NACCHO Aboriginal Health News : Download @aihw Aboriginal health organisations : Online Services Report—key results 2016–17 : Part 2 Is the Closing the Gap ‘too focused on prosperity debate

 ” The National Congress of Australia’s First Peoples has also warned that a focus on “economic prosperity” in the current Close the Gap review “is misguided and should not serve as an overarching focus for government policy”.

The Lowitja Institute has called for “prosperity” to be ­removed as a criteria, saying it “has strong monetary connotations and does not adequately speak to the health and education sectors”, and warns that the ­review will fail “if effective partnerships and engagement, not consultation, with Aboriginal and Torres Strait Islander leaders and communities is not undertaken from the start to the end of the process”.

From the Australian 14 July see Part 2 Below

Part 1 : Download Aboriginal and Torres Strait Islander health organisations: Online Services Report—key results 2016–17

This ninth national report provides information on 266 organisations funded by the Australian Government to deliver health services to Aboriginal and Torres Strait Islander people. These organisations contributed to the 2016–17 Online Services Report. Information is presented on the characteristics of these organisations; the services they provide; client numbers, contacts and episodes of care; staffing levels; and service gaps and challenges.

Some changes were made to the 2016–17 data collection, aimed at ensuring consistency in episode of care reporting between the different data collection systems. This resulted in a decrease in primary health episode of care counts in 2016–17. These are not comparable with previous collections, so comparisons are not presented in this report. See Chapter 2 for more information about the data collection, data quality and the impacts of these changes.

Download the full report 120 Page HERE

aihw-ihw-196

Key messages

1.A range of services are provided to Aboriginal and Torres Strait Islander people

Of the 266 organisations in 2016–17:

  • 196 (74%) provided a range of primary health-care services to around 444,700 clients through 3.2 million episodes of care. Just over two-thirds of these organisations (136) were Aboriginal Community Controlled Health Organisations. Services provided include: health promotion; clinical care; substance-use treatment and prevention; and social and emotional wellbeing support. These organisations also provided access to specialist, allied health and dental services, either on site or by facilitating off-site access. For example, most provided access to cardiologists (90%); renal specialists (87%); ophthalmologists (86%); paediatricians (90%); psychiatrists (87%); diabetes specialists (90%); and ear, nose and throat (ENT) specialists (88%). They also provided access to dental services (94%) and to allied health services such as physiotherapists (89%); psychologists (93%); dieticians (95%); podiatrists (96%); optometrists (94%); and audiologists (91%).
  • Around 7,600 full-time equivalent (FTE) staff were employed by organisations providing primary health-care services and just over half of all staff (53%) were Aboriginal and/or Torres Strait Islander (see Chapter 3).
  • 213 (80%) provided maternal and/or child health services through their primary health and/or New Directions funding. Around 8,400 Indigenous women were seen through 42,200 antenatal visits—an average of 5 visits per client (see Chapter 4).
  • 88 (33%) provided social and emotional wellbeing services. The 189 counsellors in these organisations saw around 16,300 clients, through 77,100 client contacts—an average of 5 contacts per client (see Chapter 5).
  • 80 (30%) provided substance-use services to around 39,400 clients through 197,700 episodes of care. Most episodes of care (88%) were for non-residential or after-care services (see Chapter 6).

2.Many funded organisations provide services in Remote and Very remote areas

Nearly half (46%) of the organisations funded to provide primary health-care services to Aboriginal and Torres Strait Islander people did so in Remote or Very remote areas and they saw around 168,100 (38%) clients. Around 44% of employed staff (3,347 FTE) worked in Remote or Very remote areas, including a higher proportion of employed nurses and midwives (59% or 664 FTE) and a lower proportion ofemployed dental care staff (21% or 38 FTE).

There were more FTE nurses and midwives per 1,000 clients in Remote (3.5) and Very remote areas (4.4), compared with 2.6 per 1,000 clients overall. There were fewer doctors in Very remote areas (0.9 FTE doctors per 1,000 clients compared with 1.3 overall), perhaps reflecting a greater reliance on nurse-led clinics in these areas. Contacts by nurses and midwives represented half (51%) of all contacts in Very remote areas compared with 29% overall.

Over 800,000 episodes of care (25%) were provided to clients in Very remote areas. However, organisations in Very remote areas were still more likely to report staffing vacancies. Nearly one-third (31%) of reported health-staff vacancies were in organisations in Very remote areas. They also had more health-staff vacancies per 1,000 clients (1.0 compared with 0.7 overall). Organisations in Very remote areas were also more likely to report the recruitment, training and support of staff as one of the challenges they faced in providing quality care to clients (75% compared with 67% overall) as well as staff retention and turnover (75% compared with 57% overall).

3.Various group activities are run to promote health and wellbeing

Organisations delivered a range of group activities in 2016–17 to improve the health of the community:

  • Those funded to provide primary health-care services ran around 8,400 physical activity/healthy weight sessions; 4,300 chronic disease client support sessions; and 3,300 tobacco-use treatment and prevention sessions. Other common health promotion activities included campaigns to encourage immunisation services (in 81% of organisations), healthy lifestyle programs (75%) and sexual health/ education (71%).
  • With respect to maternal and child health services, around 20,300 home visits; 3,100 maternal and baby/child health group sessions; 2,100 parenting group sessions and 1,000 antenatal group sessions were provided.
  • In those funded to provide substance-use services, most (93%) provided community education, while 60% did school visits. Around 4 in 5 (80%) ran physical activity or healthy weight programs and around three-quarters ran tobacco-use treatment and prevention groups (76%),  alcohol-misuse  treatment and prevention groups (74%), living skills groups (75%), men’s groups (75%) and women’s groups (74%).

Things to note

  • Most (94%) organisations funded to provide primary health care also provided social and emotional wellbeing or mental health or counselling services, and over half (57%) had mental health promotion activities in 2016–17; however, nearly two-thirds of organisations still reported mental health and social and emotional wellbeing services as a service gap (63%). This was even higher (78%) in organisations funded to provide substance-use services, but not primary health care.
  • Some organisations indicated that clients with high needs had to wait too long for some services,   in particular to access dental services and mental health professionals. For example, 50 (27%) organisations providing on-site or off-site access to dental services still felt clients with high needs often had to wait a clinically unacceptable time for dental services. This was higher in organisations in Remote (44%) and Very remote (34%) areas.
Part 2 Is the Closing the Gap ‘too focused on prosperity debate

The Closing the Gap program aimed at reducing indigenous disadvantage has hit stasis 10 years after it began, with four of its seven measures expired, a review of the scheme still months off being completed and warnings from a range of peak organisations that some proposed criteria for replacement targets are irrelevant or unhelpful.

Some fear the 11th annual Prime Minister’s report due in February might focus more on ­details of the review and launching a reboot, rather than accounting for any actual achievements in the scheme’s aims.

Submissions to the review warn of a “dire need for greater government accountability” and say “a myopic focus on national statistics” in the past has led to the needs of individual remote communities being unmet, as well as criticising the awarding of contracts to mainstream organisations which “frequently lack the capacity, knowledge and cultural competence required to effectively deliver services to our communities”.

The National Congress of Australia’s First Peoples has also warned that a focus on “economic prosperity” in the current review “is misguided … and should not serve as an overarching focus for government policy”.

The Lowitja Institute has called for “prosperity” to be ­removed as a criteria, saying it “has strong monetary connotations and does not adequately speak to the health and education sectors”, and warns that the ­review will fail “if effective partnerships and engagement, not consultation, with Aboriginal and Torres Strait Islander leaders and communities is not undertaken from the start to the end of the process”.

It also warns of unhelpful uses of nationwide targets “which, due to data-collection protocols were unmeasurable, and secondly, did not seem to consider the distinct challenges faced at both the state and local levels”.

Of the four Closing the Gap targets that expired at the beginning of this month, just one — halving the gap in infant mortality rates — was said to be on track, ­although even that assessment has been questioned.

The other three — closing the gap on school attendance, halving the gap in reading and numeracy and halving the employment gap — expired without being on track.

Only two of the still active three targets are on track: getting 95 per cent of all indigenous four-year-olds enrolled in early childhood education by 2025 and halving the gap for Year 12 or equivalent attainment by 2020.

A third, closing the life expectancy gap by 2031, is not on track.

The Weekend Australian understands two review workshops are scheduled in Canberra for the end of this month, for peak groups in the sector and others who have made submissions.

The review, which is being conducted by the Department of Prime Minister and Cabinet as a Council of Australian Governments exercise, is then expected to report back by October 31 with a new “framework, targets and performance indicators”.

However congress co-chair Rod Little warned this might still be merely a report that requires further refining, with the outcome that by next February, when the Prime Minister’s annual report should be delivered, “that’s one year that’s gone into reshaping the framework rather than working on outcomes”.

But he said the October deadline opened the door for further consolidation.

NACCHO Aboriginal Health : Download the ANAO Report : Primary Healthcare Grants under the IHAP Indigenous Australians’ Health Program : Effective high quality, comprehensive, culturally appropriate, primary healthcare services in urban, regional, rural and remote locations

” The bulk of IAHP expenditure is via grants. Since 2015, IAHP primary healthcare grants totalling approximately $1.44 billion have been awarded with 85 per cent of this funding going to Aboriginal Community Controlled Health Organisations.

The audit objective was to assess the effectiveness of the Department of Health’s design, implementation and administration of primary healthcare grants under the IAHP.”

Download the report HERE

ANAO Report PHC Grants Under IAHP – DoH

Summary and recommendations

Background

1. The Indigenous Australians’ Health Program (IAHP) was established in 2014 through the consolidation of four existing Indigenous health funding streams administered by the Department of Health (the department).

The IAHP aims to provide Aboriginal and Torres Strait Islander people with access to effective high quality, comprehensive, culturally appropriate, primary healthcare services in urban, regional, rural and remote locations across Australia.1

Primary healthcare services are usually the ‘entry point’ for persons into the broader health system and can be contrasted to services provided through hospitals or when people are referred to specialists.

The IAHP access to effective high quality, comprehensive, culturally appropriate, primary healthcare services in urban, regional, rural and remote locations

2. The bulk of IAHP expenditure is via grants. Since 2015, IAHP primary healthcare grants totalling approximately $1.44 billion have been awarded with 85 per cent of this funding going to Aboriginal Community Controlled Health Organisations.

3. As at March 2018, a total of 164 organisations are receiving IAHP primary healthcare grant funding. In 2016–17, IAHP-funded services provided primary healthcare services to an estimated 352,000 Indigenous Australians. This represents 54.2 per cent of the estimated total Indigenous population.

Rationale for undertaking the audit

4. The IAHP was selected for audit because it is intended to contribute towards achieving the Indigenous health-related ‘Closing the Gap’ targets regarding life expectancy and infant mortality. The program represents the Australian Government’s largest direct expenditure on Indigenous primary healthcare.

Audit objective and criteria

5. The audit objective was to assess the effectiveness of the Department of Health’s design, implementation and administration of primary healthcare grants under the IAHP.

6. To form a conclusion against this objective, the ANAO adopted the following high-level criteria:

  • Did the department design the IAHP primary healthcare components consistent with the Government’s objectives in establishing the IAHP?
  • Has implementation of the IAHP primary healthcare components been supported through effective coordination with key Government and non-Government stakeholders?
  • Has the department’s approach to assessing primary healthcare funding applications and negotiating funding agreements been consistent with the Commonwealth Grant Rules and Guidelines?
  • Has the department implemented a performance framework that supports effective management of individual primary healthcare grants and enables ongoing assessment of program performance and progress towards outcomes?

Conclusion

7. The department’s design and implementation of the primary healthcare component of the IAHP was partially effective as it has not yet achieved all of the Australian Government’s objectives in establishing the program. The department has not implemented the planned funding allocation model and there are shortcomings in performance monitoring and reporting arrangements. However, the department has consolidated the program, supported it through coordination and information-sharing activities and continued grant funding.

8. The Government’s original objectives in establishing the IAHP are due to be fully achieved in 2019–20, four years later than originally planned. The majority of IAHP primary healthcare grant funding to date has been allocated in essentially the same manner as previous arrangements rather than the originally intended needs based model. Program implementation has been supported through appropriately aligning funding streams to intended outcomes and coordination and information-sharing with relevant stakeholders.

9. Most aspects of the department’s assessment of IAHP primary healthcare funding applications and negotiation of funding agreements were consistent with the Commonwealth Grants Rules and Guidelines (CGRGs). The exception to this was the poor assessment of value for money regarding the majority of grant funds. The grant funding agreements were fit for purpose, but the department has not established service-related performance benchmarks for funded organisations that were provided for in most of the agreements.

10. The department has not developed a performance framework for the Indigenous Australians’ Health Program. Extensive public reporting on Indigenous health provides a high level of transparency on the extent to which the Australian Government’s objectives in Indigenous health are being achieved. However, this reporting includes organisations not funded under the IAHP and, as such, it is not specific enough to measure the extent to which IAHP funded services are contributing to achieving program outcomes.

11. In managing IAHP primary healthcare grants, the department has not used the available provisions in the funding agreements to set quantitative benchmarks for grant recipients. This limits its ability to effectively use available performance data for monitoring and continuous quality improvement. Systems are in place to collect performance data, but systems for collecting quantitative performance data have not been effective. Issues with performance data collection limit its usefulness for longitudinal analysis.

Supporting findings

Program design and implementation

12. The design of the IAHP was consistent with the Government’s objectives of achieving budget savings and reducing administrative complexity through consolidation of existing grant programs. The objective of allocating primary healthcare grant funding on a more transparent needs basis will not be achieved until 2019–20, four years behind the timetable agreed by Government in establishing the IAHP.

13. Three outcomes were established for the program and set out in published IAHP grant guidelines. One of the outcomes does not clearly identify the desired end result. IAHP funding, including the primary healthcare component, are appropriately aligned to the outcomes.

14. The department uses a wide variety of forums and networks to share information and seek feedback about its current and planned Indigenous health activities, including the IAHP. Some coordination and joint planning activities relating to primary healthcare have also been undertaken through the Aboriginal Health Partnership Forums.

Awarding Grants

15. Ninety eight per cent of IAHP primary healthcare grant funding has been provided through non-competitive processes. The department obtained Ministerial agreement for these processes.

16. Most aspects of the assessment of funding proposals were undertaken consistently with the CGRGs and IAHP guidelines. The exception was assessment of value for money. Assessment records for some funding rounds, including the $1.23 billion ‘bulk’ round undertaken in 2015, lacked evidence of substantive analysis of value of money considerations. The department was also unable to provide evidence it had undertaken a value for money assessment regarding the $114 million grant to the Northern Territory Government. In virtually all cases, risk assessments formed part of the assessment process.

17. Departmental delegates were provided with sufficient advice to enable them to discharge their obligations under the Public Governance, Performance and Accountability Act 2014 in approving IAHP grant proposals. The timeliness of the advice varied, but was provided relatively quickly for the larger 2015 funding rounds.

18. Funding agreements are fit for purpose, using a grant head agreement and an IAHP-specific schedule. The specific services to be provided by each funded organisation are set out in separate Action Plans, which are appropriately referenced in the agreement schedule. The agreements with Aboriginal Community Controlled Health Organisations allow for the setting of individual performance targets, but no targets have been set. All agreements also clearly set out reporting requirements.

Monitoring and Reporting

19. The department has not established a performance framework for the primary healthcare component of the IAHP.

20. Systems are in place to collect performance data, but systems to collect quantitative performance data have not been effective. Several changes to data collection processes have resulted in an increased reporting burden on IAHP grant recipients and two six-monthly data collections being discarded or uncollected. These breaks in the data series limit its usefulness for longitudinal analysis of performance trends. The department has commenced projects to improve the quality of data, but has limited assurance over the quality of data collected before 2017 as it has not been validated.

21. The department relies on public reporting of a range of Indigenous health indicators to monitor achievement of program outcomes. The reporting includes data about services not funded under the IAHP. As such, it is not specific enough to measure the extent to which IAHP funded services are contributing to achieving program outcomes. The department was also unable to demonstrate how it used the data to inform relevant policy advice and program administration.

22. The department is not effectively using available performance data to monitor IAHP grant recipient performance and has not set quantitative national key performance indicator (nKPI) based benchmarks for grant recipients. The department’s ability to set performance expectations and assess actual performance is limited by the currency of data and variability in the content of Action Plans.

Recommendations

Recommendation no.1

Paragraph 3.21

The Department of Health improve the quality of IAHP primary healthcare value for money assessments, including ensuring their consistency with the new funding allocation model.

Department of Health response: Agreed.

Recommendation no.2

Paragraph 4.10

The Department of Health assess the risks involved in IAHP-funded healthcare services using various clinical information software systems to support the direct online service reporting and national key performance indicator reporting process, and appropriately mitigate any significant identified risks.

Department of Health response: Agreed.

Recommendation no.3

Paragraph 4.30

The Department of Health ensure that new IAHP funding agreements for primary healthcare services include measurable performance targets that are aligned with program outcomes and that it monitors grant recipient performance against these targets.

Department of Health response: Agreed.

Summary of entity response

23. The Department of Health (‘the Department’) notes the findings of the report and agrees with the recommendations.

It is pleasing that the report finds: the program has been consolidated and supported through coordination and information sharing activities; programme implementation has appropriately aligned funding streams to intended outcomes; and the objective of reducing administrative complexity has been achieved.

Work is already underway within the Department which aligns with the report’s recommendations, and the report provides a platform to continue these efforts. In particular, the Department has introduced more robust assessment processes for primary health care grants under the Indigenous Australians’ Health Programme and has also commenced development of enhanced performance measurements of program outcomes, supported by an outcomes-focussed policy framework. The Department’s responses to the individual recommendations provide further detail.

The report identifies that the introduction of a new funding allocation model for the distribution of primary health care funding as announced in the 2014–15 Budget is yet to be completed and finds that this deferral has contributed to a partially effective implementation of the Australian Government’s objectives in establishing the programme. The Government announced in the 2018–19 Budget that the model will be implemented from 1 July 2019 and the Department will continue to work closely with Aboriginal Community Controlled Health Services to deliver this important initiative. The Department notes that this deferral occurred in the context of extensive stakeholder engagement together with significant data improvement activities designed to support a robust and well-developed funding model.

Whilst the Department is committed to continuous improvement of the administration of the Indigenous Australians’ Health Programme, the Department wishes to acknowledge and recognise the significant contribution our network of Aboriginal Community Controlled Health Services are making to improve the health of their communities under the Australian Government’s Closing the Gap agenda

1. Background

Indigenous health and government funding

1.1 In 2008, the Council of Australian Governments set targets aimed at reducing or eliminating differences in specific outcomes between Indigenous and non-Indigenous Australians. These Closing the Gap targets covered three broad areas, of which health was one. In 2013, the Australian Government released the National Aboriginal and Torres Strait Islander Health Plan 2013–23, which set out a 10 year plan for the direction of Australian Government Indigenous health policy. This was followed in 2015 by an Implementation Plan for the Health Plan. The Implementation Plan outlines the actions to be taken by the Australian Government, the Aboriginal community controlled health sector, and other key stakeholders to give effect to the Health Plan. Progress under the Implementation Plan is measured against 20 goals and 106 deliverables that were developed to complement the existing Closing the Gap targets.

1.2 While the 2018 Prime Minister’s Closing the Gap report and the 2017 Aboriginal and Torres Strait Islander Health Performance Framework report show gains have been made in some areas, Indigenous Australians continue to experience significantly poorer health outcomes than the general population.2 Life expectancy is about 10 years lower. Rates of chronic disease are higher, with some tending to occur at a younger age in Indigenous Australians compared to the general population. The overall burden of disease3 for Indigenous Australians is also 2.3 times higher. Some factors potentially impacting on health, such as smoking and obesity, are higher: the overall smoking rate is 2.7 times higher and Indigenous Australians are 1.6 times as likely to be obese as the general population. Some health interventions can have a long lead time before measurable impacts are seen across the target population—for example, up to three decades in the case of many smoking-related diseases.

1.3 The Australian and state and territory governments all fund Indigenous health. Estimated total direct funding on Indigenous health4 has increased since the setting of the Closing the Gap targets: from $4.76 billion in 2008–09 to $6.30 billion in 2015–16.5 Of this, expenditure specifically targeted at Indigenous Australians was $1.44 billion in 2015–16. The remainder is expenditure on ‘mainstream’ services used by Indigenous Australians, notably hospitals, and the cost of various Australian Government subsidies, including the Medicare Benefits Scheme and the Pharmaceutical Benefits Scheme. Indigenous-related expenditure on public and community health services6 in 2015–16 is estimated at $1.73 billion. The Australian Government contributes 59 per cent of the total 2015–16 government expenditure on the Indigenous public and community health services category.

1.4 Measured on a per-person basis, total direct health funding on Indigenous Australians in 2015–16 by all Governments in Australia is 1.83 times greater than the direct health funding on non-Indigenous Australians. Funding on the public and community health services category of Indigenous health is 3.59 times higher.

The Indigenous Australians’ Health Program

1.5 The Department of Health (the department) has had primary responsibility for Commonwealth Indigenous health policy and funding since 1995. Since that time, the department’s role has been to improve both Indigenous Australians’ access to mainstream primary healthcare and increase the capacity of the Indigenous-specific sector to provide comprehensive primary healthcare.7

1.6 In the May 2014 Budget, the Australian Government announced the establishment of the Indigenous Australians’ Health Programme (IAHP). It was formed by consolidating four existing funding streams administered by the department, which between them included around 30 discrete funding components.8 The consolidation was intended to reduce administrative complexity and enable an improved focus on basic health needs (including clinical primary healthcare) at a local level to improve health outcomes. The stated high-level objective for the IAHP is:

to provide Aboriginal and Torres Strait Islander people with access to effective high quality, comprehensive, culturally appropriate, primary health care services in urban, regional, rural and remote locations across Australia.

1.7 A new primary healthcare grant funding allocation model was also to be developed for implementation from 2015–16. As discussed in Chapter 2, development and implementation of the new allocation model has been delayed.

1.8 With the exception of ‘social and emotional wellbeing’ activities being transferred to the Department of Prime Minister and Cabinet9, the range of activities funded by the department under IAHP are broadly similar to those under the pre-IAHP arrangements and funding levels have increased. In 2013–14, funding under predecessor grant programs was $682.3 million (excluding social and emotional wellbeing activities). The budget allocation for IAHP funding in 2017–18 is $856.1 million.

1.9 The bulk of IAHP expenditure is via grants. As at March 2018, $743.5 million of 2017–18 grant funds had been expended or committed.10 The largest component is grants to provide primary healthcare services to Indigenous Australians, which account for $461.5 million (62 per cent) of total IAHP 2017–18 expended and committed grant funding.11 Other significant grant funding areas under the IAHP relate to activities intended to increase Indigenous Australians’ access to mainstream services12 ($108 million, or 15 per cent) and funding for various maternal/early childhood health and anti-smoking activities (about five per cent each).

1.10 As at March 2018, 164 organisations are receiving IAHP primary healthcare grant funding. Around 140 of these organisations are Aboriginal Community Controlled Health Organisations (ACCHOs), which collectively account for 85 per cent of total IAHP core primary healthcare grant funding in 2017–18. The remaining primary healthcare grant recipients include the Northern Territory Government, various public sector regional health bodies across several states, and a small number of private sector providers and non-government organisations.

1.11 The geographical distribution of the healthcare facilities receiving IAHP primary healthcare funding is shown in Figure 1.1.

Figure 1.1: Distribution of IAHP primary healthcare funded facilities

Source: Department of Health.

1.12 The 2017–18 primary healthcare grant funding amounts according to jurisdiction and remoteness index is shown in Table 1.1.

 

NACCHO Aboriginal Health and #MensHealthWeek 3 of 3 #OchreDay2018 News 1. @GregHuntMP announces a National Male Health Strategy to support the health of men and boys 2. @MyHealthRec Men encouraged to connect with their health with a #Myhealthrecord

During 2018 Men’s Health Week it is important to remember that in Australia, like most countries, males have poorer health outcomes on average than females.

More males die at every stage of life. Males have more accidents, are more likely to take their own lives and are more prone to lifestyle-related chronic health conditions than women and girls at the same age.

This is why I am announcing today, the beginning of a process to establish a National Male Health Strategy for the period 2020 to 2030. “

The Hon. Greg Hunt Minister for Health full press release Part 1

The AMA welcomes today’s announcement of the establishment of a 10-year National Male Health Strategy that will target the mental and physical health of men and boys.

The AMA called for a major overhaul of men’s health policy in April this year, including a new national strategy to address the different expectations, experiences, and situations facing Australian men.

Australian men are less likely to seek treatment from a general practitioner or other health professional, and are less likely to have the supports and social connections needed when they experience physical and mental health problems

We look forward to engaging with the Turnbull Government to develop initiatives to address the reasons why men are reluctant to engage with GPs, and the consequence of that reluctance, and to invest in innovative models of care than overcome these barriers “

AMA President, Dr Tony Bartone, said the AMA was pleased that the Federal Government recognised that Australian males have poorer health outcomes, on average, than Australian females. In full Part 2 below

Encouraging men to discuss their health with their doctor, pharmacist, or other healthcare specialist can be difficult.

My Health Record supports and assists men to have these conversations, enabling better connected care and, ultimately, better health outcomes,”

My Health Record gives men and the broader community the capacity to upload important health information including allergies, medical conditions and treatments, medicine details, test results and immunisations; supporting them in remembering the dates of tests, medicine names, or dosages “

Australian Digital Health Agency Chief Medical Adviser Clinical Professor Meredith Makeham said My Health Record provided many valuable benefits for men. in full Part 3 Below

NACCHO Aboriginal #MensHealthWeek and #OchreDay2018 Launch :

Download 30 years 1988 – 2018 of Aboriginal Male Health Strategies and Summit recommendations

To celebrate #MensHealthWeek NACCHO has launched its National #OchreDay2018 Mens Health Summit program and registrations

The NACCHO Ochre Day Health Summit in August provides a national forum for all Aboriginal and Torres Strait Islander male delegates, organisations and communities to learn from Aboriginal male health leaders, discuss their health concerns, exchange share ideas and examine ways of improving their own men’s health and that of their communities

The two day conference is free: To register

Part 1 Greg Hunt press release

The Australian Government will establish a decade-long National Male Health Strategy that will focus on the mental and physical health of men and boys.

During 2018 Men’s Health Week it is important to remember that in Australia, like most countries, males have poorer health outcomes on average than females.

More males die at every stage of life. Males have more accidents, are more likely to take their own lives and are more prone to lifestyle-related chronic health conditions than women and girls at the same age.

This is why I am announcing today, the beginning of a process to establish a National Male Health Strategy for the period 2020 to 2030.

Building on the 2010 National Male Health Policy, the strategy will aim to identify what is required to improve male health outcomes and provide a framework for taking action.

The strategy will be developed in consultation with key experts and stakeholders in male health, and importantly, the public will be invited to have a say through online consultation later this year.

Australian men and boys are vital to the health and happiness of their families and communities, but need to pay more attention to their own mental and physical wellbeing.

During Men’s Health Week, men are encouraged to talk about their health with someone they trust.

I encourage all men to take time this week to think about their own health and wellbeing and participate in events happening across the country.

The Turnbull Government provides funding to a number of organisations that focus on the health of men and boys including Men’s Health Information Resource Centre at Western Sydney University, Andrology Australia and the Australian Men’s Health Forum.

The National Male Health Strategy builds on and complements the National Women’s Health Strategy 2020 to 2030 I announced at the National Women’s Health Summit in February.

Part 2 AMA WELCOMES NATIONAL MALE HEALTH STRATEGY

The AMA welcomes today’s announcement of the establishment of a 10-year National Male Health Strategy that will target the mental and physical health of men and boys.

AMA President, Dr Tony Bartone, said the AMA was pleased that the Federal Government recognised that Australian males have poorer health outcomes, on average, than Australian females.

“In Australia, men have a life expectancy of approximately four years less than women, and have a higher mortality rate from most leading causes of death,” Dr Bartone said.

“Australian men are less likely to seek treatment from a general practitioner or other health professional, and are less likely to have the supports and social connections needed when they experience physical and mental health problems.

“An appropriately-funded and implemented National Male Health Strategy is needed to deliver a cohesive platform for the improvement of male health service access and men’s health outcomes.

“This does not mean taking funding away from women’s health strategies. Initiatives that address the health needs of one gender should not occur at the expense of the other.

“Men and women should be given equal opportunity to realise their potential for a healthy life.

“The AMA congratulates Health Minister, Greg Hunt, for his decision to begin the process to establish a National Male Health Strategy for the period 2020 to 2030.

“We look forward to engaging with the Turnbull Government to develop initiatives to address the reasons why men are reluctant to engage with GPs, and the consequence of that reluctance, and to invest in innovative models of care than overcome these barriers.

“Compared to women, Australian men not only see their GP less often but, when they do see a doctor, it is for shorter consultations, and typically when a condition or illness is advanced.

“Men’s Health Week is an opportune time for Australian men to do something positive for their physical or mental health – book in for a preventive health check with a trusted GP, get some exercise, have an extra alcohol-free day, or reach out to check on the wellbeing of a mate.”

The AMA Position Statement on Men’s Health 2018 is at https://ama.com.au/position-statement/mens-health-2018

Background

  • Australian men are more than twice as likely to die in a motor vehicle accident than Australian women.
  • Men have a lower five-year survival rate for all cancers than women.
  • Australian men experience approximately 75 per cent of the burden of drug-related harm.
  • More than three in four suicide deaths in Australia are men, and intentional self-harm is the leading cause of death in men under 54 years of age.
  • Men are more likely to be in full-time work and may have less time for medical appointments.
  • Men are traditionally employed in high-risk jobs, especially in the trades, transport, construction, and mining industries.
  • Australian men are twice as likely as Australian women to exceed the lifetime risk guidelines for alcohol consumption, with one in four men drinking at a rate that puts them at risk of alcohol-related disease.

 

Part 3

Creating a My Health Record is one way men can be proactive about their health and make it a priority this Men’s Health Week, running between June 11 – 17.

My Health Record is a secure online summary of a person’s health information that can be accessed at any time by the individual and their healthcare providers.

Australian Men’s Shed Association Executive Officer David Helmers said My Health Record will make it easier for men who may find visiting healthcare professionals difficult or uncomfortable.

“We know that men often avoid having conversations about their health – particularly when those conversations involve visiting a healthcare provider.

“My Health Record takes some of the pain out of keeping a consistent record of our health and is a great platform for ongoing health management.

“Right from the get-go males are more likely to be involved in accidents or become ill, so as we age, it becomes even more important to stay on top of health information,” Mr Helmers said.

33 year-old Nick Morton was forced to take a serious look at his overall health after suffering a heart attack while working in North Queensland.

“I had a rupture in my artery wall – it was a big wake-up call going into cardiac rehab and I was the youngest by 20 years. I ended up really thinking about my health and becoming more aware of my medical history so I registered with My Health Record,” Mr Morton said.

After Nick returned to the family doctor back in his home state, his Melbourne based doctor was able to securely log onto My Health Record and view Nick’s Queensland medical history.

“It helped me having a digital copy of everything instead of having to go to my GP or cardiologist with a binder full of all my records,” Mr Morton said.

All Australians will have the benefit of receiving a My Health Record before the end of 2018, unless they choose not to have one.

Getting familiar with what is included in an individual’s personal record can assist in being prepared in an emergency like the one Nick Morton experienced. Nick now advocates a more proactive approach.

“I thought I was in control of my health and took it for granted like most blokes my age. There’s no excuse not to keep track of your health. Go to your GP and ask about my Health Record.”

Australian Digital Health Agency Chief Medical Adviser Clinical Professor Meredith Makeham said My Health Record provided many valuable benefits for men.

“Encouraging men to discuss their health with their doctor, pharmacist, or other healthcare specialist can be difficult.”

“My Health Record supports and assists men to have these conversations, enabling better connected care and, ultimately, better health outcomes,” Dr Makeham said.

My Health Record gives men and the broader community the capacity to upload important health information including allergies, medical conditions and treatments, medicine details, test results and immunisations; supporting them in remembering the dates of tests, medicine names, or dosages.

A major advantage of having a My Health Record is individuals having 24-hour, 7 day per week access to their own health information.

For further information visit www.myhealthrecord.gov.au or call 1800 723 471

NACCHO Aboriginal Health #AFL @AlcoholDrugFdn #NRW2018 #WorldNoTobaccoDay : Senator Bridget McKenzie Minister for Sport and Rural Health supports Redtails Pinktails #SayNoMore Drugs, #Smoking and #FamilyViolence #SayYesTo #Education #Employment #Family #Community

 

 ” Over the weekend Senator Bridget McKenzie had a chat pregame to local Central Australia Redtails before they took on Darwin’s TopEnd Storm curtain raiser to AFL Sir Doug Nicholls Indigenous round , a 6 hour broadcast on Channel 7 nationally : The Redtails and PinkTails Right Tracks Program is funded by the Local Drug Action Teams Program ”

See Part 1 Below

Part 2 Say No more to Family Violence all players link up

Part 3 #WorldNoTobaccoDay May 31 launched in the Alice

 ” Tobacco smoking is the largest preventable cause of death and disease in Australia and the Coalition Government is further committing to reduce the burden on communities.

In the lead up World No Tobacco Day on 31 May, today I am pleased to launch the next phase of the Coalition Government’s highly successful campaign Don’t Make Smokes Your Story,”

Watch video launch in the

The Minister for Rural Health, Senator Bridget McKenzie was also is in Alice Springs to launch the next phase of the National Tobacco Campaign and said that smoking related illness devastates individuals, families and the wider community : see Part 3 below

PART 1

Arrernte Males AFL Opening Ceremony

Arrernte women AFL Opening Ceremony

Part 1 The Australian Government and the ADF are excited to welcome an additional 92 Local Drug Action Teams, in to the LDAT program

The Senator with Alcohol and Drug Foundation CEO Dr Erin Lalor and  General Manager of Congress’ Alice Springs Health Services, Tracey Brand in Alice Springs talking about the inspirational Central Australian Local Drug Action Team at Congress and announcing 92 Local Drug Action Teams across Australia building partnerships to prevent and minimise harm of ice alcohol & illicit drugs use by our youth with local action plans

WATCH VIDEO of Launch

The Local Drug Action Team Program supports community organisations to work in partnership to develop and deliver programs that prevent or minimise harm from alcohol and other drugs (AOD).

Local Drug Action Teams work together, and with the community, to identify the issue they want to tackle, and to develop and implement a plan for action.

The Alcohol and Drug Foundation provides practical resources to assist Local Drug Action Teams to deliver evidence-informed projects and activities. The community grants component of the Local Drug Action Team Program may provide funding to support this work.

Each team will receive an initial $10,000 to develop and finalise a Community Action Plan and then to implement approved projects in your community. Grant funding of up to a maximum of $30k in the first year and up to a maximum of $40k in subsequent years is also available to help deliver approved projects in Community Action Plans. LDAT funding is intended to complement existing funding and in kind support from local partners.

LDATs typically apply for grants of between $10k and $15k to support their projects

 

See ADF website for Interactive locations of all sites

The power of community action

Community-based action is powerful in preventing and minimising harm from alcohol and other drugs.

Alcohol and other drugs harms are mediated by a number of factors – those that protect against risk, and those that increase risk. For example, factors that protect against alcohol and other drug harms include social connection, education, safe and secure housing, and a sense of belonging to a community. Factors that increase risks of alcohol and other drug harms include high availability of drugs, low levels of social cohesion, unstable housing, and socioeconomic disadvantage. Most of these factors are found at the community level, and must be targeted at this level for change.

Alcohol and other drugs are a community issue, not just an individual issue.

Community action to prevent alcohol and other drug harms is effective because:

  • the solutions and barriers (protective/risk factors) for addressing alcohol and other drugs harm are community-based
  • it creates change that is responsive to local needs
  • it increases community ownership and leads to more sustainable change

Part 2 Say No more to Family Violence all players link up

Such a powerful message told here in Alice Springs today as the Redtails Football Club, Top End Storm football club, link arms with the Melbourne Football Club, Adelaide Football Club for the NO MORE Campaign AU before the AFL Indigenous Round started.

WEBSITE Link up and say ‘No More’

 

 Watch Channel 7 Coverage of this special statement from all players

Part 3 #WorldNoTobaccoDay May 31 launched in the Alice

Tobacco smoking is the largest preventable cause of death and disease in Australia and the Coalition Government is further committing to reduce the burden on communities.

In the lead up World No Tobacco Day on 31 May, today I am pleased to launch the next phase of the Coalition Government’s highly successful campaign Don’t Make Smokes Your Story,”

Watch the ABC TV Interview HERE

Watch video of launch in the Alice

Successful Tobacco Campaign Continues

Tobacco smoking is the largest preventable cause of death and disease in Australia and the Coalition Government is further committing to reduce the burden on communities.

The Minister for Rural Health, Senator Bridget McKenzie was in Alice Springs to launch the next phase of the National Tobacco Campaign and said that smoking related illness devastates individuals, families and the wider community.

“In the lead up World No Tobacco Day on 31 May, today I am pleased to launch the next phase of the Coalition Government’s highly successful campaign Don’t Make Smokes Your Story,” Minister McKenzie said.

“The latest phase of Don’t Make Smokes Your Story continues to focus on Indigenous Australians aged 18–40 years who smoke and those who have recently quit. The campaign also concentrates on pregnant women and their partners with Quit for You, Quit for Two.

“An evaluation of the first two phases of the campaign revealed they had successfully helped to reduce smoking rates.

“More than half of the Aboriginal and Torres Strait Islander participants who saw the campaign took some action towards quitting smoking — and 8 per cent actually quit.

“These are very promising stats, however, we must continue to support and encourage those Australians who want to quit, but need help.”

The launch of the next phase of the campaign aligns with World No Tobacco Day and this year’s theme is Tobacco and heart disease.

“Cardiovascular disease is one of the leading causes of death in Australia, killing one person every 12 minutes,” Minister McKenzie said.

“There is a clear link between tobacco and heart and other cardiovascular diseases, including stroke — a staggering 45,392 deaths in Australia can be attributed to cardiovascular disease in 20151.

“Latest estimates show that tobacco use and exposure to second-hand tobacco smoke not only costs the lives of loved ones, but it costs the Australian community $31.5 billion in social — including health — and economic costs.”

“The Coalition Government, along with all states and territories, has made significant efforts to reduce tobacco consumption across the board.

“For example, we know that tobacco is the leading cause of preventable disease for Aboriginal and Torres Strait Islander people accounting for more than 12 per cent of the overall burden of illness.

“The Coalition Government has recently invested $183.7 million continuing to boost the Tackling Indigenous Smoking program to cut smoking and save lives.

“This comprehensive program has helped to cut the rates of Aboriginal and Torres Strait Islander people smoking and we want to build on this success.

“The Government’s investment in this program highlights our long-term commitment to Closing the Gap in health inequality.”

The ABS report Aboriginal and Torres Strait Islander People: Smoking Trends, Australia, 1994 to 2014-15, reported a decrease in current (daily and non-daily) smoking rate in those aged 18 years and older from 55 per cent in 1994 to 45 per cent in 2014-15, which shows Indigenous tobacco control is working.

For help to quit smoking, phone the Quitline on 13 7848, visit the Department of Health’s Quitnow website or download the free My Quitbuddy app.

Your doctor or healthcare provider can also help with information and support you may need to quit.

 

NACCHO Aboriginal Youth Health News @KenWyattMP launches Aboriginal Youth Health Strategy 2018-2023, Today’s young people, tomorrow’s leaders at @TheAHCWA

“ The youth workshops confirmed young people’s biggest concerns are often not about physical illness, they are issues around mental health and wellbeing, pride, strength and resilience, and ensuring they can make the most of their lives

Flexible learning and cultural and career mentoring for better education and jobs were highlighted, along with the importance of culturally comfortable health care services.

While dealing with immediate illness and disease is crucial, this strategy’s long-term vision is vital and shows great maturity from our young people.”

Federal Minister for Health and Aged Care Ken Wyatt, AM launched AHCWA’s Western Australia Aboriginal Youth Health Strategy 2018-2023, Today’s young people, tomorrow’s leaders at AHCWA’s 2018 State Sector Conference at the Esplanade Hotel in Fremantle. Read the Ministers full press release PART 2 Below

See Previous NACCHO Post

NACCHO Aboriginal Health @TheAHCWA pioneering new ways of working in Aboriginal Health :Our Culture Our Community Our Voice Our Knowledge

“If we are to make gains in the health of young Aboriginal people, we must allow their voices to be heard, their ideas listened to and their experiences acknowledged.

Effective, culturally secure health services are the key to unlocking the innate value of young Aboriginal people, as individuals and as strong young people, to become our future leaders.”

AHCWA Chairperson Vicki O’Donnell said good health was fundamental for young Aboriginal people to flourish in education, employment and to remain socially connected.

Download the PDF HERE

The Aboriginal Health Council of Western Australia (AHCWA) has this launched its new blueprint for addressing the health inequalities of young Aboriginal people.

“The Turnbull Government is proud to have supported this ground-breaking work and I congratulate everyone involved,” Minister Wyatt said.

“Young people are the future, and thinking harder and deeper about their needs and talking to them about how to meet them is the way forward.”

Developed with and on behalf of young Aboriginal people in WA, the strategy is the culmination of almost a decade of AHCWA’s commitment and strategic advocacy in Aboriginal youth health.

The strategy considered feedback from young Aboriginal people and health workers during 24 focus groups hosted by AHCWA across the Kimberley, Pilbara, Midwest-Gascoyne, Goldfields, South-West, Great Southern and Perth metropolitan areas last year.

In addition, two state-wide surveys were conducted for young people and service providers to garner their views about youth health in WA.

During the consultation, participants revealed obstacles to good health including boredom due to a lack of youth appropriate extracurricular activities, sporting programs and other avenues to improve social and emotional wellbeing.

Of major concern for some young Aboriginal people were systemic barriers of poverty, homelessness, and the lack of adequate food or water in their communities.

Significantly, young Aboriginal people shared experiences of how boredom was a factor contributing to violence, mental health problems, and alcohol and other drug use issues.

They also revealed that racism, bullying and discrimination had affected their health, with social media platforms used to mitigate boredom leading to issues of cyberbullying, peer pressure and personal violence and in turn, depression, trauma and social isolation.

Ms O’Donnell said the strategy cited a more joined-up service delivery method as a key priority, with the fragmentation and a lack of coordination in some areas making it difficult for young Aboriginal people to find and access services they need.

“The strategy provides an opportunity for community led solutions to repair service fragmentation, and open doors to improved navigation pathways for young Aboriginal people,” she said.

Ms O’Donnell said the strategy also recognised that culture was intrinsic to the health and wellbeing of young Aboriginal people.

“Recognition of and understanding about culture must be at the centre of the planning, development and implementation of health services and programs for young Aboriginal people,” she said.

“AHCWA has a long and proud tradition of leadership and advocacy in prioritising Aboriginal young people and placing their health needs at the forefront.”

Under the strategy, AHCWA will establish the Aboriginal Youth Health Program Outcomes Council and local community-based Aboriginal Youth Cultural Knowledge and Mentor Groups.

The strategy also mandates to work with key partners to help establish pathways and links for young Aboriginal people to transition from education to employment, support young Aboriginal people who have left school early or are at risk of disengaging from education; and work with local schools to implement education-to-employment plans.

More than 260 delegates from WA’s 22 Aboriginal Community Controlled Health Services are attending the two-day conference at the Esplanade Hotel Fremantle on April 11 and 12.

Over the two days, 15 workshops and keynote speeches will be held. AHCWA will present recommendations from the conference in a report to the state and federal governments to highlight the key issues about Aboriginal health in WA and determine future strategic actions.

The conference agenda can be found here: http://www.cvent.com/events/aboriginal-health-our-culture-our-communities-our-voice-our-knowledge/agenda-d4410dfc616942e9a30b0de5e8242043.aspx

Part 2 Ministers Press Release

A unique new youth strategy puts cultural and family strength, education, employment and leadership at the centre of First Nations people’s health and wellbeing.

Indigenous Health Minister Ken Wyatt AM today launched the landmark Western Australian Aboriginal Youth Health Strategy, which sets out a five-year program with the theme “Today’s young people, tomorrow’s leaders”.

“This is an inspiring but practical roadmap that includes a detailed action plan and a strong evaluation process to measure success,” Minister Wyatt said.

“It sets an example for other health services and other States and Territories but most importantly, it promises to help set thousands of WA young people on the right path for healthier and more fulfilling lives.”

Produced by the Aboriginal Health Council of WA (AHCWA) and based on State wide youth workshops and consultation, the strategy highlights five key health domains:

    • Strength in culture – capable and confident
    • Strength in family and healthy relationships
    • Educating to employ
    • Empowering future leaders
    • Healthy now, healthy future

Each domain includes priorities, actions and a “showcase initiative” that is already succeeding and could be replicated to spread the benefits further around the State.

Development of the strategy was supported by a $315,000 Turnbull Government grant, through the Indigenous Australians Health Program.

“I congratulate AHCWA and everyone involved because hearing the clear voices of these young Australians is so important for their development now and for future generations,” the Minister said.

NACCHO Aboriginal Health : Download @KenWyattMP speech to @CISOZ : The question of leadership and responsibility in Aboriginal health – addressing the Centre for Independent Studies

 ” Last year, we led a massive group listening program – the My Life My Lead consultations involved 600 people at 13 forums across Australia, plus more than 100 written submissions were received.

Seven priority areas were identified, and are informing the current Closing the Gap refresh agenda.

The priorities we heard from First Australians are:

  • Putting culture at the centre of change
  • Success and wellbeing for health through employment
  • Foundations for a healthy life
  • Environmental health
  • Healthy living and strong communities
  • Health service access, and
  • Health and opportunity through education

We need to be fully committed to sitting down and listening; hearing what’s being said, and continuing to invest in programs that do their work from the ground up.

Policies and services that reflect local voices and wisdom are more closely owned by the people they serve.”

Minister Ken Wyatt MP speaking at Centre for Independent Studies in Sydney yesterday

Download full address or read below

FINAL Wyatt CIS speech 10 April 2018

Family the key to Indigenous health, says Ken Wyatt

Executive summary from the The Australian Stephen Fitzpatrick 

Good parenting rather than increased funding for programs and services is key to improving Indigenous health, the federal minister responsible for the sector has ­declared.

Warning that “doing more of the same is an option we can no longer afford”,

Aboriginal Liberal MP Ken Wyatt said the successes and the failures in indigenous health demonstrated that “responsible parents and families provide the most consistent and enduring interventions”.

“Funding for health programs and services, from public or private sources, will only ever be part of the currency of change,” Mr Wyatt said at a speech to the Centre for Independent Studies in Sydney. “By far the greatest value will come from every mother, father, uncle, aunt and elder every day, taking responsibility for and contributing to better health.”

Calling for a declaration of “non-negotiable standards to be met from the bottom up”, Mr Wyatt said these standards must “reflect the pride of the oldest continuous culture on the planet” but should also extend “far beyond families, to health and community groups and organisations too”.

He said there had for too long been a “piecemeal approach” to indigenous health, with “inadequate accountability” for repeated programs and yet “every time there’s been a new issue or challenge, ­people say we need more money”.

Efforts to close the gap between indigenous and non-indigenous health outcomes would not succeed “until we eliminate the mindset that Aboriginal Australians could be, and even should be on occasions, dealt with differently”.

The current syphilis epidemic in northern Australian indigenous communities, which has prompted the Turnbull government to commit $8.8 million in an attempt to turn its tide seven years after it began, was a case in point.

“If this outbreak had occurred on Sydney’s north shore, in ­Cottesloe in Perth or Toorak in Melbourne — in any city or major town, in fact — there would have been a rapid response years ­earlier,” Mr Wyatt said.

However, he cautioned that there must also be a greater focus on strategies that clearly work, calling for governments and NGOs to “hear the voices of families, of mothers, fathers and community elders, not just the voices of those who are the strongest ­advocates for the establishment of organisations or services”.

He cited the work of Fitzroy Crossing women including Aboriginal and Torres Strait Islander Social Justice Commissioner June Oscar in curbing the spectre of ­fetal alcohol spectrum disorder, saying it had “turned the town around and you now see strong families there, bound by the glue of love and caring”.

He had ordered his department to overhaul a Medicare provision designed for indigenous Australians that provides physical, psychological and social wellbeing assessments as well as preventive healthcare, education and other options to improve health.

He said only 217,000 people ­accessed this provision last year but he wanted this number to rise because “what I want to see is all First Nations people accessing all relevant (Medicare) items in the same way other Australians do”.

He praised the growing number of indigenous health professionals at all levels, “as doctors and nurses, in allied health, administration and management (and) in policy planning and research”.

Mr Wyatt said this was likely to be the best hope for the future, with more than 40 per cent of the 720,000-strong indigenous population aged under 24, so that many of this group were “set to make a big impact across many fields that may help to close the gap”.

Full Speech Minister Ken Wyatt


Download FINAL Wyatt CIS speech 10 April 2018

Thank you Tom, [Switzer, Executive Director, Centre for Independent Studies] for your introduction.

In West Australian Noongar language, I say kaya wangju – hello and welcome.

At the same time, I acknowledge the traditional owners of the land on which we meet, the Gadigal people of the Eora Nation, and pay my respects to Elders past and present.

Today, I want to pose the question: “What is the currency of positive change for the health of First Nations people?”

Is it government or private investment; is it determination; is it personal motivation?

To begin, I’d like those of us who can remember, to think back to 1972.

Australia’s Helen Reddy was topping the international charts and we were getting out of Vietnam.

The Tent Embassy went up at Parliament House in Canberra on Australia Day that year, a symbolic foreign mission erected in the fight for land rights, after years of dashed hopes – an embassy that continues today in the fight for equality.

1972 was a potentially life-changing year for thousands of Aboriginal and Torres Strait Islander Australians.

Prime Minister Gough Whitlam established the Commonwealth Department of Aboriginal Affairs, ushering in an era of bold new promise, building on changes implemented by previous governments following the 1967 referendum.

Looking back – in so many different ways since then – we have come so far.

Yet, since 1972, we have not seen the broad, wholesale change that we would expect, especially given the significant funding and vast amount of good intentions that have been invested in Aboriginal affairs.

Yes, for the first time in several years, we are on track to reach three of the seven Closing the Gap targets – but what lies behind the statistics that still highlight health inequities today?

What have we got right – and wrong – since 1972?

As I travel our nation, I see and hear more and more inspiring stories of First People’s achievement and the journey to equality, from almost every corner of the country.

Perhaps I’m a bit old-fashioned, but I like to call these “jewels in the crown” – because they shine so brightly, and they exemplify the things that work.

One of these is a university college for Aboriginal students I recently launched in Perth.

Now doubling in size six years after it began, it boasts a 90 per cent retention rate, with almost 80 percent of students passing all their exams.

Head to remote communities in the Kimberley and the Pilbara and you’ll find the EON program, literally teaching children how to grow vegetables and good health.

This is especially close to my heart, because I approved the initial, modest, funding to help start the project 10 years ago.

Since then, EON’s employed scores of local Aboriginal people, worked with students and families to create dozens of school vegetable gardens and has run countless cooking classes, including bush tucker, too.

The compelling taste and health benefits of home grown food are one thing; but it’s the ownership, the healthy habits, the skills learned, and the pride that are also helping change young lives.

The EON program’s now in high demand, extending further south in WA and into the Northern Territory this year.

In the Western Desert, the Pintupi Luritja people saw the tragedy of kidney failure and decided it wasn’t going to be a one-way ticket off their beloved country, to being hooked up to dialysis in Alice Springs.

They took control, famously painted and sold precious artworks – and raised a million dollars to start realising their dream.

Eighteen years on, the Purple House project has treatment centres across their vast lands, a mobile dialysis truck and, just as important, a growing primary and preventive health care network.

Not surprisingly, the wraparound approach – from the ground and the street up – most often shows the common denominator of success.

This local impetus is being strongly supported, and replicated with careful community consultation, through significant Turnbull Government programs.

Better Start to Life and its care and family partnerships begin a child’s health journey before conception. We have funded 124 sites nationwide, and counting.

The results are showing fewer low birth weight babies, higher rates of breastfeeding and, in our Australian Nurse Family Partnership Program sites, 100 per cent immunisation rates, the highest in the nation.

At the same time, from Alice Springs to Port Augusta and from Doomadgee to Canberra, the Connected Beginnings program links parents, health care and education, so children are ready to start school, learn and grow into healthy teenagers and adults.

As Nelson Mandela rightly said: “There can be no keener revelation of a society’s soul than the way in which it treats its children.”

But sometimes, I go into communities and I meet with organisations that tell me they are meeting their health targets — the key performance indicators.

I then get permission from Elders to walk around and chat with locals.

On one particular occasion, in the Kimberley, I met a significant Aboriginal artist.

We were walking along and a friend was talking with this painter and I noticed that her eyes looked opaque, so I asked her: How much can you see?

She said: “I can’t see very much at all, I’m hoping for my cataract surgery.”

At that time, it had been a two-year wait – yet the health organisation’s KPIs were being met. How could this be?

In a country as rich and advanced as Australia, how can this happen?

This is not an isolated incident.

Improving overall Aboriginal and Torres Strait Islander health is, first and foremost, critical for the well-being and dignity of hundreds of thousands of First Australians.

But it is also fundamental to our nation’s commitment to equality, and our global health status.

The health of First Nations Australians is everyone’s business.

We must continually celebrate with Aboriginal communities and families the many milestones in health, education, careers and cultural achievement.

At the same time, it is crucial we look carefully at where poorer aspects of health and wellbeing remain.

In these cases, doing more of the same is an option we can no longer afford – the high cost in lives and lost futures is incalculable, and budgets are also under intense pressure.

First Nations knowledge is embedded in the memories of the living – knowledge that is imparted through teaching, storytelling, music, art and dance.

They are our living libraries and losing each individual means a precious book of knowledge is lost forever.

It is imperative that we enable people to be healthy and live longer.

For far too long in Aboriginal health there was a piecemeal approach; series upon series of programs, often with inadequate accountability.

Every time there’s been a new issue or challenge, people say we need more money.

Currently, there are two evaluations underway to identify opportunities to improve; access to quality and effective primary health care services; assess health gains; and identify the social returns and the broader economic benefits of the Indigenous Australians’ Health Program.

While Government investment in the program will continue to grow over the forward estimates, it is imperative – especially for those in greatest need – that we maximise the health value in every dollar.

To illustrate this point I want to look at the current challenges of Sexually Transmitted Infections and Blood Borne Viruses.

Recently, I was asked to approve significant special funding for a targeted program to tackle the increasing prevalence of STIs, particularly the alarming rise of syphilis in northern areas.

When I asked ‘What are the States and Territories doing about this?’ I was disturbed to find too little had been invested and too little done when the first warning signs appeared, almost seven years ago – certainly not to the extent I would have expected from the responsible jurisdictions.

There was still an overwhelming reliance on Commonwealth leadership and funding in order to address the spread of STIs across the Top End.

I committed $8.8 million dollars, to provide a surge approach that is currently ramping up, aiming to turn the tide of infection.

I also make the point that these First Nations people now struggling under the burden of this deadly disease are, first and foremost, citizens of Australia.

If this outbreak had occurred on Sydney’s North Shore, in Cottesloe in Perth, or Toorak in Melbourne – in any city or major town, in fact – there would have been a rapid response years earlier.

I believe there will not be complete success, in terms of Closing the Gap, until we eliminate the mindset that Aboriginal Australians could be, and even should be on occasions, dealt with differently.

Ensuring awareness and respect for First Nations people and culture throughout our health system may be critical to equality of access – but above all, there is a fundamental human right we must accord every one of our citizens, and that is the right to good health.

Picture this scenario.

A doctor based in Kintore – around 2,000 kilometres South-West of Darwin visited the community of Kiwirrkurra located in Western Australia’s sandhill country — the Gibson Desert.

This doctor reports meeting a group of nine nomadic Aboriginal people, and he says:

“…They were the most healthy people I have ever seen…They were literally glowing with health – not an ounce of superfluous fat. They were extremely fit…”

The year was 1984.

Today, we hear a different narrative too often: There is an alarming rise in obesity and diabetes, suicide levels are high, there is alcohol and drug misuse and the impacts of poverty leave many people with a sense of powerlessness.

Too often, First Nations people’s achievements are overshadowed by health and welfare stories of deep, and understandable, concern.

We’re seeing laudable improvements because of interventions, but they’re not always consistent enough, and they’re often not equivalent to results achieved by other sectors within multicultural Australia.

I’m strongly focussed on where we need to improve; on why – even after accounting for the social and environmental impacts on health – we’re still seeing better outcomes for non-Aboriginal people.

For almost 20 years now, the Medicare Benefits Schedule (MBS) has included Item number 715 – a health assessment especially designed to ensure Aboriginal and Torres Strait Islander people receive primary care matched to their needs.

A 715 looks at a patient’s health — physical, psychological and their social wellbeing.

It also assesses what preventative health care, education and other assistance should be offered to improve health and wellbeing.

It’s holistic. Not body part, by body part. The whole body.

Australia’s Aboriginal and Torres Strait Islander population is around 720,000.

Yet only 217,000 people in 2016-17 have been assessed under MBS Item 715.

At the same time, I see organisations such as the Institute for Urban Indigenous Health, that according to their 2016-17 Annual Report have over 33,000 active patients, of which approximately 60 per cent have had their 715 health check.

In 2016-17, the organisations Members’ Network of 19 Aboriginal Community Controlled Health Care Clinics generated more than $14.3 million in Medicare income, with all funds re-invested in the delivery of comprehensive health care for Aboriginal and Torres Strait Islander people in South East Queensland.

What I see here are significantly better results, through completion of a “cycle of care”, comprising the range of chronic disease and other MBS items.

The Institute has grown its clinics from 5 to 19 in the past nine years, with their 20th soon to open in the Moreton Bay region.

I’m excited by this work – the innovation and capacity to change, and the resolve not to accept the status quo of poorer health outcomes.

I look at some of the health disparities and think, why aren’t we as a nation case managing, fundamentally, 720,000 people in a way that would make a difference to so many chronic conditions?

I have asked my department for an overhaul of 715s – what I want to see is all First Nations people accessing all relevant MBS items in the same way that other Australians do.

A key Government focus is on the health of our children, from conception right through to their late teens, so they can grow into strong and healthy men and women who can be the best mentors for their own children.

With more than 1700 First Australians receiving kidney dialysis, and rheumatic heart disease affecting another 6,000 mainly younger people, this year I’ve also prioritised renal health and RHD, along with eye and ear health.

From four national roundtables, we’re now charting Australia’s first roadmaps to coordinate efforts to combat these debilitating and deadly conditions.

It’s absolutely intolerable that RHD among our First Nations people is happening at more than 50 times the rate of other groups in Australian society.

In parts of the Northern Territory, those horrific rates of RHD are doubled again.

And Aboriginal and Torres Strait Islander people under the age of 55 are starting dialysis at twice the rate of non-Aboriginal Australians, with many showing danger signs in their teens.

The unfinished business of today is disappointing because we should be celebrating more successes.

And are community-controlled health organisations and other community groups established to service great need, sitting down enough and asking families and individuals what they know, what they want and what they think would work best?

They must ask: Where is the continuity of service for anyone who requires an intervention to prolong their life or to circumvent an illness?

Minor ailments like skin sores or strep throats, if treated consistently and effectively, won’t develop into early onset renal failure or rheumatic heart disease.

In the same way, neither will ear infections become impaired hearing, that can stunt a child’s learning capacity and their chances of a good job, or any job at all.

There is a need for a holistic approach to the health of each individual.

Some of the benefits flowing from Australia’s recent mining boom have been great employment opportunities, close to country, for thousands of First Nations people.

But the job hopes of many were hampered by deafness contracted in childhood, much to the frustration of mining companies committed to hiring keen local staff.

Hearing and communication are fundamental to fulfilling our life’s potential.

They’re also two of the most valuable commodities for sustainable change in Aboriginal and Torres Strait Islander health.

Governments and non-government organisations across the board must listen to and hear the voices of families, of mothers, fathers and community Elders.

Not just the voices of those who are the strongest advocates for the establishment of organisations or services that, theoretically, should make a difference on the ground.

I say this with no political overtones – the Prime Minister and the Turnbull Government are committed to doing things with Aboriginal and Torres Strait Islander people, not to them.

Last year, we led a massive group listening program – the My Life My Lead consultations involved 600 people at 13 forums across Australia, plus more than 100 written submissions were received.

SEE NACCHO report

Seven priority areas were identified, and are informing the current Closing the Gap refresh agenda.

The priorities we heard from First Australians are:

Putting culture at the centre of change

Success and wellbeing for health through employment

Foundations for a healthy life

Environmental health

Healthy living and strong communities

Health service access, and

Health and opportunity through education

We need to be fully committed to sitting down and listening; hearing what’s being said, and continuing to invest in programs that do their work from the ground up.

Policies and services that reflect local voices and wisdom are more closely owned by the people they serve.

People are empowered, because they’ve been heard, and take responsibility because they’re respected and proud.

Around the nation there are many things that are working and I have seen programs and services where Aboriginal organisations, Aboriginal people and non-Aboriginal people are highly successful in the most difficult of circumstances.

I see June Oscar and her community’s work in Fitzroy Crossing, which has changed the whole dynamic of buying alcohol and curbed the local tragedy of Foetal Alcohol Spectrum Disorder.

Together, they have turned the town around and you now see strong families there, bound by the glue of love and caring.

Alcohol and the bad behaviour of a few no longer defines Fitzroy Crossing, the strength and the story of the community does.

When I think about the successes, as well as the failures, I know that responsible parents and families provide the most consistent and enduring interventions.

Funding for health programs and services, from public or private sources, will only ever be part of the currency of change.

By far the greatest value will come from every mother, father, uncle, aunt and Elder every day, taking responsibility for and contributing to better health.

For over 65,000 years, First Nations people survived and thrived without a plethora of organisations – individual families and communities pulled together, to ensure the health and wellbeing of all.

Working and walking together with local communities, we collectively need to declare non-negotiable standards to be met, from the bottom up.

Standards that also reflect the pride of the oldest continuous culture on the planet.

This individual responsibility extends far beyond families, to health and community groups and organisations, too.

Everyone working to close the gap in health equality must look at themselves and say: Together, we have outcomes to achieve – what difference are we really making today and how can we do better?

We must constantly walk around the communities we serve and look for patterns of disparity.

If that’s what we’re seeing, the question should be: Are we fighting our own people? Are we listening enough?

Fortunately for the future, increasing numbers of young First Nations people are hearing the call to lead the next wave of change.

With more than 40 per cent of our Aboriginal and Torres Strait Islander population aged under 24, large groups – like the undergraduates I met recently at the university college – are set to make a big impact across many fields that may help close the gap.

Through concerted programs around the country, there’s also a growing number of First Nations health professionals at all levels – as doctors and nurses; in allied health, administration and management; in policy, planning and research.

My message to them and to all Aboriginal and Torres Strait Islander people, in communities across this nation, is that we are proud descendants of those who came here at least 65,000 years ago.

We have proven incredibly resilient, and we’ll continue that tradition of resilience, and respect for our country and for all Australians.

But the strength of our cultural identity will always remain the basis for our health – and what we strive for and live for.

Thank you.

 

NACCHO Media Alerts : Top 10 Current Aboriginal Health News Stories to keep you up to date

1. Aboriginal sexual health: The Australian : Was the syphilis epidemic preventable ? NACCHO responds

2.Royal Flying Doctors Service extra 4-year funding $84 million Mental Health and Dental Services

3.Nurses PAQ continues political membership campaign spreading false and misleading information about our cultural safety

4.AMSANT has called for re-doubled efforts to implement the recommendations of the Royal Commission into the care and protection of children in partnership with NT Aboriginal leaders

5.Dialysis facilities worth $17 million are sitting padlocked, empty and unused in WA’s north

6.ALRC Report into Incarceration of Aboriginal and Torres Strait Islander People.

7. Minister Ken Wyatt : Listening to Indigenous Needs: Healthy Ears Program Extended with $29.4 commitment

8.Tangentyere Alice Springs Women’s Family Safety Group visits Canberra

9.Minister Ken Wyatt launches our NACCHO RACGP National Guide to a preventative health assessment for Aboriginal and Torres Strait Islander people

10. Your guide to a healthy Easter : #Eggs-actly  

 

1.Aboriginal sexual health: The Australian : Was the syphilis epidemic preventable ? NACCHO responds

“These (STIs) are preventable diseases and we need increased testing, treatment plans and a ­culturally appropriate health ­education campaign that focuses resources on promoting safe-sex messages delivered to at-risk ­communities by our trained Aboriginal workforce,”

Pat Turner, chief executive of peak body the National Aboriginal Community Controlled Health Organisation, is adamant about this.

Read full article in Easter Monday The Australian or Part B below

2.Royal Flying Doctors Service extra 4-year funding $84 million Mental Health and Dental Services

Read full press release here

 

3.Nurses PAQ continues political membership campaign spreading false and misleading information about cultural safety

SEE NACCHO Response

SEE an Indigenous Patients Response

See Nurses PAQ Misleading and false campaign

4. AMSANT  has called for re-doubled efforts to implement the recommendations of the Royal Commission into the care and protection of children in partnership with NT Aboriginal leaders

Read full AMSANT press Release

Listen to interview with Donna Ah Chee

Press Release @NACCHOChair calls on the Federal Government to work with us to keep our children safe

#WeHaveTheSolutions Plus comments from CEO’s @Anyinginyi @DanilaDilba

4.Dialysis facilities worth $17 million are sitting padlocked, empty and unused in WA’s north

Read full Story HERE

6.ALRC Report into Incarceration of Aboriginal and Torres Strait Islander People;

Read Download Full Transcript

Senator Patrick Dodson

Download the report from HERE

Community Groups Call For Action on Indigenous Incarceration Rates

7. Minister Ken Wyatt : Listening to Indigenous Needs: Healthy Ears Program Extended with $29.4 commitment

The Australian Government has committed $29.4 million to extend the Healthy Ears – Better Hearing, Better Listening Program, to help ensure tens of thousands more Indigenous children and young adults grow up with good hearing and the opportunities it brings.

Read Press Release HEAR

8.Tangentyere Alice Springs Women’s Family Safety Group visits Canberra

This week the Tangentyere Women’s Family Safety Group from Alice Springs were in Canberra. They shared with politicians, their own solutions for their own communities, and they are making an enormous difference.
Big thanks to all the Tangentyere women who made it to Canberra.

Read Download the Press Release

TANGENTYERE WOMEN’S FAMILY SAFETY GROUP (FED

9. Minister Ken Wyatt launches our NACCHO RACGP National Guide to a preventative health assessment for Aboriginal and Torres Strait Islander people

Read press releases and link to Download the National Guide

10. Your guide to a  healthy Easter : #Eggs-actly  

And finally hope you had a Happy Easter all you mob ! After you have enjoyed your chocolate eggs and hot cross buns , this is how much exercise you will require to work of those Easter treats .

For medical and nutrition advice please check with your ACCHO Doctor , Health Promotion / Lifestyle teams or one of our ACCHO nutritionists

 

Part B Full Text The Australian Article Easter Monday

There is no reason it should have happened, especially not in a first-world country like Australia, but it has: indigenous communities in the country’s north are in the grip of wholly treatable sexually transmitted diseases.

In the case of syphilis, it is an epidemic — West Australian Labor senator Patrick Dodson ­described it as such, in a fury, when health department bureaucrats mumbled during Senate estimates about having held a few “meetings” on the matter.

There have been about 2000 syphilis notifications — with at least 13 congenital cases, six of them fatal — since the outbreak began in northern Queensland in 2011, before spreading to the Northern Territory, Western Australia and, finally, South Australia.

What’s worse, it could have been stopped. James Ward, of the South Australian Health and Medical Research Institute, wrote in mid-2011 that there had been a “downward trend” over several years and it was likely at that point that the “elimination of syphilis is achievable within indigenous ­remote communities”.

But governments were slow to react, and Ward is now assisting in the design of an $8.8 million emergency “surge” treatment approach on the cusp of being rolled out in Cairns and Darwin, with sites in the two remaining affected states yet to be identified.

It will be an aggressive strategy — under previous guidelines, you had to have been identified during a health check as an active carrier of syphilis to be treated. Now, anyone who registers antibodies for the pathogen during a blood prick test, whether actively carrying syphilis or not, will receive an ­immediate penicillin injection in an attempt to halt the infection’s geographical spread.

This is key: the high mobility of indigenous people in northern and central Australia means pathogens cross jurisdictions with ­impunity. Australian Medical ­Association president Michael Gannon calls syphilis a “clever bacterium that will never go away”, warning that “bugs don’t respect state borders”.

Olga Havnen, one of the Northern Territory’s most respected public health experts, points out that many people “will have connections and relations from the Torres Strait through to the Kimberley and on to Broome — and it’s only a matter of seven or eight kilometres between PNG and the northernmost islands there in the Torres Strait”.

“This is probably something that’s not really understood by the broader Australian community,” Havnen says. “I suspect once you get a major outbreak of something like encephalitis or Dengue fever, any of those mosquito-borne diseases, and that starts to encroach onto the mainland, then people will start to get a bit worried.”

Olga Havnen, CEO of the Danila Dilba Health Service, says transmission is complex issue in Australia’s indigenous communities.
Olga Havnen, CEO of the Danila Dilba Health Service, says transmission is complex issue in Australia’s indigenous communities.

But it is not just syphilis — ­indeed, not even just STIs — that have infectious disease authorities concerned and the network of Aboriginal Community Controlled Health Organisations stretched.

Chlamydia, the nation’s most frequently diagnosed STI in 2016 based on figures from the Kirby Institute at the University of NSW, is three times more likely to be contracted by an indigenous Australian than a non-­indigenous one.

The rate was highest in the NT, at 1689.1 notifications per 100,000 indigenous people, compared with 607.9 per 100,000 non-indigenous Territorians. If you’re indigenous, you’re seven times more likely to contract gonorrhoea, spiking to 15 times more likely if only women are considered. Syphilis, five times more likely.

As the syphilis response gets under way, health services such as the one Havnen leads, the Darwin-based Danila Dilba, will be given extra resources to tackle it. “With proper resourcing, if you want to be doing outreach with those people who might be visitors to town living in the long grass, then we’re probably best placed to be able to do that,” she says.

But the extra focus comes with a warning. A spate of alleged sexual assaults on Aboriginal children, beginning with a two-year-old in Tennant Creek last month and followed by three more alleged ­attacks, has raised speculation of a link between high STI rates and evidence of child sexual assault.

After the first case, former NT children’s commissioner Howard Bath told this newspaper that STI rates were “a better indicator of background levels of abuse than reporting because so many of those cases don’t get reported to anyone, whereas kids with serious infections do tend to go to a ­doctor”. Others, including Alice Springs town councillor Jacinta Price and Aboriginal businessman Warren Mundine, raised the ­spectre of the need for removing more at-risk indigenous children from dangerous environments.

Children play AFL in Yeundumu. Picture: Jason Edwards
Children play AFL in Yeundumu. Picture: Jason Edwards

However, Sarah Giles, Danila Dilba’s clinical director and a medical practitioner of 20 years’ standing in northern Australia, warns this kind of response only exacerbates the problem. She is one of a range of public health authorities who, like Havnen, say connecting high STI figures to the very real scourge of child sex abuse simply makes no sense. They do not carry correlated data sets, the experts say.

“One of the things that’s really unhelpful about trying to manage STIs at a population level is to link it with child abuse and mandatory reporting, and for people to be fearful of STIs,” Giles says. “The problem is that when they’re conflated and when communities feel that they can’t get help ­because things might be misinterpreted or things might be reported, they’re less likely to present with symptoms. The majority of STIs are in adults and they’re sexually transmitted.”

Havnen says there is evidence of STIs being transmitted non-sexually, including to children, such as through poor hand ­hygiene, although Giles says that is “reasonably rare”. And while NT data shows five children under 12 contracted either chlamydia or gonorrhoea in 2016 (none had syphilis), and there were another five under 12 last year, Havnen points to the fact that over the past decade there has been no increasing trend in under 12s being affected. Where there has been a rise in the NT is in people aged between 13 and 19, with annual gonorrhoea notifications increasing from 64 cases in the 14-15-year-old ­female cohort in 2006 to 94 notifications in 2016.

In the 16-17-year-old female ­cohort the same figures were 96 and 141 and in the 12-13-year-old group it rose from 20 in 2006 to 33 in 2016. Overall, for both boys and girls under 16, annual gonorrhoea notifications rose from 109 in 2006 to 186 in 2016, according to figures provided to the royal ­commission into child detention by NT Health. Havnen describes the rise as “concerning but not, on its own, evidence of increasing ­levels of sexual abuse”.

Ward is more direct. Not all STIs are the result of sexual abuse, he warns, and not all sexual abuse results in an STI. If you’re a health professional trying to deal with an epidemiological wildfire, the distinction matters — the data and its correct interpretations can literally be a matter of life and death.

Indeed, in its own written cav­eats to the material it provided to the royal commission, the department warns that sexual health data is “very much subject to variations in testing” and warns against making “misleading assumptions about trends”. Ward says: “Most STIs notified in remote indigenous communities are ­assumed to be the result of sex ­between consenting adults — that is, 16 to 30-year-olds. Of the under 16s, the majority are 14 and 15-year-olds.” He says a historically high background prevalence of STIs in remote indigenous communities — along with a range of other ­infectious diseases long eradicated elsewhere — is to blame for their ongoing presence. Poor education, health services and hygiene contribute, and where drug and ­alcohol problems exist, sexually risky behaviour is more likely too. The lingering impact of colonisation and arrival of diseases then still common in broader ­society cannot be underestimated.

But Ward claims that an apparently high territory police figure of about 700 cases of “suspected child sexual offences” in the NT over the past five years may be misleading. He says a large number of these are likely to be the result of mandatory reporting, where someone under 16 is known to have a partner with an age gap of more than two years, or someone under 14 is known to be engaging in sexual activity. Ward points out that 15 is the nationwide ­median sexual debut age, an age he suggests is dropping. At any rate, he argues, child sex abuse is unlikely to be the main reason for that high rate of mandatory ­reporting in the NT.

Areyonga is a small Aboriginal community a few hours drive from Alice Springs.
Areyonga is a small Aboriginal community a few hours drive from Alice Springs.

Data matters, and so does how it is used. Chipping away at the perception of child sexual abuse in indigenous communities are the latest figures from the Australian Institute of Health and Welfare showing the rate of removals for that crime is actually higher in non-indigenous Australia.

According to a report this month from the AIHW, removals based on substantiated sex abuse cases in 2016-17 were starkly different for each cohort: 8.3 per cent for indigenous children, from a total of 13,749 removals, and 13.4 per cent for non-indigenous children, from 34,915 removals.

Havnen concedes there is a need for better reporting of child abuse and has called for a confidential helpline that would be free of charge and staffed around the clock by health professionals.

It’s based on a model already in use in Europe that she says deals with millions of calls a year — but it would require a comprehensive education and publicity campaign if it were to gain traction in remote Australia. And that means starting with the adults.

“If you’re going to do sex ­education in schools and you start to move into the area about sexual abuse and violence and so on, it’s really important that adults are ­educated first about what to do with that information,” she says. “Because too often if you just ­educate kids, and they come home and make a disclosure, they end up being told they’re liars.”

These challenges exist against the backdrop of a community already beset by a range of infectious diseases barely present elsewhere in the country, including the STIs that should be so easily treatable. It is, as Havnen is the first to admit, a complex matter.

Cheryl Jones, president of the Australasian Society for Infectious Diseases, says the answer is better primary treatment solutions and education, rather than trying to solve the problem after it has ­occurred. “For any of these public health infectious disease problems in ­remote and rural areas, we need to support basic infrastructure at the point of care and work alongside communities to come up with ­solutions,” she says.

Sisters play in the mud after a rare rain at Hoppy's 'town camp' on the outskirts of Alice Springs.
Sisters play in the mud after a rare rain at Hoppy’s ‘town camp’ on the outskirts of Alice Springs.

Pat Turner, chief executive of peak body the National Aboriginal Community Controlled Health Organisation, is adamant about this. “These (STIs) are preventable diseases and we need increased testing, treatment plans and a ­culturally appropriate health ­education campaign that focuses resources on promoting safe-sex messages delivered to at-risk ­communities by our trained Aboriginal workforce,” Turner says.

The Australian Medical ­Association has called for the formation of a national Centre for Disease Control, focusing on global surveillance and most likely based in the north, as being “urgently needed to provide national leadership and to co-ordinate rapid and effective public health responses to manage communicable diseases and outbreaks”.

“The current approach to disease threats, and control of infectious diseases, relies on disjointed state and commonwealth formal structures, informal networks, collaborations, and the goodwill of public health and infectious disease physicians,” the association warned in a submission to the Turnbull government last year.

However, the federal health ­department has rebuffed the CDC argument, telling the association that “our current arrangements are effective” and warning the suggestion could introduce “considerable overlap and duplication with existing functions”.

“I think it (the CDC) might have some merit, if it helps to ­advocate with government about what needs to happen,” Havnen says, “but if these things are going to be targeted at Aboriginal bodies, it needs to be a genuine partnership. It’s got to be informed by the realities on the ground and what we know. That information has to be fed up into the planning process.”

NACCHO Aboriginal Health #CloseTheGap Research @GregHuntMP and @KenWyattMP announces $6 million 3 year funding for Aboriginal led , only Academic Health Science Centre in Australia with a primary focus on #Aboriginal and #remote health

As the only Academic Health Science Centre in Australia with a primary focus on Aboriginal and remote health, we are pleased that Minister Hunt is leading on the front foot with an announcement such as this.

It’s especially pleasing that this is happening just as we are about to engage with a wide consultation between our members over health research priorities in Central Australia in the coming years—this three year commitment allows us to do this with confidence.

The Centre is already working in key areas such as endemic HTLV-1 infection, exploring the complex interplay between communicable and chronic disease as well as exploring the capacity of the primary health care sector to reduce avoidable hospitalisations,”

The Chairperson of the Central Australia Academic Health Science Centre [CA AHSC] John Paterson has welcomed the commitment over three years of significant research funding to the Centre by Federal Health Minister Greg Hunt.

“Research projects that will be supported will emphasise those based on community need and initiative especially as expressed by the Aboriginal partner organisations, though this will not necessarily preclude externally identified needs. 

In any case, we will focus on comprehensive approaches to consultation and participation in the ethical design of research projects, the carriage of the research, and the rapid implementation of positive research results.

A key activity will be that of building future leaders in the Aboriginal research workforce. We have already started this critical work with the first meeting of a network of more than 15 Aboriginal researchers in Central Australia.”

A health research partnership benefitting Warumungu, Arrernte (Eastern), Pintupi, Pitjantjatjarra, Arrernte (Central), Yankunytjarra, Luritja, Arrernte (Western), Warlpiri, Anmatyere, Ngaanyatjarra, Kaytetye and Alyawarre speakers across Central Australia

Project website

Press Release : Medical research to uncover better treatment for Indigenous Australians

The Turnbull Government will invest more than $6 million in a health science centre in Alice Springs which is focused on addressing health challenges faced by Indigenous Australians.

The Central Australia Academic Health Science Centre will receive $6.1 million over three years from the Medical Research Future Fund (MRFF).

This funding will support better treatment and diagnosis of health challenges experienced by Indigenous Australians.

The Centre brings together top researchers, medical experts and local communities to look at ways to improve healthcare options for the specific health challenges facing Indigenous Australians.

The Central Australia Academic Health Science Centre is the first Aboriginal-led collaboration of its kind and demonstrates the importance of Aboriginal community leadership in research and health improvement.

See NACCHO Coverage of launch July 2017

Aboriginal Health #NAIDOC2017 : New Aboriginal-led collaboration has world-class focus on boosting remote Aboriginal health

These projects will directly benefit regional and remote Aboriginal communities and it is our hope that medical research will help in closing the gap on disadvantage.

The first priority project that will be supported through the Central Australia Academic Health Science Centre will be a study into addressing HTLV-1.

Additional areas that will be considered by the Centre include addressing research into ear and eye health, renal health and dialysis, children and maternity health in Indigenous communities.

Indigenous health is one of the Turnbull Government’s fundamental priorities and while progress has been made on some key indicators, with male and female life expectancy increasing and child mortality and smoking rates decreasing, more needs to be done.

Today I am also pleased to announce more than $740,000 of MRFF funding for University of Queensland researchers to undertake a world-first project, in collaboration with Aboriginal communities, to find ways to improve Aboriginal food security and dietary intake in cities and remote areas.

Poor diet and food insecurity are major contributors to the excess mortality and morbidity suffered by Aboriginal and Torres Strait Islander people in Australia.

The Turnbull Government is committed to improving the health services for Indigenous Australians and we will continue to invest in better treatment, care and medical research.

NACCHO Aboriginal #SexualHealth debate #CloseTheGap : Media reports ” Warning on sexually transmitted diseases ignored ” corrected by Minister

 ” Indigenous Affairs Minister Nigel Scullion ignored a plea from a government MP more than a year ago to implement a $25 million policy to combat sexually transmitted diseases gripping Aboriginal communities, instead adopting a $9m program that remains stalled.

The Australian has obtained a letter penned by Liberal senator Dean Smith warning that the rise of STIs in indigenous communities was “disturbing” and urged Senator Scullion to take immediate action, describing the situation as “critical”.

See Minister Scullion’s  Correction part 2 below

 ” The Minister for Indigenous Health, Ken Wyatt, has confirmed that the surge response is not “stalled” as The Australian has claimed and is being rolled out in partnership with the States and Territories as well as Aboriginal Community Controlled Health Organisations.”

Front Page of the Australian this morning

“I’m sure you would agree that the increase in rates are disturbing and it’s critical that we tackle this challenge head on to ensure the problems do not escalate to a crisis point,” Senator Smith told Senator Scullion in December 2016.

When contacted yesterday about the letter, Senator Scullion shifted blame for the government’s inaction to Indigenous Health Minister Ken Wyatt.

Senator Scullion’s spokesman told The Australian he passed Senator Smith’s letter on to the “health portfolio”.

The letter, addressed to Senator Scullion and copied to Mr Wyatt and former health minister Sussan Ley, outlined a ­detailed proposal drafted by ­experts James Ward and Frank Bowden, in consultation with the National Aboriginal Community Controlled Health Organisation, to tackle a syphilis epidemic in ­indigenous communities.

Professor Ward yesterday confirmed he had meetings with Senator Scullion, Mr Wyatt and Health Minister Greg Hunt about his policy proposal. The Ward-Bowden policy was drafted following meetings with Ms Ley.

Six children have died from gestational syphilis since the epidemic emerged in north Queensland in 2011 and later spread to the Northern Territory, Western Australia and South Australia.

The government sat on the $25m policy until last November when it agreed to adopt one third of it as part of an $8.8m plan to tackle the syphilis outbreak in central and northern Australia.

The two other elements of the proposed three-year program — to reduce HIV risks and broader STI risks in Aboriginal communities — were rejected.

Since announcing the watered-down policy, the government has failed to rollout the program ­despite bureaucrats holding meetings about its implementation since August, before its funding was signed off by Mr Wyatt.

Mr Wyatt said yesterday the rollout would begin in Cairns and Darwin in May. He said the syphilis outbreak was an “absolute ­priority” and had been targeted on a national basis since 2015 but more funding was needed because the states had not contained it.

“This is why the Chief Medical Officer is leading a nationally co-ordinated enhanced response to the outbreak in conjunction with states and territories who have the primary role for delivering sexual health services and dealing with infectious disease outbreaks,” Mr Wyatt said.

Professor Ward said adopting only a third of the policy would ­reduce its efficacy and cost the community more money to address the problem in the long term.

“We put it to them in December 2016 and they still haven’t rolled out any of it. I don’t mean to make any judgment about whether they are dragging their heels or not,” Professor Ward said.

Olga Havnen, chief executive of the Darwin-based Danila Dilba health service, said she was consulted on Professor Ward’s policy and expressed anger it had not been adopted in full.

“It is obscene, it is ridiculous. If you are going to tackle STIs then it would have made sense to do a comprehensive response,” she said. “This is a preventable disease and, I can tell you now, if this was happening in the major suburbs of Sydney or Melbourne there would have been ­urgent and immediate action.”

Retired Aboriginal magistrate Sue Gordon, who chaired the Howard government’s Northern Territory intervention taskforce, said it was about time state and federal governments took the issue seriously.

Labor indigenous senator Pat Dodson said: “The government has not taken the outbreak seriously enough and have not taken appropriate action to tackle the outbreak, otherwise we would not be in this situation.”

Part 2 **CORRECTION**

Minister for Indigenous Affairs
Senator the Hon. Nigel Scullion

Correction to incorrect reporting in The Australian newspaper

Thursday 15 March 2018
Today’s Australian article by Greg Brown, Sex disease warning ignored,  incorrectly states I ignored a letter by Senator Dean Smith in December 2016 regarding a plan to tackle increasing rates of Sexually Transmissible Infections (STIs) in the Indigenous population.

This is grossly misleading and entirely incorrect. I did not ignore Senator Smith’s letter or the request contained in it but referred it to the Indigenous Health portfolio as the relevant and appropriate portfolio with responsibility for Indigenous Health issues. I responded to Senator Smith on this basis.

Notwithstanding that States and Territories have primary responsibility for delivering sexual health services and dealing with infectious disease outbreaks, the Minister for Indigenous Health announced a nationally coordinated surge response in November last year to address the rising rates of STIs in the Aboriginal and Torres Strait Islander population.

The Minister for Indigenous Health, Ken Wyatt, has confirmed that the surge response is not “stalled” as The Australian has claimed and is being rolled out in partnership with the States and Territories as well as Aboriginal Community Controlled Health Organisations.

Questions about the status of the surge response or the proposal referred to in this article should be referred to the Department of Health, as is appropriate.

To suggest however that I ignored any warnings regarding the protection of human life is absolutely repugnant and appalling and I reject any such assertion unequivocally.

This is yet another example of ill-informed and incorrect reporting of Indigenous issues by The Australian newspaper.

NACCHO Aboriginal Health Alert : Download The 2018 Closing the Gap report finds that for the first time since 2011, three out of the seven #ClosingtheGap targets are on track to be met

Closing the Gap aims to improve the lives of Aboriginal and Torres Strait Islander Australians.

In 2008, the Council of Australian Governments (COAG) set targets aimed at eliminating the gap in outcomes between Indigenous and non-Indigenous Australians.

The 2018 Closing the Gap report finds that for the first time since 2011, three out of the seven Closing the Gap targets are on track to be met.

Download the Report HERE

ctg-report-2018

Download the Executive Summary

NACCHO Executive summary 2018 Closing the Gap Report

Current Closing the Gap targets:

  • Close the gap in life expectancy within a generation (by 2031)
  • Halve the gap in mortality rates for Indigenous children under five within a decade (by 2018)
  • 95 percent of all Indigenous four-year-olds enrolled in early childhood education (by 2025) – renewed target
  • Close the gap between Indigenous and non-Indigenous school attendance within five years (by 2018)
  • Halve the gap for Indigenous children in reading, writing and numeracy achievements within a decade (by 2018)
  • Halve the gap for Indigenous Australians aged 20-24 in Year 12 attainment or equivalent attainment rates (by 2020)
  • Halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade (by 2018).

In 2018 four of the seven targets will expire. Commonwealth, state and territory governments have agreed to work together with Aboriginal and Torres Strait Islander leaders, organisations, communities and families on a refreshed agenda and renewed targets.

It will be important to look at what has worked well over the last decade, and where more needs to be done. COAG leaders have welcomed a focus on a strength-based approach that supports Indigenous advancement. All levels of government will work with Aboriginal and Torres Strait Islander people in genuine partnership to develop renewed targets that are measurable and meaningful.

A Taskforce has been established in the Department of the Prime Minister and Cabinet to progress this important work.

Any enquires about the process can be sent to ClosingtheGapRefresh@pmc.gov.au. Further details and opportunities to contribute to the process will be made available soon

The rich history of Australia’s First Peoples stretches back at least 65,000 years – and is celebrated as one of the longest living civilisations on earth.

It is a history based on the extraordinary strength and resilience of Aboriginal and Torres Strait Islander people, their families and communities. This endurance of human life and caring for country is both profound and inspiring.

The cultural strength and resilience of Aboriginal and Torres Strait Islander people continue to play a significant role in creating pathways for healing and addressing the trauma inflicted upon Australia’s First Peoples through past policies.

Over the past year we have spent time acknowledging significant moments in Australia’s modern history that brought us closer together as a nation:the 50th anniversary of the successful 1967 referendum and the 25th anniversary of the Mabo High Court decision.

The 1967 referendum and Mabo High Court decision were momentous occasions that followed Indigenous and non-Indigenous Australians standing side by side – campaigning for recognition of what has always been true; that Aboriginal and Torres Strait Islander people have cared for this country for tens of thousands of years. That their songs have been sung since time out of mind and these songs have held and passed on the knowledge of customs and traditions for 65,000 years.

These anniversaries are humbling reminders that enduring reform and change only occur when we bring all Australians along; that the continued march of reconciliation in this country is not an inexorable one and requires the leadership and relentless pragmatism of those campaigners we honoured in 2017.

We have a unique opportunity in 2018 – a decade after Australia committed to a new framework called Closing the Gap – to reflect, and recommit and renew our collective efforts and focus on improving outcomes for Aboriginal and Torres Strait Islander people.

As we look back on the 10 years that the Closing the Gap framework has been in place, there is much to celebrate.

  • Today, the annual growth rate of Supply Nation registered Indigenous businesses is an average of 12.5 per cent – the envy of all other sectors of the Australian economy.
  • Today, Aboriginal and Torres Strait Islander people, on average, are living longer than ever before – and factors contributing to the gap such as death from circulatory disease (heart attack and stroke) are going down.
  • Today, around 14,700 Aboriginal and Torres Strait Islander children are enrolled in early childhood education the year before full-time school, and there have been improvements in literacy and numeracy.
  • And today, more Aboriginal and Torres Strait Islander children are staying in school through to Year 12. While closing the employment gap is challenging, we know educational attainment opens pathways to greater economic opportunity and can make an important difference in the lives of Aboriginal and Torres Strait Islander people.

This reflects the efforts of successive governments – but more importantly, the efforts of First Australians to reach their full potential and live lives that they value. Importantly, it is something we should all be proud of.

The Closing the Gap framework has provided the architecture for Commonwealth, state and territory governments to work with Aboriginal and Torres Strait Islander people in a holistic way to improve outcomes.

Indigenous and non-Indigenous Australians, as well as governments, need to nurture honest, transparent, robust relationships based on mutual respect. It is a journey all Australians are walking.

Although much progress has been made, we know we have a continuing journey ahead of us to truly Close the Gap.  Like any great journey, we must ensure we continually review and realign our collective efforts based on what the data, the outcomes, and the people are telling us.

What is clear is we must continue to maintain a long-term vision of what success looks like, and importantly how success is defined by Aboriginal and Torres Strait Islander people themselves.

In this 10th Closing the Gap report, the Australian Government commits to staying the course with our First Australians – and working to help deliver a prosperous future.

The Hon Malcolm Turnbull MP
Prime Minister of Australia

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