NACCHO #HaveYourSayCTG about #closingthegap on Aboriginal and Torres Strait Islander youth health : #NACCHOYouth19 Registrations Close Oct 20 @RACGP Doctor :Routine health assessments co-created with young Aboriginal and Torres Strait Islander people may soon be adopted by general practice.

Part 1 : Research project ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’

Part 2 : Registrations close 20 October for the NACCHO Youth Conference Darwin 4 November 

Part 3 : If you cannot get to Darwin  you can still have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander youth

‘General practice needs to think more carefully about the issues facing young people as a distinct group. Better understanding has to start with asking Aboriginal and Torres Strait Islander people about important health priorities, and then listening carefully to the responses.

Once we have listened to community voices on health priorities and co-created the young person’s health assessment, we intend to conduct a pilot randomised trial of the new health assessment looking at outcomes including social and emotional wellbeing, detection of psychological distress and appropriate management and referrals.” 

Dr Geoffrey Spurling first had the idea for his research project ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’ during a moving experience not so long ago, when he attended the funeral of a young Aboriginal woman who had committed suicide. See Part 1

The project was originally published in the RACGP News GP

Read all NACCHO Youth Articles HERE 

Part 1 ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’. Continued from intro above

‘It was a profoundly sad experience,’ Dr Spurling told newsGP.

‘At the same time, community members were telling me that social and emotional wellbeing, especially for young people, was a health priority.

‘I wanted to do what I could with my medical and research skills to understand and help address the social and emotional wellbeing issues facing the community.’

It was here that his research project began to take shape.

Dr Spurling, a GP at Inala Indigenous Health Service and senior lecturer at the University of Queensland, was recently granted funds from the National Health and Medical Research Council (NHMRC) to develop his project, ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’.

Through collaboration with Aboriginal and Torres Strait Islander community members, this research aims to develop and implement a health check especially tailored for young people in these communities.

Current Aboriginal and Torres Strait Islander Medicare health assessments involving adolescents are constructed for 5–14-year-olds and 15–54-year-olds. Dr Spurling believes more focus is needed on the health of young people within the second age group, and a specific health assessment should be implemented.

Following development of the tailored health assessments, Dr Spurling and his team intend to conduct a trial comparing the new health check with the current one available in clinical software, aiming to show better detection and management of social and emotional wellbeing concerns.

‘By creating a youth health assessment together with both young people and clinicians, I hope we can have more relevant conversations about health in general practice within both the specific context of the newly developed young person’s Aboriginal and Torres Strait Islander health assessment, and more broadly in general practice.’

The National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people recommends the Social Emotional Wellbeing (SEW) and HEEADSSS screening tools as part of health assessments for young people.

Investigator Grants is the NHMRC’s largest funding scheme, with a 40% allocation from the Medical Research Endowment Account. The scheme’s objective is to support the research of outstanding investigators at all career stages, providing five-year funding security for high-performing researchers through its salary and research support packages. The 2019 Investigator Grants funding totals $365.8 million.

Part 2 NACCHO Youth Conference Darwin 4 November 

 ” Culturally-appropriate care and safety has a vast role to play in improving the health and wellbeing of our people.

In this respect, I want to make special mention of the proven record of the Aboriginal Community Health Organisations in increasing the health and wellbeing of First Peoples by delivering culturally competent care.

I’m pleased to be here at this conference, which aims to make a difference with a simple but sentinel theme of investing in what works, surely a guiding principle for all that we do

Providing strong pointers for this is a new youth report from the Australian Institute of Health and Welfare.

Equipped with this information, we can connect the dots – what is working well and where we need to focus our energies, invest our expertise, so our young people can reap the benefits of better health and wellbeing “

Minister Ken Wyatt launching AIHW Aboriginal and Torres Strait Islander Adolescent and Youth Health and Wellbeing 2018 report at NACCHO Conference 31 October attended by over 500 ACCHO delegates including 75 ACCHO Youth delegates Pictured above 

Read Download Report HERE

The central focus of the NACCHO Youth Conference Healthy youth, healthy future is on building resilience. For thousands of years our Ancestors have shown great resolve thriving on this vast continent.

Young Aboriginal and Torres Strait Islander people, who make up 54% of our population, now look to the example set by generations past and present to navigate ever-changing and complex social and health issues.

Healthy youth, healthy future provides us with opportunities to explore and discuss issues of importance to us, our families and communities, and to take further steps toward becoming tomorrow’s leaders.

We hope to see you there!

Registrations CLOSE 20 October 

Registrations are now open for the 2019 NACCHO Youth Conference, which will be held November 4th in Darwin at the Darwin Convention Centre

REGISTER HERE

Part 3 Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander youth #HaveYourSay about #closingthegapCTG

Aboriginal and Torres Strait Islander people know what works best for us.

We need to make sure Aboriginal and Torres Strait Islander youth voices are reflected and expertise is recognised in every way at every step on efforts to close the gap in life outcomes between Aboriginal and Torres Strait Islander people and other Australians.’

‘The Coalition of Peaks is leading the face to face discussions, not governments.

The Peaks are asking Aboriginal and Torres Strait Islander youth to tell us what should be included in a new Closing the Gap agreement and we will take this to the negotiating table.’

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

The Coalition of Peaks will be leading #HaveYourSayCTG meetings with Aboriginal and Torres Strait Islander people, communities and organisations on #ClosingtheGap during the month of October.

Aboriginal and Torres Strait Islander people know what works best for us.

We need to make sure Aboriginal and Torres Strait Islander voices are reflected and expertise is recognised in every way at every step on efforts to close the gap in life outcomes between Aboriginal and Torres Strait Islander people and other Australians.’

‘The Coalition of Peaks is leading the face to face discussions, not governments.

The Peaks are asking Aboriginal and Torres Strait Islander people to tell us what should be included in a new Closing the Gap agreement and we will take this to the negotiating table.’

Acting Lead Convener of the Coalition of Peaks and Chairperson of the ACT Aboriginal and Torres Strait Islander Elected Body, Katrina Fanning, said we must ensure the community’s voice is truly heard and understood.

NACCHO will be updating all states and territories meeting locations and times each Tuesday ( NACCHO Save a date ) and Friday ( NACCHO Good News  )

The Coalition of Peaks are leading face to face meetings with Aboriginal and Torres Strait Islander people, communities and organisations on Closing the Gap during the month of October.

The meetings provide an opportunity for Aboriginal and Torres Strait Islander people in each state and territory to tell the Coalition of Peaks and governments what changes are needed to improve their lives.

The Coalition of Peaks is working with the Council of Australian Governments (COAG) to develop a new National Agreement on Closing the Gap for the next ten years and wants to ensure that Aboriginal and Torres Strait Islander people across the country can have a say about what should be included in it.

The Coalition of Peaks is made up of around forty Aboriginal and Torres Strait Islander peak organisations who have come together to negotiate a new Closing the Gap agreement with governments.

The Peaks are committed to representing the views of their membership and the communities who elected them in negotiations with government.

The face to face discussions are part of comprehensive set of engagements which also includes an online survey and Peak consultations with its own membership.

The online survey is open until 25 October 2019.

A report on the engagements will be prepared by the Coalition of Peaks, to be provided to governments and made public.

The report will inform the finalisation the new National Agreement between the Coalition of Peaks and COAG.

October Engagement Meetings:

South Australia

2 October – Adelaide

15 October – Ceduna

18 October – Port Augusta

23 October – Mount Gambier

 

Tasmania

11 October – Launceston

 

Western Australia

14 October – Broome

17 October – Geraldton

21 October – Kalgoorlie

23 October – Port Headland

28 October – Perth

30 October – Narrogin

 

Australian Capital Territory

17 October – Canberra

28 October – Canberra

Victoria

15 October – Melbourne

16 October – Bendigo

17 October – Morwell

See update below for details

New South Wales

21 October – Sydney

 All NSW Regional see below

Northern Territory

4 October – Katherine

11 October – Yirrkala

30 October – Darwin

 

National

23 and 24 October – Canberra

 

Note: Each jurisdiction has structured the events differently, some opting for fewer large events and some opting for a larger number of smaller events.

Dates and locations for Queensland will be finalised soon.

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

VIC Update

There will be three meetings held across Victoria, details are below.

Website RSVP 

City Date Venue Time
Bendigo Monday 14 October Comfort Inn Julie Anna, 268/276 Napier Street 12PM – 4PM
Melbourne Tuesday 15 October Mantra Bell City, 215 Bell Street, Preston 12PM – 4PM
Morwell Thursday 17 October Gathering Place, 99 Buckley Street 12PM – 4PM

NSW Update 

The NSW Coalition of Aboriginal Peak Organisations (CAPO) of which NSW Aboriginal Land Council is a member, are leading the Closing the Gap engagements across the state.

28 consultations will be taking place during the month of October and early November. The consultations are an opportunity for communities to have their say on Closing the Gap.

The 2019 Closing the Gap consultation will see a new way of doing business, with a focus on community consultations. NSW is embarking on the largest number of membership consultations, more than any other state or territory, with an emphasis on hearing your views about what is needed to make the lives of Aboriginal people better.

Your voices will formulate the NSW submission to the new National Agreement. By talking to Aboriginal people, communities and organisations, CAPO can form a consensus on priority areas from NSW when finalising the new National Agreement on Closing the Gap with governments.

The discussion booklet: ‘A new way of doing business’ provides background information on Closing the Gap and sets out what will be discussed at the consultations.

The consultations are being supported by the NSW Government.

Come along and join in the conversation. The dates and locations are:

Route 1
Albury Monday 14th Oct
Deniliquin Tuesday 15th Oct
Balranald Wednesday 16th Oct
Griffith Thursday 17th Oct

Route 2
Wagga Wagga Tuesday 15th Oct
Young Wednesday 16th Oct
Queanbeyan Thursday 17th Oct
Batemans Bay Friday 18th Oct

Route 3
Dubbo Tuesday 22nd Oct
Condobolin Wednesday 23rd Oct
Cobar Thursday 24th Oct
Bourke Friday 25th Oct

Route 4
Newcastle Tuesday 22nd Oct
Central Coast Wednesday 23rd Oct
Muswellbrook Thursday 24th Oct
Tamworth Friday 25th Oct

Route 5
Broken Hill Tuesday 29th Oct
Wilcannia Wednesday 30th Oct
Menindee Thursday 31st Oct
Dareton Friday 1st Nov

Route 6
Lismore Monday 28th Oct
Coffs Harbour Tuesday 29th Oct
Kempsey Wednesday 30th Oct

Route 7
Redfern Monday 4th Nov
Mount Druitt Tuesday 5th Nov
Bathurst Thursday 7th Nov

Route 8
Moree Tuesday 5th Nov
Walgett Wednesday 6th Nov

To register your attendance at Routes 1 and 2, please do so via Eventbrite:

https://www.eventbrite.com.au/o/nsw-coalition-of-aboriginal-peak-organisations-16575398239.

Routes 3 to 8 will follow shortly.

Consultations will run from 11am – 3pm with lunch provided.

If you are unable to make the consultations, you can still have your say through an online survey. The survey closes on 25 October, 5pm.

For more information on the Closing the Gap consultations: https://www.aecg.nsw.edu.au/close-the-gap/

NSW Coalition of Aboriginal Peak Organisations (CAPO)

NSW Aboriginal Land Council (NSWALC)
NSW/ACT Aboriginal Legal Services (ALS)
Link Up (NSW) Aboriginal Corporation (Link-Up)
NSW Aboriginal Education Consultative Group (NSW AECG)
NSW Child, Family and Community Peak Aboriginal Corporation (AbSec)
First Peoples Disability Network (FPDN)

NSW CAPO is co-chaired by the NSW Aboriginal Land Council and the NSW Aboriginal Education Consultative Group. NSW CAPO member organisations are non-government Aboriginal peak bodies with boards that are elected by Aboriginal communities and/or organisations which are accountable to their membership.

 

NACCHO Aboriginal Health and our Workforce #IAHAConf19 #ClosingTheGap : Read John Paterson’s CEO @AMSANTaus Keynote Speech :The importance of collaboration , partnerships and the role of leadership vital in supporting and expanding our Aboriginal health workforce.

 

” Allied health professionals play a very important role in the health system and our services increasingly employ a range of allied health professionals as part of providing holistic, comprehensive primary health care: podiatrists, diabetes educators, dieticians, optometrists, audiologists, dental workers and physiotherapists.

Some areas have received increasing recognition and associated resourcing. For example, better understanding of the issues associated with social and emotional wellbeing, the impact of trauma and the need to address the tragic loss of so many of our people to suicide, has resulted in increased resourcing and employment of allied health professionals, particularly within the multi-disciplinary teams of our health services.

IAHA’s role, as is AMSANT’s, is to build our Aboriginal and Torres Strait Islander health workforce that is critical to improving health outcomes.”

John Paterson CEO AMSANT Keynote Speech IAHA Conference Darwin 25 September

I would like to begin by acknowledging the traditional owners on whose land we gather upon today, the Larrakia people – and to honour their leaders past, present and emerging.

My name is John Paterson and I am the Chief Executive Officer of Aboriginal Medical Services Alliance NT, or more commonly known as AMSANT. AMSANT is the peak body for Aboriginal community controlled health services (ACCHSs) in the Northern Territory and we are an affiliate of the National Aboriginal Community Controlled Organisation, NACCHO. We provide a range of support to our members including workforce, public health, policy, digital health, continuous quality improvement and trauma informed care.

I’d like to thank the Indigenous Allied Health Association for inviting me to present this morning at this important conference.

I’d also like to acknowledge my colleague, Donna Ah Chee, who gave an inspiring keynote speech yesterday.  In her presentation, Donna outlined the characteristics and importance of the comprehensive model of primary health care, delivered through Aboriginal community controlled health services, and so I won’t go over the same ground here today.

Instead I’d like to focus on the importance of collaboration and partnership that in many ways have come to define the way we work in Aboriginal health; and also to reflect on the role of leadership that is so vital in supporting and expanding our Aboriginal health workforce.

Can I firstly congratulate IAHA on celebrating their first 10 years—hopefully the first decade of many more to come—and to acknowledge their hard work across the nation to build and support quality Indigenous Allied Health professionals for our mob.

I would also like to acknowledge IAHA’s CEO, Donna Murray, their board and its members for the hard work you continue to do to build IAHA to where it is today.  We look forward to seeing where your future takes you.

We know how important it is to have our own Aboriginal and Torres Strait Islander national and peak organisations to advocate for our mob. We have to be there, in the tent, at the negotiating table, making our case.

And we’ve got to be working together.

One of my other hats is as one of the governing group of CEOs of the Aboriginal Peak Organisations NT, or APO NT, along with the CEOs of the Northern Land Council and Central Land Council. The APO NT alliance was formed in 2010 to provide coordinated Aboriginal leadership in the Territory in the wake of the NT Intervention, although we have also worked effectively at the national level.

APO NT is a member of the National Indigenous Coalition of Peaks, within which IAHA is also represented as a member. The work of the Coalition of Peaks and the outcomes we are achieving in relation to a renegotiation of Closing the Gap is an important example of why working together in partnership is so vital to the future of Aboriginal health. This is a theme I will return to later in my presentation.

The other critical element, of course, is the frontline workers at the health service and community levels, who care for our mob.  I want to acknowledge and thank all of the Aboriginal and Torres Strait Islander Allied Health Professionals and students in the room today and across the nation who do such an exceptional job in their chosen fields to help make a difference in health.

Find a a job in an ACCHO with NACCHO Job Alerts

You are an essential part of the health system and we thank you for your tireless efforts in everything that you do.

Allied health professionals play a very important role in the health system and our services increasingly employ a range of allied health professionals as part of providing holistic, comprehensive primary health care: podiatrists, diabetes educators, dieticians, optometrists, audiologists, dental workers and physiotherapists.

Some areas have received increasing recognition and associated resourcing. For example, better understanding of the issues associated with social and emotional wellbeing, the impact of trauma and the need to address the tragic loss of so many of our people to suicide, has resulted in increased resourcing and employment of allied health professionals, particularly within the multi-disciplinary teams of our health services.

IAHA’s role, as is AMSANT’s, is to build our Aboriginal and Torres Strait Islander health workforce that is critical to improving health outcomes.

The untapped potential is huge. Collectively, the Aboriginal community controlled health sector employs about 6,000 staff, 56 per cent whom are Aboriginal and Torres Strait Islander people. This makes us the single largest employer of Aboriginal and Torres Strait Islander people in the country.

But there is still such a long way to go.

One of the areas requiring attention is the need to be advocating for more allied health positions within our sector. Many Aboriginal community controlled health services are not sufficiently funded to employ the multi-disciplinary workforce required to deliver the full range of core comprehensive primary health care services. Expanding and increasing the resourcing of Aboriginal community-controlled comprehensive primary health care services is a key strategy in developing our Indigenous workforce, particularly in allied health positions.

Further potential is provided by the opportunities to expand services in regional and remote areas in aged care and through the NDIS.

The lack of aged care and disability services in regional and remote areas is a major problem that needs to be addressed in ways that take account of the lack of economies of scale and difficulty in attracting health professionals to such areas, as well the need for culturally responsive service delivery. This requires consideration of regional hub models and opportunities for joint initiatives in workforce development, capacity building and the employment of specialist and other allied health professionals.

Some ACCHSs already provide aged care and disability services, sometimes by default due to the failure or lack of service providers. There is further potential for ACCHSs to employ staff who can provide aged care and disability services.

Our vision is for people with disabilities in remote and regional areas to be able to access the services they need and to lead active and fulfilling lives. And for our old people to be able to live out their days in dignity on country and pass away surrounded by family.

We have such a long way to go to achieve this vision and we hope that the current Royal Commissions into these areas will provide a catalyst for action.

Increasingly, building our Indigenous workforce requires collaboration between providers and sectors. AMSANT works in collaboration with a wide range of key stakeholders to create career opportunities for our next generation coming through, and to build initiatives and opportunities for our existing Aboriginal health workforce in developing career pathways, whether it be as community workers, health workers or in management.

An important initiative for AMSANT has been our involvement in the Lowitja Institute-funded Career Pathways Project. This is an Aboriginal-led national research project to provide insights and guidance to enhance the capacity of the health system to retain and support the development and careers of Aboriginal and Torres Strait Islander people in the health workforce. The project partners include Aboriginal health services in NSW and the NT along with university and peak organisation partners.

This project was important to us. We wanted to give our Aboriginal health professionals a voice that was evidence-based. To be able to provide solutions from the ground up that we could advocate for at local, regional and national platforms. To demonstrate with evidence where the need for investment is and emphasise how critical our Aboriginal health workforce is to improve health outcomes for our mob.

Other significant collaborations include working with Indigenous workforce bodies, such as IAHA and the National Aboriginal and Torres Strait Islander Health Workers Association, or NATSIHWA, on expanding Indigenous workforce in key areas.

You may have heard yesterday that AMSANT has been working in partnership with IAHA for the past 2-3 years to develop and implement a VET in schools pathway for high school students here in Darwin. This will provide students an opportunity to gain a qualification in allied health support and consider a career in health.

This has been a priority for AMSANT for many years, to source opportunities in many health disciplines for the next generation of our kids to start a journey in health. We have known for too long here in the NT that there are simply not enough opportunities for our kids to start that journey. A journey that is supported, nurtured and led by the Aboriginal health sector.

We have also successfully advocated alongside IAHA and other key organisations to the Council of Australian Governments (COAG) at a meeting in Alice Springs, for the development of an Aboriginal health workforce plan.

The important message from this is that we can’t do workforce strategy, or broader health strategy for that matter, alone.

Partnerships are vital. We need them to help bridge the gap between the too-often siloed mentality of governments and funders and the reality that health is holistic and demands focus on the big picture.

Partnerships enable us to work together to push the health agenda and encourage investment in the areas our communities so desperately need.

This means following the evidence and advocating on it.

For example, it’s now commonly understood that health services only account for approximately a third of health outcomes, with the other two thirds accounted for by the social and cultural determinants of health.

Increasingly, AMSANT’s partnerships have focused on health determinants, following the evidence and responding to the issues raised by our membership and the community. Our sector’s model of comprehensive primary health care encourages cross sectoral action on the social determinants.

Housing has been at the forefront of community concern, with high levels of overcrowded and inadequate housing and homelessness. We know the health and wellbeing impacts that poor housing and homelessness causes. This includes impacts on the Aboriginal health workforce who struggle with living in inadequate or overcrowded houses while maintaining their responsibilities to their work in health. Strong Aboriginal advocacy on housing is needed.

As a member of APO NT, AMSANT has contributed to the development of a Northern Territory Aboriginal peak housing body, Aboriginal Housing NT or AHNT. The new body will provide a strong Aboriginal voice on housing as well as a mechanism for government to engage with in increasing the involvement of Aboriginal organisations in housing provision and management.

I use this example to illustrate the importance of taking a role in advocating on the social determinants as a means of improving health outcomes as opposed to focusing exclusively on health service or disease specific strategies.

However, it also illustrates the point that I began this presentation with—the importance of Aboriginal leadership and having our own Aboriginal and Torres Strait Islander organisations to advocate for our mob and to deliver services to our communities that are culturally responsive and effective.

I want to return briefly to my earlier mention of Closing the Gap and the membership of APO NT and IAHA as members of the National Indigenous Coalition of Peaks.

 

The Coalition of Peaks emerged as a result of a group of national Indigenous organisations writing to the Prime Minister in relation to the exclusion of our mob from the decision-making process for the Closing the Gap Refresh.

After ten years of failed progress under Closing the Gap we weren’t about to submit to another top-down, government-imposed process on our communities.

The letter sparked a meeting with the Prime Minister and subsequently, negotiations with the Council of Australian Governments, or COAG, that have resulted in a formal Partnership Agreement on Closing the Gap with the Coalition of Peaks, and the establishment of a Joint Council on Closing the Gap with the Coalition of Peaks represented as a Council member—the first time that a non-governmental body has been represented within a COAG structure.

Importantly, the central ask of the Coalition of Peaks, is not around new indicators—although these are important tools to get right—but for a fundamental change in the way governments work with our people and the full involvement of our people in shared decision-making at all levels.

This includes a commitment to building, strengthening and expanding the formal Aboriginal and Torres Strait Islander community controlled sector to deliver Closing the Gap services and programs.

We are also calling for the new Closing the Gap strategy to be properly funded, at least matching the ten-year funding of the original Closing the Gap.

The potential for this new national partnership with government is that support for the expansion of the Aboriginal community controlled service delivery sector and with it the Indigenous health workforce could be a game-changer.

While nothing is certain in this world, this is one development that gives me real hope that fundamental change is possible.

Have Your Say SURVEY HERE

And it started with Aboriginal leadership.

Of course, Aboriginal leadership is just as important at the sector and service level if we are to be true to our commitment to the aspirations and standards of community control.

AMSANT has been committed to building leadership capacity within the health sector in the NT and has been delivering leadership workshops for over 11 years now. We have recently developed a formal partnership with the Australian Indigenous Leadership Centre which will further build our capacity in leadership support within the NT. We look forward to seeing this partnership develop and deliver for our sector.

We especially need to acknowledge our elders—our leaders and mentors who have or still work tirelessly to keep doing what they do to give our communities the best possible chance of improving health outcomes. Too often they are the unsung heroes that have paved the way for the next generations to keep building on the hard work that’s been done.

Leadership is vital at every level, not least in supporting our Aboriginal workforce. We know the many challenges that our workforce face, dealing with burnout, the vicarious trauma they experience, as well as day to day stress—and we know that we have to have in place effective strategies to support them. We know there is much still to do in supporting career pathways. And we know that there are many issues of equity, such as addressing the lack of housing for local workers.

The Aboriginal health sectors and its workforce has decades of knowledge, know-how and lived experience to know what we need by way of services and ways to improve health outcomes.

AMSANT recently celebrated our 25th anniversary and our oldest member service, the Central Australia Aboriginal Congress, has now been in existence for 45 years. They, along with other pioneers such as the Redfern Medical Service, paved the way for the more than 150 Aboriginal community controlled health services that are currently working for our communities across the country.

Here in the Territory, AMSANT is a member of the Northern Territory Aboriginal Health Forum along with the Northern Territory and Commonwealth governments, and the NT Primary Health Network. The Forum is a high level Aboriginal health planning body that assures us a seat at the table.

Our sector today continues the mission it took on 45 years ago to provide Aboriginal community controlled holistic, comprehensive primary health care to our people. We have continued to grow our place in the health system, currently providing around two thirds of all primary health care services to our communities. And we are supported to continue to transfer government run services to community control over time.

I hope that the students amongst the audience today can take encouragement from this history of our sector, that you have a secure future in Aboriginal health and that you have a welcome place in our services.

Believe me, as a former bureaucrat and ATSIC Commissioner, there is not much that survives the relentlessly changing priorities of government. That we continue to prevail is a true success story!

And I hope you can take the courage to dream big as our leaders did all those years ago.

Today we have a new vision to follow: the Uluru Statement from the Heart, adopted by the First Nations National Constitutional Convention at Uluru in May 2017.

Treaty, truth, voice!

We have support and as Indigenous peoples we are persistent and patient.

But keep that fire in your belly!

I hope you enjoy the rest of the conference and I wish you all the very best for your futures.

Thank you.

NACCHO Aboriginal #Environmental Health ClosingtheGap #HaveYourSay : Our CEO Pat Turner’s speech to the National Aboriginal and Torres Strait Islander Environmental Health Conference in Perth this week

” In mainstream settings, there is no battle for recognition or resources for environmental health from finance departments. There is nothing more to prove and a fully resourced framework is in place. 

But Aboriginal environmental health is something else again.

Aboriginal environmental health combines deep cultural knowledge of how things work in Aboriginal communities with these hard scientific facts about disease.

Aboriginal environmental health must forge high-trust partnerships with community. 

Aboriginal environmental health is a community asset.

And Aboriginal environmental health is needed now more than ever.   Why is this so?

Public housing and public utilities have largely been taken out of Aboriginal control. In some locations, funding for the Aboriginal Environmental Health workforce has evaporated.\

Sometimes, the power to make the simplest decision on the ground has been ripped away from local communities. 

Instead, this power is with someone far away who doesn’t even know us.

This is nowhere more manifest than in Aboriginal housing. 

Effective Aboriginal environmental health programs must be in Aboriginal hands. 

Community controlled organisations must drive the necessary knowledge exchange between those who hold technical expertise and those who have been denied it.

The very nature of this work means that Aboriginal communities must retain the reins – and retain the knowledge

Selected extracts NACCHO CEO Pat Turner addressing the National Aboriginal and Torres Strait Islander Environmental Health Conference in Perth this week

As an Aboriginal woman of Gudanji-Arrernte heritage, I wish to acknowledge the Whadjuk people of the Noongar nation as traditional owners of the land where we meet today.

I also acknowledge our continuing and vibrant First Nations cultures.  I am grateful for the contributions of our past, present and emerging leaders.

Our cultures, our leaders and our country give us collective strength and resilience as Aboriginal and Torres Strait Islander peoples.

Just a note for about language conventions in Western Australia. I tend to use the term Aboriginal in recognition that Aboriginal people are the original inhabitants here. This is not out of any disrespect to Torres Strait Islander colleagues and communities.

I have discovered that the first NATSIEH conference was held in 1998. Every second year or so since, the aim of these national conferences is to increase the understanding and awareness of environmental health issues in our communities.

This year, your theme is ONE GOAL: MANY PATHS.  There must be a huge diversity of backgrounds, professions and experiences in the room.   I am delighted to be here.  I hope I have something for everyone in my address to you today.

I will begin with recent CHANGES in the way governments must now work with Aboriginal and Torres Strait Islander people.

Then I’ll cover some CHALLENGES that we can no longer ignore.

And finally, I’ll explain how Aboriginal LEADERSHIP will show the right path that we must take together.

How has our political landscape changed?

Please cast your minds back to 2008 when the original Closing the Gap policy was agreed by the Council of Australian Governments – known as COAG.

There was never full ownership of Closing the Gap from Aboriginal and Torres Strait Islander peoples. CLOSING the Gap was always considered to be an initiative of Governments.  Frankly, it was governments talking to other governments ABOUT us.  WITHOUT us.

Many Aboriginal and Torres Strait Islander Peak bodies supported Closing the Gap in good faith, particularly with new funding given to specific issues including housing, health and education.

But was Closing the Gap ever going to work with its genesis in the bureaucratic backrooms of Canberra?

Our people were always going to be configured as ‘the problem’.  Not as allies, not as experts, not as partners, not as equals.  It was not surprising to Aboriginal people to see that progress was patchy.

As Prof Marcia Langton, a leading Aboriginal academic of Yiman and Bidjara heritage, said in February this year at the Australian and New Zealand School of Government Indigenous conference:

“You can’t have administration of very complex matters from the Canberra bubble. It’s not working and lives are being lost. 

… We must push for policies that give formal powers to the Indigenous sector and remove incompetent, bureaucratic bungling.”

Marcia made a specific request of those who were listening:

“Please do not feel personally offended by what I have to say to you” she said.

I also ask this of you today.  And as Marcia continued to say:

‘… we must all take responsibility and be courageous enough to take action, to put an end to the policies and programs that disempower Aboriginal and Torres Strait Islander people, not just causing a decline in their living standards, but accelerating them into permanent poverty.

Especially the vulnerable. The children and youth are victims of a failed view of the Indigenous world and Indigenous people. This is a dystopian nightmare. We must imagine a future in which Indigenous people thrive and we must do whatever it takes to reach that future. This is urgent.”

It is not surprising then, that after 10 years, not much progress against the Closing the Gap targets had been made.

As the Closing the Gap targets were expiring, COAG announced a “Refresh” of Closing the Gap.  This “refresh” kicked in during 2017.  As various conversations took place however, it became clear that governments were still not listening properly or engaging in a genuine way, and they only wanted to talk about new targets.

Many Aboriginal Peak bodies wanted more time to test the options being put before us in these conversations. Most importantly, Peak bodies needed to be sure that THEIR voices were truly being heard. There was a real concern – AGAIN – that governments had already decided what they wanted to do. That governments were now negotiating behind closed doors to decide new priorities and targets without our input.

As Aboriginal peak bodies, we had to call this out before the country made another momentous mistake. We were very insistent.  We formed a Coalition.  The Prime Minister and his COAG colleagues had to adopt a better way of working.  Without a radical change in approach, the next ten years would be more of the same lack luster approach.

To his credit, Prime Minister Morrison listened.

He opened the door to a new way of working, giving his personal authority to change.

An historic Partnership Agreement on Closing the Gap was signed this year in March between COAG and the Coalition of Peaks.  This means that now, 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.

How is this to be done?

This Partnership Agreement has created a high-level COAG Joint Council.  This Joint Council is made up of 22 members.  That means a Minister from the Commonwealth Government, a Minister from each State and Territory Governments, and a representative for local government. This makes up ten members.

But significant success was realized when the Coalition of Aboriginal Peak Bodies ensured TWELVE Aboriginal or Torres Strait Islander representatives were on the Joint Council.  Chosen by us, in the majority, working for our mobs.

The Joint Council is co-chaired by the current Commonwealth Minister for Indigenous Australians and a representative of the Coalition of Peaks chosen by the Peaks. Currently, that representative is me.

The Partnership Agreement embodies the belief of all signatories that:

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

So to those public servants in the audience, whether you work in Commonwealth, state, territory or local government institutions, I say this.

If the Director-General, Secretary or CEO of your department or agency is not enabling you to do your work differently and act in accordance with the Partnership Agreement, Principles, then you need to join the movement and shake the tree.

I encourage you to:

  • Initiate co-design that looks entirely different to the way your department worked two years ago.
  • Give power of veto to communities on priorities. Listen to what THEY say.
  • Double the number of Indigenous people on your committees.
  • Forget ‘one size fits all’ … because it doesn’t.
  • Immerse yourself in this unprecedented opportunity for true equity in our country.

Trust me, your change of practice will be noticed, commended and supported.

Within the Joint Council, we will continue to lead the structural reform that will make your change of practice easier.  At our recent meeting in Adelaide, the Joint Council significantly agreed to develop a new National Agreement on Closing the Gap centred on three reform priorities.

The reform priorities seek to change the way Australian Governments work with Aboriginal and Torres Strait Islander peoples and organisations, and accelerate life outcomes for Aboriginal and Torres Strait Islander peoples, these are:

  1. Establishing shared formal decision making between Australian governments and Aboriginal and Torres Strait Islander people at the State/Territory, regional and local level to embed ownership, responsibility and expertise on Closing the Gap.
  2. Building and strengthening Aboriginal and Torres Strait Islander community-controlled organisations to deliver services and programs in priority areas.
  3. Ensuring all mainstream government agencies and institutions undertake systemic and structural transformation to contribute to Closing the Gap.

The Joint Council also agreed to the Coalition of Peaks leading engagements with Aboriginal and Torres Strait Islander people over the next two months to ensure others can have a say on the new National Agreement on Closing the Gap.

The Coalition of Peaks want to hear views from across the country on what is needed to make the reform priorities a success.

 

I encourage you all to contribute and have your say.

You can find out more on the NACCHO website. Step up and join in!

I know these priorities, especially the first two, are critical to our success as Aboriginal  people. And I know this from a lifetime of advocacy and service for my people, including my current role as CEO of NACCHO.

NACCHO is the living embodiment of the aspirations of Aboriginal and Torres Strait Islander communities and our struggle for self-determination.  NACCHO is the national peak body representing 143 Aboriginal Community Controlled Health Services or “ACCHOs” across the country.   NACCHO has a history stretching back to a meeting in Albury in 1974 in country New South Wales.

For those who don’t know, an “ACCHO” is a primary health care service initiated and operated by the local Aboriginal community to deliver holistic, comprehensive, and culturally appropriate health care to the community which controls it, through a locally elected Board of Management.

As a sector, we are especially proud that ACCHOs are the largest employer of Aboriginal and Torres Strait Islanders in the country.  Not even the mining sector compares. We also have evidence that ACCHOs are demonstrably better than mainstream in providing culturally responsive, clinically effective primary health care.

At this year’s AMSANT conference, Donna Ah Chee, a Bundgalung woman from NSW and CEO of Central Australian Aboriginal Congress, said precisely what community control means in this context.

Read full speech HERE

It means:

  • The right to set the agenda and determine what the issues are
  • The right to determine which programs or approaches are best suited to tackle the problems in the community
  • The right to determine how a program is run, its size and resources
  • The right to determine when a program operates, its pace and timing
  • The right to say where a program will operate, its geographic coverage and its target groups
  • The right to determine who will deliver the program its staff and advisers.

This commitment to equal partnership through COAG has brought us to the table.  There’s no going back.

I’d now like to cover some CHALLENGES in environmental health. 

Environmental health is a science-based, technical practice.  Environmental health takes scientific knowledge to people. It focuses on disease risk and finds the way to limit disease in modern society. Environmental Health Practitioners draw the connection between environmental factors and health outcomes.

Environmental health practitioners take this science and fix environmental hazards to prevent risk. They nip outbreaks in the bud.

They influence and draft legislation, and monitor compliance with public health laws and the regulations to protect people’s health.

Of course, in mainstream Australia, hardly anyone recognizes the role that environmental health plays.  For the majority of the population, environmental health is silently present. Water, sanitation, rubbish, housing standards, food safety, everything … it is all taken for granted.

In mainstream settings, there is no battle for recognition or resources for environmental health from finance departments. There is nothing more to prove and a fully resourced framework is in place.

But ABORIGINAL environmental health is something else again.

Aboriginal environmental health combines deep cultural knowledge of how things work in Aboriginal communities with these hard scientific facts about disease. Aboriginal environmental health must forge high-trust partnerships with community.

Aboriginal environmental health is a community asset.

And Aboriginal environmental health is needed now more than ever.   Why is this so?

Public housing and public utilities have largely been taken out of Aboriginal control. In some locations, funding for the Aboriginal Environmental Health workforce has evaporated. Sometimes, the power to make the simplest decision on the ground has been ripped away from local communities.  Instead, this power is with someone far away who doesn’t even know us.

This is nowhere more manifest than in Aboriginal housing.

First, the evidence.  A recent systematic review of the scientific literature has summarized the known causal links between the home environment and health.  Here are some examples:

  • Skin-related diseases are associated with crowding
  • Viral conditions such as influenza are also associated with crowding.
  • Ear infections are associated with crowding, lack of functioning facilities for washing people, bedding and sewerage outflow.
  • Gastro infections are associated with poorly maintained housing and the state of food preparation and storage.

These are not hypothetical claims yet to be proved.  These have academic weight and the verdict is in.

In mainstream Australia, these causal links between the housing and health have been actioned.  In mainstream Australia, sustained progress in the social and environmental determinants of health has permanently reduced the rates of preventable infectious diseases.  One look at the disease burden tells us that.

BUT … because of the state of OUR environmental conditions, Aboriginal people are denied the health outcomes that non-Indigenous people now enjoy.

The challenge is huge.

  • Let’s consider clinic presentations for Aboriginal children for their first year of life. Did you know that research has found that the median number of clinic presentations per child in the first year of life was 21.  Twenty-one! Per child!   Children in this NT study would typically have six clinic presentations for diarrhea in any one year!  SIX! An infectious ear disease known as Otitis Media and skin infections were also high on the list of most frequent reasons for Aboriginal children coming to the clinic in their first year of life. These infectious diseases are NOT caused by bad parents.  They are caused by poor living conditions, overcrowding and poverty imposed on our people.
  • In the Fitzroy Valley in the Kimberley here in Western Australia, 70% of Aboriginal children have been admitted to hospital at least once before they turn seven years of age. A closer look at the reasons why is shocking.  The researchers concluded that most of these admissions would not have happened at all if household disadvantage, poor quality housing and access to primary health care had been addressed.
  • Another example comes from the Western Desert region here in Western Australia. This looked at clinic presentations of all children aged 0 to 5 years of age.  These children had on average more than 30 clinic visits each per year to their clinic. ………  Think about what that means to the morale of the parents, the attitudes of the clinicians, the health budget bottom line. Infectious diseases explained half of these presentations:
    • Ear infections were 15%
    • Upper respiratory tract infections, 13%
    • Skin sores were 12% of the total.
    • And 25% needed treatment for scabies.
  • These statistics aren’t just confined to remote communities. Aboriginal children in Western Sydney in homes with 3 or more housing problems were two and a half times more likely than others to have recurrent gastro-enteritis. For every additional housing problem, the odds of infectious disease significantly increased.

But is this all NEWS?  What about the year of your first NATSIEH conference in 1998?

1998 was the year a study was published showing that admissions to hospital for skin disease of Aboriginal children under five years of age was ten times higher than that of their non-Indigenous counterparts.

It was also the year that deaths among Aboriginal men from infectious diseases were calculated to be some 15 times higher than deaths among non-Indigenous men.

1998 was also the year a study measured the precise “wear and tear” on washing machines installed in seven remote communities.

1998 was a year AFTER a study had already been published showing that over one-third of Aboriginal remote communities had water supply or sanitation problems. Seventy percent had housing problems.  In the words of the researchers, overcrowding and substandard housing were “commonplace”.

So there we have it.   Even this brief snapshot shows we have a disconnect between data and decisions.

From your first conference in 1998 to this one in 2019 …

….  Aboriginal people, their children and now their children’s children have NOT been afforded their DUE HUMAN RIGHTS in response to these “repeat plays” of research data.

Should we have mobilised a more strategic response at the time these research studies were published?

Perhaps data sovereignty is another challenge we need to face.

I regret thinking of the number of children growing up since 1998 who should have been safe from preventable infections IF THERE HAD BEEN ACTION.  I think of how many children need not have gone to hospital.  Who should NOT have ended up with permanent damage for life from rheumatic heart disease or deafness …

… and would NOT have ended up with these conditions if their houses had been safe, healthy and affordable.

I have been told even mental health problems – including suicide – get worse in overcrowded houses not fit for social purpose.

And please don’t tell me we can’t find the money.  My colleagues in the Kimberley estimate that one third of the entire cost of hospital admissions of Aboriginal children is DIRECTLY due to the environmental conditions in which these children live.  Let me repeat that. One third of the entire cost.

In one year alone, $16.9 million is the estimated cost for hospitalisations of Aboriginal people directly due to the environment. And that was just the Kimberley.

Maybe all those departments of housing really don’t have the money BUT their colleagues in health departments are spending it hand over fist.

The Australian Indigenous Governance Institute affirms that Aboriginal people have the right to:

  • Exercise control of the data “ecosystem” including creation, development, stewardship, analysis, dissemination and infrastructure.

We also have the right to:

  • Data structures that are accountable to Aboriginal and Torres Strait Islander peoples and their governance structures.

And the right to

  • Data that is protective and respects our individual and collective interests.

AND

  • Data that is relevant and empowers sustainable self-determination and effective self-governance.

In my view, Aboriginal people must more clearly set the agenda for the health data story.

As Aboriginal people, WE are vested in the outcomes.  WE are accountable to each other, our families and communities.  These research studies represent OUR families, OUR loved ones, OUR LOST ones.

I believe the character and foresight of Aboriginal leadership will show the right path. 

Should you need convincing, I can think of no better example in environmental health than Yami Lester and the Nganampa Health Council in the APY lands.

Decades ago, these leaders knew that health improvement required medical services AND a healthy living environment.  In 1986, they initiated a collaborative project between local Anangu people and technical experts to ‘stop people getting sick’. Some of you may recognise this as the UKP project.

These Aboriginal leaders engaged Paul Pholeros and Dr Paul Torzillo to work together to develop a codified schedule for home assessments and repairs.  When assessments were finished, simple repairs to health hardware that could be fixed, WERE fixed.  Immediately, over 75% of these assessment and repair teams were local Aboriginal and Torres Strait Islander people trained and assisted by skilled managers and team leaders.

Any requirements for major repairs that were the responsibility of the landlord were submitted, logged and monitored. As this program expanded, data from different locations showed that the reasons for poor housing conditions were shoddy building materials in the first place (22%); inadequate maintenance schedules by the landlord (70%) and less than 8% was due to damage by occupants.

As relevant today, Yami Lester and his Council knew the importance of sharing with their people knowledge about disease transmission and supporting households to adopt new habits to sustain health in circumstances none of us would find easy.

And they succeeded.

Their legacy is the framework of nine Healthy Living Practices about washing, clothes, wastewater, nutrition, crowding, animals, dust, temperature and safety against injury.

Today, housing audits and home hardware assessments conceived by Aboriginal leaders in this UKP project MUST be permanently funded everywhere and combined with culturally responsive support directed by communities to re-build THEIR knowledge about disease transmission.

Every home is different.  Every environmental risk assessment is unique.  In one, there might be an issue with food-borne diseases. In another, passive smoking that affects the children’s ears, lungs and eyes.  In another, it could be …

– a blocked toilet,

– a shower dislodged from a poorly laid wet floor, or

– a washing machine that has collapsed under the pressure from multiple loads and hard water every single day.

Resources enable Aboriginal environmental health workers and families to work together over time to build the household’s confidence and knowledge.  The shared goal is self-management in healthy habits ….. AND an assertiveness as tenants to report poor quality building materials, housing problems and urgent repairs to the respective housing landlord.

Effective Aboriginal environmental health programs must be in Aboriginal hands.  Community controlled organisations must drive the necessary knowledge exchange between those who hold technical expertise and those who have been denied it. The very nature of this work means that Aboriginal communities must retain the reins – and retain the knowledge.

What Yami Lester envisaged is our unrealized obligation.

Housing programmes will have limited impact UNLESS they are controlled in their design and delivery by Aboriginal organisations with sustained visibility, authority and relationships in the community.  Communities have ideas on how to manage overcrowding, maintain housing stock and build new housing through local entrepreneurship. It is time once again for Aboriginal leaders to be heard.

You may know about extensive consultations conducted across the country in 2017 known as “My Life My Lead”.

The purpose of these consultations was to provide an opportunity to shape the next update of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan released originally in 2013.

At these consultations, Aboriginal people spoke up about the fundamental significance of social, economic and environmental determinants affecting their health and wellbeing.

Environmental health was identified as one of seven top priorities for the next Implementation Plan.

I quote:

Addressing the underlying environmental health conditions that contribute to poor health outcomes in many Aboriginal and Torres Strait islander communities will lead to long-term improved health, education and employment outcomes. 

This is why I hope my message to you today is clear. We will get better health by improving housing and environmental health programs. Regaining control over decisions about housing will also lead to better health.  Returning authority for decision-making to communities about resources and program design reinvigorates empowerment, autonomy and more equitable power arrangements.  Self-determination promotes health.

With a decent investment in Aboriginal housing alongside genuine shifts in who makes decisions about resource allocation, I am prepared to guarantee to you today that the impact on Aboriginal health outcomes will be large, positive and permanent.

If those estimates of the costs from hospital admissions hold true nationally, I am also prepared to guarantee a significant reduction in healthcare budgets.

Our Prime Minister is inclined to miracles … so I think this would be the next miracle he’d very much like to see!

If we believe in public health and preventing the preventable …

If we believe in equity and social justice …

If we believe in community control …

… then we have everything we need to turn this around.

To governments I say let Aboriginal leaders sit down with you and – together in partnership – analyse the current state of environmental health and housing in your jurisdictions.

Let’s establish the level of investment that will reduce the cost of hospitalisations of Aboriginal children, adults and elders due to poor housing and living conditions.

Let’s develop national standards for a safe house. Let’s agree to strict criteria for urgent and priority housing repairs.  Let’s audit repair performance.  Let’s publish the data.

Let’s get more accountability from public housing for proactive home maintenance schedules and repairs.

Let’s invest in environmental and building programs that will cut the demand in primary health care clinics by a quarter and let these busy staff focus on other priorities.

Let’s grow knowledge in our communities as experts in healthy living.

Let’s train, credential and employ young Aboriginal people as environmental health workers, plumbers, electricians and carpenters to keep houses safe, healthy and ready for climate change ahead.

Let’s ensure a sustainable on-the-ground workforce for effective environmental health employed by Aboriginal organisations.

Here at this conference, let’s create the cross-sectoral approach involving communities, environmental health, primary health care and governments IN PARTNERSHIP to get this moving.

In closing, I’d like to quote Senator Patrick Dodson, a Yawuru man from Broome who, in February this year, asked a very important question:

“Who actually closes the gap?”

He answered this by saying:

“It’s the people working at the grassroots, led by First Nations peoples, with a deep understanding and lived experience of the needs of their communities.”

It is in that spirit that I thank each and every Aboriginal Environmental Health Practitioner at this conference whether it is your 1st or your 12th.

I know you work hard. I know you care deeply about your communities.  I know you lead by example.

I respect your hard-earned skills and your expertise to provide a huge scope of professional services ranging from dog control to vector management.

I admire your precise and up-to-date knowledge of disease transmission routes, hazardous chemicals, sanitation and practical engineering.

I am sincerely impressed by the care you take to work with families whose circumstances are complex … and that you find THEIR strengths and work with their capacities.

You respect cultural protocols.  You deliver with few resources, a lot of ingenuity and teamwork.

It is enabling YOU to do an even better job for YOUR communities that motivates me to do mine.  And I will keep on working just as hard as you do.

It’s been a pleasure sharing my reflections with you all.

Thank you for this opportunity to kick off the second day of your 12th NATSIEH conference here in Perth.

 

NACCHO Aboriginal Health #ClosingtheGap : Pat Turner Convener #CoalitionofPeaks Speech at the National #PHN Conference : Challenging the way Governments and Primary Health Networks work with us

The reform priorities, and that they are being discussed in a COAG forum with Aboriginal and Torres Strait Islander people at the table, as well as the upcoming engagements is a demonstration of how the conversation and approach is changing as a result of the Partnership Agreement on Closing the Gap.  

But this changed approach is not to be just contained to the Partnership Agreement and governments work with the Coalition of Peaks. It is to be applied to all your policy practice and service delivery.

It is a challenge for you (PHN’s) to reconsider how you develop policies and programs with and for Aboriginal and Torres Strait Islander people and communities.

The Partnership Agreement means that:

  • Aboriginal and Torres Strait Islander people are no longer government ‘stakeholders’ but are full partners in the development of policies and programs that impact on us.
  • Primary Health Networks need to develop formal arrangements with us, through our community controlled health organisations, to agree policy and programs, based on our own structures and not your own appointed advisory bodies.
  • The knowledge of Aboriginal and Torres Strait Islander peoples to determine their own solutions must be given primacy in policy and program design and delivery.

I ask that you all consider what the Partnership Agreement will mean to your own Primary Health Network, to the area and team that you work with, to start a conversation with your team members about it, to read further about the work we are doing and set up a time to speak to one of our Coalition of Peaks members to learn more.

The Partnership Agreement presents a significant opportunity for you all to think creatively and with innovation, to not just think about what is possible in the relationship between government and Aboriginal and Torres Strait Islander people, but to be at the forefront of the change.”

Pat Turner NACCHO CEO speaking at the PHN NATIONAL FORUM, 11TH September 2019 HYATT HOTEL, Canberra

Hello everyone, thank you for inviting me here today to speak to at the seventh Primary Health Network National Forum.

It is testament to the changing times that you now have delegates from national health peak bodies like mine, the National Aboriginal Community Controlled Health Organisation (NACCHO), attending your forums and being invited to share our own stories.

My name is Pat Turner. I am the CEO of NACCHO, and the Lead Convener of the Coalition of Peaks. Foremost, I am an Aboriginal woman, the daughter of an Arrente man and a Gurdanji woman.

Before we start, I want to acknowledge the traditional custodians of the lands where we are meeting today.

Canberra is Ngunnawal country. The Ngunnawal are the Aboriginal people of this region and its first inhabitants.

The neighbouring people are the Gundungurra to the North, the Ngarigo to the South, the Yuin on the coast, and the Wiradjuri inland.

It is a harsh climate and difficult country for hunter-gatherer people. To live here required great knowledge of the environment, skillful custodianship of it and close cooperation.

It is this knowledge and ways of working that continue to guide Aboriginal and Torres Strait Islander peoples across the in today’s Indigenous policy landscape.

As we navigate the changing policy environment, Aboriginal people draw strength from our lands and our customs. And we continue the cooperation amongst our many nations for the betterment of all of us. This is the approach that we take to the Coalition of Aboriginal and Torres Strait Islander Peaks Bodies and our work on Closing the Gap.

The Coalition of Peaks are made up of some forty national and state/territory community controlled Aboriginal and Torres Strait Islander Peak Organisations. We have come together to be formal partners with Australian Governments on Closing the Gap.

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

Together, we are changing the way governments work with Aboriginal and Torres Strait Islander peoples on policies and programs that impact on us: we are setting a new benchmark for how our voices are heard in the design and implementation of policies and programs that impact on us.

I come before you to not only share the story of the Coalition of Peaks and their work with governments. Importantly, I also want to talk to you about what these new arrangements mean for Primary Health Networks and for your own daily work practices.

The new approach to Closing the Gap is a challenge you to change the way you work with and engage with Aboriginal and Torres Strait Islander people in the development of policies and delivery of health and wellbeing programs.

BACKSTORY

I will start by going back, to tell you how the Coalition of Peaks got to where we are today.

You might recall the Council of Australian Governments (COAG) in 2007 committed to ‘closing the gap’ in life expectancy between Aboriginal and Torres Strait Islander and other Australians, and a range of targets to end the disparity between Aboriginal and Torres Strait Islander peoples and other Australians in areas like infant mortality, employment and education.

  1. It was the first time that Australian Governments had come together in a unified way to address the disadvantage experienced by too many Aboriginal and Torres Strait Islander peoples.
  2. An unprecedented investment of around 4.6 billion dollars in programs and services to ‘close the gap’ as also made.
  3. Governments also agreed to new oversight, monitoring and reporting arrangements, including an annual report to the Commonwealth Parliament by the Prime Minister.

Aboriginal and Torres Strait Islander leaders at the time welcomed this new approach from governments and some of us were consulted in the early stages of the Commonwealth’s thinking.

However, despite this unprecedented coming together of Australian Governments and investment and initial engagement with our peoples, we were not formally involved in Closing the Gap, it was not agreed by us and it was a policy of governments and not for our people.

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

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

The policies and programs that then followed whilst making some difference to our peoples lives did not achieve their potential.

Over time government commitment to work together fell away. Funding to our programs and services were cut or not continued.

It is not surprising then, that, now ten years later, we have not made the progress against the closing the gap targets that had been hoped.

“REFRESH”

As you know, in 2017 the Commonwealth Government embarked on a ‘refresh’ of the Closing the Gap framework and undertook a series of consultations. In the view of many Aboriginal and Torres Strait Islander organisations, the consultations were inadequate and superficial. There was no public report prepared on their outcomes.

The lack of transparency and accountability surrounding these consultations were very disappointing, but also not surprising. Many of our organisations made submissions to government on Closing the Gap but we felt like our voices were ignored.

We were worried that governments commitment to work differently with us going forward was not backed by meaningful demonstrations. And we were concerned that governments wanted to walk away from the intergovernmental arrangements that brought a national integrated policy strategy needed to close the gap.

No new funding was announced to accompany the ‘refresh’ and there were no specific actions being discussed that we could see or feel confident would make a positive change to our lives.

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

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

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

Eventually, we were invited to meet with the Prime Minister, who acknowledged that the current targets were ‘government targets’ not ‘shared targets’, and that for Closing the Gap to be realised Aboriginal and Torres Strait Islander people had to be able to take formal responsibility for the outcomes through shared decision making.

On 12 December 2018, COAG publicly committed to developing a genuine, formal partnership with Aboriginal and Torres Strait Islander people, through their representatives, on Closing the Gap; and that through this partnership a new Closing the Gap policy would be agreed.

THE PARTNERSHIP AGREEMENT ON CLOSING THE GAP

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

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

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

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

WHERE ARE AT NOW

Progress is being made under the Partnership Agreement on Closing the Gap:

  • All Council of Australian Government members, including the local government association, have signed the Partnership Agreement.
  • The National Indigenous Reform Agreement (NIRA) has been reviewed by the Coalition of Peaks and officials from Australian Governments.
  • It has been agreed that the NIRA will be replaced with a new National Agreement on Closing the Gap covering the next ten years, to be signed off by the Council of Australian Governments and the Coalition of Peaks. It will continue the NIRA’s successful elements, strengthen others and address foundational areas that were previously excluded from consideration.
  • New accountability, monitoring and reporting arrangements are being developed for the new National Agreement that will strengthen public transparency and accountability.

Most importantly, the Coalition of Peaks have also proposed reform priorities to underpin the new National Agreement on Closing the Gap.

The reform priorities seek to change the way Australian Governments work with Aboriginal and Torres Strait Islander peoples and organisations, and accelerate life outcomes for Aboriginal and Torres Strait Islander peoples, these are:

  1. Establishing shared formal decision making between Australian governments and Aboriginal and Torres Strait Islander people at the State/Territory, regional and local level to embed ownership, responsibility and expertise on Closing the Gap.
  2. Building and strengthening Aboriginal and Torres Strait Islander community-controlled organisations to deliver services and programs in priority areas.
  3. Ensuring all mainstream government agencies and institutions undertake systemic and structural transformation to contribute to Closing the Gap.

These reforms have been agreed in principle by the COAG established Joint Council on Closing the Gap, made up of Ministers from each jurisdiction and Coalition of Peak representatives on 23 August 2019. And they have direct relevance to the Primary Health Networks and our work together.

The Joint Council also agreed to the Coalition of Peaks leading engagements with Aboriginal and Torres Strait Islander representatives of communities and organisations on new National Agreement.

These engagements are happening over the next two months and include open meetings across Australia agreed to and supported by governments. The Coalition of Peaks are also consulting with their own memberships and there is an online public opportunity for people to have their say.

The primary focus of the engagements is to build understanding and support for the reform priorities and to have a detailed discussion on what is needed to make those reform priorities a success. The discussions and input from Aboriginal and Torres Strait Islander communities will help inform the finalisation of the negotiations on the New National Agreement on Closing the Gap.

This is also a significant shift in the approach to policy development. It is the first time that governments have agreed to leaders of Aboriginal and Torres Strait Islander organisations engaging with representatives from our communities and organisations about important government policy.

Pat Turner Lead Convener of the Coalition of Peaks invites community to share their voice on #ClosingtheGap

This week a survey will be sent to hundreds of Aboriginal and Torres Strait Islander community-controlled organisations and their networks, inviting responses from both individuals and organisations.

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

Aboriginal and Torres Strait Islander Survey #HaveYourSay : Pat Turner Lead Convener of the Coalition of Peaks invites community to share their voice on #ClosingtheGap

“Aboriginal and Torres Strait Islander peoples know what works best for us and now the conversation on Closing the Gap is changing because we are finally at the negotiating table.

The Coalition of Peaks want to hear ideas on what should be included in the new National Agreement. We want to hear from enough people across Australia to make sure we’re on the right track and have support to finalise the new national agreement with governments.

Some communities, organisations and people may have attended government led meetings about Closing the Gap targets in 2017 and 2018, but this is different.

This time the Coalition of Peaks are leading the discussion and we are now also talking about some important changes that we think needs to happen to improve our lives faster.

And we have a seat at the table with governments so that the better hear what we are saying.

I hope every person and community-controlled organisation takes up this opportunity to influence policies that will have a direct impact on our communities.

And I really look forward to reading the survey responses and attending engagement events across Australia over the next few months,

Lead Convener of the Coalition of Peaks, CEO of NACCHO and Co-Chair of the Joint Council, Pat Turner said that listening to the voice of an affected community is critical to the success of any policy or program.

This week marks the start of the Coalition of Aboriginal and Torres Strait Islander Peak Organisations (Coalition of Peaks) led engagements with Aboriginal and Torres Strait Islander people on the next phase of Closing the Gap – a national policy aimed at improving the lives of Aboriginal and Torres Strait Islander people.

The Coalition of Peaks is working with the Council of Australian Governments (COAG) to develop a new National Agreement that will set out efforts over the next ten years to help close the gap.

 

This is the first time Aboriginal and Torres Strait Islander peak bodies will have an equal say in the design, implementation, monitoring and evaluation of the policy framework.

And the Coalition of Peaks, together with Australian governments, want to ensure that all Aboriginal and Torres Strait Islander people have an opportunity to contribute their voice.

The Survey

This week a survey will be sent to hundreds of Aboriginal and Torres Strait Islander community-controlled organisations and their networks, inviting responses from both individuals and organisations.

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/.

The survey will close at 5pm on October 25, 2019.

There will also be opportunities in every State and Territory for Aboriginal and Torres Strait Islander people to have a say through face-to-face meetings, to ensure that the community’s voice is truly heard and understood.

A Joint Council meeting of COAG Ministers and the Coalition of Peaks recently agreed in principle to the three priority reforms that will underpin the new agreement and form the basis of the survey and other engagements that will take place over the coming months.

Those priority reforms are:

1.Developing and strengthening structures to ensure the full involvement of Aboriginal and Torres Strait Islander peoples in shared decision making at the national, state and local or regional level and embedding their ownership, responsibility and expertise to close the gap;

2.Building the formal Aboriginal and Torres Strait Islander community-controlled services sector to deliver closing the gap services and programs in agreed priority areas; and

3.Ensuring all mainstream government agencies and institutions undertake systemic and structural transformation to contribute to Closing the Gap.

A report on what people say during the engagements will be prepared by the Coalition of Peaks, to be provided to governments and made public.

The report will inform the finalisation the new National Agreement between the Coalition of Peaks and COAG.