gap between Indigenous and non-Indigenous people isn’t a one-man job.

But he takes comfort in knowing that he can contribute and make a difference to his fellow Indigenous people’s lives – prolonging and preserving a culture that holds a very important place for himself and many others.

The AMA worked hard to achieve Deductible Gift Recipient (DGR) status for our scholarship, and we are actively seeking donations, hoping to award a second annual scholarship for the first time this year.

Increasing the number of Indigenous doctors is a goal, not just for the AMA, but for all of those involved in closing the gap and improving the health and wellbeing of Australia’s first peoples.

The AMA will continue advocating for an increase in the number of Indigenous doctors in Australia.

The AMA has been a persistent, sustained, and powerful voice on Indigenous health for decades.

During that time, much has changed for the better, particularly as a result of the Close the Gap campaign. Recent cuts to funding are a huge concern.

Despite good intention and considerable investment by successive governments, the disparity in health outcomes remains.

Each year, the Prime Minister delivers a report on Closing the Gap, which in recent years has been profoundly disappointing.

The Closing the Gap reports sadly are not delivering on positive outcomes to improve Indigenous health.

Nor do they deliver one extra doctor when and where they are needed most.

They certainly provide no new funding.

Achieving health equality for Aboriginal and Torres Strait Islander Australians is an incredibly difficult task.

There have been some gains, but we need to do more – much more.

We must ensure that our governments do not fatigue in this task. They have the support of the broader Australian community.

It will take time, but most of all it will take ongoing commitment.

Governments at all levels must make meaningful investment in Indigenous health, and work with Indigenous communities to develop solutions that address their unique health needs.

Local Indigenous communities and local Indigenous people have the knowledge and expertise. They know what works. Without using this experience, the gap will remain wide and intractable.

The AMA has repeatedly said that it is not credible that Australia, one of the world’s wealthiest countries, cannot address the health and social justice issues that affect three per cent of its citizens.

We will continue to work with governments to take action to improve health and life outcomes for Aboriginal and Torres Strait Islander people.

NACCHO congratulates the Australian Indigenous Doctors Association #AIDAconf2017 @AIDAAustralia for 2O years of strong leadership

 ” Since the first Indigenous doctor graduated in 1983, more than 300 other Aboriginal and Torres Strait Islander people have gone onto become doctors.

The Australian Indigenous Doctors Association (AIDA) has played an important role in contributing to the growth of this critical workforce through the strong support it provides Indigenous doctors and medical students,

This week AIDA will celebrate its 20th anniversary during its annual conference starting today .

A recent commitment to work with the Australian Government, National Aboriginal Community-Controlled Health Organisation (NACCHO) and the Council of Presidents of Medical Colleges (CPMC) will see further improvements in health systems capabilities to deliver appropriate services for Aboriginal and Torres Strait Islander peoples “

Karen Wyld is covering the #AIDAconf2017 conference for the Croakey Conference News Service 

Picture above : AIDA emerged from a conference of Aboriginal and/or Torres Strait Islander medical students and doctors in 1997

You can read some of the stories of its members in this publication

Download PDF Journeys into Medicine

AIDA Journeys-

Watch recent interview with Dr Mark Wenitong on NACCHO TV

Watch recent interview with Dr Ngiare Brown  on NACCHO TV

Karen Wyld is covering the conference for the Croakey Conference News Service and provides a comprehensive preview below. Karen Wyld is an author, consultant and freelance writer from South Australia. Of Aboriginal descent (Martu), she has a background in community development, social/health research, health workforce training, and Aboriginal community-controlled health. ( See  full info below )

Family Unity Success – 20 years strong,

This week, there will be more than a few doctors in the house at Cypress Lakes Resort in Pokolbin, New South Wales, when the Australian Indigenous Doctors Association (AIDA) holds its annual conference.

This year’s AIDA conference theme is Family Unity Success – 20 years strong, which is well reflected in the program. Featuring VIP guest speakers, informative sessions with inspiring leaders in health, and numerous cultural activities and networking opportunities, the program runs from Wednesday 20 through to Saturday 23 September 2017.

From little things, big things grow

AIDA is a strong, supportive network of over 500 doctors, medical students, and partner organisations. This year’s conference will be its biggest ever, with more than 360 registered delegates and speakers.

AIDA emerged from a conference of Aboriginal and/or Torres Strait Islander medical students and doctors in 1997. That inaugural event was held at Salamander Bay in the Hunter region of NSW. And in 2017 AIDA returns to NSW, this time Hunter Valley, for their 20th year celebration.

Since its inception, AIDA has been achieving its goals of contributing to equitable health and life outcomes and the cultural wellbeing of Indigenous people by reaching population parity of Indigenous medical graduates and supporting a culturally safe health care system.

The culturally-appropriate high-level support that AIDA provides members, especially Aboriginal and/or Torres Strait Islander medical students, is both a contributing factor to the association’s success and to an expanding Indigenous health workforce.

With a Secretariat led by CEO Craig Dukes, AIDA continues to grow from its base in Old Parliament House Canberra. The Board of Aboriginal and/or Torres Strait Islander doctors and a student Director provide direction to the Secretariat.

AIDA’s Student Representative Committee (SRC) is another means of supporting Aboriginal and/or Torres Strait Islander medical students. With representatives from most Australian medical universities, the SRC provides advice to AIDA on initiatives to support Indigenous medical students to succeed in their studies and personal career aspirations.

Through strengthening collaboration with key medical bodies and colleges, AIDA continues to influence the Australian health care system to work towards strategic changes within provision of health services for Aboriginal and/or Torres Strait Islander peoples.

Conference highlights

Starting on Wednesday 20 September, with member-only sessions and the AGM, this year’s AIDA conference has plenty to offer delegates. In the morning, James Wilson Miller and Laurie Perry of the Wonnarua Nation will conduct the welcome to Country. Dr Kali Hayward, AIDA President, and Dr Louis Peachey, AIDA Life Member, will present a session on the history of AIDA, and the vision for its future.

The agenda will be complemented with cultural activities, including a dance workshop and yarning circles. The day will finish with an evening gathering that includes a smoking ceremony, dance performances, unveiling of art, and Indigenous astronomy.

With renowned journalist and filmmaker Dr Jeff McMullen as MC, Thursday and Friday’s agenda has many informative sessions and skills-based workshops. AIDA has also attracted many Australian and international special guest speakers, including:

  • The Hon Ken Wyatt AM, MP, Minister for Indigenous Health
  • Senator Richard Di Natale, Leader of the Australian Greens
  • Professor Tom Calma, AO National Coordinator Tackling Indigenous Smoking, and Consultant to Commonwealth Health
  • Associate Papaarangi Reid, Deputy Dean Maori, Tumuaki, University of Auckland
  • Dr Michael Gannon, President of the Australian Medical Association
  • Mr Philip Truskett AM, Chair-Elect of the Council of Presidents of Medical Colleges, and AIDA Patron
  • Dr Martina Kamaka, Associate Professor, Department of Native Hawaiian Health, John A. Burns School of Medicine
  • Dr Nathan Joseph, Chairperson, Te Ora

A presentation by the Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women’s Council Ngangakaris on Thursday is another highlight in an agenda that features Aboriginal and Torres Strait Islander perspectives of health and wellbeing, and cultural activities.

Thursday evening, AIDA’s SRC will be hosting a networking event with sponsorship from National Aboriginal and Torres Strait Islander Health Workers Association (NATSIHWA). And on Friday night the Platinum Gala Dinner and awards ceremony will be held, MCed by Steven Oliver, Aboriginal writer, performer and comedian.

On the Saturday, an optional tour of Baiame Cave is offered to delegate and guests, or a choice of three specialised professional development workshops.

Moving forward with cultural safety

After presenting a VIP address in the plenary session on the Friday, the Hon Ken Wyatt MP will be participating in the Cultural Safety Panel. With his previous experience working within the health sector, and current appointment of Minister for Aged Care and Indigenous Health, Minister Wyatt’s contribution to this panel will be a conference highlight.

The cultural safety panel builds on recent work that AIDA has conducted in strengthening cultural competency within the Australian health sector. In 2016, AIDA conducted a survey to collate feedback from members on incidents of bullying, racism and lateral violence in the workplace. AIDA is now working on strategies to address the key issues that arose from the survey report.

A recent commitment to work with the Australian Government, National Aboriginal Community-Controlled Health Organisation (NACCHO) and the Council of Presidents of Medical Colleges (CPMC) will see further improvements in health systems capabilities to deliver appropriate services for Aboriginal and Torres Strait Islander peoples

Presidential perspectives

Dr Kali Hayward, AIDA President, is looking forward to celebrating the 20th year milestone with fellow AIDA members, by reliving AIDA’s history and acknowledging those who have contributed to its success.

Since the first Indigenous medical graduate in 1983, there are now over 300 Aboriginal and/or Torres Strait Islander doctors, specialists and surgeons. AIDA’s strong support of the Indigenous medical workforce and mentoring of Indigenous students in medicine has contributed to this outstanding growth in the number of medical practitioners.

Hayward acknowledges the supporting environment that AIDA’s conferences provide Indigenous medical students, and speaks highly of the Growing Our Fellows session. This provides Aboriginal and/or Torres Strait Islander medical students an opportunity to have a one to one conversation with a representative from fifteen medical colleges. With strong competition to get into college training programs, this is unique opportunity for students to discuss their career pathways through medicine.

Whilst the CEO and Secretariat have worked tirelessly to ensure this year’s conference will be special, AIDA’s strong reputation has meant that they received many offers of support. This has resulted in an enviable conference program. Dr Hayward says that AIDA is very appreciative of people giving their time, with many VIP speakers and guests eager to celebrate the 20th milestone.

Hayward also stated that she “…is very proud to be the current President. Proud of the students, and other AIDA members. And proud to be able to help create a safe environment for students and doctors to come together.”

Looking at how far AIDA has come since 1997, there is much to be proud of, and many examples of Family Unity Success to celebrate at the conference.

Join the conversation

Karen Wyld is covering the #AIDAconf2017 for the Croakey Conference News Service

Please join the conversations arising during and after the conference.

Karen Wyld is an author, consultant and freelance writer from South Australia. Of Aboriginal descent (Martu), she has a background in community development, social/health research, health workforce training, and Aboriginal community-controlled health. She currently has a draft novel long-listed for the 2017 Richell Prize. Read her recent articles for Al Jazeera, Monumental Errors, and for @IndigenousX: Ongoing administrative errors afflict the Indigenous Advancement Strategy. Follow on Twitter:  @1karenwyld

NACCHO Aboriginal Health News Alert @AMApresident speech National Press Club -Time for heavy lifting in Health


” Aboriginal & Torres Strait Islander Health

So too, the AMA takes Indigenous health very seriously.

Last year, I travelled to Darwin to launch our annual Indigenous Health Report card, which focused on Rheumatic Heart Disease.

In simple terms, RHD is a bacterial infection from the throat or the skin that damages heart valves and ultimately causes heart failure.

It is a disease that has virtually been expunged from the non-Indigenous community. It is a disease of poverty.

RHD is perhaps the classic example of a Social Determinant of Health.

It proves why investment in clean water, adequate housing, and sanitation is just as important as echocardiography and open heart surgery.

Smart policy. Saving money. Preventing heartache. The right thing to do.

I remain committed to partnering with other health professionals and champions of Indigenous health like Ken Wyatt and Warren Snowdon to continue to Close the Gap.

Dr Michael Gannon  : Pictured above after speaking at the National Press Club , meeting two new members of the NACCHO Communications and Digital Team Wendy Brookman and Oliver Tye

Beyond the Medicare freeze – Time for heavy lifting in Health

I acknowledge the traditional owners of the land on which we meet, and pay my respects to their elders past and present.

Good afternoon. It is a great honour to address the National Press Club for a second time as AMA President.

There have been many changes over the last twelve months.

There is no more talk of co-payments.

The cuts to pathology and diagnostic imaging bulk billing incentives have been reversed.

The general practice pathology rents issue has, for the most part, been resolved.

The Medicare freeze has a ‘use by date’. It can’t come soon enough.

The AMA wanted an immediate end to the freeze right across the Medicare Benefits Schedule. We did not get it.

But in 300 days’ time we will see a return to annual indexation of patient rebates to see GPs and other specialists.

The extended freeze has been a major contributor to out-of-pocket expenses when patients see doctors.

We have a new Health Minister – Greg Hunt. He has been consultative and highly engaged with the health sector. He and I speak most weeks. He is a good listener.

He genuinely wants to be across the complexities of his portfolio.

The same can be said of Shadow Minister Catherine King and Greens Leader Richard Di Natale. They get health. They know how health policy affects people’s lives.

This is why Greg Hunt has played a key role in repairing the Government’s relationship with the major stakeholders in health – with the backing of the Prime Minister.

The health policy environment is much calmer, but this does not mean that everything has been fixed. Far from it. There is plenty of heavy lifting to do.

The lifting of the freeze has raised the curtain to allow a greater focus on the other health priorities that require Government action ahead of the next election. 2

These include long-standing structural issues around public hospital funding, private health insurance, the Review of the Medicare Benefits Schedule, and the My Health Record.

The AMA’s priorities extend to Indigenous Health, medical training and workforce, the Pharmaceutical Benefits Scheme, and the many public health issues facing the Australian community – most notably tobacco, immunisation, obesity, and alcohol abuse.

I have called for the establishment of a no-fault compensation scheme for the very small number of individuals injured by vaccines.

I have called on the other States and Territories to mirror the Western Australian law, which exempts treating doctors from mandatory reporting and stops them getting help.

We also need to deal with ongoing problems in aged care, palliative care, mental health, euthanasia, and the scope of practice of other health professions.

In the past 12 months, the AMA has released statements on infant nutrition, female genital mutilation, and addiction.

In coming months, we will have more to say on cost of living, homelessness, elder abuse, and road safety, to name but a few.

Then there are the prominent highly political and social issues that have a health dimension, and require an AMA position and AMA comment.

All these things have health impacts.

As the peak health and medical advocacy group in the country, the community expects us to have a view and to make public comment. And we do.

Not everybody agrees with us. But our positions are based on evidence, in medical science, and our unique knowledge and experience of medicine and human health.

Health policy is ever-evolving. Health reform never sleeps.

I cannot and will not cover all these issues in my prepared speech today. There is not time. I will highlight a few of the most pressing.

Health Economics

As I have stated many times, health is the best investment that governments can make.

Health should never be considered just an expensive line item in a budget – it is an investment in the welfare, wellbeing, and productivity of the Australian people.

Despite constant claims to the contrary, often from governments, Australia’s health budget is not experiencing an expenditure crisis.

Commonwealth health expenditure is actually reducing as a percentage of the total Commonwealth Budget. 3

In the 2016-17 Budget, health was 15.8 per cent of the total, down from 18 per cent in 2006-07.

While health spending has reached a 10 per cent share of GDP, this is less than comparable countries.

France, Sweden, Germany, and Switzerland all spend 11 per cent.

The United States, with their managed care system of private medicine demands more than 17 per cent of GDP to provide worse health outcomes.

Our system may be the envy of many other countries, but that doesn’t mean we can’t or shouldn’t seek to improve it.

Public Hospitals

Our health system cannot improve without properly-resourced public hospitals.

The doctors, nurses, and other staff who work in them are some of the most skilled in the world.

In 2015-16, there were more than 6 million episodes of admitted patient care in Australia’s public hospitals.

Between 2011-12 and 2015-16, the number of separations rose by 3.3 per cent on average each year.

This was greater than the average growth in population over this period, which was 1.6 per cent.

In 2015-16, public hospitals managed 92 per cent of emergency admissions.

They provide services in a time of need. But they need support.

We are not meeting critical targets.

Against key measures, the performance of our hospitals is stagnant or declining.

Bed number ratios have remained static despite the celebrated opening of multiple shiny new hospitals.

Emergency Department waiting times have worsened and, in most cases, they remain well below the target set by governments to be achieved by 2012-13.

The percentage of ED patients treated in four hours has not moved over the past three years.

It is well below our target of 90 per cent. Elective surgery waiting times have worsened.

So when we talk about the need for secure, long-term, and adequate funding, we need to remember what that funding is for. 4

Only last month, it was suggested that there wasn’t enough ‘competition’ between public hospitals.

Competition? I can’t imagine the mother of a young child with suspected meningitis checking the internet at midnight to see which hospital might provide the most competitive offer.

No, that family would be rushing that child to the nearest ED.

We hear more and more about the idea of ‘docking’ funding to hospitals for what are deemed ‘avoidable readmissions’ and ‘acquired complications’.

Doctors take an oath to look after patients. They take it seriously.

They train their entire careers with the primary purpose to heal people. To make them better.

The idea that a financial disincentive, applied against the hospital, will somehow ‘encourage’ doctors to take better care of patients than they already do is ludicrous.

Unfortunately, some complications are unavoidable.

Where there are errors, or where targets are not met, these are almost always due to not having the resources, the staff, or the time.

Taking funding away from hospitals would make things worse.

We need greater certainty and an increase in funding.

We call on the Federal Government and the States and Territories to listen to doctors in the lead-up to 2018 negotiations.

The concept of a 10-year funding agreement sounds attractive. But it must not become a plan to simply lock in chronic underfunding.

Private Health

Our public hospitals would not survive without the support of our private health system.

As a private practitioner who works in the public system, I am well placed to comment on the relationship between these two pillars of our health system.

Australia’s health system relies on the dual system of public and private health. The two complement each other.

Nearly 70 per cent of elective surgery occurs in private hospitals.

We often talk about private health offering choice – choice of doctor, choice of hospital. It’s why people take out insurance policies.

We talk about private health offering shorter waiting times – it’s a major benefit of the system. 5

But we also need to talk about private health as a critical component of taking pressure off the public system.

As a forceful advocate for public hospitals and those Australians who do not have the luxury of a choice, I am therefore an advocate for private health.

However, I am concerned. Very concerned.

If we do not get reforms to private health insurance right – and soon – we may see essential parts of health care disappear from the private sector.

Doctors have a complicated relationship with private health insurance. Indeed, private health insurance itself is complicated.

There are more than 20,000 policy variations around the country.

They are littered with inconsistent terminology and a bewildering array of exclusions, caveats, carve-outs, and excesses.

There are policies out there that offer inappropriate cover.

There are cases where removal of metal is not covered. So, you have had your head caved in. A surgeon repairs the fracture and inserts a plate at midnight on a Saturday night. All covered by health insurance.

But they do not cover removal of that plate at a later date.

We have seen cases where mothers covered for pregnancy have been told their newborn baby cannot be looked after in the special care nursery.

We are calling for pregnancy cover to be included in all levels of policies, adding it to the risk equalisation pool.

It’s a natural part of life. Two thirds of pregnancies are unplanned. So let’s cover it properly, spread the cost appropriately, and make it affordable for more people.

The same applies to mental health services. Suffering anxiety, depression, or a situational crisis are all too common ‘speed bumps’ in life. They are not predictable. This is why we need insurance.

We need to put the concept of value back into private health insurance.

Market power has dramatically shifted in favour of the private health insurers.

They are deciding who can provide what treatment, and where they can provide it.

We have situations where clinical decision-making is being questioned, and overridden, in some cases, by insurers.

If this shift is allowed to flourish, it will undermine both the private and public systems. 6

Insurers are also insisting practitioners agree to the publication of their details, their fees, and allowing customer testimonials that they do not get to verify.

This is dangerous territory.

The consideration of clinical performance and the years of training to improve safety and quality cannot be captured in a customer ‘star rating system’.

Joint replacement surgery is a bit more nuanced and complicated than an Uber ride.

We note also that contracting arrangements with hospitals have ‘no pay’ clauses for adverse events.

Insurers should not interfere with the established safety and quality system that is achieved via the independent accreditation agencies.

The AMA will fight this deliberate drift towards United States style managed care – a system that performs worse than ours according to nearly every metric.

In the last decade we have seen the PHI industry move from one that was dominated by Mutual insurers, who have members, to for-profits, who have policy-holders and, of course, shareholders.

Private health insurance should serve the needs of health consumers who have paid for it.

Patients should not have health care options available to them curtailed for profits.

We see premiums rise five to six per cent every year, at the same time that people are facing increasing cost of living pressures.

It is no surprise that we see people downgrading or dropping their cover.

This has to stop. It requires careful Government action.

Doctors are not the affordability problem.

Too often we hear misguided and misinformed claims – usually from the very big, very powerful health funds – that doctors’ fees are the reason that premiums are rising. This is an appalling and deliberate lie.

As soon as a doctor charges one cent above the insurers’ scheduled fee or, where it exists, their known gap arrangement, the insurer reverts to paying only 25 per cent of the MBS scheduled fee.

That’s about $330 for a hip replacement, $170 for delivering a baby. The insurers actually save money!

In an admission to hospital that might cost $30,000, do you really think the doctor’s fee is the affordability problem in PHI?

The other argument is that doctor fees are creating out-of-pockets – and a disincentive to private health insurance. 7

But the statistics again disprove it. Doctors’ fees are only 16 per cent of insurer outlays.

Australian Prudential Regulation Authority (APRA) statistics show that 88.1 per cent of services are charged at no gap. That is, nothing to pay – zero dollars. The patient’s health insurance covers it.

A further 6.9 per cent are at a known gap of $500 or less.

Now reflect on the fact that the MBS hasn’t been indexed since 2013. Nor have the insurers indexed their payment schedules anywhere near health inflation, if at all.

APRA recently reported that insurers’ profits were up 17 per cent to $1.8 billion before tax for the 2016-17 financial year.

So governments and insurers set the underlying price for a service – and that price has largely been stagnant.

As a private practitioner, I can promise you that my insurance, my rent, my electricity, my staff wages, my supplies, are all increasing in cost.

Doctors have absorbed these costs. Just look at the combined no-gap and known-gap rate of 95 per cent.

Let’s have a look at the out-of-pockets.

The average known-gap cost for Anaesthesia is $96. So, a specialist doctor with 10 years of training and potentially 30 years of experience comes in to help out with an emergency Caesarean Section at 3.00am in the morning. Try getting your plumbing fixed for that price.

Look at the bulk billing rates in general practice. They too have held firm.

The medical profession has done its utmost best to protect patient access to affordable care.

But unless the ‘payers’ in the system start to work with us, it is simply not sustainable.

When we get instability, patients suffer. They lose access. They lose supply. They lose the quality of care they have a right to.

We will continue to participate in the Ministerial Advisory Committee.

But our patients need and deserve certainty. And so do doctors.

Medical Indemnity

An area of great concern to the medical profession has recently re-emerged.

I am talking about medical indemnity. Some of you may remember the indemnity crisis more than a decade ago. 8

The reforms and protections put in place by then Health Minister Tony Abbott are showing signs of stress.

While back in the UK recently, I saw what could happen here again without intelligent policy.

Medical indemnity in the UK is becoming unstable. The two major providers have pulled out of private Obstetrics. There is talk of pulling out of coverage in other high risk areas.

More than a decade ago, the AMA advocated tirelessly, brought together the profession, and worked with the Government to design a series of schemes that have been a resounding policy success.

They promote stability. They provide affordable insurance, which flows through to affordable care.

That has been the AMA’s strong message heading into the current review of indemnity insurance.

Thankfully, the Government has been receptive to our advice, and I am grateful to Minister Hunt for listening.

He was surprised to hear that annual premiums got as high as $126,000 a few years ago. And that’s after the support schemes’ contributions are taken into account.

We now have a review that is focussed on improving and building on the current policy success. It is not a savings exercise.

It removes a threat to a stable medical workforce.

Medical Workforce

For many Australians, access to a doctor remains a problem. People in rural Australia often find it difficult to access care in a timely fashion.

But the problem is not that we don’t have enough doctors. We have more doctors per head of population than the OECD average.

We are graduating record numbers of medical students, putting us well above the OECD average. But we are not providing enough prevocational and specialist training places for our medical graduates.

We must address workforce shortages in particular specialty areas.

Many people think that medical training finishes at the medical school gates. However, medical training is a much longer journey.

It requires an internship, a period of prevocational training and, ultimately, specialist training, which can last upwards of seven years.

I wrote recently that my training took seventeen and a half years, half my life when I opened my practice on my 35th birthday. 9

With record medical graduate numbers, the pressure this is placing on the medical training pipeline is widely acknowledged.

Next year we face a shortage of 569 first year advanced specialist training places.

The bottleneck of doctors in training waiting to get on to a specialist training program is growing, and the projections suggest it will only get worse.

This has implications for the community’s access to services, and the career aspirations of our best and brightest.

We do not need more medical school places. The focus needs to be further downstream.

Unfortunately, we are seeing Universities continuing to ignore community need and lobbying for new medical schools or extra places.

This is a totally arrogant and irresponsible approach, fuelled by a desire for the prestige of a medical school and their bottom line.

Macquarie University is just the latest case in point.

With a looming oversupply of doctors, they have developed a $250,000 medical degree for those who are wealthy enough to be able to afford it.

With that kind of debt, their graduates will not work in areas where they are needed.

They will opt for more lucrative specialties in major metropolitan locations – assuming they can get a job at all.

It’s an example of greed trumping need, and governments need to work with the AMA to stop this from happening.

The evidence clearly shows that, if you select doctors from a rural background, or provide them with opportunities to train in rural areas, they are much more likely to work in a rural area.

We support Minister Gillespie and his idea for training hubs in the regions.

We will keep arguing about the problems with Bonding. We hope that more graduates will choose general practice or rural practice, or both. We will continue to argue for measures that will work.

General Practice

General practice is under pressure, yet it continues to deliver great outcomes for patients.

GPs are delivering high quality care, and remain the most cost effective part of our health system. But they still work long and hard, often under enormous pressure. 10

The decision to progressively lift the Medicare freeze on GP services is a step in the right direction.

But the Government needs to do much more to recognise and reward quality general practice.

The Government is proceeding with its Health Care Homes trial and, while we share the vision of the trial, it is not without problems.

Significant questions also remain over the adequacy of funding for the trial, given the Government is asking GPs to do more for patients, but with no additional investment.

It will be a number of years before we learn what impact the trial has had for patients, health costs, and whether it relieves pressure on our hospital system.

General practice can’t wait that long. It is already under pressure and needs new investment now.

We must have everything funded and connected – strong primary care, led by general practice; properly resourced public hospitals; and a complementary private hospital sector underpinned by a stable private health insurance industry.

This is a handy ‘to do’ list for the Government.

I turn now to a couple of topics that have put the AMA is a different sort of spotlight.

Marriage Equality

The AMA gets accused of being too conservative.

So, it was not totally surprising to see the reaction to the launch of our new Position Statement on Marriage Equality a few months back.

The AMA position generated significant coverage in both mainstream and social media.

It also generated interest within our membership, the medical profession more broadly, and with the general public.

We received overwhelming support – in line with public opinion polls which indicate the majority of Australians support marriage equality.

Our Position Statement outlines the health implications of excluding LGBTIQ individuals from the institution of marriage.

Things like bullying, harassment, victimisation, depression, fear, exclusion, and discrimination, all impact on physical and mental health.

I received correspondence from AMA members and the general public. The overwhelming majority applauded the AMA position.

Those who opposed the AMA stance said that we were being too progressive, and wading into areas of social policy. 11

The AMA will from time to time weigh in on social issues. We should call out discrimination and inequity in all forms, especially when their consequences affect people’s health and wellbeing.

It is not our place to determine how we achieve marriage equality. That is for our legislators.

We hope this process goes ahead with honesty and respect.

Euthanasia and Physician Assisted Suicide

Last year, we released an updated Position Statement on Euthanasia and Physician Assisted Suicide.

It came at a time when a number of States, most notably South Australia and Victoria, were considering voluntary euthanasia legislation.

There was an expectation in some quarters that the AMA would come out with a radical new direction. We didn’t.

The AMA maintains its position that doctors should not be involved in interventions that have as their primary intention the ending of a person’s life.

This does not include the discontinuation of treatments that are of no medical benefit to a dying patient. This is not euthanasia.

Doctors have an ethical duty to care for dying patients so that they can die in comfort and with dignity.

We are always there to provide compassionate care for each of our dying patients so they can end the last chapter of their lives without suffering.

We believe that governments must do all they can to improve end of life care for all Australians.

They must properly resource palliative care services and advance care planning, and produce clear legislation to protect doctors who are providing good end of life care in accordance with the law.

Of course, euthanasia is a matter for society and its Parliaments.

However, if new legislation does come into effect, doctors must be involved in the development of the legislation, regulations, and guidelines.

We must protect doctors acting within the law, vulnerable patients, those who do not want to participate, and the wider health system.

The AMA recognises that good quality end of life care can alleviate pain and other causes of suffering for the overwhelming majority of people. 12

There is already a lot that doctors can ethically and legally do to care for dying patients experiencing pain or other causes of suffering.

This includes giving treatment with the intention of stopping pain and suffering, but which may have the secondary effect of hastening death.

I reiterated all of this yesterday in an address to 40 MPs in Victoria, imploring them to legislate protections according to this ‘doctrine of double effect’.

Bills in South Australia and Tasmania have been defeated. I encourage politicians in Victoria to ‘put the horse before the cart’ and focus on the everyday issues in end of life care.

Our position does not appeal to everyone, least of all high profile euthanasia campaigners and their enthusiastic supporters in the media.

We also have members who differ in their view.

But our position, supported by the overwhelming majority of our Federal Council, is supported by the bulk of the medical profession.

There are medical, ethical, and moral responsibilities at the heart of the doctor-patient relationship, and we all take them and our oath, the Declaration of Geneva, very seriously indeed.

Aboriginal & Torres Strait Islander Health

So too, the AMA takes Indigenous health very seriously.

Last year, I travelled to Darwin to launch our annual Indigenous Health Report card, which focused on Rheumatic Heart Disease.

In simple terms, RHD is a bacterial infection from the throat or the skin that damages heart valves and ultimately causes heart failure.

It is a disease that has virtually been expunged from the non-Indigenous community. It is a disease of poverty.

RHD is perhaps the classic example of a Social Determinant of Health.

It proves why investment in clean water, adequate housing, and sanitation is just as important as echocardiography and open heart surgery.

Smart policy. Saving money. Preventing heartache. The right thing to do.

I remain committed to partnering with other health professionals and champions of Indigenous health like Ken Wyatt and Warren Snowdon to continue to Close the Gap.

The significance of challenging social issues like Indigenous health, marriage equality, and euthanasia is that they highlight the unique position and strengths of the AMA.

We are completely independent of governments. 13

We rely near totally on member subscription income to survive. I can promise you, as a Board member, it is often a concern.

But unlike many other lobby groups, inside and outside the health industry, this gives us a total legitimacy to speak honestly, robustly, and without fear or favour in line with our mission – to lead Australia’s doctors, to promote the health of all Australians.

We have strong public support and respect as the peak medical organisation.

The AMA was recently ranked the most ethical organisation in the country in the Ethics Index produced by the Governance Institute of Australia.

People want and expect us to have a view, an opinion. Sometimes a second opinion.

The media demand that we have an opinion. And not just on bread and butter health issues. But also on social issues that have an impact on health.

Our view is never knee-jerk.

We consult our members and the broader medical profession. Often we encourage feedback from other health professionals – the ones who provide quality health care with us in teams.

We attract public feedback whether we like it or not. I can promise you that social media has taken this to a whole new level.

In the last year I have been criticised by the Pharmacy Guild, the College of Midwives, the Greens, One Nation, the ALP, the Coalition, pro-Euthanasia campaigners, E-cigarette enthusiasts, Anti-Vaccination campaigners, shareholders in Medicinal Cannabis enterprises, and the occasional celebrity chef.

And that is before I get home to my 13 year old daughter.

All of our consultation and engagement informs our policies, our views, our opinions.

Our opinions are not designed to be popular.

Many feel uncomfortable when we talk about healthcare standards for asylum seekers and refugees on Nauru and Manus Island.

We make Australians feel uncomfortable when we ask them to reflect on the amount they drink and the fact that licit drugs like tobacco and alcohol cause far more carnage than Ice ever will.

People might not like it when we use scientific evidence to inform our views on the limitations on the usefulness of Medicinal Cannabis, climate change and health, air quality, expanding adult and child vaccination programs, restricting Codeine use, or call for a tax on sugar-sweetened beverages.

But we believe we get it right most of the time. 14

We are the only body that can possibly represent the whole medical profession – from medical student to retired doctor, from Psychiatrist to Vascular Surgeon to Paediatrician, whether trained in Mumbai or at Monash.

From Busselton to Bundaberg, we will continue to fight for the health of our patients and their communities.

That is why governments take notice of our policies. They are informed by what our patients and what our members tell us, based on what is happening at the front line of health service delivery.


I want to finish today with a message to our political leaders.

Last year we had a very close election, and health policy was a major factor in the closeness of the result.

The Coalition very nearly ended up in Opposition because of its poor health policies.

Labor ran a very effective Mediscare campaign.

As I have noted, the Government appears to have learnt its lesson on health, and is now more engaged and consultative – with the AMA and other health groups.

The next election is due in two years. There could possibly be one earlier. A lot earlier.

As we head to the next election, I ask that we try to take some of the ideology and hard-nosed politicking out of health.

I talked today about some of the structural pillars of our health system – public hospitals, private health, the balance between the two systems, primary care, the need to invest in health prevention.

Let’s make these bipartisan. Let’s take the point scoring out of them.

Both sides should publicly commit to supporting and funding these foundations.

The public – our patients – expect no less.


NACCHO Aboriginal Health and #Smoking : @TheMJA #npc Mass-reach #anti-smoking campaigns must return

Disadvantaged groups are and should be a key focus of action to reduce smoking further. This has long been recognised, including in the report of the National Preventative Health Taskforce, which specifically called for action in relation to Aboriginal and Torres Strait Islander people and other highly disadvantaged groups, such as people with mental health problems,”

The evidence tells us that we need a mix of approaches. We need whole-of-community approaches, with measures such as tax increases and strong mass media campaigns, which benefit disadvantaged groups disproportionately. We also need specific targeted approaches, as this article notes: the Talking About the Smokes project and the Tackling Indigenous Smoking program have played valuable role in complementing mainstream activity.”

 Professor Mike Daube, professor of health policy at Curtin University, welcomed calls for further action on smoking prevalence in disadvantaged groups, and said that a mix of approaches was needed. Professor Daube told MJA InSight.

Read over 100 NACCHO Smoking articles published in past 5 years

NACCHO Aboriginal Health and Smoking : Download Tackling Indigenous Smoking Program prelim. evaluation report

TARGETED tobacco control strategies are urgently needed to tackle the “remarkably high” smoking rates in some high-risk groups, according to Australian authors, but leading public health experts say reinstatement of mass-reach campaigns should be a priority.

Writing in the MJA, Professor Billie Bonevski, a health behaviour scientist and researcher at the University of Newcastle, and co-authors said that the overall smoking prevalence in Australia was now 14%, but among population subgroups, such as those with severe mental illness and those who had been recently incarcerated, the rates were upwards of 67%.

Tobacco use among Aboriginal and Torres Strait Islander people also remained high, with the prevalence among Indigenous people aged 15 years and older being about 39% in 2014–15.

Listen to Podcast HERE

The authors said that a truly comprehensive approach to tobacco control should include targeted campaigns in high smoking prevalence populations.

“If we are truly concerned about this issue, we must focus more attention on the groups that are being left behind,” they wrote.

Novel, targeted interventions and increased delivery of evidence-based interventions was needed, the authors said, noting that tobacco harm reduction strategies, such as vaporised nicotine, should also be further investigated.

In an MJA InSight podcast, lead author Professor Bonevski said that smoking was still “almost … socially acceptable” in some subgroups, such as those from low socio-economic populations.

“People who have lower incomes end up smoking from a younger age and, by the time they reach adulthood, they are more heavily nicotine dependent and … it becomes much harder to quit,” she said. “This is a vicious cycle in terms of socio-economic status contributing to high smoking rates, and then high smoking rates contributing to poor health, and then poor health keeping you in that low socio-economic status group, and so on.”

Professor Simon Chapman, Emeritus Professor in the University of Sydney’s School of Public Health, said that targeting high smoking prevalence subgroups sounded sensible “until we unpack what targeting involves”.

“The world-acclaimed, highly successful Australian national Quit campaign has been scandalously mothballed since 2013. So, talk of fracturing what is now a zero-budgeted, non-operational population-wide campaign into multiple targeted campaigns is currently a ‘brave’ call,” he said.

Professor Chapman said that Australia’s main goal should be to restore our “family silver”: properly funded, mass reach campaigns that reach all subgroups.

He pointed to research, published in 2014, that found that the decline in smoking prevalence in Australia – from 23.6% in 2001 to 17.3% in 2011 – was largely due (76%) to stronger smoke-free laws, tobacco price increases and greater exposure to mass media campaigns.

Professor Chapman said that higher smoking rates among disadvantaged groups were more likely to be explained by higher uptake, than by failure to quit.

He noted that 22.7% of the most disadvantaged people were ex-smokers, versus 26.9% of the least disadvantaged. “But only 53.5% of the least disadvantaged people have never smoked, compared with 62.9% of the most advantaged,” he said.

Professor Chapman said that labour-intensive interventions were inefficient in preventing uptake among young people.

“It remains the case that most kids who don’t start smoking and most smokers who quit do not attribute their status to a discrete intervention,” he said.

Professor Mike Daube, professor of health policy at Curtin University, welcomed calls for further action on smoking prevalence in disadvantaged groups, and said that a mix of approaches was needed.

See opening statement


Professor Daube said that strong action at the public policy and health system levels was crucial.

“At the policy level, this should include immediate resumption by the federal government of national mass media campaigns, which have, incomprehensibly, been absent over the past 4 years; and action to combat the tobacco industry’s cynical strategies to counter the impacts of tax increases and plain packaging,” he said.

“We also need more than lip service within health systems about the physical health of people with mental health problems, not least through support and assistance in quitting smoking. There are some who try, but they are the exception.”

Professor Daube said that the suggestion that vaporised nicotine may play a role in reducing smoking was “very speculative”, and still “some way ahead of the evidence”.

“[We] should await any determination by the [Therapeutic Goods Administration] as to their safety and efficacy,” he said.

Earlier in 2017, the TGA decided to uphold the ban on vaporised nicotine in e-cigarettes in Australia

NACCHO supports Family Doctor Week #amafdw17 : Our ACCHO doctors – are the key to better physical and mental health for all our mob

  ” The key to a longer and healthier life is eliminating risky health habits and behaviours from your daily routine, and the best advice on minimising health risks is available from your local GP

Many Australians face the prospect of a premature death or lower quality of life through risky behaviours that are often commonplace, but are still very detrimental to their health.

Many people may not even realise that they are putting themselves, and sometimes others, at risk through everyday poor health habits and decisions

AMA President, Dr Michael Gannon pictured above recently visiting Danila Dilba ACCHO Darwin with NACCHO Chair Matthew Cooke

Launching AMA Family Doctor Week 2017 – the AMA’s special annual tribute to all Australia’s hardworking and dedicated GPs – AMA President, Dr Michael Gannon, urged all Australians to establish and maintain a close cooperative relationship with their local family doctor.

Photo above  :All AMA Presidents from all states and Territories met at Winnunga Nimmityjah Aboriginal Health Service (AHS) for Close the Gap Day Event : Winnunga is an Aboriginal community controlled ACCHO primary health care service for Canberra and the ACT community

See interview here : Dr Nadeem Siddiqui Executive Director Clinical Services Winnunga AMS ACT

Dr Gannon said that having a trusting professional relationship with a GP is the key to good health through all stages of life, for every member of the family.

“GPs are highly skilled health professionals and the cornerstone of quality health care in Australia,” Dr Gannon said.

“They provide expert and personal advice and care to keep people healthy and away from expensive hospital treatment.

“General practice provides outstanding value for every dollar of health expenditure, and deserves greater support from all governments.”

Dr Gannon said that 86 per cent of Australians visit a GP at least once every year, and the average Australian visits their GP around six times each year.

“Around 80 per cent of patients have a usual GP, which is the best way to manage your health throughout life,” Dr Gannon said.

“Your usual GP will be able to provide comprehensive care – with immediate access to your medical history and a long-term understanding of your health care needs, including things like allergies or medications.

NACCHO APP : Find an ACCHO Doctors at one of our 302 clinics

Photo above : The NACCHO App contains a geo locator, which will help you find the nearest Aboriginal Community Controlled Health Organisation in your area and  provides heath information online and telephone on a wide range of topics and where you can go to get more information or assistance should you need urgent help 

Links to Download the APP HERE

“Family doctors are the highest trained general health professionals, with a minimum of 10 to 15 years training.

“They are the only health professionals trained to diagnose undifferentiated conditions and provide holistic care from the cradle to the grave

“Your GP, your family doctor, is all about you.

“When you are worried about your health, or just want to know how to take better care of your health, you should talk to your GP.”

View Interview Here : Dr Marjad Page Gidgee Healing Mt Isa Aboriginal Health In Aboriginal Hands

Dr Gannon said that the specialised work of GPs is in great demand due to the growing and ageing population, and because of health conditions that result from our contemporary lifestyles and diets.

“The importance of quality primary health care and preventive health advice has never been higher due to our modern way of life,” Dr Gannon said.

According to the Australian Institute of Health and Welfare (AIHW):

  • 45 per cent of Australians are not active enough for a healthy lifestyle;
  • 95 per cent of Australians do not eat the recommended servings per day of fruit and vegetables;
  • 63 per cent of Australians are overweight or obese;
  • 27 per cent of Australians have a chronic disease;
  • 21 per cent of Australians have two or more chronic diseases; and
  • 20 per cent of Australians have had a mental disorder in the past 12 months.

“Our hardworking local GPs – our family doctors – are the key to better physical and mental health for all Australians,” Dr Gannon said.

“They provide quality expert health advice and help patients navigate their way through the health system to achieve the most appropriate care and treatment for their condition.

“Join the AMA in acknowledging their great work during Family Doctor Week.”

Follow all the FDW action on Twitter: #amafdw17

NACCHO Aboriginal Health #Smoking #WNTD @AMAPresident awards #NT Dirty Ashtray Award for World #NoTobacco Day

“Research shows that smoking is likely to cause the death of two-thirds of current Australian smokers. This means that 1.8 million Australians now alive will die because they smoked.

The Northern Territory, a serial offender in failing to improve tobacco control, has been announced as the recipient of the AMA/ACOSH Dirty Ashtray Award for putting in the least effort to reduce smoking over the past 12 months.

But it seems that the Northern Territory Government still does not see reducing the death toll from smoking as a priority. Smoking is still permitted in pubs, clubs, dining areas, and – unbelievably – in schools.

The NT Government has not allocated funding for effective public education, and is still investing superannuation funds in tobacco companies.

“It is imperative that Governments avoid complacency, keep up with tobacco industry tactics, and continue to implement strong, evidence-based tobacco control measures.”

Ahead of World No Tobacco Day on 31 May, AMA President, Dr Michael Gannon, announced the results today at the AMA National Conference 2017 in Melbourne.

Previous NACCHO Press Release Good News :

NACCHO welcomes funding of $35.2 million for 36 #ACCHO Tackling Indigenous Smoking Programs

The Northern Territory, a serial offender in failing to improve tobacco control, has been announced as the recipient of the AMA/ACOSH Dirty Ashtray Award for putting in the least effort to reduce smoking over the past 12 months.

It is the second year in a row that the Northern Territory Government has earned the dubious title, and its 11th “win” since the Award was first given in 1994.

AMA President, Dr Michael Gannon, said that it is disappointing that so little progress has been made in the Northern Territory over the past year.

“More than 22 per cent of Northern Territorians smoke daily, according to the latest National Drug Strategy Household Survey, well above the national average of 13.3 per cent,” Dr Gannon said.

“Smoking will kill two-thirds of current smokers, meaning that 1.8 million Australian smokers now alive will be killed by their habit.

“But it seems that the Northern Territory Government still does not see reducing the death toll from smoking as a priority. Smoking is still permitted in pubs, clubs, dining areas, and – unbelievably – in schools.

“The Government has not allocated funding for effective public education, and is still investing superannuation funds in tobacco companies.”

Victoria and Tasmania were runners-up for the Award.

“While the Victorian Government divested from tobacco companies in 2014, and has made good progress in making its prisons smoke-free, its investment in public education campaigns has fallen to well below recommended levels, and it still allows price boards, vending machines, and promotions including multi-pack discounts and specials,” Dr Gannon said.

“It must end the smoking exemption at outdoor drinking areas and the smoking-designated areas in high roller rooms at the casino.

Learn more about the great work our Tackling Indigenous Smoking Teams are doing throughout Australia 100 + articles HERE

“Tasmania has ended the smoking exemption for licensed premises, gaming rooms and high roller rooms in casinos, but still allows smoking in outdoor drinking areas.

“While Tasmania has the second highest prevalence of smoking in Australia, the Tasmanian Government has not provided adequate funding to support tobacco control public education campaigns to the evidence-based level.  It should provide consistent funding to the level required to achieve reductions in smoking.”

Tasmania should also ban price boards, retailer incentives and vending machines, and divest the resources of the Retirement Benefits Fund (RBF) from tobacco companies, limit government’s interactions with the tobacco industry and ban all political donations, ACOSH said.

It should also ban all e-cigarette sale, use, promotion and marketing in the absence of any approvals by the Therapeutic Goods Administration.


Download the app today & prepare to quit for World No Tobacco Day

Queensland has topped the AMA/ACOSH National Tobacco Control Scoreboard 2017 as the Government making the most progress on combating smoking over the past 12 months.

Queensland narrowly pipped New South Wales for the Achievement Award, with serial offender the Northern Territory winning the Dirty Ashtray Award for putting in the least effort.

Judges from the Australian Council on Smoking and Health (ACOSH) allocate points to each State and Territory in various categories, including legislation, to track how effective government has been at combating smoking in the previous 12 months.

“Disappointingly, no jurisdiction scored an A this year, suggesting that complacency has set in,” Dr Gannon said.

“Research shows that smoking is likely to cause the death of two-thirds of current Australian smokers. This means that 1.8 million Australians now alive will die because they smoked.

“It is imperative that Governments avoid complacency, keep up with tobacco industry tactics, and continue to implement strong, evidence-based tobacco control measures.”

The judges praised the Queensland Government for introducing smoke-free legislation in public areas, including public transport waiting areas, major sports and events facilities, and outdoor pedestrian malls, and for divesting from tobacco companies.

However, they called on all governments to run major media campaigns to tackle smoking, and to take further action to protect public health policy from tobacco industry interference.

31 May is World No Tobacco Day Tweet using “Protect health,reduce poverty, promote development”

NACCHO Aboriginal Health Workforce and #457visas : Overseas trained doctors still essential in the bush: assurances needed on 457

 ” While the Federal Government’s work to deliver more Australian-trained doctors to the bush is very positive and welcome, International Medical Graduates (IMGs) will continue to be essential in providing medical care in rural and remote communities for at least the next 5 years — and probably for the next 15 years “

RDAA President, Dr Ewen McPhee Rural Doctors Association of Australia has warned. (article 1 below )

View the many current Doctor vacancies in our ACCHO’s

 Advertised each week in our NACCHO #Jobalerts

Many communities would not have doctors if it were not for the excellent work of IMGs,”

It is important that we strike the right balance between filling vacancies with locally trained graduates and ensuring that communities, especially in rural and remote Australia, have doctors in the right numbers and with the appropriate specialist skills and experience to meet patient needs.

The AMA welcomes the emphasis of the new arrangements to better target recruitment and the mandatory requirement for labour market testing, which the AMA has been calling for in light of the significant increases in locally-trained medical graduate numbers. ”

AMA President, Dr Michael Gannon (article 2 below)

Australian government to replace 457 temporary work visa  Source

Returning now to the Government’s announcement today that it’s scrapping the 457 visa program for foreign workers.

It is interesting to note that, of the 2618 people who arrived on Government sponsored 457 visas last year, 2268 were health professionals. It’s a huge proportion.

This graphic, which was published originally by The Guardian, shows the most common 457 visa jobs in different areas in Australia. You can see a lot of blue there, which represents café workers, but all the green that you can see on that graphic, mainly there in rural and regional areas, does represent doctors and nurses, health workers who have been brought in on 457 visas.

SkyNews interview Dr Michael Gannon (article 3 below )

Banning 457 visas will have an immediate and potentially significant impact on the recruitment of health professionals in rural and remote Australia.

Despite the increase in the number of health professionals graduating from Australian universities, recruiting professionals to work in rural and remote Australia is still difficult.

“I would love to be in the situation where we rely on locally trained health professionals to fill all vacancies in rural and remote communities“,

David Butt, Chief Executive Officer of the National Rural Health Alliance (article 4 below )

Article 1 RDAA continued

For this reason, RDAA has urged the Government to assure these much-needed doctors of their continued future support in Australia, under the 457 visa changes announced yesterday.

“Many rural medical practice employers, as well as IMGs, are highly concerned about the as yet unexplained requirements of the new visa arrangements, particularly around market testing and the changes to permanent residency applications” RDAA President, Dr Ewen McPhee, said.

“Market testing evidence has been a requirement for IMGs in applying for a Medicare provider number for many years, so we are hoping this is not going to duplicate a process that is already in place for these doctors.

“It is important that the Government works closely with all stakeholders — including rural medical practices and IMGs themselves — to educate them on the changes to the visa requirements, as this announcement has caused significant angst for many IMGs and practices with regards to what it means for them.

“RDAA understands that doctors listed in the revised visa arrangement’s ‘medium category’ will be eligible for a four year visa, with permanent residency applications eligible after three years — a change from the two year requirement under the current 457 visa.

“The recruitment of an IMG is a long process involving many steps. A number of the steps outlined in the Government’s new visa policy, such as market testing and criminal history checks, are already in place for IMG recruitment, therefore it is essential this change to the visa requirements does not duplicate but rather replaces the processes that are already in place.

“IMGs have been a backbone of medical care in rural and remote Australia for many years — and they will continue to be for at least the next 5 years, and probably even up to 15 years.

“If it weren’t for the many dedicated and highly trained IMGs who have delivered medical care in rural and remote Australia for many years, a large number of communities would not have had access to a local doctor for decades.

“Even with the very positive measures that the Federal Government has been taking to encourage more Australian-trained doctors to work in the bush, we are still a minimum of 4-5 years away from seeing the full benefits of these measures being realised.

“It will take time to deliver more of the next generation of Australian-trained doctors who are able to work unsupervised in rural and remote communities, and then it will be a slow, ongoing process of capacity building, with a gradual year-on-year increase in the number of Australian-trained doctors choosing to work in the bush.

“With IMGs still comprising approximately 40% of Australia’s rural and remote medical workforce, we will continue to need IMGs in country Australia in the short and medium-term at least, and probably well into the long-term for some locations.

“IMGs are highly appreciated and respected by the many rural and remote communities they serve, as well as by their Australian-trained colleagues.

“They deserve significant and increased support in their critical role, particularly at a time when they are highly concerned about what the 457 visa changes will mean for them and their families.”


The AMA has cautiously welcomed the Government’s new visa arrangements, but is seeking more detail and clarification of the possible impact of the changes on medical workforce shortages.

The current 457 visas will be abolished from March 2018, and replaced by a new Temporary Skills Shortage Visa, which will have tighter conditions and have a smaller number of eligible occupations. It will also be harder to progress to permanent residency from the new visa class.

The AMA has been advised that doctors will still be eligible for the new visa, but there is little detail about medical specialties or groups. Existing 457 visa holders will continue on the same conditions they have now. It is important that doctors with these visas who have been working hard towards permanent residency are not disadvantaged.

AMA President, Dr Michael Gannon, said that international medical graduates (IMGs) have made a huge contribution to the Australian medical workforce, especially in rural areas and during periods of chronic workforce shortages.

“Many communities would not have doctors if it were not for the excellent work of IMGs,” Dr Gannon said.

“Australia is presently in the fortunate position of producing sufficient locally-trained medical graduates to meet current and predicted need. It is time to focus our energies on training the hundreds of Australian medical graduates seeking specialist training.

“But we still need to have the flexibility to ensure that under-supplied specialties and geographic locations can access suitably-qualified IMGs when locally trained ones cannot be recruited.

“It is important that we strike the right balance between filling vacancies with locally trained graduates and ensuring that communities, especially in rural and remote Australia, have doctors in the right numbers and with the appropriate specialist skills and experience to meet patient needs.

“The AMA welcomes the emphasis of the new arrangements to better target recruitment and the mandatory requirement for labour market testing, which the AMA has been calling for in light of the significant increases in locally-trained medical graduate numbers.

“We also need to see the Government step up policy efforts to encourage local graduates to work in the areas and the specialties where they are needed.”

Today, the chief executive officer of the National Rural Health Alliance, David Butt, did warn that banning 457 visas will have an immediate, and potentially significant, impact on the recruitment of health professionals in rural and remote Australia.

Article 3 SkyNews interview

So what does the Australian Medical Association think of the change? Joining me now live from his office in Perth is Dr Michael Gannon. He’s the President of the Australian Medical Association. Dr Gannon, thank you for your time. Do you have any concerns about the changes announced today?

MICHAEL GANNON: Well, we cautiously welcome these changes, but what we want to see is flexibility in the new arrangements to make sure that areas that still do have genuine shortages, like the rural and regional areas you mentioned, do have the ability to recruit doctors, nurses, other health workers, if need be.

ASHLEIGH GILLON: I note, looking down the list of just over 200 job categories that are being removed from that list as to people who are eligible to apply for these visas to work here, doctors are obviously not on that list, but there are plenty in the medical field. Occupations being taken off the list include medical administrators, nurse researchers, operating theatre technicians, pathology collectors, dental therapists, mothercraft nurses, first aid trainer, Aboriginal and Torres Strait Islander health workers, also exercise physiologists. Are you confident those type of roles can actually be filled by Australians?

MICHAEL GANNON: Well, certainly what we’ve seen in Australia in recent years is tremendous investment in medical students, and we’ve seen similar investments in a lot of these other health professions. We need to see flexibility in the arrangements, so for those specialties or those areas of the workforce where genuine shortages remain, that we are able to get staff from overseas. But what we’ve seen too much of is this mechanism gamed. We need employers to be more honest about the needs for extra staff, and what we need to see is greater investment in training positions for those hundreds of locally trained doctors who are now lining up desperately trying to find specialist training, and then deploy them where they’re needed, making sure that Australians in rural and regional areas continue to be well serviced by health professionals.

ASHLEIGH GILLON: How far away are we from that point? From being in a position where we don’t actually need foreign doctors and nurses to bolster our health system, especially in those rural and regional areas?

MICHAEL GANNON: Well, certainly, in terms of numbers, we’ve got it about right. If anything, we’ve got an oversupply. But what we need to do, and this is going to require the input of government, it’s going to require the profession to change, we need to make sure that those potentially thousands of extra doctors that we’ve got are deployed in areas where we need them.

So we need to get smart in the future. The AMA’s calling for a third of all medical students to come from rural areas. We want to see more positive experiences for junior doctors and medical students when they go to the regions. We know from evidence that that means they’re more likely to go and work in the bush later.

There’s a moral dimension to these changes: every time Australia recruits a doctor from a Third World country, or from another country, they are taking those doctors away from populations that desperately need them. Australia’s definitely reached self-sufficiency in terms of total numbers of medical graduates. We’ve got to make sure that the public hospitals, the private hospitals, the general practices, have the training positions so that we can get Australian-trained doctors out there and working.

ASHLEIGH GILLON: Aside from the job numbers that are decreasing in terms of occupations that we’re looking for to fill some of the roles here in Australia, there still are some substantial changes involved in the announcement today, including mandatory police checks, labour market testing, but is it safe to assume that already happens in the medical field? Do you see any of the changes announced today impacting specifically people working in the health area?

MICHAEL GANNON: Look, I think that there’s going to be plenty of positives to this announcement, as long as we do maintain that flexibility. So if there is the opportunity for us to recruit a genuine superstar of academia, or someone who brings a new skill to Australia, we need the flexibility to be able to employ them. If we identify specialty by specialty, or region by region, genuine shortages, we must maintain that flexibility to employ them.

But too often it’s been easy in the public hospital system to say to Australian-trained doctors with genuine grievances, ‘look, take your problem and take it away with you. We’ll find another doctor from overseas’. It’s incumbent that the employers actually produce environments that are safe for doctors to work with and to work within. And it’s actually incumbent on them to listen to doctors if they identify shortages or shortcomings in the system.

This will make it harder for hospitals just to ignore problems. They might find it harder to just say to an Australian-trained doctor, ‘go away, we can find someone else from overseas to fill the shortage’.

ASHLEIGH GILLON: Just on another matter Dr Gannon, expectations are pretty high that the Government will be lifting the freeze on Medicare rebates for doctor visits in the Budget. You’ve been lobbying pretty hard for this change, for a long time now. How confident are you that we will see that change on Budget night?

MICHAEL GANNON: Look, I’m very confident that we’ll see some change. But one of the reasons that discussions continue between myself and the Health Minister is that he’s got a budgetary environment that is hard to give me everything that I’m asking for. We would like to see the freeze lifted across the entire Medicare Benefits Schedule. The freeze on patient rebates not only impacts on GPs, but it impacts on specialists who bulk bill their payments. And what it’s meant is that for many years now, procedural specialists have had the amount that they’re paid by the insurers frozen. That, in turn, has an impact on the public hospital system.

So you can see that the freeze is impacting across the board. To thaw out across the entire system costs over $3 billion. I’m sure there’s a situation where every other Minister is being asked to deliver substantial cuts in their budgets. And in the health sphere, we’re asking for increased spending. That’s difficult for the Minister to deliver on. Equally, he’ll be in no doubt that we want to see the freeze unravelled across the entire schedule.

ASHLEIGH GILLON: Only a few weeks to go and we’ll know all. And just finally, Dr Gannon, before you go, we saw these reports yesterday that doctors are fearing that the overuse of antibiotics could see common illnesses become life threatening. It follows the death of a woman in the US from an antibiotic resistant infection. Should we be worried about this? Should we be concerned that simple childhood illnesses could one day again become deadly?

MICHAEL GANNON: I think we’ve got a lot to worry about, and it’s not just children that need to worry, it’s adults as well. We potentially face returning to the pre-antibiotic era. This has numerous dimensions of concern. We might see what we regard now as very simple operations become too dangerous to perform. We might see people who are potentially able to be cured of auto-immune disease or cured of cancer denied these treatments because we can no longer deal with the infections that come from immune suppression.

This requires numerous elements of attention. It requires international cooperation through bodies like the G20 to recognise there is market failure in here and big pharmaceutical companies can’t afford to make the investment in looking for new antibiotics. At the individual hospital level, we need to see smarter antibiotic stewardship. At the individual patient level, we need to see patients understanding reasons why doctors don’t just want to dish out antibiotics for viral infections. These individual reports are going to become more common.

ASHLEIGH GILLON: So you think Australians at the moment are taking too many antibiotics when they don’t really need them?

MICHAEL GANNON: Well, certainly, individual doctors need to get smarter when they’re prescribing antibiotics. We need to de-escalate treatment in accordance with the results of microbiological testing, where it’s appropriate to use a narrower spectrum antibiotic. Individual patients need to get smarter in preventing the infections that can be prevented through vaccination, and they need to get smarter in understanding the difference between a virus and a bacterial infection, and if the doctor says you don’t need antibiotics for bronchitis or you don’t need antibiotics because this is a virus, they need to heed that advice and do their bit to prevent antibiotic resistance.

ASHLEIGH GILLON: Dr Michael Gannon, appreciate you joining us live there from Perth. Thank you.

MICHAEL GANNON: Pleasure, Ashleigh.

Article 4 : 457 visas vital for rural and remote health workforce

Banning 457 visas will have an immediate and potentially significant impact on the recruitment of health professionals in rural and remote Australia.

Despite the increase in the number of health professionals graduating from Australian universities, recruiting professionals to work in rural and remote Australia is still difficult.

“I would love to be in the situation where we rely on locally trained health professionals to fill all vacancies in rural and remote communities”, said David Butt, Chief Executive Officer of the National Rural Health Alliance, “but that is still many years away. Without overseas trained health professionals, many rural and remote communities would simply be without access to health care.”

“I note that a new class of visa will be available, and while I have not yet seen the requirements, I would urge the Government to be mindful of the need to ensure implementation does not impact negatively on the health needs of the seven million people living outside Australia’s major cities,” said Mr Butt.

“The people who live in rural and remote Australia have higher rates of diseases than their city cousins, and have poorer health outcomes, with death rates up to 60% higher for Coronary heart disease and 35% higher for lung cancer.

NACCHO TOP10+ #JobAlerts : This week in Aboriginal Health : Doctors, Aboriginal Health Workers etc. etc.



NACCHO #ClosetheGap Aboriginal Health : Read Download Top 10 Press releases #Closethegapday


In this NACCHO Alert you can read /download Close the Gap Press Releases from

1.AMA 2.NACCHO 3.RACGP 4. FVLPS/#JustJustice 5. Healing Foundation

6.Pallative Care 7.Labor Party 8.Stroke Foundation

9.NSW Aboriginal Land Council .10. Australian Psychological Society (APS) is

Please note  :  Only a selection and in no particular order from hundreds released

” The Close the Gap Campaign 2017 Progress and Priorities Report, released today, shows that, despite their best efforts, all Australian governments are failing in their endeavours to meet their own targets in closing the gap – but we can turn this around,” Dr Gannon said.

The AMA believes that positive progress can be made if governments work directly with Aboriginal and Torres Strait Islander people, and better understand the approaches that they know work in their own communities.”

AMA President, Dr Michael Gannon, said today that genuine cooperation between all political parties and across all levels of government is needed if Australia is to achieve significant improvements in closing the gap in life expectancy and health outcomes between Indigenous and non-Indigenous Australians

Photo above All AMA Presidents from all states and Territories met at Winnunga Nimmityjah Aboriginal Health Service (AHS) for Close the Gap Day Event : Winnunga is an Aboriginal community controlled ACCHO primary health care service for Canberra and the ACT community

Read full article here


” Hard figures and targeted investment, not rhetoric, are key to solving indigenous disadvantage, Aboriginal health leader Pat Turner said as she called for at least 4000 homes to be built in remote Australia to help tackle the ­problem.”

As published in The Australian

Ms Turner, chief executive of the National Aboriginal Community Controlled Health Care Organisation, said indigenous health problems would be ­addressed only through “far greater ­investment … in the physical environment including safe houses, communities and roads.

“I would estimate there are 4000 dwellings required in remote Australia alone.

“We have not had this investment,” she said. “We need to take account of the factors that contribute to good health: housing, education, employment and access to justice.

“And why hasn’t there been far greater innovation, why is the passing on of knowledge of language and culture not recognised as legitimate work? This sounds fuzzy, but it’s not. We know that around 30 per cent of Aboriginal and Torres Strait Islander health problems are to do with social and cultural factors.

“The context of people’s lives is what matters most in determining health outcomes, and that is something that individuals are unlikely to be able to control. We ask that the federal government replace its rhetoric about economic empowerment with significant public policy initiatives that produce specific outcomes.”

Close the Gap Campaign

Download CTG Press Release : 17.03.16 MR for CTG Progress & Priorities report launch FINAL

Download PHAA Press Release :PHAA CTG 2017

Close the Gap Campaign report: Australia ‘going backwards’ in fight to end Indigenous disadvantage

Download the Press Release NACCHO CTG 2017

A peak Northern Territory  Aboriginal community controlled  health organisation which  was on track  to close  the life expectancy gap between First Nations peoples and other Australians  has challenged Governments to listen to what programs really work… and then give their people the capacity to deliver them.

Speaking to CAAMA  on  National Close the Gap Day  Donna Ah Chee CEO of the Alice Springs based Central Australian Aboriginal Congress , AMSANT Chair and NACCHO Board member  was scathing in her criticism of Government and  its inability to actually listen to what her people have been saying for decades.

Listen here :

Download the report HERE CTG Report 2017


The RACGP recognises the importance of supporting our members to be great doctors for all Australians, including Aboriginal and Torres Strait Islander people

 We are committed to developing culturally safe GPs and practice staff so that they are able to work effectively in the cross-cultural context and in partnership with Aboriginal and Torres Strait Islander people and communities. ”

RACGP President Dr Bastian Seidel said the organisation was an active member of the Close the Gap Steering Committee, proudly committed to ending the health gap by 2030.

Download the Press release RACGP CTG 2017

4.FVPLS / #JustJustice

” We know being incarcerated affects someone’s health and yet it is not one of the Closing the Gap targets. It’s Close the Gap Day and the Close the Gap Campaign Steering Committee’s Progress and Priorities report 2017 has been released.

The 2017 report calls for a social and cultural approach and covers many issues, including justice. This is the fourt report from the Steering Committee to call for Justice Targets.

Since 2004, there has been a 95 per cent increase in the number of Aboriginal and Torres Strait Islander people in custody. Over the same time, we have seen the crime rates decrease across the country.

Urgent action is required to reduce incarceration if we are ever to see life expectancy parity between Aboriginal and Torres Strait Islander people and other Australians.

Despite the urgency of the need, and the calls by Aboriginal and Torres Strait Islander people and organisations for an urgent response to this need, there has been no indication that governments are responding with the level of urgency required.”

Summer May Finlay from Croakey : Read Full report HERE

5. Healing Foundation

 “The social determinants of health need to be realigned in a cultural context of understanding the impact of trauma for Aboriginal and Torres Strait Islander people and how to overcome – to heal – from this. Focusing on changing just economic or education levels alone will not fix the profound challenges we face without also giving people the opportunity to improve their social and cultural connectedness and feel greater inclusion.”

Meanwhile, Richard Weston, CEO of the Healing Foundation, writes in The Guardian of the vital importance of trauma-informed practices and services, as well as for broadening discussion of the social determinants of health.

6.Palliative Care Australia

While this report doesn’t address palliative care, it is important that all people with a life-limiting illness are able to access palliative care.

“We understand that while some parts of the country offer exceptional levels of palliative care, culturally appropriate care is still not done well everywhere in Australia. We need to see that good work spread,” Ms Callaghan said.

“Community-based local approaches to end-of-life care are preferred, which leads to a significant role for Aboriginal and Torres Strait Islander health professionals in the delivery of quality end-of-life care.

“It is also very important that non-Indigenous health professionals develop culturally safe practice through education or training and appropriate engagement with local Indigenous communities.

“Culturally safe palliative and end-of-life care means that providers or practitioners must understand how these communities want health care to be provided

Download the Press Release Pallative Care CTG 2017

7. Labor Party

 ” The 2017 Close The Gap Progress and Priorities Report reiterates the need for all levels of Government to recommit and refocus, Labor stands ready to work in partnership with Aboriginal and Torres Strait Islander Peoples and their Communities.”

Labor is committed to working in a bi-partisan way, striving for the best possible outcomes for Australia’s First Peoples. Labor recognizes the importance of relationships that harness the knowledge, creativity and innovation that community controlled originations bring to driving decisions; strong relationships, working in partisanship, is the only way forward.

“Genuine partnerships with Aboriginal and Torres Strait Islander people and organisations, are essential to improving the quality of life for our First Peoples. As stated in the Report, the health and wellbeing of Aboriginal and Torres Strait Islander peoples cannot be considered at the margins”,

Senator Dodson said.

Download the Press Release Labor Party CTG 2017

8.Stroke Foundation

 ” Currently, Aboriginal and Torres Strait Islander people suffer stroke at a younger age, are more than twice as likely to be hospitalised with a stroke and 1.4 times as likely to die from stroke as non-Indigenous Australians. Aboriginal and Torres Strait Islanders experience multiple risk factors for stroke and cardiovascular disease and there are significant challenges around identifying and managing that risk. 

As a healthcare community we need to come together to close the stroke gap which is claiming the lives of too many Aboriginal and Torres Strait Islander people. The Stroke Foundation is committed to working with Aboriginal and Torres Strait Islander health organisations to improve the health outcomes of Indigenous communities.”

By Stroke Foundation Chief Executive Officer Sharon McGowan

Today is Close the Gap day – a national movement demanding equal access to healthcare for Aboriginal and Torres Strait Islander Australians. Most Australians enjoy one of the highest life expectancies of any country in the world – but this is not true for Aboriginal and Torres Strait Islander people.

Aboriginal and Torres Strait Islander people can expect to live 10 –17 years less than fellow Australians.  The mortality rates for Aboriginal and Torres Strait Islander people is on par with some of the world’s most impoverished nations. The United Nations Report, The State of the World’s Indigenous Peoples (2009) indicated Australia and Nepal have the world’s worst life expectancy gaps between Indigenous and non-Indigenous people – we must do better.

Here at the Stroke Foundation we believe everyone should have the opportunity to lead a healthy life and have access to best practice healthcare. While Australia has made some big strides towards improving Aboriginal and Torres Strait Islander health, as a nation we have a long way to go.

Equal access to healthcare is a basic human right. Everyone in Australia should have the opportunity to live a long and healthy life. It is time our Aboriginal and Torres Strait Islander communities get the health care and support they need and deserve.

The facts

• Aboriginal and Torres Strait Islander people are more than twice as likely to be hospitalised with stroke.
• Aboriginal and Torres Strait Islander people are 1.4 times as likely to die from stroke as non-indigenous Australians.
• Aboriginal and Torres Strait Islander people are 1.5 times as likely as non-Indigenous people to be obese – seven in 10 adults are overweight or obese.
• Two in five indigenous Australians smoke daily, 2.6 times the rate of non-Indigenous Australians.
• More than half of Indigenous Australians (over 15) put themselves at risk of harm by drinking alcohol.
• 64 percent of Indigenous adults do not get enough exercise.
• 85 percent on Indigenous children and 97% of Indigenous adults do not eat enough fruit and vegetables.
• One in five Indigenous adults have high blood pressure.
• One in four Indigenous adults have abnormal or high cholesterol levels

– See more at:

9.NSW Aboriginal Land Council (NSWALC)

Aboriginal and Torres Strait Islander people can expect to live 10 to 17 years younger than other Australians and the data on preventable illness and infant mortality is an appalling reminder of the challenges we face.

“The inequalities in health are a generational challenge and we have to continue the fight because the lives of our children depend on it.

“Positive change is possible – particularly when Aboriginal and Torres Strait Islander organisations are driving those changes.

“Solutions that are generated by Aboriginal and Torres Strait Islander peoples are a key part of any efforts to Close the Gap on health and living standards in Australia.”

Further progress to Close the Gap can be made if Aboriginal and Torres Strait Islander peoples are able to drive change, the Chair of the NSW Aboriginal Land Council (NSWALC) Roy Ah-See said today

Please note the above NACCHO TV was recorded when Roy was Chair of Yerin ACCHO

Download Press release NSW Land Councils CTG 2017

10. Australian Psychological Society (APS)

” There is a need for more community-based, culturally appropriate mental health services that include strengthening culture and identity, and that are delivered by culturally responsive health professionals “

Leading Aboriginal psychologist and Chair of the National Aboriginal and Torres Strait Islander Leadership in Mental Health (NATSILMH) Professor Pat Dudgeon FAPS, agrees that building on social and emotional wellbeing and cultural strengths is the foundation for improving Indigenous health and preventing suicide.

Picture : Our NACCHO CEO Pat Turner as a contributor to the report attended the launch pictured here with Senator Patrick Dodson and co-author Prof. Pat Dudgeon

 Download Press Release dAustralian Psycholigical Society CTG 2017


NACCHO Aboriginal Health #obesity : What is the #sugartax and who reckons it’s a good idea?

 ” JUNK food would be banned from schools and sports venues, and a sugar drink tax introduced, under a new blueprint to trim the nation’s waistline.

The 47-point blueprint also includes a crackdown on using junk food vouchers as rewards for sporting performance and for fundraising.

State governments would be compelled to improve the healthiness of foods in settings controlled by them like hospitals, workplaces and government events.

And they would have to change urban planning rules to restrict unhealthy food venues and make more space for healthy food outlets. “

Download the 47-point blueprint Report here :



 NACCHO Aboriginal Health and #Obesity #junkfood : 47 point plan to control weight problem that costs $56 billion per year


” In 2014-15, 63.4% of Australian adults were found by the National Health Survey to be overweight or obese. In response to Australia climbing up the ladder of the most obese countries in the world, professor Stephen Colagiuri, a diabetes expert at the University of Sydney, has urged the government to introduce a sugar tax to dissuade people from consuming sugary foods.”

Sophie Heizer Crikey intern

But what if you live in a place where you don’t have easy access to fresh food? What if the Macca’s down the road is within walking distance, but you have to jump in the car and drive for miles to get to the nearest supermarket? That’s called a food desert, and the sugar tax could have a bigger impact on people who live in those areas.

What is the sugar tax?

At this point, it is a recommendation from some health experts, which would place a levy on sugary drinks in order to mitigate obesity rates.

A report from the World Health Organization (WHO) says that a tax of 20% or more results in the drop of soft drink sales, which they say would also cut healthcare costs if it succeeded in improving health outcomes.

The Grattan Institute has suggested a tax of 40 cents per 100 grams of sugar, and calculated that obesity costs Australians $5.3 billion a year. The savings they have projected would mean an extra $500 million for the budget.

Is there support for the sugar tax?

The WHO called for a tax on sugary drinks across the world in October 2016 to curb the effects of sugary drinks on health.

Many health researchers also advocate for the tax as well. Dr Belinda Reeve from the University of Sydney writes that there needs to be more things done at the same time to reduce obesity rates and the risk of diabetes, but the tax could be effective in Australia, as the tobacco tax has been.

The Greens have released a statement saying that if the government doesn’t act on the issue, they will draft a private senator’s bill and introduce it to the Senate by the end of 2017.

Who is against it?

The Turnbull government, Labor, and senators Pauline Hanson and Derryn Hinch have all rejected the idea of imposing a sugar tax.

Minister for Health Greg Hunt has said the government was taking action in other ways: “We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer.”

Pauline Hanson said she would not support the tax because she believes it’s high time people take responsibility for what they put in their mouths, and Derryn Hinch said the tax would be unfair and unworkable.

Labor leader Bill Shorten said the opposition had no plans for a sugar tax, but said it was probably time to “toughen up advertising restrictions around junk food at peak periods when the little eyeballs are on the TV and getting all the wrong messages about food and healthy eating”.

What is a food desert?

A food desert is an area where there are no fresh fruit or vegetable outlets within a 500-metre radius. They are also defined by limited access to shops that sell healthy foods, coupled with an abundance of fast-food takeaway options within easy walking distance. These areas leave people disenfranchised by lack of access to affordable, healthy food and at a greater risk of obesity and the development of diabetes.

There have been a number of food deserts identified in Australia: Braybrook, Maidstone and West Footscray/Kingsville have been identified in Victoria, areas of western Sydney including Blacktown (where residents are three times more likely to develop diabetes) and Mount Druitt and even in wealthy areas of Canberra. Research commissioned by Anglicare and Red Cross showed that there was insufficient access to affordable and nutritionally adequate food in inner suburbs such as Kingston, Red Hill and Fyshwick, as well as Narrabundah Longstay Caravan Park, Belconnen, Weston Creek and newer suburbs in the Gungahlin region.

How would the sugar tax affect people living in food deserts?

The same kind of sugar tax was proposed in the UK. It was met with heavy resistance from the seemingly conservative lobby group, the TaxPayers’ Alliance, which cited the ineffectiveness of the tax in Mexico, the chief executive stating:

“It is astonishing that the government is pressing ahead with this pernicious tax when the evidence clearly suggests that it will simply not affect consumption in any meaningful way. As with any regressive tax, this will only raise living costs for hard-pressed families, already struggling with big tax bills. Politicians must look at the evidence and ignore the High Priests of the Nanny State in the public health lobby, and abolish the Sugar Tax before it is too late.”

Food deserts are, in particular, an issue for people of low socio-economic status (SES) and where there are people with mobility issues in the community. The tax will undeniably hit the poor and those living in food deserts harder because more of their income goes towards poor quality food, but there is evidence from studying the effectiveness of the tax in Mexico that it does decrease spending on unhealthy food products for everyone.

A research paper by PLOS One, which also supports the 20% hike in tax on sugar, states:

“We note that Australians of low SES are disproportionately affected by high rates of diet-related illnesses and are therefore likely to experience greater dietary improvements as a result of a tax on SSBs. Inequitable aspects are likely to be further ameliorated if revenue was used to support healthy eating initiatives and subsidies on healthy foods for low-SES households.”

This means the sugar tax could actually be beneficial to low-SES households in food deserts, as a result of both a shift in eating habits, and a freeing up of space in the health budget to rectify access issues in relation to cost and geography.

NACCHO Aboriginal Health and #Budget2017 : @AMAPresident launches Pre-Budget Submission 2017-18


 ” The gap in health and life expectancy between Aboriginal and Torres Strait Islander people and other Australians is still considerable, despite the commitment to closing the gap.

The AMA recognises the early progress that is being made, particularly in reducing early childhood mortality rates, and in addressing major risk factors for chronic disease, such as smoking.

To maintain this momentum for the long term, the Government must improve resourcing for culturally appropriate primary health care for Aboriginal and Torres Strait Islander people, and the health workforce.

Despite recent health gains for Aboriginal and Torres Strait Islander people, progress is slow and much more needs to be done.”

AMA President, Dr Michael Gannon launching the AMA’s Pre-Budget Submission 2017-18

Download AMA submission here


AMA President, Dr Michael Gannon, said today that the appointment of Greg Hunt as Health Minister provides the Government with the perfect opportunity to change direction on health policy, and to consign any links to the disastrous 2014-15 Health budget to history.

Launching the AMA’s Pre-Budget Submission 2017-18, Dr Gannon said the key for the Government and the Health Minister is to look at all health policies as investments in a healthier and more productive population.

“Health is the best investment that governments can make,” Dr Gannon said.

AMA POSITION Indigenous Health pages 14/15

The AMA calls on the Government to:

• correct the under-funding of Aboriginal and Torres Strait Islander health services;

• establish new or strengthen existing programs to address preventable health conditions that are known to have a significant impact on the health of Aboriginal and Torres Strait Islander people, such as cardiovascular diseases (including rheumatic fever and rheumatic heart disease), diabetes, kidney disease, and blindness;

• increase investment in Aboriginal and Torres Strait Islander community-controlled health organisations. Such investment must support services to build their capacity and be sustainable over the long term;

• develop systemic linkages between Aboriginal and Torres Strait Islander community-controlled health organisations and mainstream health services to ensure high quality and culturally safe continuity of care;

• identify areas of poor health and inadequate services for Aboriginal and Torres Strait Islander people, and direct funding according to need;

• institute funded, national training programs to support more Aboriginal and Torres Strait Islander people to become health professionals to address the shortfall of Indigenous people in the health workforce;

• implement measures to increase Aboriginal and Torres Strait Islander people’s access to primary health care and medical specialist services;

• adopt a justice reinvestment approach to health by funding services to divert Aboriginal and Torres Strait Islander people from prison, given the strong link between health and incarceration;

• appropriately resource the National Aboriginal and Torres Strait Islander Health Plan to ensure that actions are met within specified timeframes;

• adopt the recommendations of the AMA’s 2016 Report Card on Indigenous Health and commit to a target to eradicate new cases of Rheumatic Heart Disease (RHD); and

• support a National Aboriginal and Torres Strait Islander Hearing Health Taskforce that can provide evidence-based advice to Government, embed hearing health in Closing the Gap targets, and recognise its importance in early childhood development, education, and employment.

“The AMA agrees with and supports Budget responsibility. But we also believe that savings must be made in areas that do not directly negatively affect the health and wellbeing of Australian families.

“Health must be seen as an investment, not a cost or a Budget saving.

“There are greater efficiencies to be made in the health system and in the Health budget, but any changes must be undertaken with close consultation with the medical profession, and with close consideration of any impact on patients, especially the most vulnerable – the poor, the elderly, working families with young children, and the chronically ill.

“But the AMA urges caution – and care. The Government must not make long-term cuts for short-term gain. Patients will lose out.

“In this Pre-Budget Submission, the AMA is urging the Government to invest strategically in key areas of health that will deliver great benefits – in economic terms and with health outcomes – over time.

“The first task of the new Minister must be to lift the freeze on Medicare patient rebates, which is harming patients and doctors.

“Primary care and prevention are areas where the Government can and should make greater investment.

“General practice, in particular, is cost-effective and proven to keep people well and away from more expensive hospital care. It was pleasing to hear Minister Hunt use his first health media conference to declare that he wanted to be the Health Minister for GPs.

“The Government must also fulfil its responsibilities – along with the States and Territories – to properly fund our public hospitals.

“So too, the Government must deliver on its commitments to improve the health of Indigenous Australians.

“In this submission, the AMA provides the Government with affordable, targeted, and proven policies that will contribute to a much better Budget bottom line in coming years.

“More importantly, the AMA’s recommendations will deliver a healthier and more productive population to drive further savings into the future.”

The AMA Pre-Budget Submission 2017-18 covers the following key areas:

  • Medicare Indexation Freeze;
  • Public Hospitals;
  • Health Care Home;
  • Medicare Reviews;
  • Medicare Levy;
  • Pathology;
  • Private Health Insurance;
  • Medical Indemnity – Underpinning Affordable Health Care;
  • Medical Care for Palliative Care and Aged Care Patients;
  • Indigenous Health;
  • Mental Health;
  • Medical Workforce and Training;
  • Obesity;
  • Nutrition;
  • Physical Activity;
  • Alcohol and Drugs; and
  • Climate Change and Health.

The AMA Pre-Budget Submission 2017-18 is at

This Submission was lodged with Treasury ahead of the cob Thursday 19 January 2017 deadline.