NACCHO Aboriginal Health and #refreshtheCTGrefresh : New @HealthInfoNet publication supports the need for #ClosingtheGap Refresh initiatives for Aboriginal and Torres Strait Islander people

“ The Overview is our flagship knowledge exchange resource as we summarise information from many publications into one document, ensuring those working in the sector receive a comprehensive update that is both accessible and timely’.

HealthInfoNet Director, Professor Neil Drew

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

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

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

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

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

 

The most recent indicators of the health of Aboriginal and Torres Strait Islander people are documented in the Australian Indigenous HealthInfoNet’s authoritative publication, the Overview of Aboriginal and Torres Strait Islander health status

Download

Overview+of+Aboriginal+and+Torres+Strait+Islander+health+status,+2018 (1)

The annual Overview contains updated information across many health conditions.

It shows that despite some improvements, there are still significant health disparities between Aboriginal and Torres Strait Islander people and other Australians, which supports the need for the broader refresh of the Closing the Gap targets.

The Overview also includes a strengths based approach and highlights areas where improvements have been achieved or positive outcomes realised. It provides a comprehensive summary of the most recent indicators of the health and current health status of Aboriginal and Torres Strait Islander people.

As part of the HealthInfoNet’s commitment to knowledge exchange, there are other tools and resources to access this information including:

A plain language Summary version of the Overview

Summary+of+Aboriginal+and+Torres+Strait+Islander+health+status+2018

PowerPoints that can be used as a teaching resource

https://healthinfonet.ecu.edu.au/key-resources/publications/36501/

The Australian Indigenous HealthInfoNet is based at Edith Cowan University in Western Australia. The HealthInfoNet is a massive web resource that informs practice and policy in Aboriginal and Torres Strait islander health by making up to date research and other knowledge readily accessible via any platform.

For over 21 years, working in the area of knowledge exchange with a population health focus, the HealthInfoNet makes research and other information freely available in a form that has immediate, practical utility for practitioners and policy-makers in the area of Aboriginal and Torres Strait Islander health, enabling them to make decisions based on the best available evidence.

www.healthinfonet.ecu.edu.au

NACCHO Aboriginal Health Press Release : @NACCHOChair appalled and perplexed about Non -Aboriginal privately-owned company being granted $1.7 million funding

“ The National Aboriginal Community Controlled Health Organisation ( NACCHO ) is appalled that funding of almost $1.7 mill to Redimed was approved by the federal Aboriginal Health Minister Ken Wyatt 2 weeks ago

I am totally perplexed how a non-Aboriginal, privately-owned company, that has no experience whatsoever of working in the delivery of comprehensive primary health to Aboriginal people, can be given a federal government grant of almost $1.7 million.”

Ms Donnella Mills, Acting Chair of NACCHO

Download full NACCHO Press Release or read Part 1 Below 

NACCHO Press Release Questions about Aboriginal funding to Non Aboriginal Company

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

Vicki O’Donnell, chair of the Aboriginal Health Council of WA, the peak body for the state’s 23 Aboriginal community-controlled health services said Aboriginal-controlled services were more accessible, performed better in key areas, and were the most cost-effective vehicles for delivering primary health care to Indigenous communities. See Full SMH Coverage Part 2

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

Unless government begins to enable our Aboriginal Organisations to provide community-driven strength-based approaches to our people, it will not close the gap.”

Moorditj Koort Aboriginal Health and Wellness Centre, Indigenous-owned and run in Perth since being founded in 2010, CEO Jonathan Ford told the National Indigenous Times that it was unethical for non-Indigenous organisations to receive funds for Indigenous health services.

“NACCHO strongly believes that any such funding should only be given when there is an open and transparent process. In this case it was not.

We already have two well established Aboriginal Community Health Services operating in Perth, Derbal Yerrigan and Moorditj Court,  and they would have welcomed the opportunity to apply for that funding.” she said.

“It is especially concerning that Redimed and its newly created entity, Aboriginal Medical Care 360 was not required to go through the proper normal application process that all our 145 Members Aboriginal Health Services must always do. Where is the clinical accreditation all our organisations must have prior to receiving government funding?” Ms Mills said.

“We trust the Federal Budget will include the much-needed funding of our sector that has repeatedly sought and as it is outlined in our pre-budget submission lodged through Treasury in late January this year.” Ms Mills concluded.

See our NACCHO Pre Budget Submission HERE

Read AHCWA NACCHO Article HERE

Part 2 : Despite DIY rhetoric, federal Aboriginal health grant goes to non-Indigenous WA service

The federal Liberal government has shocked the Indigenous community by awarding almost $1.7 million from a funding program aimed at Aboriginal health services to a non-Indigenous organisation that employs a former WA Liberal minister.

From the SMH

Privately owned Redimed has former WA Liberal health minister Kim Hames on its staff as a GP.

Self-described in advertising materials as a “provider of specialised medical and injury management services”, it has not previously listed Indigenous health as a specialty.

But it says its pilot program will create Indigenous jobs and address unmet healthcare demand in one of Perth’s priority areas for Closing the Gap.

Senate estimates 22 February revealed there had been no tender process, closed or otherwise; the company had made an unsolicited bid for the two-year grant, approved by Indigenous Health Minister Ken Wyatt.

A fortnight ago, when the 11th annual Closing the Gap report revealed that only two of seven targets were on track – neither concerning life expectancy – Prime Minister Scott Morrison had said the system was “set up to fail” through a lack of true partnership with Indigenous people, and promised an equal role for Indigenous leaders in redesigning the Closing the Gap process.

But the Indigenous community has “major concerns” about this federal funding decision, said a public statement from Vicki O’Donnell, chair of the Aboriginal Health Council of WA, the peak body for the state’s 23 Aboriginal community-controlled health services.

Ms O’Donnell queried how Redimed would add value to the two Aboriginal-controlled services already operating in Midland that had built connections with local Aboriginal people.

“How was the need for this additional service determined when there are already existing services in the area including Mooditj Koort, Derbarl Yerrigan and other not-for profit services?” she said.

She questioned how Redimed’s capacity to deliver the contract was determined, in terms of clinical accreditation and experience in delivering primary health care to Aboriginal people.

She also asked why, if additional funding was available, the government would not increase the support for the two Aboriginal-controlled services in Midland to expand.

Ms O’Donnell said Aboriginal-controlled services were more accessible, performed better in key areas, and were the most cost-effective vehicles for delivering primary health care to Indigenous communities.

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

The $800 million federal funding stream is “primarily aimed at and spent on Aboriginal-controlled organisations”, according to the Health Department.

About 85 per cent of its funding for front-line medical care goes to Aboriginal-controlled organisations, and another 10 per cent goes to state government services.

Only 5 per cent goes elsewhere, including now to Redimed for the pilot program of health assessments and follow-up home visits for Indigenous people in Rockingham, Joondalup and the eastern suburbs.

Moorditj Koort Aboriginal Health and Wellness Centre, Indigenous-owned and run in Perth since being founded in 2010, told the National Indigenous Times that it was unethical for non-Indigenous organisations to receive funds for Indigenous health services.

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

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

After questions from WA Senator Rachel Siewert in a Senate estimates hearing, the Health Department’s Caroline Edwards said while the “key focus” of the funding program was supporting Aboriginal-controlled organisations, the department was also “looking at alternative methods of primary care and alternative delivery methods to cater for different types of circumstances.”

“This particular grant is one of those instances of having a go at a different form of delivery to see how it works in a particular area,” she said.

Redimed won the grant on condition it consult and collaborate with Indigenous organisations. It says Koya Aboriginal Corporation in Midland will lead delivery of the project and will face independent evaluation at the end of the two years.

“We did state that the pilot was not to duplicate any already funded service and was to serve only clients who weren’t already visiting other funded services,” the Health Department’s Mark Roddam said at the estimates hearing.

Indigenous Health Minister Ken Wyatt emphasised the Redimed plan would be delivered in partnership with Koya Aboriginal Corporation in a “holistic and culturally focused” way.

He said it was normal for this funding program to receive unsolicited bids.

“It aims to fill a gap in services in two areas of Perth where there has been significant growth in Aboriginal and Torres Strait Islander populations,” he said.

“Under the Indigenous Australians’ Health Program, unsolicited funding applications can be assessed against IAHP Guidelines. The key consideration is their capacity to help in Closing the Gap in health equality.”

A Redimed spokesman said Dr Hames was part of the initial funding application advisory team but was not involved with the team of 14 that developed the pilot program and submitted the final funding application.

Asked about Redimed’s Indigenous healthcare qualifications, he said the pilot would be delivered by a newly created entity, Aboriginal Medical Care 360, in close partnership with Koya and the Pindi Pindi Centre of Research Excellence in Aboriginal Wellbeing.

Koya Aboriginal Corporation founding chairman and stolen generation survivor Allan Kickett, and Pindi Pindi patron Professor Fiona Stanley, both supported Redimed’s research and Mr Kickett would be in a leadership role on its delivery.

“Medical Practitioners care for people from all cultures and Redimed is already caring for Aboriginal patients,” he said.

“Statistics show that a high percentage of Aboriginal people are unable to attend Aboriginal Health centres for a variety of reasons, including not having access to or being able to afford transport to and from appointments.

“To address this, AMC360 will deliver health care in people’s homes or in local community settings where patients have family and friends close by.”

He said these home services, delivered by Aboriginal clinicians, were a key point of difference to existing  services.

He said the Greater City of Swan region was a federal priority area for Closing the Gap and up to 20 new Indigenous jobs would be created through the project.

State Coroner Ros Fogliani’s recent report into a string of Indigenous children’s suicides in the Kimberley resulted in 42 recommendations for this state.

Many of these, as well as the overall conclusion to the report, used the recommendations to push for better service design and delivery by Aboriginal people themselves.

She recommended the principles of self-determination and empowerment be given emphasis in programs relating to Aboriginal people in WA; that Aboriginal people and organisations be involved in setting and formulating policy and to share service delivery responsibilities.

“The considerable services already being provided to the region are not enough. They are still being provided from the perspective of mainstream services, that are adapted in an endeavour to fit into a culturally relevant paradigm,” she wrote.

“It may be time to consider whether the services themselves need to be co-designed in a completely different way, that recognises at a foundational level, the need for a more collective and inclusive approach.”

The Closing the Gap report revealed that while targets for increased participation in early childhood education and higher rates of year 12 attainment among Indigenous students were on track, the other five targets were not.

There had been little progress towards closing the gap in life expectancy, halving the gap in child mortality rates, halving the gap in employment and in reading and numeracy and closing the gap in school attendance.

NACCHO Aboriginal Health Research : Ministers @GregHuntMP and @KenWyattMP announce $160 million funding for Indigenous health research over 10 years targeting three flagship priorities and five key areas

“It is time to come together as a nation to work as partners in bringing equity in health outcomes”

The right research into improved treatments and services has the potential to dramatically accelerate the progress we have seen over the last six years in achieving better health for Indigenous Australians,”

Minister for Indigenous Health, Ken Wyatt AM

The fund is a vital step towards improving the health of our Aboriginal and Torres Straits Islander communities. Ultimately, parity in health outcomes is the only acceptable goal, and this fund will help to achieve it.

The research into improving the system is critical, but we are also absolutely committed to delivering real, on-the-ground improvements and frontline services right now “

Health Minister Greg Hunt

” It is a great honour to be asked to co-chair this critical research platform for the future.  Health and social inequity as experienced by Indigenous Australians stands as one of our nations great challenges.  Only through dedicated, collaborative, adequately resourced action, led by community priorities and processes can we hope to make meaningful change. 

Our collective job is to unlock the expertise and capabilities of the Indigenous community, backed the brightest and most gifted scientists and medical researchers and their institutions to make a more equitable future for all Australians.”

Professor Alex Browne : South Australian Health and Medical Research Institute

The Federal Government will provide $160 million for a national research initiative to improve the health of Aboriginal and Torres Strait Islander people.

The Indigenous Health Research Fund will be a 10-year research program funded from the Medical Research Future Fund (MRFF).

It will support practical, innovative research into the best approaches to prevention, early intervention, and treatment of health conditions of greatest concern to Indigenous communities.

First three flagship priorities

The funding’s first three flagship priorities, which aim to deliver rapid solutions to some of the biggest preventable health challenges faced by our First Nations peoples, are:

  • Ending avoidable blindness
  • Ending avoidable deafness
  • Ending rheumatic heart disease

Minister for Indigenous Health, Ken Wyatt AM announced the first project to be funded under the Indigenous Health Research Fund on Sunday – $35 million for the development of a vaccine to eliminate rheumatic heart disease in Australia.

Rheumatic heart disease is a complication of bacterial infections of the throat and skin. Australia currently has the highest rate of rheumatic heart disease in the world.

Every year, nearly 250 children are diagnosed with acute rheumatic fever and 50 – 150 people die from rheumatic heart disease in Australia. Aboriginal and Torres Strait Islander people are 64 times more likely than non-Indigenous people to develop rheumatic heart disease, and nearly 20 times as likely to die from it.

“Rheumatic heart disease kills young people and devastates families. This funding will save countless lives in Australia and beyond,” Health Minister Greg Hunt said.

Five key areas of Research

The remaining $125 million Indigenous Health Research funding will be focussed on research projects that fall into five key areas – guaranteeing a healthy start to life, improving primary health care, overcoming the origins of inequality in health, reducing the burden of disease, and addressing emerging challenges.

An advisory panel comprising prominent Indigenous research experts and community leaders, cochaired by Prof. Alex Browne (South Australian Health and Medical Research Institute) and Prof. Misty Jenkins (Walter and Eliza Hall Institute of Medical Research), will guide the Indigenous Health Research Fund investments.

It will be the first national research fund led by Indigenous people, and conducted with close engagement with Indigenous communities.

The Indigenous Health Research Fund will also seek contributions from philanthropic organisations, state governments, industry, and the private sector in order to increase the reach and impact of the fund.

The Indigenous Health Research Fund will provide the knowledge and understanding to make health programs for Aboriginal and Torres Strait Islander people more effective and lead to lasting health improvements.

This is key to closing the gap in health outcomes since, despite considerable investment by the Commonwealth in existing programmes, Indigenous Australians currently have about a 10 year lower life expectancy and 2.3 times the burden of disease compared to non-Indigenous Australians.

The Morrison Government will provide separate funding of $3.8 million over four years to fund the University of Melbourne’s Indigenous Eye Health Program. This program aims to improve Indigenous eye health in Australia.

“The research into improving the system is critical, but we are also absolutely committed to delivering real, on-the-ground improvements and frontline services right now,” Minister Hunt said.

Our  Government has a long-standing and important commitment to achieving health equity between Indigenous and non-Indigenous Australians.

The Government is investing $3.9 billion in Indigenous-specific health initiatives (from 2018-19 to 2021-22), an ongoing increase of around four per cent per year. This includes investment under the Indigenous Australians’ Health Program.

The MRFF is key to the Government’s health and research plans and is delivering significant benefits for Australian researchers, with over $2 billion in disbursements announced to date

NACCHO Aboriginal Health 2019 #SaveADate Calendar : How your organisation can get involved in our March 21 National #ClosetheGap Day ? Register your event HERE

Featured NACCHO SAVE A DATE event

 ” National Close the Gap Day is a time for all Australians to come together and commit to achieving health equality for Aboriginal and Torres Strait Islander people.”

Download the 2019 Health Awareness Days Calendar 

6 March AIATSIS Culture and Policy Symposium

9 March  Bush to Beach Project Grazing Style Light Indigenous Marathon Fundraiser

12- 13 March Overcoming Indigenous Family Violence 

14 March Workshop Brisbane Moving Beyond the Frontline project 

14 – 15 March 2019 Close the Gap for Vision by 2020 – National Conference 2019

21 March National Close the Gap Day

21 March Indigenous Ear Health Workshop Brisbane

22 March : The experts priorities for the 2019 Federal Election 

24 -27 March National Rural Health Alliance Conference

20 -24 May 2019 World Indigenous Housing Conference. Gold Coast

18 -20 June Lowitja Health Conference Darwin

2019 Dr Tracey Westerman’s Workshops 

7 -14 July 2019 National NAIDOC Grant funding round opens

23 -25 September IAHA Conference Darwin

24 -26 September 2019 CATSINaM National Professional Development Conference

5-8 November The Lime Network Conference New Zealand 

21 March National Close the Gap Day

Featured Save date

For the last 10 years many thousands of Australians from every corner of the country, in schools, businesses and community groups, have shown their support for Close the Gap by marking National Close the Gap Day each March.

This National Close the Gap Day, we have an opportunity to send our governments a clear message that Australians value health equality as a fundamental right for all.

On National Close the Gap Day we encourage you to host an activity in your workplace, home, community or school.

Our aim is to bring people together to share information, and most importantly, to take meaningful action in support of achieving Indigenous health equality by 2030.

How to get involved in National Close the Gap Day

  • Register your activity. You can download some online resources to support your event
  • Invite your friends, workmates and family to join you
  • Take action by signing the Close the Gap pledge and asking your friends and colleagues to do the same
  • Call, tweet or write to your local Member of Parliament and tell them that you want them to Close the Gap
  • Listen to and share the stories of Aboriginal and Torres Strait Islander people on Facebook – visit our Close the Gap Facebook page.
  • Share your photos and stories on social media. Use the hashtag #ClosetheGap
  • Donate to help our work on Close the Gap

With events ranging from workplace morning teas, sports days, school events and public events in hospitals and offices around the country — tens of thousands of people take part each year to make a difference.

Your actions can create lasting change. Be part of the generation that closes the gap.

National Close the Gap Day is a time for all Australians to come together and commit to achieving health equality for Aboriginal and Torres Strait Islander people.

The Close the Gap Campaign will partner with Tharawal Aboriginal Aboriginal Medical Services, South Western Sydney, to host an exciting community event and launch our Annual Report.

Visit the website of our friends at ANTaR for more information and to register your support. https://antar.org.au/campaigns/national-close-gap-day

EVENT REGISTER

Download the 2019 Calendar Health Awareness Days

For many years ACCHO organisations have said they wished they had a list of the many Indigenous “ Days “ and Aboriginal health or awareness days/weeks/events.

With thanks to our friends at ZockMelon here they both are!

It even has a handy list of the hashtags for the event.

Download the 53 Page 2019 Health days and events calendar HERE

naccho zockmelon 2019 health days and events calendar

We hope that this document helps you with your planning for the year ahead.

Every Tuesday we will update these listings with new events and What’s on for the week ahead

To submit your events or update your info

Contact: Colin Cowell www.nacchocommunique.com

NACCHO Social Media Editor Tel 0401 331 251

Email : nacchonews@naccho.org.au

6 March AIATSIS Culture and Policy Symposium 

Info and Register

9 March  Bush to Beach Project Grazing Style Light Indigenous Marathon Fundraiser

The Port Macquarie Running Festival is happening over the weekend of the 9th-10th March 2019. As a part of this event we are running a fundraiser to support the important work being undertaken by Charlie & Tali Maher as a part of the Indigenous Marathon Project Running And Walking group. Come along to hear from Olympians Nova Peris, Steve Moneghette & Robert de Castella while meeting members of the Indigenous Marathon Project over lunch. We hope to see you there.

All funds raised will go towards the Bush to Beach Project. The project aims
to develop a strong relationship between the Northern Territory community of
Ntaria and the coastal community of Port Macquarie, with an exchange program
occurring several times throughout the year. This will include young Indigenous
people visiting the communities and participating in running and walking events
to promote healthy living. We thank you for your support.

Guest Speakers: Olympians Nova Peris, Steve Moneghetti & Robert de Castella.

Any enquiries please get in touch with Nina Cass or Charlie Maher (ninacass87@gmail.com / charles.maher@det.nsw.edu.au)

Tickets $59 Register HERE 

12- 13 March Overcoming Indigenous Family Violence 

Djirra has been chosen to be the charity partner of the next Overcoming Indigenous Family Violence conference organised by Aventedge in Melbourne on the 12th and 13th of March.

On the first day, Tuesday 12th of March, Marion Hansen, Djirra’s chairperson, will give the opening and closing address. At 10.30am, Djirra’s CEO Antoinette Braybrook will share her experience and knowledge on Supporting Aboriginal women, their children and communities to be safe, culturally strong and free from violence.

Family violence against Aboriginal and Torres Strait Islander people, predominantly women and their children, is a national crisis.

Aboriginal and Torres Strait Islander communities and their organisations hold the solutions to ending the disproportionate rates of family violence. However this requires the support and involvement of a range of stakeholders around the country.

The 5th annual Overcoming Indigenous Family Violence Forum (Melbourne & Perth) has partnered with Djirra and brings together representatives from Aboriginal and Torres Strait Islander Community Controlled Organisations, specialist family violence support and prevention services, community legal services, government, police and not-for-profit organisations.

During the course of this conference and 1-day workshop, we will explore critical issues in working to end family violence against Aboriginal and Torres Strait Islander people, including state and federal government initiatives; how frontline services are engaging in prevention, early intervention and response; learning from the stories and experiences of survivors of family violence; working more effectively with people who use violence towards accountability and behaviour change and the impacts of family violence on children and young people.

For more information on these events, pricing and discounts click below:
Melbourne | 12th-14th March 2019
Event homepage – www.ifv-mel.aventedge.com
Register here – http://elm.aventedge.com/ifv-mel-register

Perth | 5th-6th March 2019
Event homepage – www.ifv-per.aventedge.com
Register here – http://elm.aventedge.com/ifv-per/register

14 March Workshop Brisbane Moving Beyond the Frontline project 

An interactive workshop for currently enrolled Aboriginal and Torres Strait Islander health and medical students.

Panel conversations with

Associate Professor Chelsea Bond (UQ Poche)
Associate Professor Shannon Springer (Bond Uni)
Professor Mark Brough (QUT) &
Dr Bryan Mukandi (UQ Medicine)

The workshop shares key findings from the Moving Beyond the Frontline project to facilitate a broader conversation about how to foster culturally safe learning environments for Indigenous health and medical students. 

Aboriginal and Torres Strait Islander students currently enrolled in a health or health related degree program (undergraduate or postgraduate), at any institution, are eligible to attend.

Register by 6 March to secure your place.

Catering will be provided.

** Please note that due to limited capacity, preference is to accomodate Australian Aboriginal and/or Torres Strait Islander students **

For more information about Moving Beyond the Frontline project, visit the Lowitja Institute website or watch a short video about the project here: https://vimeo.com/278096582

For further information about the event, please email UQ Poche at poche@uq.edu.au

REGISTER HERE

14 – 15 March 2019 Close the Gap for Vision by 2020 – National Conference 2019

Indigenous Eye Health (IEH) at the University of Melbourne and co-host Aboriginal Medical Services Alliance Northern Territory (AMSANT), are pleased to invite you to register for the Close the Gap for Vision by 2020:Strengthen & Sustain – National Conference 2019 which will be held at the Alice Springs Convention Centre on Thursday 14 and Friday 15 March 2019 in the Northern Territory. This conference is also supported by our partners, Vision 2020 Australia, Optometry Australia and the Royal Australian and New Zealand College of Ophthalmologists.

The 2019 conference, themed ‘Strengthen & Sustain’ will provide opportunity to highlight the very real advances being made in Aboriginal and Torres Strait eye health. It will explore successes and opportunities to strengthen eye care and initiatives and challenges to sustain progress towards the goal of equitable eye care by 2020. To this end, the conference will include plenary speakers, panel discussions and presentations as well as upskilling workshops and cultural experiences.

Registration (including workshops, welcome reception and conference dinner) is $250. Registrations close on 28 February 2019.

Who should attend?

The conference is designed to bring people together and connect people involved in Aboriginal and Torres Strait Islander eye care from local communities, Aboriginal Community Controlled Health Organisations, health services, non-government organisations, professional bodies and government departments from across the country. We would like to invite everyone who is working on or interested in improving eye health and care for Aboriginal and Torres Strait Islander Australians.

Speakers will be invited, however this year we will also be calling for abstracts for Table Top presentations and Poster presentations – further details on abstract submissions to follow.

Please share and forward this information with colleagues and refer people to this webpage where the conference program and additional informationwill become available in the lead up to the conference. Note: Please use the conference hashtag #CTGV19.

We look forward to you joining us in the Territory in 2019 for learning and sharing within the unique beauty and cultural significance of Central Australia.

Additional Information:

If you have any questions or require additional information, please contact us at indigenous-eyehealth@unimelb.edu.au or contact IEH staff Carol Wynne (carol.wynne@unimelb.edu.au; 03 8344 3984 email) or Mitchell Anjou (manjou@unimelb.edu.au; 03 8344 9324).

Close the Gap for Vision by 2020: Strengthen & Sustain – National Conference 2019 links:

– Conference General Information

– Conference Program

– Conference Dinner & Leaky Pipe Awards

– Staying in Alice Springs

More information available at: go.unimelb.edu.au/wqb6 

21 March National Close the Gap Day

 

Description

National Close the Gap Day is a time for all Australians to come together and commit to achieving health equality for Aboriginal and Torres Strait Islander people.

The Close the Gap Campaign will partner with Tharawal Aboriginal Aboriginal Medical Services, South Western Sydney, to host an exciting community event and launch our Annual Report.

Visit the website of our friends at ANTaR for more information and to register your support. https://antar.org.au/campaigns/national-close-gap-day

EVENT REGISTER

21 March Indigenous Ear Health Workshop Brisbane 

The Australian Society of Otolaryngology Head and Neck Surgery is hosting a workshop on Indigenous Ear Health in Brisbane on Thursday, 21 March 2019.

This meeting is the 7th to be organised by ASOHNS and is designed to facilitate discussion about the crucial health issue and impact of ear disease amongst Indigenous people.

The meeting is aimed at bringing together all stakeholders involved in managing Indigenous health and specifically ear disease, such as:  ENT surgeons, GPs, Paediatricians, Nurses, Audiologists, Speech Therapists, Allied Health Workers and other health administrators (both State and Federal).

Download Program and Contact 

Indigenous Ear Health 2019 Program

22 March : The experts priorities for the 2019 Federal Election 

Listen to 3 of Australia’s leading health advocates outline their top priorities for change

Book Here

24 -27 March National Rural Health Alliance Conference

Interested in the health and wellbeing of rural or remote Australia?

This is the conference for you.

In March 2019 the rural health sector will gather in Hobart for the 15th National Rural Conference.  Every two years we meet to learn, listen and share ideas about how to improve health outcomes in rural and remote Australia.

Proudly managed by the National Rural Health Alliance, the Conference has a well-earned reputation as Australia’s premier rural health event.  Not just for health professionals, the Conference recognises the critical roles that education, regional development and infrastructure play in determining health outcomes, and we welcome people working across a wide variety of industries.

Join us as we celebrate our 15th Conference and help achieve equitable health for the 7 million Australians living in rural and remote areas.

Hobart and its surrounds was home to the Muwinina people who the Alliance acknowledges as the traditional and original owners of this land.  We pay respect to those that have passed before us and acknowledge today’s Tasmanian Aboriginal community as the custodians of the land on which we will meet.

More info 

20 -24 May 2019 World Indigenous Housing Conference. Gold Coast

Thank you for your interest in the 2019 World Indigenous Housing Conference.

The 2019 World Indigenous Housing Conference will bring together Indigenous leaders, government, industry and academia representing Housing, health, and education from around the world including:

  • National and International Indigenous Organisation leadership
  • Senior housing, health, and education government officials Industry CEOs, executives and senior managers from public and private sectors
  • Housing, Healthcare, and Education professionals and regulators
  • Consumer associations
  • Academics in Housing, Healthcare, and Education.

The 2019 World Indigenous Housing Conference #2019WIHC is the principal conference to provide a platform for leaders in housing, health, education and related services from around the world to come together. Up to 2000 delegates will share experiences, explore opportunities and innovative solutions, work to improve access to adequate housing and related services for the world’s Indigenous people.

Event Information:

Key event details as follows:
Venue: Gold Coast Convention and Exhibition Centre
Address: 2684-2690 Gold Coast Hwy, Broadbeach QLD 4218
Dates: Monday 20th – Thursday 23rd May, 2019 (24th May)

Registration Costs

  • EARLY BIRD – FULL CONFERENCE & TRADE EXHIBITION REGISTRATION: $1950 AUD plus booking fees
  • After 1 February FULL CONFERENCE & TRADE EXHIBITION REGISTRATION $2245 AUD plus booking fees

PLEASE NOTE: The Trade Exhibition is open Tuesday 21st May – Thursday 23rd May 2019

Please visit www.2019wihc.com for further information on transport and accommodation options, conference, exhibition and speaker updates.

Methods of Payment:

2019WIHC online registrations accept all major credit cards, by Invoice and direct debit.
PLEASE NOTE: Invoices must be paid in full and monies received by COB Monday 20 May 2019.

Please note: The 2019 WIHC organisers reserve the right of admission. Speakers, programs and topics are subject to change. Please visit http://www.2019wihc.comfor up to date information.

Conference Cancellation Policy

If a registrant is unable to attend 2019 WIHC for any reason they may substitute, by arrangement with the registrar, someone else to attend in their place and must attend any session that has been previously selected by the original registrant.

Where the registrant is unable to attend and is not in a position to transfer his/her place to another person, or to another event, then the following refund arrangements apply:

    • Registrations cancelled less than 60 days, but more than 30 days before the event are eligible for a 50% refund of the registration fees paid.
    • Registrations cancelled less than 30 days before the event are no longer eligible for a refund.

Refunds will be made in the following ways:

  1. For payments received by credit or debit cards, the same credit/debit card will be refunded.
  2. For all other payments, a bank transfer will be made to the payee’s nominated account.

Important: For payments received from outside Australia by bank transfer, the refund will be made by bank transfer and all bank charges will be for the registrant’s account. The Cancellation Policy as stated on this page is valid from 1 October 2018.

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18 -20 June Lowitja Health Conference Darwin


At the Lowitja Institute International Indigenous Health and Wellbeing Conference 2019 delegates from around the world will discuss the role of First Nations in leading change and will showcase Indigenous solutions.

The conference program will highlight ways of thinking, speaking and being for the benefit of Indigenous peoples everywhere.

Join Indigenous leaders, researchers, health professionals, decision makers, community representatives, and our non-Indigenous colleagues in this important conversation.

More Info 

2019 Dr Tracey Westerman’s Workshops 

More info and dates

7 -14 July 2019 National NAIDOC Grant funding round opens 

The opening of the 2019 National NAIDOC Grant funding round has been moved forward! The National NAIDOC Grants will now officially open on Thursday 24 January 2019.

Head to www.naidoc.org.au to join the National NAIDOC Mailing List and keep up with all things grants or check out the below links for more information now!

https://www.finance.gov.au/resource-management/grants/grantconnect/

https://www.pmc.gov.au/indigenous-affairs/grants-and-funding/naidoc-week-funding

23 -25 September IAHA Conference Darwin

 

24 -26 September 2019 CATSINaM National Professional Development Conference

 

 

The 2019 CATSINaM National Professional Development Conference will be held in Sydney, 24th – 26th September 2019. Make sure you save the dates in your calendar.

Further information to follow soon.

Date: Tuesday the 24th to Thursday the 26th September 2019

Location: Sydney, Australia

Organiser: Chloe Peters

Phone: 02 6262 5761

Email: admin@catsinam.org.au

 

5-8 November The Lime Network Conference New Zealand 

This years  whakatauki (theme for the conference) was developed by the Scientific Committee, along with Māori elder, Te Marino Lenihan & Tania Huria from .

To read about the conference & theme, check out the  website. 

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

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

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

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

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

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

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

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

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

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

CEO of the Consumers Health Forum, Leanne Wells

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

Part 1 News summary AAP

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

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

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

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

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

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

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

The checks will be available through Medicare from April.

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

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

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

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

Part 2 AMA president Tony Bartone also welcomed the commitments.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Part 4 Consumers Health Forum

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

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

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

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

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

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

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

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

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

 

 

NACCHO Aboriginal Health #ClosingTheGap : Our #ACCHO Aboriginal health sector could face a major shake-up, with the federal government flagging a preference for more mainstream funding and services 

” The government has been evaluating the IAHP, a $3.6 billion, four-year grants scheme running to 2021-22.

The Department of Health recently asked consultants to develop and test a sustainability strategy for Aboriginal Community Controlled Health Services .

It has told the consultants that “reducing the relative reliance of the ACCHS sector on IAHP grant funding” and making better use of Medicare and other funding is one solution.

Sean Parnell Health Editor The Australian Published HERE

Read our NACCHO Aboriginal Health and #RefreshtheCTGRefresh HERE

 

The Aboriginal health sector could face a major shake-up, with the federal government flagging a preference for more mainstream funding and services as it struggles to improve outcomes.

The commonwealth leads the delivery of primary healthcare, the Medicare Benefits Schedule, the Pharmaceutical Benefits Scheme and funding for indigenous health through the Indigenous Australians Health Program.

Alongside mainstream services, there are more than 140 Aboriginal-controlled health services employing about 6000 staff, most of whom are indigenous, while the states

145 members operating 302 ACCHO Clinics

Get the ACCHO FACTS

Key-facts-1-why-ACCHS-are-needed-FINAL

The latest update on the Closing the Gap strategy, released last week, showed a smaller-than-expected increase in life expectancy for indigenous people, who continue to die about eight years earlier than other Australians.

“The target to close the gap in life expectancy by 2031 is not on track,” the report concluded.

While there had been a significant reduction in the indigenous mortality rate from chronic diseases, rates from cancer are rising and the gap in cancer mortality rates is widening.

The report foreshadowed more work being done on the social determinants of health; however, Scott Morrison declared “the main area of change needs to be in how governments approach implementation of policies and delivery of services”.

The government has been evaluating the IAHP, a $3.6 billion, four-year grants scheme running to 2021-22.

The Department of Health recently asked consultants to develop and test a sustainability strategy for Aboriginal Community Controlled Health Services .

It has told the consultants that “reducing the relative reliance of the ACCHS sector on IAHP grant funding” and making better use of Medicare and other funding is one solution.

IAHP funding is capped and distributions are based on historical allocations plus indexation, running at a rate of about 4 per cent. Medicare itself is not capped, although indexation of rebates can be frozen by the government.

“Therefore, improving access to and the appropriate use of Medicare benefits will also allow growth funding to be more specifically targeted towards gaps, deficiencies and barriers to access of (primary health) services by indigenous people,” the department told consultants.

The department expects the consultants to consider non-IAHP funding sources for the ACCHS, including their “ability to access philanthropic donations and their suitability for social impact bonds”.

The government has previously sought to stimulate more social impact investment, with Treasury arguing it has “the ­potential to complement (but not replace) the Australian government’s existing role and responsibilities across many portfolios”.

The engagement of consultants comes as the department awaits an evaluation of the effectiveness of the IAHP, having been advised that the ACCHS sector had a positive impact. In providing that advice, Deakin University noted that Medicare-funded mainstream services would otherwise expose vulnerable patients to out-of-pocket costs.

“If reliance were to be placed on mainstream services in lieu of ACCHS, reduced attendance and adherence to treatment is highly likely, due to services that may not meet their cultural needs and ­expectations,” the university reported.

“If this occurred, the gap in life expectancy between Aboriginal and Torres Strait Islander people and non-indigenous Australians would increase rather than reduce.”

A recent study by the Australian National University and the National Aboriginal and Torres Strait Islander Health Workers Association found the growth in indigenous health workers had not kept up with population growth. There has been an increase in NSW and Queensland but a decrease in the Northern Territory.

Association chief executive Karl Briscoe has emphasised they were a vital conduit between health services and the community. “It is the world’s first ethnic-based health profession that has national training curriculum as well as national regulation sitting behind it,” Briscoe says.

The Nursing and Midwifery Board has revised its code of conduct to refer to the need for indigenous patients to be afforded culturally safe and respectful care.

Some health and non-health groups opposed the move and, with the Medical Board of Australia now looking to adopt similar wording in its code, it remains a contentious issue.

While the department is still supportive of the ACCHS sector, it has foreshadowed a 2020 funding overhaul, subject to the outcome of the federal election and any change in policy.

Documents obtained under Freedom of Information laws show former commonwealth bureaucrat David Tune was asked to examine how unsolicited IAHP funding proposals were considered by the department and ­minister.

He found the process — which releases about $40 million a year — “works reasonably well” but still has “a number of serious problems”.

“Firstly, the nature of the process itself creates an inherent bias towards those ‘in the know’,” Tune concluded in November.

“This means that many (possibly worthy) organisations are missing out on opportunities to seek funding.”

Tune said there was also no mechanism for prioritising such funding andthere was a need for more weight to be given to innovative proposals.

The Australian National Audit Office last year criticised the lack of performance measurement and reporting for the IAHP, prompting the department to promise changes.

 

NACCHO Aboriginal Health and @END_RHD @telethonkids #RHD : Aboriginal and Torres Strait Islander peak bodies welcome Minister @KenWyattMP announcement of $35 million funding for vaccine to end rheumatic heart disease

“Today is a game-changing step. Ending RHD is a critical, tangible target to close the gap in Indigenous life expectancy.

Our Government is building on the work of the Coalition to Advance New Vaccines Against Group A Streptococcus (CANVAS) initiative, by providing $35 million over 3 years to fund the creation of a vaccine that will bring an end, once and for all, to RHD in Australia.

The trials and development, led by Australia’s leading infectious disease experts and coordinated by the Telethon Kids Institute, will give hope to thousands of First Nations people whose lives and families have been catastrophically affected by this illness.”

The funding announced today by Indigenous Health Minister Ken Wyatt AM is being provided from the Medical Research Future Fund (MRFF).

The eradication of rheumatic heart disease, a deadly and devastating illness largely affecting Indigenous communities, is taking a major step forward, with the Federal Government investing $35 million in the development of a vaccine to combat the disease.

SEE Full Press Release Part 2 Below

Pictured below  : Saving the lives of children like 7 year old Tenaya, who has Rheumatic Heart Disease – Perth Hospital

“It is wonderful that the Commonwealth Government research funds have been directed to address this leading cause of inequality for young Aboriginal and Torres Strait Islander people in Australia. It is a turning point in progress towards a Strep A vaccine.

The Aboriginal Community Controlled Health sector welcomes this funding for the Strep A vaccine as one part of the work needed to end RHD.

It does not distract us from the ultimate goal of addressing the social and environmental factors – such as inequality, overcrowding, inadequate housing infrastructure, insufficient hygiene infrastructure and limited access to appropriate health services – which drive the high rates of RHD in Australia.

We hope that research funds will be mirrored by investment in frontline health services, such as ours, as part of a comprehensive strategy to end rheumatic heart disease in Australia”

NACCHO CEO Ms Pat Turner AM

ACHWA was represented at the launch by Vicki O’Donnell Chairperson

Part 1 : Aboriginal and Torres Strait Islander peak bodies welcome Federal Government funding for new Australian-led Strep A vaccine  

Download full Press Release 

ACCHO_END RHD Statement 240219 Announcement_

Aboriginal and Torres Strait Islander peak bodies for the Aboriginal Community Controlled Health sector as leaders of END RHD advocacy alliance, warmly welcome Minister Wyatt’s announcement today of $35 million of funding for the acceleration of an Australian-led Strep A vaccine.

The National Aboriginal Community Controlled Health Organisation (NACCHO), Aboriginal Medical Services Alliance Northern Territory (AMSANT), Aboriginal Health Council of South Australia (AHCSA), Queensland Aboriginal and Islander Health Council (QAIHC), Aboriginal Health Medical Research Council of New South Wales (AH&MRC), Aboriginal Health Council of Western Australia (AHCWA) are Founding Members of END RHD, leading a campaign calling for an end to rheumatic heart disease in Australia.

We congratulate Telethon Kids Institute, one of our fellow END RHD founding members, on being awarded this vital funding, and look forward to further engagement with researchers, communities, and other stakeholders as the project progresses.

END RHD has been calling for investment in strategic research and technology – including the development of a vaccine – as part of a range of funding priorities needed to eliminate rheumatic heart disease (RHD) in Australia. This funding is an important step towards that goal.

A vaccine has an important role to play in reducing the rates of rheumatic heart disease in years to come. We celebrate this announcement and recognise it is one important part of the comprehensive action needed to end RHD in Australia, and truly close the gap in health outcomes for Aboriginal and Torres Strait Islander Australians.

We invite you to join the movement to end rheumatic heart disease in Australia. You can pledge your support for the END RHD campaign at https://endrhd.org.au/take-action/

Part 2 

It will allow manufacture and testing of a number of vaccines currently being developed, and fast-tracking and funding of clinical trials in Australia. The aim is to accelerate availability of a vaccine for use in Australia and internationally.

“Today is a game-changing step,” said Minister Wyatt. “Ending RHD is a critical, tangible target to close the gap in Indigenous life expectancy.

“Our Government is building on the work of the Coalition to Advance New Vaccines Against Group A Streptococcus (CANVAS) initiative, by providing $35 million over 3 years to fund the creation of a vaccine that will bring an end, once and for all, to RHD in Australia.

“The trials and development, led by Australia’s leading infectious disease experts and coordinated by the Telethon Kids Institute, will give hope to thousands of First Nations people whose lives and families have been catastrophically affected by this illness.”

Rheumatic Heart Disease (RHD) is a complication of bacterial Streptococcus A infections of the throat and skin. Strep A and RHD are major causes of death around the world, with Strep A killing more than 500,000 people each year.

Australia has one of the highest incidences of rheumatic heart disease in the world. It is the leading cause of cardiovascular inequality between Indigenous and non-Indigenous Australians and is most commonly seen in adolescents and young adults.

Alarmingly, Aboriginal and Torres Strait Islander people are 64 times more likely than non Indigenous people to develop rheumatic heart disease, and nearly 20 times as likely to die from it.

Every year in Australia, nearly 250 children are diagnosed with acute rheumatic fever at an average age of 10 years. 50 – 150 people, mainly indigenous children or adolescents, die from RHD every year.

“Rheumatic heart disease kills young people and devastates families. This funding will save countless lives in Australia and beyond,” said Health Minister Greg Hunt.

“This initiative will also benefit Australia by ensuring it continues to be the global leader in Strep A and RHD research and public health implementation, and can build on its worldclass clinical trial and medical industry.

“Vulnerable communities, in particular Indigenous communities, will get the medicines they need; and Australian industry will have the opportunity to collaborate in developing and distributing the breakthrough vaccine, both here and overseas.”

The End RHD vaccine initiative will be directed by Prof Jonathan Carapetis AM (Director of the Telethon Kids Institute in Perth) and overseen by a Scientific Advisory Board including leading Australian and International experts.

The project will also be informed by an Indigenous Advisory Committee who will ensure that the voices of our First Nations people are heard and acknowledged, and that all components of the work are culturally safe and appropriate.

This latest initiative builds on funding already provided under our Government’s Rheumatic Fever Strategy. This includes $12.8 million to continue support for the existing state-based register and control programs in the Northern Territory, Western Australia, Queensland and South Australia; and new funding of $6 million for focused prevention activities in high-risk communities to prevent the initial incidence of acute rheumatic fever.

Our Government has also provided $165,000 to the END RHD Alliance to complete development of a roadmap to eliminate the disease in Australia.

“The death and suffering caused by Strep A and RHD is preventable,” said Minister Hunt. “RHD can be stopped and we want to end it on our watch.

“This is a further demonstration of our Government’s strong commitment to health and medical research, which is a key pillar of our Government’s long term health plan.”

NACCHO Aboriginal Health #RefreshTheCTGRefresh News : Dr @mperkinsnsw #ClosingtheGap failures are firmly rooted in racism and Nicholas Biddle From @ANU_CAEPR 4 lessons from 11 years of #ClosingtheGap reports

 

1. Some targets are easier than others

2. The life-expectancy measure is unpredictable

3. On-track one year, off-track the next

4. Indigenous Australians in the city and country have different needs

5.Closing the Gap Failures are firmly rooted in racism

” Scott Morrison last week became the fifth prime minister to deliver a Closing the Gap report to parliament – the 11th since the strategy began in 2008. Closing the Gap has aimed to reduce disadvantage among Aboriginal and Torres Strait Islander people with particular respect to life expectancy, child mortality, access to early childhood education, educational achievement and employment outcomes.

Almost every time a prime minister delivers the report, he or she states the need to move on from a deficits approach.

Which is exactly what Morrison did this time. But he also did something different. Four of the seven targets set in 2008 were due to expire in 2018.

So last year, the government developed the Closing the Gap Refresh – where targets would be updated in partnership with Indigenous people.

Nicholas Biddle ANU : Four lessons from 11 years of Closing the Gap reports : See in full Part 1 Below 

Read NACCHO Closing the Gap response and download the report

” Once again, minimal progress has been made towards closing the gap on Indigenous disadvantage.

Racism has been mentioned as an issue, but exactly how does racism make a contribution to this “unforgivable” state of affairs ?.

The answer is in the criminal justice system. Studies have shown mass incarceration has a profoundly negative effect on the health, education, and employment of families and communities-and Indigenous Australians are the most incarcerated group on Earth.

The US, the mother of all jailers imprisoned 655 people per 100,000 in 2018. Australia imprisoned 164 non Indigenous people and 2481 Indigenous people per 100,000. Western Australian imprisoned 3663 Aboriginal people per 100,000.

In 1991, when the report on Aboriginal Deaths in Custody was handed down, 14% of all prisoners were First Nations people.  By last year, the figure was 28%. ”

Lesson 5 Dr Meg Perkins is a registered psychologist, researcher and writer : See Part 2 Below

First Published in The Conversation 

The current report and the work leading up to it has led to new targets, such as a “significant and sustained progress to eliminate the over-representation of Aboriginal children in out-of-home care” and old targets framed differently.

For example, the headline new outcome for families, children and youth is that “Aboriginal and Torres Strait Islander children thrive in their early years”. This is on top of more specific targets such as having 95% of Aboriginal and Torres Strait Islander four-years-olds enrolled in early childhood education by 2025 – which this year is on track.


Read more: Closing the Gap is failing and needs a radical overhaul


Looking back on the past 11 years, there are several things we’ve learned. This includes those targets that seem easiest to meet, as well changes in the demographics of the population that complicate the measuring of the targets. Below are three lessons from the last decade of the policy.

https://datawrapper.dwcdn.net/74BbT/1/

1. Some targets are easier than others

The targets where there has been some success tend to be those where government has more direct control. Consider the Year 12 attainment compared to the employment targets. To increase the proportion of Indigenous Australians completing year 12, the Commonwealth government can change the income support system to create incentives to not leave school, while state and territory governments can adjust the school leaving age.

That is not to downplay the efforts of parents, teachers, community leaders, and the students themselves. But, there are some direct policy levers.

To improve employment outcomes, on the other hand, discrimination among employers needs to be reduced, human capital levels increased, jobs need to be in areas where Indigenous people live and to match the skills and experiences of the Indigenous population. These are solvable policy problems with the right settings and community engagement. But, they are substantially more complex.


Read more: Three reasons why the gaps between Indigenous and non-Indigenous Australians aren’t closing


2. The life-expectancy measure is unpredictable

The main target has always been related to Aboriginal and Torres Strait Islander life expectancy. The 2019 report shows the target of closing the gap by 2031 is not on track.

Unfortunately, the life expectancy target is one of the more difficult to measure, as it uses multiple datasets that are potentially affected by different ways Indigenous people are counted in the census and changing levels of identification. The most recent estimates, based on data for 2015-17, are that life expectancy at birth is 71.6 years for Indigenous males and 75.6 years for Indigenous females.

While the gaps with the non-Indigenous population of 8.6 years and 7.8 years respectively are smaller than they were in 2010-12 (the previous estimates) the Australian Bureau of Statistics (ABS) and most demographers suggest extreme caution around the interpretation of this change. The ABS writes:

While the estimates in this release show a small improvement in life expectancy estimates and a reduction in the gap between 2010-2012 and 2015-2017, this improvement should be interpreted with considerable caution as the population composition has changed during this period.

More people have been identifying as being Aboriginal and/or Torres Strait Islander over recent years. What’s more, the newly identified Indigenous people tend to have better outcomes on average (across health, education, and labour market outcomes) than those who were identified previously. This biases our estimates, making it appear there is more rapid progress than there might otherwise be.


Read more: Three charts on: the changing status of Indigenous Australians


The Closing the Gap framework was implicitly designed around improving the circumstances of the 2008 Indigenous population relative to the 2008 non-Indigenous population. However, both populations have changed substantially over the intervening years. There has been a growth of the non-Indigenous population due to international migration. It is hard to measure and track differences in changing populations.

3. On-track one year, off-track the next

There is also the yearly reporting cycle. The target of child mortality, for instance, no longer appears to be on track. This is despite it being on track in previous years. Yearly fluctuations make it hard to gauge the effectiveness of long-term policy settings.

For other indicators, such as employment, the data is available far less frequently than it could be, and we are less able to judge the effect of individual policies and interventions. Having said that, in my view, the sophistication and nuance with which data in the Closing the Gap reports has been presented has improved considerably.

It seems most policies prioritise Indigenous Australians living in remote areas than those in the city. David Clode/Unsplash

4. Indigenous Australians in the city and country have different needs

This isn’t always reflected in policy settings. The current report shows many outcomes are worse in remote compared to non-remote Australia. It also makes the point (though less frequently), that the vast majority of Indigenous Australians live in regional areas and major cities. This creates a tension between relative and absolute need. Unfortunately, the policy responses of government often don’t get that balance right.

Take the signature policy proposal announced with the current report – a suspension or cancelling of HECS debt for teachers who work in remote schools. What the policy ignores is that the vast majority of Indigenous students live outside remote Australia, that outcomes for Indigenous students in non-remote areas are well behind those of non-Indigenous students, and that the schools Indigenous students attend in non-remote areas tend to be very different from those of non-Indigenous students.


Read more: Infographic: Are we making progress on Indigenous education?


Attracting and keeping more high quality teachers in remote areas is a worthwhile policy aim. Alone, it is not sufficient.

The current report and speech by the prime minister states that “genuine partnerships are required to drive sustainable, systemic change” and that the government needs “to support initiatives led by Aboriginal and Torres Strait Islander communities to address the priorities identified by those communities”.

These are admirable goals. But, they require significant resources, a genuine engagement with the evidence (even if it isn’t positive), taking the Uluru Statement from the Heart seriously, and real ceding of control to Aboriginal and Torres Strait Islander people

5.Closing the Gap Failures are firmly rooted in racism

Some people think Aboriginal people must be uniquely anti-social and/or make very bad choices, but research tells us the majority of people in prison are suffering from severe cognitive impairments and/or mental health issues such as post-traumatic stress disorder and major depression.

Why are we punishing people with disabilities for behaviour that may not be intentional ?.

When we look at children in school, we find three times as many Aboriginal children are suspended from school than non-Aboriginal children. Some of the special purpose schools in NSW are filled with Aboriginal children only.

Many youth detention centres in the country have 100 per cent Aboriginal inmates. Why are so many Aboriginal children being suspended from school and set on the road to crime and punishment, and what happens to white Australian children who are not able to behave appropriately in the classroom ?.

It seems mainstream Australian children are referred to health professionals when they have difficulties at school. They are seen as suffering from learning disabilities, autism, or ADHD. Speech therapists and other allied health professionals work to help them catch up with peers and stay in school.

Due to intergenerational disadvantage, Indigenous people often don’t have the resources to find a therapist to assist their child. People born before 1972 were not guaranteed a place in school, and so grand parents may not have had much education.

Parents may have left school in Year 8 or 9 and are not familiar with developmental norms or disabilities. If they know that their child is falling behind at school, they often do not have the money to pay for expensive psychological assessments, which cannot be done in Medicare. Without an assessment, and a diagnosis , the school cannot make allowances for a child with brain-based disabilities.

The racist policies of the past have left many Aboriginal people disadvantaged when it comes to dealing with the education system. If their child is having difficulties, suspensions are often the consequence. Once suspended and out on the street, racism sets in again.

Aboriginal children are searched and arrested more often. We will never close the disadvantage gap until we can offer support to the children of young people. We need to raise the age criminal responsibility from 10 to 15 years, and spend money on supporting children, not punishing them.

Dr Meg Perkins

 

NACCHO Aboriginal Health #Obesity #Diabetes News: 1. @senbmckenzie report #ObesitySummit19 and 2. @MenziesResearch are calling for immediate action to reduce risk the of #obesity and #diabetes in #Indigenous children and young people.

Type 2 Diabetes is a particular concern as there is a global trend of increasing numbers of young people being diagnosed, there is limited data available in Australia but anecdotally numbers are rising rapidly amongst young Indigenous Australians.

Childhood obesity and Type 2 diabetes leads to other serious health issues such as kidney disease which then puts a huge burden on families, communities and health facilities. When it occurs at a young age, it is a much more aggressive disease than in older people.

It is critical that we act now to prevent this emerging public health issue, with engagement of Indigenous communities in the design of interventions being crucial.

“A suite of interventions across the life course are required, targeting children and young people before they develop disease, particularly childhood obesity, as well as targeting their parents to prevent intergenerational transmission of metabolic risk” 

Dr Angela Titmuss, paediatric endocrinologist at Royal Darwin Hospital and Menzies School of Health Research (Menzies) PhD student : See Press Release Part 1

Read over 150 Aboriginal Health and Diabetes articles published by NACCHO over past 7 years

Read over 70 Aboriginal Health and Obesity articles published by NACCHO over past 7 years

” The latest Australian Bureau of Statistics National Health Survey shows that previous efforts to combat obesity have had limited success.

Two-thirds of adults and a quarter of children aged from five to 17 years are now overweight or obese.

While the rate for children has been stable for 10 years, the proportion of adults who are not just overweight but obese has risen from 27.9 per cent to 31.3 per cent.

Overweight and obesity not only compromise quality of life, they are strongly linked to preventable chronic diseases—heart disease, diabetes, lung disease, certain cancers, depression and arthritis, among others.

Senator McKenzie #ObesitySummit19 See Press Release Part 2 Below

Researchers are calling for immediate action to reduce risk the of obesity and diabetes in Indigenous children and young people.

A suite of interventions across the life course are required, targeting children and young people before they develop disease, particularly childhood obesity, as well as targeting their parents to prevent intergenerational transmission of metabolic risk.

The in utero period and first 5 years of life are influential in terms of the long term risk of chronic disease, and we propose that identifying and improving childhood metabolic health be a targeted priority of health services.

In an article published in the Medical Journal of Australia (MJA) today, researchers have identified childhood obesity and the increasing numbers of young people being diagnosed with Type 2 diabetes as emerging public health issues.

Lead author Dr Angela Titmuss, paediatric endocrinologist at Royal Darwin Hospital and Menzies School of Health Research (Menzies) PhD student, says in the MJA Perspective article that collaboration between communities, clinicians and researchers across Australia is needed to get an accurate picture of the numbers involved.

In Indigenous Australian young people with type 2 diabetes, there are also higher rates of comorbidities, with 59% also having hypertension, 24% having dyslipidaemia and 61% having obesity.

These comorbidities will have a significant impact on the future burden of disease, and may lead to renal, cardiac, neurological and ophthalmological complications. Canadian data demonstrated that 45% of patients with youth onset type 2 diabetes had reached end‐stage renal failure, requiring renal replacement therapy, 20 years after diagnosis, compared with zero people with type 1 diabetes.

Youth onset type 2 diabetes was associated with a 23 times higher risk of kidney failure and 39 times higher risk of need for dialysis, compared with young people without diabetes.

This implies that many young people who are being diagnosed with diabetes now will be on dialysis by 30 years of age, with significant effects on Aboriginal and Torres Strait Islander families and communities.

Menzies HOT NORTH project is supporting this research through the Diabetes in Youth collaboration, a Northern Australia Tropical Disease Collaborative Research Program, funded by the NHMRC.

The MJA Article is available here

https://www.mja.com.au/journal/2019/210/3/emerging-diabetes-and-metabolic-conditions-among-aboriginal-and-torres-strait

 Comprehensive strategies, action plans and both funding and better communication across sectors (health, education, infrastructure and local government) and departments are required to address obesity, diabetes and metabolic risk among Indigenous young people in Australia.

It requires a radical rethinking of our current approach which is failing Aboriginal and Torres Strait Islander young people and communities, and a commitment to reconsider the paradigm, to be open to innovative approaches and the involvement of multiple sectors

Part 2

I again apologise for any offence taken by the unfortunate photo taken out of context at the Obesity Summit on Friday, and I am happy if my ridicule leads to action on the complex issue of obesity in this country.

The Senator has apologised.

The issue of obesity is a matter I take very seriously and would never triavisie it- or to add in any way to stigmatisation. I sincerely apologise for this very unfortunate photo taken as I demonstrated how my stomach felt after scrambled eggs reacted w yogurt I had just eaten.

That is exactly the reason I called international and Australian experts together for the National Obesity Summit last week

Last October, the Council of Australian Governments’ (COAG) Health Council— comprising federal, state and territory ministers—agreed to develop a national strategy on obesity.

Friday’s National Obesity Summit in Canberra represented an important first step towards a new nationally cohesive strategy on obesity prevention and control.

The Summit focussed on the role of physical activity, primary health care clinicians, educators and governments to work collaboratively rather than in silos.

At the Summit we heard from national and global experts because obesity is an international issue and we need to understand how other jurisdictions are tackling the problem.  We also heard that stigma surrounding obesity can be a barrier to help being accessed.

The latest Australian Bureau of Statistics National Health Survey shows that previous efforts to combat obesity have had limited success.

Two-thirds of adults and a quarter of children aged from five to 17 years are now overweight or obese.

While the rate for children has been stable for 10 years, the proportion of adults who are not just overweight but obese has risen from 27.9 per cent to 31.3 per cent.

Overweight and obesity not only compromise quality of life, they are strongly linked to preventable chronic diseases—heart disease, diabetes, lung disease, certain cancers, depression and arthritis, among others.

We know that there is not one simple solution to tackling the problem so we need to examine all options and develop a multi-faceted approach.

The Obesity Summit represented an important moment for Australians’ health and recognised that there is no magic fat-busting policy pill.

NACCHO Aboriginal Health Pre- #Budget2019 -2020 : #RefreshTheCTGRefresh :The following #ClosingTheGap policy proposals are informed by NACCHO’s consultations with its Affiliates and our 145 Aboriginal Community Controlled Health Services:

 

The proposals included in this submission are based on the extensive experience NACCHO member services have of providing many years of comprehensive primary health care to Aboriginal and Torres Strait Islander peoples.

We have long recognised that closing the gap on Aboriginal and Torres Strait Islander health and disadvantage will never be achieved until primary health care services’ infrastructure hardware is fit for purpose; our people are living in safe and secure housing; culturally safe and trusted early intervention services are available for our children and their families; and our psychological, social, emotional and spiritual needs are acknowledged and supported.=

If these proposals are adopted, fully funded and implemented, they provide a pathway forward where improvements in life expectancy can be confidently predicted. “  

Pat Turner AM NACCHO CEO on behalf of our State and Territory Affiliates and 145 Aboriginal Community Controlled Health Services operating 302 ACCHO Clinics

Download this 20 Page NACCHO Submission

NACCHO Budget Submission 2019-20 FINAL

NACCHO is the national peak body representing 145 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 provide about one million episodes of care in a twelve-month period.

Collectively, we employ about 6,000 staff (56 per cent whom are Indigenous), which makes us the single largest employer of Indigenous people in the country.

The following policy proposals are informed by NACCHO’s consultations with its Affiliates and Aboriginal Community Controlled Health Services:

  1. Increase base funding of Aboriginal Community Controlled Health Services;
  2. Increase funding for capital works and infrastructure;
  3. Improve Aboriginal and Torres Strait Islander housing and community infrastructure;
  4. Reduce the overrepresentation of Aboriginal and Torres Strait Islander children and young people in out-of-home care and detention; and
  5. Strengthen the Mental Health and Social and Emotional Wellbeing of Aboriginal and Torres Strait Islander peoples.

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.

1. Increase base funding of Aboriginal Community Controlled Health Services

Proposal:

That the Australian Government:

  • Commits to increasing the baseline funding for Aboriginal Community Controlled Health Services to support the sustainable delivery of high quality, comprehensive primary health care services to Aboriginal and Torres Strait Islander people and communities.
  • Works together with NACCHO and Affiliates to agree to a new formula for the provision of comprehensive primary health care funding that is relative to need.

Rationale: 

The Productivity Commission’s 2017 Indigenous Expenditure 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.

The Commonwealth Government spends $1.4 for every $1 spent on the rest of the population, while Aboriginal and Torres Strait Islander people have 2.3 times the per capita need of the rest of the population because of much higher levels of illness and burden of disease. In its 2018 Report Card on Indigenous Health, the Australian Medical Association (AMA) states that spending less per capita on those with worse health, is ‘untenable national policy and that must be rectified’.1 The AMA also adds that long-term failure to adequately fund primary health care – especially Aboriginal Community Controlled Health Services (ACCHSs) – is a major contributing factor to failure in closing health and life expectancy gaps.

Despite the challenges of delivering services in fragmented and insufficient funding environments, studies have shown that ACCHSs deliver more cost-effective, equitable and effective primary health care services to Aboriginal and Torres Strait Islander peoples and are 23 per cent better at attracting and retaining Aboriginal and Torres Strait Islander clients than mainstream providers.2 ACCHSs continue to specialise in providing comprehensive primary care consistent with clients’ needs.

This includes home and site visits; provision of medical, public health and health promotion services; allied health, nursing services; assistance with making appointments and transport; help accessing child care or dealing with the justice system; drug and alcohol services; and providing help with income support.

                                                        

1https://ama.com.au/system/tdf/documents/2018%20AMA%20Report%20Card%20on%20Indigenous%20Heal th_1.pdf?file=1&type=node&id=49617, page 6.

2 Ong, Katherine S, Rob Carter, Margaret Kelaher, and Ian Anderson. 2012. Differences in Primary Health Care

Delivery to Australia’s Indigenous Population: A Template for Use in Economic Evaluations, BMC Health

Services Research 12:307; Campbell, Megan Ann, Jennifer Hunt, David J Scrimgeour, Maureen Davey and

Victoria Jones. 2017. Contribution of Aboriginal Community Controlled Health Services to improving Aboriginal

There are limits, however, to the extent that ACCHSs can continue to deliver quality, safe primary health care in fragmented and insufficient funding environments. This is particularly challenging to meet the health care needs of a fast-growing population.3 There is an urgent need to identify and fill the current health service gaps, particularly in primary health care, and with a focus on areas with high preventable hospital admissions and deaths and low use of the Medical Benefits Scheme and the Pharmaceutical Benefits Scheme.

An appropriately resourced Aboriginal Community Controlled Health sector represents an evidence-based, cost-effective and efficient solution for addressing the COAG Close the Gap and strategy and will result in gains for Aboriginal and Torres Strait Islander peoples’ health and wellbeing.

Strengthening the workforce

NACCHO welcomes COAG’s support for a National Aboriginal and Torres Strait Islander Health and Medical Workforce Plan. A long-term plan for building the workforce capabilities of ACCHSs is overdue. Many services struggle with the recruitment and retention of suitably qualified staff, and there are gaps in the number of professionals working in the sector.

NACCHO believes that the plan will be strengthened by expanding its scope to include:

  • metropolitan based services;
  • expanding the range of workforce beyond doctors and nurses; and
  • recognising that non-Indigenous staff comprise almost half of the workforce. While Aboriginal and Torres Strait Islander health staff are critical to improving access to culturally appropriate care and Indigenous health outcomes, consideration to the non-Indigenous workforce who contribute to improving Aboriginal and Torres Strait Islander Health outcomes should also be given.

An increase in the baseline funding for Aboriginal Community Controlled Health Services, as set out in this proposal will enable our sector to plan for and build workforce capabilities in line with the Health and Medical Workforce Plan objectives.

2. Increase funding for capital works and infrastructure upgrades

Proposal:

That the Australian Government:

  • Commits to increasing funding allocated through the Indigenous Australians’ Health Programme for capital works and infrastructure upgrades, and  Telehealth services; noting that at least $500m is likely to be needed to address unmet needs, based on the estimations of 38.6 per cent of the ACCHO sector, and we anticipate that those needs may be replicated across the sector (see Table A below).

Rationale: 

There is a current shortfall in infrastructure with a need for new buildings in existing and outreach locations, and renovations to increase amenities including consultation spaces. Additional funding is required for additional rooms and clinics mapped against areas of highest need with consideration to establishing satellite, outreach or permanent ACCHSs.

Many of the Aboriginal health clinics are 20 to 40 years old and require major refurbishment, capital works and updating to meet increasing population and patient numbers. The lack of consulting rooms and derelict infrastructure severely limits our services’ ability to increase MBS access.

Further, whilst there may be some scope to increase MBS billing rates for Aboriginal and Torres Strait Islander peoples, this cannot be achieved without new services and infrastructure. A vital priority is seed funding for the provision of satellite and outreach Aboriginal Community Controlled Health Services that Aboriginal and Torres Strait Islander people will access, and which provide the comprehensive services needed to fill the service gaps, to boost the use of MBS and PBS services to more equitable levels, and to reduce preventable admissions and deaths.

Improvements to the building infrastructure of ACCHSs are required to strengthen their capacity to address gaps in service provision, attract and retain clinical staff, and support the safety and accessibility of clinics and residential staff facilities. However, the level of funding of $15m per annum, under the Indigenous Australians’ Health Programme allocated for Capital Works – Infrastructure, Support and Assessment and Service Maintenance, is not keeping up with demand.

In our consultations with Affiliates and ACCHSs, NACCHO is increasingly hearing that

Telehealth services,[1] including infrastructure/hardware and improved connectivity, is required to support the provision of NDIS, mental health and health specialist services. A total of 22 out of 56 survey responses (see Table A below) identified the need for Telehealth to support service provision.

NACCHO believes that insufficient funding to meet capital works and infrastructure needs is adversely impacting the capacity of some ACCHSs to safely deliver comprehensive, timely and responsive primary health care; employ sufficient staff; to improve their uptake of Medicare billing; and to keep up with their accreditation requirements. In January 2019, we surveyed ACCHSs about their capital works and infrastructure needs, including Telehealth services. We received 56 responses, representing a response rate of 38.6 per cent.

 

Survey respondents estimated the total costs of identified capital works and infrastructure upgrades (see Table A below). The estimated costs have not been verified; however, they do

suggest there is a great level of unmet need in the sector. Please note that not all respondents were able to provide estimates.

Table A. Estimated costs of capital works and infrastructure upgrades identified by ACCHSs

Type Number of respondents Percentage of respondents Total estimated costs
Replace existing building 43 76.7% 207,559,043
New location/satellite clinic 21 37.5% 53,480,000
Extension 24 42.8% 18,310,000
Refurbishment 29 51.7% 35,251,000
Staff accommodation 25 44.6% 39,450,000
Telehealth services 22 39.2% 6,018,763
Total estimated costs of capital works and infrastructure upgrades $361,068,806

 

37 survey respondents applied for funding for infrastructure improvements from the Australian Government Department of Health during 2017 and/or 2018. Of the 11 that were successful, four respondents stated that the allocated funds were not sufficient for requirements.

ACCHSs believe that the current state of their service infrastructure impedes the capacity of their services as depicted in Table B, below:

Table B: Impact of ACCHSs’ infrastructure needs on service delivery

Infrastructure impeding service delivery Highly affected Somewhat affected
Safe delivery of quality health care 48.1% 51.9%
Increase client numbers 74.1% 25.9%
Expand the range of services and staff numbers 83.3% 16.7%
Increase Medicare billing 66% 34%

 

An extract of feedback provided by ACCHSs relating to their capital works and infrastructure needs is at Appendix A.

3. Improve Aboriginal and Torres Strait Islander housing and community infrastructure

Proposals:

That the Australian Government:

  • Expand the funding and timeframe of the current National Partnership on Remote Housing to match AT LEAST that of the former National Partnership Agreement on Remote Indigenous Housing.
  • Establish and fund a program that supports healthy living environments in urban, regional and remote Aboriginal and Torres Strait Islander communities, similar to the Fixing Houses for Better Health program. Ensure that rigorous data collection and program evaluation structures are developed and built into the program, to provide the Commonwealth Government with information to enable analysis of how housing improvements impact on health indicators.[2]
  • Update and promote the National Indigenous Housing Guide, a best practice resource for the design, construction and maintenance of housing for Aboriginal and Torres Strait Islander peoples.[3]

Rationale: 

Safe and decent housing is one of the biggest social determinants of health and we cannot overlook this when working to close the gap in life expectancy.

1. Remote Indigenous Housing

The National Partnership Agreement on Remote Indigenous Housing 2008-2018 was a COAG initiative that committed funding of $5.4b towards new builds, refurbishments, housing quality, cyclical maintenance, and community engagement and employment and business initiatives.

In 2016, the National Partnership Agreement on Remote Indigenous Housing was replaced by the National Partnership on Remote Housing. Under this new partnership, the Commonwealth Government committed:

  • $776.403m in 2016, to support remote housing in the Northern Territory, Queensland, South Australia, Western Australia, and the Northern Territory over a two-year period; and
  • $550m in 2018, to support remote housing in the Northern Territory, over a five-year period.

New South Wales, Victoria and Tasmania are not part of discussions with the Commonwealth Government on housing needs.

A review of the National Partnership Agreement on Remote Indigenous Housing (2018) found that:

  • An additional 5,500 homes are required by 2028 to reduce levels of overcrowding in remote areas to acceptable levels
  • A planned cyclic maintenance program, with a focus on health-related hardware and houses functioning, is required.
  • Systematic property and tenancy management needs to be faster.
  • More effort is required to mobilise the local workforces to do repairs and maintenance work.[4]

There is currently a disconnect between the levels of government investment into remote housing and the identified housing needs of remote communities. This disconnect is increasingly exacerbated by population increases in Aboriginal communities.[5]

There is a comprehensive, evidence-based literature which investigates the powerful links between housing and health, education and employment outcomes.[6] Healthy living conditions are the basis from which Closing the Gap objectives may be achieved. Commonwealth Government leadership is urgently needed to appropriately invest into remote housing.

2.Environmental health

The importance of environmental health to health outcomes is well established. A healthy living environment with adequate housing supports not only the health of individuals and families; it also enhances educational achievements, community safety and economic participation.10

Commonwealth and State and Territory Governments have a shared responsibility for housing. Overcrowding is a key contributor to poor health of Aboriginal and Torres Strait Islander peoples. In addition to overcrowding, poor and derelict health hardware (including water, sewerage, electricity) leads to the spread of preventable diseases for Aboriginal and Torres Strait Islander peoples. Healthy homes are vital to ensuring that preventable diseases that have been eradicated in most countries do not exist in Aboriginal and Torres Strait Islander communities and homes.

4. Reduce the overrepresentation of Aboriginal and Torres Strait Islander children and young people in out-of-home care and detention

Proposals:

That the Australian Government:

  • Establishes an additional elective within the existing Aboriginal Health Worker curriculum, that provides students with early childhood outreach, preventative health care and parenting support skills
  • Waives the upfront fees of the first 100 Indigenous students to undertake the Aboriginal Health Worker (Early Childhood stream) Certificate IV course.
  • Funds an additional 145 Aboriginal Health Worker (early childhood) places across ACCHSs.

Rationale:

The overrepresentation of Aboriginal and Torres Strait Islander children and young people in the child protection system is one of the most pressing human rights challenges facing Australia today.[7]

Young people placed in out-of-home care are 16 times more likely than the equivalent general population to be under youth justice supervision in the same year.[8]

Government investment in early childhood is an urgent priority to reduce the overrepresentation of Aboriginal and Torres Strait Islander children in out of home care and youth detention. Research reveals that almost half of the Aboriginal and Torres Strait Islander children who are placed to out of home care are removed by the age of four[9] and, secondly, demonstrates the strong link between children and young people in detention who have both current and/or previous experiences of out of home care.[10] There is also compelling evidence of the impact of repetitive, prolonged trauma on children and young people and how, if left untreated, this may lead to mental health and substance use disorders, and intergenerational experiences of out-of-home care and exposure to the criminal justice system.15

Despite previous investments by governments, the Aboriginal and Torres Strait Islander children and young people remain overrepresented in the children protection and youth detention systems. The Council of Australian Governments (COAG) Protecting Children is Everyone’s Business National Framework for Protecting Australia’s Children 2009–2020 (‘National Framework’) was established to develop a unified approach for protecting children. It recognises that ‘Australia needs a shared agenda for change, with national leadership and a common goal’.

One of the six outcomes of the National Framework is that Aboriginal and Torres Strait Islander children are supported and safe in their families and communities, with this overarching goal:

Indigenous children are supported and safe in strong, thriving families and communities to reduce the over-representation of Indigenous children in child protection systems. For those Indigenous children in child protection systems, culturally appropriate care and support is provided to enhance their wellbeing.16

Findings presented in the 2018 Family Matters Report reveal, however, that the aims and objectives of the National Framework have failed to protect Aboriginal and Torres Strait Islander children:

Aboriginal and Torres Strait Islander children make up just over 36 per cent of all children living in out-of-home care; the rate of Aboriginal and Torres Strait Islander children in out-ofhome care is 10.1 times that of other children, and disproportionate representation continues to grow (Australian Institute of Health and Welfare [AIHW], 2018b). Since the last Family Matters Report over-representation in out-of-home care has either increased or remained the same in every state and territory.17

Furthermore, statistics on the incarceration of Aboriginal and Torres Strait Islander children and young people in detention facilities reveal alarmingly high trends of overrepresentation:

  • On an average night in the June quarter 2018, nearly 3 in 5 (59%) young people aged 10– 17 in detention were Aboriginal and Torres Strait Islander, despite Aboriginal and Torres Strait Islander young people making up only 5% of the general population aged 10–17.
  • Indigenous young people aged 10–17 were 26 times as likely as non-Indigenous young people to be in detention on an average night.
  • A higher proportion of Indigenous young people in detention were aged 10–17 than non-Indigenous young people—in the June quarter 2018, 92% of Aboriginal and Torres

Strait Islander young people in detention were aged 10–17, compared with 74% of non-

Indigenous Islander young people.18

towardtraumainfo/Orygen_trauma_and_young_people_policy_report.aspx?ext=.; https://www.facs.nsw.gov.au/__data/assets/pdf_file/0016/421531/FACS_SAR.pdf

NACCHO believes an adequately funded, culturally safe, preventative response is needed to reduce the number and proportion of Aboriginal and Torres Strait Islander children in child protection and youth detention systems. It is vital that Aboriginal and Torres Strait Islander families who are struggling with chronic, complex and challenging circumstances are able to access culturally appropriate, holistic, preventative services with trusted service providers that have expertise in working with whole families affected by intergenerational trauma. The child protection and justice literature are united in that best practice principles for developing solutions to these preventable problems begin with self-determination, community control, cultural safety and a holistic response.[11] For these reasons, we are proposing that the new Aboriginal Health Worker (Early Childhood) be based within the service setting of the Aboriginal Community Controlled Health Service.

The cultural safety in which ACCHSs’ services are delivered is a key factor in their success. ACCHSs have expert understanding and knowledge of the interplays between intergenerational trauma, the social determinants of health, family violence, and institutional racism, and the risks these contributing factors carry in increasing Aboriginal and Torres Strait Islander peoples’ exposure to the child protection and criminal justice systems.

Our services have developed trauma informed care responses that acknowledge historical and contemporary experiences of colonisation, dispossession and discrimination and build this knowledge into service delivery.

Further, they are staffed by health and medical professionals who understand the importance of providing a comprehensive health service, including the vital importance of regular screening and treatment for infants and children aged 0-4, and providing at risk families with early support. Within the principles, values and beliefs of the Aboriginal community controlled service model lay the groundwork for children’s better health, education, and employment outcomes. The addition of Aboriginal Health Workers with early childhood skills and training will provide an important, much needed role in preventing and reducing Aboriginal and Torres Strait Islander children and young peoples’ exposure to child protection and criminal justice systems.

 

Aboriginal Peak Organisations of the Northern Territory, Submission to the Royal  

Commission into the Protection and Detention of Children in the Northern Territory, 2017

NACCHO supports the position and recommendations of Aboriginal Peak Organisations in the NT, that:

•        Aboriginal community control, empowerment and a trauma informed approach should underpin the delivery of all services to Aboriginal children and their families. This applies to service design and delivery across areas including early childhood, education, health, housing, welfare, prevention of substance misuse, family violence prevention, policing, child protection and youth justice.

•        The Australian Government develops and implements a comprehensive, adequately resourced national strategy and target, developed in partnership with Aboriginal and Torres Strait Islander peoples, to eliminate the over-representation of Aboriginal and Torres Strait Islander children in out-of-home care.

•        There is an urgent need for a child-centred, trauma-informed and culturally relevant approach to youth justice proceedings which ultimately seeks to altogether remove the need for the detention of children.

•        Early childhood programs and related clinical and public health services are provided equitably to all Aboriginal children (across the NT) through the development and implementation of a three-tiered model of family health care – universal, targeted and indicated – to meet children’s needs from before birth to school age. Services should be provided across eight key areas:  o quality antenatal and postnatal care;

o clinical and public health services for children and families; o a nurse home visiting program; o parenting programs; o child development programs; o two years of preschool; o targeted services for vulnerable children and families; and o supportive social determinants policies.

•        These services need to be responsive to, and driven by, the community at a local level.

5. Strengthen the mental health and social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples

Proposal:

That the Australian Government:

  • Provide secure and long-term funding to ACCHSs to expand their mental health, social and emotional wellbeing, suicide prevention, alcohol and other drugs services, using best practice trauma informed approaches.
  • Urgently increase funding for ACCHSs to employ staff to deliver mental health and social and emotional wellbeing services, including psychologists, psychiatrists, speech pathologists, mental health workers and other professionals and workers; and
  • Urgently increase the delivery of training to Aboriginal health practitioners to establish and/or consolidate skills development in mental health care and support, including suicide prevention; and
  • Return funding for Aboriginal and Torres Strait Islander suicide prevention, health and wellbeing and alcohol and other drugs from the Indigenous Advancement Strategy to the Indigenous Australians’ Health Programme.

Rationale: 

The Australian Institute of Health and Welfare has estimated that mental health and substance use are the biggest contributors to the overall burden of disease for Aboriginal and Torres Strait Islander peoples. Indigenous adults are 2.7 times more likely to experience high or very high levels of psychological distress than other Australians.[12] They are also hospitalised for mental and behavioural disorders and suicide at almost twice the rate of non-Indigenous population and are missing out on much needed mental health services.

Suicide is the leading cause of death for Aboriginal people aged 5-34 years, the second leading cause of death for Aboriginal and Torres Strait Islander men. In 2016, the rate of suicide for Aboriginal and Torres Strait Islander peoples was 24 per 100,000, twice the rate for non-Indigenous Australians.[13] Aboriginal people living in the Kimberley region are seven times more likely to suicide than non-Aboriginal people.

Many Aboriginal Community Controlled Health Services deliver culturally safe, trauma informed services in communities dealing with extreme social and economic disadvantage that are affected and compounded by intergenerational trauma and are supporting positive changes in the lives of their members. The case study provided by Derby Aboriginal Health Service demonstrates not only the impact that this ACCHS is having on its community. It also illustrates the rationale for each of the proposals described in this pre-budget submission.

Case Study: Derby Aboriginal Health Service, WA

Derby Aboriginal Health Service’s Social and Emotional Wellbeing Unit (SEWB) have partnered with another organisation to employ someone in our SEWB unit to work directly with families on issues that contribute to them losing their children to Department of Child Protection (DCP). This program is designed to help prevent the children from being removed by DCP by working one to one with families on issues such as budgeting, education, substance misuse, a safe and healthy home etc.

Our SEWB unit has a community engagement approach which involves working directly with clients and their families, counselling with the psychologist and mental health worker, the male Aboriginal Mental Health Worker taking men out on country trips as part of mental health activities for men, the youth at risk program (Shine), the Body Clinic, the prenatal program working directly with mums, dads and bubs around parenting, relationships between mums, dads and children etc. The team work directly with the community.

We are now introducing a new SEWB designed program into the Derby prison which focuses on exploring men and women’s strengths and abilities rather than looking at their deficits. Using a strengths based program was very successfully delivered with a group of 22 Aboriginal men and 16 Aboriginal women where, for many of the participants, they were told for the first time in their lives that they matter and that they have good things about them and they are strong men and women (this naturally brought in some behavior modification that they could attempt in making changes in their lives; e.g. one participant said that when he went home, he was going to make his wife a cup of tea instead of expecting her to make him tea – he said he had never thought of that before). The SEWB team presented this at the National Mental Health Conference in Adelaide, August last year.

Given the deep and respectful footprint the SEWB team has in the town and surrounding communities, they, and the people, deserve and need a new building in which to continue their important work. If we can help people deal with the issues above, then they will be much more empowered to prevent/deal with their own health issues – perhaps then we can Close the Gap.

Given the burden of mental, psychological distress and trauma that our communities are responding to and the impact this has on Aboriginal and Torres Strait Islander peoples’ life expectancy, educational outcomes, and workforce participation, NACCHO believes it is imperative that a funded implementation plan for the National Strategic Framework for Aboriginal and Torres Strait Islander Mental Health and Social and Emotional Wellbeing

2017-2023 (‘the Framework’) be developed as a priority. The following Action Areas of the Framework relate to this proposal:

  • Action Area 1 – Strengthen the foundations (An effective and empowered mental health and social and emotional wellbeing workforce);
  • Action Area 2 – Promote wellness (all outcome areas);[14] and
  • Action Area 4 – Provide care for people who are mildly or moderately ill (Aboriginal and Torres Strait Islander people living with a mild or moderate mental illness are able to access culturally and clinically appropriate primary mental health care according to need).

As the above case study suggests, our trusted local Aboriginal community controlled services are best placed to be the preferred providers of mental health, social and emotional wellbeing, and suicide prevention activities to their communities. Australian Government funding should be prioritised to on the ground Aboriginal services to deliver suicide prevention, trauma and other wellbeing services. Delivering these much-needed services through ACCHSs, rather than establishing a new service, would deliver economies of scale and would draw from an already demonstrated successful model of service delivery.

Further, NACCHO believes that the current artificial distinction between separating mental health, social and emotional wellbeing and alcohol and drug funding from primary health care funding, must be abolished. Primary health care, within the holistic health provision of ACCHS, provides the sound structure to address all aspects of health care arising from social, emotional and physical factors. Primary health care is a comprehensive approach to health in accordance with the Aboriginal holistic definition of health and arises out of the practical experience within the Aboriginal community itself having to provide effective and culturally appropriate health services to its communities.

The current artificial distinction, as exemplified by program funding for ACCHS activities being administered across two Australian Government Departments, does not support our definition of health and wellbeing. It also leads to inefficiencies and unnecessarily increases red tape, by imposing additional reporting burdens on a sector that is delivering services under challenging circumstances.     

APPENDIX A

Qualitative feedback from Aboriginal Community Controlled Health Services  capital works and infrastructure needs 

The following comments from ACCHSs have been extracted from a survey administered by NACCHO in January 2019:

  • Currently at capacity and as the government focusses more on Medicare earnings and less on funding we need the ability to expand into this area as well as the NDIS in order to meet our client service needs and build sustainability.
  • The facility that our service currently occupies is state government owned, on state crown land, is over 40 years old and is ‘sick’ – it is not fit for purpose with an irreparable roof, significant asbestos contamination, water ingress, mould and recurrent power outages. The maintenance costs are an unsustainable burden, it is unreliable, unsuitable and unsafe for clients and staff, and there is no room for expansion for program and community areas. We applied for funding from the Australian Government Department of Health, but the application was not successful. This figure is inclusive of early works transportable – temporary accommodation, building works, demolition works, services infrastructure, external works, design development contingency, construction contingency, builder preliminaries and margin, loose furniture and equipment, specialist/medical equipment, ICT & PABX, AV equipment, professional including.

disbursements (to be confirmed), statutory fees, locality loading, and goods and services tax.

  • We are in need of kitchen renovations to each of our community care sites that do meals on wheels. The WA Environmental Health unit has informed us that we need to upgrade all our kitchens to meet Food Safety requirements or they will enforce closure of some of our kitchens, which would then mean we are unable to do our Meals on Wheels service in some communities
  • Currently limited by space to employ support staff and increase our GP’s, our waiting room is around 3x4m and we are always having clients standing up or waiting outside until there is space for them. We currently have three buildings in the one township with two being rentals, if we could co-locate all services, we could offer a higher level of integrated care and save wasted money on rent.
  • Not currently enough space to house staff and visiting clinicians.
  • Have been applying for grants in infrastructure and included in Action Plan for quite a few years and still not successful.
  • We need a multi-purpose building to bring together our comprehensive range of services in a way that enables community to gather, express their culture and feel safe and welcome whilst receiving a fully integrated service delivery model of supports. We have more than doubled in staffing and program delivery and are still trying to operate out of the same space. The need for further expansion is inevitable and the co-operative welcomes the opportunity to bring more services to our community, but infrastructure

is a barrier and we have taken the strategic decision to acquire vacant land near our main headquarters with the view to obtaining future infrastructure funding – it is much needed.

  • The three sites we currently lease are all commercial premises and we have to make our business fit, the buildings are not culturally appropriate nor are they designed for a clinical setting.
  • For eight years we have struggled to grow in line with our community service needs and the requirement to become more self-sufficient in the face of a funding environment which is declining in real terms (not keeping pace with CPI and wages growth). Further to this, every time we add a building our running costs go up so even capital expansion comes at a cost to the organisation as it takes time to build up to the operating capacity that the new/improved buildings provide. This is the ongoing struggle in our space.
  • Our service was established in 1999 and has been operating from an 80 year old converted holiday house, with a couple of minor extensions. The clinic does not meet the contemporary set up for an efficient clinic from viewpoint of staff, medical services and for community members. Space is very limited, and service delivery is also limited due to room availability. Demand for services both for physical and mental health/SEWB is growing strongly. We have 425 Community Members (with 70 currently in prisons in our region) and our actual patient numbers accessing services over 12 months have increased 50%.
  • We never received support or funding to acquire a purpose-built facility from the outset and as there was no suitable accommodation for rent or lease, we acquired two small houses to deliver our services from. These were totally inadequate but all we could acquire at the time. We have 31 staff accommodated through three locations and require a purpose-built facility to deliver quality primary health care to our Community.
  • Over the last two years we have been able to purchase the site it is currently located on. This site is based on five contiguous residential properties, with each property containing a 2-3 bedroom, approximately 40 year old house. Two of these houses have been joined together to form the Medical Clinic, the other three houses have all been renovated and upgraded to various levels in order to make them usable by the service. The next step in the plan is to redevelop the entire site to build an all-in-one centre to replace the current four separate buildings. In our 12 years of service we have moved from renting at a number of locations to being able to purchase our current site. The current site of old, converted residential buildings while viable in the short term, does not allow for efficient use of the site nor capacity for growth. Parking is scattered around the site, staff are scattered and continually moving from building to building to serve clients. There is no excess accommodation capacity to allow for growth of services. Our intention is to re-develop the site to house all staff in one building, which will be configured for growth over the long term and allow efficient use of the available grounds for parking, an Elders shed, and so on.
  • We have run out of room. Every office is shared, including the CEO’s office. We can’t hire any staff – nowhere to house them. Whenever a visiting service is operating – GP clinic, podiatry, optometry, audiology, chiropractor etc, offices have to be vacated to house

them, displaced staff basically have nowhere to go. Fine balancing act to schedule things to displace as few people as possible.

  • We are currently located in two refurbished community buildings as there is no suitable accommodation for lease. Our organisation is growing very quickly, and we need all services located under one roof – one identity, one culture.
  • Rapidly reaching the point where services will be diminished because of failing infrastructure or insufficient housing for the nursing staff required.
  • Some clinical rooms are not fit for purpose. Clinicians working from rooms without hand washing facilities. Medical Clinic is old, out of date, some rooms not fit for purpose, ineffective air conditioning, clinical staff sharing rooms, no room for expansion, difficult to house students due to lack of appropriate space.
  • We have made a number of applications to improve infrastructure, and to replace current infrastructure, all have been unsuccessful, in some cases we have purchase buildings & land to try and demonstrate a commitment to ongoing growth and servicing of clients. We get little feedback in relation to funding applications.
  • Spread across three sites with some providers having to share rooms and staff being required to work outside on laptops at times. Desperately needing to build a purposebuilt facility in order to stop paying high amounts of rent and allow effective primary health care to an increasing client number.

Derby Aboriginal Health Service

The Derby Aboriginal Health Service (DAHS) Social and Emotional Wellbeing (SEWB) unit is housed in a 60+ year old asbestos building that was originally a family home. It has an old and small transport unit connected to the house by an exposed verandah. There are 6 staff working from the house who provide individual and family counselling and support. The clients who come to SEWB experience mental health issues, family violence, poverty, Department of Child Protection (DCP) issues around removal of children, alcohol and other drug issues and supporting those released from the Derby local Prison (approx. 200 prisoners). It is difficult to safely secure SEWB to the extent it is required given the age and asbestos nature of the building (security alarms etc). In the photos, you can see the buildings are old and are of asbestos. The transportable out the back houses the manager who is also the psychologist – this means she is in a vulnerable position when counselling should the session not go as planned (potential for a violent situation – see photo showing external verandah connecting to the donga).

The size of the house means that counselling clients privately is difficult as everything happens in close quarters. The number of clients the team work with exceeds the capacity of the building which impacts on the number of Aboriginal clients the team can help. The SEWB building has been broken into a number of times the last being during the long weekend in September 2018 where significant damage was done. Given the age of the house, during the past 18 months, parts of the internal ceiling including cornices have been falling away from the structures creating potential issues of asbestos fibre being released into the air. In addition, there are plumbing problems and the wooden floor is becoming a safety issue in one area of the building.

SEWB runs a vulnerable youth programme (the Shine Group) and a Body Shop clinic for youth who will not attend the main clinic for shame and fear reasons (special appointments are made with a doctor so that the young person doesn’t have to wait in the waiting area. In addition, a doctor runs a monthly session at the SEWB building with youth around health education and also sees them if there is a clinical need). These programmes run out of another 60+ year old asbestos family house some distance from the main SEWB house. Not only is the house not suitable but there may be security risks for the staff member working with vulnerable youth.  The Shine House was also broken into in September 2018 where significant damage was done (see photos).

The DAHS main building has no further office or other space to house staff.  This is particularly the case for 2019 as DAHS takes on new programmes (e.g. 2 staff for the new Syphilis Programme).  DAHS is acutely aware of the need to source funding to build new administration offices in order to release current admin offices for clinical and programme purposes.

DAHS requires a new or upgraded SEWB building. DAHS first applied for service maintenance funding in March 2017 but were unsuccessful. DAHS applied in June 2018 for Capital Works but were unsuccessful because it didn’t fit in with IAHP Primary Health Care as it was about mental health. DAHS also paid for an Architect to draw up the plans for a new SEWB building.  It is my view that one of the main issues is that the government separates SEWB from primary health care.

Social and emotional wellbeing issues CANNOT be separated from primary health care.  As is well known, a person’s SEWB impacts on the physical health of an individual.  Physical illhealth is frequently caused by the SEWB condition of an individual (i.e. historical and current experiences of trauma frequently commencing in the pre-natal phase of a child’s life, family violence, alcohol and other drug use, smoking, anxiety, removal of children, mental health issues etc). Aboriginal people suffer greatly from SEWB issues which impacts on their overall physical health.  Mental health in all its forms is part and parcel of physical health so it must be included in primary health care.

However, both state and commonwealth governments do not seem to prioritise or even support funding for SEWB (such as service and maintenance work, capital works or funding to continue key positions in the SEWB team – in fact, the government actively separates funding for SEWB and primary health care).  DAHS also provides clinical services to 7 remote communities most of whom are up to 400 kms away with Kandiwal Community 600kms away where we supply a fly in/fly out clinical service. There are many demands placed on a team of SEWB workers stationed in a working environment that does not allow them to function to the best of their abilities or offer increased services to our clients. Passion for the cause alone does not help in Closing the Gap. Working with one hand tied behind one’s back is not effective in reducing mental health issues and chronic diseases.

Part of an upgrade we requested was to renovate reception to make it safer for receptionist staff and to increase confidentiality when clients speak with reception staff (it also doesn’t meet the needs of disabled clients). There are a number of times throughout the year when receptionist staff are verbally abused with threats of physical harm. The current reception was designed prior to more recent events of aggression exhibited by clients under the influence of drugs.  The design now enables abusive clients to quite easily reach across the reception counter and hurt staff or can jump over the same counter to gain access to staff.  In addition, given there is no screen and the current open nature of the reception area, sharing confidential information can be compromised. DAHS applied for services and maintenance funding to make the changes but were unsuccessful.

[1] ACCHSs may apply for Telehealth funding through the Indigenous Australians’ Health Programme, Governance and System Effectiveness: Sector Support activity.

[2] https://www.anao.gov.au/work/performanceaudit/indigenoushousinginitiativesfixinghousesbetterhealthprogram  

[3] http://web.archive.org/web/20140213221536/http://www.dss.gov.au/sites/default/files/documents/05_201 2/housing_guide_info_intro.pdf  

[4] https://www.pmc.gov.au/resourcecentre/indigenousaffairs/remotehousingreview, page 3.

[5] https://www.caac.org.au/uploads/pdfs/CongressHousingandHealthDiscussionPaperFinalMarch2018.pdf

[6] https://www.pmc.gov.au/resourcecentre/indigenousaffairs/healthperformanceframework2017report; https://www.mja.com.au/journal/2011/195/11/closinggapandindigenoushousing;  https://probonoaustralia.com.au/news/2016/02/housingkeyclosinggap/; https://ama.com.au/positionstatement/aboriginalandtorresstraitislanderhealthrevised2015; https://www.caac.org.au/uploads/pdfs/CongressHousingandHealthDiscussionPaperFinalMarch2018.pdf. 10 https://www.anao.gov.au/work/performanceaudit/indigenoushousinginitiativesfixinghousesbetterhealthprogram  

[7] Australia Human Rights Commission Social Justice and Native Title Report 2015, cited in the Australian Law

Reform Commission publication, Pathways to JusticeInquiry into the Incarceration Rate of Aboriginal and Torres Strait Islander Peoples (ALRC Report 133)https://www.alrc.gov.au/publications/crossoverouthomecaredetention.

[8] https://www.alrc.gov.au/publications/crossoverouthomecaredetention; https://www.aihw.gov.au/getmedia/06341e00a08f4a0b9d33d6c4cf1e3379/aihwcsi025.pdf.aspx?inline=true  

[9] https://www.snaicc.org.au/ensuring-fair-start-children-need-dedicated-funding-stream-aboriginal-torresstrait-islander-early-years-sector/

[10] https://www.alrc.gov.au/publications/crossoverouthomecaredetention;

https://aifs.gov.au/cfca/publications/intersectionbetweenchildprotectionandyouthjusticesystems 15 https://aifs.gov.au/cfca/sites/default/files/publicationdocuments/cfcapracticebraindevelopmentv6040618.pdf; https://www.orygen.org.au/PolicyAdvocacy/PolicyReports/TraumaandyoungpeopleMoving

[11] http://www.familymatters.org.au/wpcontent/uploads/2018/11/FamilyMattersReport2018.pdf; Thorburn, Kathryn and Melissa Marshall. 2017. The Yiriman Project in the West Kimberley: an example of justice reinvestment? Indigenous Justice Clearinghouse, Current Initiatives Paper 5; McCausland, Ruth, Elizabeth McEntyre, Eileen Baldry. 2017. Indigenous People, Mental Health, Cognitive Disability and the

Criminal Justice System. Indigenous Justice Clearinghouse. Brief 22; AMA Report Card on Indigenous Health 2015. Treating the high rates of imprisonment of Aboriginal and Torres Strait Islander peoples as a symptom of the health gap: an integrated approach to both; Richards, Kelly, Lisa Rosevear and Robyn Gilbert. 2011.

Promising interventions for reducing Indigenous juvenile offending. Indigenous Justice Clearinghouse, Brief 10.

[12] Australian Institute of Health and Welfare. 2018. Australia’s Health 2018. Australia’s health series no. 16. AUS 221. Canberra: AIHW.

[13] Ibid

[14] Outcome areas: Aboriginal and Torres Strait Islander communities and cultures are strong and support social and emotional wellbeing and mental health; Aboriginal and Torres Strait Islander families are strong and supported; Infants get the best possible developmental start to life and mental health; Aboriginal and Torres Strait Islander children and young people get the services and support they need to thrive and grow into mentally healthy adults.