NACCHO Coverage #Budget2018 No 5/5 : Senator Nigel Scullion’s #Indigenous #budget2018 under fire from opposition forces for not #ClosingTheGap

 ” Malcolm Turnbull is more interested in giving a $80-billion-dollar tax cut to big business than he is to improving the lives of First Nations People.

This budget is an indictment on the Turnbull Government that pretends it wants to do things with First Nations peoples.

The Turnbull Government has shown no vision, no plan, no insight and no desire to close the gap and provide a pathway out of poverty for First Nations people.

The 2018 Budget contains a litany of decisions which demonstrate neglect of First Nations people, including housing , The Closing the Gap Strategy , Community Development Program and over-incarceration of First Nations Peoples

Leader of the Opposition, Bill Shorten, Shadow Assistant Minister for Indigenous Affairs, Patrick Dodson, and Shadow Assistant Minister for Indigenous Health, Warren Snowdon

See Attached Press Release or Read Part 1 Below

Labor Response Indigenous Budget 2018

 ” There is very little money going into the Closing the Gap service areas, in fact there is no new money that has been allocated there.

So, the priorities for Closing the Gap which are linked to the reduction in housing funding is a serious worry for many of our people.

And not just Indigenous Peoples, but service providers and public sector health providers.

The whole approach of this Government is neglectful of First Nations People in the remote areas.

ABC Interview with Senator Patrick Dodson SUBJECTS: Budget, Remote Housing, CDP, Closing the Gap, Captain Cook monuments

See Attached Press Release or Read Part 2 Below

ABC interview

“We are pleased that there will be subsidies for 6000 jobs and an improved assessment process to ensure vulnerable people are not forced to participate beyond their capabilities.

However, the Government has engaged in a cherry-picking exercise rather than wholeheartedly adopting the positive Aboriginal community-driven model developed by APO NT, which will limit the benefits possible on the ground,”

John Paterson, spokesperson for APO NT, said that for three years Aboriginal and Torres Strait Islander organisations have been dealing with the devastation wrought by the Government’s program

See Attached Press Release or Read Part 3 Below

APONT_HRLC

 ” Yet again, our people have been let down with this year’s Federal Budget. The investment in our communities is more eroded, our quality of life more diminished, our voices and needs more blatantly ignored.

While the Budget seeks to commemorate colonisation, it fails to address its ongoing consequences and the oppression that our people continue to experience. The most alarming aspects of the Budget further stack the system against our people and punish people living in poverty.

As a co-chair of NATSILS, I have been actively involved in trying to engage with governments to provide insight and solutions into justice and social issues we face, and the need for greater  investment. It is disheartening that they are not listening, and actively doing damage to our communities.

Closing the Gap is not mentioned, despite a year-long refresh agenda. There is some welcome investment in Indigenous health organisations and aged care for Aboriginal and Torres Strait Islander people.

On the other hand, the Budget is strangely silent on justice, family violence, Closing the Gap and child protection. All of these areas have been identified as ‘a national crisis’ and are all interlinked.”

Cheryl Axleby co-chair of NATSILS writing for IndigenousX Budget ignores solutions and damages our communities see part 4

Post 1 of our NACCHO Posts on #Budget2018 NACCHO

Post 2 will be the NACCHO Chair Press Release

Post 3 will be Health Peak bodies Press Release summary

Post 4 will be Government Press Releases

Post 5 Opposition responses to Budget 2018 Here

ALL NACCHO BUDGET COVERAGE HERE

The Government has shown no respect, no vision, no plan, no insight and no desire to improve the lives of First Nations people.

This budget clearly demonstrates why First Nations people need a Voice to the Parliament.

Senator Malarndirri McCarthy – Northern Territory Linda Burney Warren Snowdon MP

View Interview with above Labor Team

Part 1 Press Release from Leader of the Opposition, Bill Shorten, Shadow Assistant Minister for Indigenous Affairs, Patrick Dodson, and Shadow Assistant Minister for Indigenous Health, Warren Snowdon

HOUSING

  •  Slashing 1.5 billion dollars to remote housing over the next four years.
  •  Western Australia, South Australia and Queensland will no longer receive any funding for remote housing. These savage cuts to housing will have a devastating effect in remote communities, where overcrowding and homelessness are rife.
  •  Housing is key determinant to close the gap and underpins the health and well-being of First Nations Peoples. Without safe and secure housing, the gap will never be closed.

Read Housing article Here

CLOSING THE GAP STRATEGY

  •  No new funding has been allocated to the Closing the Gap strategy, despite the Government announcing a 10 year refresh process in February this year.
  •  The fact that the Government has failed to allocate adequate funding to the Closing the Gap Refresh is insulting to First Nations peoples and their peak organisations who have been trying to cooperate with the Government on new Closing the Gap targets.
  •  The closing the gap strategy has been left to languish under this Government, while the gap widens.
  •  Further, the government has yet again failed to fund the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.

COMMUNITY DEVELOPMENT PROGRAM

  •  Failing to address the strategic, integrated and practical reform needed to the CDP program.
  •  The Minister for Indigenous Affairs Nigel Scullion announced 6,000 new wage-based subsides, but this leaves some 30,000 First Nations peoples subject to the current punitive, discriminatory CDP scheme, which is driving up poverty in remote areas.

INCARCERATION

  •  Failing to address the shameful over-incarceration of First Nations Peoples.
  •  The Government has not provided funding to implement the recommendations from the Northern Territory Royal Commission, or the Australian Law Reform Commissions ‘Pathways to Justice’ report.
  •  Both the Northern Territory Royal Commission and the ALRC Inquiry into the incarceration rates of Aboriginal and Torres Strait Islander People were called for by the Turnbull Government, to effectively wash their hands of its findings and provide no fiscal outlays for the recommendations exhibits a shameful lack of leadership.
  •  This is a human rights abrogation and shows a callous disregard for equal justice for First Nations people.
  •  Labor has long called for national justice targets, to reduce incarceration rates and improve community safety.

FIRST NATIONS CHILDREN

  •  First Nations children, our future Australians, are left behind in this budget.
  •  In 2017, more than 17,000 Aboriginal and Torres Strait Islander children were living in out-of-home care, compared with about 9,000 a decade ago.
  •  To respond to the shocking number of Aboriginal kids growing up away from country and culture, a Labor Government will convene a national summit on First Nations Children in our first 100 days.

This budget is an indictment on the Turnbull Government that pretends it wants to do things with First Nations peoples.

The Turnbull Government has shown no vision, no plan, no insight and no desire to close the gap and provide a pathway out of poverty for First Nations people.

Part 2 ABC Interview SUBJECTS: Budget, Remote Housing, CDP, Closing the Gap, Captain Cook monuments.

MOLLY HUNT: Senator, what’s your reaction to last night’s budget?

SENATOR DODSON: Well, from the First Nations perspective it’s pretty poor.

It’s unimaginative and disastrous. Remote housing to the State (of WA) is not being supported by the Federal Government’s budget which means over the next couple of years there will be at least 1.5 billion dollars slashed to remote housing.

The Western Australian portion of that is annually is around $100 million dollars. This means serious impacts for people in the regions in relation to housing.

We have no money allocated for roads in this budget. The Territory is getting an upgrade to the Buntine Highway; most of the roads money for WA is going into the metropolitan areas.

There is very little money going into the Closing the Gap service areas, in fact there is no new money that has been allocated there.

So, the priorities for Closing the Gap which are linked to the reduction in housing funding is a serious worry for many of our people.

And not just Indigenous Peoples, but service providers and public sector health providers.

The whole approach of this Government is neglectful of First Nations People in the remote areas.

There are some positives in the procurement area in other states but that doesn’t help in many of these places.

There’s some money allocated into Indigenous Protected Areas, $15 million dollars, but what take of that comes into the Kimberley is unclear at this point, but hopefully some of it comes there.

There is also some money in age care which we hope will help in some of those cases where carers have to look after their families at home.

Again the detail around that in relation to the Northern part of the State is not clear.

There’s a bit of a tantalising flirt with the CDP, with a promise of 6000 new wage type subsidies for a scheme that has absolutely failed First Nations peoples.

There are 30,000 current CDP participants and there is no clarity about what their destinies are going to be.

Overall, it’s a bit like being a kid who’s in a foster home watching all the other kids get a present off the Christmas tree and being left to pick up the glittering wrappers and hopefully play with the busted toys once they have been discarded.

So the budget is very disappointing. A very sad neglect of First Nations peoples and an indictment on the Turnbull Government that pretends it wants to do things with First Nations peoples.

And it’s a neglect of the bush as well. There is no clarity around the mobile black spot concerns that many of our people in remote areas have got or any improvement of communication systems to the remote areas.

The whole question of how that could assist families, pastoral properties and others – there is no clarity around that at all and that is a major concern.

We know there is some funding for the Cape Leveque Road which is a good thing, but that’s not out of this budget, that has come with the state’s contributions as well.

So overall, a very sad return for First Nations. It looks like the cuts to the IAS overall is going to mean a lot of hardship to service providers.

The clarity around that we are yet to distil but there will be cuts like there are to all departments, I think of about $32 million dollars to the IAS… but there is no reform, no insight and no real plan to move things to a better place for Indigenous peoples.

MOLLY HUNT: You’re with ABC Kimberley, I’m talking to WA Senator Patrick Dodson, my name is Molly Hunt. Senator, we have about three minutes until the seven o’clock news, I just want to know, is the Government making any substantiative changes to the ongoing trial of the cashless welfare card in this year’s extension?

SENATOR DODSON: The Government wants to roll it out in Kalgoorlie. Labor is obviously not happy about that. There is not sufficient evidence to say its working either in Kununurra or Ceduna.

The need for wrap around services obviously have to be improved. The Government wanted to introduce drug testing, we’ve opposed that, but it will more than likely come up in the Senate during these sittings with Kalgoorlie.

But it has no other mandate from the Parliament to go further than Kalgoorlie until there is some clear and unequivocal evidence that this particular draconian measure actually works.

MOLLY HUNT: And just lastly Senator, overall impression of last night’s budget?

SENATOR DODSON: Well as I said I’m like the kid at the Christmas tree watching all the other kids jumping with joy and celebrating and waiting for their wrappers to be dropped to the floor so we can pick them up.

MOLLY HUNT: Senator, do you support the money for the Captain Cook anniversary?

SENATOR DODSON: Well no, not really. I think we have got to find ways to deal with our history and we have heard from the Uluru Statement from the Heart for the need for a truth telling commission, for a Makarrata Commission, so we can come to a greater consensus around the settlement narrative, the occupation narrative and the so called discovery narrative of this nation.

I think we have to get beyond these colonial and draconian measures that keep continuing to divide us.

Part 3 The Aboriginal Peak Organisations NT (APO NT) and the Human Rights Law Centre Discriminatory remote work scheme improved but onerous work hours and harsh penalties will drive poverty

The need for fair pay for work in Aboriginal and Torres Strait Islander communities has finally been acknowledged by the Federal Government but Budget measures outlined for its remote work for the dole scheme fall well-short of realising this in practice.

The Aboriginal Peak Organisations NT (APO NT) and the Human Rights Law Centre cautiously welcomed some changes to the Community Development Program (CDP), but expressed deep concern about the Government’s piecemeal approach and its decision to continue with onerous obligations while introducing a harsher penalty system in remote communities.

John Paterson, spokesperson for APO NT, said that for three years Aboriginal and Torres Strait Islander organisations have been dealing with the devastation wrought by the Government’s program.

“The hard work of APO NT and other Aboriginal organisations and CDP providers has started to pay-off, with the Minister for Indigenous Affairs recognising that paid work with proper entitlements is the key to lifting families out of poverty, stimulating social enterprise and creating meaningful employment opportunities,” said Mr Paterson.

Mr Paterson welcomed the announcement of 6000 subsidised jobs with proper work entitlements and improvements to the way that people’s work capacity is assessed but said the Government should be adopting the Aboriginal-led model already developed by APO NT.

“We are pleased that there will be subsidies for 6000 jobs and an improved assessment process to ensure vulnerable people are not forced to participate beyond their capabilities.

However, the Government has engaged in a cherry-picking exercise rather than wholeheartedly adopting the positive Aboriginal community-driven model developed by APO NT, which will limit the benefits possible on the ground,” said Mr Paterson.

The Budget measures include a reduction in work requirements from 25 to 20 hours, but people in remote communities, 83 per cent of whom are Aboriginal and Torres Strait Islander, will still have to work around 270 hours more each year than people in urban areas.

Adrianne Walters, senior lawyer at the Human Rights Law Centre, said that it was mind-boggling that after three years, a racist and inflexible work hours requirement will continue to be imposed on remote communities, albeit in slightly modified form.

“Equal pay for equal work is a core tenet of Australian society. The Federal Government must eliminate the blatantly discriminatory requirement which sees people in remote Aboriginal and Torres Strait Islander communities forced to work more hours for the same basic Centrelink payment as people in cities,” said Ms Walters.

Both organisations have also warned that the new compliance measures announced in the Budget will undermine the potential for positive outcomes.

“The inclusion of more onerous compliance measures is likely to drive up poverty and disengagement.

The Government’s own data indicates that people subject to the remote CDP scheme are already at least 20 times more likely to be financially penalised,” said Mr Paterson.

“Unfair financial penalties have already seen parents struggling to put food on the table for their kids.

The Government appears satisfied to dump a new harsh one-size-fits-all penalty system on remote communities, but still discriminate against them in terms of work hours,” said Ms Walters.

Further information

The Aboriginal Peak Organisations NT has worked with other Aboriginal and Torres Strait Islander organisations to develop an alternative model for fair work and strong resilient communities. The model focuses on waged work, fair participation obligations, access to support services and

Aboriginal-led institutional arrangements.

Key aspects of the alternative model that are missing from Minister Scullion’s CDP reforms include:

  •  Flexibility and community governance structures so that jobs and community projects meet the needs of communities and remote employers.
  •  An approach to participation obligations that allows local organisations to tailor arrangements to their own communities, with a focus on support and incentives, rather than heavy-handed compliance and financial penalties.
  •  Work activity obligations that are no greater than those that apply to people in the urban Jobactive program.
  •  1500 paid jobs with training for people under 25, giving disengaged young people a reason to re-engage and a pathway to future employment.
  •  An Aboriginal and Torres Strait Islander led agency to manage the scheme instead of the current non-Indigenous led Canberra-based model.
  •  A reduction in pointless and excessive administration requirements, which is a hallmark of the current program and consumes valuable funding.

Part 4 Cheryl Axleby writing for IndigenousX Budget ignores solutions and damages our communities

Originally published on Indigenous X

Yet again, our people have been let down with this year’s Federal Budget. The investment in our communities is more eroded, our quality of life more diminished, our voices and needs more blatantly ignored.

While the Budget seeks to commemorate colonisation, it fails to address its ongoing consequences and the oppression that our people continue to experience. The most alarming aspects of the Budget further stack the system against our people and punish people living in poverty.

As a co-chair of NATSILS, I have been actively involved in trying to engage with governments to provide insight and solutions into justice and social issues we face, and the need for greater  investment. It is disheartening that they are not listening, and actively doing damage to our communities.

Housing

One role of the Government is to recognise that poverty, racial and structural disadvantage exists and to do something about it, including making the right investments to drive change.

More pressure has been placed on rural and remote communities to increase employment where there are no opportunities, and at the same time, the National Partnership agreements on remote housing for WA, Qld and SA have not been funded.

Yet we know that many people accessing Aboriginal and Torres Strait Islander Legal Services need help with housing and tenancy. These measures are set to create more legal need and greater barriers to accessing justice which directly impacts upon people’s physical, emotional and social wellbeing.

Welfare & CDP

Stringent measures deducting welfare payments from people with unpaid fines and outstanding warrants have been introduced. These measures come in the face of increasing rates of over-representation, and a demonstrated connection between poverty and imprisonment for Aboriginal and Torres Strait Islander people.

Across Australia, governments should be abolishing imprisonment for unpaid fines, not deducting welfare payments from people who are already oppressed by the system. This will likely have a huge impact on Aboriginal and Torres Strait Islander communities. We cannot afford to lose more lives to unpaid fines.

The concerning welfare measures include extending a punitive demerit point system to Community Development Program (CDP) participants. This cuts and suspends welfare payments for weeks at a time, risking further deep financial disadvantage for our most vulnerable people.

The over-penalising of CDP participants is causing high levels of financial hardship and shows that the program is deeply flawed. Since the introduction of the CDP, 300,000 financial penalties were applied, despite having only around 33,000 participants.

Despite the clear failures of the CDP, only minor improvements were introduced, including a new wage subsidy scheme and slight reduction in the hours participants need to work for their benefits. But for a wage subsidy scheme to have any impact, there must be jobs available in the first place. The loss of people’s income is causing deep distress and harming health. The CDEP programs previously supported within our communities, in my view, more adequately met the needs of our people and contributed to building community capacity.

Closing the Gap

Closing the Gap is not mentioned, despite a year-long refresh agenda. There is some welcome investment in Indigenous health organisations and aged care for Aboriginal and Torres Strait Islander people.

On the other hand, the Budget is strangely silent on justice, family violence, Closing the Gap and child protection. All of these areas have been identified as ‘a national crisis’ and are all interlinked.

Yet the Government has neglected the needs of our people who are victims and survivors of family violence. And while the NDIS is fully funded, there is no funding to ensure Aboriginal and Torres Strait Islander people with disability will have equal access to culturally-safe support services under the NDIS.

Justice

When it comes to justice, the Australian Government has ignored the findings from their own Law Reform Commission ‘Pathways to Justice’ and Northern Territory Royal Commission inquiries. The recommendations, including introducing national justice targets, support for justice reinvestment and Aboriginal and Torres Strait Islander Legal Services to deliver essential legal help, did not form part of the Budget. Instead, they have introduced oppressive, punitive measures which will disproportionately affect Aboriginal and Torres Strait Islander people’s quality of life.

We all know the statistics. Aboriginal and Torres Strait Islander people are 13 times more likely to be imprisoned than non-Indigenous people. This is worse, and increasing, for Aboriginal and Torres Strait Islander women, who are imprisoned at 21 times the rate of non-Indigenous women. Aboriginal and Torres Strait Islander children, who are 6% of the Australian youth population, make up 55% of children and young people in prison are 25 times more likely to be imprisoned.

How can it be, that these shameful statistics, continue to be ignored by our Commonwealth, state and territory governments.

The escalation of increasing rates of overrepresentation demonstrates current government policy and programs are not meeting the needs of our people. And we know that the Government could save $19 billion annually by 2040 if the gap between Indigenous and non-Indigenous rates of incarceration were closed.

The welcome investment in Indigenous health will not outweigh the government’s changes to housing and welfare, which will further entrench disadvantage. This will lead to more unmet legal need for Aboriginal and Torres Strait Islander Legal services, already at crisis level. This need must be comprehensively mapped to determine the gaps in providing essential legal help.

Part 5 Government’s Indigenous budget strategy blasted for failures and hundreds of millions to non-Indigenous organisations

 

NACCHO #HealthBudget18 Coverage 3/5 Read and Download the Top 10 Peak Health Organisation Press Release responses to #Budget2018NACCHO

1.NATSIHWA welcomes the 2018 budget announcements of additional funding to Aboriginal and Torres Strait Islander Peak Health Workforce Professional Bodies

2. IAHA : Allied health undervalued in 2018 Federal Budget

3.AIDA funded to continue our work in improving health outcomes for Indigenous Australians

4.1 AMA : SAFE AND STEADY HEALTH BUDGET, BUT BIGGER REFORMS ARE STILL TO COME

5.NRHA :RURAL HEALTH BUDGET $$ WELCOME – BUT NOT ENOUGH

6.AHHA : Health data boost right step on the road to reform

7. PHAA : Budget 2018 – prevention focus goes missing

8.RACGP : Signs Federal Government beginning to recognise vital role of specialist GPs in Australia’s healthcare system

9.CHF Health budget includes welcome consumer focus

10. Vision 2020 Australia welcomes the Australian Government’s investment to target major causes of vision loss in Aboriginal and Torres Strait Islander communities.

Post 1 of our NACCHO Posts on #Budget2018 NACCHO

Post 2 will be the NACCHO Chair Press Release

Post 3 will be Health Peak bodies Press Release summary

Post 4 will be Government Press Releases

Post 5 Opposition responses to Budget 2018 (Monday )

ALL NACCHO BUDGET COVERAGE HERE

1.NATSIHWA welcomes the 2018 budget announcements of additional funding to Aboriginal and Torres Strait Islander Peak Health Workforce Professional Bodies

“Today’s budget announcement presents an important opportunity for NATSIHWA. It will enable us to progress key strategic priorities, including the development of a National Mentor program to support Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners. This is a very exciting time for our members”

Mr Karl Briscoe, NATSIHWA CEO.

Download full Press Release

1.NATSIHWA BUDGET Media Release 2018

The National Aboriginal and Torres Strait Islander Health Workers Association (NATSIHWA) welcomes the 2018 Australian Government budget announcement that signal growth in funding for Aboriginal and Torres Strait Islander workforce organisations.

These organisations (NATSIHWA, CATSINaM, IAHA and AIDA) work togetherto support the Aboriginal and Torres Strait Islander health workforces and improve health outcomes for Aboriginal and Torres Strait Islander people.

“We thank the Australian government for the continued support of NATSIHWA. This funding will not only enhance the sustainability of our profession, but will also lead to opportunities that promote the recognition and professionalism of Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners” said Ms Josslyn Tully, NATSIHWA Chairperson.

In particular, the budget announcement support the progression of NATSIHWA’s strategic plan 2017-2020. Key strategic priorities for NATISHWA over the next 12 months, include the:

  • Development of a National Mentoring Program for Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners;
  • Implementation of the National Professional Development Symposium which will bring together over 100 Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners in Alice Springs in October 2018;
  • Continuation of Regional forums to support professional development and networking of Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners in regions across Australia;
  • Development of further educational resources to support individuals and services in defending Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners’ Scope of Practice; and,
  • Enhanced influence of national policy and program that improve Aboriginal and Torres Strait Islander health and health workforce outcomes that support a culturally safe work environment.

“NATSIHWA looks forward to progressing these initiatives with our membership, which includes over 750 full members who are qualified Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners across Australia”, said Ms Josslyn Tully

2. IAHA : Allied health undervalued in 2018 Federal Budget

Improving Aboriginal and Torres Strait Islander health and wellbeing must remain a national priority. Action is needed to improve outcomes for Aboriginal and Torres Strait Islander people.

Download full Press Release

2. Media-Release_allied-health-undervalued-in-2018-Federal-Budget

Those actions must involve: a coherent strategy to tackle the causes of disadvantage and enable our people to achieve their potential; governments showing the stamina to address issues that come from generations of trauma and disadvantage; and commitment to work with, hear and respect Aboriginal and Torres Strait Islander people and the knowledge they bring to issues that shape their lives.

IAHA now has a commitment of funding for a further four years. We also have a commitment of $1.55M per year in additional funding to share with our fellow Aboriginal and Torres Strait Islander health workforce peak organisations: AIDA, CATSINAM and NATSIHWA. We have proven our approaches deliver results and build the Aboriginal and Torres Strait Islander health workforce.

IAHA has a significant advocacy role and interest in several other initiatives announced in the 2018-19 Budget, including measures responding to urgent needs across Australian communities, including:

  • $105M over four years to improve access to aged care for Aboriginal and Torres Strait Islander people
  • $30M over four years for ear health assessment in pre-schools
  • $34.3M over four years for eye health and
  • Extra commitment to suicide prevention, additional mental health care.

IAHA CEO Donna Murray said “For initiatives to deliver for Aboriginal and Torres Strait Islander people, community must be involved in how those measures are developed and implemented. This applies to new measures and to addressing existing acute allied health shortages in health, disability, aged care and other social services.”

A culturally safe and responsive skilled workforce, is critical in working with Aboriginal and Torres Strait Islander people and communities. To ensure the workforce has the skills needed to deliver results, strategies and solutions need to be developed and delivered in partnership with IAHA, our members and communities.

“IAHAs success thus far in developing and implementing innovative allied health career pathway programs and supports, providing leadership opportunities and development, mentoring, in partnering and in promoting person-centred, multidisciplinary care needs to be leveraged further. We, therefore, welcome a stronger partnership with Government to enable this success to continue and grow”, said Ms Murray.

IAHA chairperson, Nicole Turner, commented “By leading and facilitating inter-professional approaches that fit with Aboriginal and Torres Strait Islander notions of health and wellbeing, we’ve supported and enabled rapid growth in the Aboriginal and Torres Strait Islander health workforce. But we still represent less than 1 percent of the allied health workforce. Our workforce must continue to grow. Continued funding for IAHA is a vital step in the right direction.”

IAHA welcomes the $550M allocated to the Stronger Rural Health Strategy and the aim of ensuring the right health professionals are available when and where they are needed. However, IAHA remains concerned and disappointed that acute shortages in rural and remote allied health services have been largely ignored, and particularly that there appears to be almost no gain for Aboriginal and Torres Strait Islander communities who have little or no access to allied health services at present.

CEO, Donna Murray, added “IAHA will continue to advocate for the National Aboriginal and Torres Strait Islander Health Plan and Implementation Plan to be fully funded. IAHA will continue to seek opportunities to work constructively with Government to achieve this result.”

3.AIDA funded to continue our work in improving health outcomes for Indigenous Australians

This week the Australian Government announced the 2018/2019 Budget to the Australian public. The Australian Indigenous Doctors’ Association (AIDA) welcomes the news of increased government investment into Aboriginal and Torres Strait Islander peak workforce organisations of $33.4 million over four years from 2018-2019.

Download full Press Release

3.AIDA-budget-response_MEDIA-RELEASE-9-May-2018

We take this as a tangible measure of the genuine commitment of the Turnbull Government to work with us to build the Aboriginal and Torres Strait Islander health workforce.

As the only professional association for both Aboriginal and Torres Strait Islander doctors and medical students, AIDA is committed to improving the health of our people and enriching the health profession by growing the numbers of Indigenous doctors.

This renewed funding certainty will allow AIDA, through our strong relationships with key stakeholders, to keep supporting efforts to increase the cultural safety of mainstream medical education and health care systems.

This continued financial support from the government means job security for our employees, increased resourcing for emerging issues and the ability to continue to implement our long-term strategic agenda.

This includes:

  •  Development of our 2018 policy priorities
  •  Further investment in Indigenous-led health research
  • The delivery of a cultural safety program for doctors, by Indigenous doctor
  • Ongoing support to our student and doctor member base

Doing things with, not to Aboriginal and Torres Strait Islander Peoples

AIDA encourages the Turnbull Government to maintain its stated commitment to work in a consultative and collaborative way with Aboriginal and Torres Strait Islander Peoples.

We remain concerned that there is no commitment in the 2018/19 Budget to adequately resource the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.

AIDA maintains that this is the roadmap for the government to work with us to genuinely redress health disparity and deliver culturally appropriate and needs-based health care to Aboriginal and Torres Strait Islander Peoples.

We encourage the government to commit to implementing the social determinants of health framework into future Indigenous health policy development.

AIDA also remains concerned about the lack of targeted funding commitment around Closing the Gap.

We maintain that measureable targets, accountability mechanisms and appropriately funded policy design and program delivery are essential to closing the gap on Indigenous disadvantage.

With this renewed funding certainty, AIDA will continue working towards our vision for an Australian health care system that is free of racism, and one that affords Aboriginal and Torres Strait Islander Peoples the health care they have a right to expect and receive.

4.1 AMA : SAFE AND STEADY HEALTH BUDGET, BUT BIGGER REFORMS ARE STILL TO COME

VIEW NACCHO TV HERE

The Government has tonight delivered a safe and steady Health Budget, which outlines a broad range of initiatives across the health portfolio – but some of the bigger reforms and the biggest challenges are yet to come.

AMA President, Dr Michael Gannon, said the Government has provided some necessary funding to aged care, mental health, rural health, the PBS, and medical research, with many decisions directly responding to AMA policy.

Download full Press Release

4.1 Safe and Steady Health Budget, But Bigger Reforms Are Still to Come

4.2 AMSA Rural

AMSA Rural enthusiastically supports the changes to rural bonding and the opportunities presented by the Junior Doctor Training Program and the National Rural Generalist Pathway.

While the MDMS network may represent an expensive mis-step in addressing rural health workforce shortages, with funds better spent on rural Specialty Training Places, the announcement of better targeting, monitoring and planning for future rural workforce needs is encouraging.

Overall, AMSA Rural welcomes the government’s renewed focus on health equity for rural and regional communities, and looks forward to hearing more details of the Stronger Rural Health Strategy.

Download full Press Release

4.2 AMSA RH MR-  RURAL HEALTH IN FOCUS

5.NRHA :RURAL HEALTH BUDGET $$ WELCOME – BUT NOT ENOUGH

New funding to attract more doctors to country areas has been welcomed by the National Rural Health Alliance, Australia’s peak body for rural and remote health.

“We are pleased tonight’s Federal Budget allocates $550 million over 10 years to help fill the health workforce gaps that exist in so many parts of country Australia,” said Alliance CEO Mark Diamond.

The government says it will deliver 3,000 new specialist GPs, and 3,000 additional nurses over ten years mainly through providing end to end training in country areas.

“It’s not only doctors and nurses that are missing outside major cities. Equally there are not enough allied health professionals. Some areas have no psychologists, no physiotherapists, no occupational therapists,” Mr Diamond said.

A new Workforce Incentive Program will provide some funds to general practices to employ more nurses, doctors and, for the first time, allied health workers.

Download full Press Release

5. National Rural Health Alliance

6.AHHA Health data boost right step on the road to reform

‘The lack of any concrete action on preventive health is concerning—it has been allowed to slip down health budget priorities, despite its proven benefits in preventing big health bills later. This particularly applies to dental health, which once again has been overlooked.

‘In terms of Closing the Gap in Aboriginal and Torres Strait Islander health, we note some modest investments, including the commitment of $5 million per year for the next 3 years to address trachoma in Aboriginal communities’, Ms Verhoeven said.

‘It is disappointing that the government didn’t take the opportunity to address one of our pre-Budget recommendations to make the administrative changes to ensure patients discharged from hospital have access to Closing the Gap prescriptions.

This would have been a practical and relatively inexpensive measure to improve health outcomes for Aboriginal and Torres Strait Islander peoples.’

7.1 PHAA : Budget 2018 – prevention focus goes missing

Tonight’s national Budget continues to fund the health care systems, but is woefully short on preventative health measures to keep Australians from becoming sick in the first place, according to Public Health Association Australia (PHAA) Chief Executive Michael Moore AM.

“Despite repeated advice – and repeated commitments in principle – the Government is still not developing a preventative health focus for our health system,” said Mr Moore.

“It’s true there are a few modest measures tonight – including additional vaccinations funded, very welcome measures to promote mental wellbeing, and the Good Sports Program to reduce alcohol consumption in sporting contexts.”

“But Australia’s people will continue to experience avoidable chronic disease in the years ahead. People who should be destined to live healthy lives will not because of the preventable diseases they will suffer. While we need to look after the aged populations and those requiring medical treatment, we need to focus even more heavily on the younger generation we are failing,” Mr Moore said.

“The inevitable cost to Budgets far into the future will be greater than the investments that might have been funded.”

“What is also noticeable is that there are no preventive measures in this budget which impact negatively on industry.”

“Just last week we saw Australia’s first ever dedicated conference of preventative health professionals, with 300 expert Australians gathering in Sydney to debate the way forward to a more preventive approach to health and wellbeing.

“Yet tonight, preventive health has again been relegated to a low priority.”

“Future Health Ministers and Treasurers will rue the mistakes of this generation, including tonight’s Budget, in failing to invest in preventive health.”

Mr Moore also acknowledged Minister for Aged Care and Indigenous Health Ken Wyatt for securing a number of important initiatives in Indigenous health, Australia’s most agonizing continuing health crisis.

The Public Health Association welcomed a number of specific initiatives in tonight’s Budget:

  • Improving physical activity with a $50.4m investment to get people moving and expanding other physical activity.
  • Funding to expanding four forms of vaccinations, including Pertussis, and a targeted program to address low vaccination rate areas.
  • A National Injury Prevention Strategy for children and older people, including a program to prevent water and snow sport injuries
  • Additional funding for suicide prevention

Download 2 full Press Release

7.1 PHAA Prevention

7. 2 PHAA

NACCHO would also wish Michael a healthy future

8.RACGP Signs Federal Government beginning to recognise vital role of specialist GPs in Australia’s healthcare system

 

The Federal Government’s commitment to fund training for general practice is a sign political leaders are finally beginning to understand the vital role of specialist GPs in Australia’s healthcare system.

Royal Australian College of General Practitioners (RACGP) President Dr Bastian Seidel commended the government for investing to fund a world class, contemporary postgraduate training program for medical graduates through Australian medical colleges and in particular through the RACGP.

“We are cautiously optimistic that the penny has finally dropped,” Dr Seidel said.

“A commitment to unconditionally fund postgraduate GP training will ensure that all Australians have access to a doctor with specialist qualifications in general practice, and this has not always been the case.

Additionally, the commitment to support 3,000 international medical graduates (IMGs) to attain Fellowship as a specialist general practitioner is welcomed.

“Far too often, doctors without any postgraduate qualifications were placed in so called ‘areas of need’ and ‘district workforce shortages’.

“They were asked to work there with little or no professional support or continuous professional training.

“The funding made available in this year’s Federal Budget will finally start to rectify this shortcoming.”

Dr Seidel said while Australian GPs would be pleased with the Federal Government’s commitment to improving general practice training, there were still significant issues that needed to be addressed before the next Federal election. The indexation of general practice consultation item numbers, whilst welcome, does not go far enough.

Dr Seidel said he would like to see the Federal Government show its commitment to general practice by increasing the Medicare rebate for GP attendances by 18.5% to bring specialist GPs into line with other medical specialist attendance items.

“We must see coherent and cohesive funding for general practice that reflects the expertise of all specialist GPs.

“Appropriate investment in general practice has been proven, repeatedly, to be the most cost-effective way to deliver effective healthcare to the Australian population, particularly as the numbers of patients with chronic conditions continue to increase.

“Patients want to spend more time with their GP, and the evidence shows that time with your GP is good for patients,” Dr Seidel said.

“The Federal Government can really make a difference to the quality of care GPs are able to provide Australians by increasing this rebate before the Federal election and as a matter of urgency

 

9.CHF Health budget includes welcome consumer focus

The #digitalhealth slides from @CHFofAustralia #HealthBudget18 response. Note : Funding for things where digital health is a big part. Especially interesting is the work happening with Healthy Active Beginnings.Thx @deanhewson ‬

All 23 slides here:

Record funding for hospitals from 2020 and a $5 billion rise for aged care are contained in a Federal Budget which also provides for more consumer-focused approaches to care and research.

Download full Press Release

9. CHF Federal Health Budget

10. Vision 2020 Australia welcomes the Australian Government’s investment to target major causes of vision loss in Aboriginal and Torres Strait Islander communities.

Vision 2020 Australia welcomes the Australian Government’s investment to target major causes of vision loss in Aboriginal and Torres Strait Islander communities.

Download full press release

10. Vision Australia welcomes Eye Health Funding

The Government’s 2018-19 budget allocated $34.3 million to the eye health issues that disproportionately impact on Aboriginal and Torres Strait Islander people.

Vision 2020 Australia CEO Carla Northam said “Our members consistently tell us that the three major causes of vision loss for Aboriginal and Torres Strait Islander people are eye problems associated with diabetic retinopathy, uncorrected refractive error and the length of time people wait for cataract surgery.

“With the right amount of funding, we can address these debilitating eye conditions.”

Dr Dawn Casey, Acting CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO) welcomed the focus on providing eye health checks, especially for Aboriginal and Torres Strait Islander people who have diabetes. “We need to do all we can to make sure all Aboriginal people with diabetes have an annual eye test. At the moment, only around half are getting their eyes checked every year.”

Professor Hugh Taylor from Indigenous Eye Health, the University of Melbourne identified access to cataract surgery as needing serious attention. He said “Vision loss from cataract is twice as common in Indigenous Australians and they have to wait almost twice as long for surgery.”

Professor Taylor added “Eye care services at the local and regional levels must be planned and resourced to meet population-based needs.”

While the details on how the Government will spend the $34.3 million are unclear, Vision 2020 Australia believes that activity must focus on cutting cataract surgery wait times, making sure everyone with diabetes has an annual eye test and getting glasses to people who need them. Through these measures the Government will meet its commitment to address the major causes of vision loss in Aboriginal and Torres Strait Islander communities.

 

NACCHO #Budget2018 Coverage 4 of 5 : Government Press Releases @GregHuntMP #HealthBudget18 @senbmckenzie #RuralHealthBudget @KenWyattMP #IndigenousHealth @NigelScullion #IndigenousAffairs #Budget2018NACCHO

 

1.Minister Health Greg Hunt

1.1 Guaranteeing essential services – record investment in health

1.2 Guaranteeing Medicare with record funding

1.3 More choices for a longer life

1.4 Providing record access to life-saving and life-improving medicines

1.5 Record Commonwealth funding for public hospitals

1.6 Supporting better mental health for all Australians

1.7 Boosting essential infant and maternal health services

1.8 Promoting a healthy and active Australia

2.Minister Rural Health Bridget McKenzie

2.1 Stronger Rural Health Strategy to deliver high quality care

3.Minister Indigenous Health Ken Wyatt

3.1 Better targeting support to improve Indigenous health

3.2 : Close to Country: $25 million for remote area dialysis

4. Minister Indigenous Affairs Nigel Scullion

4.1: 2018-19 Budget to strengthen economic, employment and health opportunities for First Australians

 “ This Budget confirms the Coalition Government’s continued investment of $5 billion over four years through the Indigenous Advancement Strategy which is making targeted investments in the three priorities fundamental to improving outcomes – getting kids to school, adults to work and making communities safer. Importantly, the number of Indigenous organisations delivering services has drastically increased under the Indigenous Advancement Strategy from 30 to 45 per cent now. “

Post 1 of our NACCHO Posts on #Budget2018 NACCHO

Post 2 will be the NACCHO Chair Press Release

Post 3 will be Health Peak bodies Press Release summary

Post 4 will be Government Press Releases

Post 5 Opposition responses to Budget 2018

ALL NACCHO BUDGET COVERAGE HERE

1.Minister Health Greg Hunt

1.1 Guaranteeing essential services – record investment in health

Download Health Budget HERE  NACCHO Budget INFO

The 2018–19 Budget is guaranteeing the essential health services that Australians rely on, with a $12.4 billion increase in the Health Budget and a $414.5 billion investment in health, aged care and sport.

We will increase:

Medicare funding by $4.8 billion;

public hospital funding by more than $30 billion;

investment in new medicines by $2.4 billion; and

funding for aged care by $5.0 billion.

We will invest in a National Health and Medical Industry Growth Plan of $1.3 billion, including a ground-breaking $500 million Australian Genomics Health Futures Mission.

The Government is also delivering the More Choices for a Longer Life Package to help Australians maximise the opportunities that a longer life brings.

1.2 Guaranteeing Medicare with record funding

The Turnbull Government will continue our absolute rock-solid commitment to Medicare with an additional $4.8 billion investment, building on the Medicare Guarantee Fund we established last year.

For 2017-18, $34.4 billion has been credited to the Fund. A further credit of $35.3 billion will be made to meet the estimated Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) expenditure for 2018-19.

Medicare spending is guaranteed and increasing every year from $24 billion in 2017-18 to $28.8 billion in 2021-22 to support healthcare for every Australian.

Indexation of the Medicare Benefits Schedule, which the Government reintroduced in last year’s Budget will deliver an additional $1.5 billion for Medicare services through to 2021-22.

Following recommendations from the expert MBS Review Taskforce and the independent Medical Services Advisory Committee we will provide new Medicare support for renal dialysis in remote communities, MRI scans for prostate cancer checks, a new cutting edge 3D mammography test for the early detection of breast cancer and new genetic testing for cystic fibrosis.

1.3 More choices for a longer life

The 2018-19 Budget will deliver the More Choices For a Longer Life package which will support older Australians to live longer and be better prepared, healthier, more independent and connected to their communities,

The Package gives older Australians more choices and greater flexibility, including:

An additional 14,000 high-level home care packages so older Australians can stay in their homes longer if they want to;

Allowing pensioners to earn more without reducing their pension;

Greater flexibility to use home equity to increase retirement incomes.

Since the last Budget, the Turnbull Government has delivered an extra 20,000 high-level home care packages, to support people to live at home longer.

We will provide 13,500 new residential aged care places and 775 short-term restorative places to be made available where they are most needed, plus $60 million for capital investment.

We will also invest $40.0 million to support aged care providers in regional, rural and remote Australia for urgent building and maintenance works.

More than $105 million will improve access to culturally safe aged care services in remote Indigenous communities.

The Turnbull Government will establish an Aged Care Quality and Safety Commission to create a tough cop on the beat to ensure older Australians receive the best possible care, with an additional $50 million to assist providers implement the new standards.

MyAged Care will be improved with an investment of $61.7 million to make it easier to use, along with simplifying the forms required to apply for aged care services, and $7.4 million to trial navigators to assist people to choose the aged care services that suit their needs.

We will invest $32.8 million to improve palliative care for older Australians living in residential aged care, filling current gaps in support services, $5.3 million for innovations in managing dementia, and $102.5 million for mental health programs for older Australians.

And people over 65 will be assisted to undertake more physical activity, with locally-based sporting organisations receiving grants totalling $22.9 million to deliver new programs for older Australians.

The Government is helping Australians to work for as long as they want, laying the foundations for a secure retirement. We will provide up to $10,000 in Restart wage subsidies for employing Australians aged 50 and over. The Skills and Training incentive will provide up to $2,000 to fund up-skilling opportunities for mature aged workers.

The 2018-19 Budget delivers measures to boost living standards and expand retirement income options to give retirees confidence in their financial security.

We are increasing the Pension Work Bonus to allow age pensioners to earn an extra $50 per fortnight without reducing their pension. The Pension Loans Scheme will be expanded giving greater flexibility to use home equity to boost retirement incomes, e.g. up to $17,787 a year for a full rate age pensioner (couple).

1.4 Providing record access to life-saving and life-improving medicines

The Turnbull Government will invest $2.4 billion on new medicines to build on our commitment to guarantee those essential services that all Australians rely on. This includes a new $1 billion provision to maintain our commitment to listing all new medicines recommendation by the independent Pharmaceutical Benefits Advisory Committee.

Unlike Labor, we list and will continue to list, every single drug recommended by the medical experts – the Pharmaceutical Benefits Advisory Committee – with approximately $9 billion of investment in new drug listings since coming into government.

In particular, the Government will provide $703.6 million for the listing of Kisqali ® on the PBS to support women with breast cancer. Without subsidy, patients would pay $71,820 per year.

We will also list Spinraza ® on the PBS, a life-changing medicine which treats the devastating illness Spinal Muscular Atrophy. Without subsidy, patients would pay more than $367,850 per year. These new listings mean patients will have access to these medicines paying a maximum of $39.50 per script. Concessional patients, including pensioners, will pay just $6.40.

The Turnbull Government has also signed a landmark agreement with Medicines Australia to improve access to life saving medicines for rare diseases through key reforms to the Life Saving Drugs Program.

1.5 Record Commonwealth funding for public hospitals

The Government will deliver more than $30 billion in additional public hospital funding under a five-year National Health Agreement, with funding increasing for every state and territory, every year.

From 2020-21 to 2024-25, the new agreement will deliver a record $130.2 billion in public hospital funding, with six of Australia’s eight states and territories now covered by this new agreement, including three Labor governments and three Liberal governments.

This represents a more than doubling of public hospital funding under the Coalition Government, rising from $13.3 billion in 2012-13 to $28.7 billion in 2024-25.

1.6 Supporting better mental health for all Australians

The Turnbull Government will deliver an increase of $338.1 million in mental health funding, with a focus on suicide prevention, research and older Australians and advancing the Fifth National Mental Health and Suicide Prevention Plan.

We will expand the beyondblue Way Back Support Service across Australia, which provides outreach, follow-up care and practical support to people discharged from hospital after a suicide attempt. This will see an investment of $37.6 million.

We will provide Lifeline Australia $33.8 million to support its phone counselling services, and SANE Australia will receive $1.2 million for the Better off With You campaign.

The Government will fund a new Million Minds Mission through the Medical Research Future Fund. Over the next 10 years, $125 million will be invested in new research to support an additional million people with mental illness, through new research, diagnosis and treatment.

Men over 85 years of age have the highest risk of suicide for all ages. That’s why the Government will deliver $82.5 million for psychological services in residential aged care, while mental health nurses will help develop and deliver a $20 million program to support older Australians in the community who are isolated and at risk.

The National Mental Health Commission will receive an increase of $12.4 million to oversee mental health reform and take an expanded role under the Fifth National Mental Health and Suicide Prevention Plan. Funding of $4.7 million will support the continued operation of Head to Health, the new digital gateway for mental health services.

We will also fund the Royal Flying Doctor Service for mental health outreach, which will receive $20.4 million to ensure regional and rural Australians get care wherever they are.

1.7 Boosting essential infant and maternal health services

To give Australian children the best possible start in life, we are investing $77.9 million in infant and maternal health and for the first 2,000 days of a child’s life.

This includes $17.5 million for maternal and infant health medical research.

Health professionals will give parents-to-be simple and effective guidance on staying healthy during pregnancy with a $3.0 million program.

The Government will extend the childhood immunisation education campaign, targeting areas with low vaccination rates.

Every mother will be given the opportunity to vaccinate against whooping cough, with $39.5 million to fund the pertussis vaccine to all pregnant women.

To help parents keep track of their children’s health from birth, the Government will introduce a national digital baby book with $5.0 million of funding, replacing state and territory hard copy baby books, and giving children their passport to a lifelong health record.

We will invest $6.2 million to subsidise the cost of more insulin pumps for children with type 1 diabetes.

With injury the leading cause of death of children aged one to 16 years, the Government will fund $0.9 million for the development of a new National Injury Prevention Strategy aimed at reducing childhood injuries. In addition, funding of $1.0 million for the SeeMore Safety Program will support preschool and kindergarten children and their families to reduce the number of preventable childhood injuries.

We will also roll out a new $1 million program to assist GPs to learn more about endometriosis, so they can better diagnose and treat the condition, which can affect around one in ten women and is a key contributor to infertility.

1.8 Promoting a healthy and active Australia

The Turnbull Government will invest $230 million to implement a range of sport and physical activity initiatives that will see more Australians, more active, more often.

This investment builds on our national strengths and will provide more opportunities for Australians to participate in sport and physical activity and promote healthy, active life styles.

The Government will invest $28.9 million in participation grants targeted at less active Australians.

This includes an extension of the Local Sporting Champions grants program which will see more than 3,000 additional young athletes receiving support, including for young athletes in the regions to attend competitions.

The Government will also provide $41.7 million towards extending the popular Sporting Schools Program which provides opportunities for children to participate in sport by reducing the financial burden for parents and building a culture of the enjoyment and benefits of sport for a digitally focused generation.

The Government is acting to reduce drowning at Australia’s beaches, rivers and waterways, as well as improving safety on our snow fields through the Water and Snow Safety Program, with a total investment of $48.5 million.

Participation in sport is vital for the health and wellbeing of all Australians, and is foundational to the Government’s sport plan which will be released later this year.

The Turnbull Government is delivering a strong economy which means we can guarantee the essentials that Australians rely on like Medicare, hospitals, lifesaving medicines and aged care.

2.1 Stronger Rural Health Strategy to deliver high quality care

The Turnbull Government will deliver the most comprehensive rural health package in decades, which will improve access to doctors, nurses and other health care services for all Australians, especially those in the regions.

The Stronger Rural Health Strategy will improve the delivery of healthcare by ensuring we have the right health care professionals located in the regions. It will provide greater opportunities for Australian doctors through better teaching, training, recruitment and retention. The package will see growth in multidisciplinary care and increased access to nursing and allied health services.

This comprehensive strategy has been developed in close consultation with the AMA, RACGP, ACRRM and other rural medical leaders.

In order to support teaching in the regions, we will invest $95.4 million to create the new Murray Darling Medical Schools Network comprising of the University of NSW (Wagga Wagga), University of Sydney (Dubbo), Charles Sturt University/Western Sydney University (Orange), Monash University (Bendigo, Mildura), and University of Melbourne/La Trobe University (Bendigo, Wodonga, Shepparton). The Government will also include Curtin University (for medical training) and La Trobe University (for nursing and allied health training) in the Rural Health Multidisciplinary Training (RHMT) program.

This will be done while retaining the existing number of Commonwealth Supported Places for medical students.

This is a fundamental change in the teaching and supply of rural and regional doctors and will transform rural training schools, enabling students to undertake most of their education and training in rural areas to provide a continuum for doctors to learn, train and work in the regions.

The Stronger Rural Health Strategy will mean more Australian doctors for the regions.

3.1 Better targeting support to improve Indigenous health

The Budget provides ever greater support for our effort to Close the Gap and better targets funding to improve outcomes for Aboriginal and Torres Strait Islander people, with funding for Indigenous Health of $3.9 billion from 2018-19 to 2021-22 and $10 billion over a decade.

In particular, the Turnbull Government will deliver $33.4 million for Aboriginal and Torres Strait Islander health workforce, and provide funding to prevent and treat complex and chronic health conditions including eye disease ($34.3 million), hearing loss ($30.0 million), and crusted scabies ($4.8 million).

3.2 : Close to Country: $25 million for remote area dialysis

The Australian Government is funding a $25 million expansion of remote renal clinics, so more Aboriginal people in Central Australia who suffer from kidney disease can receive dialysis on country or as near to their communities as possible.

Minister for Indigenous Health, Ken Wyatt AM, said the Government was proud to support the highly successful Western Desert Nganampa Walytja Palyantjaku Tjutaku, also known as Purple House, to complete four new clinics and extend a fifth.

“Purple House is making a huge difference to the physical, mental and spiritual health of people across Central Australia, by allowing them to receive care while remaining connected to their land and their people,” Minister Wyatt said.

“This expansion will take the number of remote clinics in the region to 17 and builds on this community driven project’s outstanding record.

“Purple House now provides 70 per cent of Central Australian dialysis services and is not only changing lives, its vast program has saved many lives, because patients don’t have to leave their families and communities for treatment.”

Recent clinical data shows the mortality rate for people on dialysis in Central Australia is now less than half the rate of the rest of the nation.

The funding will allow completion of clinics this year at Utopia, Ampilawatja, Kalkarindji and Ernabella, plus the expansion of the Lajamanu clinic. It will also support the operating costs of another three clinics

The expansion will take the number of remote dialysis machines from 36 to 54 and increase the remote patient group from around 250 to more than 400.

Chronic kidney disease is a significant health challenge among Aboriginal and Torres Strait Islander communities. More than 1,800 First Nations people are currently receiving dialysis, with almost 60 per cent of these starting dialysis before they were 55 years old.

Minister Wyatt said reducing the misery and death caused by kidney disease was a key Turnbull Government priority.

“Following a recent roundtable in Darwin, development of an Aboriginal and Torres Strait Islander renal health road map is underway,” said the Minister.

“Prevention is crucial and it starts during pregnancy, with low birthweight babies born with weaker kidneys.

“Organisations like Purple House are showing the way, through community based, holistic services and strong and effective Aboriginal governance.

“An independent study has shown Purple house delivers remote renal services at a cost comparable to or even lower than the standard Australian hospital dialysis cost.”

Purple House was formed in 2003, following years of work by Aboriginal leaders and supporters that culminated in a million-dollar fundraising auction of local art to establish the project.

The Commonwealth Government has previously provided $17.6 million over four years to Purple House for renal support services in the NT and Western Australia, including $6.45 million to enable the Purple House to build and expand renal infrastructure in Central Australia at six locations in the NT and one in South Australia.

The new funding, under the Government’s Indigenous Australians’ Health Program, will apply for three years from July 2018.

4.1: 2018-19 Budget to strengthen economic, employment and health opportunities for First Australians

 

First Australians right across the nation will benefit from a stronger economy, more jobs and guaranteed essential services through the 2018-19 Federal Budget.

Minister for Indigenous Affairs, Nigel Scullion, said this year’s Budget is delivering for First Australians across the board by investing in health, safety and security through economic and employment opportunities.

“The Coalition Government’s economic plan has already delivered over 400,000 jobs last year – the highest number of any year on record.

“We are delivering tax relief to hard-working Australian families, guaranteeing the essential services in health, education and community safety that all Australians rely upon, returning the Budget to a credible trajectory to surplus, while setting the stage for a return of business confidence and the jobs boom. We are also ensuring that First Australians have their fair share of this economic success.”

The Coalition Government’s cross-portfolio investment in initiatives to improve outcomes for Aboriginal and Torres Strait Islander Australians include:

  • The Community Development Programme (CDP) reforms to ensure remote job seekers are further supported on their pathway to employment. It will now be a simpler, more streamlined program, with less interactions with the national welfare system for remote job seekers. This is being complemented by a government-funded employment program for 6,000 jobs in remote Australia.
  • A new Aboriginal and Torres Strait Islander Land and Sea Future Fund (ATSILSFF) will replace the $2 billion Aboriginal and Torres Strait Islander Land Account (Land Account) leaving the Fund up to $1.5 billion better off, over 20 years, compared to the current investment mandate.
  • $550 million over five years ($110 million per annum) to support remote housing in Aboriginal and Torres Strait Islander communities across the Northern Territory. This funding will be matched by Northern Territory Government contributions. Negotiations remain ongoing with Western Australia, South Australia and Queensland however the Commonwealth remains hopeful of reaching an agreement with these jurisdictions soon.
  • $3.8 billion investment to the Indigenous Australians’ Health Programme (IAHP) from 2018‑19, an increase of over $800 million compared with the previous four years.
  • $38.1 million, over five years, to support Aboriginal and Torres Strait Islander students who need to travel away from home for education, in recognition of the 50th anniversary of ABSTUDY.
  • $105 million for better access to aged care Aboriginal and Torres Strait Islander people.
  • $18.2 million to support domestic violence prevention and protection programs for women and girls including maintaining the current DV alert service and 1800RESPECT trauma counselling service.
  • $34.8 million over four years to support the delivery of dialysis by nurses, including Aboriginal and Torres Strait Islander health workers in remote areas, under a new Medicare Benefits Schedule item.
  • $23.2 million over four years for Healthy Active Beginning Package which includes a policy to reduce the traumatic injury rate among young Indigenous Australians, who are 4.5 times more likely to sustain serious injury than non-Indigenous children.
  • $200 million for a third round of the Building Better Regions Funding to support rural, regional and remote community infrastructure projects.
  • $28.3 million over four years for Remote Airstrip Upgrade works supporting air access to remote towns and Indigenous communities.
  • $2 million over three years to the Australian Institute for Aboriginal and Torres Strait Islander Studies (AIATSIS) for a program of preservation and celebration of Indigenous languages and culture.

This Budget confirms the Coalition Government’s continued investment of $5 billion over four years through the Indigenous Advancement Strategy which is making targeted investments in the three priorities fundamental to improving outcomes – getting kids to school, adults to work and making communities safer. Importantly, the number of Indigenous organisations delivering services has drastically increased under the Indigenous Advancement Strategy from 30 to 45 per cent now.

Minister Scullion said efforts across the government would build on the success of initiatives such as the Indigenous Procurement Policy, which has seen over 1,000 Indigenous businesses win Australian Government contracts worth more than $1 billion since the policy’s inception in July 2015.

The IPP stands in stark contrast to the pathetic $6.2 million to just 30 Indigenous businesses in Labor’s last year in government.

“The Indigenous Grants Policy (IGP) we unveiled in February will see services intended specifically for Aboriginal and Torres Strait Islander communities to be delivered by local Indigenous organisations.

The policy will be trialled later this year for grants administered by the Department of Communications and the Arts, the Department of Social Services and the Department of the Prime Minister and Cabinet.

“The IGP builds on the Coalition’s efforts to deliver more grant funding through the Indigenous Advancement Strategy to Aboriginal and Torres Strait Islander organisations.

We are now delivering 55 per cent of grants through First Australian owned or controlled organisations compared with 35 per cent under Labor.

“To drive greater change and to close the gap, we need to harness greater opportunities for Aboriginal and Torres Strait Islander peoples across all areas of government expenditure and investment and that is precisely what we are doing,” Minister Scullion said.

“Through the Indigenous Business Sector Strategy, the Employment Parity Initiative, the Vocational Training and Employment Centre programme and the Indigenous Rangers Programme we are supporting First Australians realise their economic aspirations.

“Our strategic partnerships with First Nations’ representative bodies like the New South Wales Aboriginal Land Council in Western Sydney to include procurement and employment targets as part of the $5 billion Western Sydney Airport, and with the Northern Land Council on remote housing in the Northern Territory, demonstrates our strong commitment to putting First Australians at the heart of our economic plan for the nation,” Minister Scullion said today.

 

“The IGP builds on the Coalition’s efforts to deliver more grant funding through the Indigenous Advancement Strategy to Aboriginal and Torres Strait Islander organisations. We are now delivering 55 per cent of grants through First Australian owned or controlled organisations compared with 35 per cent under Labor.

“To drive greater change and to close the gap, we need to harness greater opportunities for Aboriginal and Torres Strait Islander peoples across all areas of government expenditure and investment and that is precisely what we are doing,” Minister Scullion said.

“Through the Indigenous Business Sector Strategy, the Employment Parity Initiative, the Vocational Training and Employment Centre programme and the Indigenous Rangers Programme we are supporting First Australians realise their economic aspirations.

“Our strategic partnerships with First Nations’ representative bodies like the New South Wales Aboriginal Land Council in Western Sydney to include procurement and employment targets as part of the $5 billion Western Sydney Airport, and with the Northern Land Council on remote housing in the Northern Territory, demonstrates our strong commitment to putting First Australians at the heart of our economic plan for the nation,” Minister Scullion said today.

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NACCHO Aboriginal #HealthBudget18 Press Release @KenWyattMP Federal Government announces new funding model for ACCHS Aboriginal Community Controlled Health Services #Budget2018NACCHO

 

 ” It is important to strengthen and expand our Aboriginal Community Controlled Health Services  role as primary care providers in our communities as there will be 1 million Aboriginal people 2030, ”

NACCHO Chair Mr John Singer believes ‘that funding certainty is critical to ACCHSs achieving good health outcomes.

 

See our live interviews on NACCHO Facebook

Picture above : Day after Budget night and NACCHO Chair faces media at Parliament House

The National Aboriginal Community Controlled Health Organisation (NACCHO) has welcomed the Budget announcement of a new needs based funding formula model for the Indigenous Australians’ Health Program (IAHP).

Although this new model requires further refinement, feedback and work.

Download this NACCHO Press Release

NACCHO Press Release Government announces new funding model for ACCHS

This new model for our 144 Aboriginal Community Controlled Health Service (ACCHS) provides funding for our primary health care services and now excludes 7 inconsistent data points related to NKPIs.

NACCHO Chair Mr John Singer believes ‘that funding certainty is critical to ACCHSs achieving good health outcomes.

Mr John Singer called on the government to ensure there was no adverse impact on our Model of Care.

NACCHO welcomes the 5-year funding agreements and grandfathering arrangements under this new model.

NACCHO welcomes the new money for preventing and treating complex chronic health conditions such as Eye disease ($34.3 million) hearing loss ($30.0 million) and crusted scabies ($4.8 million).

Acknowledges the new investment in remote renal services and infrastructure with a MBS item for dialysis.

Also, the $105.7 over four years to deliver additional residential aged care places and home care packages in remote Indigenous communities.

The Government has advised that the new funding model can be varied up to July 2019 and NACCHO will continue work in consultation with the Funding Model committees.

Aboriginal controlled health services provide about three million episodes of care each year for about 350,000 people and employ about 6,000 staff.

Post 1 of our NACCHO Posts on #Budget2018 NACCHO HERE

Post 2 will be the NACCHO Chair Press Release and Analysis above

Post 3 will be Health Peak bodies press release summary

Post 4 will be Government Press Releases

 

NACCHO Aboriginal Health #HealthBudget18 : Will the #Budget2018NACCHO Improve health outcomes for Indigenous Australians ?

 

” A greater focus on outcomes and transparency of funding will support our ongoing commitment to Closing the Gap in Indigenous health with a total of $10 billion for Indigenous health over the next decade.”

Extract from Health budget papers See Part 2 below Improving health outcomes for Indigenous Australians : download full copy of Health Budget

 ” Funding for a key Aboriginal health program will climb $200 million to nearly $4 billion as the Turnbull government negotiates with the states over other investments.

The government will implement a new primary care funding model for the Indigenous Australians’ Health Program to provide greater transparency of funding and improve health outcomes.

This new transparency initiative would be based on patient numbers, episodes of care and the remote nature of the treatment and be designed to ensure resources are directed to the right areas, minimising waste.

The contribution will total $3.9bn over four years from 2018-19 and the budget papers state that extra funding could also be provided under the Medicare system.”

From the Australian see Part 1 Below

Post 1 of our NACCHO Posts on #Budget2018 NACCHO below

Post 2 will be the NACCHO Chair Press Release and Analysis

Post 3 will be Health Peak bodies press release summary

Post 4 will be Government Press Releases

See our live interviews on NACCHO Facebook

 ” National Congress welcomes the renewal of funding for our health organisations and programs. In particular, we appreciate the recognition of the crucial role which the Aboriginal and Torres Strait Islander workforce plays in delivering positive health outcomes for our peoples.

However, we note that the provision of culturally safe and appropriate healthcare must also be integrated into the mainstream health system.

We also acknowledge the Government’s commitment to provide new funding to aged care, but unless the large gap in life expectancy is resolved, many of our peoples may not enjoy the longevity to benefit from these services.”

National Congress Press Release see Part 3 Below

Part 1 The Australian Continued

Existing eye health initiatives will be bolstered by $34m to provide further health checks and address the issue of vision loss. The government has pledged more than $33m to bolster the Aboriginal and Torres Strait Islander workforce.

Indigenous Affairs Minister Nigel Scullion also earmarked $550m over five years for remote housing in the Northern Territory, with matched funding from the territory government.

“Local Aboriginal decision-making, local Aboriginal employment and local Aboriginal procurement are at the heart of our investment,” he said.

Senator Scullion said the government was in negotiations with the Queensland, South Australian and West Australian governments about future funding.

The budget would support 6000 jobs in remote areas, with so-called tailored support to indigenous jobseekers.

The overhaul of the Community Development Program would start from early next year, cutting income reporting demands to Centrelink.

Senator Scullion said the new system would ensure that all jobseekers — regardless of their location — would face the same compliance framework

Part 2 From Health Budget Papers : Improving health outcomes for Indigenous Australians

 

Download the 472 Page Health budget here

NACCHO Budget INFO

 Funding for the Indigenous Australians’ Health Programme (IHAP) will increase by $200 million to total $3.9 billion over four years from 2018-19.

As part of the Closing the Gap agenda, the Government will implement a new primary care funding model for IHAP to improve outcomes for Aboriginal and Torres Strait Islander peoples.

Greater transparency of funding based on patient numbers, episodes of care and remoteness will assist in ensuring resources are directed to areas of need.

The program will be introduced in consultation with the community and overall funding is retained, while increased opportunities will exist for additional funding under Medicare.

The Government will target specific health conditions that disproportionately affect Aboriginal and Torres Strait Islander peoples, including a focus on avoiding hearing loss and vision impairment.

The Government will allocate approximately $30 million to expand hearing assessments. Aboriginal and Torres Strait Islander children have high rates of otitis media and subsequent hearing loss.

Poor vision is a barrier to education and employment, and impacts mobility, independence and social interaction.

The Government will boost existing eye health initiatives, investing $34.3 million to provide eye health checks and target the major causes of vision loss in Aboriginal and Torres Strait Islander communities.

The detection, treatment and management of crusted scabies in remote Aboriginal and Torres Strait Islander communities in Northern Australia will also be improved through an investment of $4.8 million.

The measure will help eliminate the highly infectious condition, which can lead to acute rheumatic fever, rheumatic heart disease and renal disease.

This initiative builds on a successful pilot in East Arnhem, which achieved a 44 per cent reduction in recurring crusted scabies over four years.

Funding for Aboriginal and Torres Strait Islander Health Professional Organisations will also be boosted, with funding of $33.4 million over four years to enable further increases to the Aboriginal and Torres Strait Islander health workforce.

This will assist with meeting increased demand for services and will also help non-Indigenous Australians develop cultural understanding and capability.

The Government will also expand the National Aboriginal and Torres Strait Islander Flexible Aged Care (NATSIFAC) program to improve access to culturally safe aged care services in remote Indigenous communities.

From 2018-19 to 2021-22, the Government will provide $105 million to better support older Aboriginal and Torres Strait Islander people.

Part 3 National Congress

 

The Government’s priority for First Australians focuses primarily on economic prosperity. While many would welcome this outcome, the Government’s roadmap to accomplishing this prosperity is fanciful, incoherent and sorely lacking in the detail necessary for success.

Although the Government has listened to a few of our concerns regarding the Community Development Program, major issues largely remain unresolved in this budget.

The harsh and discriminatory penalty system is largely intact. In fact, penalties have worryingly been strengthened in cases involving participants who need the greatest amount of support. For this reason alone we renew our call for the CDP to be replaced with a wage-based program which provides meaningful employment and training for our peoples.

We are deeply concerned by the Government’s proposal to withhold income support payments from individuals who default on fines. This is a recipe for ensuring that the poorest and most vulnerable members of our society will remain so, with unpaid fines likely leading to increased rates of incarceration rather than pathways to prosperity. Our peoples cannot achieve economic prosperity if we cannot meet our basic needs.

In claiming that it will provide $550 million in new funding for remote housing in the Northern Territory, the Government has attempted to hide its abandonment of a national housing strategy.

The National Partnership Agreements on Remote Indigenous Housing have expired. Prospects of renewal are slim, particularly if negotiations with state and territory governments are unsuccessful.

If Aboriginal and Torres Strait Islander peoples are forced to live in insecure, overcrowded and unsafe homes, or are homeless, the barriers to economic empowerment are overwhelming.

The Federal Budget fails to address the shameful over-incarceration of Aboriginal and Torres Strait Islander peoples. We make up 3% of Australia’s population, but 27% of its prisoners.

If anything, the Government’s callous disregard for our basic human rights to equality and quality health, education, housing and employment opportunities makes this problem worse.

These factors are also responsible for child removal rates being ten times greater than for non-Indigenous Australians, which threatens to create a new Stolen Generation and perpetuates intergenerational trauma.

Aboriginal and Torres Strait Islander legal services have highlighted gross inadequacies in government funding for civil cases.

As Centrelink breaches, inability to repay fines and housing tenancy disputes become more commonplace due to Budget measures, the demand for legal services will only increase and these inadequacies are likely to become more severe.

Attempts to Close the Gap appear to have stalled, with Minister Scullion making no reference to the program in his media release.

No new funding has been allocated to the strategy, despite a dire need for further community consultation and national co-operation between governments and our organisations.

The Government’s failure to Close the Gap must not be used as an excuse to abandon the targets altogether, lower expectations and wide the life expectancy gaps or shift responsibilities to state and territory governments.

We note in this budget that $50 million has been allocated for the memorialisation of the 250th Anniversary of Captain Cook’s voyage to Australia. Whilst gaining pockets of local support, this appears a controversial investment in the Treasurer’s own electorate.

Our preference would be to redirect these funds into community based Closing the Gap initiatives to address the negative impacts of the European invasion of Australia.

National Congress welcomes the renewal of funding for our health organisations and programs. In particular, we appreciate the recognition of the crucial role which the Aboriginal and Torres Strait Islander workforce plays in delivering positive health outcomes for our peoples.

However, we note that the provision of culturally safe and appropriate healthcare must also be integrated into the mainstream health system.

We also acknowledge the Government’s commitment to provide new funding to aged care, but unless the large gap in life expectancy is resolved, many of our peoples may not enjoy the longevity to benefit from these services.

We reiterate our call for the Government to work collaboratively with us. The need for an independent and well funded national representative body to inform Governments is greater now than ever.

Our organisations are in the best position to provide culturally safe and appropriate services to our peoples. However, we cannot achieve this without adequate resources and support.

On reflection this budget leaves so many of us uncertain of the true value of our extensive consultations with Government over the past year. So little of what we have said, like so little of what we have recommended, has been taken up by this Government in this underwhelming budget.

Our political leaders have seemingly exhibited an attention deficit; one proportional to the surplus evident in their own self-interest.

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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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

NACCHO Aboriginal Health #NTRC : Olga Havnen Danila Dilba AMS and Yothu Yindi Foundation question how the billion of $ dollars Indigenous expenditure is spent

Try go looking for any kind of detail around Indigenous expenditure — it’s completely and utterly opaque,

Is it 50 per cent, is it 60 per cent, is it 70 per cent (that’s being misspent)? I really don’t know. I would say at least 50 per cent.

We call for a 15-year plan guaranteeing long-term investment but also predicted little improvement in results until all organisations submitted to greater scrutiny.

I think we have to include all funding. When I’m talking about transparency and accountability, I’d also be prepared to say that as Aboriginal organisations we too need to be open and transparent about the ways in which we spend public money,”

Olga Havnen, who now heads the Darwin-based Danila Dilba Health Service, yesterday said that almost six years on, it remained impossible to tell where Indigenous dollars were going

 ” A submission to the Productivity Commission’s current inquiry into how the GST is distributed argues that a “pattern of underspending compared to need has become entrenched” and warns that “indigenous Territorians retain unresolved concerns that the Northern Territory government does not fully apply the funds it receives as assessed by CGC for the benefit of indigenous people”.

The submission, by influential northeast Arnhem Land social organisation the Yothu Yindi Foundation, calls for “fundamental reform” of commonwealth-Territory relations, an argument backed up this month by the royal commission into child detention.”

See Part 2 below

Half of Indigenous funding in the Northern Territory is being misspent, says Olga Havnen

From Todays The Australian

At least half of all funding allocated to tackling indigenous disadvantage in the Northern Territory is being misspent, according to the former co-ordinator general for remote services, who issued a scathing report in 2012 and believes little has changed since.

That report found governments could not tell if indigenous Australians were benefiting from extra money because so much of it was being wasted on bureaucracy.

It highlighted excessive focus on “inputs and outputs rather than outcomes”, funding streams that were “fragmented, complex and administratively burdensome” and an “apparent indifference” on the part of public agencies to evaluating their own performance.

The then CLP government abolished the position of co-ordinator-general soon after.

“If you have a look at the budget for Territory Families, there’s an awful lot of money that gets spent on out-of-home care — purchase family-based daycare, for example, is expensive. Is there a better way of getting children looked after in a safe environment at a far cheaper cost?”

Her comments follow stand-offs between the Territory and federal governments over a proposed spending audit and demands for extra money to implement the recommendations of the Royal Commission into the Protection and Detention of Children in the NT.

The federal Social Services minister, Dan Tehan, yesterday promised to work “collaboratively” with the Territory government to address the commission’s recommendations but added it was vital that the $4.2bn in annual funding to Darwin be adequately accounted for.

“The royal commission came out very clearly and said this isn’t an issue about money, this is about how the money is being spent to get outcomes, and that’s why we’re going to get the Productivity Commission to look at how the money is being spent and whether it’s being spent in a way which is getting those outcomes on the ground,” Mr Tehan said.

NT families minister Dale Wakefield wrote to Mr Tehan yesterday saying there was “little appetite in the community for excuses and blame shifting”. She told reporters it was crucial governments work with Aboriginal people design and to implement changes.

However, The Australian has learned that approaching two years after Labor won office, the Gunner government’s new consultation framework has still not passed cabinet or been funded. Ms Wakefield said it was “one of those processes that takes time.”

Opposition leader, Gary Higgins, called the plan “yet another throwaway line”.

“It is pathetic that its much-talked about policy has not even made it to Cabinet, 18 months after being elected,” he said. “There is no excuse for the Gunner government to have not prioritised local decision making for Territory communities.”

A spokesman for the Chief Minister, Michael Gunner, did not respond to questions

Northern Territory cash shuffle sees $2bn taken from Indigenous aid

From the Australian

Successive Northern Territory governments have redirected more than $2 billion in GST intended to address remote and ­indigenous disadvantage, promp­ting new calls for urgent reform in the wake of shocking child abuse revelations in Tennant Creek.

Since the tax began operating in 1999, the NT has received $6.4bn in GST for welfare, housing, family and children’s needs, based on the Commonwealth Grants Commission’s remote and indigenous criteria.

However, because the grants are not tied, just $4.2bn of this has gone to those categories, analysis of the commission’s figures shows, with a large part of the rest ending in consolidated revenue.

Aborigines make up 30 per cent of the Territory’s 245,000 population, with about 80 per cent of these living in ­remote and very remote areas, ­according to the government.

The Northern Territory was allocated $73 million from the first year of GST, but spent just $24m on family and child services — the category in which a significant amount of indigenous disadvantage would be likely to be addressed, though not the only one.

In successive years the total allocation rose in real terms but so did the underspend, peaking after eight years at $126m siphoned off: in 2006-07 just $43m, or 24 per cent, of a total allocation of $179m went to family and child services.

Assessing the figures is complicated by the fact NT governments have imposed a series of changes of reporting categories in the area over almost two decades, as well as by the distorting effect of extra funds coming from a joint commonwealth-Territory remote ­indigenous housing program starting in 2007-08.

However, the trend has continued throughout the period, with the three years from 2013-14 showing an improvement in relative terms over the early years but a significant underspend increase in real terms. In 2015-16, just $285m, or 67 per cent, was spent on the welfare category from an assessed amount of $422m, the previous year $285m of $407m (69 per cent) and in 2013-14 $282m of $381m (74 per cent of the total).

A submission to the Productivity Commission’s current inquiry into how the GST is distributed argues that a “pattern of underspending compared to need has become entrenched” and warns that “indigenous Territorians retain unresolved concerns that the Northern Territory government does not fully apply the funds it receives as assessed by CGC for the benefit of indigenous people”.

The submission, by influential northeast Arnhem Land social organisation the Yothu Yindi Foundation, calls for “fundamental reform” of commonwealth-Territory relations, an argument backed up this month by the royal commission into child detention.

That inquiry recommended a review of commonwealth expenditure in the Territory in the area of family and child services relating to the prevention of harm to children, addressing “co-ordination of programs, funding agreements and selection of service providers”.

Northern Territory Chief Minister Michael Gunner this month slammed the Turnbull government for responding to this with a proposed review of both commonwealth and Territory spending, saying he would “not take a single worker off the frontline” to support it.

About 80 per cent of the Territory’s $5.5bn budget comes from GST receipts and special purpose commonwealth payments. The Gunner government has blamed an estimated $2bn reduction in GST for a hit to its forward estimates, arguing in its Productivity Commission submission this would have “implications for the Northern Territory’s capacity to invest in closing the gap in outcomes between Aboriginal and non-Aboriginal Territorians”.

It has called for separate commonwealth funding to be provided to address Aboriginal disadvantage, outside the GST distribution so that it is upheld “and not redistributed to other states”.

However, Indigenous Affairs Minister Nigel Scullion, a NT senator, hit back yesterday, accusing Mr Gunner of “hiding from transparency around remote education funds and remote policing numbers and (having) refused to participate in a commonwealth review of how federal funds are spent in the NT”.

“He should get his own house in order before demanding other states pay even more for his failures,” Senator Scullion said.

The latest startling figures come as the Turnbull government accuses Labor of frustrating its proposed new position of indigenous productivity commissioner, whose tasks would include examining the indigenous funding regime nationwide.

Malcolm Turnbull announced the position more than a year ago but, since introducing the enabling legislation in September, the government has resisted a Labor push to expand its definition of “indigenous” beyond a dated reference to “race”, so that it also includes now standard self-identification and community acceptance elements.

Aboriginal Health Download NACCHO Pre #Budget2018 Submission : Budget proposals to accelerate #ClosingTheGap in #Indigenous life expectancy

 

 ” 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.”

Download the full NACCHO submission HERE

NACCHO-Pre-budget-submisson-2018

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

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

 

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

“Doctors are seeing high rates of mortality in Aboriginal and Torres Strait Islander people and this is largely attributable to chronic disease,

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.

And this accounts for about 70% of Indigenous mortality. But it’s not all gloom and doom. I think if we all work strongly together, I do believe we can improve Aboriginal and Torres Strait Islander health significantly. For example, what we’ve been able to do is we’ve actually got Aboriginal people to attend primary care. But more importantly now, my aim is to integrate specialist care.

So now we have a visiting endocrinologist, we’ve got a paediatrician, we’ve got a cardiologist, we’ve got a registrar from rehabilitation medicine, we’ve got an ophthalmologist. So private physicians and also hospital-based physicians, and the ones that are hospital-based, they come out here. The cardiologist, for example he does two sessions a month. He does his echocardiograms here and also exercise stress tests.

To me, integrating specialist care into a centre of excellence is to me is a “one stop shop” and Aboriginal people are more likely to attend. And we’ve actually shown that. And we’ve got better outcomes and we’ve got data on that through continuous quality improvement.”

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.

Press release continued

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

Aboriginal and Torres Strait Islander health leadership and authentic community engagement is crucial to achieving improved health outcomes. The Aboriginal Community Controlled Health sector is of vital importance in delivering effective, culturally safe care to Australia’s First Peoples; and service development and provision should be led by Aboriginal and Torres Strait Islander health organisations where ever possible. The sector must have long-term, sufficient and secure funding to both retain and grow their capacity.

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

Sexual Health

There continue to be ongoing outbreaks of infectious syphilis across Australia affecting Aboriginal and Torres Strait Islander people, which has occurred in the context of increasing rates of other Sexually Transmitted Infections (STIs) and some Blood Borne Viruses (BBVs) in some Aboriginal and Torres Strait Islander communities. STIs are endemic in some regions; an unprecedented syphilis epidemic in Queensland began in 2011 and extended to the Northern Territory, Western Australia and South Australia.

Since 2011 there have been six fatalities in Northern Australia from congenital syphilis, and a further three babies are living with serious birth defects in the Northern Territory. In addition, there has been one reported case of congenital syphilis so far in 2017 in South Australia. Despite the existence of a number of Federal and state-level sexual health strategies, the situation remains dire.

Appropriate funding needs to be allocated to the implementation of the Fifth National Aboriginal and Torres Strait Islander Blood-Borne Viruses and Sexually Transmissible Infections Strategy

A Healthy Future for all Australians: RACP Pre-Budget Submission 2018-19 13

and sexual health services; particularly to ensure sufficient capacity for the delivery of core STI/BBV services within models of care that provide comprehensive primary health care services (particularly Aboriginal and Torres Strait Islander community controlled health services). People should have access to specialist care when needed, through integration with comprehensive primary health care services to ensure sustainable and culturally appropriate service provision.

We welcome the plans to activate a short-term response across the state and territories on the continuing syphilis outbreaks, coordinated by the Federal Department of Health. However, whilst this Action Plan and short-term funding is urgently needed; the short-term activities need to be coordinated with and contribute to longer-term strategies and investments.

 

 

 

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

 

 ” It is unacceptable that Australia, one of the world’s wealthiest nations, cannot address health and social justice issues affecting Aboriginal and Torres Strait Islander people, who comprise just three per cent of the population. Funding for Aboriginal and Torres Strait Islander Health is inadequate to meet the burden of illness.

Every year, the AMA says that this situation is not acceptable, and every year governments fail to implement the health plans, recommendations, and strategies that will deliver improvements and hasten the closing of the gap in health outcomes.

The 2018-19 Budget is an opportunity to start properly funding and resourcing Indigenous Health ”

Extract from

AMA Budget Submission 2018-19

AMA President, Dr Michael Gannon, said today 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.

Releasing the AMA’s Pre-Budget Submission 2018-19, Dr Gannon said the key for the Government is to look at all health policies as investments in a healthier and more productive population.

“The conditions are ripe for a new round of significant and meaningful health reform, underpinned by secure, stable, and sufficient long-term funding to ensure the best possible health outcomes for the Australian population,” Dr Gannon said.

“The next Budget provides the Government with the perfect opportunity to reveal its health reform vision, and articulate clearly how it will be funded.

“We have seen years of major reviews of some of the pillars of our world class health system.

“The review of the Medicare Benefits Schedule (MBS) is an ambitious project.

“Its methods and outcomes are becoming clearer. Its best chance of success is if the changes are evidence-based and clinician-led and approved.

“A new direction for private health insurance (PHI) has been determined following the PHI Review.

“We must maintain flexibility and put patients at the centre of the system, but recognise the fundamental importance of the private system to universal health care.

“The Medicare freeze will be lifted gradually over the next few years.

“There is now a greater focus on the core health issues that will form the health policy battleground at the next election.

“There is no doubt, as shown at the last Federal election, that health policy is a guaranteed vote winner … or vote loser.

“Our Submission sets out a range of policies and recommendations that are practical, achievable, and affordable.

“They will make a difference. We urge the Government to adopt them in the Budget process.

“Health should never be considered an expensive line item in the Budget.

“It is an investment in the welfare, wellbeing, and productivity of the Australian people.

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

The AMA Pre-Budget Submission 2018-19 covers:

·         General Practice and Primary Care;

·         Public Hospitals;

·         Private Health Insurance;

·         Medicare Benefits Schedule (MBS) Review;

·         Preventive Health;

·         Diagnostic Imaging;

·         Pathology;

·         Mental Health and the NDIS;

·         Medical Care for Older Australians;

·         My Health Record;

·         Rural Health;

·         Indigenous Health;

·         Medical Workforce;

·         Climate Change and Health; and

·         Veterans’ Health.

 The AMA Pre-Budget Submission 2018-19 is at https://ama.com.au/ama-pre-budget-submission

This Submission was lodged with Treasury ahead of the Friday, 15 December 2017 deadline.

Part 2 The gap in health and life expectancy between Aboriginal and Torres Strait Islander people and other Australians is still considerable, despite a decade of commitments to closing the gap.

NACCHO Aboriginal #EarHealthforLife @KenWyattMP and @AMAPresident Launch AMA Indigenous Health Report Card 2017:

The AMA values the progress being made in reducing early childhood mortality rates, and in addressing major risk factors for chronic disease, such as smoking. But if the Government is serious about building on this early but slow progress, it must create sustainable, long-term improvements by increasing funding and resourcing for culturally appropriate primary health care for Aboriginal and Torres Strait Islander people. It must also increase and properly resource the health workforce.

Many of the chronic health conditions experienced by Aboriginal and Torres Strait Islander people should not be endemic in a highly-developed country like Australia. Chronic diseases are known to be the main cause of the life expectancy gap between Indigenous and non- Indigenous Australians.

Despite some recent health gains for Aboriginal and Torres Strait Islander people, awareness and political will is frustratingly slow-moving. There is an urgent need for the Commonwealth to deliver on the well-documented research and national strategies showing how to tackle health inequalities and the social determinants of health.

Closing the gap in health outcomes means addressing: poverty; unhygienic, overcrowded conditions; poor food security and access to potable drinking water; lack of transport; and an absence of health services.

Every year, the AMA says that this situation is not acceptable, and every year governments fail to implement the health plans, recommendations, and strategies that will deliver improvements and hasten the closing of the gap in health outcomes.

The 2018-19 Budget is an opportunity to start properly funding and resourcing Indigenous Health.

AMA POSITION

The AMA calls on the Government to:

• prioritise Indigenous health funding in the 2018-19 Budget and fund Aboriginal and Torres Strait Islander health services according to need;

• support measures to increase the uptake of MBS and PBS items;

• fund and implement the National Aboriginal and Torres Strait Islander Health Plan;

• adopt the recommendations in the AMA’s Report Cards on Indigenous Health, in particular the recommendations in the 2016 Report Card calling for a target to eradicate new cases of Rheumatic Heart Disease (RHD); and the recommendations in the 2017 Report Card to address ear health (otitis media);

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

• commit to the principles of the Redfern Statement, which calls on all political parties to make Aboriginal and Torres Strait Islander affairs a key election priority;

• meaningfully address the disadvantage experienced by Aboriginal and Torres Strait Islander people by reversing cuts to the Indigenous Affairs portfolio;

• reinvest in health, justice, early childhood, and disability services, as well as services to prevent violence;

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

• recognise that chronic disease in Indigenous communities is inextricably connected to the social determinants of health such as: poverty; inappropriately designed, unhygienic, overcrowded housing conditions; inadequate access to affordable food and potable water supplies; and an absence of health services;

• acknowledge the wealth of existing reports, Parliamentary inquiries, strategies, and plans to improve Indigenous health and close the gap, and start to fund and implement them; and

• fund national training programs to support more Aboriginal and Torres Strait Islander people to become health professionals to address the shortfall of Indigenous people in the health workforce.