NACCHO Aboriginal Health #ClosingTheGap #NAIDOC2019 : @AIHW Key results report 2017-18 Aboriginal and Torres Strait Islander health organisations:

Findings from this report:

  • Just under half (45%) of organisations provide services in Remote or Very remote areas

  • In 2017–18, around 483,000 clients received 3.6 million episodes of care

  • Nearly 8,000 full-time equivalent staff are employed in these organisations and 4,695 (59%) are health staff

  • Organisations reported 445 vacant positions in June 2018 with health vacancies representing 366 (82%) of these
  • In 2017–18, nearly 200 organisations provided a range of primary health services to around 483,000 clients, 81% of whom were Indigenous.
  • Around 3.6 million episodes of care were provided, nearly 3.1 million of these (85%) by Aboriginal Community Controlled Health Services.

See AIHW detailed Interactive site locations map HERE

In 2017–18, Indigenous primary health services were delivered from 383 sites (Table 3). Most sites provided clinical services such as the diagnosis and treatment of chronic illnesses (88%), mental health and counselling services (88%), maternal and child health care (86%), and antenatal care (78%). Around two-thirds provided tobacco programs (69%) and substance-use and drug and alcohol programs (66%).

Most organisations provided access to a doctor (86%) and just over half (54%) delivered a wide range of services, including all of the following during usual opening hours: the diagnosis and treatment of illness and disease; antenatal care; maternal and child health care; social and emotional wellbeing/counselling services; substance use programs; and on‑site or off-site access to specialist, allied health and dental care services.

Most organisations (95%) also provided group activities as part of their health promotion and prevention work. For example, in 2017–18, these organisations provided around:

  • 8,400 physical activity/healthy weight sessions
  • 3,700 living skills sessions
  • 4,600 chronic disease client support sessions
  • 4,100 tobacco-use treatment and prevention sessions.

In addition to the services they provide, organisations were asked to report on service gaps and challenges they faced and could list up to 5 of each from predefined lists. In 2017–18, around two-thirds of organisations (68%) reported mental health/social and emotional health and wellbeing services as a gap faced by the community they served.

This was followed by youth services (54%). Over two-thirds of organisations (71%) reported the recruitment, training and support of Aboriginal and Torres Strait Islander staff as a challenge in delivering quality health services.

Read full report and all data HERE

This is the tenth national report on organisations funded by the Australian Government to provide health services to Aboriginal and Torres Strait Islander people.

Indigenous primary health services

Primary health services play a critical role in helping to improve health outcomes for Aboriginal and Torres Strait Islander people. Indigenous Australians may access mainstream or Indigenous primary health services funded by the Australian and state and territory governments.

Information on organisations funded by the Australian Government under its Indigenous Australians’ health programme (IAHP) is available through two data collections: the Online Services Report (OSR) and the national Key Performance Indicators (nKPIs). Most of the organisations funded under the IAHP contribute to both collections (Table 1).

The OSR collects information on the services organisations provide, client numbers, client contacts, episodes of care and staffing levels. Contextual information about each organisation is also collected. The nKPIs collect information on a set of process of care and health outcome indicators for Indigenous Australians.

There are 24 indicators that focus on maternal and child health, preventative health and chronic disease management. Information from the nKPI and OSR collections help monitor progress against the Council of Australian Governments (COAG) Closing the Gap targets, and supports the national health goals set out in the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023.

Detailed information on the policy context and background to these collections are available in previous national reports, including the Aboriginal and Torres Strait Islander health organisations: Online Services Report—key results 2016–17 and National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care: results for 2017.

At a glance

This tenth national OSR report presents information on organisations funded by the Australian Government to provide primary health services to Aboriginal and Torres Strait Islander people. It includes a profile of these organisations and information on the services they provide, client numbers, client contacts, episodes of care and staffing levels. Interactive data visualisations using OSR data for 5 reporting periods, from 2013–14 to 2017–18, are presented for the first time.

Key messages

  1. A wide range of primary health services are provided to Aboriginal and Torres Strait Islander people. In 2017–18:
  • 198 organisations provided primary health services to around 483,000 clients, most of whom were Aboriginal and Torres Strait Islander (81%).
  • These organisations provided around 3.6 million episodes of care, with nearly 3.1 million (85%) delivered by Aboriginal Community Controlled Health Services (ACCHSs).
  • More than two-thirds of organisations (71%) were ACCHSs. The rest included government-run organisations and other non-government-run organisations.
  • Nearly half of organisations (45%) provided services in Remoteand Very remote
  • Services were delivered from 383 sites across Australia. Most sites provided the diagnosis and treatment of chronic illnesses (88%), social and emotional wellbeing services (88%), maternal and child health care (86%), and antenatal care (78%). Around two-thirds provided tobacco programs (69%) and substance-use and drug and alcohol programs (66%).

See this AIHW detailed Interactive site locations map HERE

  1. Organisations made on average nearly 13 contacts per client

In 2017–18, organisations providing Indigenous primary health services made around 6.1 million client contacts, an average of nearly 13 contacts per client (Table 2). Over half of all client contacts (58%) were made by nurses and midwives (1.8 million contacts) and doctors (1.7 million contacts). Contacts by nurses and midwives represented half (49%) of all client contacts in Very remote areas compared with 29% overall.

  1. Organisations employed nearly 8,000 full-time equivalent (FTE) staff

At 30 June 2018, organisations providing Indigenous primary health services employed nearly 8,000 FTE staff and over half of these (54%) were Aboriginal or Torres Strait Islander. These organisations were assisted by around 270 visiting staff not paid for by the organisations themselves, making a total workforce of around 8,200 FTE staff.

Nurses and midwives were the most common type of health worker (14% of employed staff), followed by Aboriginal and Torres Strait Islander health workers and practitioners (13%) and doctors (7%). Nurses and midwives represented a higher proportion of employed staff in Very remote areas (22%).

  1. Social and emotional health and wellbeing services are the most commonly reported service gap

Organisations can report up to 5 service gaps faced by the community they serve from a predefined list of gaps. Since this question was introduced in 2012–13, the most commonly reported gap has been for mental health and social and emotional health and wellbeing services. In 2017–18, this was reported as a gap by 68% of organisations.


NACCHO Aboriginal Health and #ClosingTheGap @nhmrc and @UniCanberra Project : Commissioning stronger evaluations of Indigenous health and wellbeing programs

 ” Billions of dollars are spent annually on Indigenous programs, services and initiatives yet, despite the need, there is limited evidence on what programs are effective for improving Indigenous health outcomes.

The Productivity Commission has called for ‘more and better’ evaluations of Indigenous programs and commissioning processes that engage Indigenous communities, organisations and leaders.

The commissioning of evaluations plays a significant role in the way program evaluations are carried out. It is through the commissioning process that the budget is set, the evaluators are identified, the aims and objectives of the evaluation are set, and many other aspects of the evaluation are determined.” 

See University of Canberra website 

This National Health and Medical Research Council funded project (GNT1165913) responds to a call from Indigenous leaders for opportunities to influence decision-making processes within the health system and across sectors for the commissioning of health programs to reflect their needs, priorities and views on program design, delivery and evaluation.

This project aims to identify how government (federal, state/ territory) and non-government (not-for-profit, corporate, foundation, philanthropic) commissioning practices can better support Indigenous engagement and leadership in the evaluation of health and wellbeing programs in Australia.

To achieve this aim, this project will address the following objectives:

  1. To characterise the spectrum of commissioning practices of government and non-government organisations in contracting evaluations for health and wellbeing programs particularly the role of Indigenous engagement and leadership during, and resulting from, the commissioning process.
  2. To identify the issues, challenges and opportunities for Indigenous engagement and leadership across the spectrum of commissioning practices from the perspectives of: (a) commissioners/policy makers; (b) service providers; and (c) the Indigenous community.
  3. To translate the findings into resources to support Indigenous engagement and leadership in the commissioning of program evaluations.

The project will be supported by an advisory group, chaired by Professor Tom Calma AO.

The project is funded until October 2022.

Research team


For more information on the project, please contact Margaret Cargo at

NACCHO Aboriginal Health News : @pmc_gov_au Minister @KenWyattMP ( NIAA ) National Indigenous Agency Marks A New Era of Co-Design and Partnership to #ClosetheGap with Ray Griggs CEO

“Establishing this agency solely dedicated to the advancement of Australia’s First Nations is a significant opportunity for the Government to work with Aboriginal and Torres Strait Islander people on the ground to provide opportunities for growth and advancement, in education, employment, suicide prevention, community safety, health and constitutional recognition.

Over my life I have seen progress made but there is still more to do to find solutions and make a difference at the community level.

The NIAA will play a critical role in supporting me, as the first Indigenous Cabinet Minister and Minister for Indigenous Australians, to meet the changing needs of Aboriginal and Torres Strait Islander peoples, their leaders and communities

All of us must work together with State and Territory Governments to bring about change and close the gap in Indigenous communities.”

Minister Ken Wyatt

The National Indigenous Australians Agency (NIAA) was officially established today as an Executive Agency under the Prime Minister’s portfolio, marking a new era of co-design and partnership.

Minister for Indigenous Australians, the Hon Ken Wyatt AM, MP said the new agency represented a fundamental change in the way of doing business with Indigenous Australians by forming partnerships with Indigenous Australians at all levels, from children in remote communities to peak national organisations.

Minister Wyatt also announced that the inaugural Chief Executive Officer will be Mr Ray Griggs AO, CSC whose entire career has been in service to Australia and its peoples.

See NACCHO post for background

“NIAA is privileged to have such an experienced leader at the helm,” Minister Wyatt said.

“Ray Griggs will lead a dedicated team of some 1200 staff committed to making a significant contribution to an Australia that respects Aboriginal and Torres Strait Islander cultures and peoples.”

Chief Executive Officer Ray Griggs, said evolving the Indigenous Affairs Group of the Department of the Prime Minister and Cabinet into an Executive Agency in its own right was a natural progression.

“This change provides the opportunity to enhance the way we work across Government and ensure we have better coordination across the Commonwealth on matters that affect Indigenous Australians,” Mr Griggs said.

Minister Wyatt said he was looking forward to strong working partnerships with all levels of the team at NIAA to walk and work with Aboriginal and Torres Strait Islander peoples.

“Together we can build on our shared successes but also do many things differently, to deliver real change,” Minister Wyatt said.


NACCHO Aboriginal Health and #IndigenousEvaluationStrategy : The Australian Government has asked the @ozprodcom to develop a whole-of-government evaluation strategy for policies and programs affecting Indigenous Australians

 ” We are developing an evaluation strategy for Australian Government policies and programs affecting Aboriginal and Torres Strait Islander people.

 Better evidence about what works and why is needed to improve policies and programs.

The strategy will cover both Indigenous‑specific and mainstream policies and programs.”

 Romlie Mokak, Commissioner, Productivity Commission

Download the brochure HERE


Great ideas, engagement and interest in #IndigenousEvaluationStrategy workshop at #LowitjaConf2019 facilitated by Commissioner @RMokak and team members. Strong indicator of need for more attention on policy and program development and evaluation.

Evaluation can help policy-makers and communities determine:

  • whether government policies and programs are achieving their objectives
  • what influences whether government policies and programs are effective
  • how government policies and programs can be improved

We will engage widely across metropolitan, regional and remote locations.

We want to hear from individuals, communities and organisations.

  • How can Aboriginal and Torres Strait Islander knowledge, priorities and values be better integrated into policy and program evaluation?
  • What principles should guide Australian Government agencies’ evaluation efforts?
  • What should be the priority policy areas for future Australian Government evaluation efforts?
  • How can evaluation results be better used in policy and program design and implementation?

We are particularly keen to get input and advice from Aboriginal and Torres Strait Islander people, communities and organisations.

An issues paper will be released in June 2019.

Learn more about the project, or register your interest or call 1800 020 083

Indigenous Evaluation Strategy

Letter of Direction

Evaluation of policies and programs impacting on Indigenous Australians

I, Josh Frydenberg, Treasurer, pursuant to Parts 2 and 4 of the Productivity Commission Act 1998 hereby request the Productivity Commission to develop a whole-of-government evaluation strategy for policies and programs affecting Indigenous Australians. The Commission will also review the performance of agencies against the strategy over time, focusing on potential improvements and on lessons that may have broader application for all governments.


A number of high profile reports have highlighted the need for more evaluation of policies and programs that have an impact on Indigenous Australians. For example, the Commission’s Overcoming Indigenous Disadvantage Report 2016found that only a relatively small number of programs have been rigorously evaluated.

Improving outcomes for Indigenous Australians depends on agencies with responsibility for policies and programs affecting Indigenous Australians undertaking meaningful evaluations. The Commission is to develop a strategy to guide that evaluation effort.


The Commission should develop an evaluation strategy for policies and programs affecting Indigenous Australians, to be utilised by all Australian Government agencies. As part of the strategy, the Commission should:

  • establish a principles based framework for the evaluation of policies and programs affecting Indigenous Australians
  • identify priorities for evaluation
  • set out its approach for reviewing agencies’ conduct of evaluations against the strategy.

In developing the strategy, the Commission should consider:

  • how to engage Indigenous communities and incorporate Indigenous knowledge and perspectives
  • ethical approaches to evaluations
  • evaluation experience in Australia and overseas
  • relevant current or recent reviews commissioned or undertaken by Australian, state, territory or local government agencies
  • the availability and use of existing data, and the further development of other required data and information
  • areas in which there may be value in the Productivity Commission undertaking evaluation
  • how to translate evidence into practice and to embed evaluation in policy and program delivery.


The Commission should consult widely on the strategy, in particular with Indigenous people, communities and organisations (such as the Empowered Community regions), and with all levels of government. It should also consult with non-Indigenous organisations, and individuals responsible for administering and delivering relevant policies and programs.

The Commission should adopt a variety of consultation methods including seeking public submissions.

The Commission should provide the evaluation strategy and forward work program to Government within 15 months of commencement.

The Hon Josh Frydenberg MP

[10 April 2019]


Aboriginal Health and Indigenous Advancement Strategy : NACCHO CEO Pat Turner expresses her frustration that another ANAO report raises concerns about @pmc_gov_au management of #Indigenous Affairs.   

 ” It is very frustrating that we have another report from the Australian National Audit Office raising serious concerns about the Department of the Prime Minister and Cabinet’s management of Indigenous Affairs.  , 

In this case, it is the arrangements for the evaluation of the Indigenous Advancement Strategy which is a multi-billion dollar investment.  

The report tells us that five years after the introduction of the IAS, the Department is only in the early stages of implementing an evaluation framework and that there has been substantial delays.  

That is not good enough for the Department in charge of the Australian public service. ”  


Listen to ABC World Today Interview Here 

Download the full ANAO report HERE

Evaluating Aboriginal and Torres Strait Islander Programs

The prime minister’s department acknowledged the findings of the audit report but said the strategy was set up within a “very challenging timeframe”.

It was “moving into a more mature phase of implementation that draws on lessons learned”.

The report made four recommendations, which the department agreed to and was already working to meet.

It intended to revise the strategy’s guidelines, and improve the application process and its own record keeping.

The Indigenous Australians minister, Ken Wyatt, said he “acknowledges the frustration we all share that we are not seeing quick enough progress on closing the gap between Indigenous and non-Indigenous Australians”.

“This is why Coag has agreed governments – both commonwealth and states and territories – and Aboriginal and Torres Strait Islander people will share ownership of and responsibility for a jointly agreed framework and targets and ongoing monitoring of the Closing the Gap agenda,” he said.

Labor, the Greens and peak Indigenous groups say the government must overhaul its Indigenous advancement strategy after a report found that the $5.1bn program was not being properly evaluated and did not align with the government’s policy objectives.

From The Guardian 19 June

Read full article 

After five years and $4.8 billion dollars, a new Auditor General’s report has revealed the Liberals and Nationals still can’t say whether their Indigenous Advancement Strategy is working.

Serious questions about the administration of the IAS have been swirling for years. Funding decisions have been notoriously opaque and the effectiveness of many programs is unclear.

This new report confirms the IAS has been operating for years without proper evaluation processes. Despite the former Minister being warned by his Department in 2016:

“At some point the current situation will become untenable as it is not sustainable to continue to fund activities that lack a good evidence base.”

[ANAO Report, p21, 2019]

Labor Response to ANAO report

Download Press Release Here

IAS Labor Response


The Department of the Prime Minister and Cabinet (PM&C or the department) has been the lead agency for Aboriginal and Torres Strait Islander Affairs since 2013.

With the introduction of the Indigenous Advancement Strategy (IAS) in 2014, 27 programs were consolidated into five broad programs under a single outcome, with $4.8 billion initially committed over four years from 2014–15.

The Australian National Audit Office’s (ANAO’s) performance audit of the IAS (Auditor-General Report No.35 2016–17) noted that the department did not have a formal evaluation strategy or evaluation funding for the IAS for its first two years.

In February 2017 the Minister for Indigenous Affairs announced funding of $40 million over four years from 2017–18 to strengthen IAS evaluation, which would be underpinned by a formal evidence and evaluation framework.

In February 2018 the department released an IAS evaluation framework document, describing high level principles for how evaluations of IAS programs should be conducted, and outlining future capacity-building activities and broad governance arrangements.

Part 1 Pat Turner comments continued

It follows a string of bad audits starting with the audit of the IAS which found that the Department had not consulted properly in designing the IAS and rolling out a disastrous application process that led to many community controlled organisations losing their funding without reason.

Now the Government has decided to set  up a new executive agency, inside the Prime Minister’s portfolio but outside the Department of the Prime Minister and Cabinet to manage Indigenous Affairs.

It is good that a separate agency  for Indigenous Affairs is being re-established as it is one of the most important functions of the Commonwealth.

Aboriginal people and Torres Strait Islanders never asked or supported Indigenous Affairs being moved into the department of the Prime Minister and it is clear it has not done a good job on the IAS.

Whether setting up a new agency gets better outcomes remains to be seen.

Many say that the very disruptive shift of Indigenous Affairs into the Department of the Prime Minister and Cabinet has resulted in Indigenous Affairs being hollowed out and a loss of nearly all the capacity that it had before.

In the meantime, we are pleased that the Prime Minister has agreed to a new COAG  Partnership Agreement on Closing the Gap which includes agreement to an Indigenous led evaluation  of Closing the Gap progress after 3 years.

We think that bringing the representatives of Aboriginal and Torres Strait Islander peoples into the equation, and allowing them to share decision making about Government policy, programs and evaluation will improve outcomes.

It will allow us to hold agencies much more to account for what they are doing and not doing.

But we also have to commit to building up the community controlled organisations of Aboriginal and Torres Strait peoples to manage programs and deliver services to our people.

That is key to closing the gap and there are some signs that this is understood by the Coalition Government which committed in its election policy to increasing the Aborginal service sector.

That must go to giving them the responsibility for delivering programs and funding instead of public servants.

This audit shows that it is time for a radical shift away from governments and public servants to Aboriginal led delivery through their own community controlled organisations.

They will take responsibility for outcomes in a way that the public servants do not.


NACCHO Aboriginal Health and #LowitjaConf2019 Speech  : Donnella Mills Acting Chair NACCHO and John Paterson CEO AMSANT presents the Coalition of ACCO Peaks on #ClosingtheGap


We have started the task of determining an Aboriginal and Torres Strait Islander position on Closing the Gap. We know that Closing the Gap needs to be more than a set of targets. What we need is a radical shift to the way governments work with Aboriginal and Torres Strait Islander peoples at all levels of policy design and implementation. We also want to place Aboriginal Community Controlled Services at the heart of delivering programs and services to our people.”

Donnella Mills, the Acting Chair of the National Aboriginal Community Controlled Health Organisation or NACCHO, and John Paterson, the Chief Executive Officer of the Aboriginal Medical Services Alliance Northern Territory, an affiliate member of NACCHO, and convener of the Aboriginal Peak Organisations Northern Territory.

I wish to acknowledge the traditional custodians of the land we are meeting on. I wish to acknowledge and respect their continuing culture and the contribution they make to the life of this city and this region.

I would also like to acknowledge and welcome other Aboriginal and Torres Strait Islander people who may be attending today’s session and acknowledge their lands and culture.

We thank the Lowitja Institute for bringing us together again to think, speak and be First Nations solutions for global change, and for giving us the opportunity to speak with you today about the work of Aboriginal and Torres Strait Islander peak organisations across Australia on Closing the Gap.

Aboriginal and Torres Strait Islander peoples have historically been excluded from decision-making on the policies and programs that directly affect them and the communities in which they live. This is despite evidence which demonstrates that the only way to improve our people’s health and wellbeing is with their full participation in the design and delivery of services that impact on us. And despite our collective repeated calls over many years for full participation in decisions that impact on our lives.

Today we want to share with you how a group of Aboriginal community controlled organisations have exercised political agency by leading the way, challenging the possibilities and imagining a future of shared decision-making with governments on policies and programs that impact on our people and our communities.

You may remember that in 2007, the Council of Australian Governments (COAG), comprising leaders of federal, state and territory, and local governments, committed to ‘closing the gap’ in life expectancy between Aboriginal and Torres Strait Islander and other Australians. They also committed to a range of targets to end the disparity between Aboriginal and Torres Strait Islander peoples and other Australians in areas like infant mortality, employment and education.

This was the first time that Australian Governments had come together in a unified way to address the disadvantage experienced by too many Aboriginal and Torres Strait Islander peoples. The Commonwealth Government at the time also made an unprecedented investment in programs and services to ‘close the gap’.

Despite this unprecedented coming together of Australian Governments and investment, Aboriginal people were not formally involved in Closing the Gap, it was not agreed by us and it was a policy of governments and not for our people.

Many Aboriginal and Torres Strait Islander people felt that Closing the Gap presented the issue of our disadvantage as a technical problem built around non-Indigenous markers of poverty. This only served to hide the extent to which Aboriginal and Torres Strait Islander peoples’ disadvantage is a political problem requiring deep structural reforms.

Closing the Gap did not address the biggest gap that we face: the gulf between the political autonomy and economic resources of Aboriginal and Torres Strait Islander peoples and non-Indigenous people.

The policies and programs that then followed whilst making some difference to our peoples lives did not achieve their potential. Now ten years later we have not made the progress against the closing the gap targets that had been hoped.

In 2017 the Commonwealth Government embarked on a ‘refresh’ of the Closing the Gap framework and undertook a series of consultations. The consultations were inadequate and superficial. There was no independent report prepared on their outcomes. The lack of transparency and accountability surrounding these consultations were very disappointing, but not surprising.

As the ‘refreshed’ Closing the Gap strategy was being prepared for sign off by the Australian Governments, our dismay and disappointment galvanised a small group of community controlled organisations to come together to write to the Prime Minister, Premiers and Chief Ministers asking that it not be agreed.

We weren’t going away, and there were three important messages that we wanted governments to hear. These were:

  1. When Aboriginal and Torres Strait Islander peoples are included and have a real say in the design and delivery of services that impact on them, the outcomes are far better;
  2. Aboriginal and Torres Strait Islander peoples need to be at the centre of Closing the Gap policy: the gap won’t close without our full involvement; and
  3. the Council of Australian Governments cannot expect us to take responsibility and work constructively with them to improve outcomes if we are excluded from the decision making.

By staying strong and consistent in our messaging, our voices could not be ignored. In late October 2018, we were invited to meet with the Prime Minister, who acknowledged that the current targets were ‘government targets’ not ‘shared targets’, and that for Closing the Gap to be realised Aboriginal and Torres Strait Islander people had to be able to take formal responsibility for the outcomes through shared decision making.

On 12 December 2018, Australian Governments publicly committed to developing a genuine, formal partnership between the Commonwealth, state and territory governments and Indigenous Australians through their representatives on Closing the Gap and that through this partnership a new Closing the Gap policy would be agreed.

The initial fourteen organisations then became almost forty, as we brought together Aboriginal and Torres Strait Islander Peaks bodies across the country to form a formal Coalition to negotiate a new Closing the Gap framework with Australian Governments. We include both national and state and territory based Aboriginal and Torres Strait Islander Peaks representing a diverse range of services and matter that are important to us as Aboriginal and Torres Strait Islander peoples and to Closing the Gap.

As a first step and through our initiative, we negotiated and agreed a formal Partnership Agreement between the Council of Australian Governments and the Coalition of Aboriginal and Torres Strait Islander peak organisations which came into effect in March 2019.

The Partnership Agreement sets out that the Coalition of Peaks will have shared decision making on developing, implementing and monitoring and reviewing Closing the Gap for the next ten years. This is an historic achievement.

It is the first time that Aboriginal and Torres Strait Islander Peaks have come together in this way, to work collectively and as full partners with Australian Governments. Its is also the first time that there has been formal decision making with Aboriginal and Torres Strait Islander peoples and Australian Governments in this way.

A key commitment of the Partnership is the creation of the new Joint Council on Closing the Gap. The inaugural meeting of COAG’s Joint Council on Closing the Gap took place on 27 March. Noting that it is the first Council established by COAG that has representatives from outside government, it marked a historic step forward in the working relationship between Aboriginal and Torres Strait Islander peoples and governments.

It is not an easy path that we are on and there are many challenges.

The Coalition of Peaks are strengthening their own governance and it is not always easy coming together by teleconferences to work through our positions as we navigate our distances and the pace in which we need to work to stay in front of Australian Governments with their many resources.

We are committed to being transparent and accountable to each other through consensus-based decision-making. This has helped us build trust in each other, in our agreed processes of negotiation and representation, and has made us a strong and effective force to be reckoned with.

Australian Governments are also slow to change, and despite agreeing to the formal partnership with us, we are yet to see them fully embrace what it means to have us at the table and respond to our propositions.

We have started the task of determining an Aboriginal and Torres Strait Islander position on Closing the Gap. We know that Closing the Gap needs to be more than a set of targets. What we need is a radical shift to the way governments work with Aboriginal and Torres Strait Islander peoples at all levels of policy design and implementation. We also want to place Aboriginal Community Controlled Services at the heart of delivering programs and services to our people.

The Coalition of Peaks have also agreed with Australian Governments that they will lead consultations with Aboriginal and Torres Strait Islander organisations and communities across Australia on a new Closing the Gap framework later this year. This will be the first time that Aboriginal and Torres Strait Islander peak bodies will lead consultations with our own peoples on government policy.

Whilst the road is challenging, by presenting governments with alternative model for engaging with us, an historic new model of power sharing has been forged.

In conclusion, I’d like to share with you some of the key learnings of partnering for success and keeping governments accountable to community health priorities.

Throughout our negotiations with government, we learned the importance of staying strong and presenting a unified voice. Our membership may be large and reflective of very diverse organisations. But this diversity is also a strength, as long as we are willing to stay true to our common.


NACCHO Aboriginal Health #NRW2019 Our CEO Pat Turner Interview : Could @KenWyattMP historic Ministerial appointment be truly transformational for our mob #ClosingTheGap #Refresh and the #Voice

“Closing the Gap and the Voice are the two big issues, they’re separate but complimentary, and they can run in parallel. We want both. We want a real say over our lives. We have to be at the negotiating table.”

The Aboriginal heath sector is the biggest employer of Aboriginal people in Australia.

By investing in Aboriginal community controlled health organisations, they are investing in communities but they’re also employing Aboriginal people in real jobs.

They need to remove the punitive welfare measures immediately. they make absolutely no sense. It’s accountability gone mad. We’ve offered him a briefing, we’re looking forward to a positive working partnership, and for the ministry to be properly funded.”

It was well past time to get moving on the voice to parliament.

We are more than ready to finalise the model with our own people, and get out in the broader Australian community and have the conversations with them about why it’s important.

The PM said he wouldn’t be rushed on the matter of the voice, but the PM has to take a leadership role. When has he got the best chance of getting things done? In the first term. There’s no reason why we have to wait.”

CEO the National Coalition of Aboriginal Community Controlled Health Organisations (NACCHO), Pat Turner said Wyatt had a big job ahead, facing “massive expectations” on all sides. Pat also co-chairs the joint council on Closing the Gap, a 10 year agreement between Australian governments and Aboriginal organisations to work together on solutions

Watch ABC TV News interview with Pat Turner

” When I saw Ken’s tweet about his appointment on Sunday, my heart grew big with pride. It was a welcome joy on a day that is always hard and sad – Sorry Day – the day we remember the pain and heartache of the stolen generations and all the histories and reverberations through families that came from this terrible period of pain, inflicted on First Australians by the government.

There is deep significance in Ken’s appointment being announced on Sorry Day, given his own family was directly affected by the then government’s actions.

Ken brings a depth of experience in Aboriginal education, health and policy, but of course the one thing he has that none of the previous office holders have ever had is that he is Indigenous. “

Dr Jessa Rogers is a Wiradjuri academic, consultant and board director based in Adelaide : see full article Part 2 Below

Part 1 from The Guardian 

Praise, hope and high expectation have followed the appointment of Noongar man Ken Wyatt as minister for Indigenous Australians in the new Morrison government.

Wyatt is the first Aboriginal person to hold the federal ministry, and the first Aboriginal person to sit in cabinet.

In a statement Wyatt said he was “incredibly honoured to be the first Aboriginal minister for Indigenous Australians, committed to working and walking together with our elders, families and communities, to ensure the greatness of our many nations is reflected in the greatness of the Australian nation, now and forever”.

The appointment, made on national Sorry Day and at the start of Reconciliation Week, has been welcomed by Aboriginal organisations and advocates, hopeful of progress on constitutional reform, a voice to parliamentClosing the Gap targets and long-standing welfare, health and justice issues.

Wyatt arrived in Canberra on Monday from his home state of Western Australia amid speculation about how he might consult Indigenous organisations and communities.

Scott Morrison said a new “national Indigenous Australians agency” would be established, but details are yet to be announced.

Nor would the prime minister give a timeframe for a referendum on constitutional reform and a voice to parliament.

The federal government has set aside $7.3m for co-design, and while Morrison said the work would start immediately, he would not set a deadline for a result.

“I’m committed to getting an outcome on recognition, but we need to work together across the aisle and across our communities to get an outcome that all Australians can get behind and we’ll take as long as is needed to achieve that,” Morrison said.

“My priorities for Indigenous Australians are to ensure Indigenous kids are in school and getting an education, that young Indigenous Australians are not taking their own lives and that there are real jobs for Indigenous Australians so they can plan for their future with confidence like any other Australian.

“Recognition must be achieved alongside these practical goals and we will continue to work together.”

Newly minted Labor leader Anthony Albanese said the ALP was ready to advance the agenda of the Uluru statement in a bipartisan manner.

“Our nation is diminished by not recognising first Australians in our constitution. And while Indigenous Australians are the most disadvantaged in our nation, Labor stands ready to cooperate on how we advance the agenda of the Uluru statement,” Albanese said.

The Greens also said a voice should happen without delay. Senator Rachel Siewert said Wyatt’s appointment was a “positive step towards self-determination”.

The social justice commissioner and fellow Western Australian, June Oscar, said Wyatt’s appointment was “truly historic”.

“Ken Wyatt carries the hopes and aspirations of Aboriginal and Torres Strait Islander people across the country, and we look forward to working together,” Oscar said.

The co-chair of the National Congress of Australia’s First Peoples, Rod Little, said Wyatt’s appointment “heightens our hope that things will be different”.

“We have hope every time there’s an election. We hope there are people who can work with us, who we can trust, who know how our communities are feeling, and we need somebody who is trustworthy and honest who is going to take on the challenges to make our lives better.”

Chief executive of the National Coalition of Aboriginal Community Controlled Health Organisations (Naccho), Pat Turner said Wyatt had a big job ahead, facing “massive expectations” on all sides.

The first Indigenous member of the House of Representatives Ken Wyatt delivers his maiden speech to the House of Representatives in Canberra, 29 September 2010

Part 2 Ken Wyatt’s historic appointment could be truly transformational for Indigenous Australians : from Jessa Rogers

Also from The Guardian 

For the first time the final approval on policies and funding which affect our lives will be made by an Indigenous person

Ken Wyatt was announced the minister of Indigenous affairs on Sunday, which was also Sorry Day. Wyatt’s own family was part of the stolen generations. Photograph: Mick Tsikas/AAP

Scott Morrison has made an historic appointment early in his new term as prime minister that has the potential to radically alter the way Indigenous policy is made in Canberra.

One hundred and eighteen years after the commonwealth of Australia was formed we finally have our first ever minister of Indigenous affairs (now appropriately called minister for Indigenous Australians) who is actually Indigenous. Ken Wyatt, who in 2010 was the first Aboriginal man to be elected to the House of Representatives, has made history again. And while I do not know him well, I know he is a decent man with a heart for the people.

Some may argue that this appointment is merely symbolic given any major policy direction is likely to require the approval of the cabinet, but the minister for Indigenous Australians will have significant influence over major government programs and resources.

Ken brings a depth of experience in Aboriginal education, health and policy, but of course the one thing he has that none of the previous office holders have ever had is that he is Indigenous. And we now no longer have a non-Indigenous person with no experience in our world, making and influencing important decisions on our behalf.

This is the first time senior officials in the Department of Prime Minister and Cabinet (where Indigenous Affairs is currently based) will have to answer to an Indigenous person. This will be the first time the final approval on policies and hundreds of millions of dollars will be made by an Indigenous person.

Having spent over a decade working in schools and universities where the people who hold the power to make the key decisions that affect Aboriginal and Torres Strait Islander students and staff are almost always non-Indigenous, I am encouraged to think that this decision by Scott Morrison is more than just symbolic. It has the potential to be truly transformational.

The first Indigenous member of the House of Representatives, Ken Wyatt, delivers his maiden speech on 29 September 2010. On Sunday Wyatt was appointed the first ever minister of Indigenous affairs.

For many years now, I have had an image board of inspirational people, moments and quotes in my office. Ken Wyatt has been on that board, his image taken in September 2010, when he took his seat as member for Hasluck wearing a kangaroo skin.

That image made me proud then, as I know it did for many people. That symbol of leadership, presented by Elders, showed so much of what it means to be an Aboriginal person who also represents a wide and diverse group of Australians in his home electorate.

The picture I had of Ken delivering his first speech always reminded me of the important points he made that day, in particular his recollection of the apology. It brought tears to my eyes, and something burned inside me when he said that the standing orders at that point prevented an Indigenous response.

So during that speech, cloaked in kangaroo skin, Ken said: “On behalf of my mother, her siblings and all Indigenous Australians, I, as an Aboriginal voice in this chamber, say thank you for the apology delivered in the federal parliament.” That voice in the chamber was so important, just as his voice as minister for Indigenous Australians will be now.

‘I feel like Labor was the only hope for our mob’: Indigenous people cannot feel defeated

I have raised my children to believe that we as Aboriginal people cannot let negative opinions, low expectations or stereotypes hold us back from achieving our goals. We have the power to shape our futures, even though we still have a long road ahead of us

As Ken has said, the decisions we make determine our destiny, and the choices we make shape our future. We need to work hard towards a world where Indigenous people can determine our own destinies, but also take time to celebrate the wins, when we have them.

So, today I am celebrating Ken’s appointment as a step in the right direction for the newly elected government, and for us as Indigenous peoples in Australia.

I am hoping this appointment will bring about more than just symbolic change, because we need more than that to improve our lives as Indigenous Australians.

NACCHO Aboriginal Health @NACCHOChair Press Release and Media wrap #SorryDay #BridgeWalk @TheLongWalkOz @DeadlyChoices #Racism and @RecAustralia #ReconciliationWeek #NRW2019 a time to encourage national conversation on truth-telling and cultural understanding

 In this special NACCHO Sorry Day and National Reconciliation Edition

1.NACCHO Chair Press Release

2.National Sorry Day : School resources

3.Sorry Day Bridge Walk Canberra

4.National Reconciliation Week : Download the Guide

5. NRL and AFL  Indigenous Round will see moving ceremonies and grand sentiments — and then what?

6. The Long Walk : Racism #DreamtimeatheG

“National Sorry Day and Reconciliation week remind us that Australia’s colonial past has resulted in different outcomes for different people. Our shared story of Australia needs to be grounded in truth so that we can cultivate positive race relations and work to make our country stronger, together

As a nation we must continue to speak about our history as a way to understand and heal deep wounds suffered as a result of our colonial past which laid the groundwork for decades of harmful policies directed at Aboriginal and Torres Strait Islander peoples.

We must continue to work together as a community, and indeed, as a country, to support the health and well-being of those from the Stolen Generations who are still recovering from loss of family, loss of culture and loss of life.

Truth-telling is a difficult yet courageous act. The journey of reconciliation takes time but every step forward creates a more solid foundation for our country to walk together, hand in hand, towards a hopeful future.

Acting Chair of NACCHO, Ms Donnella Mills.

The National Aboriginal Community Controlled Health Organisation (NACCHO) encourages all Australians to take time to engage in conversations about our shared histories, cultures and achievements and reflect on the ways we can support reconciliation in Australia

Download Read in full NACCHO Chair Press Release

2.National Sorry Day : School resources

Sorry Day (26 May) is a time to remember the past policies of forced child removal, and reflect on the sad and painful stories of the Stolen Generations.

It is a time to recognise the resilience of Aboriginal and Torres Strait Islander peoples and the power of saying Sorry.

Did you know?

  •  The first Sorry Day was held on 26 May 1998—exactly one year after the Bringing Them Home Report was presented to the Parliament.
  •  The Bringing Them Home Report was the result of an inquiry into the removal of Aboriginal and Torres Strait Islander children from their families, and recommends both an apology to Aboriginal and Torres Strait Islander people and reparations.
  •  The term “Stolen Generations” refers to Aboriginal and Torres Strait Islander Australians who were forcibly removed as children from their families by government, welfare, or church authorities, and placed into institutional care or with non-Indigenous foster families.
  •  The forced removal of Aboriginal and Torres Strait Islander children began as early as the mid-1800s and continued until the 1970s.

The Healing Foundation’s Stolen Generations Resource Kit for Teachers and Students has been created to educate young people about the Stolen Generations.

It makes it easy for school communities to start the conversation and inform classroom discussions using facts, real examples and stories.

Cultural consultation and guidance from Stolen Generations members has been an essential part of this project. The Healing Foundation has also worked closely with Aboriginal and Torres Strait Islander and non-Indigenous teachers, parents, early childhood specialists and curriculum writers.

This teaching resource has been developed to introduce students from Foundation to Year 9 to the firsthand experiences of Stolen Generations members. While the policies and suffering of the Stolen Generations is only one part of the ongoing story of Aboriginal and Torres Strait Islander people, it is an essential one to learn and to teach so students have a full understanding of the history of Australia.

Cultural consultation and guidance from Stolen Generations members has been an essential part of creating this project.

We would like to acknowledge the Healing Foundation’s Stolen Generations Reference Group members who guided the development of this project.


3.Sorry Day Bridge Walk Canberra

Our NACCHO , Winnunga ACCHO and Reconciliation Australia staff joined thousand of marchers on 24 May : The walk each year is organised by Julie Tongs CEO Winnunga

4.National Reconciliation Week : Download the Guide

Our purpose is to inspire and enable all Australians to contribute to the reconciliation of the nation.

Our vision is for a just, equitable and reconciled Australia.

Reconciliation Australia was established in 2001 and is the lead body for reconciliation in the nation. We are an independent not-for-profit organisation that promotes and facilitates reconciliation by building relationships, respect and trust between the wider Australian community and Aboriginal and Torres Strait Islander peoples.

Our vision of national reconciliation is based on five critical dimensions: race relations, equality and equity, institutional integrity, unity and historical acceptance. These five dimensions do not exist in isolation; they are inter-related and Australia can only achieve full reconciliation if we progress in all five Case Studies

 Download the 22 Page Reconciliation 2019 Guide


5. AFL, NRL Indigenous Round will see moving ceremonies and grand sentiments — and then what?

Over the weekend, both the AFL and NRL celebrated the vast contribution of Indigenous players who provide welcome visibility and wonderful role models for a people too easily overlooked and forgotten.

First published Here on ABC News

There was colourful jerseys,

moving ceremonies, the soothing drone of the didgeridoo and grand sentiments about how much the first Australians have given to the game.

The sights and sounds of 40,000 years of Indigenous culture was symbolised at football grounds across the country before vast audiences and then… what?

The answer lies in whether the AFL and NRL see Indigenous Round as an opportunity to go beyond the comfortable symbolism of inclusion and use the occasion to express support for more direct action and even controversial causes on behalf of their players.

Or whether they are merely appropriating Indigenous culture for yet another orgy of feel-good celebration that does more to advance the corporate interests of Australia’s most predominant football codes than those it purports to honour.

There are many who will argue that it is possible for Indigenous Rounds to be both a powerful celebration of Indigenous culture and politics-free; that unity rather than confrontation will help “bring more Australians along for the ride” on contentious issues such as granting treaty and a voice to Parliament.

The investment of the Indigenous players who design guernseys and choreograph celebrations demonstrate they have now appropriated their own round and are using it to drive their personal messages.

But having created such a powerful platform around Indigenous culture, surely we are also entitled to ask the AFL and NRL where they stand on the really big issues confronting Indigenous Australians.

Same-sex marriage is just one recent example of an issue on which both the AFL and NRL took sides on behalf of their playing groups.

Although, as the non-binding postal ballot proved, they were surfing a wave of public support, not entering the more turbulent political waters of Indigenous affairs.

For the AFL, this Indigenous Round has proven particularly problematic because of the imminent release of The Final Quarter — a reportedly confronting documentary about the treatment of Adam Goodes in the bitter finals seasons, marred by racist jeering.

Typically, AFL officials have been heavily briefed and are “on message” about the documentary. Mea culpas have been issued and we’ve-learned-from-this statements released even before next week’s media preview.

Indeed such are the depths of the AFL’s official contrition you could be forgiven for thinking the league executives, Collingwood president Eddie McGuire and other heavyweights, are delighted to have been cast in the most unflattering terms because it will help “show how much we’ve grown as a competition”.

Of course, the AFL’s craven failure to acknowledge and respond to the racist element of Goodes’s awful treatment, for fear of offending the sensibilities of the vilest element of its support base, is not absolved by the current frenzy of self-flagellation.

It merely presents a challenge: Do much better next time when confronted with similar circumstances or be condemned as opportunistic cause merchants who use the Indigenous brand to satisfy the clauses in government contracts and project good corporate citizenship.

The NRL’s more tactile message

As it is, even as the lights go out and 80,000 fans celebrate the “Dreamtime at the G”, there will be an uncomfortable sense that Indigenous Round merely highlights how out of touch the AFL remains with the real, dirt-under-the-fingernails problems confronting Indigenous Australians.

You might even argue that the symbolism of Indigenous Round is being used to absolve the league from confronting the hardcore issues in the communities from which many of its Indigenous players emerge.

The AFL’s relatively strong response to the racial vilification of Nicky Winmar and Michael Long is rightly celebrated on Indigenous Round, along with their bravery.

Yet it is only six years since then Adelaide Crows recruiting chief Matthew Rendell lost his job for clumsily stating clubs would not recruit an Indigenous player unless he had one white parent — a statement rightly condemned, but which also revealed the massive disconnection between clubs intoxicated by what they once called “Aboriginal magic” and the everyday realities of the players they seek to recruit.

If the AFL sells an ethereal message around Indigenous Round, there is something more tactile about the NRL version.

That stems from the more organic connection between the regions and the clubs from which Indigenous players have come, compared with the AFL where there remains a sense Indigenous stars are “imported” from another planet.

As a consequence, the NRL has seemed better placed to use the Indigenous message to create practical solutions, such as the initiative whereby Indigenous youths were given jerseys if they met certain health conditions. Note Deadly Choices 715 Health Checks

Great to have Indigenous players and legend stop in at our activation as we launch our partnership with Winnunga Nimmityjah AH&CS – at GIO Stadium

This direct connection with community is exemplified by Sydney Roosters star Latrell Mitchell’s words in The Daily Telegraph about what he hopes to achieve in his Indigenous jersey this weekend.

“Because with Indigenous Australians there’s this stereotype that says we’re lazy, on the dole, get given houses,” Mitchell said.

“Well, I want kids to know I’ve never been on the dole in my life. Want them to know I finished school and just went out and got myself a house. It wasn’t given to me for free. I bought it.”

6. The Long Walk


Stand against racism 

VAHS ACCHO Thanks  to Essendon Football Club and The Long Walk for allowing our Deadly Choices Students to do a guard of honour at Dreamtime At The G.

All students enjoyed themselves. Also thanks to our schools for selecting the students on our behalf. #vahsdc


NACCHO Aboriginal Women’s Health and How to #quitsmoking during #pregnancy with @sistaquit Plus #WorldNoTobaccoDay2019 May31 #WNTD2019 #WNTD

” Every year, on 31 May, the World Health Organization (WHO) and global partners celebrate World No Tobacco Day (WNTD). The annual campaign is an opportunity to raise awareness on the harmful and deadly effects of tobacco use and second-hand smoke exposure, and to discourage the use of tobacco in any form.

The focus of World No Tobacco Day 2019 is on “tobacco and lung health.” The campaign will increase awareness on:

  • the negative impact that tobacco has on people’s lung health, from cancer to chronic respiratory disease,
  • the fundamental role lungs play for the health and well-being of all people.

The campaign also serves as a call to action, advocating for effective policies to reduce tobacco consumption and engaging stakeholders across multiple sectors in the fight for tobacco control. ”

See full detail of World No Tobacco Day Part 2 Below

” In 2014 it was reported 45 per cent of surveyed Indigenous mothers smoked during pregnancy, compared to 13 per cent of non-Indigenous pregnant women.

Those figures have spurred University of Newcastle associate professor Gillian Gould to study what can be done to help reduce rates of Indigenous women smoking while pregnant.

It’s not only that they may be born with low birth rate, or have risks of premature birth, but it can set them up for things like obesity, diabetes, a higher risk of heart disease, and lots of respiratory illnesses.”

Smoking rates among pregnant Indigenous women tackled in major research project 

“ It’s imperative that Indigenous women have good access to smoking cessation services as 43 per cent of Indigenous women smoke. Essentially, we’re trying to ensure that Indigenous people have the same health outcomes as non-Indigenous people and we need to start before they’re born. 

Nothing like this is currently available and there are many systematic barriers that prevent women from accessing medical or antenatal care, which is a problem as it means women may present later than usual during their pregnancy,” Associate Professor Gould said.

We want to start the conversation about smoking as early as possible and found that many general practitioners and obstetricians lack the confidence or skills to provide this specialised type of knowledge.

Some women also receive mixed messages about the safety of quitting smoking or using nicotine replacement therapy during their pregnancy, so this initiative will bring health providers up to speed with the latest evidence-based treatment methods.”

Associate Professor Gould see full Press Release Part 1

Read over 130  + NACCHO Aboriginal health and Smoking articles HERE

Part 1

Health professionals and organisations will receive additional training and resources to help support Indigenous women quit smoking during pregnancy under a new multi-million dollar initiative being funded by the Australian Government Department of Health.

Led by renowned smoking cessation expert, Associate Professor Gillian Gould, the initiative will enable health practitioners who treat a pregnant woman in any medical capacity to complete an online training module and access a range of tailored treatment materials.

With smoking in pregnancy having a major impact on the lifelong health of mother and child, including birth complications and low birth weight, Associate Professor Gould said quitting smoking early in pregnancy would help to close the gap on Indigenous health.

As a general practitioner and researcher with the University of Newcastle and Hunter Medical Research Institute (HMRI)*, Associate Professor Gould said the iSISTAQUIT (Supporting Indigenous Smokers to Assist Quitting) initiative would help to provide a culturally sensitive and consistent approach to delivering better care across the country.

Building on lessons and findings from a separate pilot program, also led by Associate Professor Gould, iSISTAQUIT will feature online training via webinars that are self-paced, along with hard copy material such as a treatment manual and patient booklet.

“Many of the resources were developed during the pilot program and trialled across six states, so we’ve adapted them slightly and made them suitable for online delivery,” Associate Professor Gould said.

“Our pilot study revealed that 41 per cent of participants made quit attempts and the resources resulted in a quit rate of 14 per cent and increased engagement between Indigenous women and services.

“Ideally we want these resources to be available to all health practitioners and will look to disseminate them through our existing networks across Aboriginal services, professional colleges and bodies, primary health networks, obstetricians, hospital departments and other medical services throughout Australia when they become available.”

On April 4, 2019 the Department of Health awarded $3,891,801 to the initiative, from the Tackling Indigenous Smoking program. The national development of iSISTAQUIT will commence in the next few months from a newly-established centre in Coffs Harbour.

HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.

 Part 2 How tobacco endangers the lung health of people worldwide

World No Tobacco Day 2019 will focus on the multiple ways that exposure to tobacco affects the health of people’s lungs worldwide.

These include:

Lung cancer. Tobacco smoking is the primary cause for lung cancer, responsible for over two thirds of lung cancer deaths globally. Second-hand smoke exposure at home or in the work place also increases risk of lung cancer. Quitting smoking can reduce the risk of lung cancer: after 10 years of quitting smoking, risk of lung cancer falls to about half that of a smoker.

Chronic respiratory disease. Tobacco smoking is the leading cause of chronic obstructive pulmonary disease (COPD), a condition where the build-up of pus-filled mucus in the lungs results in a painful cough and agonising breathing difficulties. The risk of developing COPD is particularly high among individuals who start smoking at a young age, as tobacco smoke significantly slows lung development. Tobacco also  exacerbates asthma, which restricts activity and contributes to disability. Early smoking cessation is the most effective treatment for slowing the progression of COPD and improving asthma symptoms.

Across the life-course. Infants exposed in-utero to tobacco smoke toxins, through maternal smoking or maternal exposure to second-hand smoke, frequently experience reduced lung growth and function. Young children exposed to second-hand smoke are at risk of the onset and exacerbation of asthma, pneumonia and bronchitis, and frequent lower respiratory infections.

Globally, an estimated 165 000 children die before the age of 5 of lower respiratory infections caused by second-hand smoke. Those who live on into adulthood continue to suffer the health consequences of second-hand smoke exposure, as frequent lower respiratory infections in early childhood significantly increase risk of developing COPD in adulthood.

Tuberculosis. Tuberculosis (TB) damages the lungs and reduces lung function, which is further exacerbated by tobacco smoking. About one quarter of the world’s population has latent TB, placing them at risk of developing the active disease. People who smoke are twice as likely to fall ill with TB. Active TB, compounded by the damaging lung health effects of tobacco smoking, substantially increases risk of disability and death from respiratory failure.

Air pollution. Tobacco smoke is a very dangerous form of indoor air pollution: it contains over 7 000 chemicals, 69 of which are known to cause cancer. Though smoke may be invisible and odourless, it can linger in the air for up to five hours, putting those exposed at risk of lung cancer, chronic respiratory diseases, and reduced lung function.

Goals of the World No Tobacco Day 2019 campaign

The most effective measure to improve lung health is to reduce tobacco use and second-hand smoke exposure. But knowledge among large sections of the general public, and particularly among smokers, on the implications for the health of people’s lungs from tobacco smoking and second-hand smoke exposure is low in some countries. Despite strong evidence of the harms of tobacco on lung health, the potential of tobacco control for improving lung health remains underestimated.

The World No Tobacco Day 2019 campaign will raise awareness on the:

  • risks posed by tobacco smoking and second-hand smoke exposure;
  • awareness on the particular dangers of tobacco smoking to lung health;
  • magnitude of death and illness globally from lung diseases caused by tobacco, including chronic respiratory diseases and lung cancer;
  • emerging evidence on the link between tobacco smoking and tuberculosis deaths;
  • implications of second-hand exposure for lung health of people across age groups;
  • importance of lung health to achieving overall health and well-being;
  • feasible actions and measures that key audiences, including the public and governments, can take to reduce the risks to lung health posed by tobacco.

The cross-cutting theme of tobacco and lung health has implications for other global processes, such as international efforts to control noncommunicable diseases (NCDs), TB and air pollution for promoting health. It serves as an opportunity to engage stakeholders across sectors and empower countries to strengthen the implementation of the proven MPOWER tobacco control measures contained in the WHO Framework Convention for Tobacco Control (WHO FCTC).

Call to action

Lung health is not achieved merely through the absence of disease, and tobacco smoke has major implications for the lung health of smokers and non-smokers globally.

In order to achieve the Sustainable Development Goal (SDG) target of a one-third reduction in NCD premature mortality by 2030, tobacco control must be a priority for governments and communities worldwide. Currently, the world is not on track to meeting this target.

Countries should respond to the tobacco epidemic through full implementation of the WHO FCTC and by adopting the MPOWER measures at the highest level of achievement, which involves developing, implementing, and enforcing the most effective tobacco control policies aimed at reducing the demand for tobacco.

Parents and other members of the community should also take measures to promote their own health, and that of their children, by protecting them from the harms caused by tobacco.

NACCHO Aboriginal Health and #SuicidePrevention Recommendation 4 of 10 : Why does an Aboriginal ACCHO Health Service in one of Australia’s worst suicide regions have to self-fund #MentalHealth roles

“I think it’s appalling that we have to raise Medicare funds to subsidise services when the need is clearly demonstrated in umpteen coroner’s reports.

There are many gaps in the services that are currently available across Australia.

We welcome Labor policies to move SEWB funding into the federal health department, as well as its proposed multi-disciplinary teams of paediatricians, social workers, psychologists and Aboriginal counsellors.

But I criticize the “piecemeal approach” of the major parties. What governments don’t get is that the overall needs based funding required for Aboriginal community controlled health organisations (ACCHOs) to deliver fully on comprehensive primary healthcare hasn’t been built in to our model of care funding.”

As a result, the sector has had to seek additional funding for services like SEWB, instead of receiving a sufficient level as the base

We call for money to go to ACCHOs instead of mainstream services for Aboriginal healthcare.

We have a much better understanding of the issues [Aboriginal communities] deal with day in and day out. I also believe there should be workers engaged in the communities who are available out of hours, because most people don’t suicide between 9 and 5.”

Pat Turner AM  CEO of the National Aboriginal Community Controlled Health Organisation, told BuzzFeed News it was unacceptable, given the situation in the Kimberley

“We need those two positions given everything that’s happening in the community. People know them, they trust them, they will work with them. And it takes a long time to build up that trust with Aboriginal people.

Derby Aboriginal Health Service ( DAHS CEO )  Lynette Henderson-Yates said she is unsure how much longer DAHS will be able to find the $330,000 funding

Recommendation 4.Address Aboriginal and Torres Strait Islander youth suicide rates

  • Provide $50 million over four years to ACCHOs to address the national crisis in Aboriginal and Torres Strait Islander youth suicide in vulnerable communities
  • Fund new Aboriginal support staff to provide immediate assistance to children and young people at risk of self-harm and improved case management
  • Fund regionally based multi-disciplinary teams, comprising paediatricians, child psychologists, social workers, mental health nurses and Aboriginal health practitioners who are culturally safe and respectful, to ensure ready access to professional assistance; and
  • Provide accredited training to ACCHOs to upskill in areas of mental health, childhood development, youth services, environment health, health and wellbeing screening and service delivery.

More info

 Part 1 This is what it’s actually like to work on the frontline of Australia’s youth suicide Crisis

 “Alongside its beauty and isolation, the Kimberley is also known for its suicide rate. Last year, Indigenous health minister Ken Wyatt told the World Indigenous Suicide Prevention Conference: “If [the Kimberley] was a nation, it would have the highest suicide rate in the world.”

About eight years ago, Derby was at the epicentre of this ongoing catastrophe. In 2011 three young people died by suicide in as many weeks. The following year, the Aboriginal community of Mowanjum, 10km out of town, was rocked by the suicides of six people within six months.

Trent Ozies, 27, is a Djugun man from the Broome area who grew up in Derby. Ozies also has Filipino, Chinese and European heritage, as well as a gentle manner and a thoroughly infectious laugh. But he is grave as he recalls this terrible period.

“It was almost as if we went full circle,” he says. “Someone passed. Had their funeral, had the wake, someone passed. Had the funeral, had the wake, someone passed.

Read article in full HERE

Part 2

An Aboriginal health service in one of Australia’s worst suicide affected regions faces losing its psychologist and Aboriginal mental health worker, after money for the positions was cut in a state funding restructure last year.

The community controlled Derby Aboriginal Health Service (DAHS), located 220km east of Broome in Western Australia’s Kimberley region, delivers social and emotional wellbeing (SEWB) services in Derby.

The region has long struggled with the issue of Indigenous youth suicide. Coroner Ros Fogliani’s recent report into the deaths of 13 Aboriginal children and young people who died in the Kimberley found that 12 had died by suicide, the tragedies prompted by widespread poverty and intergenerational trauma.

The five person SEWB team in Derby is considered a model for how community mental health outreach should work in remote towns, according to Rob McPhee, the deputy CEO of Kimberley Aboriginal Medical Services.

But in a state funding restructure last year, DAHS lost funding for psychologist Maureen Robertson and mental health worker Ash Bin Omar and is now covering the $330,000 per year with money raised through Medicare consultations. SEWB services are generally funded by the Commonwealth.

Omar, who works with young Aboriginal men and boys, is also running a new project aimed at families with a low to medium risk of having their children removed to try and improve the situation and keep families together.

“For us not to have a psychologist and an Aboriginal mental health worker is really crazy,” Henderson-Yates said. “To my mind, there’s no debate about whether you have them or not have them.”

Senator Pat Dodson, who will become Indigenous affairs minister if Labor wins the election on May 18, told BuzzFeed News a Labor government would look to provide Commonwealth funding for two positions in Derby.

Labor has pledged $30 million over three years to support Aboriginal mental health and SEWB services in three high-need regions, including the Kimberley.

“If you don’t have these people being employed through the community health services, it just makes the effort to try and assist young people from taking these extreme measures totally impossible,” Dodson said.

Indigenous health minister Ken Wyatt told BuzzFeed News in a statement that the $19.6 million for suicide prevention pledged by the Coalition “builds on existing funding” provided through the Indigenous Advancement Strategy (IAS) in the department of prime minister and cabinet.

The sum includes $15 million for the rollout of mental health first aid training in 12 Indigenous communities and for youth, as well as continuing training for frontline workers. Another $4.6 million will go towards community-led programs — designed to complement existing services — in areas such as leadership, sports and culture.

The IAS currently funds about $55 million per year for SEWB, Wyatt said.

If you or someone you know needs help, you can visit your nearest ACCHO or call Lifeline Australia on 13 11 14 or Beyond Blue Australia on 1300 22 4636.