NACCHO Aboriginal #Heart Health : Major health groups welcome cross-party @GregHuntMP  @billshortenmp commitment on health checks @amapresident @heartfoundation   @strokefdn  @ACDPAlliance @CHFofAustralia 

” The support for comprehensive health checks to tackle cardiovascular disease is an acknowledgement of the importance of general practice to preventive health care and we are looking forward to more promises ahead of the federal election

AMA President Tony Bartone welcomed the commitments see full press release Part 2

 “Chronic diseases affect half of the Australian population and are the leading cause of death in Australia , yet, many people are unaware of their risk and the first sign something is wrong is a trip to the hospital.

 Chronic diseases – including heart disease and stroke – account for more than one-third of health spending, with costs expected to increase as the population ages.

Investment in prevention is crucial to address the growing impact of chronic disease and reduce unnecessary hospitalisations,”

Chair of the Australian Chronic Disease Prevention Alliance Sharon McGowan said investment in comprehensive health checks would encourage people to consider their health before a crisis : See full Press Release Part 3 below

“ Even though there is one case of heart attack or stroke occurring in Australia every five minutes according to government figures, too many Australians don’t realise the importance of checking how their heart is performing.   This check should nudge more patients and their doctors to make that check.

Labor has announced that in government it would spend $170 million on a new Medicare item for comprehensive heart health checks to support doctors in better preventing, detecting and managing heart disease.

And from April 1 this year, the Health Minister, Greg Hunt, has announced there will be a dedicated Medicare item to support GPs to assess cardiovascular risk”

CEO of the Consumers Health Forum, Leanne Wells

Read over 70 Aboriginal Heart Health articles published by NACCHO over last 7 years

Part 1 News summary AAP

Heart disease is a huge and often unrecognised problem for many Australians, and it is good news that both sides of politics today have announced their support for a comprehensive heart health check to be financed by Medicare.

When it comes to matters of the heart, the federal government and Labor are beating to the same rhythm each vowing millions to fund life-saving health checks.

One Australian dies of cardiovascular disease every 12 minutes, with one Australian experiencing a heart attack or stroke every five minutes.

Opposition Leader Bill Shorten matched the $170 million over five years for general practice in Melbourne, just hours after a Liberal counterpart announced the same plan.

“Heart disease is Australia’s silent killer,” Mr Shorten told reporters on Sunday.

“My father died prematurely at the age of 70 with a catastrophic heart attack. We will make sure the funding is available so that everyone who wants to get a heart health check will be able to do so.

“It is good the government has agreed that to this proposition as well.”

The checks will be available through Medicare from April.

Health Minister Greg Hunt told Nine’s Weekend Today show it would mean “a better chance for people to have a proper test with their doctor”.

“They can see whether there are any issues either around their lifestyle or whether any further action needs to be taken,” he said.

National Heart Foundation chief executive Garry Jennings AO said it was an important announcement, not for what people will see rather what they won’t see as a result.

“You won’t see people who seem to be going happily through life and suddenly die from coronary disease or have a heart attack,” he said on Sunday, noting about four million Aussies with heart disease may have avoided the condition had they been checked.

Part 2 AMA president Tony Bartone also welcomed the commitments.

The commitment by both major parties to invest an estimated $170 million extra over five years into general practice to support longer health consultations is a welcome start to better investment in primary care.

“The support for comprehensive health checks to tackle cardiovascular disease is an acknowledgement of the importance of general practice to preventive health care,” AMA President, Dr Tony Bartone, said today.

“Longer consultations enhance continuity of care, and the AMA looks forward to seeing further announcements detailing plans for investment in general practice in the lead-up to the next election.

“The recent report of the Medicare Benefits Schedule General Practice and Primary Care Clinical Committee recognised the central role of general practice in the health system and called for a significant new investment in general practice. All parties must heed this advice.

“Today’s announcements by the coalition and Labor, targeting one health condition, can be regarded as a good first step. However, much more is needed to support general practice in delivering holistic care to our patients and the whole community.

“It is heartening to see that, as we approach the Federal Election, the major parties have turned their attention to better supporting general practice.

“General practice is in urgent need of an injection of new funding as Australia tackles the growing burden of complex and chronic disease, and the need for prevention.

“High quality, GP led, patient-centred primary health care is key to improving the effectiveness of care, preventing illness, and reducing inequality, variation, and health system costs.

“There is no doubt that a significant investment now in general practice will bring the promise of long-term improvements in health care outcomes for patients and savings to the health system.

“The AMA’s priorities for investment in general practice are detailed in our 2019 Pre-Budget Submission. We will be calling on all major parties to release full details of their general practice policies and their vision for Australia’s health system well ahead of the election.”

The AMA Pre-Budget Submission is at https://ama.com.au/sites/default/files/budget- submission/AMA_Budget_Submission_2019_20.pdf

Part 3 Health groups welcome cross-party commitment on health checks

The Australian Chronic Disease Prevention Alliance welcomes support by the Australian Government and the federal Opposition for a Medicare item to prevent and manage vascular disease – heart, stroke, kidney disease and type 2 diabetes. Funding for an integrated health check has also been backed by the Australian Greens.

Alliance members, including the National Heart Foundation, Stroke Foundation, Diabetes Australia, Kidney Health Australia and Cancer Council Australia, have long championed integrated health checks to stem the tide of Australia’s chronic disease burden.

Chair of the Australian Chronic Disease Prevention Alliance Sharon McGowan said investment in comprehensive health checks would encourage people to consider their health before a crisis.

Around one-third of chronic disease could be prevented through modifiable risk factors, such as smoking, unhealthy weight, poor diet and high blood pressure. Although the new item has been focused around vascular disease, key risk factors, such as smoking, cause several chronic diseases and many people suffer co-morbidities through lifestyle.

Ms McGowan said today’s announcement was an important step forward in Government recognition of the importance of prevention as well as cure.

“A Medicare item for integrated health checks provides an important opportunity for people to consider their risk in consultation with their GP and take steps to reduce their risk through lifestyle changes and/or medication,” she said.

Chronic diseases – including heart disease and stroke – account for more than one-third of health spending, with costs expected to increase as the population ages.

“Investment in prevention is crucial to address the growing impact of chronic disease and reduce unnecessary hospitalisations,” Ms McGowan said.

“The Australian Chronic Disease Prevention Alliance welcomes the cross-party support for comprehensive health checks to reduce disease risk and improve the health and wellbeing of Australians.”

Part 4 Consumers Health Forum

Heart disease is a huge and often unrecognised problem for many Australians, and it is good news that both sides of politics today have announced their support for a comprehensive heart health check to be financed by Medicare.

“Even though there is one case of heart attack or stroke occurring in Australia every five minutes according to government figures, too many Australians don’t realise the importance of checking how their heart is performing.   This check should nudge more patients and their doctors to make that check,” the CEO of the Consumers Health Forum, Leanne Wells, said.

“Labor has announced that in government it would spend $170 million on a new Medicare item for comprehensive heart health checks to support doctors in better preventing, detecting and managing heart disease.

“And from April 1 this year, the Health Minister, Greg Hunt, has announced there will be a dedicated Medicare item to support GPs to assess cardiovascular risk.

“We also need to do much more in the way of preventive health measures to educate people and promote better diet and lifestyles to reduce obesity and other chronic illnesses that increase the risk of heart disease.

“The heart check plan is a good down payment in the wider investment we need in prevention.  It should also provide a platform for more announcements to come about supporting general practice to better prevent and manage chronic disease in enrolled patients.  We will be watching the development of those approaches with much interest.

“The suggestion that this heart health check be part of a Medicare-funded comprehensive health check for other lifestyle risk factors should be embedded in the Health Care Home enrolment model making the most of general practitioners as the accessible, appropriate and trusted setting for preventive health care.

“However, we need to acknowledge that a new Medicare item number is not an end in itself.  Such a development needs to be accompanied by a package of wider reforms that include patient supports such as self-management programs, access to health coaching and use of patient activation measures by GPs so they better understand the likelihood that patients are receptive to and will follow up on lifestyle advice.

“In our Federal Budget submission, we called for more support for patients to take an active and engaged interest in their health care and support for doctors to encourage that engagement.  The Consumers Health Forum will be reinforcing those calls in our soon-to-be released election priorities,” Ms Wells said.

 

 

NACCHO Aboriginal Health @TheAHCWA Chair Vicki O’Donnell and Moorditj Koort’s ACCHO express deep concern over the Federal Government’s decision to award over $1.6m to a non-Indigenous organisation

“It is quite concerning, considering there are only two Aboriginal Health Services in the Perth Metropolitan Region. There’s no reason why we shouldn’t have been consulted,.

From an economic standpoint, Moorditj Koort should have been considered for the government grant as research shows Indigenous organisations deliver greater outcomes than non-Indigenous organisations. ”

Moorditj Koort’s CEO Jonathon Ford said the organisation was not consulted by the government to apply for the grant. Moorditj Koort Aboriginal Health and Wellness Centre has been Indigenous-owned and run in Perth since it was founded in 2010 See Part 2 Below 

Chair of the Aboriginal Health Council of Western Australia (AHCWA), Vicki O’Donnell has expressed deep concern over the Federal Government’s decision to award over $1.6m to a non-Indigenous organisation to deliver primary health care to Indigenous Australians.

AHCWA is the peak body for its 23 Aboriginal Community Controlled Health Services across WA.

On February 14th, the Prime Minister stated “Governments fail when accountabilities are unclear ,when investment is poorly targeted, when systems aren’t integrated.

And when we don’t learn from evidence.”

Read Download HERE 

We have major concerns with the procurement process in relation to this funding decision.

  • How was the need for this additional service determined when there are already existing services in the area including Mooditj Koort, Derbarl Yerrigan and other not-for profit services? Is this not a duplication of services?
  • How would Redimed add value to the services already being provided in Midland given the existence of Aboriginal Community Controlled Health Services (ACCHS) that have already built connections with the local Aboriginal community?
  • Why was the funding approval process not subject to an open tender process in fairness to existing agencies?
  • How was the capacity of the grant recipient to deliver the contract determined in terms of clinical accreditation and experience in delivering primary health care to Aboriginal people?
  • What is the rationale for introducing an additional non-Indigenous provider to deliver primary health care services to the area, rather than increasing the capacity of the two current ACCHS operating in Midland?

The AMA 2018 Report Card on Indigenous Health highlights the fundamental issues such as committing to equitable needs-based funding; systematically costing, funding, and implementing the ‘Closing the Gap’ health and mental health plans; identifying and filling the gaps in primary health care; addressing environmental health and housing; addressing social determinants; and Aboriginal leadership.

“Sizeable and rapid health gains would result from additional primary health care services and targeted improvements to existing primary health services to prevent, detect, and then manage the conditions that lead to potentially preventable hospital admissions and deaths.

By definition, it is these conditions that must be addressed if the life expectancy gap is to close….these services should generally be provided by Aboriginal Community Controlled Health Services that are more accessible, perform better in key areas, and are the most cost-effective vehicles for delivering primary health care to Aboriginal and Torres Strait Islander communities.”

Read Download AMA Report Card HERE

The decision to award such significant funding to a non-Indigenous organisation goes completely against the sentiments made in Prime Minister’s recent statement at the launch of the Closing the Gap Report

BACKGROUND NIT 

Over $1.6 million of funding for Indigenous health services has been awarded to a non-Indigenous health organisation.

Redimed, a private Perth-based company, has been the recipient of an Indigenous Comprehensive Primary Health Care grant worth $1,692,856 from the Commonwealth Department of Health.

Redimed’s grant application was labelled as targeted or restricted, indicating other organisations may not have been invited to tender.

The number of organisations asked to apply is unconfirmed and questions are arising over the suitability of selecting a non-Indigenous organisation to deliver culturally competent health services to Indigenous peoples.

The Australian Health Review reported in 2017 that Aboriginal Community-Controlled Health Services are more effective at improving Indigenous health than other health providers as they are specialised in delivering care that is consistent with Indigenous patient needs.

“Simply, we have evidence that we can do better with the same amount of funds,” Mr Ford said.

He said it is ethically wrong for non-Indigenous organisations to receive Indigenous health funds.

“Our Aboriginal Community-Controlled Health Organisations have the right to self-determination and self-management under the UN Declaration on the Rights of Indigenous Peoples.”

Ford said he is unsure why the government would give a hefty sum like that awarded to Redimed without consulting the First Nations people of the land in Perth.

“I do know that unless government begins to enable our Aboriginal Organisations to provide community driven strength-based approaches to our people, it will not close the gap.”

National Indigenous Times can report that Redimed has registered a new business name: Aboriginal Health Care 360. It is unclear whether Redimed is collaborating with 360 Health which provides some Indigenous health care services.

Redimed owner Dr Hanh Nguyen was contacted for comment, however no response was received.

The funding issue is expected to be brought up in Friday’s Senate Estimates.

Minister for Indigenous Health Ken Wyatt did not respond to National Indigenous Times’ requests for comment.

By Hannah Cross

NACCHO Aboriginal Health #RefreshtheCTGRefresh : Read and /Or Download #ClosingtheGap response Press Releases from Pat Turner NACCHO CEO @June_Oscar @congressmob @closethegapOZ @amapresident @RACGP @RecAustralia @Change_Record @Mayi_Kuwayu

Close the Gap Campaign

AMA

RACGP

Reconciliation Australia

Change the Record

AMSANT Darwin

Mayi Kuwayu /ANU

Greens

Introduction NACCHO Closing the Gap response CEO Pat Turner AM 

On the floor of Parliament yesterday, the Prime Minister spoke of a change happening in our country: that there is a shared understanding that we have a shared future- Indigenous and non-Indigenous Australians, together. But our present is not shared. Our present, and indeed our past is marred in difference, in disparity. This striking disparity in quality of life outcomes is what began the historic journey of the Closing the Gap initiatives a decade ago.

But after ten years of good intentions the outcomes have been disappointing. The gaps have not been closing and so-called targets have not been met. The quality of life among our communities is simply not equal to that of our non-indigenous Australian counterparts.

Yes change must come from within our communities, but change must also come from the whole of Australia. We must change together.

The time has come for our voices to be heard and for us to lead the way on Closing the Gap. We are ready for action. ”

Pat Turner AM is the CEO of the National Aboriginal Community Controlled Health Organisation.

But I’m ever hopeful that change is near. I was heartened by the statement made by the Prime Minister yesterday on the floor of Parliament. For the first time, I heard a genuine acknowledgement of why the Closing the Gap outcomes seem steeped in failure. I heard an acknowledgement that until Aboriginal and Torres Strait Islander people are brought to the table as equal partners, the gap will not be closed and progress will not be made. This is a view that our community has expressed for many years – a view I am encouraged has finally been heard.

Historically, Aboriginal and Torres Strait Islander community leaders have not been equal decision-makers in steering attempts to close the unacceptable gaps between Aboriginal and Torres Strait Islander Australians and the broader community. Our struggle as community-controlled organisations to even gain a voice at the table  – let alone for governments to actually listen to us – has long been at the crux of the disappointing progress.

Last year, an accord on the first stage of the Closing the Gap Refresh languished because discussions were not undertaken with genuine input from community members. We turned an important corner in December when an historic agreement was reached to include a coalition of peak bodies as equal partners in refreshing the Closing the Gap strategy.

We now need to ensure that the agreement blossoms into genuine action.

We simply cannot let this opportunity to make a real difference to the lives of our people slip by. Government cannot be allowed to drag the chain on this until it becomes another broken promise.

We are doing the heavy lifting and have drafted a formal partnership agreement for the Commonwealth, state and territory governments to consider. We are determined to do all that we can to fulfil COAG’s undertaking to agree formal partnership arrangements by the end of February.

The agreement sets out how we all work together and have shared and equal decision making on closing the gap. We are confident that a genuine partnership will help to accelerate positive outcomes to close the gaps.

The lack of progress under Closing the Gap is the lived reality of our people on the ground everyday. They are being robbed of living their full potential. Sadly, attending the funerals of people in our community – including increasingly young people taking their own lives – is all too common.

A coalition of Aboriginal and Torres Strait Islander peak bodies from across the nation has formed to be signatories to the partnership arrangements. We are now almost 40* service delivery, policy and advocacy organisations, with community-control at our heart. This is the first time our peak bodies have come together in this way.

Our coalition brings a critical mass of independent Indigenous organisations with deep connections to communities that will enhance the Closing the Gap efforts. We are a serious partner for government. We want to ensure our views are considered equal and that we make decisions jointly.

We cannot continue to approach Closing the Gap in the same old ways. The top-down approach has reaped disappointing results as evidenced by the lack of progress of previous strategies to reach their targets.

We must not lose sight of the most crucial point of Closing the Gap, which is to improve the everyday lives of our people. We must ensure our people are no longer burdened with higher rates of child mortality, poorer literacy, numeracy and employment outcomes and substantially lower life expectancies.

Yesterday on the floor of Parliament, the Prime Minister said that this will be a long journey of many steps. And I say, we have been walking for centuries. We have journeyed far and we will keep walking forward and climbing up until we reach a place where we are all on equal ground.

I also heard the Leader of the Opposition say that the burden of change needs to be carried by non-Indigenous Australians in acknowledging that racism still exists, that our justice system is deeply flawed and that generational trauma cannot be ignored.

Yes change must come from within our communities, but change must also come from the whole of Australia. We must change together.

The time has come for our voices to be heard and for us to lead the way on Closing the Gap. We are ready for action.

1 .Close the Gap Campaign

“We have had so many promises and so many disappointments. It’s well and truly time to match the rhetoric. We cannot continue to return to parliament every year and hear the appalling statistics,

 Last December, the Council of Australian Governments (COAG), led by the Prime Minister, agreed to a formal partnership with peak Indigenous organisations on Closing the Gap.

We strongly support the Coalition of Aboriginal and Torres Strait Islander Peak bodies that has formed to be signatories to the partnership agreement with COAG, and for them to share as equal partners in the design, implementation and monitoring of Closing the Gap programs, policies and targets.

This partnership really does have the potential to be a game changer. It means active participation in decisions about matters that affect us. It will allow the voices of Indigenous Australians at community, local and national levels to be heard. “

The Co-Chairs of the Close the Gap Campaign, the Aboriginal and Torres Strait Islander Social Justice Commissioner June Oscar AO and the Co-Chair of the National Congress of Australia’s First Peoples Rod Little, say that commitment must be followed by action.

It was imperative for Australian governments to have an agreement in place by the end of February with the coalition of more than 40 Aboriginal and Torres Strait Islander health and justice groups, so all stakeholders can get onto the “nitty gritty” of the Closing the Gap Refresh with new targets set to be finalised by mid year. ”

National Family Violence Prevention Legal Services (FVPLS) Forum convenor Antoinette Braybrook 

Download CTG Press Release

1.Close the Gap response to CTG

2.AMA

“After more than a decade, the lack of resourcing and investment in the health and well-being of Aboriginal and Torres Strait Islander peoples continues to see unacceptable gaps across a range of outcomes.

The lack of sufficient funding to vital Indigenous services and programs is a key reason for this.”

The AMA supports the comments made by Ms Pat Turner, CEO of Aboriginal Community Controlled Health Organisation (NACCHO) who said: ‘While our people still live very much in third-world conditions in a lot of areas still in Australia … we have to hold everybody to account’.

Closing the Gap targets are vital if we are to see demonstrable improvements in the health and well-being of Aboriginal and Torres Strait Islander people.

The call for a justice target and a target around the removal of Aboriginal children should be considered.

The AMA welcomes the decision of the Council of Australian Governments (COAG) to agree a formal partnership with us on Closing the Gap. This is an historic milestone in the relationship between Governments and Aboriginal and Torres Strait Islander peoples.” 

AMA President, Dr Tony Bartone

Download the AMA Press Release

2 AMA Closing the Gap progress disappointing

See all NACCHO AMA posts

3.RACGP

‘This year’s Closing the Gap report reminds us that whilst we are making important progress, we are still not doing enough for Aboriginal and Torres Strait Islander peoples.

It’s critical we get this right. Our people deserve to live full and healthy lives, like every other Australian. We know the best way to achieve this is when Aboriginal and Torres Strait Islander peoples have a say in the decisions that impact them.

Governments must acknowledge the critical role of primary healthcare and particularly the culturally responsive care offered by Aboriginal Community Controlled Health Services in Closing the Gap “

Chair of RACGP Aboriginal and Torres Strait Islander Health, Associate Professor Peter O’Mara, told newsGP he welcomes the Prime Minister’s commitment to establishing a formal partnership with Aboriginal and Torres Strait Islander peoples on the Closing the Gap Strategy.

Read full Press Release HERE

Read NACCHO RACGP articles HERE

4.Reconciliation Australia

“Aboriginal and Torres Strait Islander leaders and peak bodies have been demanding a greater say in the policy priorities, and design and implementation of programs around the CTG since its inception over a decade ago. Today’s commitment by the Prime Minister, supported by the Opposition Leader, is welcome albeit overdue, and builds on the COAG commitment in December.

It is simple common sense that people, who live each day with the problems CTG is trying to address, will have the greatest knowledge and understanding of the causes and solutions to these problems “

Karen Mundine, CEO of Reconciliation Australia, said her organisation was disappointed by the failure but remained hopeful that a bipartisan commitment to a greater First Nations’ voice in the planned refresh of the CTG would lead to more effective programs being delivered in partnership with communities.

Download the Press Release

4.Reconciliation Aust CTG Response

5.Change the Record

 “Change the Record calls on the Prime Minister to listen to the majority of        Australians who believe governments must act to close the gap on justice, as shown by the 2018 Australian Reconciliation Barometer results.

“Almost 60% of Australians want the Federal Government to include justice in Closing the Gap, and 95% agree our people should have a say in matters that affect us,”

In the past year the Government engaged selected stakeholders in a nation-wide consultation, however many Aboriginal and Torres Strait Islander organisations were excluded. Change the Record stands in support of the Coalition of Aboriginal and Torres Strait Islander community-controlled peak bodies as they push for a formal partnership agreement to finalise the Closing the Gap Refresh.

This historic step to make our peak bodies equal partners with Government is critical to our self-determination and to Closing the Gap,”

Change the Record co-chair Damian Griffis.

Download the CTG Press Release

5. Change the Record

6. AMSANT Darwin

We would have loved to be part of those discussions about what to prioritise. We absolutely support education being a top priority target, but we need to ensure we are also prioritising some of those targets such as housing.”

You are not going to get kids to go to school if they haven’t had a decent night’s sleep because of an overcrowded house, you are not going to get kids to go to school if they haven’t got food in their tummy … you ain’t going to get kids to go to school if parents are not encouraging them to go to school due to lack of support services for parents”,

John Paterson AMSANT Darwin

From SMH Interview

7.Mayi Kuwayu /ANU

 ” The refreshed targets help us focus on progress and achievement. Most of these refreshed targets are not dependent on how things are going within the non-Indigenous population (they are not moving targets) — they are absolute, fixed targets that we can work towards. For example, the old target of “halve the gap in employment by 2018” is replaced by “65 per cent of Aboriginal and Torres Strait Islander youth (15-24 years) are in employment, education or training by 2028”.

Further, the refreshed targets are evidence-based and appear to be achievable.

This is a change from the original targets which the evidence showed could never have been met. They were always going to fail. This is a problem because it has reinforced the idea held by many in the wider Australian community that Aboriginal and Torres Strait Islander inequality was “too big of a problem” and could never be overcome. Or even worse, it supported the myth that Aboriginal and Torres Strait Islander people themselves were the problem

Ray Lovett, Katherine Thurber, and Emily Banks are part of the Aboriginal and Torres Strait Islander Health Program at the National Centre for Epidemiology and Population Health, Australian National University, and conduct research on the social and cultural determinants of Aboriginal and Torres Strait Islander health and wellbeing.

Their approach is to conduct research in partnership with Aboriginal and Torres Strait Islander individuals, communities, and organisations, and to frame research using a strengths-based approach, where possible. Follow the program @Mayi_Kuwayu Professor Maggie Walter is the Pro Vice-Chancellor Aboriginal Research and Leadership at the University of Tasmania.

 Read Article in Full 

8.Greens

” Mr Morrison’s closing the gap address was paternalistic and patronising and a clear indication that he doesn’t get it.

Mr Morrison lectured the Parliament about co-design and collaboration but he does not practice what he preaches

The Coalition was dragged kicking and screaming to a co-design approach and the Government’s failure to listen when the process started was in fact the reason we are so delayed with the Close the Gap refresh.

You would think that he was the first person to think of collaboration and co-design!

Senator Rachel Siewert 

Download the Greens CTG Press Release

8.Greens Party CTG Response

NACCHO Aboriginal Health #refreshtheCTGRefresh : @NACCHOchair Welcomes the release of the @AMAPresident 2018 Report Card on Indigenous Health and joins its call for rebuilding the #ClosingtheGap health strategy from the ground up

It’s been a decade since the Council of Australian Governments (COAG) launched the Closing the Gap Strategy, with a target of achieving life expectancy equality by 2031

But 10 years on, progress is limited, mixed, and disappointing. If anything, the gap is widening as Aboriginal and Torres Strait Islander health gains are outpaced by improvement in non-Indigenous health outcomes.

The Strategy has all but unravelled, and efforts underway now to refresh the Strategy run the risk of simply perpetuating the current implementation failures.

The Strategy needs to be rebuilt from the ground up, not simply refreshed without adequate funding and commitment from all governments to a national approach.”

The Closing the Gap Strategy is unravelling, and must be rebuilt from the ground up to have any chance of closing the life expectancy gap between Indigenous and non-Indigenous Australians, AMA President, Dr Tony Bartone said today at the launch of the AMA report at the ATSICHS ACCHO in Brisbane : Interview with The Guardian Part 3 Below 

Download the 24 Page AMA Report 

AMA Indigenous Health Report Card 2018 (2)

Dr Tony Bartone (left ) and Ms Donnella Mills ( Second left ) on tour of ATSICHS

We congratulate the AMA on their work to support closing the gap and endorse the recommendations in the report.”

The report highlights research which indicates the mortality gaps between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians are widening, not narrowing.

Urgent and systematic action is needed to reverse these failures and to have any prospect of meeting the Council of Australian Governments’ goal to Close the Gap in life expectancy by 2031

NACCHO calls for the immediate adoption of the Report Card’s recommendations.

We are seeking a formal partnership between Aboriginal and Torres Strait Islander peoples and governments to be included in the Closing the Gap Refresh policy , Aboriginal people need to be at the centre of Closing the Gap strategies; the gap won’t close without our full engagement and involvement.

The Chairperson of the peak body for Aboriginal controlled health services Ms Donnella Mills today welcomed the release of the AMA’s 2018 Report Card on Indigenous Health and joined its call for rebuilding the Closing the Gap from the ground up. See full NACCHO Press Release HERE 

It doesn’t mean that things aren’t improving, because health outcomes for our people are improving

The challenge is that we’re trying to actually improve the pace of that improvement faster than some of the healthiest people in the world, which is what Australians enjoy – one of the healthiest countries on the globe.

So you’re trying to actually close the gap between some of the sickest people in the world to some of the healthiest people in the world – it was always an ambitious target.”

Adrian Carson, CEO of the Urban Institute of Indigenous Health, said while national outcomes lagged behind, he had seen “significant” health improvements at a local level in south-east Queensland. see Part 3 below or in full here 

Busting the myth that Indigenous-led organisations ‘don’t deliver’

Dr Bartone today launched the AMA Indigenous Health Report Card 2018, the AMA’s annual analysis of an area of Aboriginal and Torres Strait Islander health across the nation.

This year’s Report Card scrutinises the 10-year-old Closing the Gap Strategy, and recent efforts to “refresh” the Strategy.

“It’s been a decade since the Council of Australian Governments (COAG) launched the Closing the Gap Strategy, with a target of achieving life expectancy equality by 2031,” Dr Bartone said.

“But 10 years on, progress is limited, mixed, and disappointing. If anything, the gap is widening as Aboriginal and Torres Strait Islander health gains are outpaced by improvement in non-Indigenous health outcomes.

“The Strategy has all but unravelled, and efforts underway now to refresh the Strategy run the risk of simply perpetuating the current implementation failures.

“The Strategy needs to be rebuilt from the ground up, not simply refreshed without adequate funding and commitment from all governments to a national approach.”

The Report Card outlines six targets to rebuild the Strategy:

  • committing to equitable, needs-based expenditure;
  • systematically costing, funding, and implementing the Closing the Gap health and mental health plans;
  • identifying and filling primary health care service gaps;
  • addressing environmental health and housing;
  • addressing the social determinants of health inequality; and
  • placing Aboriginal health in Aboriginal hands.

“It is time to address the myth that it is some form of special treatment to provide additional health funding to address additional health needs in the Aboriginal and Torres Strait Islander population,” Dr Bartone said.

“Government spend proportionally more on the health of older Australians when compared to young Australians, simply because elderly people’s health needs are proportionally greater.

“The same principle should be applied when assessing what equitable Indigenous health spending is, relative to non-Indigenous health expenditure.

“The Australian Institute of Health and Welfare estimates that the Aboriginal and Torres Strait Islander burden of disease is 2.3 times greater than the non-Indigenous burden, meaning that the Indigenous population has 2.3 times the health needs of the non-Indigenous population.

“This means that for every $1 spent on health care for a non-Indigenous person, $2.30 should be spent on care for an Indigenous person.

“But this is not the case. For every $1 spent by the Commonwealth on primary health care, including Medicare, for a non-Indigenous person, only 90 cents is spent on an Indigenous person – a 61 per cent shortfall.

“For the Pharmaceutical Benefits Scheme, the gap is even greater – 63 cents for every dollar, or a 73 per cent shortfall from the equitable spend.

“Spending less per capita on those with worse health, and particularly on their primary health care services, is dysfunctional national policy. It leads to us spending six times more on hospital care for Indigenous Australians than we do on prevention-oriented care from GPs and other doctors.

“We will not close the gap until we provide equitable levels of health funding. We need our political leaders and commentators to tackle the irresponsible equating of equitable expenditure with ‘special treatment’ that has hindered efforts to secure the level of funding needed to close the health and life expectancy gap.”

AMA Media Coverage 

The AMA 2018 Indigenous Health Report Card is at https://ama.com.au/article/2018-ama-report-card-indigenous-health-rebuilding-closing-gap-health-strategy-and-review

Part 2 : The Chairperson of the peak body for Aboriginal controlled health services Ms Donnella Mills today welcomed the release of the AMA’s 2018 Report Card on Indigenous Health and joined its call for rebuilding the Closing the Gap from the ground up.

Download the full NACCHO Press Release HERE

National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson, Ms Donnella Mills said, “We congratulate the AMA on their work to support closing the gap and endorse the recommendations in the report.”

The report highlights research which indicates the mortality gaps between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians are widening, not narrowing.

The AMA estimate that the Commonwealth government spend on Aboriginal and Torres Strait Islander health is only 53% of needs-based requirements. Aboriginal and Torres Strait Islander peoples have at least twice the per capita need of the rest of the population because of much higher levels of illness and burden of disease.

“This underspend represents a significant failure” Ms Mills said. “Genuine commitment by Australian governments to Closing the Gap requires equitable funding.”

The funding shortfall is particularly important for primary health care services where big gains could be made in improving health, keeping people out of hospital and preventing premature deaths. Funding for Aboriginal Community Controlled Health Services, which deliver accessible, culturally safe, comprehensive primary health care across Australia, is not keeping up with need.

Alongside the increased funding for Aboriginal Community Controlled Health Service there is an urgent need for government to address the environmental health, housing and other social determinants of health inequality.

NACCHO, its Affiliates and members will continue to work with the AMA to urge the adoption of the Report Card’s recommendations by Australian governments.

Part 3 Busting the myth that Indigenous-led organisations ‘don’t deliver’

From NITV

Adrian Carson, CEO of the Urban Institute of Indigenous Health, said while national outcomes lagged behind, he had seen “significant” health improvements at a local level in south-east Queensland.

He urged governments to place more trust in Indigenous-led organisations to deliver services.

“This country’s still got a crisis in terms of its relationship with the First People,” Mr Carson told NITV News.

“The narrative’s a negative one, it’s always deficit-based, but we turn around and look at what parts of our sector are doing… we’re actually coming up with improved health outcomes within our community – they’re actually solutions that could benefit the whole country.

So this whole idea that somehow our communities can’t be trusted, or that we don’t have the capacity to deliver, is a myth.”

Mr Carson said while he welcomed the AMA’s report, it was important to take a proactive approach rather than dwelling on negative statistics.

“It doesn’t mean that things aren’t improving, because health outcomes for our people are improving,” he said.

“The challenge is that we’re trying to actually improve the pace of that improvement faster than some of the healthiest people in the world, which is what Australians enjoy – one of the healthiest countries on the globe.

“So you’re trying to actually close the gap between some of the sickest people in the world to some of the healthiest people in the world – it was always an ambitious target.”

Part 4 The Guardian Interview

The Australian Medical Association says the Closing the Gap strategy has “all but unravelled” and insists that the policy needs to be rebuilt from the ground up, starting with boosting health expenditure on Indigenous Australians and putting Aboriginal healthcare in Aboriginal hands.

A refresh of the program is expected to be considered at the December meeting of the Council of Australian Governments, but the AMA president, Tony Bartone, says Closing the Gap needs root-and-branch reform, not changes “without adequate funding and commitment from all governments to a national approach”.

Read in full 

 

 

NACCHO Aboriginal Health NEWS ALERT : @AMAPresident speech to Indigenous Doctors @AIDAAustralia #AIDAConf2018 – Making Indigenous health an election issue -Together we can indeed turn vision into action.

 

” The latest data indicate that only three of the seven Closing the Gap targets are on track to be met.

This is a potent political message to get the attention of the major parties and the broader Australian community – the voters.

And we now have a significant opportunity to advocate strongly for Government action to do better – a Federal Election is drawing closer.

The coming months are the perfect time to campaign and advocate to improve the health of Aboriginal and Torres Strait Islander people and communities.”

Everybody knows that health policy changes votes.

There will be more significant funding announcements across the health portfolio in the next six to nine months.

We must ensure that Indigenous health gets its fair share.”

Tony Bartone AMA President AIDA Conference 28 September

Picture above : Dr Bartona congratulating Dr Kris Rallah-Baker new AIDA president and looking forward to welcoming him at AMA Federal Council. 

Picture below Dr Bartone meeting with the Minister and NACCHO Executive team

Read over 30 NACCHO Aboriginal Health posts from the AMA

I acknowledge the Wadjuk Noongar people – thetraditional 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.

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.

There are many groups and organisations dedicated fulltime to changing things – AIDA, NACCHO, Lowitja, Aurora, the Medical Colleges, the universities, AMSA (our medical students), the nurses and midwives, and other foundations and agencies. Too many to mention.

And there are many individuals who campaign long and loud and hard – people like our MC today, Dr Jeff McMullen.

The AMA places improving Indigenous Health always as a major priority in our advocacy.

I see our role more as a catalyst for political action.

We have significant influence within Federal politics in Canberra across the whole spectrum of health.

We have policy, much of it contained in our annual Report Cards.

And we respond to policy or funding announcements – or lack of them – at Budget time.

Tragically, we have seen more cuts than top-ups. Funding is going backwards.

The core of AMA policy is the same as everybody at this Conference – proper funding for proven targeted programs and services that are delivered in a community-controlled way.

The AMA will work closely with all stakeholders to ensure all our policies get the attention and responses they deserve.

But, as we all know, the battle to gain meaningful and lasting improvements has been long and hard, and it continues.

The statistics speak for themselves:

  • A life expectancy gap of around ten years remains between Aboriginal and Torres Strait Islander people and other Australians.
  • The death rate for Aboriginal and Torres Strait Islander children is still more than double the rate for non-Indigenous children.
  • Preventable admissions and deaths are three times higher in ATSI people.
  • Medicare expenditure is about half the needs-based requirements, and PBS expenditure is about one third the needs-based requirements.

On top of this, we have the Closing the Gap targets to map progress – or measure failure.

The latest data indicate that only three of the seven Closing the Gap targets are on track to be met.

The target to halve the gap in child mortality by 2018 is on track.

The target to have 95 per cent of all Indigenous four-year-olds enrolled in early childhood education by 2025is on track.

The target to close the gap in school attendance by 2018is not on track.

The target to halve the gap in reading and numeracy by 2018 is not on track.

The target to halve the gap in Year 12 attainment by 2020 is on track.

The target to halve the gap in employment by 2018 is not on track.

The target to close the gap in life expectancy by 2031 is not on track.

Three out of seven is not good.

This is a potent political message to get the attention of the major parties and the broader Australian community – the voters.

And we now have a significant opportunity to advocate strongly for Government action to do better – a Federal Election is drawing closer.

The coming months are the perfect time to campaign and advocate to improve the health of Aboriginal and Torres Strait Islander people and communities.

Everybody knows that health policy changes votes.

The Coalition almost lost Government in 2016 because of health policy.

It is not surprising that we are currently seeing a much higher profile for health issues.

We currently have a focus on aged care. The Government has announced a Royal Commission.

This week the Government announced more funding for meningococcal vaccine.

There is an ongoing review of the Medicare Benefits Schedule.

The Health Minister relishes making regular ‘good news’ announcements of new drugs and treatments under the Pharmaceutical Benefits Scheme – the PBS.

Changes to private health insurance will be announced soon.

And there will be a bidding war on public hospital funding, just like we saw this week on MRI machines.

All these things cost money – lots of money.

There will be more significant funding announcements across the health portfolio in the next six to nine months.

We must ensure that Indigenous health gets its fair share.

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 all governments and all political parties to improve health and life outcomes for Aboriginal and Torres Strait Islander people.

More importantly, we will work tirelessly with you to achieve our shared goals.

Together we can indeed turn vision into action.

NACCHO Aboriginal Health Workforce and Training News : Our peak bodies @KenWyattMP and @CPMC_Aust Building the Aboriginal and Torres Strait Islander health workforce and strengthening alliances to address the health priorities of Indigenous Australians.

 

” NACCHO stresses the importance of continuing to grow the depth and number of Indigenous people in the health sector.

Improving the health of our people can only occur through partnership, and integrating health care providers with community controlled services is the key.

Ms Patricia Turner, CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO)

 “Background :  On 31 May 2017 the Australian Government joined with the Council of Presidents of Medical Colleges, the Australian Indigenous Doctor’s Association and the National Aboriginal Community Controlled Health Organisation as partners to improve the good health and wellbeing for Aboriginal and Torres Strait Islander peoples.

Focussing on Tier Three of the National Aboriginal and Torres Strait Islander Health Plan, partners are working in collaboration to improve system performance by focussing on two key comprehensive areas for collective strategic action: increase the health workforce and embed cultural safety and competency in the system

Download a full copy of the signed agreement 

Signed Agreement

Australia’s peak bodies for Indigenous health and specialist medicine have reaffirmed their commitment to working with the Australian Government as partners in reducing the current gap in health outcomes and life expectancy between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians under the Closing the Gap strategy.

Introducing the forum held on Wednesday 12th September at Parliament House, Minister Ken Wyatt AM, welcomed the opportunity to continue discussions under the National Partnership, highlighting the Australian Government’s commitment to Closing the Gap as the platform for improving the health and wellbeing for Aboriginal and Torres Strait Islander peoples.

The decision by Australian Health Ministers through the Council of Australian Governments Health Council to develop a National Aboriginal and Torres Strait Islander Health Workforce Plan by 2019 was welcomed by the collaborative partners.

Discussing the key areas of the partnership, cultural safety and access to services remain top priorities.

The Chair of the Council of Presidents of Medical Colleges (CPMC) Dr Philip Truskett AM reported that the key focus area of increasing the Indigenous specialist medical workforce by focussing on support, mentoring, role modelling was core business for Australia’s specialist Medical Colleges.

Indigenous Health Minister Ken Wyatt AM said the collaborative group was ideally placed to play an essential role in the COAG Health Council resolution to develop a National Aboriginal and Torres Strait Islander Health and Medical Workforce Plan – to ensure more Aboriginal doctors, nurses and health workers on country and in our towns and cities, local warriors for health among our families and communities.

Dr Kali Hayward, President Australian Indigenous Doctor’s Association (AIDA) reflected on building culturally appropriate health workforce and the need to discover champions in the system to support training.

Ms Janine Mohammed, CEO Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) highlighted the merit in greater coordination of services to deliver improvements in health outcomes.

Mr Karl Briscoe, CEO, National Aboriginal and Torres Strait Islander Health Workers Association (NATSIHWA) highlighted the importance of building the Aboriginal and Torres Strait Islander health workforce and strengthening alliances to address the health priorities of Indigenous Australians.

All partners acknowledged a National Aboriginal and Torres Strait Islander Health Workforce Plan will form the framework for furthering collective action to increase the Indigenous health workforce and embed a cultural safety capability in Australia’s health system.

 

NACCHO Aboriginal Health joins other health peak bodies @AMAPresident @RACGP @RuralDoctorsAus @NRHAlliance welcoming the reappointment of the health ministry team but #ruralhealth no longer a distinct portfolio

 ” The Chairperson of the National Aboriginal Community Controlled Health Organisation (NACCHO) John Singer today joined other peak health bodies welcoming the election of Scott Morrison MP as the 30th Prime Minister of Australia and reappointments of Greg Hunt MP as the Federal Minister for Health, Ken Wyatt AM MP as the Federal Minister for Indigenous Health, and Senator Bridget McKenzie as the Federal Minister for Regional Services. “

See Part 1 NACCHO Media 

“With an election due in the first half of 2019, new Prime Minister Scott Morrison has made the right call in leaving Health in the safe hands of Greg Hunt.

A fourth Health Minister in five years would have undermined the priority that Australians place on good health policy,”

AMA President, Dr Tony Bartone see in full part 2 Below

‘Health is an integral part of any Governments agenda and I look forward to working with Minister Hunt on the future direction of healthcare in Australia,’ 

Minister Hunt has worked closely with the RACGP over the past two years, achieving positive results, including investment into general practice research, the removal of the Medicare freeze and the return of general practice training to the RACGP.’

Dr Nespolon told newsGP see in full Part 3 Below

It was only on Friday last week that rural health sector stakeholders met in Canberra, for a meeting convened by the (former) Minister for Rural Health, to discuss the issues and solutions for achieving better health outcomes for rural Australia’, 

The key message of the Roundtable meeting was very clear. The health and wellbeing issues faced by rural and remote Australia cannot be addressed using market-driven solutions that work in the cities.’

We need a genuine, high level commitment from the Commonwealth, State and Territory Governments to deliver a new National Rural Health Strategy that will address the unacceptable gap in health outcomes for rural Australians. This is not the time to be relegating Rural Health to the back burner’.

National Rural Health Alliance Chair, Tanya Lehmann see in full Part 4 below

With Minister McKenzie receiving an expanded set of other portfolio responsibilities, we are worried that the significant level of focus she has given to Rural Health to-date will, due to her increased workload in other

There has never been a more important time for Rural Health to retain a distinct portfolio.

As a sector, Rural Health continues to face significant challenges, but also significant opportunities.

Rural Australians continue to have poorer health outcomes than their city counterparts, and poorer access to healthcare services.

There continues to be an urgent need to deliver more doctors, nurses and allied health professionals to rural and remote communities, with the advanced training required to meet the healthcare needs of those communities.”

Rural Doctors President, Dr Adam Coltzau see Part 5 below in full 

Part 1 NACCHO

I was very pleased to hear Mr Morrison’s at his first media conference after winning the leadership say that chronic disease was one of his top three priorities as he  ” was distressed by the challenge of chronic illness in this country, and those who suffer from it ” Mr Singer said from Hobart where he was hosting Ochre Day a National Aboriginal Men’s Health Conference opened by the Minister Ken Wyatt

“ Chronic disease is responsible for a major part of the life expectancy gap and  accounts for some two thirds of the premature deaths among our Aboriginal and Torres Strait Islander community.

A large part of the burden of disease is due to chronic diseases such as cardiovascular disease, diabetes, cancer, chronic respiratory disease and chronic kidney disease. With the Prime Ministers increased support our 302 ACCHO clinics can be reduce by earlier identification, and management of risk factors and the disease itself.

Recently I attended the Council of Australian Governments Health Council meeting in Alice Springs, when it made two critical decisions to advance First Nations health. Firstly, it has made Aboriginal and Torres Strait Islander health a national priority, including by inviting the Indigenous Health Minister to all future meetings.

The Council also resolved to create a national Indigenous Health and Medical Workforce Plan, to focus on significantly increasing the number of First Nations doctors, nurses and health professionals.

However, NACCHO would also share our disappointment with Rural Doctors Association of Australia (RDAA) that Rural Health, while still being an area of responsibility for Minister McKenzie, will no longer have its own distinct portfolio under the revamped Coalition Government . ”

Minister Ken Wyatt Statement

I am honoured to be appointed as the Minister for Senior Australians and Aged Care and Minister for Indigenous Health in the Morrison Government. My focus will be building on the strong foundations we have in place through the 2018–19 Budget to deliver better outcomes for senior Australians and Aboriginal and Torres Strait Islander Australians.

We are investing an additional $5 billion in aged care over the next five years — a record amount — and our investments in the health of First Australians will be more targeted and based on what we know works. Our senior Australians are among our country’s greatest treasures.

They have earned the right to be cared for with dignity through our aged care system and this is something the Morrison Government is absolutely committed to delivering.

The aged care reform agenda we are implementing has already delivered senior Australians greater choice in the care they receive, and greater scrutiny of the sector — something that will be reinforced by the new independent Aged Care Quality and Safety Commission that will open its doors on 1 January 2019.

My administrative responsibilities will not change in the Morrison Government. However, the change to the Minister for Senior Australians and Aged Care reflects my focus on taking a broader, whole-of-government approach to advancing the interests of senior Australians.

Part 2 AMA 

AMA President, Dr Tony Bartone, said today that the AMA is pleased that Greg Hunt has been re-appointed Minister for Health.

Dr Bartone said that the health portfolio is broad and complex, and it takes time for Ministers to get fully across all the issues and get acquainted with all the stakeholders.

“Greg Hunt has been a very consultative Minister who has displayed great knowledge and understanding of health policy and the core elements of the health system,” Dr Bartone said.

“In his time as Minister, he has presided over the gradual lifting of the Medicare freeze and the major reviews of the Medicare Benefits Schedule (MBS) and the private health insurance (PHI).

“And he has acknowledged that major reform and investment is needed in general practice.

“These are all complex matters that would have been challenging for a new Minister.

“It takes months for new Ministers to gain command of the depth and breadth of the Health portfolio.

“With an election due in the first half of 2019, new Prime Minister Scott Morrison has made the right call in leaving Health in the safe hands of Greg Hunt.

“A fourth Health Minister in five years would have undermined the priority that Australians place on good health policy,” Dr Bartone said.

Dr Bartone said that the AMA looked forward to continuing its strong working relationship with the Minister for Senior Australians and Aged Care, Ken Wyatt, who is also Minister for Indigenous Health.

The AMA has been advised that Senator Bridget McKenzie will retain Rural Health as part of her Regional Services, Sport, Local Government, and Decentralisation portfolio.

Part 3 RACGP 

Dr Nespolon believes Minster Hunt understands the fundamental role primary care plays in the wellbeing of all Australians and will continue to make general practice a focal point of Government health policies.

‘Health is an integral part of any Governments agenda and I look forward to working with Minister Hunt on the future direction of healthcare in Australia,’ Dr Nespolon told newsGP.

‘Minister Hunt has worked closely with the RACGP over the past two years, achieving positive results, including investment into general practice research, the removal of the Medicare freeze and the return of general practice training to the RACGP.’

Dr Nespolon said he is particularly keen to discuss matters that lie at the heart of general practice.

‘The RACGP will continue to work with Minister Hunt on our core patient priority areas, including preventive health and chronic disease management,’ Dr Nespolon said.

Minister Hunt was re-appointed to his position on the frontbench following a cabinet reshuffle that took place in the wake of last week’s Liberal Party leadership challenge. Ken Wyatt was also re-appointed as the Federal Minister for Indigenous Health and for Aged Care.

Part 3 National Rural Health Alliance 

The Ministerial line-up announced by Prime Minister Scott Morrison has a glaring omission.

At a time when great swathes of rural and remote Australia are experiencing the impact of devastating drought conditions, including significant impacts on the health and wellbeing of our communities, the key portfolio of Rural Health is nowhere in sight.

The new Morrison Ministry does not include a Minister for Rural Health. That key responsibility was on Friday held by the Deputy Leader of the Nationals, Senator Bridget McKenzie. By Sunday it was gone.

‘It was only on Friday last week that rural health sector stakeholders met in Canberra, for a meeting convened by the (former) Minister for Rural Health, to discuss the issues and solutions for achieving better health outcomes for rural Australia’, National Rural Health Alliance Chair, Tanya Lehmann said.

‘The key message of the Roundtable meeting was very clear. The health and wellbeing issues faced by rural and remote Australia cannot be addressed using market-driven solutions that work in the cities.’

‘We need a genuine, high level commitment from the Commonwealth, State and Territory Governments to deliver a new National Rural Health Strategy that will address the unacceptable gap in health outcomes for rural Australians. This is not the time to be relegating Rural Health to the back burner’.

‘We call upon the Morrison Government to demonstrate it is fair dinkum about improving the health and wellbeing of rural Australians by reinstating Rural Health as a Ministerial portfolio and committing to the development of a National Rural Health Strategy’, Ms Lehmann said.

The Alliance welcomes the re-appointment of the Hon Greg Hunt MP, Federal Minister for Health and the Hon Ken Wyatt AM MP, Minister for Aged Care and Minister for Indigenous Health, and acknowledges their continuing contribution to addressing the health and aged care needs of all Australians. We also welcome Senator the Hon Bridget McKenzie’s contribution to regional services, sport, Local Government and decentralisation, however we remain concerned that rural health, as a separate Ministerial portfolio has been overlooked.

‘While we understand Minister McKenzie will continue to be responsible for Rural Health — and we very much look forward to continuing to work with her — we are concerned that this critical area will no longer have its own dedicated portfolio’, Ms Lehmann said.

Background:

The National Rural Health Alliance is the peak body for rural, regional and remote health. The Alliance has 35-member organisations representing the peak health professional disciplines (eg doctors, nurses and midwives, allied health professionals, dentists, pharmacists, optometrists, paramedics, health students, chiropractors and health service managers), Aboriginal and Torres Strait Islander health peak organisations, hospital sector peak organisations, national rurally focused health service providers, consumers and carers.

Some of the worst health outcomes are experienced by those living in very remote areas. Those people are:

  • 1.4 times more likely to die than those in major cities
  • More likely to be a daily smoker, obese and drink at risky levels
  • Up to four times as likely to be hospitalised

Part 5 Rural Doctors Association of Australia (RDAA) 

Ministerial reappointments welcomed, loss of Rural Health portfolio not

The Rural Doctors Association of Australia (RDAA) has welcomed the reappointment of Greg Hunt MP as the Federal Minister for Health, Ken Wyatt AM MP as the Federal Minister for Indigenous Health, and Senator Bridget McKenzie as the Federal Minister for Regional Services.

However, the Association is disappointed that Rural Health, while still being an area of responsibility for Minister McKenzie, will no longer have its own distinct portfolio under the revamped Coalition Government.

“We strongly welcome the continuation of the federal health leadership team under the new Prime Minister, Scott Morrison” RDAA President, Dr Adam Coltzau, said.

“The Coalition has been making significant progress on important health policy issues, and looking forward there remain big reform agendas to be delivered in the health policy space, so it makes sense to have continued stable leadership here

“While we understand Minister McKenzie will continue to be responsible for Rural Health — and we very much look forward to continuing to work with her — we are concerned that this critical area will no longer have its own dedicated portfolio.

“With Minister McKenzie receiving an expanded set of other portfolio responsibilities, we are worried that the significant level of focus she has given to Rural Health to-date will, due to her increased workload in other

“There has never been a more important time for Rural Health to retain a distinct portfolio.

“As a sector, Rural Health continues to face significant challenges, but also significant opportunities.

“Rural Australians continue to have poorer health outcomes than their city counterparts, and poorer access to healthcare services.

“There continues to be an urgent need to deliver more doctors, nurses and allied health professionals to rural and remote communities, with the advanced training required to meet the healthcare needs of those communities.

“Retaining Rural Health as a distinct portfolio would assist in progressing solutions in this area.

“For example, the development of a National Rural Generalist Pathway — to deliver more of the next generation of doctors to the bush with the advanced skills needed in rural settings — would benefit greatly from continuing to receive the strong political focus of a dedicated Rural Health portfolio.

“There also continues to be an urgent need to make the most of new technologies like telehealth, to broaden access to healthcare for rural and remote Australians, in particular with their own GP.

“We strongly urge Prime Minister Morrison to consider retaining Rural Health as a dedicated portfolio under Minister McKenzie’s stewardship, to ensure the focus can remain firmly on delivering the best healthcare outcomes for rural and remote Australians.

NACCHO Aboriginal Health celebrates #AMAFDW18 AMA Family Doctor Week : @amapresident Speech to @PressClubAust #NPC Includes support #ulurustatement #prevention investment #obesity #Chronic Disease funding #MentalHealth

 

” I am very pleased that one of my first announcements as AMA President was the AMA endorsement of the Uluru Statement from the Heart.

The Uluru Statement expresses the aspirations of Aboriginal and Torres Strait Islander people with regard to self-determination and status in their own country.

The AMA has for many years supported Indigenous recognition in the Australian Constitution.

The Uluru Statement is another significant step in making that recognition a reality.

The AMA is committed to improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

It is simply unacceptable that Australia, one of the wealthiest nations in the world, cannot solve a health crisis affecting fewer than three per cent of its citizens.”

AMA President Dr Tony Bartone speaking at the National Press Club 25 July 2018

 ” This week just happens to be AMA Family Doctor Week – a tribute to hardworking GPs.

GPs of Australia, I salute you. We all salute you.

Your hard work and dedication is highly valued. The AMA will always support you and promote you.

Your GP – your family doctor – will ensure that your health needs are met throughout all stages of your life.

Be it immunisation, preventative health care, age specific medical checks, chronic disease management, or aged care, the life long relationship with your GP underpins continuous and appropriate care.

This is especially the case for patients who are from culturally or linguistically diverse backgrounds. For them, GPs truly are their trusted health advocates.”

 ” The burden of chronic disease in Australia is significant.

Chronic disease is responsible for around 83 per cent of premature deaths and 66 per cent of the burden of disease.

Chronic disease has a significant impact on the health system, but the reality is that most of these conditions can be prevented.

It simply makes enormous sense to invest in prevention.

Taxes collected from tobacco and alcohol excise generate around $16 billion each year for the Government.

In return, total Government spending on prevention is around $2 billion a year, which equates to about $89 per person.

If we are to reduce the impact of chronic disease in Australia, all our governments must invest more in prevention.

Tackling obesity is a priority.

Doctors are well placed to identify and support patients who are overweight or obese. Two thirds of adults are either overweight or obese. ”

Full Speech : Health reform: Improving the patient journey

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

It is a humbling experience to be elected President of such a proud and respected organisation as the AMA.

It is an equally humbling experience to speak here at the National Press Club in Canberra. I thank the Press Club for this opportunity.

I am a GP, and I have been in practice in the northern suburbs of Melbourne for more than 30 years.

Some of you may know that I was inspired to become a GP by watching my own family doctor, who cared for my ill father when I was growing up.

Even now, my mother reflects on the care and dedication my family GP displayed in caring for her family. It’s no surprise that he became an early mentor in my professional life.

I have seen it all as I have looked after the health of my community and my patients, including generations of the same families.

I like to think that my experience has given me some credibility in knowing what works and what doesn’t work in the health system, especially in primary care.

My overarching concern has always been the patient journey – ensuring that people get the right care at the right time in the right place by the right practitioner.

The priorities for me are always universal access to care, and affordability.

Today, I will share my views on what can be done to make our great health system even better – how to improve the patient journey.

I will also introduce you to some of my patients, and reflect on the barriers in their access to timely care, to further illustrate our concerns.

General practice and primary care reform

On the day I was elected, I made it very clear that one of the hallmarks of my Presidency would be stridently advocating for significant investment in general practice.

This week just happens to be AMA Family Doctor Week – a tribute to hardworking GPs.

see intro for text

However, there is something really crook about how GPs have been treated by successive Governments.

They have paid lip service to the critical role GPs play in our health system, often borne out of ignorance and often in a misguided attempt to control costs.

General practice has been the target of continual funding cuts over many years. These cuts have systematically eaten away at the capacity of general practice to deliver the highest quality care for our patients.

They threaten the viability of many practices.

I talk to my GP members regularly, both metropolitan and rural.

The message is simple – some are at a tipping point and have a very bleak view of the future.

They see general practice becoming increasingly corporatised, burdened with more red tape, and GPs are less able to spend the necessary time with patients.

This is not the future that GPs want to see.

This is not the future that our patients want to see.

We can and must avoid these bleak predictions, but it requires significant real and immediate investment from the Government with a clear pathway to long-term reform.

Let me be very clear about this: we must put general practice front and centre in future health policy development.

We have seen too many mistakes. Too many poor policy decisions.

Despite the Government’s best intentions – and lots of goodwill within the profession – the Health Care Homes trial and implementation failed to win the support of GPs or patients.

Instead of real investment, the Trial largely shifted existing buckets of money around.

It has fallen well short of its practice enrolment targets, and it looks like only a small fraction of the targeted 65,000 patients will sign up.

There is no doubt that the challenge of transforming general practice was severely underestimated by policy makers. At least with this model.

But general practice still needs transformation and rejuvenation to meet growing patient demand and to keep GPs working in general practice.

The AMA has a plan for reform of general practice and primary care.

It is patient-centred and focuses on better access to long-term continuous quality care and managing patients more effectively in the community.

It takes the best elements of the ‘medical home’ concept and adapts them to the Australian context.

It is a plan that will require upfront and meaningful new investment, in anticipation of long-term savings in downstream health costs.

In the short term, the AMA plan for general practice will involve:

  • significant changes to Chronic Disease funding, including a process that strengthens the relationship between a patient and their usual GP, and encourages continuity of care;
  • cutting the bureaucracy that makes it difficult for GPs to refer patients to allied health services;
  • formal recognition in GP funding arrangements of the significant non-face-to-face workload involved in caring for patients with complex and chronic disease;
  • additional funding to support enhanced care coordination for those patients with chronic disease who are at risk of unplanned hospital admission – a similar model to the Coordinated Veterans Care Program funded by the Department of Veterans Affairs;
  • a properly funded Quality Improvement Incentive under the Practice Incentive Program – the PIP;
  • changes to Medicare that improve access to after-hours GP care through a patient’s usual general practice;
  • support for patients with chronic wounds to access best practice wound care through their general practice;
  • better access to GP care for patients in residential aged care; and
  • annual indexation of current block funding streams that have not changed for many years … including those that provide funding to support the employment of nursing and allied health professionals in general practice.

In the longer term, we need to look at moving to a more blended model of funding for general practice.

While retaining our proven fee-for-service model at its core, the new funding model must have an increased emphasis on other funding streams, which are designed to support a high performing primary care system.

This will allow for increasing the capability and improving the infrastructure supporting general practice to allow it to become the real engine room of our health system.

It is about scaling up our GP-led patient-centred multidisciplinary practice teams to better provide the envelope of health care around the patient in their journey through the health system.

A good example is the Blacktown Hospital Diabetes Outpatient Clinic in New South Wales.

This Clinic has a waiting time of less than a week because the service is distributed to its catchment GPs with the appropriate funding and support for both personnel and infrastructure.

This is a small example, but a significant one when you consider the scale and prevalence of diabetes across Australia, let alone the western suburbs of Sydney, and the average access times for outpatient hospital clinics.

We cannot continue to do things the way we always have.

The bulk-billing rate should not be the metric by which we judge the performance of general practice.

Chronic conditions have become more prevalent in Australia. The ones causing most concern are:

  • arthritis;
  • asthma;
  • back pain and problems;
  • cancer;
  • cardiovascular disease;
  • chronic obstructive pulmonary disease;
  • diabetes; and
  • mental health conditions.

One in two people now report having at least one of these eight common chronic conditions.

These conditions account for around 60 per cent of the total disease burden, and they contribute to nearly 90 per cent of deaths in Australia.

We must reshape our primary care system to meet these challenges.

We must put in place the funding support that general practice needs to better manage patients in the community – and keep people out of hospital.

Our plan is a smarter and more sustainable blueprint … a better plan for general practice. A better plan for Australians.

Public hospitals

We also need a better plan for public hospitals.

In an election year, voters tend to focus very closely on public hospitals when they are comparing health policies.

Public hospitals are a critical part of our health system. They are highly visible. They are greatly loved institutions in the community. They are vote changers.

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

In 2016-17, public hospitals provided more than six and a half million episodes of admitted patient care. They managed 92 per cent of emergency admissions.

If the state of general practice is crook, then our public hospitals are on permanent code yellow.

Despite their importance, and despite our reliance on our hospitals to save lives and improve quality of life, they have been chronically underfunded for too long.

Between 2010-11 and 2015-16, average annual real growth in Federal Government recurrent funding for public hospitals has been virtually stagnant – a mere 2.8 per cent.

The AMA welcomes that, between 2014-15 and 2015-16, the Federal Government boosted its recurrent public hospital expenditure by 8.4 per cent.

But a one-off modest boost from a very low base is not enough.

I deal with the results of stressed public hospitals every day and manage the impact it has on my patients.

Ollie is a patient with well-controlled Parkinson’s disease. He now also has a recently diagnosed lung cancer, which has been caught early, resected, and appropriately managed.

But he has been denied care for his resulting poor control of his Parkinson’s disease in the same hospital’s neurology outpatient department and referred back to me.

I have been advised that I must source an alternative option for his neurological care.

Another of my patients, Carlo, is a victim of the never ending Federal-State buck passing when it comes to health.

Having developed poorly controlled reflux and having been referred to the local hospital outpatient department for a gastro consult, Carlo was referred back to me.

I was advised that I had to arrange a referral at the same hospital’s diagnostic imaging service for a possible coordination and swallowing problem, which ultimately proved correct.

He was then referred back to the gastroenterology department to manage his newly diagnosed oesophageal condition.

Barbara is another very common example of the funding chaos.

She is a very active 68-year-old lady who was troubled by severe osteoarthritis of the knee for many years. She was placed on a waiting list for surgery two years ago.

She has had to attend our practice regularly for pain management and supportive referrals for physiotherapy, while I continued to manage the consequences of her inability to lose weight due to her exercise restrictions and worsening diabetes and blood pressure profile.

She has just finally had her knee joint replaced.

These are the experiences of everyday patients.

They underpin the troubling headlines that came from the AMA’s 2018 Public Hospital Report Card. Our hospitals are stretched to the limit.

Likewise, the AMA’s Safe Hours Audit is a window into the lived experience of dedicated doctors, struggling to deliver quality care in over-crowded, under-funded hospitals.

But instead of helping the hospitals improve safety and quality, governments decided to financially punish hospitals for poor safety events.

There is no evidence to show that financial penalties work.

Health care is complex. Not all patient complications can be avoided.

The 2020-25 hospital funding agreement does little to improve the situation.

Funding levels stay the same, but public hospitals will have to do more with it to help coordinate patient care post-discharge.

The AMA supports better discharge planning and integrated care, especially for patients with complex and chronic disease.

But this will cost money – and public hospitals need extra funding.

The AMA calls on the major parties to boost funding for public hospitals beyond that outlined in the next agreement.

There must be a plan to lift public hospitals out of their current funding crisis, which is putting doctors and patients at risk.

Governments must stop penalising hospitals for adverse patient safety events.

We need policies to fully fund hospitals. We must help them improve patient safety and build their internal capacity to deliver high value care in the medium to long term.

They must link up and work with primary care to deliver better coordinated care.

I note that Labor has pledged an extra $2.8 billion for public hospitals.

I expect that the Coalition will match that as the election draws nearer.

They do not want another Medi-scare style campaign.

Medical care for older Australians

Older Australians are voters, too.

Aged care was, until very recently, one of the highest profile segments of the health system – but for all the wrong reasons.

It is now emerging as an area in need of significant reform as the population ages and lives longer.

Older Australians all too frequently do not have the same access to medical care as other age groups – a longstanding result of inadequate funding in the aged care system.

This inequity will likely only grow as the Australian population ages with more complex, chronic medical conditions requiring more medical attention than ever before.

We have witnessed numerous consultations and reviews.

Enough! Now is the time for action.

There is already sufficient information to underpin the final recommendations. It is simply unfair and unjust to delay this any further.

An increase in funding for GP visits to aged care facilities would result in many savings, including from reduced ambulance transfers to hospital emergency departments.

Changes to after-hours care remuneration must consider services that are currently provided under ‘urgent’ item numbers to patients in aged care facilities.

We also need to ensure that the critical role that nurses play in caring for older Australians is recognised in those facilities.

The AMA wants to see Medicare rebates that adequately cover the time that doctors spend with the patient assessing and diagnosing their condition and providing medical care.

We want new telehealth Medicare items that compensate GPs, and other medical specialists, for the time spent organising and coordinating services for the patient.

This includes the time that they spend with the patient’s family and carers to plan and manage the patient’s care and treatment.

There must be funding for the recruitment and retention of quality, appropriately trained aged care staff.

And we must reverse the decline in the proportion of Registered Nurses in aged care.

The AMA Aged Care Survey, released today, shows that AMA members who work in aged care have identified the shortage of Registered Nurses – who should be available 24 hours a day – as the biggest priority for aged care reform.

The survey also shows that one in three doctors are planning to cut back on, or completely end, their visits to patients in aged care facilities over the next two years.

This is largely because the Medicare rebates are inadequate for the amount of time and work involved.

The AMA will ensure that aged care gets the attention and profile it deserves in the election campaign.

Private health insurance:

Private health insurance has been in the headlines for much of the past year – again, for all the wrong reasons.

The AMA has always called for a simpler and fairer private health insurance system.

Without the private system, the public system would likely collapse.

But we cannot expect the private system to thrive – or even survive – if there is not value in insurance policies.

Patients are smart – they know there is no point outlaying thousands of dollars every year if the coverage isn’t there.

Affordability means very little without value.

We are clearly at a crisis point in private health insurance. And the Government knows it.

Hence the latest Review, and the recent announcement by the Minister of new categories of policies … and greater transparency.

We support the concept of developing Gold, Silver, and Bronze insurance categories.

We can’t expect consumers to understand the many different definitions, the carve outs, and exclusions of some 70,000 policy variations.

Australians want reasonable and simple things from their insurance.

They want coverage.

They want a choice of the practitioner, and a choice of the hospital.

They want treatment when they need it.

We can’t have patients finding out they aren’t covered after the event, or when they require treatment and it’s all too late.

To that end, we have been very clear – we don’t support the use of restrictions in Gold, Silver, and Bronze.

Restrictions lead people to believe they are covered, when in reality they are exposed to additional costs.

We don’t support junk policies. If a Basic policy category doesn’t provide much coverage, that should be made crystal clear.

We don’t support dismantling community rating. This must be protected to maintain equity of access to private health treatment.

When the objective is to support a strong private health sector to take pressure off the public sector, it makes no sense to financially discourage the patients who are most likely to need access to private health.

We support standard clinical definitions. Whatever is involved for coverage for heart conditions should not vary between insurers and policies.

I urge the Government to continue to work with the Colleges to ensure that these definitions are robust.

There is increasing corporatisation of private health and the market power is shifting in favour of private health insurers.

Insurers, whether private or via Medicare, cannot determine the provision of treatment in Australia.

They cannot and must not interfere with the clinical judgement of medical practitioners.

Australians do not support a US-style managed care health system. Neither does the AMA.

One area we are disappointed with in the recent announcements is pregnancy cover.

It does not make sense to us, as clinicians, to have pregnancy cover in a higher level of insurance only.

Many pregnancies are unplanned – meaning people are caught out underinsured when pregnancy is restricted to high-end policies.

Pregnancy is a major reason that the younger population considers taking up private health insurance.

They are less likely to be able to afford the higher-level policies. We need to make sure it is within reach.

I having female reproductive services at a different level to pregnancy coverage is, to us, problematic, and will leave a lot of people caught out.

There will be much more to talk about as the private health reforms are finalised and bedded down.

Mental Health

As a suburban GP who sees the whole range of health ailments and conditions, an area of special interest to me is mental health.

I do not think the unique role and special skills of GPs are used enough at the front line of mental health care.

The AMA earlier this year called for a national, overarching mental health “architecture”, and proper investment in both prevention and treatment of mental illnesses.

Almost one in two Australian adults – that is more than seven million people – will experience a mental health condition in their lifetime.

Almost every Australian will experience the effects of mental illness in a family member, friend, or work colleague.

The statistics are startling. For example:

  • More than half a million children and adolescents, aged four to 17, experienced mental health disorders in 2012-13.
  • Australians living with schizophrenia die 25 years earlier than the general population, mainly due to poor heart health.

And yet mental health and psychiatric care are grossly underfunded.

Strategic leadership is needed to integrate all components of mental health prevention and care.

For mental health consumers and their families, navigating the system and finding the right care at the right time can be difficult and frustrating.

There is no vision of what the mental health system will look like in the future.

Poor access to acute beds for major illness leads to extended delays in emergency departments.

Poor access to community care leads to delayed or failed discharges from hospitals.

And poor funding of community services makes it harder to access and coordinate prevention, support services, and early intervention.

Significant investment is urgently needed to reduce the deficits in care, fragmentation, poor coordination, and access to effective care.

We have repeatedly called for support for carers of people with mental illness, which is often the result of necessity, not choice.

Access to respite care is vital for many people with mental illness and their families, who are the ones who bear the largest burden of care.

Indigenous health

I am very pleased that one of my first announcements as AMA President was the AMA endorsement of the Uluru Statement from the Heart.

The Uluru Statement expresses the aspirations of Aboriginal and Torres Strait Islander people with regard to self-determination and status in their own country.

The AMA has for many years supported Indigenous recognition in the Australian Constitution.

The Uluru Statement is another significant step in making that recognition a reality.

The AMA is committed to improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

It is simply unacceptable that Australia, one of the wealthiest nations in the world, cannot solve a health crisis affecting fewer than three per cent of its citizens.

Prevention

There is not enough time today to cover all the issues I would like to cover in one speech.

I could deliver a whole speech on each of the following topics – medical workforce, rural health, medical research, genetic testing, e-cigarettes and vaping, opioids, medicinal cannabis, scope of practice, asylum seeker health, the NDIS, or palliative care, to name just a few.

I could probably manage a few words about the My Health Record, too. No doubt there will be questions about that.

But I have to talk to you about prevention, if only briefly.

The burden of chronic disease in Australia is significant.

Chronic disease is responsible for around 83 per cent of premature deaths and 66 per cent of the burden of disease.

Chronic disease has a significant impact on the health system, but the reality is that most of these conditions can be prevented.

It simply makes enormous sense to invest in prevention.

Taxes collected from tobacco and alcohol excise generate around $16 billion each year for the Government.

In return, total Government spending on prevention is around $2 billion a year, which equates to about $89 per person.

This amounts to a measly 1.34 per cent of all health spending. This is considerably less than comparable countries such as Canada, the United Kingdom, and New Zealand.

If we are to reduce the impact of chronic disease in Australia, all our governments must invest more in prevention.

Tackling obesity is a priority.

Doctors are well placed to identify and support patients who are overweight or obese. Two thirds of adults are either overweight or obese.

The evidence shows that advice to lose weight given by a doctor increases the motivation to lose weight. It also increases engagement in weight loss behaviours.

But the support and advice from doctors can only achieve so much.

Population level measures are needed. We need to see action on a sugar tax, banning junk food advertising to kids, and improving urban planning to help get people moving and active.

Governments have the tools to implement these measures. A sugar tax would be a good start.

In closing, I know the challenges ahead for the health system.

I will dedicate my Presidency to improving health policy so that we have a system that delivers the best possible care to our patients.

The AMA will be a very strong and loud advocate.

There is nothing like a Federal election to help our political leaders share the public’s interest in good health policy.

The election will happen within twelve months, possibly this year.

Along with the members of the National Press Club, the AMA will be watching the political events of this weekend and the coming months with very close interest.

NACCHO Aboriginal Health and the #UluruStatement promoted during #NRW18 and @TheLongWalkOz Thanks to @AMAPresident @EssendonFC @VAHS1972 @quitvic @DeadlyChoices

” What you (Victorian Premier Daniel Andrews ) said about Aboriginal and Torres Strait Islander advancement being led by Aboriginal and Torres Strait Islander people is absolutely right,

The great Australian Chris Sarra said very wisely … governments have got to stop doing things to Aboriginal people and start doing things with them and that is my commitment.”

Prime Minister Malcolm Turnbull has told a Reconciliation event The Long Walk he is committed to following the lead of Indigenous people, less than a year after rejecting their call for an enshrined voice in parliament.

After Premier Daniel Andrews spoke of his government’s efforts to create a state Treaty at the Long Walk event at Melbourne’s Federation Square, Mr Turnbull said the two leaders were “starting to agree on more things all the time”.

During a summit at Uluru in May 2017, Indigenous leaders rejected symbolic constitutional recognition in favour of an elected parliamentary advisory body and a treaty.

But in October, Mr Turnbull said a new representative body was not desirable or capable of winning acceptance at a referendum

NACCHO Aboriginal Health #treaty : #Uluru Summit calls for the establishment of a First Nations Voice enshrined in the Constitution

Australian Medical Association has thrown its support behind last year’s Uluru Statement from the Heart: It was a fairly clear-cut decision for us to make.

We recognise the issue regarding the will to want to have the right to self-determination. We recognise the health inequities, the social justice inequities, the wellness inequities that confront our Indigenous population.

And this Statement is just another way of trying to ensure that we can continue to work and get all governments, both State, Federal, and Territory, to work towards closing the gap, improving the social determinants of health, and recognising the need and the required improvements that are necessary to address the gap that currently exists.

The ACCHOs, or Aboriginal Community Controlled Health Organisations, are a very important part of the health delivery process. It recognises that the usual relationships, when it comes to health facilities in a different way, it’s a different connectivity. “

The recently elected Australian Medical Association’s President, Tony Bartone, who participated in the Long Walk spoke with ABC Radio reporter, Dan Conifer . See full interview and AMA press release Part 1 and 2 below

 

 ” Politicians, footballers and campaigners have joined thousands of Australians in the Long Walk event to support moves to improve Indigenous health and celebrate Aboriginal and Torres Strait Islander culture.

It has been 14 years since AFL champion Michael Long’s momentous journey from his home in Melbourne to the Prime Minister to get the lives of Aboriginal and Torres Strait Islander people back on the national agenda.

Indigenous health is focal point of this year’s walk, with the Victorian Aboriginal Health Service Australian Medical Association (AMA) and Quit Victoria both throwing their support behind the event.

Ill health forced Essendon great Michael Long to miss this year’s Long Walk.

Part 1 : Australian Medical Association has thrown its support behind last year’s Uluru Statement from the Heart

The AMA Federal Council has endorsed the Uluru Statement from the Heart, which calls for a First Nations’ voice in the Australian Constitution.

AMA President, Dr Tony Bartone, said today that the AMA has for many years supported Indigenous recognition in the Australian Constitution, and that the Uluru Statement is another significant step in making that recognition a reality.

“The Uluru Statement expresses the aspirations of Aboriginal and Torres Strait Islander people in regard to self-determination and status in their own country,” Dr Bartone said.

“The AMA is committed to improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

“Closing the gap in health services and outcomes requires a multi-faceted approach.

“Cooperation and unity of purpose from all Australian governments is needed if we are to achieve meaningful and lasting improvements.

“This will involve addressing the social determinants of health – the conditions in which people are born, grow, live, work, and age.

“Constitutional recognition can underpin all these endeavours, as we work to improve the physical and mental health of Indigenous Australians.”

Dr Bartone said the AMA was proud to announce its endorsement of the Uluru Statement during National Reconciliation Week.

Part 2 :The recently elected Australian Medical Association’s President, Tony Bartone, who participated in the Long Walk spoke with ABC Radio reporter, Dan Conifer

ELIZABETH JACKSON: Within the next couple of years, your local doctor’s surgery could be adorned with posters supporting Indigenous Constitutional change. The highly influential

Australian Medical Association has thrown its support behind last year’s Uluru Statement from the Heart. The peak body says including Aboriginal and Torres Strait Islander people in the nation’s founding document could help make Indigenous patients healthier. The AMA’s President Tony Bartone has told our political reporter Dan Conifer the organisation is unequivocal in its support.

TONY BARTONE: It was a fairly clear-cut decision for us to make. We recognise the issue regarding the will to want to have the right to self-determination. We recognise the health inequities, the social justice inequities, the wellness inequities that confront our Indigenous population. And this Statement is just another way of trying to ensure that we can continue to work and get all governments, both State, Federal, and Territory, to work towards closing the gap, improving the social determinants of health, and recognising the need and the required improvements that are necessary to address the gap that currently exists.

DAN CONIFER: Can you just explain for us how something like the Uluru Statement from the Heart, and the changes that it calls for, would support health outcomes, would improve life expectancy and so on?

TONY BARTONE: They’re fairly fundamental aspirations that are part of the Uluru Statement, and those aspirations and recognitions really speak to a number of emotional, physical, and broader social, environmental issues that really will address, as we say, the social determinants of health. We can’t really seek to close the gap when it comes to health outcomes until we address the fundamental building blocks.

DAN CONIFER: Now, one of the key elements of the Uluru Statement is about involving Aboriginal and Torres Strait Islander Australians in decision-making processes. In the medical profession, how has involving Indigenous Australians driven improvements?

TONY BARTONE: The ACCHOs, or Aboriginal Community Controlled Health Organisations, are a very important part of the health delivery process. It recognises that the usual relationships, when it comes to health facilities in a different way, it’s a different connectivity. Put another way, it recognises the inherent qualities and behavioural patterns of our Indigenous population, and that is different from a traditional Western-type setting which we’ve become experienced with.

DAN CONIFER: And if a referendum were to be held on any of the elements of the Uluru Statement, how would the AMA, individual doctors and specialists around the country, take part or be involved in that campaign?

TONY BARTONE: We would use all avenues open to us, both in terms of our advocacy and communication with our members, to ensure that the information and the sharing of that information, in terms of the wider community, patients who come to our surgery, the access points that we do have, are used to the fullest in terms of ensuring a proper address of the Statement’s initiatives.

DAN CONIFER: So we could see Vote Yes posters or pamphlets or badges in GP surgeries when this, or if this comes to a vote?

TONY BARTONE: What we’d see is the Association taking a front foot in our communication and advocacy on behalf of members. Of course, each individual member is free and would be wanting to participate to perhaps even a fuller extent, which would lead to putting up of posters and sharing that material in a surgery environment. But we would take a front foot more at an Association level to ensure that we communicate with our stakeholders, with our leaders in Parliament, and with the community in general through our media connectivity to communicate that wish and desire.

Part 3 The Long Walk ,VAHS and Quit Victoria promotes Indigenous health

Smoking rates among Aboriginal and Torres Strait Islander people are almost three times the national average of non-Indigenous people, although the prevalence in Indigenous communities is falling steadily.

In Victoria, 41 per cent of the Aboriginal and Torres Strait Islander population are smokers.

Quit Victoria’s Aboriginal Tobacco Control Program Coordinator Jethro Pumirri Calma-Holt told SBS News the health of Indigenous Australians should be kept at the top of the agenda.

“Indigenous health is something that needs to be invested in by everyone and that’s part of national reconciliation week.”

“What Michael Long did all those years ago has created a really big legacy for everyone to follow in his footsteps,” he said

Check it out the legend himself Anthony McDonald-Tipungwuti wearing the VAHS Deadly Choices Shirt out during the warm up for Dream Time at the G. The other players also wore the shirts as well… What a moment !

If you want your very own VAHS Deadly Choices Shirt just like Tippa the only way you can get one is to complete a health check at VAHS. So call us and book your health check on 03 9419 3000

 

 

 

NACCHO Guide to Aboriginal Health and the #Budget2018NACCHO : What @NACCHOAustralia @AMAPresident @RACP @CroakeyNews and 21 peak health groups would like to see in tonight’s #Healthbudget18 ?

 

We need political will to #CloseTheGap. There are volumes of research, strategies and action plans sitting with governments – but they are not being properly resourced and funded. Make it right in tonight’s Budget “

AMA President, Dr Michael Gannon, said that the culmination of key reviews, under the guidance of Health Minister Greg Hunt, provides the Government with a rare opportunity to embark on a new era of ‘big picture’ health reform – but it will need significant long-term investment.

Also read NACCHO Aboriginal Health @AMAPresident Download AMA Pre-Budget Submission 2018-19 #Indigenous health reform – needs significant long-term investment

 ” The Federal Government must provide long-term funding certainty for the Medical Outreach Indigenous Chronic Disease Program, which is focused on preventing, detecting and managing chronic disease for Aboriginal and Torres Strait Islander people.”

RACP President Dr Catherine Yelland

Download the full submission here or read Aboriginal health extracts below

racp-2018-19-pre-budget-submission

Historical background RACP Associate Professor Noel Hayman

 “I’ve been working in the field of Indigenous health for 20 years now. The major changes, trends that I’ve seen over the years, has been improvements in infant mortality. But the one that contrasts that is the worsening mortality in middle age—we see high rates of mortality in Aboriginal people in their 40s and 50s. And this is due to chronic disease, particularly diabetes, ischaemic heart disease and chronic kidney disease.

Associate Professor Noel Hayman, Clinical Director of the Inala Indigenous Health Service in Brisbane.

He was the first Aboriginal GP in Queensland, and the first Aboriginal and Torres Strait Islander person to become a Fellow of the Australasian Faculty of Public Health Medicine at the RACP.

From Interview June 2016 Listen HERE

RACP Press Release

Doctors are calling for the Federal Government to provide long-term funding to programs that prevent, detect and manage chronic disease for Aboriginal and Torres Strait Islander people.
As detailed in the Royal Australasian College of Physicians’ pre-budget submission, these programs could help ensure better health outcomes and close the gap between Aboriginal and Torres Strait Islander health outcomes and those of the non-Indigenous community.

The RACP recommends that the Australian government :

Aboriginal and Torres Strait Islander Health

• Allocate secure long-term funding to progress the strategies and actions identified in the National Aboriginal and Torres Strait Islander Health Plan (NATSIHP) Implementation Plan.

• Provide secure, long-term funding for the Rural Health Outreach Fund (RHOF) and Medical Outreach Indigenous Chronic Disease Program (MOICDP).

• Build and support the capacity of Aboriginal and Torres Strait Islander health leaders by committing secure long-term funding to the Indigenous National Health Leadership Forum.

• Reinstate funding for a clearinghouse modelled on the previous Closing the Gap clearinghouse, in line with the recommendations of the Fifth National Mental Health and Suicide Prevention Plan. Allocate sufficient funding for the implementation of the Fifth National Aboriginal and Torres Strait Islander Blood-Borne Viruses (BBV) and Sexually Transmissible Infections (STI) Strategy.

• Fund the syphilis outbreak short-term action plan and coordinate this response with long term strategies.

• Allocate long-term funding for primary health care and community- led sexual health programs to embed STI/BBV services as core primary health care (PHC) activity, and to ensure timely and culturally supported access to specialist care when needed, to achieve low rates of STIs and good sexual health care for all Australians.

• Invest in and support a long-term multi-disciplinary sexual health workforce and integrate with PHC to build longstanding trust with communities.

• Allocate funding for STI and HIV point of care testing (POCT) devices, the development of guidelines for POCT devices and Medicare funding for the use of POCT devices.

Extract from Pre budget submission

Aboriginal and Torres Strait Islander Health

Aboriginal and Torres Strait Islander people continue to experience poorer health outcomes than non-Indigenous Australians.

The latest ‘Closing the Gap’ report found that Australia is not on track to close the life expectancy gap by 2031 – with the gap remaining close to ten years for both men and women.

The gap for deaths from cancer between Aboriginal and Torres Strait Islander and non-Indigenous Australians has in fact widened in recent years, with Aboriginal and Torres Strait Islander cancer death rates increasing by 21 percent between 1998 and 2015, while there was a 13 per cent decline for non-Indigenous Australians in the same period8.

To address these inequities and improve access to care, continuing and strengthened focus and appropriate long-term funding is required. It is imperative that there is secure funding for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 (NATSIHP) Implementation Plan.

Funding uncertainty and frequent changes create significant issues that impact the continuity of services to patients and organisations in their ability to retain and build their capacity.

Read in full NACCHO Aboriginal Health and #Sexual Health @TheRACP 2018-19 Pre-#budget submission : Long-term funding needed to improve #Indigenous health

 

”  A December 2017 report from the Australian Institute of Health and Welfare (AIHW) shows that the mortality gaps between Indigenous and non-Indigenous Australians are widening, not narrowing.

Urgent action is needed to reverse these trends to have any prospect of meeting the Council of Australian Governments’ goal to Close the Gap in life expectancy within a generation (by 2031).

The following submission by the National Aboriginal Community Controlled Health Organisation (NACCHO) in relation to the Commonwealth Budget 2018 aims to reverse the widening mortality gaps.

The following policy proposals are divided into four areas below and summarised in the following table:

  1. Proposals that strengthen and expand ACCHOs’ capacity and reach to deliver health services for Indigenous people
  2. Proposals that improve responsiveness of mainstream health services for Indigenous people
  3. Proposals that address specific preventable diseases
  4. Proposals that build in an Indigenous position into policy considerations that impact on health.

NACCHO is committed to working with the Australian Government to further develop the proposals, including associated costings and implementation plans and identifying where current expenditure could be more appropriately targeted ”

Download the full NACCHO submission HERE or part 3 below

NACCHO-Pre-budget-submisson-2018

Connect tonight with NACCHO #Budget2018NACCHO

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Besides our NACCHO live and recorded interviews

What will the 2018 Federal Budget mean for the health sector and consumers?

Consumers Health Forum of Australia Policy Team will be holding a free public webinar next Wednesday 16 May, 12:30pm AEST, to discuss the key health measures in the budget from a consumer perspective.

They will share our position on them, and take participants’ feedback and questions.

To join , register herehttps://chf.org.au/events/budget-2018-consumer-perspective

Part 2 Federal Budget 2018/19 – Preview and review of 21 health sector submissions

What is the number one health issue that the Government should address in tonight’s  Federal Budget?  Jennifer Doggett from Croakey analyses the pre-Budget Submissions from 21 health groups and finds surprising agreement among them on the urgent need for action in one key area.

Read on to find out what this issue is and the six key measures the Government should announce on Tuesday night if it wants to keep the health sector onside.  Check back on Wednesday to see how closely the Federal Government has followed the proposals from health and medical groups in this (possibly) pre-election Budget.

Bookmark this link for our coverage of the Federal Budget, and please use the hashtag #HealthBudget18 to share health-related budget news.

Read and subscribe here

Read full article here

2018/19 Federal Budget priorities

So what do this year’s crop of Pre-Budget submissions tell us about the current priorities of the health sector? After reviewing a slew of health-related pre-Budget submissions it is clear that there is one stand-out issue that has the overwhelming support of the health sector, with virtually every submission supporting action on this issue in some form or other.

That issue is prevention.  The clear message emerging from the submissions was that preventive health is the glaring gap in health policies at the federal level and the most pressing issue that needs to be addressed to improve the health of our community.

Almost every health-related pre-Budget submission included a strong focus on prevention, in particular those from the Public Health Association of Australia (PHAA), the Consumers Health Forum (CHF), the Australian Healthcare and Hospitals Association (AHHA), the Australian Medical Association (AMA), the Complementary Medicines Association (CMA), the Victorian Healthcare Association (VHA) and the Royal Australian College of Physicians (RACP).

The most strongly supported proposal overall was for the establishment of a national preventive health body to oversee and coordinate preventive health policies across all sectors and level of government.

The AMA’s submission reflected the reasons expressed in many submissions for such a national body: Obesity, nutrition, alcohol, tobacco and physical activity are health policy areas desperately in need of funded national strategies and measurable targets. These are best delivered through an independent, dedicated organisation.

Obesity was the most commonly mentioned health issue with a number of groups supporting a sugar tax, junk food advertising restrictions and physical activity programs.

Indigenous health

There was broad agreement across the submissions that we need to do more to close the health and life expectancy gap between Indigenous and non-Indigenous Australians and that supporting Indigenous community-controlled initiatives and services are the best way to achieve this.

Supporting and growing the Indigenous health workforce was a key feature of NACHHO’s submission, along with establishing an Aboriginal and Torres Strait Islander Commonwealth Advisory Group to support consideration, implementation and monitoring of an Indigenous position in efforts to Close the Gap and on jurisdictional agreements that have high impact on Indigenous peoples.

The AHHA and the AMA called for funding to implement the National Aboriginal and Torres Strait Islander Health Plan and the AMA also called for the Government to support the Redfern Statement.

Six key actions

After reviewing these submissions, the message is clear.  If the Government wants to win over the health sector on Tuesday night it needs to do the following:

  1. Establish a National Preventive Health Body (although this could be slightly awkward for the Government, given it abolished a similar body, the Australian National Preventive Health Agency in 2014)
  2. Announce a national obesity strategy
  3. Set up a Productivity Commission review of private health insurance
  4. Increase funding for the community-controlled Indigenous health sector
  5. Increase funding for public dental services
  6. Take action on mental health

Part 3

Widening mortality gaps require urgent action

The life expectancy gap means that Indigenous Australians are not only dying younger than non-Indigenous Australians but also carry a higher burden of disease across their life span, impacting on education and employment opportunities as well as their social and emotional wellbeing.

Preventable admissions and deaths are three times as high in Indigenous people yet use of the main Commonwealth schemes, Medicare Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS) are at best half the needs based requirements.

It is simply impossible to close the mortality gaps under these conditions. No government can have a goal to close life expectancy and child mortality gaps and yet concurrently preside over widening mortality gaps.

Going forward, a radical departure is needed from a business as usual approach.

Funding considerations, fiscal imbalance and underuse of MBS/PBS

The recent Productivity Commission Report found that per capita government spending on Indigenous services was twice as high as for the rest of the population.

The view that enormous amounts of money have been spent on Indigenous Affairs has led many to conclude a different focus is required and that money is not the answer.

Yet, the key question in understanding the relativities of expenditure on Indigenous is equity of total expenditure, both public and private and in relation to need.

In terms of health expenditure, the Commonwealth spends $1.4 for every $1 spent on the rest of the population, notwithstanding that, on the most conservative assumptions, Indigenous people have at least twice the per capita need of the rest of the population because of much higher levels of illness and burden of disease.

This represents a significant market failure. The health system serves the needs of the bulk of the population very well but the health system has failed to meet the needs of the Indigenous population.

A pressing need is to address the shortfall in spending for out of hospital services, for which the Commonwealth is mainly responsible, and which is directly and indirectly responsible for excessive preventable admissions funded by the jurisdictions – and avoidable deaths.

The fiscal imbalance whereby underspending by the Commonwealth leads to large increases in preventable admissions (and deaths) borne by the jurisdictions needs to be rectified.

Ultimately, NACCHO seeks an evidenced based, incremental plan to address gaps, and increased resources and effort to address the Indigenous burden of disease and life expectancy.

The following list of budget proposals reflect the burden of disease, the underfunding throughout the system and the comprehensive effort needed to close the gap and ideally would be considered as a total package.

NACCHO recommends initiatives that impact on the greatest number of Indigenous people and burden of preventable disease and support the sustainability of the Aboriginal Community Controlled Health Organisation (ACCHO) sector – see proposals 1. a) to e) and 3. a) and b) as a priority.

NACCHO is committed to working with the Australian Government on the below proposals and other collaborative initiatives that will help Close the Gap.

National Aboriginal Community Controlled Health Organisation

NACCHO is the national peak body representing 144 ACCHOs across the country on Aboriginal health and wellbeing issues

In 1997, the Federal Government funded NACCHO to establish a Secretariat in Canberra, greatly increasing the capacity of Aboriginal peoples involved in ACCHOs to participate in national health policy development.

Our members provide about three million episodes of care per year for about 350,000 people. In very remote areas, our services provided about one million episodes of care in a twelve-month period.

Collectively, we employ about 6,000 staff (most of whom are Indigenous), which makes us the single largest employer of Indigenous people in the country.

The following proposals are informed by NACCHO’s work with Aboriginal health services, its members, the views of Indigenous leaders expressed through the Redfern Statement and the Close the Gap campaign and its engagement and relationship with other peak health organisations, like the Australian Medical Association (AMA).

Guiding principles

Specialised health services for Indigenous people are essential to closing the gap as it is impossible to apply the same approach that is used in health services for non-Indigenous patients.

Many Indigenous people are uncomfortable seeking medical help at hospitals or general practices and therefore are reluctant to obtain essential care. Access to healthcare is often extremely difficult due to either geographical isolation or lack of transportation.

Many Indigenous people live below the poverty line so that services provided by practices that do not bulk bill are unattainable. Mainstream services struggle to provide appropriate healthcare to Indigenous patients due to significant cultural, geographical and language disparities: ACCHOs attempt to overcome such challenges.

An ACCHO is a primary health care service initiated and operated by the local Aboriginal community to deliver holistic, comprehensive, and culturally appropriate health care to the community which controls it, through a locally elected Board of Management.

They form a critical part of the Indigenous health infrastructure, providing culturally safe care with an emphasis on the importance of a family, community, culture and long-term relationships.

Studies have shown that ACCHOs are 23% better at attracting and retaining Indigenous clients than mainstream providers and at identifying and managing risk of chronic disease.

Indigenous people are more likely to access care if it is through an ACCHO and patients are more likely to follow chronic disease plans, return for follow up appointments and share information about their health and the health of their family.

ACCHOs provide care in context, understanding the environment in which many Indigenous people live and offering true primary health care. More people are also using ACCHOs.

In the 24 months to June 2015, our services increased their primary health care services, with the total number of clients rising by 8%. ACCHOs are also more cost-effective providing greater health benefits per dollar spent; measured at a value of $1.19:$1.

The lifetime health impact of interventions delivered our services is 50% greater than if these same interventions were delivered by mainstream health services, primarily due to improved Indigenous access.

If the gap is to close, the growth and development of ACCHOs across Australia is critical and should be a central component to policy considerations.

Mainstream health services also have a significant role in closing the gap in Indigenous health, providing tertiary care, specialist services and primary care where ACCHOs do not exist.

The Indigenous Australians’ Health Programme accounts for about 13% of government expenditure on Indigenous health.

Given that other programs are responsible for 87% of expenditure on Indigenous health, it reasonable to expect that mainstream services should be held more accountable in closing the gap than they currently are.

Greater effort is required by the mainstream health sector to improve its accessibility and responsiveness to Indigenous people and their health needs, reduce the burden of disease and to better support ACCHOs with medical and technical expertise.

The health system’s response to closing the gap in life expectancy involves a combination of mainstream and Indigenous-specific primary care providers (delivered primarily through ACCHOs) and where both are operating at the highest level to optimise their engagement and involvement with Indigenous people to improve health outcomes.

ACCHO’s provide a benchmark for Indigenous health care practice to the mainstream services, and through NACCHO can provide valuable good practice learnings to drive improved practices.

NACCHO also acknowledges the social determinants of health, including housing, family support, community safety, access to good nutrition, and the key role they play in influencing the life and health outcomes of Indigenous Australians.

Elsewhere NACCHO has and will continue to call on the Australian and state and territory governments to do more in these areas as they are foundational to closing the gap in life expectancy.

Addressing the social determinants of health is also critical to reducing the number of Indigenous incarceration. Comprehensively responding to the Royal Commission into the Protection and Detention of Children in the Northern Territory must be a non-negotiable priority.

Proposals

The following policy proposals are divided into four areas below and summarised in the following table:

  1. Proposals that strengthen and expand ACCHOs’ capacity and reach to deliver health services for Indigenous people
  2. Proposals that improve responsiveness of mainstream health services for Indigenous people
  3. Proposals that address specific preventable diseases
  4. Proposals that build in an Indigenous position into policy considerations that impact on health.

NACCHO is committed to working with the Australian Government to further develop the proposals, including associated costings and implementation plans and identifying where current expenditure could be more appropriately targeted

Continued HERE NACCHO-Pre-budget-submisison-2018