NACCHO Aboriginal Health and #Housing #SocialDeterminants @2019wihc News : @AIHW report Our #housing situation of #IndigenousAustralians has improved – with rises in #homeownership and housing provided through the private rental market, and falling levels of #homelessness.

 ” Stable and secure housing is fundamentally important to health and well-being.

Historically, Aboriginal and Torres Strait Islander people have experienced much higher rates of homelessness and have been overrepresented among clients seeking homelessness and social housing services than non-Indigenous Australians.

These higher rates of unstable housing relate to complex and interrelated factors including the lasting impacts of colonisation on Indigenous Australians, exposure to family violence, substance disorders, unemployment, low education levels and poor health—which are both contributors to, and outcomes of, insecure housing circumstances (Flatau et al. 2005; Keys Young 1998; Silburn et al. 2018).

Even though there is still much progress to be made, the findings in this report covering the last 15 years demonstrate the housing situation of Indigenous Australians has improved—with rises in home ownership and housing provided through the private rental market, and falling levels of homelessness. “

From AIHW Report March 2019 see Part 1 Below and Download the Report

aihw-housing Report

“The Territory Labor Government has fought long and hard for the housing funding that was promised to us 9 months ago. We’ve now won that fight.

“When you invest in housing and address indigenous disadvantage, you are investing in generational change – and saving money in the long term.

“Since coming to Government the Territory Labor Government has built and upgraded more than 1350 homes. The Federal Government’s contribution to our Government’s trail-blazing remote housing program will allow us to continue to make tangible and sustainable differences to the lives of Territorians.

Local Decision Making is at the core of our work in remote communities where we are building new homes, improving living conditions and creating jobs and generational change.

“People from the bush have told us that having jobs and better homes gives them a sense of pride and dignity. We know our remote housing program is working. It is changing the housing landscape and improving social outcomes in communities across the Territory.”

The Territory Labor Government has secured a $550 million investment from the Federal Government to continue to deliver remote housing in the NT. The deal comes nine months after the funding was first committed by the Commonwealth. 

The NT Government will work with the Federal Government and Land Councils to continue the delivery of remote housing.

The deal will see the Federal Government add $550 million to the NT Government’s investment of $1.1 billion for remote housing. In return, the NT Government will accept responsibility for remote housing leases until 2023

NT Chief Minister Michael Gunner

Download Full Press Release 

Territory Govt Housing Win

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.

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)

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.

Part 1

Read full AIHW Report Online HERE

More Indigenous households own their home or rent privately

Across the 4 most recent Censuses, there has been a steady rise in Indigenous home ownership, with 38% of Indigenous households (or around 100,000) owning a home (with or without a mortgage) in 2016, compared with 32% in 2001. The opposite trend was observed for other Australian households (69% home ownership in 2001, 66% in 2016).

For both Indigenous and other Australians, there was a steady fall in the proportion of households in social housing between 2001 and 2016, offset by a rise in the proportion of private renters. Indigenous households were consistently more likely than other households to be renting in private housing (32% compared with 25% in 2016) over the period. The largest difference between Indigenous and other households remains the proportion of households renting in social housing (21% compared with 4% in 2016), however, this gap has been narrowing over time.

Fewer households in mortgage stress, more in rental stress

Increasing home ownership levels are a positive sign, particularly when considered in combination with data about households in mortgage stress. The proportion of Indigenous households with a mortgage considered to be in mortgage stress has dropped from a peak of 30% in 2011 to 21% in 2016. In 2016, 68,000 Indigenous home owners had a mortgage (26% of Indigenous households).

In contrast, of those Indigenous households renting, the proportion considered to be in rental stress increased from 22% in 2001 to 39% in 2016. In private rental housing, rental stress for Indigenous households increased similarly in both urban and rural areas over this period (from 34% to 43% in urban areas and 29% to 38% in rural areas in 2016).

Indigenous households in public housing

While the proportion of the Indigenous household population living in social housing has decreased, the number of households has increased. There are three main types of social housing available to eligible Australians. In 2016–17, of the 66,700 Indigenous households in social housing:

  1. Half (50%, or 33,300) were in public housing, with this number rising by one-third (8,200 households) since 2008–09.
  2. The number of Indigenous households in community housing more than doubled from 2,700 households in 2008–09 to 5,800 in 2016–17.
  3. In contrast, the numbers of households in Indigenous-specific housing programs remained relatively stable over the period (around 10,000 for state owned and managed housing (SOMIH) and 18,000 for Indigenous community housing).

Fall in wait times for social housing

Waiting times for Indigenous Australians are generally shorter compared with other applicants. For both public housing and SOMIH housing programs there were improvements from 2013–14 to 2016–17. A larger proportion of clients waited less than 3 months (35% in 2013–14 and 42% in 2016–17 for public housing and 38% and 48% for SOMIH), and a smaller proportion waited more than 2 years to be housed. However, up to 1 in 6 (17%) Indigenous households waited more than 2 years for public housing.

Conditions in social housing have also improved over the 6 years to 2018. Data show a fall in overcrowding among Indigenous households, and a rise in the proportion of Indigenous tenants who rated their dwellings at an ‘acceptable’ standard.

1 in 28 Indigenous people are homeless

One in 28 Indigenous people (23,000) were homeless on Census night in 2016—representing more than 1 in 5 (22%) homeless Australians. More than half of Indigenous people experiencing homelessness lived in Very remote areas.

The rate of Indigenous homelessness decreased from 571 per 10,000 population in 2006 to 361 in 2016. The decline in Indigenous homelessness since 2006 is due predominantly to the decrease in Indigenous people living in ‘severely’ crowded dwellings (75% in 2006 to 70% in 2016). However, the 2016 Indigenous homelessness rate is 10 times that of non-Indigenous Australians. The differences in the rates of homelessness for Indigenous and non-Indigenous Australians were higher in Remote and Very remote areas than in Major cities.

The main type of homelessness experienced by Indigenous Australians was living in ‘severely crowded’ dwellings; that is, dwellings that need 4 or more extra bedrooms. Of those homeless on Census night 2016, Indigenous Australians (70%) were much more likely than non-Indigenous Australians (42%) to be living in severely crowded dwellings, yet the gap has narrowed over the past decade. Indigenous Australians were 68 times more likely to live in severely crowded dwellings in 2006; decreasing to 16 times more likely in 2016.

1 in 4 specialist homelessness services clients are Indigenous

Indigenous clients made up a quarter (25%) of all clients assisted by specialist homelessness services (SHS) in 2017–18; a rate 9 times that of non-Indigenous clients (803 per 10,000 population compared with 86). Most Indigenous people using these services were at risk of homelessness (53%), with the remainder homeless (47%), when they sought assistance.

Since 2011–12, SHS have assisted more Indigenous clients (43,600 in 2011–12; 65,200 in 2017–18). Of the Indigenous SHS clients in 2017–18:

  • 1 in 8 (13% or 8,500) were aged under 5, reflecting that families often seek assistance
  • 4 in 10 had experienced domestic and family violence (domestic and family violence was a reason they sought help and/or they required domestic or family violence assistance).

Homelessness services help clients keep tenancies and find homes

In 2017–18, more than half of Indigenous SHS clients (53% or 32,400 people) sought help when they were in unstable housing situations (at risk of homelessness)—more than 1 in 2 (16,400 clients) were living in social housing (either renting or rent free) when they sought assistance, while another third (12,100 clients) were in private or other housing (renting, rent free or owning). Most clients at risk of homelessness (89%) maintained their tenancies with SHS support.

Of the 20,700 Indigenous clients who were homeless when they sought help from SHS and had ended support in 2017–18, 38% (or 7,200 clients) were assisted into stable housing; an increase from 29% in 2012–13. In 2017–18 most Indigenous homeless clients who were assisted into housing ended support in social housing (around 3,800) with a further 3,100 clients in private rentals.

NACCHO Aboriginal Health and #ClosingtheGap : Read or Download these Indigenous Peak bodies responses to historic hard-fought #COAG partnership agreement @NACCHOAustralia @VACCHO_org @IAHA_National @SNAICC @AIDAAustralia @nswalc @AMSANTaus

This historic achievement of a hard-fought partnership between peak Aboriginal organisations and governments on Closing the Gap should be celebrated,”

This weeks Joint Council meeting represented the first time we’ve had a seat at the table and was a culmination of many years of negotiations and hard work.”

From this day forward, expert Aboriginal and Torres Strait Islander voices in health, education and community services will be working as equal partners with COAG in crafting the best solutions to achieve better life outcomes within our communities.

The health disparities and widening gaps between Aboriginal and Torres Strait Islanders and other Australians are unacceptable and as leaders in our fields, we are ready to do the hard work to reverse these trends.

We are so pleased to see the Federal Government step up and commit $4.6 million to support the efforts of our peaks to undertake this important work,”

Pat Turner, CEO of NACCHO after the first ever Joint Council meeting on Closing the Gap was held this week in Brisbane between the Council of Australian Governments (COAG) and a Coalition of National Aboriginal Peak Bodies (Coalition of Peaks).

Updated Friday PM NATSIHWA and Reconcilition Australia

The Joint Council is comprised of 12 representatives elected by the Coalition of Peaks, a Minister nominated by the Commonwealth and each state and territory governments and one representative from the Australian Government Association.

Read or Download this full NACCHO Press Release Here

The Joint Council agreed on a communique which can be read here: https://www.naccho.org.au/wp-content/uploads/ctg-joint-council-communique.pdf

For more information on The Joint Council, The Partnership Agreement, The Coalition of Peaks and to sign up for our mailing list, go to: https://www.naccho.org.au/ programmes/coalition-of-peaks/

We believe that shared decision making between governments and Aboriginal and Torres Strait Islander community-controlled representatives in the design, implementation and monitoring of new Closing the Gap targets and framework is essential

This is self-determination in action. Self-determination is a proven approach to Closing the Gap for Indigenous peoples; global research provides that evidence-base, including research done at Harvard University.

The new Closing the Gap targets must use Aboriginal holistic definitions of social and emotional health and wellbeing, and address systemic inequity and racism.

Closing the Gap encompasses much more than health indicators. We are resilient peoples who have survived for thousands of years and hundreds of detrimental government policies.

We know what works to help our people thrive and this Partnership Agreement will make sure that we are heard.”

VACCHO Chairperson and CEO BADAC ACCHO Ballarat Karen Heap

Read or Download this full VACCHO Press Release Here

2.VACCHO-MEDIA-PEAKS-COALITION

“Shared decision making between governments and Aboriginal and Torres Strait Islander community-controlled representatives in the design, implementation and monitoring of Closing the Gap is essential to improve the health and well-being of Aboriginal and Torres Strait Islander people

We have a lot of work to do, but through genuine engagement and a constructive partnership with governments we are in a position to improve outcomes for Aboriginal and Torres Strait Islander Peoples,”

IAHA CEO Donna Murray.

Read or Download this full IAHA  Press Release Here

3. Peaks-Partnership-Agreement-Media-Release-27-3-19-1

 

“After the first ten years of the original Closing the Gap Framework, it was clear that little progress was made against targets.

We believe that one of the reasons is insufficient ownership and engagement by Aboriginal and Torres Strait Islander Peoples.

This new and historic approach is a very important first step. Now begins the real work of refreshing targets, implementing measures we believe are necessary to achieve real change and monitor the progress of this new framework”.

CEO of the Victorian Aboriginal Child Care Agency (VACCA) and Chair of SNAICC – National Voice for our Children, Muriel Bamblett

Read or Download this full SNAICC Press Release Here

4.SNAICC CTG

Read or Download this full VACCA Press Release Here

VACCA CTG

“It is time for standard practice to include Aboriginal and Torres Strait Islander voices when making decisions and writing policy that impacts our lives, health and wellbeing. By signing this agreement, the government is committing to doing things in consultation with us, not to us or for us.”

AIDA President Dr Kris Rallah-Baker

Read or Download this full AIDA Press Release Here

5.AIDA CTG

We believe that the commitment in the Partnership Agreement to co-design, implement and monitor programs in partnership with Aboriginal and Torres Strait Islander community-controlled representatives and their members, is essential to closing the gap.

NSW CAPO along with other National Peak Aboriginal Organisations have been calling for a greater role with governments on efforts to close the unacceptable gaps in life outcomes within the Aboriginal and Torres Strait Islander community.

The Partnership Agreement sets out how governments and Aboriginal and Torres Strait Islander Peaks bodies will work together toward a refreshed national agreement on Closing the Gap, including any new Closing the Gap targets and implementation and monitoring arrangements.”

Co-Chair NSW CAPO Roy Ah-See,

Read or Download this full NSW ALC / CAPO Press Release Here

“And now collectively, we can come up with a plan to address those issues that we share.

Despite the federal election being only months away, I do not believe the agreement was a bid to win votes by the Morrison government because it was not on a party political level, and was under the COAG instead.

Regardless of who’s in power of the Australian government, this commitment will continue to exist with maybe some minor amendments, depending on the possible change of government,” he said.

But essentially, this is a non-political process “

John Paterson, the CEO of Aboriginal Medical Services Alliance Northern Territory and one of the Coalition Peak members, said the announcement was significant because it gave Aboriginal and Torres Strait Islander leaders equal opportunity to discuss pressing issues affecting Indigenous people.

Read full Press Coverage

Our people understand deeply the needs of our communities and this partnership brings
about a platform for these needs to be voiced with emphasised importance”

Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners have an
unmatched role in delivering health services to our communities. Our members are in a
prime position to play a key role in reducing barriers Aboriginal and Torres Strait Islander
peoples face in accessing health services and are critical to ensuring the provision of
cultural safety in care.

 Karl Briscoe, Chief Executive Officer, NATSIHWA.

Read or Download the NATSIHWA Press Release HERE

closing_the_gap_partnership_agreement_media_release

CEO, Karen Mundine said formalising this new partnership giving key Aboriginal and Torres Strait organisations a formal role in redesigning, implementing and monitoring the Closing the Gap strategy signals a significant shift towards shared decision making.

“The additional experience, knowledge and skills that the Peak Organisations can bring to COAG’s deliberations will lead to better outcomes,” said Ms Mundine. “And better outcomes are critical given the latest disappointing results which saw five of seven Closing the Gap targets not met.”

Reconciliation Australia CEO, Karen Mundine said formalising this new partnership giving key Aboriginal and Torres Strait organisations a formal role in redesigning, implementing and monitoring the Closing the Gap strategy signals a significant shift towards shared decision making.

Read full press release HERE

 

 

 

 

 

 

NACCHO Aboriginal Health and #ClosingtheGap “ @NITV ‘The buck will stop with us’: As representatives of 40 Indigenous peak groups meet with #COAG in historic #ClosingtheGap partnership

“ It’s the first time ever that COAG has Aboriginal people as equal partners at the table negotiating how we work over the next decade to Close the Gap for our people

We’re at a crossroads, and we’ve decided to take up our rightful role.

I want our people living in safe, secure housing. I want them to have access to community-controlled health services no matter where they live. I want our people to have the best access to all education services, and I want our people to generally have the same opportunities as other Australians,” Ms Turner said.

I want our people to have full-time jobs. We’ve got to scrap the negative issues that we have deal with every day. We have to take a strengths-based approach and we have to make sure that we are getting our people out of poverty.”

National Aboriginal Community Controlled Health Organisation (NACCHO) CEO  Pat Turner.

 See NACCHO Press Release and CTG Agreement Here

“If we’re stepping up to this level than we have to take on the responsibility and be prepared to work extensively to achieve the outcomes we’re all aspiring to, and if there are changes along the way, then so be it. The buck will stop with us.”

Aboriginal Medical Services Alliance Northern Territory chief executive, John Paterson, said the agreement also means Indigenous groups are just as accountable as governments.

“ Labor welcomes the Closing the Gap Partnership Agreement announced by the Coalition Government and the Coalition of Peaks, made up of some 40 Aboriginal and Torres Strait Islander national and state /territory peaks and other organisations across Australia.

A formal agreement with First Nations organisations and providers to work together to Close the Gap is long overdue.

This announcement comes after years of delay, dysfunction and poor communication due to the failure in leadership of this government. It has been two years since the government announced a ‘refresh’ of the Close the Gap”

For Labor Party response /support see Full Press Release attached

Labor Party CTG Press Release

Representatives of around 40 Indigenous peak bodies, making up a ‘coalition of peaks’ will co-chair a new joint council alongside ministers. Picture Brisbane Yesterday

The Council of Australian Governments has unveiled an historic partnership with Aboriginal and Torres Strait Islander organisations, as they look to refresh the Closing the Gap strategy and turn around a decade of disappointing results.

Our thanks to NITV for this excellent coverage Nakari Thorpe

Original article 

Aboriginal and Torres Strait Islander groups have sat down with state, territory and Commonwealth ministers, for the first time, to work on Closing the Gap.

Under a ten-year agreement, Indigenous peak bodies will share ownership and accountability to deliver real, substantive change for Indigenous Australians.

The partnership marks an historic turning point for the Closing the Gap strategy, which for the past eleven years has seen dismal results in delivering better outcomes for Indigenous Australians.

Last year, just two of the seven targets were on track to being met.

Representatives of around 40 Indigenous peak bodies, making up a ‘coalition of peaks’ will co-chair a new joint council alongside ministers.

Ms Turner and Indigenous Affairs Minister Nigel Scullion co-convened the first meeting in Brisbane on Wednesday.

The Morrison government is committing $4.6million over three years to fund the coalition’s secretariat work, and additional funding is expected in next Tuesday’s budget for the Closing the Gap refresh framework.

But Ms Turner warns the new coalition is not a substitute for an ‘Indigenous voice to the parliament.’

“Our focus is on the Close the Gap. We in no way are the ‘voice’ – that is a process that still has to be settled by the incoming government at the federal level,” she said.

The framework will undergo Indigenous-led evaluations every three years.

Details of new targets are expected to be revealed in mid-2019 but Indigenous groups have already flagged key areas of concern.

“We’ve got too many people in juvenile justice, we’ve got too many children being removed from their families, we’ve got so much family violence, drug and alcohol abuse.

And all those issues, this Closing the Gap can do something about,” said Victorian Aboriginal Community Controlled Health Organisation chief executive, Muriel Bamblett.

Ms Bamblett told NITV she hopes the new agreement will bring about real outcomes for Aboriginal and Torres Strait Islander people on the ground.

“We’re tired of going to the table and saying this is wrong … We know we’ve got the answers.”

NACCHO Aboriginal Health and #ClosingTheGap Prime Minister Scott Morrison announces new #ClosingtheGap Partnership Agreement 2019-2029 with 40 Indigenous peak bodies able to engage and negotiate as equal partners with governments to design and monitor Closing the Gap.

“The Closing the Gap Partnership Agreement will focus all of our efforts to deliver better health, education and employment outcomes for Indigenous Australians.

It recognises that Aboriginal and Torres Strait Islander peoples must play an integral part in making the decisions that affect their lives. This agreement will put Indigenous peoples at the heart of the development and implementation of the next phase of Closing the Gap, embedding shared decision making and accountability at the centre of the way we do business.

In order to effect real change, governments must work collaboratively and in genuine, formal partnership with Aboriginal and Torres Strait Islander peoples because they are the essential agents of change. The change we all want to see will only come if we work together.

Prime Minister Scott Morrison said the new Closing the Gap Partnership Agreement between the Federal Government, states, territories and the National Coalition of Aboriginal and Torres Strait Islander Peak Organisations (Coalition of Peaks) would ensure decision makers worked closer than ever to deliver real change for Indigenous Australians.

Download the CTG FACT Sheet and Partnership Agreement from Here

CTG Final fact sheet (1)

– Partnership Agreement on Closing the Gap 2019-2029[73948]

“The historic Partnership Agreement means that for the first time Aboriginal and Torres Strait Islander peoples, through their peak bodies, will share decision making with governments on Closing the Gap.

Closing the gap is not just about targets and programs. It is about making sure that Aboriginal and Torres Strait Islander peoples can share in the decision making about policies and programs that impact on them and have a real say over their own lives.

The Partnership Agreement is a significant step forward in this direction and the Coalition of Peaks is looking forward to working closely with the Council of Australian Governments to honour our shared commitment to closing the gap.”

Patricia Turner (CEO of NACCHO ) on behalf of the Coalition of Aboriginal and Torres Strait Islander Peak Organisations said almost 40 Aboriginal and Torres Strait Islander Peak Bodies across Australia had come together as partners with governments on Closing the Gap. See Also NACCHO Press Release Part 2

PRIME MINISTER

THE HON. SCOTT MORRISON MP

MINISTER FOR INDIGENOUS AFFAIRS
SEN. THE HON. NIGEL SCULLION
 

PATRICIA TURNER
ON BEHALF OF THE COALITION OF ABORIGINAL AND TORRES STRAIT ISLANDER PEAK ORGANISATION

PARTNERING WITH INDIGENOUS AUSTRALIANS TO CLOSE THE GAP

Read all NACCHO COAG Articles Here 

An historic agreement is set to change the way governments and Indigenous Australians work together on Closing the Gap.

The Agreement was developed collaboratively with the Coalition of Peaks, the largest group of Indigenous community controlled organisations, and committed to by all levels of government. It builds on the December 2018 decision by the Council of Australian Governments to  establish a formal partnership on Closing the Gap between governments and Indigenous Australians.

The partnership will include a Joint Council on Closing the Gap, which for the first time will include ministers nominated by jurisdictions, together with Aboriginal and Torres Strait Islander representatives chosen by the Coalition of Peaks.

Minister for Indigenous Affairs Nigel Scullion will co-chair the first meeting of the Joint Council alongside Pat Turner, CEO of the National Aboriginal Community Controlled Health Organisation and on behalf of the Coalition of Peaks.

“The Joint Council represents an historic step forward in the practical working relationship between Aboriginal and Torres Strait Islander peoples and governments,” Minister Scullion said.

“This is the first time Aboriginal and Torres Strait Islander representatives and ministerial leaders have met formally as part of a Joint Council to progress the Closing the Gap agenda and improve the lives of Indigenous Australians no matter where they live.

“To support this historic partnership, we will deliver $4.6 million to the National Coalition of Aboriginal and Torres Strait Islander Peak Organisations to ensure the representatives of Aboriginal and Torres Strait Islander Australians are able to engage and negotiate as equal partners with governments to design and monitor Closing the Gap.

“This is a new way of doing business that reflects that the top-down approach established in 2008 while well-intentioned, did not truly seek to partner with Aboriginal and Torres Strait Australians. We enter this partnership recognising that Canberra cannot change it all and that we need more then lofty goals and bureaucratic targets.

“Finalising the refresh of the Closing the Gap framework and monitoring its implementation over the next ten years is critical to the future and prosperity of all Australians.

“We are committed to working closely with Aboriginal and Torres Strait Islander people across Australia to improve the lives of Indigenous Australians.”

Patricia Turner on behalf of the Coalition of Aboriginal and Torres Strait Islander Peak Organisations said almost 40 Aboriginal and Torres Strait Islander Peak Bodies across Australia had come together as partners with governments on Closing the Gap.

The refreshed Closing the Gap framework and targets will be finalised through the Joint Council by mid-2019, ahead of endorsement by COAG. The Joint Council will meet for the first time on 27 March 2019 in Brisbane.

“Closing the gap is not just about targets and programs. It is about making sure that Aboriginal and Torres Strait Islander peoples can share in the decision making about policies and programs that impact on them and have a real say over their own lives.

“The Partnership Agreement is a significant step forward in this direction and the Coalition of Peaks is looking forward to working closely with the Council of Australian Governments to honour our shared commitment to closing the gap.”

Part 2

Download a copy of this NACCHO Press Release

The National Aboriginal Community Controlled Health Organisation (NACCHO) has welcomed the signing of an historic Partnership Agreement on Closing the Gap between the Commonwealth Government, State and Territory Governments and the Coalition of Aboriginal and Torres Strait Islander Peak Bodies.

The announcement will be made at the first Joint Council Meeting between the new partners in Brisbane

The Coalition of Peaks is made up of around forty Aboriginal and Torres Strait Islander community controlled organisations that have come together to negotiate with governments and be signatories to the Partnership Agreement.

NACCHO Chief Executive, Pat Turner, said the Agreement means that for the first time Aboriginal and Torres Strait Islander people, through their peak body representatives, will share decision making with governments on Closing the Gap.

“For some time now, NACCHO, along with other Aboriginal and Torres Strait Islander Peak Organisations have been calling for a greater say with governments on efforts to close the unacceptable gaps in life outcomes between Aboriginal and Torres Strait Islander peoples and the broader community,” said Ms Turner.

“The Coalition of Peaks believe that shared decision making between governments and Aboriginal and Torres Strait Islander community-controlled representatives in the design, implementation and monitoring of Closing the Gap is essential to closing the gap”.

The Partnership Agreement sets out how governments and Aboriginal and Torres Strait Islander Peaks bodies will work together to agree a refreshed national agreement on Closing the Gap, including any new Closing the Gap targets and implementation and monitoring arrangements.

Ms Turner said the Partnership Agreement also marks the establishment of a new, Joint Council on Closing the Gap that will be co-chaired by a Minister and a representative of the Coalition of Aboriginal and Torres Strait Islander Peak Bodies.

“We look forward to a hardworking and constructive partnership with the Commonwealth, State and Territory Governments to secure better outcomes for Aboriginal and Torres Strait Islander Peoples,” said Ms Turner.

The Partnership Agreement can be accessed at After 8.00am : https://www.naccho.org.au/ programmes/coalition-of-peaks/

NACCHO #Saveadate Aboriginal #SocialDeterminants #Health and #Housing : @2019wihc Registrations for The World Indigenous Housing Conference #2019WIHC on the #GoldCoast 20-24 May are now open #Itsabasichumanright

” The 2019 World Indigenous Housing Conference on the Gold Coast will bring together over 2,000 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 is pleased to announce the following invited speakers who bring their expertise and knowledge to share with attendees at 2019WIHC.

Our local and international speakers will bring to life the focus areas of this three-day conference on the Gold Coast.

Their keynote presentations will be complemented by concurrent sessions, panel discussions, plenary sessions and networking opportunities.

See details of all speakers HERE

Download the WIHC Conference Brochure and share

2019WIHC_Overview_Feb2019

 ” Thousands of Aboriginal Territorians are being left in limbo as a remote housing squabble between the Commonwealth and NT Governments reaches an “outrageous, crazy” fever pitch.

Key points:

  • The NT Government has handed over the maintenance and management of 44 remote Aboriginal communities’ housing to the Commonwealth
  • Chief Minister Michael Gunner’s move has been slammed by Indigenous Affairs Minister Nigel Scullion as unconstitutional
  • CEO of AMSANT John Paterson said Indigenous Territorians were being treated like political footballs

Territory Chief Minister Michael Gunner on Monday relinquished the remote housing leases of 44 remote communities back to the Federal Government — the latest move in an heated public spat over a $550 million housing agreement.

Mr Gunner’s decision will mean the NT Labor Government’s hallmark $1.1 billion housing policy will cease to be rolled out across those 44 communities in Central Australia, the West Daly, Tiwi Islands and Arnhem Land.

Treated like a political football’: John Patterson AMSANT 

Indigenous leaders have voiced their anger at how the negotiations have been handled.

John Paterson, chief executive officer of the Aboriginal Medical Services Alliance Northern Territory, said his board was “absolutely furious that we can’t get two governments to sort out … an essential service such as housing for Indigenous Territorians”.

“We have Indigenous Territorians that are suffering from rheumatic heart disease, from other serious chronic illnesses, living in substandard housing throughout the NT, who had all these promises from both levels of government and here we have a big spit-fight between the two governments and using the Aboriginal housing as a political football,” Mr Paterson said.

“This is absolutely disgraceful and a lack of leadership from everyone.”

Mr Paterson said he would be taking further action with the Federal Government if no resolution was sorted out promptly.

“If we can’t get a resolution or find a solution to this fairly quickly, then we’ll be writing to the Prime Minister to seek his intervention as he’s done with the Close the Gap process and demonstrate and provide the appropriate leadership to have this resolved,” he said.

Read todays NT media coverage here

 “ Australian State and Territory Health Ministers discussed the conditions that make up the health gap for Aboriginal and Torres Strait Islander people and are associated with a range of social and environmental determinants.

Communicable diseases in particular share the same environmental risk factors of poor cleanliness and hygiene, the impacts of which are exacerbated by overcrowded living conditions.

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are two examples of diseases resulting from overcrowding and poverty in remote Aboriginal and Torres Strait Islander communities. ” 

March 8 Communique :  Diseases of housing overcrowding and poverty in remote Aboriginal and Torres Strait Islander communities

As you may be aware the National Congress and the National Aboriginal Torres Strait Islander Housing Authority (NATSIHA) are hosting the 2019 World Indigenous Housing Conference.

NATSIHA a peak body for Aboriginal and Torres Strait Islander Housing has been formed as a response to the Redfern Statement.

They have the United Nations Special Rapporteur for Indigenous Peoples and the UN Special Rapporteur for Adequate Housing attending along with Community representatives from Australia, NZ , USA, Canada , Fiji , Samoa , Tonga just to name a few.

There are Ministerial Delegations from a number of Countries and DFAT will be hosting a side event. This will not be a talk fest as a report will be taken to the UN Permeant Forum next year by the UN Special Rapporteur Indigenous Peoples.

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

  • 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.com for 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.

Terms & Conditions

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NACCHO Aboriginal Health and #COAG Health Ministers Council Communique : Peak bodies welcome Roadmaps to address high priority health issues #RenalHealth  #EyeHealth #RHD #RheumaticHeartDisease #Hearing Health and #Housing

We welcome the COAG Health Council’s commitment to the RHD Roadmap today.

The RHD Roadmap was developed by the National Aboriginal Community Controlled Health Organisation (NACCHO) on behalf of END RHD.

We look forward to supporting the AHMAC review of the RHD Roadmap, and ask that the National RHD Steering Committee – which underpins governance of the RHD Roadmap – be convened as a matter of priority to oversee development of the implementation plan. ” 

END RHD Press Release see 2.30 below for full release 

“ The need to close the gap for vision and achieve a world class system of eye health and vision care for Aboriginal and Torres Strait Islander people is a critically important objective and rightly belongs on the national agenda.”

The fact Aboriginal and Torres Strait Islander people are still three times more likely to experience blindness than non-Indigenous Australians illustrates the need for action.

We welcome the leadership shown by Minister Wyatt in bringing this issue to the COAG Health Council, and strongly encourage all governments and all sides of politics to join together with Aboriginal and Torres Strait Islander communities, their organisations and Vision 2020 Australia members to close the gap for vision.”

Vision 2020 Australia CEO Judith Abbott:

The Federal, state and territory Health Ministers met in Adelaide last Friday at the COAG Health Council to discuss a range of national health issues.

The meeting was chaired by the Hon Roger Cook MLA, Western Australian Minister for Health and Mental Health.

Major items discussed by Health Ministers today included:

1.National Aboriginal and Torres Strait Islander Health and Medical Workforce Plan

2. Roadmaps to address high priority health issues for Aboriginal and Torres Strait Islander People

2.1 Renal Health 

2.2 Eye Health 

2.3 Rheumatic Heart Disease 

2.4 Hearing Health

3.Diseases of housing overcrowding and poverty in remote Aboriginal and Torres Strait Islander communities

1.National Aboriginal and Torres Strait Islander Health and Medical Workforce Plan 

At the August 2018 Indigenous Roundtable Health Ministers agreed to develop a National Aboriginal and Torres Strait Health and Medical Workforce Plan that provides a career path, national scope of practice and attracts more Indigenous people into health professions.

Ministers discussed the approach to develop the Plan noting that the Commonwealth will provide resources to lead its drafting, in full consultation with states and territories and other key stakeholders.

Ministers noted that in the course of developing the Plan, there may be value in engaging with other relevant COAG councils with workforce and skills responsibilities to realise meaningful, sustainable outcomes.

A draft Plan will be submitted to the next CHC Indigenous Roundtable in July 2019.

Roadmaps to address high priority health issues for Aboriginal and Torres Strait Islander People

At the July 2018 COAG Health Council meeting, Health Ministers discussed the potentially preventable burden of disease in Aboriginal and Torres Strait Islander communities caused by a number of health conditions. They discussed work to date to address these health conditions and opportunities to build on these efforts within the context of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023.

Today Health Ministers discussed four roadmaps to be a framework to deliver collaborative policies and programs to address this key health challenge. Ministers committed to working jointly to ending rheumatic heart disease and avoidable blindness and deafness.

Ministers referred the roadmaps to the Australian Health Ministers’ Advisory Council for review and reporting back in November 2019.

2.1 Renal Health 

Aboriginal and Torres Strait Islander people experience a disproportionate burden of renal disease. Research shows non-Indigenous patients are nearly four times more likely to receive kidney transplants, and Indigenous people are nine times as likely to rely on dialysis.

Ministers noted the Renal Health Roadmap, developed by the Commonwealth in conjunction with key stakeholders, as a framework to deliver collaborative policies and programs.

2.2 Eye Health 

The rate of vision impairment and blindness in Aboriginal and Torres Strait Islander people is three times higher than non-Indigenous Australians. The leading causes of vision loss and blindness in Indigenous adults are uncorrected refractive error, cataract and diabetic retinopathy. Ministers noted the Eye Health Roadmap as a framework to deliver collaborative policies and programs.

Vision 2020 Press Release

Vision 2020 Australia welcomes the leadership shown by the Minister for Indigenous Health Ken Wyatt AM, along with his state and territory counterparts, in discussing Aboriginal and Torres Strait Islander eye health and vision at today’s COAG Health Council Meeting.

Too many Aboriginal and Torres Strait Islander people still experience avoidable vision loss and blindness, and those who have lost vision often find it difficult to access the support and services they need.

Our members are working hard to improve eye care for Aboriginal and Torres Strait Islander people, and the plan discussed today is a product of their extensive input and expertise.

We encourage all governments, all sides of politics, and the many others involved in this area to work closely with Aboriginal and Torres Strait Islander communities and their organisations to achieve and sustain real improvements in eye health and vision for Aboriginal and Torres Strait Islander people across our nation.

Aboriginal and Torres Strait Islander people’s eye health – key facts

  • Cataract is the leading cause of blindness for Aboriginal and Torres Strait Islander adults and is 12 times more common than for non-Indigenous Australians.
  • Aboriginal and Torres Strait Islander people wait on average 63% longer for cataract surgery than non-Indigenous Australians.
  • Almost two-thirds of vision impairment among Aboriginal and Torres Strait Islander people is due to uncorrected refractive error – often treatable with a pair of glasses.
  • One in 10 Aboriginal and Torres Strait Islander adults has Diabetic Retinopathy, which can lead to irreversible vision loss.
  • Australia is the only developed country to still have Trachoma, found predominately in Aboriginal and Torres Strait Islander communities.

2.3 Rheumatic Heart Disease 

Rheumatic heart disease is a disease of disadvantage that affects primarily Aboriginal and Torres Strait Islander communities. It is caused by an episode or recurrent episodes of acute rheumatic fever where the heart valves remain stretched or scarred, interrupting normal bloodflow. The Roadmap has used the best available evidence to identify priority actions for the next 10 years.

RHD Press Release

We welcome the COAG Health Council’s commitment to the RHD Roadmap today. The RHD Roadmap was developed by the National Aboriginal Community Controlled Health Organisation (NACCHO) on behalf of END RHD.

We look forward to supporting the AHMAC review of the RHD Roadmap, and ask that the National RHD Steering Committee – which underpins governance of the RHD Roadmap – be convened as a matter of priority to oversee development of the implementation plan.

We look forward to working with the Commonwealth and jurisdictional governments, implementing organisations, and communities, to ensure the RHD Roadmap is implemented in a timely, consultative manner, in line with the COAG Implementation Principles as informed by Aboriginal and Torres Strait Islander Communities.

We thank Ministers Wyatt and Hunt for commissioning and championing the RHD Roadmap. We thank all our partners who contributed their experience, wisdom, and energies in preliminary consultation.

Our goal is to end rheumatic heart disease in Australia. This RHD Roadmap provides a critical opportunity for Aboriginal and Torres Strait Islander people to lead the way to achieve that shared vision.

2.4 Hearing Health

Hearing loss is a complex issue that affects millions of Australians. It is often considered a hidden or invisible issue as, despite the high prevalence of hearing loss, there is limited awareness in the broader community. There is a disproportionate impact on Aboriginal and Torres Strait Islander people due to ear disease that profoundly affects their life experiences through childhood and into adulthood. This has a significant impact on community engagement, education, employment and engagement with the criminal justice system. The Roadmap sets out the short, medium and long-term actions to address the key hearing health issues that have been identified.

3. Diseases of housing overcrowding and poverty in remote Aboriginal and Torres Strait Islander communities

Health Ministers discussed the conditions that make up the health gap for Aboriginal and Torres Strait Islander people and are associated with a range of social and environmental determinants. Communicable diseases in particular share the same environmental risk factors of poor cleanliness and hygiene, the impacts of which are exacerbated by overcrowded living conditions. Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are two examples of diseases resulting from overcrowding and poverty in remote Aboriginal and Torres Strait Islander communities.

Other Issues 

National Health Reform Agreement – Resolving reconciliation and back casting

Health Ministers discussed differing approaches to the application of back casting in the Activity Based Funding model for Commonwealth funding to states and territories under the National Health Reform Agreement.

State and Territory Ministers will develop a joint set of policy principles and directions on a clear methodology for the calculation of hospital funding for use by the national funding bodies, which will be presented to COAG by June 2019.

Australian National Breastfeeding Strategy: 2019 and Beyond

The World Health Organization’s (WHO) global nutrition target is to increase the rate of exclusive breastfeeding in the first six months up to at least 50 percent by 2025. Low breastfeeding rates and the use of infant formula within the first year of life are linked to obesity and other chronic diseases in later life.

In 2016, Health Ministers agreed to develop an enduring breastfeeding strategy following the conclusion of the Australian National Breastfeeding Strategy 2010-2015. The latest National Health Survey data shows that only around 25% of babies are exclusively breastfed to around six months.

The Australian National Breastfeeding Strategy: 2019 and Beyond seeks to achieve the World Health Organization target of 50% of babies exclusively breastfed to around six months by 2025, including a particular focus on those from priority populations and vulnerable groups. To achieve this objective, actions are proposed across three priority areas: structural enablers; settings that enable breastfeeding; and individual enablers.

Ministers discussed the Australian National Breastfeeding Strategy: 2019 and Beyond and committed to provide a supportive and enabling environment for breastfeeding mothers, infants and families. Ministers were of the view that investing in breastfeeding is an investment in chronic disease prevention and better health.

The Commonwealth Department of Health will lead national policy coordination, monitoring and evaluation and report annually on implementation progress to the Australian Health Ministers’ Advisory Council.

Professional Indemnity Insurance for Privately Practicing Midwives

In 2010, the introduction of the Health Practitioner Regulation National Law Act 2009 saw the requirement for registered health practitioners to have appropriate professional indemnity insurance in place. Despite exhaustive national and international investigations, no available or affordable commercial product in Australia covers Privately Practicing Midwives for homebirth.

Health Ministers considered the issue of professional indemnity insurance for privately practicing midwives. Health Ministers emphasised that the safety of mothers and their babies is paramount.

Health Ministers recognised that the availability of a suitable professional indemnity insurance product covering private home births would be preferable, as it would allow privately practicing midwives to remain registered under the National Law without the need for an exemption, continue to provide choice to women and take into account the rights of women and children.

In the absence of a suitable professional indemnity insurance product for privately practicing midwives, Health Ministers requested that AHMAC would complete additional work to inform the decision of Ministers in relation to the way forward by June 2020.

Health Ministers agreed for the current exemption under the National Law to be extended until December 2021 to allow time for options to be explored further.

Update on ageing and aged care matters including the Royal Commission into Aged Care Quality and Safety

All Australian Health Ministers are committed to the highest quality care for older Australians.

The Minister for Indigenous Health and Minister for Senior Australians and Aged Care, the Hon Ken Wyatt MP, provided an update on recent ageing and aged care initiatives, announcements and the Royal Commission into Aged Care Quality and Safety.

The Royal Commission has a broad scope to inquire into all forms of Commonwealth-funded aged care services, regardless of the setting in which those services are delivered. It will look at the aged care sector as a whole, including younger people with disabilities living in residential age care.

Ministers also discussed a range of issues relating to safe and quality care for older Australians, for example, the provision of primary and community care services to aged care consumers, access to acute care and rehabilitation services, timely movement of consumers from hospital to aged care services and engagement on the implementation of effective mechanisms to regulate restraint in aged care.

Update on National Missions under the Medical Research Future Fund 

National Medical Research Future Fund Missions are large programs of work with ambitious objectives to address complex and sizeable health issues that are only possible through significant investment, leadership and collaboration. They bring together key researchers, health professionals, stakeholders, industry partners, patients and governments to tackle significant health challenges, for example brain cancer and dementia.

Today Health Ministers received an update from the Commonwealth Minister for Health on the five national Missions and the Indigenous Health Futures announced to date and increased opportunities for contestable grant rounds to support health and medical research.

The five missions are

  1. Australian Brain Cancer Mission
  2. Genomics Health Futures Mission
  3. Million Minds Mental Health Research Mission
  4. Dementia, Ageing and Aged Care Research Mission
  5. Mission for Cardiovascular Health

The research work also includes the Indigenous Health Futures for which $160 million from the MRFF has been committed over ten years for a national research initiative to improve the health of Aboriginal and Torres Strait Islander people.

Health Ministers supported the work of the research Missions and the Indigenous Health Futures, agreeing to work together towards achieving their aims.

Resolving outstanding National Disability Insurance Scheme (NDIS) implementation issues

Health Ministers acknowledged the significant efforts being made by all jurisdictions to resolve issues that arise from the interface between the NDIS and health systems.

Mental Health Services

States and territories expressed concerns about access to necessary primary care mental health services. States, territories and the Commonwealth will work constructively so that access to primary mental health services is improved particularly for consumers outside the NDIS.

Regulation of misleading public health information

The Queensland Health Minister provided an update on regulation of misleading public health information in relation to misleading or inaccurate information regarding vaccines or vaccination programs.

Ministers welcomed the prompt action and leadership of the Outdoor Media Association to apply the intent of the Therapeutic Goods Advertising Code (No.2) 2018, so that advertising connected to therapeutic goods ‘must not be inconsistent with current public health campaigns.’

Tobacco industry issues

Australia has been a world leader in legislation restricting the promotion and advertising of tobacco-related products through sport, and in taking a precautionary approach to the control of smoke-free products such as e-cigarettes.

The tobacco industry is investing heavily in smoke-free products and has established associated sports sponsorships launched at the start of the 2019 F1 and MotoGP championship seasons, presenting a challenge to tobacco control legislation.

Victoria raised the issue that e-liquids for use in e-cigarettes are not in child safe packaging, do not contain sufficient warnings and may be dangerous or fatal for young children.

Health Ministers today discussed a national approach to the prohibition of smoke-free,  e-cigarette and related sponsorship and advertising in sport, based on existing tobacco control principles and legislation. This approach will have the capacity to respond to emerging products and forms of marketing.

Health Ministers also noted that the Clinical Principal Committee will develop options to better regulate e-cigarettes and related products including consideration of the need to introduce child proof lids and plain packaging, with options to be provided to the COAG Health Council for consideration.

National Medical Workforce Strategy

A National Medical Workforce Strategy is necessary to guide long-term, collaborative medical workforce planning across Australia.

The Strategy will match the supply of general practitioners, medical specialists and consultant physicians to predicted medical service needs and will involve consultation with a range of stakeholders. Health Ministers will fund the development of a National Medical Workforce Strategy. This will include sharing of data across Commonwealth and other jurisdictions to support the strategy.

It is expected that the Strategy will address several system-level issues including:

  • the number and distribution of specialist training positions and how these might be better aligned to community needs
  • access to the full range of medical services, including maternity services, in regional, rural and remote areas
  • the current reliance on overseas trained doctors to fill specific workforce shortages and how Australia can improve self-sufficiency in medical workforce development
  • integration of medical care between settings and professions
  • improving workplace culture and doctor wellbeing
  • the under-representation of Aboriginal and Torres Strait Islander doctors in the medical workforce.

A Steering Committee has been established under the National Medical Training Advisory Network to guide this work.

Options for a nationally consistent approach to the regulation of spinal manipulation on children 

Health Ministers noted community concerns about the unsafe spinal manipulation on children performed by chiropractors and agreed that public protection was paramount in resolving this issue.

Ministers welcomed the advice that Victoria will commission an independent review of the practice of spinal manipulation on children under 12 years, and the findings will be reported to the COAG Health Council, including the need for changes to the National Law.

Ministers supported the examination of an increase in penalties for advertising offences, such as false, misleading or deceptive advertising, under the Health Practitioner Regulation National Law, to bring these into line with community expectations and penalties for other offences under the National Law. This decision was informed by recent consultation about potential reforms to the National Law in 2018.

Ministers will consider the outcomes of the independent review and determine any further changes needed to protect the public.

 

 

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 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.

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

Close the Gap Campaign

AMA

RACGP

Reconciliation Australia

Change the Record

AMSANT Darwin

Mayi Kuwayu /ANU

Greens

Introduction NACCHO Closing the Gap response CEO Pat Turner AM 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

1 .Close the Gap Campaign

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

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

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

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

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

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

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

Download CTG Press Release

1.Close the Gap response to CTG

2.AMA

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

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

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

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

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

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

AMA President, Dr Tony Bartone

Download the AMA Press Release

2 AMA Closing the Gap progress disappointing

See all NACCHO AMA posts

3.RACGP

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

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

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

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

Read full Press Release HERE

Read NACCHO RACGP articles HERE

4.Reconciliation Australia

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

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

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

Download the Press Release

4.Reconciliation Aust CTG Response

5.Change the Record

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

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

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

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

Change the Record co-chair Damian Griffis.

Download the CTG Press Release

5. Change the Record

6. AMSANT Darwin

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

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

John Paterson AMSANT Darwin

From SMH Interview

7.Mayi Kuwayu /ANU

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

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

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

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

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

 Read Article in Full 

8.Greens

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

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

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

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

Senator Rachel Siewert 

Download the Greens CTG Press Release

8.Greens Party CTG Response

NACCHO Aboriginal Health #RefreshTheCTGRefresh : Read or Download @billshortenmp speech plus @Malarndirri19 @LindaBurneyMP @SenatorDodson Press Release and annual #Closingthegap report to Parliament

 “So in that spirit, I welcome the new partnership between the Commonwealth, the States and the Coalition of Aboriginal Peak bodies – and the change in thinking that that represents. I’m conscious that the Peak organisations have done the heavy lifting too, to date, with limited resources.

And I congratulate them for persevering, for refusing to meekly accept the draft framework that was presented to you as a fait accompli in the past and instead, asserting your right to a permanent place at the table.

My colleagues and I deeply respect your role as advocates, as experts and as Aboriginal community-controlled organisations, committed to Closing the Gap. If we are successful at the next election, you will be central to setting policy and seeing that it is implemented, collaborating with frontline services and community leaders at local and regional level.

Partnership in action, not just words. Plainly, after ten years, refreshing the Closing the Gap targets is necessary. But this can never mean lowering our sights, reducing our targets, limiting our ambitions. ” 

Bill Shorten MP Opposition Leader Closing the Gap speech see Part 2 Below or Download 

Download Speech HERE

Bill Shorten Speech

Download CTG Report

 NACCHO Members Service 2019 CtG Report –

Watch Coverage

One day after the eleventh anniversary of the Apology to the Stolen Generations, the Prime Minister handed down his Close the Gap report – highlighting another year of stalled progress on this critical national project.

The report reminds us of the little progress we have made in addressing the structural inequalities facing First Nations peoples.

While we are pleased to see improvements in early childhood and Year 12 retention, we cannot deny the reality: only two targets out of seven are on track.

As a nation, this is an indictment upon us all.

First Nations people are frustrated, as is Labor. The Abbott- Turnbull- Morrison Government’s delay and dysfunction has no justification.

The targets have not failed. Governments have failed. It is our collective failure to not match well-intentioned rhetoric with action.

While a refresh of the Close the Gap framework is necessary, and we welcome the government new commitment to working in partnership with First Nations people, we cannot ignore the fact that until now, the government has failed to adequately engage with First Nations people.

If the government is truly committed to ensuring First Nations people have a say in matters that affect them, then they should immediately reverse their opposition to a constitutionally enshrined Voice for First Nations people.

The government has also failed to provide national bipartisan leadership on the refresh process. Labor was not consulted at any point in this process.

Whether it’s Close the Gap, the Community Development Program, the Indigenous Advancement Strategy or Constitutional Recognition, this government has constantly pursued flawed policies and failed to engage with First Nations people in their design or implementation.

Paternalism does not work. First Nations peoples must have a say in the matters that affect their lives and policies must be co-designed with full free and prior informed consent. This is how we achieve self-determination and properly address the substantial and structural inequality facing First Nations peoples.

This is how we close the gap.

If Labor is elected at the next election, a Voice for First Nations people, enshrined in our constitution, will be our first priority for constitutional reform.

Business as usual is no longer an option.

Only when First Nations people have a permanent and ongoing say in the issues that affect their lives, will we ever close the gap.

Part 2 Bill Shorten MP Opposition Leader Closing the Gap speech

I congratulate the Prime Minister on the address he’s just given. I acknowledge the traditional owners of this land and I pay my respects to elders past and present.

At the heart of reconciliation is a profound and simple truth: Australia is, and always will be, Aboriginal land. First Nations people loved and cared for this continent for millennia, long before our ancestors first arrived by boat.

They fished the rivers, hunted the plains, named the mountains, mapped the country and the skies. They made laws and administered justice here, long before this parliament stood. They fought fiercely to defend their home and they have battled bravely ever since, against discrimination and exclusion, preserving, for their children and for all of us, the world’s oldest living culture.

In addition to the acknowledgments made by the Prime Minister, I would like to specifically acknowledge the work of Prime Minister Rudd and the member for Jagajaga, Jenny Macklin, who helped initiate this annual Closing the Gap address.

Yesterday, I was consulting my Indigenous colleagues about this morning’s address. And I asked them: What could I say to prove this day has value and meaning to our first Australians, to all Australians, to people who have listened to Closing the Gap reports and speeches for 11 years running.

How do we, in this place, demonstrate this is not just an annual exchange of parliamentary platitudes and rhetoric. And Senator Malarndirri McCarthy said to me: “Just tell the truth about how you feel”.

And the truth is that feels a bit an ambiguous, doesn’t it? I feel that there is good news, but not enough good news. I feel there is hope, but not enough hope. That there is progress, but not enough progress. And I feel ambiguous, because how do you talk about the good without varnishing and covering up the bad?

How do you talk about the bad without presenting such a view that you ignore the good work? But the truth is that at this 11th Closing the Gap exchange, I’m frustrated. I suspect many members of the House feel that frustration too.

Frustration, disappointment that after a decade of good intentions, tens of thousands of well-meaning, well-crafted and well-intentioned words, heartfelt words, from five Prime Ministers, we assemble here and we see that not enough has changed. Mind you, I was halfway through expressing these views to the colleagues, when Senator Pat Dodson cut me off, and he said: “Comrade, how do you think we feel?”

And, really, that is our task, to put ourselves in the shoes of all the people who are giving everything to this endeavour. I speak of the heroes at Deadly Choices driving huge improvements in frontline health services.

The brilliant kids of Clontarf and Stars and Girls Academy and so many other great education and mentoring programs.

I speak of brave women and communities leading initiatives against family violence. I speak of the fearless campaigners for justice at Change the Record. I speak of the Indigenous Rangers right now on country, ensuring that all of us can understand and share in the wonders of country their people have called home for 60,000 years.

I speak of the First Australians who enrich every facet of our national life: as leaders and achievers in education and sport, medicine and the law, environmental conservation and academia and politics and art and music and comedy.

I speak of the mums and dads and aunties and uncles, the elders and the grannies doing their very best to keep children and families safe, to keep community together. There is no question, that we should recognise and celebrate their boundless hope and patience and perseverance, often in the face of overwhelming odds

. But we must recognise their frustration too. We should today acknowledge, that it’s not just the gap in life expectancy or health or educational results or employment opportunities. It’s the gap between words and actions, the gap between promises and results. The good ideas and practical initiatives of people on the frontline that get swallowed up in the morass of paperwork and process and waste and lethargy.

The committee recommendations, coroner’s reports, judicial inquiries and Royal Commissions that have been left to gather dust. Of course these years of neglect and indifference are punctuated by bursts of unilateral ‘interventions’ and ‘crisis meetings’ and ‘emergency action’.

And law after law, policy after policy, about Aboriginal and Torres Strait Islander peoples, written without Aboriginal and Torres Strait Islander peoples.

So in that spirit, I welcome the new partnership between the Commonwealth, the States and the Coalition of Aboriginal Peak bodies – and the change in thinking that that represents. I’m conscious that the Peak organisations have done the heavy lifting too, to date, with limited resources.

And I congratulate them for persevering, for refusing to meekly accept the draft framework that was presented to you as a fait accompli in the past and instead, asserting your right to a permanent place at the table.

My colleagues and I deeply respect your role as advocates, as experts and as Aboriginal community-controlled organisations, committed to Closing the Gap. If we are successful at the next election, you will be central to setting policy and seeing that it is implemented, collaborating with frontline services and community leaders at local and regional level.

Partnership in action, not just words. Plainly, after ten years, refreshing the Closing the Gap targets is necessary. But this can never mean lowering our sights, reducing our targets, limiting our ambitions.

And while I understand the Prime Minister is trying to make a point about the dangers of a ‘deficit model’, even the mindset of a ‘gap’.

The uncomfortable truth is that there is a stark gap between the Australia we inhabit and the lives of too many First Nations people.

There are deficits, in justice and jobs, in health and housing, in the opportunities afforded to Aboriginal children who go to school far from where we send our own kids. It is not the targets that have failed. It’s we who have failed to meet them. It is not the targets that have failed. It is we who have failed to meet them.

This is the hard truth this report demands we confront. The truth about ongoing discrimination and disadvantage. The truth about families and communities being broken by poverty, violence, abuse, addiction and alcohol.

The truth that there are still men and women being arrested, charged and jailed – not because of the gravity of their offence, but because of the colour of their skin. If this parliament can’t admit that racism still exists in 2019, then we’re just wasting the time of our First Australians today.

If we can’t admit that racism still exists, then how on earth do we ever fix it? This isn’t political correctness, it’s just stating the obvious, it’s the truth.

The truth that Aboriginal people are still suffering from diseases the rest of us never know, still dying at an age when the rest of us are contemplating retirement.

And the truth about children and young people who are suffering violence, taking their own lives in numbers and circumstances that should shame us all to action.

Last week, Senator Pat Dodson responded to the coroner’s report from those 13 indescribably tragic deaths in the Kimberley. He spoke of ‘unresolved trauma’, a sense of suffering, hopelessness and disillusionment.

And above all, he said, none these can be fixed by answers imposed from outside. The solutions depend on a say and a sense of empowerment and self-worth for young people. And a sense of hope for communities and regions, power in the hands of people who truly live and understand the challenges they face.

Simply put, if we seek to see real change in the lives of First Nations people, then we need to change. Change our approach, change our policies. And above all, change the way that we make decisions.

We need to let First Nations have real control in how decisions are made. So this is where partnership, the word partnership, where the rubber hits the proverbial road. If we say that we want partnership with our first Australians, then we don’t get to pick and choose our partners’ values or priorities.

For more than a decade now, Prime Ministers and Opposition Leaders of both the main parties have stood in this place and said we want to work with Aboriginal and Torres Strait Islanders in partnership.

But you don’t get to tell your partner what to think. It is that spirit of partnership which we saw at Uluru in 2017. First Nations people took up the invitation, 250 delegates presented this parliament with their vision. Countless dialogues, thousands of people consulted. I concede that what the First Australians came back to us with wasn’t what we were expecting. But that’s the challenge of partnership, isn’t it?

When the partner says: “I have a different set of priorities and if you really respect me, you will listen to me.”

They came back with a Makarrata Commission to work with National Congress, Land Councils, First Nations leaders and states and territories to continue the work of truth-telling and agreement-making.

And our partners said to us, “We seek a Voice enshrined in the Constitution.” An institution with national weight and local connection, bringing a powerful sense of culture, community and country to the shape of policy and its delivery.

A meaningful, permanent say for Aboriginal people in the decisions that affect their lives. Not a long demoralising slog measured in inches of progress.

Not starting from square one every time a particular issue breaks into the broader national consciousness.

Not a sense of ‘us’ and ‘them’ in the backdrop of everything that we do. Our partners want genuine engagement with humility on the Parliament to acknowledge their role, to recognise that genuine empowerment has to involve the sharing of real power.

You can’t have a partnership of unequals. Partnership means giving as well as taking, listening as well as telling. Today I am proud to declare again that enshrining a Voice for the First Australians will be Labor’s first priority for constitutional change.

If we are elected as the next government of Australia, we intend to hold a referendum on this question in our first term, as our partners have asked us to do. I am optimistic that reform can succeed, the referendum can succeed, because the proposition we should include our First Australians in the nation’s birth certificate is an idea whose time has come. It enjoys powerful support across communities, business and Australians young and old. We will seek bipartisan support.

This is not about building a “third chamber” of parliament, it is not a matter of “separatism” or “special treatment”.

How on earth, in the light of this Closing the Gap Report, with such devastating statistics and tragedies behind these numbers, can we say that we’re giving special treatment to people who don’t even get the same treatment?

This isn’t about favouritism, or conferring unfair advantage. It is about recognising inequalities, centuries old. Bringing honour to our nation.

It’s about recognising that powerlessness is created by prejudice and by discrimination and breaking these chains which hold, not just our First Australians back, but actually chain us all back. It’s as simple as the fact that Aboriginal and Torres Strait Islander peoples do not start from a level playing field now.

And that true equality of opportunity is measured not by legal standing, or theoretical notions but by lived experienced, by the tangible chance every Australian deserves to get a great education, a good job, to live a happy, fulfilling and healthy life, to see their children grow up and flourish.

And to those who dismiss constitutional recognition as “symbolism” or “identity politics”. Perhaps, unwittingly, that final phrase is closest to the truth. Because enshrining a Voice in the constitution is most certainly about identity.

About our national identity, all of us. It’s about who we are, as Australians. Are we a people who can recognise our First Australians in our constitution, as part of our national identity. Are we big enough, are we brave enough, are we smart enough and generous enough to recognise historical truth, to commit ourselves to equal opportunity and to write that into our constitution.

And in the end, this is why, despite all the well-known impediments, the historical difficulties of changing our constitution, I remain optimistic that the referendum can and should gain support. Because beyond the specific wording of any particular question, as important as that is, this represents a simpler, more elemental test. A test about what we say about ourselves to the world, a test of what we teach our children about what it means to be Australian.

It’s a test of our generosity, of our basic, human decency. It’s a test of whether or not we are fair dinkum partners in the journey to the future. A test of our innate and instinctive sense of fairness. I believe that if we trust the people of Australia with the opportunity to broaden the definition of the fair go, to make our constitution more true to who we are, to describe who we are, they will repay the trust of parliament in overwhelming numbers.

And, Mr Speaker I say to those who somehow believe that constitutional change stands in the way of progress on other fronts, I can promise this. If we are elected as the next government of Australia, seeking to enshrine a Voice in the constitution doesn’t stop us from building the new houses that we need to. It doesn’t stop us from embracing the initiatives to encourage more teachers that we’ve heard about.

It doesn’t stop us training more Aboriginal apprentices or doubling the number of Rangers. It won’t prevent us from bringing together, in our first 100 days, people from all over the nation, the police, the child saftey people, families, to work out what must be done to protect the next generation of First Nations children.

Because we must address the two-pronged crisis in the abuse occurring in communities and the trauma being inflicted in out-of-home care. A Labor Government committed to a Voice will still invest in Aboriginal health care providers, the champions who make such a difference to new mothers and their babies.

A Labor Government will make justice reinvestment a national priority, because youth detention and jail time for young people should be a rarity, not a rite-of-passage. I acknowledge the Prime Minister’s announcement today regarding HECS relief for teachers, commitment to education is welcome. But we want people teaching in remote schools because they want to be there, and we will work to encourage that. And we want more local Aboriginal people, trained as teachers and nurses in their communities.

And to achieve real improvements, there must be not just specific funding, but real needs-based funding for schools and investments in early education, universities and TAFE.

Not just in the bush but in our cities and suburbs, where our first Australians also live, so Aboriginal and Torres Strait Islander children everywhere get the same chance as every other Australian child to get a great education.

This is the focus and purpose of Labor’s policies. We will support Australian languages in this International year of Indigenous Languages. We will provide compensation to survivors of the Stolen Generations from Commonwealth jurisdictions and create a National Healing Fund for descendants managing intergenerational trauma.

Because saying sorry must always mean making good. And we will abolish and replace the Community Development Program, not just because it is discriminatory, demoralising and punitive but because it is completely counterproductive and ineffective. Labor believes in the dignity of work and that is why we want people living in remote communities to work with dignity. And this isn’t just a job for government alone, I want to work with business and the unions to launch a trades and skills offensive, this is a call to arms.

A mass-mobilisation of training, TAFE and apprenticeships, to bring good jobs to country. Because funding projects in remote communities should not involve bringing contractors and tradies from the other side of Australia. We should give our own young people in these communities the pathway to be the tradespeople of their communities. This will be our approach, not grants without evidence or accountability but programs that put communities and regions back in control of their resources and their futures.

In conclusion, Mr Speaker, yesterday, you and I were present at the unveiling of the striking portrait of the Member for Barton.

This portrait of Australian Labor frontbencher Linda Burney, the first Aboriginal woman elected to the House of Representatives, will be displayed in a gallery dominated by white, male former prime ministers and presiding officers.

She wasn’t counted in a Commonwealth census until she was 14 years old. Now her painting will hang on the wall of the Commonwealth Parliament as an inspiration for generations to come. And if we are successful at the next election, she will be one of two First Australians in our new Cabinet, there on merit, for First Australians, and all Australians.

For those who seek to visit Linda’s portrait, it’s near the Barunga statement. A bare 327 words presented to Prime Minister Hawke in 1988. It was a vision for self-determination, for local control, for treaty, truth-telling, national reconciliation.

And just like the bark petitions from Yirrkala. Like the tent embassy on the Federation Lawns. Like Clinton Pryor’s Walk for Justice, or Michael Long’s a decade ago. All represent a message of hope. Proof that despite all the failures and shortcomings and the unfulfilled promises of political generations past, there is still a belief out there amongst our First Australians and indeed all Australians, that this place, this parliament, can play a worthwhile, valuable role in reconciling Australia.

The Uluru Statement offers us that chance, a chance to capture the spirit of the signatories at Barunga.

The Gurunji at Wave Hill. The grand campaigners of 67. The extraordinary victory against the odds of Eddie and Bonita Mabo.

The Apology. And all the other peoples and cultures and communities who have fought and won for their own patient struggles for justice.

We have a chance for Australians to celebrate the unique culture of our First Nations people, their ongoing contribution to the life of our nation.

A chance for us to affirm their special place in our nation’s history and its future. We have a chance for healing and unity and reconciliation.

And to take a further step to ensure that the next generation live to see and know an Australia where the gap is closed and the suffering has subsided.

So, with hope, with pride and with trust and faith in all of us, let us take up that challenge.