NACCHO #VoteACCHO Aboriginal Health #Election2019 @billshortenmp and @SenatorDodson set to unveil a $115 million #Labor plan to tackle the Indigenous health crisis today in Darwin : Including $ for @DeadlyChoices #SuicidePrevention  #MentalHealth #RHD #SexualHealth #EyeHealth

“Labor believes innovative and culturally appropriate health care models are central to improving the health outcomes of First Australians and closing the gap, noting that improving Indigenous health was “critical to our journey towards reconciliation. Labor would be funding programs “co-designed with and led by First Nations peoples – driven by the Aboriginal health workforce “

The Opposition Leader, who is also Labor’s spokesman for Indigenous affairs, will unveil the commitment while on the campaign trail with his assistant spokesman Senator Pat Dodson in the Northern Territory today;

Summary of the Labor Party $115 million commitments against NACCHO #VoteACCHO Recommendations

See all 10 NACCHO #VoteACCHO Recommendations Here

Refer NACCHO Recommendation 4

$29.6 million to improve mental health and prevent youth suicide : to administer the mental health funds through Aboriginal Community Controlled Health Services

See our NACCHO Chair Press Release yesterday

Refer NACCHO Recommendation 6

Sexual health promotion would get a $20 million boost

$13 million would be invested to tackle preventable eye diseases and blindness.

$3 million in seed funding provided to Aboriginal Medical Services to develop health and justice programs addressing the link between incarceration and poor health

Deadly Choices campaign would get $16.5 million for advertising to raise awareness of health and lifestyle choices

Refer NACCHO Recommendation 3

$33 million to address rheumatic heart disease

Media report from

‘Critical to reconciliation’: Labor’s plan to close the gap on Indigenous health

Bill Shorten is set to unveil a $115 million plan to tackle the Indigenous health crisis, as he seeks to position Labor as the only party capable of closing the ten-year gap in life expectancy between Aboriginal and Torres Strait Islander Australians and their non-Indigenous peers.

The package includes $29.6 million to improve mental health and prevent youth suicide, which has rocked communities in remote areas including the Kimberley where a spate of deaths has been linked to intergenerational trauma, violence and poverty.

The Opposition Leader, who is also Labor’s spokesman for Indigenous affairs, will unveil the commitment while on the campaign trail with his assistant spokesman Senator Pat Dodson in the Northern Territory on Thursday.

“Labor believes innovative and culturally appropriate health care models are central to improving the health outcomes of First Australians and closing the gap,” Mr Shorten said, noting that improving Indigenous health was “critical to our journey towards reconciliation”.

Labor’s package is $10 million more than the $19.6 million Prime Minister Scott Morrison announced for Indigenous suicide prevention on Saturday, after the suicide of an 18-year-old girl from the Kimberley last week.

Indigenous health advocates have previously raised concerns that the Coalition’s wider mental health package could be consumed by “mainstream” services like Headspace.

Mr Shorten highlighted Labor would be funding programs “co-designed with and led by First Nations peoples – driven by the Aboriginal health workforce”.

The Labor plan is to administer the mental health funds through Aboriginal Community Controlled Health Services, which employ teams of paediatricians, child psychologists, social workers, mental health nurses and Aboriginal health practitioners in vulnerable communities.

Official statistics show a ten-year gap in life expectancy between Indigenous and non-Indigenous Australians, with the rate of preventable hospital admissions and deaths three times higher for Aboriginal and Torres Strait Islander people.

Labor’s Indigenous health plan, which would be delivered over four years, also includes $33 million to address rheumatic heart disease, a preventable cause of heart failure, death and disability which is common in Aboriginal and Torres Strait Islander people.

Sexual health promotion would get a $20 million boost, while $13 million would be invested to tackle preventable eye diseases and blindness.

The Deadly Choices campaign would get $16.5 million for advertising to raise awareness of health and lifestyle choices and $3 million in seed funding provided to Aboriginal Medical Services to develop health and justice programs addressing the link between incarceration and poor health.

Mr Shorten said Labor would reinstate the National Aboriginal and Torres Strait Islander Health Equality Council, abolished by the Abbott Government in 2014.

Crisis support can be found at Lifeline: (13 11 14 and lifeline.org.au), the Suicide Call Back Service (1300 659 467 and suicidecallbackservice.org.au) and beyondblue (1300 224 636 and beyondblue.org.au) Or 1 of 302 ACCHO Clinics 

NACCHO Aboriginal Eye Health #CloseTheGap : @Vision2020Aus Launches #Strongeyesstrongcommunities – A five year plan for Aboriginal and Torres Strait Islander eye health and vision, 2019-2024 : With 24 recommendations to guide implementation

“ 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.”

Now is the time for 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.

That commitment, coupled with additional funding of $85.5 million over 5 years, will change the lives of many Aboriginal and Torres Strait Islander people, their families and their communities.

We look forward to working together to achieve a world class system that delivers culturally safe eye care to all Aboriginal and Torres Strait Islander people.”

Vision 2020 Australia CEO Judith Abbott:

The Vision 2020 Australia Aboriginal and Torres Strait Islander Committee have been advocating for change in Aboriginal and Torres Strait Islander eye health and vision care and should be proud of their work in the formation of the Strong Eyes, Strong Communities report.”

As recommended in the report, embedding eye health and vision care into Aboriginal

Community Controlled Organisations will help ensure the eye needs of Aboriginal and Torres  Strait Islander peoples are met and the gap in vision loss and blindness is closed.

National Aboriginal Community Controlled Health Organisation (NACCHO) Deputy CEO Dawn Casey:

Read Over 50 NACCHO Aboriginal Eye Health articles published in past 7 years

Vision 2020 Australia, the peak body for the eye sector, is calling for action to ensure that Aboriginal and Torres Strait Islander People have the same access to eye care as other Australians.

The newly released Strong eyes, strong communities – A five year plan for Aboriginal and Torres Strait Islander eye health and vision, 2019-2024 sets out a plan to achieve this goal.

Download the 55 Page The Five Year Plan 2019 – 2024 and Summary 24 Recommendations 

CLICK HERE for NACCHO Resources 

Most vision loss can be avoided or prevented through early identification and treatment, but Aboriginal and Torres Strait Islander people experience three times the rate of blindness and vision loss than non-Indigenous Australians and often wait much longer for treatment.

For example, Aboriginal and Torres Strait Islander people are currently waiting 63% longer on average for cataract surgery than non-Indigenous Australians.

Strong Eyes, strong communities describes what needs to be done to close this gap for vision and ensure eye problems in Aboriginal and Torres Strait Islander people are prevented wherever possible and treated early if they do develop.

Vision 2020 Australia has made 24 recommendations to implement the plan, which will require new funding of $85.5 million over the coming five years.

This funding will deliver more eye care services and glasses for Aboriginal and Torres Strait Islander people, support them to access the care they need and support the elimination of trachoma by 2020.

Vision 2020 Australia is also recommending other actions to improve overall planning and local pathways, strengthen the role of local community controlled services and increase access to specialist treatment

Key stats on Aboriginal and Torres Strait Islander People’s eye health

  • 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 is at risk of 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.

 

 

NACCHO Aboriginal Eye Health and #Housing @2019wihc #CloseTheGap : Co Host John Paterson CEO @AMSANTaus opening speech @IEHU_UniMelb #ClosingtheGap in Vision 2020 #CTGV19 Conference Plus #AliceSprings Declaration @OptometryAus @RANZCOeyedoctor @Vision2020Aus

Regarding the environmental improvements, we know that the NT Aboriginal population has the worst housing in Australia.  

Around 60% of Aboriginal people live in over-crowded housing and one third live in poorly maintained houses. 

This directly impacts on the ability of our people to maintain healthy living practices such as ensuing their kids have clean faces and clean clothes. 

We cannot keep on relying on antibiotics to get rid of trachoma – to be sustainable, there must be major improvements in environmental health and housing.

Improving housing will also lead to improvements in other infectious diseases that are way too common in our people in the NT

John Paterson CEO of the Aboriginal Medical Services Alliance of the NT or AMSANT. See full Speech Part 1 Below

Alice Springs Declaration

At the 2019 Close the Gap in vision 2020 conference, held in Alice springs, delegates heard that improvements in environmental health and housing are essential to eliminate trachoma and to reduce rates of other childhood infections that can lead to serious conditions such as rheumatic heart disease, blindness and deafness.

The conference heard about good progress in reducing trachoma rates but also that there had been some stalling in remote Central Australian communities where trachoma remains endemic and will not be eliminated unless housing is addressed.

Over half of Aboriginal people in the NT live in overcrowded housing and nearly one third live in poorly maintained housing. This is by far the worst result of any jurisdiction in Australia.

The Conference noted that there is currently a political impasse between the Commonwealth and Northern Territory governments which is preventing the completion of an agreement to enable desperately needed Commonwealth investment in Aboriginal housing to be made available.

The Conference was also concerned at the very slow pace of implementation of the Northern Territory government funded housing program, where only 62 million of 220 million has been spent in the first two years.

The delegates demand that both levels of government urgently work to fix this impasse to ensure that Aboriginal housing investment can be made available to address the critical housing needs in the NT and contribute to improving the health and wellbeing of Aboriginal Territorians.

This declaration was unanimously endorsed

Download PDF Copy

CTG19 ALICE SPRINGS DECLARATION

” Supporting and improving the local primary health care service capacity to confidently perform eye assessments should reduce the dependency on visiting eye specialists.

Going forward I see the promotion of these items as a highly effective way of investing in people and communities to have the capacity to manage and improve their own health outcomes.

Building local workforces must be key and I know that’s easier said than done.

The Roadmap to Close the Gap for Vision is a standout example of a program that has been successful in its impact towards closing the First Nations health gap.

Remarkable results have been achieved in just under a decade and the Roadmap recommendations are well on the way to being fully implemented.

Progress in Indigenous eye health has long been a challenge, making the success of this collaborative work even more remarkable.

The Hon Warren Snowdon Opposition Spokesperson Indigenous Health Keynote Address #CTG19 see full speech part 2 Below

Good morning everyone. My name is John Paterson and I am the CEO of the Aboriginal Medical Services Alliance of the NT or AMSANT. As many of you will know, AMSANT is the peak body for Aboriginal community controlled health services in the Northern Territory.

I’d like to begin by acknowledging the traditional owners, the Arrernte past, present and future, of the land on which we’re meeting: Mbantua – also known as Alice Springs.

To everyone here today, welcome to this important conference that is for the first time being held outside of Melbourne.

It will provide us with a great opportunity to share challenges, learnings and new ideas in a key regional centre for Aboriginal Australians who live in remote and very remote settings.  Aboriginal culture is strong and proud here, as it is across the NT.

Welcome to the many attendees from the NT and right across Australia. Thank you for the work you do in eye health and your interest in improving Aboriginal health outcomes.

I would like to begin by talking a little about the history of our sector in the NT.

It is a story of self-determination.

And it is a story about the passion and dedication in developing essential primary health care services to our people from the ground up.

It is a story about always being a strong advocate for our people.

Our sector provides comprehensive primary health care from Darwin to the most remote areas of the NT.

Central Australian Aboriginal Congress is 45 years old and is the second oldest ACCHS after Redfern. It is also the largest ACCHS in the NT and one of the largest in Australia.

Keynote from Donna Ah Chee CEO Congress calling on the sector to see Aboriginal and Torres Strait Islander eye health in the context of the bigger picture of Indigenous health.

Miwatj is the largest remote ACCHS in Australia and Utopia is the oldest ACCHS based in a very remote region, having also recently turned 40.

We have in total 26 members – 13 of which provide comprehensive primary health care across the NT.

We work in partnership with the Northern Territory Government, who also provide Aboriginal PHC services to the NT. However, ACCHSs are the larger of the two providers and our sector is expanding in line with the Commonwealth and NT Government commitment to transition PHC services to community control.

The theme of this conference – “Strengthen and sustain” – resonates with the foundational principles of our sector including the need to build capacity and self-determination.

The ACCHS sector aims to provide comprehensive primary health care with our larger services providing a broad and expanding range of services that go beyond providing physical health care. Comprehensive primary health care includes Social and Emotional Wellbeing, social support, youth work, health promotion and prevention, with some now extending into aged care and even disability care.

The broad range of services considered to be part of primary health care is in line with the Alma Ata Declaration of 1978, where primary health care leaders from around the world – including leaders from the Aboriginal community controlled sector – set out a vision of primary health care that is now reflected in how our sector operates.

The declaration emphasised the need for communities to have a say and be involved in the running of primary health care, hence the fundamental importance we attach to our sector being community controlled.

Another principle of the Declaration is that comprehensive primary health care should work with government policy makers and other sectors such as employment and housing, to address the conditions that lead to poor health. Our sector strives to do this at every level, from the community to national levels, and even on the international stage.

In the NT, one of the main ways we are achieving this is by working with other Aboriginal peak bodies in an Alliance called the Aboriginal Peak Organisation NT, or APONT. APONT includes AMSANT, along with the Central and Northern Land Councils, who assist traditional owners and native title holders in the management and development of their land, including through Aboriginal ranger groups and increasingly, community development projects.

The Alma Ata declaration also emphasised the need to aim for equity of outcomes in health care provision – noting that across the world including in rich countries such as Australia, there is an unacceptable health gap between the well off and those living in poverty. As you all know, on our own country, this health gap is even larger between Aboriginal Australians and the rest of Australia. Equity is a foundational principle of our sector.

The first national Aboriginal Health Strategy, in 1989, reflected these principles and others including the need to take a holistic view of health care, including the physical, social, spiritual and emotional health of people.

This strategy recognised the inter-relationship between good health and the social determinants of health and the need to partner with sectors outside health. The strategy also emphasised capacity-building of community-controlled organisations and the community itself to support local and regional solutions to improving health.

This was a fine strategy, however, an implementation plan was not properly developed and the strategy was not properly funded. This has been a recurring story in Aboriginal health over the years.

The most recent national Aboriginal health plan is also based on self-determination, including the need for community control and the critical importance of the social and cultural determinants of health.

As I hope most of you know, there are a national set of Close the Gap targets that are soon due to expire, that guide our efforts to improve Aboriginal health.  Sadly only 3 of the 8 target are currently on track – and the health gap is one of those that is not on track.

In fact, despite marked improvement in life expectancy in the NT over the last thirty years, life expectancy in the NT now seems to be stalling which is due to the failure to address social determinants, and the ever-growing chronic disease epidemic in our people.

I believe we would have seen much more progress towards closing the gap if the vision first set out in 1989 in the National Aboriginal Health Strategy had been implemented by both the Federal and State governments, including the critical need to commit to self-determination.

While that precious opportunity has foundered for the last three decades, I believe we are once again at a critical juncture and seeing a shift towards governments working in equal partnership with our people. This trend must continue if we are to see sustainable improvement.

At a national level, I am very heartened to see that the process to refresh the Closing the Gap targets is now developing into an equal partnership between Aboriginal leaders across Australia and Commonwealth, State and Territory governments through the Council of Australian Governments or COAG process.

We now, for the very first time, have a large group of Aboriginal peak bodies working closely with government to set the forward agenda for tackling the health gap. Our national peak organisation, NACCHO, led by an inspiring Aboriginal Alice Springs leader – Pat Turner – is at the vanguard of this work.

Read all 50 plus NACCHO Aboriginal Eye Health Articles Here

I represent APONT on this national coalition, ensuring that our leadership in the Northern Territory continues to influence the national agenda. We will be working hard to ensure that the targets reflect the critical issues affecting the health of our people – across the social determinants, and including issues such as housing,  the skyrocketing imprisonment rates and tragically high rates of children in the child protection system.

How does all of this high-level government policy relate to eye care?

We know that our Aboriginal community controlled health services in the NT are under resourced.

Six years ago, a study was done in a small ACCHS in the NT – one of our better funded services. The study looked at how much it cost to carry out all the chronic disease care recommended by the CARPA manual – which is the guideline that all our services use.

It found that the service was under funded to the tune of $1700 per person per year. This funding gap may have increased since then.  The AMA has recently reiterated that there is a large funding gap in Aboriginal primary health care.

We cannot build specialist services, including specialist eye services, on a foundation of an under-resourced primary health care sector.  Our sector must be properly funded.

Trachoma is often described as a disease of poverty, which is one of the reasons why its continued existence in Australia, and almost exclusively in Aboriginal communities, is a national disgrace.

The World Health Organisation has developed the SAFE strategy for eliminating trachoma.

I am sure most of you know that the S stands for surgery, A for antibiotics, F for facial cleanliness and E for Environmental Improvements.

Regarding the environmental improvements, we know that the NT Aboriginal population has the worst housing in Australia.

Around 60% of Aboriginal people live in over-crowded housing and one third live in poorly maintained houses.

This directly impacts on the ability of our people to maintain healthy living practices such as ensuing their kids have clean faces and clean clothes.

We cannot keep on relying on antibiotics to get rid of trachoma – to be sustainable, there must be major improvements in environmental health and housing.

Improving housing will also lead to improvements in other infectious diseases that are way too common in our people in the NT, including skin sores and sore throats – which can both precipitate RHD; and with skin sores also being linked to high rates of renal disease.

A recent data linkage study found that over-crowded housing was by far the biggest reason for children missing school – accounting for over 30 days of missed school a year on average.

We know that poor school attendance is very closely linked to poor school results.  Our children need decent living conditions if they are to thrive both physically but also socially and at school.

What is AMSANT doing about the shocking state of housing in the NT?

AMSANT has worked as part of the APONT alliance in supporting the formation of an Aboriginal Housing committee, AHNT, and is supporting AHNT to become the recognised Aboriginal housing peak body for the NT. Along with AHNT, we are working closely with NT Department of Housing to develop a community led housing strategy, to return Aboriginal housing to community control.

More info Register 

This is a long journey – but it is already bearing some fruit.

However, currently, as many of you will be aware from recent media reports – the NT and Commonwealth are at a stand-off about desperately needed Commonwealth funding for remote Aboriginal housing.

We must have cooperation between the two levels of government to address our housing crisis. We are tired of the excuses and political stand offs, while our communities suffer.

If they would for one moment stop and listen to us, come and talk with us, they would hear our message loud and clear – we want a seat at the decision-making table.

It the Prime Minister and the State and Territory Premiers and Chief Ministers can agree on an equal partnership with Aboriginal peak bodies on Closing the Gap, then the Commonwealth and NT governments can do the same for Aboriginal housing. We say – make it happen!

And now to eyes.

 

Eye health matters. In Australia, people with even mild vision loss have a risk of dying that is 2.6 times higher than those with good vision.

Vision loss causes 11% of the Indigenous health gap, meaning it accounts for 11% of years of life lost to disability for Indigenous people. It is the third leading cause of the gap behind cardiovascular disease and diabetes.

The 2008 National Indigenous Eye Health Strategy demonstrated the huge gap between the eye health of Indigenous and other Australians:

  • Indigenous adults were 6 times more likely to become blind as non-Indigenous, despite 94% of this vision loss being preventable or treatable;
  • Australia was the only developed country in the world to have endemic trachoma in some regions;
  • And yet studies showed that Indigenous children have better eyesight than others.

However, as you know, a lot is happening in the eye space and primary health care is a critical part of that work.

The work done to close the gap for vision has been very successful. The progress made on the Roadmap to Close the Gap for Vision, which comprises action against over 40 recommendations, is substantial and impressive, particularly given the number of stakeholders in many sectors who have contributed to its achievements.

One of the achievements in the NT has been the formation and ongoing success of regional eye health coordination groups, which are collaborations and partnerships involving all the key eye health stakeholders including primary health care, and are an important component of the Roadmap to Close the Gap for Vision.

The Central Australian and Barkly collaboration has been working effectively for 10 years now, and has been joined in recent years by a Top End collaboration.

AMSANT is involved in both groups and has been funded by the Fred Hollows Foundation to become more involved, including through a position supporting the Central Australian committee.

However, I hope that you have got the message that everyone in health care – including those in eye health care – need to think more broadly about health and not just focus on their part of the gap.

The Aboriginal vision of health is holistic and specialist services need to be built on a strong primary health care foundation.

The international health research has shown that health systems built on a strong primary health care foundation are more equitable affordable and sustainable.

I believe that the eye care gap will not sustainably close – along with the rest of the health gap – if we do not have political commitment to self-determination, and an equitable approach to funding Aboriginal primary health care, based on need.

And we also  need a commitment to fixing the social determinants of health, equitably, based on need and Aboriginal-led.

We must avoid the situation where specialist areas advocate separately to government for their bit of Aboriginal health funding without seeing the bigger picture and the lack of resources on the ground in primary health care.

We need to work together in true partnership if we are to close the gap and that means we MUST be at the decision-making table, not an afterthought.

So thank you for all the work that you do in eye health care- we do appreciate it.

And I hope that you enjoy the two days and go back to your work refreshed, invigorated and inspired.

Thank you.

Part 2 : ADDRESS TO THE CLOSE THE GAP FOR VISION BY 2020

From the outset I want to stress that Federal Labor is acutely aware that Australia remains the only developed country with endemic trachoma, which is only found in our Aboriginal and Torres Strait Islander communities.

Further, while we acknowledge the scourge of Trachoma, 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. We have seen inroads in the rates of trachoma, many thanks to people in this room.

Trachoma has dropped from 21 per cent in outback children in 2008 to 3.8 per cent in 2018 and is on track to be eliminated by the end of 2020. This is a marvellous achievement and I again want to thank the tireless effort, tenacity and dedication of those in this room over the last decade in ensuring this has remained a front and centre issue for consecutive governments across partisan lines.

Today I want to discuss three things:

  • Where to now and looking beyond 2020
  • How we can build on the success of the Roadmap in other spaces and;
  • What to expect from a Shorten Labor Government

As the incidence of Trachoma lessens and is likely to be completely eliminated come 2020/21, we will face different vision-loss challenges. Blindness and impaired vision among Aboriginal people was six times the national rate in 2008, and it is now down to three times the national rate. However, Aboriginal and Torres Strait Islander Australians are still most likely to experience permanent vision impairment, with most cases of avoidable blindness resulting from uncorrected refractive error, diabetic retinopathy and cataracts.

One in 10 Aboriginal and Torres Strait Islander adults is at risk of Diabetic Retinopathy, which we all know can lead to irreversible vision loss. 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.

And I want to note here, that I welcomed Minister Wyatt’s announcement in August last year to commit $2 million to provide Aboriginal and Torres Strait Islander people with easier access to affordable prescription glasses. This was a positive first step.

The case for well-informed advocacy around uncorrected refractive error, diabetic retinopathy and cataracts in the First Nation population must be a priority for this sector come 2020 and beyond. As we edge towards the complete elimination of Trachoma the traction from governments’ and the funding which comes attached I anticipate will lessen. This will be no surprise to people in this room.

Security of funding will decline without ongoing strategic advocacy from the sector. There will need to a be a sustained and coordinated approach as there has been with the Roadmap to ensure this doesn’t curtail the inroads that are being made in other areas of vision loss. For example; Aboriginal and Torres Strait Islander Australians with diabetes have significantly fewer recommended eye checks than the non-indigenous Australian population and this incidence is particularly escalated in remote and regional areas [35% comparted with 64% respectively].

The total indirect cost of blindness as a result of diabetic retinopathy and diabetic macular oedema, the most frequent manifestations of diabetic retinopathy, is estimated to be more than $28,000 per person. Early investment into coordinated primary healthcare presents a powerful fiscal argument for governments at all levels.

These are the sorts of messages I encourage the sector to advocate for, we are in fiscally uncertain times so governments are constantly looking for costefficient measures.  The fact the up to 98 per cent of diabetes-related blindness can be prevented through annual eye exams and timely treatment in the early stages of disease, is compelling.

Investing in professional development and training to enhance existing clinicians’ skills to perform eye-health assessments can produce significant savings for both the patient and the tax payer. I am a proponent of the MBS 715 item [Aboriginal Health Check] and the annual MBS 12325 item [Diabetic Retinopathy Screening] to be employed in all instances, as both schedule items promote early screening and diagnosis, preventing future complications and the costs associated with vison impairment.

The establishment of diabetic eye screening rates as a key performance indicator for Primary Health Networks is a sensible way to drive MBS revenue and improve eye health outcomes. Further, employing MBS item service delivery models, is a sustainable model of care which does not rely on ongoing or recurrent government funding. Increased information-sharing around the schedule benefits can produce significant preventative health gains to the target communities as well as provide large fiscal returns to service practices.  It’s a no brainer.

Further, supporting and improving the local primary health care service capacity to confidently perform eye assessments should reduce the dependency on visiting eye specialists. Going forward I see the promotion of these items as a highly effective way of investing in people and communities to have the capacity to manage and improve their own health outcomes.

Building local workforces must be key and I know that’s easier said than done.

The Roadmap to Close the Gap for Vision is a standout example of a program that has been successful in its impact towards closing the First Nations health gap. Remarkable results have been achieved in just under a decade and the Roadmap recommendations are well on the way to being fully implemented. Progress in Indigenous eye health has long been a challenge, making the success of this collaborative work even more remarkable. This work has undergone rigorous scientific process and has a strong evidence base.

Importantly it has been strongly supported by local communities and organisations, including leading peak bodies and philanthropic organisations.

This disciplined coordination is what I think other sectors can really look towards and aspire to. And I must say this discipline is attributed in major part to the work of Professor Taylor. Stopping trachoma and other infections through the promotion of good hygiene practices and the emphasis on health hardware are pathways to negate further chronic health conditions.

Including: Ear infections and otitis media

  • Respiratory infection
  • Tooth and gum disease
  • Skin infections
  • Kidney disease

And I think most markedly

  • Rheumatic Heart Disease

The Roadmap has been able to achieve comprehensive culturally safe coordination in navigating all levels of care which is critical when managing health conditions, such as avoidable blindness.  Skilled workforce shortage complications in regional areas can ultimately be ameliorated by investing in people and communities to have the capacity to manage and improve their own health outcomes.

I know Diabetic retinopathy cameras and trained operators are being placed in more than 150 Aboriginal health clinics across Australia and this ideally must be the model we aspire for in other complex health areas. This model has been promoted and driven throughout the Roadmap.

To reiterate my major point, Labor is committed to Closing the Gap in eye health. The Roadmap was established under Labor and has since made significant improvements to the eye health of First Australians, as I’ve acknowledged. A Shorten Labor Government is committed to fully implementing the Roadmap to Close the Gap for vision.

A Shorten Labor government appreciates there is still work to be done to close the gap to meet the 2020 deadline. As an outcome of the Roadmap there are many regions of Australia where successful eye care programs have been developed providing high quality eye care for First Australians.

We acknowledge these successes and aim to build on and enhance these existing services. Now is the time to consolidate this good work and finally end avoidable blindness to ensure we meet our World Health Organisation obligations and successfully eliminate Trachoma. As Professor Taylor says, “we can’t afford to take our foot off the accelerator.” Equitable access to specialist and general eye health care services is critical to reducing high rates of preventable blindness among Aboriginal and Torres Strait Islander people.

We’ve seen too many cases of good work in Aboriginal affairs left unevaluated and subsequently dismantled, especially under the Abbott/Turnbull/ Morrison government. The Tackling Indigenous Smoking program is a case in point which we’ve witnessed under this Government.

Guiding all the decisions under a Shorten Labor Government will be evidence- based policy.  The Federal Labor team will certainly have more to say on this and you can expect further announcements in the coming months in the lead up to the election. But I can say that any further investments will be to meet the 2020 Roadmap.

Under a Shorten Labor government we will be prioritising:

  • The national implementation of regional coordinators
  • Population based funding of outreach services
  • Case management and local coordination
  • Prompt housing repair and maintenance to ensure First Australians have access to safe and functioning bathrooms

We’re at the pointy end of finalising our election commitments but I do want to use this opportunity to encourage the experts before me to bring forward any policy proposals you have. If anyone wishes to share any policy ideas, as some have already, by all means I am open to hearing them and sharing them with my Federal Labor team. And for anyone in this room who isn’t aware I have an open-door policy, so please don’t hesitate to get in touch in near future.

I think that’s enough from me.

Thank you for your time this morning.

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

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

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

Minister for Indigenous Health, Ken Wyatt AM

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

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

Health Minister Greg Hunt

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

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

Professor Alex Browne : South Australian Health and Medical Research Institute

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

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

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

First three flagship priorities

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

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

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

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

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

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

Five key areas of Research

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

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

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

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

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

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

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

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

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

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

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

NACCHO Aboriginal Health and #refreshtheCTGRefresh : Download the @AIHW National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care: results for 2017 showing improvements in 16 out of a possible 23 measures

Between June and December 2017, improvements were seen in 16 out of a possible 23 measures for which comparable data for both periods were available (see Table S1 for details). Results for a further indicator remained stable between reporting periods.

The improvements were seen in 12 of the 15 process-of-care measures with comparable data. Improvements were also seen in 4 of the 8 outcome measures, while 1 outcome measure remained stable. The largest improvements (4 or 5 percentage points) were seen in the recording practices for the measuring of:

  • influenza immunisations for clients with type 2 diabetes, which rose from 31% to 36%
  • influenza immunisations for clients with chronic obstructive pulmonary disease (COPD), which rose from 32% to 37%
  • influenza immunisations for clients aged 50 and over, which rose from 32% to 36%. ” 

 Extract from good news from AIHW Report

 Download full 158 page report HERE

aihw-ihw-200 (1)

Summary

This is the fifth national report on the Indigenous primary health care national Key Performance Indicators (nKPIs) data collection. It presents data on all 24 nKPI indicators for the first time.

Data for this collection are provided to the Australian Institute of Health and Welfare (AIHW) by primary health care organisations that receive funding from the Australian Government Department of Health to provide services to Aboriginal and Torres Strait Islander people. Some primary health care organisations included in the collection receive additional funding from other sources, including state and territory health departments.

As of the June 2017 data collection, changes have been made to the data extraction method, with the Department of Health introducing a new direct load reporting process. This allowed Communicare, Medical Director, and Primary Care Information System (PCIS) clinical information systems (CISs) to generate nKPI data within their clinical system, and transmit directly to the OCHREStreams portal. Best Practice services were provided with an interim tool while MMEx has always had direct load capability.

61.9 % our ACCHO’s

The new process was introduced to provide a greater level of consistency between CISs, but the change in the extraction method means that data from June 2017 onwards are not comparable with earlier collections.

As the June 2017 collection represents a new baseline for the collection, this report only presents data for June and December 2017.

For 2 indicators (Kidney function tests recorded and Kidney function test results) only December 2017 results are presented due to unresolved data quality issues in June 2017.

See Chapter 2 for more information on the change in extraction method, data quality, and the impact  on the collection, and Appendix E for data improvement projects and the nKPI/Online Service Reporting (OSR) review under way.

Improvements were seen for most indicators between June and December 2017. Although data from these 2 reporting periods are not comparable with earlier reporting periods, an overall pattern of improvement is in keeping with the pattern of improvement previously reported for the period June 2012 to May 2015 (see AIHW 2017). This indicates that health organisations continue to show progress in service provision.

Things to work on

For the 3 process-of-care indicators that did not show improvements—glycated haemoglobin (HbA1c) result recorded (6 months), cervical screening, and Medicare Benefits Schedule (MBS) health assessment for those aged 0–4—the changes were very small (0.5, 0.4, and 0.1 percentage points, respectively).

In the case of cervical screening, this might be due to changes to the cervical screening program, which took effect from 1 December 2017 (see Chapter 4 for details).

Three outcome measures that did not show improvements—HbA1c result of 7% or less, low birthweight, and smoking status of women who gave birth in the previous 12 months—saw changes of between 0.8 and 1.8 percentage points.

Contents

  • 1 Introduction
    • The nKPI collection
    • Structure of this report
  • 2 Data quality
    • Data quality issues
    • Additional considerations for interpreting nKPI data
  • 3 Maternal and child health indicators
    • Why are these indicators important?
    • 3.1 First antenatal visit
    • 3.2 Birthweight recorded
    • 3.3 MBS health assessment (item 715) for children aged 0-4
    • 3.4 Child immunisation
    • 3.5 Birthweight result
    • 3.6 Smoking status of females who gave birth within the previous 12 months
  • 4 Preventative health indicators
    • Why are these important?
    • 4.1 Smoking status recorded
    • 4.2 Alcohol consumption recorded
    • 4.3 MBS health assessment (item 715) for adults aged 25 and over
    • 4.4 Risk factors assessed to enable cardiovascular disease (CVD) risk assessment
    • 4.5 Cervical screening
    • 4.6 Immunised against influenza-Indigenous regular clients aged 50 and over
    • 4.7 Smoking status result
    • 4.8 Body mass index classified as overweight or obese
    • 4.9 AUDIT-C result
    • 4.10 Cardiovascular disease risk assessment result
  • 5 Chronic disease management indicators
    • Why are these important?
    • 5.1 General Practitioner Management Plan-clients with type 2 diabetes
    • 5.2 Team Care Arrangement-clients with type 2 diabetes
    • 5.3 Blood pressure result recorded-clients with type 2 diabetes
    • 5.4 HbA1c result recorded-clients with type 2 diabetes
    • 5.5 Kidney function test recorded-clients with type 2 diabetes
    • 5.6 Kidney function test recorded-clients with cardiovascular disease
    • 5.7 Immunised against influenza-clients with type 2 diabetes
    • 5.8 Immunised against influenza-clients with chronic obstructive pulmonary disease
    • 5.9 Blood pressure result-clients with type 2 diabetes
    • 5.10 HbA1c result-clients with type 2 diabetes
    • 5.11 Kidney function test result-clients with type 2 diabetes-eGFR
    • 5.12 Kidney function test result-clients with type 2 diabetes-ACR
    • 5.13 Kidney function test result-clients with cardiovascular disease-eGFR
  • 6 Discussion
    • Data improvements
  • Appendix A: Background to the nKPI collection and indicator technical specifications
  • Appendix B: Data completeness
  • Appendix C: Comparison of nKPI results
  • Appendix D: State and territory and remoteness variation figures
  • Appendix E: Data improvement projects
  • Appendix F: Guide to the figures
  • Glossary
  • References

NACCHO Aboriginal #Eye Health #refreshtheCTGRefresh : @AHCSA_ @RANZCOeyedoctor @IEHU_UniMelb has launched the 2018 Annual Update on the Implementation of The Roadmap to #ClosetheGap for Vision

“All of these improvements are very encouraging, but more needs to be done if we want to achieve our goal of giving all Aboriginal and Torres Strait Island people the same eye health as other Australians,

“It is crucial that we keep working closely with local communities through Aboriginal Community Controlled Health Organisations, and at higher levels to make sure that services are properly provided and resourced across states and territories.”

Professor Hugh Taylor, Head of Indigenous Eye Health at Melbourne University

” The feeling of restoring someone’s sight is what Taylor describes as “almost biblical”.

The surgery for restoring sight is often quite simple, but the impact of the surgery, and the emotional response that comes with it, often leaves Taylor at a loss for words.   

While 94 per cent of vision loss is avoidable, Aboriginal and Torres Strait Islander adults are six times more likely to suffer from blindness than non Aboriginal and Torres Strait Islander adults.

After working in remote Indigenous communities with the Fred Hollows Foundation, as well as overseas, and seeing little change in the statistics over a number of years, Taylor decided it was time to take serious action on closing the vision gap.

Taylor is on a mission to close the gap by 2020, through sustainable health systems that will change the landscape of Indigenous eye health, forever.  

In this months Changemaker, Prof Taylor discusses why he was inspired take charge of Indigenous eye health, creating sustainable solutions, and the feeling of restoring a human’s eyesight. See Full Interview Part 2 Below

Download 2018-AnnualUpdate_Close the Gap

Part 1:The Roadmap to Close the Gap for Vision

The 2018 Annual Update on the Implementation of The Roadmap to Close the Gap for Vision was launched on this week at the 50th Annual Scientific Congress of the Royal Australian and New Zealand College of Ophthalmologists in Adelaide by Shane Mohor, CEO of the Aboriginal Health Council of South Australia and Professor Hugh Taylor, Head of Indigenous Eye Health at Melbourne University. Dr Heather Mack, President-Elect of RANZCO hosted the launch.

Philip Roberts from the indigenous eye health unit hard at work

“It is terrific to see the progress that has been made with great work being done by the Aboriginal and Torres Strait Islander health organisations and all of our partners in eye health,” Professor Taylor said. Progress includes:

  • 19 of 42 systemic issues identified in Indigenous eyecare have been fixed and three quarters of the intermediate activities have been completed
  • In 2008 blindness and impaired vision among Indigenous people were six times the national rate. Now it is down to three times the national rate
  • A third of Indigenous adults have diabetes and are at risk of blindness through diabetic retinopathy
  • Up to 98 per cent of diabetes-related blindness can be prevented through annual eye exams and timely treatment in the disease’s early stages
  • Diabetic retinopathy cameras and trained operators are being placed in more than 150 Aboriginal health clinics across Australia
  • 53 of 63 regions across the country are now working to co-ordinate eye care for Indigenous people – covering more than 70 percent of the nation’s Indigenous population
  • The rate of trachoma, a blinding eye infection passed child to child and prevented by keeping faces clean, dropped from 21 per cent in outback children in 2008 to 3.8 per cent in 2018 and is on track to be eliminated by the end of 2020
  • Australia remains the only developed country with endemic trachoma, which is only found in Indigenous communities. Prompt repair and maintenance of washing facilities is key to helping children wash faces, while more timely data-reporting would allow targeted intervention in trachoma hot spots.

Part 2 : In this months Changemaker, Taylor discusses why he was inspired take charge of Indigenous eye health, creating sustainable solutions, and the feeling of restoring a human’s eyesight.

Republished from Maggie Coggan Article Probono

What made you want to specialise in Indigenous eye health?

Back in the 70s, when I was doing my ophthalmology training, I spent a year working with the Fred Hollows Foundation. Over a period of a year or so, we examined Aboriginal and Torres Strait Islander people across the whole country, and this gave me a real insight into some of the conditions and disadvantages of Indigenous people across the country.

It was when I did a review for the Commonwealth, in the mid 90s on Indigenous eye health, and made a series of recommendations, that I realised in 30 years, nothing had changed. I realised no one else seemed to be doing much to make a change, so I rolled up my sleeves and got on with it, moved to Melbourne University and set up the eye health unit, to really try and focus on this problem full time.

When you were working in those remote communities, at what point did you realise it was a really big problem?

I’d been brought up in middle class family, and went to school and university in Melbourne, living quite a privileged life.

Keep in mind, I was there over 40 years ago, so things have changed, but when I was working in these remote communities, many were wearing old second hand clothes, lacking facilities to wash themselves or their clothes, with eye, nose, ear and skin infections. It was very different from walking around suburban Melbourne or working in the emergency room or outpatient clinic. \

That fellow Australians were allowed to live like that was just not right and a real shock. I just couldn’t understand how that could happen in Australia. It was when I went overseas and did work in Africa, Asia, America and the Middle East, and saw what can happen and change there, that I realised things hadn’t changed in Australia and we needed to do something about it.

Dr Hugh Taylor screening for trachoma

Why did you think setting up your own clinic and area of work was more effective than the work you were doing with Fred Hollows?

The stuff I did with Hollows was really a survey, and one-off eye care, and an attempt to set up ongoing eye care. I was then one of the founding board members of the foundation, they weren’t really doing much in the Indigenous eye health space, mainly focusing their work overseas. I was also running a big clinical department and research group, and the Centre for Eye Research Australia, amongst other things, and it only left an hour or two a week to think about Indigenous eye health.

I really wanted to develop long term and sustainable changes, rather than having one-off services, that needed time and effort to identify the problems, and then working out what the solutions are, and how they could be best rolled out.

Restoring someone’s eyesight is a pretty significant act, what does that feel like for you doing the work?  

Ophthalmology is almost biblical. You’re making blind people see again, and that can be both rewarding for the patient and the family, but also for the practitioners. Sometimes it’s quite embarrassing, because all you’ve done to people, once you’re trained, is a simple operation. But taking out someone’s cataract, particularly if it’s a very advanced cataract, to take that out and do it properly, you feel very satisfied at the end of surgery.

The next day when you take off the bandage and the dressing, and the patient is bursting with emotion, and joy at being able to see, count how many toes they have or touching their nose. Sometimes they are so excited, you really don’t know what to say, and that’s really very moving and very exciting.

Are there other reasons aside from a lack of services that contribute to the high numbers of vision loss for Indigenous people?  

Well it’s interesting, because when we first set up the Indigenous eye health unit, we did a survey and found that the unmet need in the inner-city Melbourne suburb of Fitzroy, is the same as it is, in Fitzroy Crossing, up in the Kimberley.

In the Kimberley, we obviously need to get more eye services out there, but the Victorian Aboriginal health service in Fitzroy is less than a mile from the Royal Victorian Eye and Ear Hospital, the largest eye hospital in the Southern Hemisphere.

They were also having seven times less surgery to remove cataracts, and they were four times more likely to wait for more than a year to get surgery done. Some of the reasons for not using services were for simple things like cultural safety, or institutional racism that was keeping people away.

Other things were the movement of more and more surgery into private hospitals, with big gap fees. We ended up saying that the path of care was like a leaky pipe, there are lots of cracks where people can fall out of the system, and if you only fix one or two cracks, the pipe is still leaking. You actually have to address each of those issues, to fix the pipe.

Changing behaviour through education

Do you feel you’ve received enough support from government?

We’ve had a lot of support from government, and there has been a lot of things done. Of our road map, there were 42 recommendations, and more than 16 of those have been fully implemented, and we have a first step done on every one of those, and about two-thirds or more of the intermediate steps have been done.

So we are actually making really good progress.

The government has put in a whole lot of funding into quite a number of those recommendations, and made a number of those changes. There’s still more work to do, and we’ve made good progress, rolling out this improved way of delivering eye care, we have halved the gap for blindness, but more needs to be done to implement those recommendations across the country. We are hopeful this will happen in the next funding cycle, people see what progress is being made, and we live in hope that we will close the gap for vision in 2020.

Do you think vision loss receives less attention because it doesn’t immediately cause death?

Something we outlined in our report on closing the gap, is the false reasons for not doing something about blindness. People say it doesn’t kill you, but actually, if you have visual impairment you have more than a two fold increased risk of dying. Vision loss caused 11 per cent of the health gap.

The first is heart disease, the second is diabetes, equal third is trauma and vision loss. It’s actually very important. The second is people say you can’t do anything about it, and it’s just a natural part of ageing, but in fact, 94 per cent of the vision impairment is unnecessary, and it’s treatable.

Much of it can be fixed overnight. You can give someone a pair of glasses, they see right away, and if you do cataract surgery, they will see the next day. So unlike some of these other chronic problems, like alcoholism, or heart disease, or kidney failure, with vision loss, most of it we can actually fix.

What we see, is the eye care is providing a paradigm or a template on how to link primary care with the specialist services, because if we can sort it out for eyes, it can work for hearts, and lungs and kidneys.

Why exactly is it that blindness is linked to shorter life expectancy?

People who have vision impairment, have a doubling risk of falls, an eight fold increase of hip fractures, are three times more likely to have depression, and you can’t actually get around to look after yourself, or go to the doctor or participate in community and religious events.

And in addition, if you’re so blind from diabetes, you can’t check your blood sugar, you can’t check all your pills, or your feet to make sure they aren’t having problems. There are some very serious impediments that happen because of sight loss. It also prevents healthy and independent ageing.

I mean, Makinti Napanangka, who won the 2008 Telstra Art award, had to stop painting because she was blind from cataract, and after she had surgery, she took out the award, and that’s fantastic. From not being able to take yourself to the doctor, or make a cup of tea, she was able to return to her career after surgery, so it’s really important.

What are you currently working on?

Our focus at the moment is working with advocacy and government to try and get additional funding, particularly the increase in funding for the visiting outreach services for ophthalmology and optometry, and funding for case management of patients who need care referrals in their treatment. We are doing a lot of work making sure that everyone with diabetes gets the regular treatment and that’s also across the country.

In the area of trachoma, while we’ve had very good progress, there is still much more work to be done to eliminate it as a blinding disease. For that we are focusing on health promotion so that every child and family knows to keep the kids faces clean, to stop the transmission of infection, and also to make sure there’s washing facilities in the houses and schools, so the kids can actually make sure that they can wash their faces.

Do you think it’s possible to close the vision gap by 2020?

Yes! There’s a lot of work to do, but you’ve gotta back things that work, and we are actually making real progress. We’ve already halved the gap for blindness, reduced the rates of trachoma in kids from remote communities from 21 per cent in 2008 to 3.8 per cent, so I think we are making some really good progress, we just need to have the support to finish the job.

What are you doing to ensure that the organisation that is set up is sustainable and continue on?

My little group may disappear, and that’ll be fine, what we are really trying to do is develop long term sustainable changes so that this system just keeps on running.

Once it’s set up in place, they’ll be checks and balances with monitoring and reporting, and the evaluation of reporting. So it’s really about building those sustainable solutions, building things into medicare, changing government policy, so services are properly funded and coordinated.

I started 40 years ago, dropping into communities and fixing eyesight and then leaving, and that’s not what we should be doing in 2018, we need to be more sustainable.

The national Close the Gap campaign extends beyond just eye health, does the complexity of the issue overwhelm you?

It is complex, and I recognise that but no I don’t feel overwhelmed. I actually feel empowered by recognising it’s complexity. Stepping back and taking this health system approach, looking at the patient journey or the pathway of care, coming up with the notion of it being a leaky pipe with many issues to fix is important.

There’s no silver bullet, it’s not the three key priorities. I’m quite empowered by a quote from Helen Keller, who said I am only one, and I can’t do everything, but I am one, and I can do something, and because I can’t do everything, doesn’t mean that I won’t do the something that I can do.

With eye care, you can actually do it, and teasing out the real things that need to be done and as I said, most of it can be fixed, and most of it can be fixed overnight. I think we are making really good progress, and learning the lessons that we’ve been working out for eye care to apply for the provisions of other specialist health services.

How has this experience changed you?

I guess it makes me optimistic that we can change, and recognising that there’s not a silver bullet, there’s not just three things that need to be done, you need to take a health systems approach, and look at the multiple things.

And so taking a complex problem and unpacking it has been very important, and I think that has given me the optimism for when people ask if we can get it all done by 2020, because of course we can! If we can keep pushing on and kicking a few goals, it’s very doable, we will get there.

 

Aboriginal #Eye Health NEWS : NACCHO and @Vision2020 Welcomes @GregHuntMP and @KenWyattMP major investment to provide approx. 18,000 Aboriginal and Torres Strait Islander people with easier access to affordable prescription glasses

“Aboriginal and Torres Strait Islander people have three times the rate of vision impairment and blindness as compared to non-Indigenous Australians.”

“This is totally unacceptable, especially when almost two-thirds of impaired eyesight can be corrected by prescription glasses.”

Health Minister Greg Hunt said the investment would allow Vision 2020 Australia to work with state and territory governments to streamline, standardise and improve their schemes that provide subsidised glasses to First Nations people

Photo above NACCHO File : Brien Holden Vision Institute with Edwina at Danila Dilba ACCHO Darwin

“To help achieve equity of access to subsidised glasses, Vision 2020 will work with governments to ensure their schemes align with eye health principles developed by Optometry Australia and the National Aboriginal Community Controlled Health Organisation.

“These principles have been supported by Aboriginal Health Forums conducted across the nation.”

Indigenous Health Minister Ken Wyatt AM

Under some State and Territory schemes at the moment, only a third of Aboriginal and Torres Strait Islander people needing glasses are actually receiving them.

We need to do what we can to provide cost-certainty and affordable access to prescription spectacles for our people.”

Dr Dawn Casey, Acting Deputy CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO) and Chair of the Vision 2020 Australia policy committee for Aboriginal and Torres Strait Islander Health also welcomed the investment

Read over 40 Aboriginal Eye Health articles published by NACCHO over past 6 years 

Part 1 Program Puts Better Vision for First Nations People in Sight

The Turnbull Government has committed $2 million to provide Aboriginal and Torres Strait Islander people with easier access to affordable prescription glasses.

Welcomes @GregHuntMP and @KenWyattMP major investment to provide approx. 18,000 Aboriginal and Torres Strait Islander people with easier access to affordable prescription glasses.

Indigenous Health Minister Ken Wyatt AM said introducing a nationally consistent system to simplify and ensure better access to affordable glasses would significantly improve people’s vision and overall quality of life.

“Not only does poor vision adversely affect a person’s general wellbeing, it can be a significant barrier to education and employment, and can restrict a person’s mobility and social interaction,” said Minister Wyatt.

“The cost of prescription glasses often deters Aboriginal and Torres Strait Islander people from visiting an optometrist to have their sight checked.”

“This can also delay detection of other serious vision-threatening conditions such as diabetic retinopathy, cataracts and glaucoma.”

A trial to improve the provision of prescription glasses in the Kimberley and Pilbara areas of Western Australia yielded positive outcomes, including improved patient medication compliance and greater independence.

Vision 2020 Australia was established in 2000 and has an experienced board including Aboriginal and Torres Strait Islander representatives.

The Turnbull Government’s 2018-19 Budget included an additional $3 million to extend First Nations eye health activities, on top of an existing $31.3 million commitment to eye health activities

Part 2 New investment in spectacles for Aboriginal and Torres Strait Islander people welcomed by Vision 2020 Australia

Vision 2020 Australia welcomes the Australian Government investment of $2 million to increase access to subsidised spectacles for Aboriginal and Torres Strait Islander people.

The one-off funds have been allocated to Vision 2020 Australia to work with the Australian Government to encourage State and Territory Governments to enhance the existing arrangements for subsidising the cost of spectacles.

Vision 2020 Australia CEO Judith Abbott said: “Our members have been actively advocating for this investment that will help make spectacles more affordable for up to 10,000 Aboriginal and Torres Strait Islander people across our country.”

“Around 60 per cent of blindness among Aboriginal and Torres Strait Islander people is due to issues that can be corrected with glasses, so this is a very positive step. We look forward to working with the government as part of Vision 2020 Australia’s ongoing commitment with our members to reduce blindness and vision loss.”

Minister for Indigenous Health the Hon. Ken Wyatt said: “While subsidised spectacle schemes exist in all Australian states and territories, the existing schemes vary and in some cases, have limited impact in overcoming barriers to access.

This new investment is being provided to encourage State and Territory Governments to work with Vision 2020 Australia to establish a nationally consistent approach to spectacle subsidies.”

“We want to remove affordability barriers so Aboriginal people can get glasses when they need them, regardless of where they live

NACCHO and @Vision2020Aus Aboriginal Eye Health Deadly Good News : #BecauseofHerWeCan #WeCan18 ! – #Indigenous women in eye health @Walgett_AMS @BADACBallarat @AHCSA_ @IEHU_UniMelb

 ” To mark NAIDOC Week 2018 and this year’s theme ‘Because of Her, We Can!’, Vision 2020 Australia is celebrating the roles and achievements of some of the incredible Aboriginal and Torres Strait Islander women working in the eye health sector.  

These women perform a range of roles across a number of areas in the sector, but they are all proud of their cultures, passionate about their work and driven to help improve health outcomes in Indigenous communities and beyond.”

Originally published HERE VISION 2020

Read over 40 Aboriginal Eye Health Articles published over the past 9 years

 ” Vision 2020 Australia’s Aboriginal and Torres Strait Islander Committee Chair, Dr Dawn Casey (COO, NACCHO), said it will be hard to improve Aboriginal health when funding bodies and Aboriginal service providers are “not on the same page”.

Dr Casey spoke at the Close the Gap for Vision by 2020: Striving Together National Conference in March about the longevity of ACCHOs delivering clinically effective health outcomes for over 40 years: “Our mob trust us”. While medical professionals have a role to play in closing the gap, sustainable approaches must be embedded in ACCHOs ”

Read full report here Aboriginal-led solutions key to closing the vision gap

1.Robyn Bradley, Aboriginal Health Liaison Officer – Royal Victorian Eye and Ear Hospital

Robyn’s father’s ancestors emigrated from England and Scotland in the early 1800s and her mother’s family are from the Dhauwurd Wurrung peoples more commonly known as Gunditjmara in Western Victoria.

“I am proud to belong to this beautiful and ancient land. If you listen quietly you can still hear the dreamtime stories of our elders rustling through the bush, whispered over the dessert country and swirling around our brilliant coastlines. I am proud I come from this perfectly crafted tapestry of ancient first nation peoples, emigrants, convicts, pioneers, bushrangers and first fleeters.

“I am also proud to share my passion for my culture and beliefs as an Aboriginal Health Liaison Officer at the Eye and Ear. I get to meet with community and act as a steward to help them receive the highest possible level of care – care that considers what is culturally appropriate and meets their unique needs.”
Robyn Bradley, Aboriginal Health Liaison Officer at the Royal Victorian Eye and Ear Hospital

2. Aboriginal women of the Aboriginal Health Council of South Australia

Since its inception, the Aboriginal Health Council of South Australia (AHCSA) has looked to the leadership of Aboriginal and Torres Strait Islander Women as trailblazers and advocates for better health outcomes for their communities.

Currently there are seven Aboriginal Women working in various roles within the AHCSA Secretariat. The women’s kinship ties extend all over the country and all are united in their efforts to contribute to improving health for their communities, acting as advocates for increased and improved access to Hospital and Health Services and creating opportunities for their communities, particularly the next generation.

Image (L-R): Sarah Betts (Sexual Health Coordinator), Ngara Keeler (Tackling Indigenous Smoking Programme Coordinator), Jessica Koncz (Student Services Officer), Jenaya Hall, (Tackling Indigenous Smoking Project Officer), Amanda Mitchell (Deputy CEO), Debra Stead (Senior Finance Officer),
Absent from photo, Hannah Keain, (Junior Project Officer)
7 Aboriginal women who work at the Aboriginal Health Council of South Australia

3.Keearny Maher, Occupational Therapist – VisAbility

Keearny Maher is a Wiradjuri woman who specialises in vision impairment at VisAbility WA. Her cultural ties originate in Narrandera, NSW through her mother and Wiradjuri woman Ann-Maree Bloomfield.

“One rewarding aspect of my role is helping people find independence again after vision loss, particularly in the simple activities we all take for granted, like making a hot cuppa.”

Keearny’s role takes her all over WA, with some of her career highlights extending overseas, including volunteer work as an occupational therapist in Ukraine and India with children with varying disabilities.

Occupational Therapist at VisAbility, Keearny Maher

Rosamond Gilden, Research Assistant – Indigenous Eye Health at the University of Melbourne and member of Orthoptics Australia

Upon completing a Masters in Orthoptics, Rosamond worked in the private and public sector. To pursue her interest in research, Rosamond joined the Centre for Eye Research Australia as Clinical Coordinator of the National Eye Health Survey. It was during this time she became aware of the poor eye health outcomes for Indigenous Australians and wanted to make a difference.
In 2016, Rosamond commenced work with Indigenous Eye Health and is part of the Roadmap team whose goal is to Close the Gap for Vision by 2020.  Rosamond has used her experiences as a clinician to inform the current work that she is now undertaking and is grateful for the opportunity she has each day to contribute to a sector that has a sincere interest in improving eye health outcomes for Aboriginal people.
Rosamond Gilden

4. Jenny Hunt, Eye Health Worker – Walgett Aboriginal Medical Service in partnership with Brien Holden Vision Institute

Jenny is a proud Gamilaraay woman who has been providing eye care services in partnership with the Brien Holden Vision Institute Aboriginal Vision Program for the past 10 years to the Walgett community.

“I find the eye program rewarding when I see the relief and smile on my people’s faces when they first put their glasses on. I feel proud. Also, if they do not attend their optometrist or ophthalmologist appointments, I will chase them up and take them there myself because I know how important it is for them.
“I have excellent communication with the outreach location workers and they do a wonderful job getting the patients in for our clinics. I travel to Narrabri, Collarenebri, Goodooga, Pilliga and Lightning Ridge for clinics as well as the one we run in Walgett. Without the help from these workers, there would be no eye clinics.”
Jenny Hunt standing in front of a sign for Walgett Aboriginal Medical Service

5.Faye Clarke, Diabetes Educator/Care Co-ordinator – Ballarat and District Aboriginal Co-operative in partnership with Indigenous Eye Health at the University of Melbourne

Faye is a Gunditjmara, Wotjobaluk and Ngarrindjeri woman who works with Aboriginal communities in the Ballarat and wider Grampians region of Victoria to help promote eye health and help those living with diabetes. Faye is passionate about working in Indigenous eye health and was excited to work with the IEH team on the Roadmap to Close the Gap for Vision.

“Vision is such an essential part of our life and when it is threatened it makes all the difference to someone’s quality of life. My dual role as a Care Co-ordinator means I can take on roles in both education and co-ordinating their path in the health care system.

“I am passionate about Indigenous eye health because of the work I do but also because of the clients I work with who are affected by threats to their vision.”

Faye Clarke from Ballarat and District Aboriginal Co-operative

6.Simone Kenmore, Manager of South Australian Trachoma Elimination Program – Country Health South Australia

Simone is a Yankunytjatjara woman from the Anangu Pitjantjatjara Yankunytjatjara Lands in remote South Australia. Simone works with Indigenous communities and health professionals across Australia to inform a model of best practice to work towards the elimination of trachoma in South Australia, and is passionate about improving health outcomes for Indigenous communities.
“I have always been passionate about working in programs that contribute to improved outcomes for Indigenous communities. My work in trachoma is driven by the fact that it is a preventable disease. By sharing what we know about eye health, building the capacity of our communities and working in partnership across health, education and housing we can eliminate trachoma and prevent blindness for future generations.”
(Image and content provided by Indigenous Eye Health at University of Melbourne)
Simone Kenmore

7.Emma Robertson, ITC Care Coordinator – Karadi Aboriginal Corporation

Emma is a Palawa woman working in a health promotion role at Karadi Aboriginal Corporation in Tasmania, encouraging people to come in for regular eye checks. Emma believes this year’s NAIDOC Week is a great chance to honour the women who have influenced her and her work in Indigenous health.

“I thinks this year’s theme is one of the best yet. I get to honour the women who were before my time that set the path that now enables me to work in my areas of passion around Indigenous health. It also makes me feel proud as an Aboriginal mum and the role I am playing in setting what I hope is a great role model for my daughters – that with hard work, determination and good people around you, you can make a profound difference in the lives of others.”

(Image and content provided by Indigenous Eye Health at University of Melbourne)
Emma Robertson from Karadi Aboriginal Corporation

NACCHO and @RACGP Aboriginal Health #Housing #Crisis #ClosetheGap #Socialdeterminants Overcrowding leads to poorer health outcomes for our Aboriginal and Torres Strait Islander peoples

 ” In the first of a series focusing on the coming third edition of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people, newsGP examines the effects of overcrowding on health outcomes “

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National-Guide-prerelease-info-Flyer-2017

Many households in Aboriginal and Torres Strait Islander communities are deemed overcrowded, a situation that can lead to a wide range of health problems.

Author of RACGP article Morgan Liotta

The National Aboriginal Community Controlled Health Organisation (NACCHO) and the RACGP’s National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (the National Guide) and the Centre for Aboriginal Economic Policy Research’s working paper, The scale and composition of Indigenous housing need, define overcrowded households as those that do not meet the following requirements:

  • No more than two persons per bedroom
  • Children aged <5 years of different sexes may reasonably share a bedroom
  • Children aged ≥5 years of opposite sex should have separate bedrooms
  • Children aged <18 years and the same sex may reasonably share a bedroom
  • Single household members aged >18 years should have a separate bedroom, as should parents or couples

The National Guide reveals that Aboriginal and Torres Strait Islander families living in overcrowded circumstances are more susceptible to contracting infections through lack of hygiene from poor sanitation and close contact with others.

Added by NACCHOFor example, situations in which several people are sharing a single bathroom, and the bore water supply (on which many remote Aboriginal and Torres Strait Islander communities depend) struggles to maintain appropriate levels, result in inadequate fresh water for basic cleaning. Another example is the ease with which an infection can spread via bed linen when several children are sharing a bedroom.

Chronic ear infections (eg otitis media), eye infections (eg trachoma), skin conditions (eg crusted scabies), gastroenteritis, respiratory infections (overcrowding has been identified as a risk factor for pneumococcal disease), and exacerbation of family violence and mental health issues are all potential outcomes from overcrowded environments.

In remote areas, overcrowded households (more than two children aged <5 years) are associated with a 2.4-fold increased risk of the youngest child having otitis media.

According to the Systematic review of existing evidence and primary care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations, these high rates of infection could be prevented if overcrowding in Aboriginal communities was improved.

Overcrowding can also present as an environmental stressor for people living in such households, including from issues such as a lack of privacy, which can have an impact on mental health. Research from the Australian Bureau of Statistics shows that 14% of Aboriginal and Torres Strait Islander people in remote areas cited overcrowding at home as this type of stressor, compared to 9% of those living in non-remote areas.

In addition, the Y health – Staying deadly: An Aboriginal youth focussed translational action research project addresses overcrowding as a potential factor when exploring issues of Aboriginal youth mental health.

However, other significant factors to recognise are that some houses need to accommodate for overcrowding due to extended family visits to deal with illness, mourning a death in the family, or sometimes for cultural reasons.

Various government strategies are in place to combat the negative impacts of overcrowding, including the National partnership agreement on remote Indigenous housing, funded by the Federal Government. This policy aims to assess the current state of poor housing conditions in Aboriginal and Torres Strait Islander communities, as well as issues of housing shortage and homelessness.

These strategies are working towards improving housing conditions in rural and remote areas, a key part in helping to close the gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians.

NACCHO and the RACGP’s National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people, provides further information on overcrowding in the following chapters:

  • Hearing loss
  • Eye health
  • Respiratory health – Pneumococcal disease prevention
  • Mental health
  • The health of young people

How to access the National Guide:

The third edition of the National Guide will be available early 2018.

Free to download on the RACGP website and the NACCHO website:

www.racgp.org.au/national-guide/ and www.naccho.org.au

For further information, contact

RACGP Aboriginal and Torres Strait Islander Health on 1800 000 251

or aboriginalhealth@racgp.org.au