Aboriginal #Nutrition Health and #Sugar : @healthgovau Health Star Rating System review closes 17 August

 ” The Health Star Rating System has been marred by anomalies. Milo powder (44% sugar) increased its basic 1.5 Stars to 4.5 by assuming it will be added to skim milk. About one in every seven products bearing health stars goes against the Department of Health’s own recommendations.

Those of us working in public health question why obvious junk foods get any stars at all.”

See Sugar, sugar everywhere MJA insight article in full Part 3 below

  ” In 2012-13, Aboriginal and Torres Strait Islander people 2 years and over consumed an average of 75 grams of free sugars per day (equivalent to 18 teaspoons of white sugar)1. Added sugars made up the majority of free sugar intakes with an average of 68 grams (or 16 teaspoons) consumed and an additional 7 grams of free sugars came from honey and fruit juice. “

ABS Report abs-indigenous-consumption-of-added-sugars 

See Part 1 below for Aboriginal sugar facts

The Health Star Rating (HSR) Advisory Committee (HSRAC), responsible for overseeing the implementation, monitoring and evaluation of the HSR system is undertaking a five year review of the HSR system.

The five year review of the system is well underway, with a public submission process opening on 8 June 2017 on the Australian Department of Health’s online Consultation Hub.

Since the consultation period has been opened there has been strong interest in the system from stakeholders representing a diverse range of views.

To ensure that as much evidence as possible is captured, along with stakeholders’ views on the system, a further two week extension to the consultation period has been agreed and it will now close on 17 August 2017

See full survey details Part 2 Below

Part 1 Aboriginal sugar facts

ABS Report

abs-indigenous-consumption-of-added-sugars

Aboriginal and Torres Strait Islander people consume around 14 per cent of their total energy intake as free sugars, according to data from the Australian Bureau of Statistics (ABS).

The World Health Organization (WHO) recommends that free sugars contribute less than 10 per cent of total energy intake.

Director of Health, Louise Gates, said the new ABS report showed Aboriginal and Torres Strait Islander people are consuming an average of 18 teaspoons (or 75 grams) of free sugars per day (almost two cans of soft drink), four teaspoons more than non-Indigenous people (14 teaspoons or 60 grams).

OTHER KEY FINDINGS

    • Aboriginal and Torres Strait Islander people derived an average of 14% of their daily energy from free sugars, exceeding the WHO recommendation that children and adults should limit their intake of free sugars to less than 10% of dietary energy.
    • Free sugars made the greatest contribution to energy intakes among older children and young adults. For example, teenage boys aged 14-18 years derived 18 per cent of their dietary energy from free sugars as they consumed the equivalent of 25 teaspoons (106 grams) of free sugars per day. This amount is equivalent to more than two and a half cans of soft drink. Women aged 19-30 years consumed 21 teaspoons (87 grams) of free sugars, which contributed 17 per cent to their total energy intake.
    • The majority (87%) of free sugars were consumed from energy dense, nutrient-poor ‘discretionary’ foods and beverages. Two thirds (67%) of all free sugars consumed by Aboriginal and Torres Strait Islander people came from beverages, led by soft drinks, sports and energy drinks (28%), followed by fruit and vegetable juices and drinks (12%), cordials (9.5%), and sugars added to beverages such as tea and coffee (9.4%), alcoholic beverages (4.9%) and milk beverages (3.4%).
    • Intakes were higher for Aboriginal and Torres Strait Islander people living in non-remote areas where the average consumption was 78 grams (18.5 teaspoons), around 3 teaspoons (12 grams) higher than people living in remote areas (65 grams or 15.5 teaspoons).
    • Aboriginal and Torres Strait Islander people consumed 15 grams (almost 4 teaspoons) more free sugars on average than non-Indigenous people. Beverages were the most common source of free sugars for both populations, however Aboriginal and Torres Strait Islander people derived a higher proportion of free sugars from beverages than non-Indigenous people (67% compared with 51%).

Part 2 @healthgovau Health Star Rating System review closes 17 August

Introduction

The Health Star Rating (HSR) Advisory Committee (HSRAC), responsible for overseeing the implementation, monitoring and evaluation of the HSR system, is undertaking a five year review of the HSR system. The HSR system is a front-of-pack labelling (FoPL) scheme intended to assist consumers in making healthier diet choices. The findings of the review will be provided to the Australia and New Zealand Ministerial Forum on Food Regulation (Forum) in mid‑2019.

In parallel with this consultation on the HSR system five year review, the HSRAC is conducting a dedicated investigation of issues and concerns raised about the form of the food (‘as prepared’) rules in the Guide for Industry to the HSR Calculator. These enable additional nutrients to be taken into account when calculating star ratings based on foods prepared according to on-label directions. A specific consultation process seeking input into this investigation opened on 19 May 2017 and will close at 11.59 pm 30 June 2017. The form of the food (‘as prepared’) consultation can be viewed on the Australian Department of Health’s Consultation Hub.

The HSR system

The HSR system is a public health and consumer choice intervention designed to encourage people to make healthier dietary choices. The HSR system is a voluntary FoPL scheme that rates the overall nutritional profile of packaged food and assigns it a rating from ½ a star to 5 stars. It is not a system that defines what a ‘healthy’ or ‘unhealthy’ food is, but rather provides a quick, standardised way to compare similar packaged foods at retail level. The more stars, the healthier the choice. The HSR system is not a complete solution to assist consumers with choosing foods in line with dietary guidelines, but should be viewed as a way to assist consumers to make healthier packaged food choices.  Other sources of information, such as the Australian Dietary Guidelines and the New Zealand Eating and Activity Guidelines, also assist consumers in their overall food purchasing decisions.

The HSR system aims to:

1. Enable direct comparison between individual foods that, within the overall diet, may contribute to the risk factors of various diet related chronic diseases;

2. Be readily understandable and meaningful across socio-economic groups, culturally and linguistically diverse groups and low literacy/low numeracy groups; and

3. Increase awareness of foods that, within the overall diet, may contribute positively or negatively to the risk factors of diet related chronic diseases.

The HSR system consists of the graphics, including the words ‘Health Star Rating’, the rules identified in the HSR system Style Guide, the algorithm and methodology for calculating the HSR identified in the Guide for Industry to the HSR Calculator, and the education and marketing associated with the HSR implementation.

The HSR system is a joint Australian, state and territory and New Zealand government initiative developed in collaboration with industry, public health and consumer groups. The system is funded by the Australian government, the New Zealand government and all Australian jurisdictions during the initial five year implementation period.

From June 2014, food manufacturers started to apply HSRs to the front of food product packaging. Further information on the HSR system is available on the HSR website. The New Zealand Ministry for Primary Industries (MPI) website also provides information on the HSR system in New Zealand.

Purpose and scope of the review
The five year review of the HSR system will consider if, and how well, the objectives of the HSR system have been met, and identify options for improvements to and ongoing implementation of the system (Terms of reference for the five year review).

With a focus on processed packaged foods, the objective of the HSR system is:

To provide convenient, relevant and readily understood nutrition information and /or guidance on food packs to assist consumers to make informed food purchases and healthier eating choices.

The HSRAC has agreed that the areas of communication, system enhancements, and monitoring and governance will be considered when identifying whether the objectives of the HSR system have been achieved.

Although HSRAC will need to be a part of the review process, a degree of independence is required and independent management and oversight of the review is an important factor to ensure credible and unbiased reporting. An independent consultant will be engaged to undertake the review. Specific detail about the scope of the review will be outlined in the statement of requirement for the independent consultant. A timeline for the five year review of the HSR system has been drafted and will be updated throughout the review.

Next steps in the review process

As part of the five year review, HSRAC is seeking evidence based submissions on the consultation questions provided in this discussion paper.

This consultation is open to the public, state and territory governments, relevant government agencies, industry and public health and consumer groups.

Making a submission

The HSRAC is seeking submissions on the merits of the HSR system, particularly in response to the consultation questions below. The aim of the questions is to assist respondents in providing relevant commentary. However, submissions are not limited to answering the questions provided.  Please provide evidence or examples to support comments. Some areas of this review are technical in nature therefore comments on technical issues should be based on scientific evidence and/or supported by research where appropriate. Where possible, please provide citations to published studies or other sources.

While the HSRAC will consider all submissions and proposals put forward, those that are not well supported by evidence are unlikely to be addressed as part of the five year review.

Enquiries specifically relating to this submission process can be made via email to: frontofpack@health.gov.au. Please DO NOT provide submissions by email.

After the consultation period closes the HSRAC will consider the submissions received and will prepare a summary table of the issues raised which will be published on the HSR website. All information within the summary table will be de-identifiable and will not contain any confidential material.

HSRAC will treat information of a confidential nature as such. Please ensure that material supplied in confidence is clearly marked ‘IN CONFIDENCE’ and is provided in a separate attachment to non-confidential material. Information provided in the submissions will only be used for the purpose of the five year review of the HSR system and will not be used for any other purpose without explicit permission.

Please see the Terms of Use and Privacy pages at the bottom of this page for further information on maintaining the security of your data.

For further information about the HSR system, including its resources and governance structure, please refer to the Australian HSR website and the New Zealand MPI website.

Part 3 Sugar Sugar MJA Insights

Originally published Here

IT’S hard to escape sugar, not only in what we eat and drink, but also in the daily news and views that seep into so many corners of our lives.

There’s nothing new about concern over sugar. I can trace my own fights with the sugar industry back to the 1960s, and since their inception in 1981, the Australian Dietary Guidelines have advised limiting sugary foods and drinks. The current emphasis in many articles in newspapers, magazines, popular books and online blogs, however, go further and recommend eliminating every grain of the stuff from the daily diet.

Taking an academic approach to the topic, the George Institute for Global Health has published data based on the analysis of 34 135 packaged foods currently listed in their Australian FoodSwitch database. They found added sugar in 87% of discretionary food products (known as junk foods in common parlance) and also in 52% of packaged foods that can be described as basic or core foods.

The George Institute’s analysis is particularly pertinent to the Department of Health’s Health Star Rating System, and found that some of the anomalies in the scheme could be eliminated by penalising foods for their content of added sugars rather than using total sugars in the product, as is currently the case.

The definition of “added sugars” used in Australia also needs attention, a topic that has been stressed in the World Health Organization’s guidelines. I will return to this later.

In Australia, the nutrition information panel on the label of packaged foods must include the total sugars present. This includes sugars that have been added (known as extrinsic sugars) as well as any sugars present naturally in ingredients such as milk, fruit or vegetables (intrinsic sugars).

There is no medical evidence to suggest that intrinsic sugars are a problem – at least not if they occur in “intact” ingredients. If you consume fruit, for example, the natural dietary fibre and the bulk of the fruit will limit the amount of the fruit’s intrinsic sugars you consume. However, if the sugar is extracted from the structure of the fruit, it becomes easy to consume much larger quantities. Few people could munch their way through five apples, but if you extract their juice, the drink would let you take in all the sugar and kilojoules of five apples in less than a minute.

The Australian Dietary Guidelines do not include advice to restrict fruit itself because there is high level evidence of its health value. The guidelines do, however, recommend that dried fruit and fruit juice be restricted – the equivalent of four dried apricot halves or 125 mL juice consumed only occasionally.

Contrary to the belief of some bloggers, Australia’s dietary guidelines have never suggested replacing fat with sugar. That was a tactic of some food companies who marketed many “low” or “reduced” fat foods where the fat was replaced with sugars or some kind of refined starch.

The wording of Australia’s guideline on sugar has changed. The initial advice to “avoid too much sugar” led to the sugar industry’s multimillion dollar campaign “Sugar, a natural part of life”. This included distributing “educational” material to the general public, politicians, doctors, dentists, pharmacists and other health professionals discussing the importance of a “balanced diet”.

In spite of fierce lobbying by the sugar industry, the next revision of the guidelines retained a sugar guideline, although it was watered down to “eat only moderate amounts of sugars”. Some school canteen operators reported that they had been confronted by sweet-talking sellers of junk foods omitting the word “only” from this guideline.

The evidence for sugar’s adverse effects on dental health have long been known, but the evidence against sugar and its potential role in obesity and, consequently, in type 2 diabetes and other health problems has grown stronger. The most recent revision of the National Health and Medical Research Council’s Dietary Guidelines, therefore, emphasises the need to “limit” added sugars and lists the foods that need particular attention.

Sugary drinks have been specifically targeted because the evidence against them is strong and extends beyond epidemiological studies. Double-blind trials now clearly link sugary drinks with weight gain, the only exceptions being a few trials funded by the food industry.

Added sugar is not the only topic for public health concern, and hence the government’s Health Star Rating System was set up to introduce a simple front-of-pack labelling scheme to assist Australians reduce their intake of saturated fat, salt and sugars from packaged foods.

A specially commissioned independent report (Evaluation of scientific evidence relating to Front of Pack Labelling by Dr Jimmy Chun Yu Louie and Professor Linda Tapsell of the School of Health Sciences, University of Wollongong) found that added sugars were the real problem, but the food industry argued that the scheme should include total sugars because this was already a mandatory inclusion on food labels and routine chemical analysis couldn’t determine the source of sugars.

This was a strange argument since food manufacturers know exactly how much sugar they add to any product, just as they know how many “offset” points the Health Star Rating System allows for the inclusion of fruit, vegetable, nuts or legumes. The content of these ingredients is only disclosed on the food label if used in the product’s name.

The Health Star Rating System has been marred by anomalies. Milo powder (44% sugar) increased its basic 1.5 Stars to 4.5 by assuming it will be added to skim milk. About one in every seven products bearing health stars goes against the Department of Health’s own recommendations.

Those of us working in public health question why obvious junk foods get any stars at all.

How can caramel topping or various types of confectionery, such as strawberry flavoured liquorice, each get 2.5 stars? Why do some chocolates sport 3.5 stars, while worthy products such as Greek yoghurt without any added sugars get 1.5 and a breakfast cereal with 27% sugar gets four stars?

The fact that over a third of Australian’s energy intake comes from discretionary products (40% for children) is the elephant in the room for excess weight. We need to reduce consumption of these products and allotting them health stars is not helping.

It’s clearly time to follow our dietary guidelines and limit both discretionary products and added sugar. Of the nutrients used in the current algorithm for health stars, the George Institute’s analysis shows that counting added rather than total sugars has the greatest individual capacity to discriminate between core and discretionary foods.

However, in moving to mandate added sugars on food labels and using added sugars in health stars, it’s vital to define these sugars. The World Health Organization has done so: “Free sugars refer to monosaccharides (such as glucose, fructose) and disaccharides (such as sucrose or table sugar) added to foods and drinks by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates”.

Regular sugar in Australia could be described as cane juice concentrate. It has no nutrients other than its carbohydrate. Fruit juice concentrates are also just sugars with no nutrients other than carbohydrates. At present the Health Star Rating System allows products using apple or pear juice concentrate to be counted as “fruit” and used to offset the total sugars. This is nonsense, and gives rise to confectionery, toppings and some breakfast cereals scoring stars they do not deserve.

Other ways to boost health stars also need attention. Food technologists boast they can manipulate foods to gain extra stars (Health Star Rating Stakeholders workshop, Sydney, 4 August 2016). For example, adding wheat, milk, soy or other protein powder, concentrated fruit purees or a laboratory-based source of fibre such as inulin will all give extra “offset” points to reduce adverse points from saturated fat, sugar or salt. Indeed, some food technologists have even suggested they could revert to using the especially nasty trans (but technically unsaturated) fatty acid from partially hydrogenated vegetable oils to replace naturally occurring saturated fat.

My alternative is to go for fresh foods and minimise packaged foods. If the stars look too good to be true, check the ingredient list. But remember that Choice found sugar may go by more than 40 different names. Buyer beware!

NACCHO Aboriginal Health : #Healthcarehome ACCHO services starts roll out 1 October 2017

 

” During the stage one trial, 200 general practices and Aboriginal Community Controlled Health Services in ten regions around Australia will start delivering Health Care Homes services.

Twenty practices will begin Health Care Home services on 1 October 2017. The other 180 will begin on 1 December 2017.

People with chronic and complex conditions, who could benefit from Health Care Homes’ flexible, coordinated care can enrol as Health Care Homes patients “

About Health Care Homes

One in four Australians have at least two chronic health conditions1. For these people, our health system can seem hard to navigate and disjointed. Different health professionals and services work in isolation from each other; care is often un-coordinated; and patients can find it difficult to get to different services and appointments.

A Health Care Home is a general practice or Aboriginal Community Controlled Health Service (ACCHS) that coordinates care for patients with chronic and complex conditions

In an Australian first, 200 practices and ACCHS around Australia will soon begin trialling Health Care Homes. Twenty practices will begin Health Care Home services on 1 October 2017. The other 180 will begin on 1 December 2017.

People with chronic and complex conditions, who could benefit from Health Care Homes’ flexible, coordinated care can enrol as Health Care Homes patients.

A patient who is eligible can choose to enrol, and also chooses a GP – usually the GP they have already been seeing – who knows them, their health conditions and priorities. This doctor leads a care team which will look after that patient.

Together, a patient and their care team will then develop and follow a shared care plan which will:

  • set health goals
  • include strategies to help each patient better manage their conditions and improve their quality of life
  • identify the best local providers who can meet each patient’s needs.

In line with this plan, Health Care Homes will also coordinate that patient’s care. For example, if a patient sees their specialist or goes to hospital, their Health Care Home will follow up. That way, they know about all the care that person receives, both inside and outside the Health Care Home.

Rather than receiving a payment each time a patient has an appointment, Health Care Homes will be paid a monthly payment to care for a patient’s chronic and complex conditions. This flexible funding allows Health Care Homes to be innovative in the way they care for their patients.

Many people with chronic and complex conditions are bulk billed by their GP. Health Care Homes are encouraged to continue to bulk bill enrolled patients. However, it will be up to each Health Care Home to tell patients if they will pay a gap fee.

To find out more about Health Care Homes, go to www.health.gov.au/healthcarehomes

Newsletter July Extracts

1.Best-practice examples of chronic disease management in Australia

The aim of this resource is to showcase practical examples of how different clinics across Australia use a variety of patient-centred and best-practice approaches to chronic disease management.

You will find a series of practice snapshots, quotes and case studies, which help illustrate key components of Health Care Homes including:

Download Providers_practice case studies_coordinated carev.2

1.2 Engaging hard-to-reach patients: Aboriginal Community Controlled Health Service

“We see some patients who live in the bush. They have multiple health issues — they are on multiple medications, have limited health literacy, English as a second language, low-socio economic circumstances and are transient.”

“They might come into the clinic for first-aid or for immediate health issues, but they rarely come in for their check-ups or for medication for their long-term conditions.”

“Instead they need to be followed up. We often find that they are not taking their medication, or not in the way it was intended.”

“We have care coordinators — either a registered nurse, an Aboriginal health worker or a staff member — who can case-manage the patient’s care. The care coordinators make sure the patient gets the full level of follow-up required. We also use an electronic recall system as part of the patient notes and have regular meetings to discuss complex patients.”

1.3 Aboriginal Community Controlled Health Service: advanced roles for nurses and Aboriginal health workers

“Our nurses and Aboriginal health workers (AHW) do a lot of case management and palliative care. This includes using telemedicine so that the patients can remain on country if they chose to die, rather than have further treatment.”

“They practice according to the Central Australian Rural Practitioners Association manual and clinical guidelines. These are the best practice clinical guidelines that registered nurses and AHWs follow to diagnose, treat, prescribe medications, order testing and refer patients.”

“They also do INR management, administer thrombolytic therapy and generally manage patients with complex conditions based on the registered care plans created by the doctors.”

“Our GPs oversee the medical management of patients, develop complex clinical care plans for other staff to administer, and review patients as referred by other team members when there are concerns with the management or condition of the patient. So the GPs are kind of like the conductor of the orchestra.”

2. Health Care Homes FAQs June 2017

Download Health Care Homes FAQs June 2017

Extracts Aboriginal Community Controlled Health Services (ACCHS)

 Will ACCHS be able to continue to access the other Commonwealth funding sources if they participate in stage one? If an ACCHS becomes a Health Care Home could they still also receive block funding for primary health care services?

Yes. Participating ACCHS can continue to access grant payments made under the Indigenous Australians’ Health Programme (IAHP), including funding for primary health care activity.

Funding for PHNs to commission integrated team care (ITC) services will also continue at current levels in stage one. An ACCHS which participates in Health Care Homes’ stage one will still be able to tender to provide ITC services.

If participation in the PIP eHealth Incentive (ePIP) is a requirement for practices to apply for Health Care Homes, will this exclude ACCHS if they are not ePIP registered?

All participating practices or ACCHS must register for ePIP before 1 December 2017.

 If patients voluntarily enrol with a participating medical clinic, how will this work for transient patients?

Enrolled patients will still be able to access MBS benefits if they need to see a different health care provider outside their Health Care Home. Transient patients may be able to be treated by a number of Health Care Homes, where a lead Health Care Home would be nominated and manage the distribution of funds accordingly. Such arrangements would need to be negotiated between participating Health Care Homes.

For patients who move between communities and who are not able to nominate and agree to a preferred Health Care Home provider, MBS billing may be more suitable than Health Care Home enrolment.

Are patients who are being care coordinated under the Integrated Team Care (ITC) activity funded by the Department of Health/PHN eligible for Health Care Home services?

Patients receiving care coordination support under an ITC activity who also meet Health Care Home eligibility requirements can be considered for Health Care Home enrolment in stage one. The Health Care Home care planning process will include an assessment of the range of services that an enrolled patient is currently receiving or eligible to access. The resulting care plan and services received should complement and not duplicate the services provided to enrolled patients.

Evaluation

What sort of information will practices need to provide for the evaluation? What KPIs are proposed and will providers be measured on health outcomes, outputs or activities?

Stage one of Health Care Homes will be evaluated to establish what works best for different patients and practices and in different communities with different demographics. The evaluation will need to examine the implementation process as well as the impact of the model. Findings will be used to make refinements to the model before government consideration of any further national roll out.

Health Care Homes will be required to participate in the evaluation by providing data in a number of ways.

The evaluation is not designed to measure the performance of individual practices or providers. Data will be aggregated and then analysed to examine how the model worked in various situations and settings. Practices will provide de-identified patient data from clinical software using an automated extraction process.

An evaluation plan will be developed in 2017. It will include details on the indicators, measures and methods of data collection. It is expected that this will include a range of information on patient and provider experience, practice processes, such as referrals and recording of risk factors, and care provision methods, quality of care and service use. In addition, it is expected to include general clinical indicators, such as blood pressure, BMI or smoking status.

Health Care Home practices will also provide information through surveys and a sample of practices will also participate in interviews or focus groups. These methods will inform the evaluation of the implementation process, types of care provided to patients and changes to practice service delivery model.

As part of the data collection process, information may be fed back to practices to assist them to benchmark their progress against national and regional averages. This information may help practices in their quality improvement activities and may assist PHNs to better target practice support activities. In this case, practice level data would only be seen by the practice itself. Data provided to PHNs would be aggregated across all practices.

What sort of information will patients need to provide for the evaluation?

Patient experience of the Health Care Home model will be a key issue for the evaluation. Patients will likely provide data for the evaluation through participation in surveys, interviews and focus groups.

Patients will also be asked to consent to their de-identified clinical data being extracted from within practice information systems as well as to the linking of their MBS, Pharmaceutical Benefits Scheme and hospital data for the purposes of the evaluation.

Patient participation in data collection for the evaluation will be voluntary.

Will there be a duplicate reporting requirement for ACCHS? For instance, ACCHS who report on National Aboriginal Health Key Performance Indicators (KPIs) using Pencat or Canning Tool?

The department will endeavour to minimise duplication wherever possible. One issue that will require consideration is that reporting on National Aboriginal Health KPIs is done at an aggregate level. In order to measure the effect of the Health Care Home model on patients across time, the evaluator will need to be able to link the data from individual patients across time points, and this is not likely to be possible using data that is aggregated at the practice level. The department will work with the Indigenous sector to determine the best use of available data.

How will reports be required? Electronically? Monthly?

Practices will provide de-identified patient data from clinical software using an automated extraction process. The timing and processes for data extraction, and other methods of evaluation data collection, is currently being considered.  Outside of the evaluation data collection methods, there will be reporting requirements for Health Care Homes regarding enrolment and assurance activities.

3.KPMG report on payment model now available

Following the general advice provided by the ATO, the Department of Health commissioned KPMG to provide further information on the implications of the Health Care Home payment model for participating general practices and Aboriginal and Community Controlled Health Services in relation to their exposure to employment tax obligations.

Download KPMG – Health Care Homes employment tax information

This is now available here in Latest Updates:  more information e-newsletters, fact sheets and booklets

Letters of offer sent out to selected Health Care Homes

Letters of offer, along with program information, are now being sent to selected general practices and Aboriginal Community Controlled Health Services. Participation of selected Health Care Homes will be confirmed when organisations formally accept. Stay tuned.

Check out our Health Care Home resources

For FAQs, fact sheets, case studies and e-newsletters, go to the Health Care Homes for health professionals‘ page then to more information e-newsletters, fact sheets and booklets. Other resources on this page include:

  • Health Care Homes information booklet
  • Minimum requirements of shared care plans fact sheet
  • Payment information fact sheet
  • Patient eligibility fact sheet
  • Stage one modelling fact sheet 
  • Health Care Homes and the quadruple aim
  • Case studies: Best practice examples of chronic disease management
  • E-newsletters — you can subscribe to and see the latest Health Care Homes e-newsletters on the more information page.

NACCHO Aboriginal Health News : Indigenous Health Minister @KenWyattMP visits , promotes and engages with our ACCHO’s during #NAIDOC2017 week

 

 “ This week, celebrating and acknowledging the power of our languages, the importance of language, but even where we’ve think we’ve lost languages I’m often surprised with the older people within our communities who can still speak the language.

And in my own country there are people teaching Noongar language and reviving the veracity of the language. Now language often is an identifier of who we are and what country we’re associated with.

NAIDOC Week is about celebrating, enjoying ourselves within our community, having fun, but also reflecting. 

Alice Springs : Ken Wyatt being interviewed by Kyle Dowling from CAAMA radio about Congress ACCHO Alice Springs and  the 11 organisations partnering in the new Central Australia Academic Health Science Centre SEE PART 3 Below

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

Victoria / VACCHO / VAHS

APY LANDS

Kowanyama /Cairns QLD  :

“I am closely involved with the Darwin and Kimberley suicide prevention trials, part of the Federal Government’s $192 million commitment to addressing regional mental health issues,

“What we learn from those sites, which have acute suicide rates, will be made available as appropriate for North Queensland, in close collaboration with local communities.”

Mr Wyatt, in was Cairns  speaking at the myPHN Conference (see Part 3 for PHN Press Release ) said close engagement with the community and respecting locally endorsed solutions to guard against suicide was the way forward

Part 1  : Minister rolls out mental health action plan for Kowanyama

FINDINGS from suicide prevention trials being carried out in Western Australia will be implemented in the Far North to help lower the rising suicide rate in indigenous communities.

From The Cairns Post

Indigenous Health Minister Ken Wyatt says he is “very concerned” about reports of the suicide rates in the region’s remote indigenous population growing to become one of the highest in the world.

The Weekend Post has reported concerns by community leaders at Kowanyama that the mental health crisis was sparked by the tragedy in the community in October, when a vehicle rammed into a house full of mourners, resulting in one death and 25 people being serious injured.

There had been more than 20 suicides or attempts at Kowanyama, which has a population of about 1200, since the ­October tragedy.

Mr Wyatt, was Cairns  speaking at the myPHN Conference, said close engagement with the community and respecting locally endorsed solutions to guard against suicide was the way forward.

“I am closely involved with the Darwin and Kimberley suicide prevention trials, part of the Federal Government’s $192 million commitment to addressing regional mental health issues,” he said.

“What we learn from those sites, which have acute suicide rates, will be made available as appropriate for North Queensland, in close collaboration with local communities.”

An experienced social work has been flown into Kowanyama to join a mental health clinical nurse consultant who travels to the remote Cape York community for four-day visits.

Mr Wyatt said further emergency action was underway with the federally-funded Northern Queensland Primary Health Network working with the Royal Flying Doctor Service to expand mental health services at Kowanyama.

“This additional commitment has already ensured an extra clinician for the community, to provide support and targeted suicide prevention activities with this full-time position starting on Tuesday, July 11,” he said.

If you or someone you know needs assistance please call Lifeline Australia on 13 11 14.

Cairns Apunipima

 Part 2  : Working with communities to deliver better health is our primary aim
The nation’s Primary Health Networks (PHNs) are being encouraged to work closely with communities to tackle health challenges and improve the wellbeing of all Australians.
Aged Care Minister and Indigenous Health Minister Ken Wyatt said he hoped opening the 2nd annual myPHN Conference in Cairns today would help guide a new era in effective and efficient care.
 
This year’s conference theme of ‘Transforming Healthcare Together’ challenges current beliefs on the best ways to improve patient outcomes,” said Minister Wyatt.
“PHNs are leading the charge in this space. After undertaking detailed analysis of their regions’ specific health needs, they are now commissioning services to fill these gaps.
 
“These range from building the capacity of General Practitioners (GPs) and tackling mental health, chronic conditions and obesity, to engaging with consumers in disease prevention.
The Minister said the first stage of the national trial of Health Care Homes was another example of the fresh approach to the care of people with complex conditions.
“Participating GPs and Aboriginal Community Controlled Health Services will work closely with patients and specialists, pharmacists and allied health care to empower patients to take an active role in health improvements,” he said.
 
Minister Wyatt said primary health providers had a vital role in helping improve Indigenous health and that of older Australians.
“Despite the progress we’ve made to date, Indigenous people still have a shorter life expectancy and are more likely to develop chronic conditions such as diabetes  kidney and cardiovascular diseases than non-Indigenous Australians,” Minister Wyatt said.
 
We have to do better, and primary health professionals are well placed to develop innovative new programs that can make a real difference.”
A good example is the Northern Queensland PHN workforce investment, including funding more than 100 Aboriginal and Torres Strait Islander people to become qualified indigenous health workers. 
 
The conference also focuses on how social and cultural influences can effect  health outcomes, promising new hope for closing the life expectancy gap for Indigenous Peoples.
 
Innovation and new thinking will help deliver a stronger health and aged care system,” said Minister Wyatt.
 
“Learning from the experiences of other communities and nations will also keep older Australians healthier for longer, and give them more flexibility on when and how they access care as they age.
“Better health is a partnership between governments, the health sector, and the consumer. Greater collaboration and new models of care promise positive outcomes.”

Part 3 Transcript of Interview on CAAMA Radio with Kyle Dowling on 5 July 2017

Ken Wyatt:What I like about the centre is that it is an alliance of organisations that have been heavily involved in research around many of the health issues impacting on our people. But what’s more important significant is that Congress is the lead agency or the lead player in all of this and having that Aboriginal leadership working so closely with the expertise and knowledge and skills and capability of research is fantastic.

Kyle Dowling: Ken Wyatt, the Federal Minister for Indigenous Health and Aged Care, recently congratulated the 11 organisations partnering in the new Central Australia Academic Health Science Centre.

Ken Wyatt: Any of us have the capability and capacity to take leading voices. It’s whether we have the confidence and courage to do it at times. And I think Congress has really set a framework for showing that they are leaders. That they are prepared to go and fight for the things they believe in, but equally they work very closely with people who’ve got a like-minded thinking who want to make a difference.

I think the other part that is important in this is their voices are also about translating research into real change on the ground in the community with families. And that’s an important translation of research into practice. And they’ve been around a long time so their knowledge of the health of people within the area, but not only the area, but nationally has been well-based on being involved with the community, listening to community, but treating community for the range of illnesses that they’ve seen over the years. So I want to complement them on their vision, but also being a leader to demonstrate that our voices do count. That they are important.

Kyle Dowling: : So Ken, can you just talk to us about the actual role of the Central Australia Academic Health Centre and the importance of the collaboration between Aboriginal community-controlled health services and leading medical researchers.

Ken Wyatt:What’s important about the centre is that it’s now recognised as a centre of excellence for research. That means it gives them access to Commonwealth funding out of the Futures Research Fund, but also NHMRC funding as well. They’re also recognised as being of a national standing in the quality of what they are capable of doing, but the team they have within that alliance. So you’re really saying that you- you’ve brought together this incredible group of skills, resources and thinking that will be used to tackle some of those complex issues on the ground.

Yesterday, Alan Cass talked about renal disease and the work that affected him into making the decision to look at the whole issue of progression to dialysis and what we still need to do. And he talked about some of the alarming figures here that- when you think about the number of Aboriginal people within the Territory- those figures are extremely high. So we’ve got to do something about it and that’s what he’s talking about when he is involved in this collaborative centre.

Kyle Dowling: Why Central Australia? Why was this area the right place for the centre?

Ken Wyatt: Look, I think it’s just natural to expect it to be here because you’ve got an incredible organisation like Congress. You have Aboriginal leadership here whose thinking and whose passion for making a difference for people here and across Australia. But you’ve also got these incredible alliances with Flinders Uni, Baker IDI, and there’s other collaborative members of that group who are also deliverers of services. And if we think of the history of the Territory, there have been some outstanding individuals that have been involved. So you only have to look at the Menzies Research Centre, the work that they have done. It’s a natural fix and it’s a good mix of bringing some incredible people together to work on these issues.

Kyle Dowling: Now the partners in the CAAHSC have identified research priorities. Can you touch on a little bit of those?

Ken Wyatt: The five areas that they have identified are good, but the one that excites me is the whole issue of workforce and development of capacity. But developing of capacity for Aboriginal research- there was a young woman I met yesterday who has become a researcher and her passion for that work now is growing. It’s- and she becomes an example for others that research is an important area and that I can do it, so can you. And that workforce capacity also means that they will be looking at, not only what’s needed today, but the type of skills we’ll need for tomorrow and the future. And aged care is in that mix.

I had a good meeting with Congress this morning about older people who live in this area that I need to have a look at the issues around their needs, but equally be made aware of the number of older people now living in community and what we have to do for them.

Kyle Dowling: Now, Central Research has been dubbed a hub of hope for Indigenous health. How would you describe Central Research as in fact being a hub of help for Indigenous hope.

Ken Wyatt: That whole hub of hope I see in an optimistic sense. I see it as a group of people believing what they do, but then wanting to turn that into having access to further work they have to do to find and identify reasons. And I use the term causes of the cause.

So what are the causes that cause an illness or what are the causes that cause renal failure. And then to look at how do we go upstream and prevent that from happening. So if it’s skin diseases, if it’s other factors that result in kidney failure, then how do we address and tackle those. But equally what they’ll be looking at is what treatment can we provide and what treatment can we also think about providing at the local community level because the problem with dialysis is that you really need to live with the chairs are that provide you with that life-saving support. But ultimately if we can find a cure for kidney failure then that makes it far more expecting of pushing out life, but also preventing kidney failure and giving people in any individual hope for a future, hope for a longer life because the point I want to make is that every person we lose out of our community is a history book.

We never write our histories, we never write our stories on paper. We only learn in transmission in conversation, art, the stories we tell dance. Now when we take one of those people out, that’s the end of that story. We can never go back and re-read it, and that’s why that the work that this centre does is critical in keeping people alive longer because young people like you will need the knowledge of the stories, but also the history and every aspect that gives us what is important spiritually, culturally, but as an identity as an individual within our community.

Kyle Dowling: Before I do let you go, I did just want to get a quick message from you. It is NAIDOC Week. Your message to everyone across the country on NAIDOC weekend, what NAIDOC means to you as an Aboriginal person?

Ken Wyatt: This week, celebrating and acknowledging the power of our languages, the importance of language, but even where we’ve think we’ve lost languages I’m often surprised with the older people within our communities who can still speak the language. And in my own country there are people teaching Noongar language and reviving the veracity of the language. Now language often is an identifier of who we are and what country we’re associated with.

NAIDOC Week is about celebrating, enjoying ourselves within our community, having fun, but also reflecting.

Kyle Dowling: Yes, well on that note, Ken thank you for taking out your time to have a chat with us here on CAAMA Radio and thank you for tuning in.

That’s going to be it for Strong Voices today. Thank you for tuning in. I hope you enjoyed the program. Make sure you check out our CAAMA webpage. It’s caama.com.au. Make sure you check out our social media as well -our Facebook and Twitter. And we’ll be back the same time tomorrow.

NACCHO Aboriginal Health News alert : Health sector responds to third Federal health minister in 2 years

hunt-and-pm

Greg Hunt has been named Australia’s new Health Minister as part of Prime Minister Malcolm Turnbull’s fourth reshuffle since taking the top office.

Mr Hunt is also the third Federal Health Minister in 2 years after Peter Dutton and Sussan Ley

3 HM

See below for 8 responses from the health sector including AMA , AHHA, CHF, Winnunga ACCHO Pharmacy Guild of Australia , RACGP , Menzies Centre for Health Policy and Labor ( where you can also download their press releases )

NACCHO will be posting its response separately today

Ken Wyatt becomes first Indigenous person in Commonwealth ministry as Minister for Indigenous Health and Aged Care

kw

What’s in store for new health minister Greg Hunt –  A Primary care trial for 2017

The other areas of unfinished business according to Jim Gillespie ( see reponse 8 below ) offer more prospects. The government’s Health Care Homes pilot, commencing in July 2017, is a response to calls for a health system that is more focused on community-level primary care.

The experiment has been heavily criticised for a lack of funding and attempts to micromanage systems that are meant to be increasing GP initiatives.

With more political commitment, it could shift Australian health care towards rewarding prevention and more effective management of chronic illness. The alternative is expensive, disconnected high-tech patches to a system increasingly inaccessible to ordinary consumers.

1.Indigenous health, mental health, and prevention are priorities says AMA

“The AMA would like to see Mr Hunt get off to a flying start by scrapping the Government’s freeze of Medicare patient rebates, which is causing great hardship for patients and doctors,

The new Minister must also quickly get across the many reviews instigated by his predecessor, most importantly the review of the Medicare Benefits Schedule (MBS) and the review of Private Health Insurance, which are key to the sustainability of our health system.

The ongoing issue of public hospital funding is another priority, along with Indigenous health, mental health, and prevention.”

Download AMA Press Release ama

 AMA President, Dr Michael Gannon, today welcomed the appointment of Greg Hunt as Health Minister, saying that Mr Hunt’s experience as a senior Minister in the Environment and Industry portfolios should prepare him for the demands of the Health portfolio.

Dr Gannon said that Mr Hunt, who has been in Federal politics since 2001, and who was named Best Minister in the World at the 2016 World Government Summit, faces many challenges from day one in his new job.

2. WINNUNGA ACCHO welcomes new ministers

Winnunga Nimmityjah Aboriginal Health Service (Winnunga AHS) welcomes the appointment of Greg Hunt as Minister for Health, and the appointment of Australia’s first federal Indigenous Minister with Ken Wyatt’s elevation to the role of Minister for Aged Care and Indigenous Health.

“He comes in fresh and hopefully keeps an open mind and that between him and Ken we can really make some progress,”

With a sorry history of funding cuts in the health sector, Ms Tongs hopes the new minister, working with his newly-elevated colleague, Ken Wyatt, will see that keeping funding in “preventative health” will continue to save substantial money in the longer term.

“Greater effort, and resources, are crucial to preventative health so that we are not forever dealing with the impact of chronic disease,”

Ms Tongs praised the appointment of Ken Wyatt as Minister for Aged Care and Indigenous Health as “an excellent move by the Prime Minister”.

“I think that as minister for Indigenous health Ken will work in collaboration with our community.

“As an Aboriginal man I believe that he is aware of the challenges that face the Aboriginal health sector and Aboriginal health needs. He sees how valuable our sector is as an integral part of the health system right across the country,”

“I know that Minister Wyatt is keen to come to Winnunga AHS, and it would be good if he brought Mr Hunt with him.

“It’s about us and Minister Wyatt educating Minister Hunt about our sector,”

The Aboriginal Community-Controlled Health sector, more than being value for money, actually saves the community much more than it costs.

“We’ve had an economist look at our numbers, and we’ve got child protection, and a lot of other unfunded services that we provide here, so the $8.5 million we are funded actually provides a $40 million benefit to the ACT.

Download press release new-health-ministers-press-release

CEO, Julie Tongs is keen for both of the new ministers for health to come and take a tour of Winnunga AHS. She praised the appointment of Ken Wyatt as Minister for Aged Care and Indigenous Health as “an excellent move by the Prime Minister”.

 Mr Hunt’s appointment also offers a “real opportunity” for a fresh start in the health sector.

3.Health Care Homes reform must deliver positive results for governments says AHHA

‘Greg Hunt is seen by his peers as a safe pair of hands, and a good performer. We are hoping that he will bring to the job a coordinated and considered approach to health policy, supporting a strong public sector as well as the private system, but always having regard to equity and affordability for patients.

‘Unfortunately, some policy decisions in the recent past, designed to streamline the system and save money, for example the freeze on Medicare rebates, have had their own side-effects of significant increases in out-of-pocket costs, and patients delaying seeking medical care as a result.

‘Delays in seeking care can lead to higher costs later on for the health system if that patient presents later in a worse state of health through lack of medical attention’

‘The positive Health Care Homes primary care reform initiated by the former Minister Sussan Ley will continue, but there are also substantial associated risks with this, including the funding of the program, its design, and its supporting e-health and data infrastructure.

‘Mr Hunt must consider these issues as the 2017–18 budget is formulated. The Health Care Homes reform must deliver positive results for governments, health services and consumers, or it will go the way of previous primary care reform attempts.

Download press release ahha

Australian Healthcare and Hospitals Association Chief Executive Alison Verhoeven

4.It is time for a National Vision for Australia’s Health 2025 says CHF

” The Health portfolio is currently in the midst of a wide range of changes and reforms, and we look forward to engaging with the new Minister to progress these important issues

It is clear that the community values the current health system – particularly our current universal public health insurance scheme – and wants all Australians to have access to quality health services. We understand that reform is necessary if the system is to be sustainable and continue to meet community expectations.”

We encourage the new Minister to recognise the value and place of Medicare as many voters do. Well-managed changes to modernise Medicare and make it fit-for-purpose for the 21st century will include both costs and savings and must include steps to y ensure quality and equitable healthcare. Balancing health system priorities will not be easy and we recognise the fiscal challenges in ensuring Medicare continues to offer realistic benefits for patient care.

In our 2017 Federal budget submission we outline consumers’ priorities for health. We commend it to the Minister as a guide for consumers wants and needs in his new portfolio” “It is time for a National Vision for Australia’s Health 2025 and for the government to move away from the current budgetary requirement for all new health expenditures to be offset by savings in the health portfolio.

We also suggest that action is taken in the following five key areas for consumers: prevention, primary health care, private health insurance, pharmacy and patient safety and participation.

Download press release chf-australia

CHF’s chief executive officer, Leanne Wells said

5. Labor is giving the new Health Minister a “to-do” list 

to-do

This morning the Turnbull Government changed their salesperson, but they didn’t change their health policy.

Greg Hunt will start day one as Health Minister inheriting a list of cuts and policies which will make health care more expensive and less accessible for every Australian.

Labor is giving the new Health Minister a “to-do” list on behalf of the millions of Australians who rejected this Governments unfair health policy at the last election:

  • Drop the Medicare freeze, which is already having an impact on bulk billing rates
  • and will drive up out-of-pocket costs;
  • Drop the unfair health cuts, such as cuts to pathology and bulk billing which will
  • make it more expensive to have vital tests and life-saving scans;
  • Reverse the cuts of $400 million to dental programs for children
  • And once and for all, drop the zombie cuts such as the planned increases to PBS co-payments for general patients, concession patients and those with chronic illnesses.

Millions of Australians rejected Malcolm Turnbull’s unfair cuts at the last election. The Liberals didn’t listen – they took the same cuts to 2017 that they took to the last election.

Time and time again, Malcolm Turnbull has proven that he simply doesn’t get it when it comes to the health of Australians.

A change of Minister won’t do anything unless the policies change as well.

Download press Release labor-response

CATHERINE KING MP SHADOW MINISTER

6.There are a number of unresolved issues of concern to community pharmacy in Australia

” Greg Hunt takes over the portfolio at a time when there are a number of unresolved issues of concern to community pharmacy in Australia

It is critical that these issues are addressed and resolved quickly and satisfactorily to give security to community pharmacists so they can continue their work in improving the health outcomes of all Australians.

During the year the Sixth Community Pharmacy Agreement will reach its halfway mark and the Pharmacy Guild is committed to working with the Minister and the Federal Government to ensure the Agreement’s funding is fully and appropriately expended on programs and initiatives to improve health outcomes for patients and consumers.

To achieve this we need to work together to resolve any and all outstanding issues to clear the way to move forward.

Full Press Release

The National President of the Pharmacy Guild of Australia, George Tambassis, said the Guild looked forward to working closely and constructively with Mr Hunt during what is a challenging time for the health system, and in particular for the community pharmacy sector.

7. The provision of essential medical care for Australians has reached a crossroads and the nation’s general practice profession is at breaking point says RACGP

“The decisions Minister Hunt makes over the coming months will have far reaching impacts for our health system, for many years to come.

Here is a fresh opportunity for the Federal Government to demonstrate once and for all it is committed to equity in health care and a general practice system accessible for all Australians.”

The first and most effective move Minister Hunt should make is to heed the RACGP’s call to lift the Medicare freeze.

With the freeze on patient Medicare rebates lifted, the profession will be better placed to collaborate with the government and discuss the best way forward for the Australian health system,

I also encourage Minister Hunt to progress the ongoing MBS review, which is an incredibly important policy instrument for strengthening general practice.

The RACGP supports a contemporary and evidence based health system that genuinely prioritises the delivery of high quality, safe patient care by highly skilled specialist GPs.”

Download press release

RACGP President Dr Bastian Seidel said the appointment of a new health minister was a timely opportunity for the government to regroup and bolster its focus on general practice

8. What’s in store for new health minister Greg Hunt

Jim Gillespie  Deputy Director, Menzies Centre for Health Policy & Associate Professor in Health Policy, University of Sydney

Greg Hunt was today announced as federal health (and sport) minister following Sussan Ley’s expenses scandal and subsequent resignation. Hunt will be the third minister to hold this portfolio since the Coalition was elected in 2013. Successful health ministers need well-honed political skills, a lot of patience and even more backbone for the very public battles needed for real change.

So far, the Coalition has not covered itself with glory in the health portfolio. Ley took over in 2014 from the hapless Peter Dutton – whose main achievement was to unite almost all sectors of health against his plans for co-payments for GP visits.

The freeze on GP payments was inherited from the Gillard government, but now seems to be a permanent part of primary care policy. The pressure on GP earnings creates strong incentives to introduce or increase co-payments. The result will be continued pressure in the sensitive area of bulk-billing rates.

Implementation of Ley’s many health reviews

Ley launched a series of major reviews of spending programs – especially the Medicare Benefits Scheme. The proposals from these reviews are now on the table, and Hunt will have difficulty implementing them.

Private health insurance provides one of the government’s most intractable quandaries. Some 20 years ago, then Prime Minister John Howard devised an assistance program to prop up a failing industry. Government subsidies, through the private health insurance rebate, now stand at more than A$6 billion, increasing at well over inflation and outstripping wages growth.

Last year Ley pushed funds to reduce their original claims. Hunt will shortly have to consider the next round of increases.

The core problem is costs, especially of hospital services. However, the government abandoned a significant attempt to reduce the costs of prostheses, so that private insurers would pay closer to the much lower prices negotiated by public hospitals. After intense lobbying from the private hospitals and manufacturers that benefit from the current system, these issues were shunted to yet another committee of inquiry.

More broadly, the private health insurance industry has been struggling to find a long term and sustainable place. For the first time since the 1990s, there has been a significant decline in the proportion of Australians buying insurance policies. Attempts to broaden its base – such as Medibank’s links with GP services – resulted in a backlash from consumers and medical practitioners.

The costs of unnecessary or low-value medical services has been at the heart of the government’s review of the Medicare Benefits Schedule (MBS) – the list of Medicare payments for services.

A recent series of articles in the prestigious Lancet journal, with substantial Australian content, has underlined the importance of improving the use of evidence-based approaches and value for money. The Lancet authors have stressed the need for system reform:

… policies must move beyond the purely incremental; that is, policies that merely tinker at the policy edges after underuse or overuse arises.

Expert taskforces led by clinicians to review the almost 6,000 MBS items have made detailed recommendations of changes to the use of items and levels of payment. Hunt will need to chart the government’s response to these recommendations. The MBS review has maintained an admirable air of consensus so far. This is unlikely to last as particular areas are singled out for action.

#NACCHOagm2016 Launch speech @KenWyattMP NACCHO #HealthyFutures Report Card

ken-speech

  I have been invited to launch the second Healthy Futures Report Card that is produced by the Australian Institute of Health and Welfare.

I applaud the National Aboriginal Community Controlled Health Organisation for commissioning this annual report for the benefit of the entire sector.

This report is an invaluable resource because it provides a comprehensive picture of a point in time.

These report cards allow the sector to track progress, celebrate success, and see where improvements need to be made.

This is critical for the continuous improvement of the Aboriginal Community Controlled Health Sector as well as a way to maintain focus  and achieve goals.

We need to acknowledge the great system in place that comprises the network of Aboriginal Community Controlled Health Organisations, and recognise the role you play to build culturally responsive services in the mainstream system.

Our people need to feel culturally safe in the mainstream health system; the Aboriginal Community Controlled Health sector must continue to play a central role in helping the mainstream services and the sector to be culturally safe “

The Hon Ken Wyatt AM,MP Assistant Minister for Health and Aged care  : SPEECH NACCHO MEMBERS CONFERENCE 2016 Launch of the Healthy Futures Report Card 8 December 2016 Melbourne

img_6352

Download copy NACCHO Healthy Futures Report Card Here

Before I begin I want to acknowledge the traditional custodians of the land on which we meet – the Wurundjeri people – and pay my respects to Elders past, present and future. I also extend this respect to other Aboriginal and Torres Strait Islander people here today.

I want to thank my hosts Matthew Cooke, Chair, NACCHO; and Patricia Turner, CEO, NACCHO for inviting me to speak and acknowledge NACCHO Board members. Distinguished guests, ladies and gentlemen.

Today I also want to specifically acknowledge Naomi Mayer and Sol Bellear from the Redfern Aboriginal Medical Service. 2016 marks the 45th anniversary of the Redfern Aboriginal Medical Service, the first such service in Australia and spearheaded by Naomi and Sol.

redfern

Thank you Naomi and Sol and congratulations on achieving such a significant and important milestone. Your work has improved the lives of countless Aboriginal and Torres Strait Islander Australians because of your leadership and compassionate care.

I have been invited to launch the second Healthy Futures Report Card that is produced by the Australian Institute of Health and Welfare. I applaud the National Aboriginal Community Controlled Health Organisation for commissioning this annual report for the benefit of the entire sector. This report is an invaluable resource because it provides a comprehensive picture of a point in time.

reportcard-1

These report cards allow the sector to track progress, celebrate success, and see where improvements need to be made. This is critical for the continuous improvement of the Aboriginal Community Controlled Health Sector as well as a way to maintain focus  and achieve goals.

Crucially, this report card is about and for the Aboriginal Community Controlled Health Services sector. It is not something that is happening at and to the sector. It’s yours.

This report card includes information from around 140 Aboriginal Community Controlled Health Services which provide care to Aboriginal and Torres Strait Islander Australians. The services you provide cover around two thirds of the services funded by the Australian Government for primary health care services specifically for Aboriginal and Torres Strait Islander people.

During 2014–15 these services saw about 275,000 of these clients who received almost 2.5 million episodes of care. More than 228,000 Australians were regular clients of the Aboriginal Community Controlled Health Services sector.

I’m pleased that there have been a number of improvements identified since the 2015 report. Improvements include:

  •  Increases in the number of clients and episodes of care for primary health care services provided by Aboriginal Community Controlled Health Services.
  •  A rise in the proportion of clients receiving appropriate processes of care for 10 of the 16 relevant indicators. This includes:
    •  antenatal visits before 13 weeks of pregnancy
    •  birth weight recorded
    •  smoking status or alcohol consumption recorded, and
    •  clients with type 2 diabetes who received a General Practice Management Plan or Team Care Arrangement.

 Improved outcomes in three out of the five National Key Performance Indicators. This includes:

  • improvements in blood pressure for clients with type 2 diabetes, and
  • reductions in the proportion of clients aged 15 or over who were recorded as current smokers.

These are commendable results from services in some of the most diverse and challenging environments in Australia.

I echo the report’s authors when they say that the findings in this Report Card will assist Services in their continuous quality improvement activities, in identifying areas where service delivery and accessibility issues need to be addressed, and in supporting the goals of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023.

We are all united in our determination to close the gap in health outcomes for Aboriginal and Torres Strait Islander people, so they live longer and have a better quality of life. A critical means to close the gap is the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.

The Implementation Plan has seven domains that focus on both community-controlled and mainstream services.

It is a huge step forward to have racism recognised in the Implementation Plan – this is a critical issue for the social and emotional wellbeing of Aboriginal and Torres Strait Islander Australians.

Domain seven of the Implementation Plan is about the social and cultural determinants of health. These determinants impact on everything that we do and contribute to at least 31 per cent of the gap in life expectancy between Indigenous and non-Indigenous Australians.

As we all know, health departments and health providers are only part of the solution. We need an integrated approach to Aboriginal and Torres Strait Islander health.

To have strong healthy children and strong communities we need to have effective early childhood education, employment, housing and economic development where people live. These issues can only be addressed through whole-of-Government action. Whole-of-Government action across departments and across jurisdictions.

However, it is not only about governments coordinating their actions because governments alone cannot progress this agenda and action. This can only be done working with Aboriginal and Torres Strait Islander people.

The Implementation Plan Advisory Group, established to drive the next iteration of the Implementation Plan, comprises representatives from the Departments of Health, Prime Minister and Cabinet and the Australian Institute of Health and Welfare.

I’m pleased that this Advisory Group also includes respected and experienced members such as:

  •  Richard Weston from the National Health Leadership Forum and the Healing Foundation, who is Co-Chair.
  •  Pat Turner from the National Aboriginal Community Controlled Health Organisation.
  •  Donna Ah Chee , Julie Tongs and Mark Wenitong who are experts on, among other things, Indigenous early childhood; comprehensive primary health care; and acute care.

See NACCHO TV Interviews

          Donna Ah Chee

           Julie Tongs

          Dr Mark Wenitong

The Group also includes jurisdictional members of the National Aboriginal and Torres Strait Islander Health Standing Committee from South Australia and Western Australia.

I believe that the next iteration of the Implementation Plan, due in 2018, will be stronger because of these ongoing—and new—collaborations and partnerships.

It is clear that you all work extremely hard on behalf of the communities you serve. You are delivering excellence in primary health care and I congratulate you on the delivery of comprehensive, holistic models of care.

At the end of the day, we share the ultimate goal of Closing the Gap in health outcomes for our people so that they live longer and experience a better quality of life.

But we also have a health system under pressure. There are frontline pressures on the whole health system from our hospitals, to rural health to remote Indigenous communities. And the pressures are mounting. There is a growth in demand for services, increasing costs and growing expectations.

Expenditure on health services accounts for approximately one-sixth of the Australian Government’s total expenses—estimated at more than $71 billion for the current financial year. This figure is projected to increase to more than $79 billion by 2019-20.

There is enormous pressure on the health and aged care sectors to do more, with less. This is why there is a clear expectation that all Government-funded organisations provide the evidence basis for what they do, and show the difference their programs are making on the ground. All of us—governments and organisations—need to ask ourselves how can we do better and continue to reform within this tight fiscal environment.

I am sure many of you will be aware of the Nous Review of the Roles and Functions of the Aboriginal and Torres Strait Islander Health Peak Bodies and some of you, of course, participated in the Review consultations. I thank you.

The Government has not published a formal response to the Review because we recognise that what happens now is a discussion that we need to have together.

I know that NACCHO, as well as State and Territory Peak Bodies, are working with the Department of Health to chart a way forward that takes into consideration the findings of the Review.

The Nous Review provided a clear message: Peak Bodies need to play a role in supporting the Aboriginal Community Controlled Health Sector AND mainstream health care providers to deliver appropriate and responsive health care services.

Governance reform for the Peak Bodies is a central element of the way forward. I know this is being driven by NACCHO in close cooperation with affiliate organisations and I applaud your initiative and commitment. I understand that Bobbi Campbell spoke with you yesterday on this matter, so I will keep my remarks brief.

I do want to say that it is important to Government to see the sector positioned as a key component of the overall health system with a clear unified voice.

The Government looks at the health system as a whole and expects collaboration that delivers effectiveness, efficiency and quality. We need a truly linked up, integrated, affordable and sustainable system.

We need to acknowledge the great system in place that comprises the network of Aboriginal Community Controlled Health Organisations, and recognise the role you play to build culturally responsive services in the mainstream system.

Our people need to feel culturally safe in the mainstream health system; the Aboriginal Community Controlled Health sector must continue to play a central role in helping the mainstream services and the sector to be culturally safe.

Australia has come a long way in improving the health of Aboriginal and Torres Strait Islander people but there is still a long, hard road ahead. I know that if we continue to work together, to collaborate and to talk about the issues and opportunities for the sector then the next Healthy Futures Report Card will have an even longer list of achievements.

I thank you for the work you do for the benefit of all Aboriginal and Torres Strait Islander people and wish you only the best now, and into the future.

Thank you.

For further reading

NACCHO November 16 Newspaper : Aboriginal Health and wellbeing is close to my heart says Ken Wyatt

ken-news

 

NACCHO Aboriginal Health and #Healthcarehome : Live webinar 17 Nov : Becoming a Health Care Home

hch

General practices and Aboriginal Community Controlled Health Services (ACCHS) in selected regions around Australia can now apply for stage one of Health Care Homes ( see 10 Regions below)

On Thursday 17 November, 10.30-11.30 AEDT, the Department of Health will host a live webinar entitled Becoming a Health Care Home.

This is a chance for Aboriginal Community Controlled Health Organisations health professionals, practice managers/owners and the health sector to learn more and ask questions about Health Care Homes.

To participate online, you do not need to register.

Simply refer to the webinar participation instructions for more information.

If you are in Canberra and would like to be part of the studio audience, register by emailing healthcarehomes@health.gov.au.

If you cannot attend or participate on Thursday 17 November, the webinar will be available the week after the webcast at health.gov.au/healthcarehomes

Learn more and have a say in this important reform. Save the date now!

Apply to become a Health Care Home

General practices and Aboriginal Community Controlled Health Services (ACCHS) in selected regions around Australia can now apply for stage one of Health Care Homes.

Health Care Homes will improve the provision of care for people with chronic and complex conditions. Participating general practices and ACCHS will play a vital role in shaping this important reform.

Ten Primary Health Network (PHN) regions have been selected for stage one. They are Perth North; Northern Territory; Adelaide; Country South Australia; Brisbane North; Western Sydney; Nepean Blue Mountains; Hunter, New England and Central Coast; South Eastern Melbourne; and Tasmania.

To apply, a general practice or ACCHS must:

  • Be located in one of these ten PHN regions
  • Meet the eligibility and assessment criteria set out in the application form and guidelines.

Applications close Thursday 15 December 2016.

Refer to the Health Care Homes information booklet and factsheets

PDF version: Health Care Homes information booklet – PDF 533 KB
Word version: Health Care Homes information booklet – Word

health.gov.au/healthcarehomes

#healthcarehomes

healthcarehomes@health.gov.au

Live webinar: Becoming a Health Care Home

Add to your calendar now!

Thursday 17 November, 10.30-11.30 AEDT

The relevant areas are:

 

Western Australia 1. Perth North
Northern Territory 2. Northern Territory
South Australia 3. Adelaide

4. Country SA

Queensland 5. Brisbane North

 

New South Wales 6. Western Sydney

7. Nepean Blue Mountains

8. Hunter, New England and Central Coast

Victoria

Tasmania

9. South Eastern Melbourne

10.Tasmania

 

NACCHO Aboriginal Health and #HealthcareHomes :No cap amendments a victory for commonsense and for patient health says our Health Peak groups

 hch

” The Department of Health advises that the payment factsheet on the Health Care Home website has been updated to make it clearer that there is no hard cap on the capability for GPs to bill MBS for services not related to an enrolled patient’s chronic conditions. “

Janet Quigley A/g First Assistant Secretary Health Systems Policy Division email advice to stakeholders 8 November

 ”  The amendment is “a victory for commonsense and for patient health . Anyny move to reintroduce the capped consults in any subsequent rollout of the Health Care Homes initiative would be met with strong concern from health sector stakeholders.

RDAA Vice President, Dr John Hall, welcomed the Government’s amendment.

 ” Health Care Homes is a major reform of primary health care and aims to reshape the management of chronic and complex conditions by placing patients at the centre of care with general practice and Aboriginal community controlled health services (ACCHS).

The Turnbull Government has allocated over $100m to support the rollout of stage one, which aims to enrol up to 65,000 patients in 200 medical practices in 10 regions across Australia.”

Press Release Sussan Ley last week

NACCHO Aboriginal Health #healthcarehomes

Tender closes 15 December : $100m to support the rollout of stage one

Based on clinical advice, it is expected that for the vast majority of patients the number of fee for service episodes of care will be small, and billing patterns for these services will be monitored in Stage 1 to inform national rollout.

This does not change the existing planning or policy.  The expectation is that all general practice health care associated with the patient’s chronic conditions, previously funded through the MBS, will be funded through the bundled payment.

Additional fact sheets will be made available in the coming days.

The Rural Doctors Association of Australia (RDAA) press release

The Rural Doctors Association of Australia (RDAA) has welcomed an amendment made by the Federal Government to its Health Care Homes regime, following concerns expressed by RDAA and other health sector organisations.

A fact sheet originally posted on the Australian Government Department of Health’s website stated that patients with chronic conditions who are registered for chronic care consults under the Health Care Homes trial, would only be allowed a maximum of 5 non-chronic disease related consults under their Health Care Homes arrangement (in addition to their chronic care consults).

But following concerns expressed by RDAA and other groups, including the Royal Australian College of General Practitioners (RACGP), the fact sheet was amended to read:

“Based on clinical advice it is expected that for the vast majority of patients the number of fee-for-service episodes of care, in addition to the bundled payment, will be small. The number of fee-for-service episodes of care will not be capped or restricted, and will be monitored during stage one of Health Care Homes.”

No cap amendments a victory for commonsense and for patient health says our Health Peak groups

RDAA Vice President, Dr John Hall, welcomed the Government’s amendment, calling it “a victory for commonsense and for patient health”.

But he warned that any move to reintroduce the capped consults in any subsequent rollout of the Health Care Homes initiative would be met with strong concern from health sector stakeholders.

“Under the original wording of the regime — which involved capping the number of non-chronic disease related visits under Health Care Home arrangements — chronic care patients unable to afford any further ‘non-chronic’ consults without Medicare assistance would be more likely to present to their local hospital’s Emergency Department for the care they require” he said.

“This would not only have seen patients going to the hospital for health concerns more appropriately and cost-effectively seen in a general practice setting, but it would also have increased the patient load (and pressure) on many hospitals, particularly those in rural and remote settings.

“Given this concern, we have welcomed the Government’s amendments.

“But we remain concerned that the original requirement around non-chronic visits signals that the real intent of the Health Care Homes initiative may not really be about improving patient access to care — it may be more about making budget savings.

“We sincerely hope this is not the case, and we are keen to work with the Government to ensure that improving access to care for patients remains at the centre of this initiative.”

no

1. NACCHO Interim 3 day Program has been release
2. The dates are fast approaching – so register today
hch

 

NACCHO Aboriginal Health #healthcarehomes Tender closes 15 December : $100m to support the rollout of stage one

hch

 ” Health Care Homes is a major reform of primary health care and aims to reshape the management of chronic and complex conditions by placing patients at the centre of care with general practice and Aboriginal community controlled health services (ACCHS).

The Turnbull Government has allocated over $100m to support the rollout of stage one, which aims to enrol up to 65,000 patients in 200 medical practices in 10 regions across Australia.”

Press Release Sussan Ley

Medical practices can apply for stage one of Health Care Homes

More information on the application process is available on the Tenders and Grant page

Read 10 NACCHO Articles about Health Care Homes Here

The Minister for Health, Sussan Ley, today announced that medical practices in selected regions around Australia can apply for stage one of Health Care Homes.

In stage one, Health Care Homes will be rolled out in selected regions from July 2017.

Ms Ley said: “Health Care Homes aims to deliver more flexible care for people with chronic and complex conditions.

“This has never been more important with one in five Australians living with two or more chronic conditions.

“Health Care Homes allows for team-based, integrated and co-ordinated care for patients and gives greater flexibility to design individual care plans for patients and co-ordinate care services to support them.”

Ms Ley said Health Care Homes is an important reform of primary health care services, which are the first and most common point of contact for most Australians.

It demonstrated the Turnbull Government’s commitment to a healthier Medicare.

Ms Ley said: “We are implementing Health Care Homes to find a better way of delivering Medicare for Australians with chronic illnesses.”

Last year the Government invested more than $21 billion in Medicare to ensure all Australians had access to affordable universal healthcare and Medicare funding is expected to grow by another $4 billion over four years.

Under the Health Care Home model, practices will be given a monthly bundled payment for delivery of effective care to patients with chronic and complex health conditions.

Ms Ley acknowledged that doctors and health professionals had played a key role in introducing the concept of the Health Care Home model.

Health Care Home services will be delivered in implementation sites from 1 July 2017 until 30 June 2019 in the first stage. Evaluation of Health Care Homes in these regions will inform refinement of the new model of care and its suitability for broader rollout.

Ms Ley said: “I encourage all accredited general practices and ACCHS organisations in the selected regions to apply to participate in the trials, which are held on a voluntary basis.”

General practices and ACCHS in these regions can now apply for stage one of Health Care Homes: Perth North; Northern Territory; Adelaide; Country South Australia; Brisbane North; Western Sydney; Nepean Blue Mountains; Hunter, New England and Central Coast; South Eastern Melbourne; and Tasmania.

More information on the application process is available on the Tenders and Grant page

The department is seeking applications from eligible organisations within ten Primary Health Network regions for a restricted competitive grants program consisting of one off payments of $10,000 (GST exclusive) each. This funding round will identify eligible organisations to participate in Stage 1 of the implementation of Health Care Homes. This payment is intended to incentivise participation and facilitate readiness for a program start date of 1 July 2017.

Under this model, eligible patients with chronic and complex health conditions will voluntarily enrol with a participating medical practice known as their Health Care Home. This practice will provide patients with a ‘home base’ for the ongoing coordination, management, and support of their conditions. Patients will nominate a preferred clinician within the Health Care Home and a tailored care plan will be developed by the clinician in partnership with the patient.

Stage 1 of the model will be implemented across ten Primary Health Network (PHN) regions that were selected to provide a good cross section of metropolitan, regional, rural and remote locations, and to leverage chronic disease programs operating in these regions.

 

NACCHO Aboriginal health : #AIHW #AustraliasHealth2016 : What are the health experts saying about the report ?

aus-2016

” The report has also pointed out ongoing areas of health inequality in Australia, driven by socioeconomic factors and social determinants.

Communities suffering socioeconomic disadvantage continued to have systematically poorer health including lower life expectancy, higher rates of chronic disease and higher smoking rates.

Aboriginal and Torres Strait Islander peoples recorded improved health indicators in some areas, including lower rates for smoking and infant mortality.

However, the report found life expectancy was shorter by 10 years than for non-Indigenous Australians, and Aboriginal and Torres Strait Islander peoples continued to suffer higher rates of diseases such as diabetes, coronary heart disease and end-stage kidney disease.

The impact of risk factors such as smoking, physical inactivity, poor nutrition and harmful alcohol use have been emphasised as significant contributors to Australia’s rising rates of chronic disease.

This is an opportunity for health leaders and the Commonwealth Government to heed the report’s message that lifestyle factors and social determinants are significant contributors to ill-health, and to address the issues of health inequality and the importance of reform across all of our care systems “

AHHA Chief Executive Alison Verhoeven

Download the report here australias-health-2016

 #AIHW and Minister Sussan Ley press releases from launch #AustraliasHealth2016 report

Life expectancy gap between Indigenous and non-Indigenous Australians remains about one decade

The life expectancy gap between Indigenous and non-Indigenous Australians remains about one decade, according to new statistics.

The latest report from the Australian Institute of Health and Welfare (AIHW) said that while health outcomes had improved for Aboriginal and Torres Strait Islander people, they still remain below those of non-Indigenous Australians.

The biennial report, published today, shows Indigenous males born between 2010 and 2012 have a life expectancy of 69.1 years, a decade less than their non-Indigenous counterparts.

The gap for women was slightly lower at 9.5 years.

Between 2009 and 2013, 81 per cent of all Indigenous deaths were of people under 75. This is more than twice the rate of non-Indigenous Australians, which stands at 34 per cent.

The latest statistics come 10 years after the establishment of the Closing the Gap campaign, which aims to end the disparity on life expectancies.

Earlier this year, Prime Minister Malcolm Turnbull pledged that the Government would better engage with Indigenous people in “hope and optimism rather than entrenched despair”.

Indigenous sobriety rate higher than non-Indigenous Australians

While smoking rates have been falling nationally, they remain high among Indigenous Australians, with 44 per cent of Aboriginal and Torres Strait Islander people aged 15 and over describing themselves as a current smoker.

The report states that 42 per cent smoke daily, 2.6 times the rate of their non-Indigenous counterparts.

However, Indigenous Australians drink less alcohol than non-Indigenous counterparts — 26 per cent of Aboriginal and Torres Strait Islander people aged 15 and over had not consumed alcohol in past 12 months.

This equates to a sobriety rate 1.6 times that of non-Indigenous Australians.

Potentially avoidable deaths — categorised as deaths that could have been avoided given timely and effective health care — accounted for 61 per cent of deaths of Indigenous Australians aged up to 74 years between 2009 to 2013.

This was 10 per cent more than their non-Indigenous counterparts.

Australians are living longer than ever but with higher rates of chronic disease, the latest national report card shows.

Reports below from the Conversation

According to the Australian Institute of Health and Welfare’s Australia’s Health 2016 report, released today, Australian boys can now expect to live into their 80s (80.3), while the life expectancy for girls has reached the mid-80s (84.4).

A boy born and girl born in 1890 could only expect to live to 47.2 and 50.8 years respectively. AIHW

The single leading cause of death in Australia is coronary heart disease, followed by:

Grouped together, cancer has overtaken cardiovascular disease (heart disease and stroke) as Australia’s biggest killer. Cancer is also the largest cause of illness, followed by cardiovascular disease:

Burden of disease, by disease group, Australia, 2011 AIHW

Chronic diseases are becoming more common, due to population growth and ageing. Half of Australians (more than 11 million) have at least one chronic disease. One quarter have two or more.

The most common combination of chronic diseases is arthritis with cardiovascular disease (heart disease and stroke):

AIHW

Australians have high rates of the biomedical risk factors that increase the risk of heart disease and stroke. Almost a quarter (23%) of Australian adults have high blood pressure and 63% have abnormal levels of cholesterol.


Lifestyle choices

Fron Jackson-Webb, Health + Medicine Editor, The Conversation

The good news is Australians are less likely to smoke and drink at risky levels than in the past.

Australia now has the fourth-lowest smoking rate among 34 OECD countries, at 13% in 2013. This is almost half that of 1991 (24%).

AIHW

The volume of alcohol Australians consume fell from 10.8 litres per person in 2007–08 to 9.7 litres in 2013–14. This is the lowest level since 1962–63. But 16% of Australians are still drinking to very risky levels: consuming 11 or more standard drinks on one occasion in the past 12 months.

AIHW

Around eight million Australians have tried illicit drugs in their lifetime, including 2.9 million in the last 12 months. The most commonly used illicit drugs are cannabis (10%), ecstasy (2.5%), methamphetamine (2.1%) and cocaine (2.1%).

Use of methamphetamine has remained stable in recent years. However, more methamphetamine users are opting for crystal (ice) rather than powder (speed).

The bad news is Australians are still struggling with their weight. Around 63% are overweight or obese, up from 56% in 1995. This equates to an average increase of 4.4kg for men and women. One in four children are overweight or obese.

Junk foods high in salt, fat and sugar account for around 35% of adults’ energy intake and around 39% of the energy intake for children and young people.

Most Australians (93%) don’t consume the recommended five serves of vegetables a day and only half eat the recommended two serves of fruit. Just 3% of children eat enough vegetables, though 70% consume the recommended amount of fruit.

Almost half (45%) of adults aged 18 to 64 and 23% of children aren’t meeting the national physical activity recommendations. These are for adults to accumulative 150 to 300 minutes of moderate intensity physical activity or 75 to 150 minutes of vigorous intensity physical activity each week. Children are advised to accumulate at least 60 minutes of moderate to vigorous physical activity every day.

Lifestyle choices have a huge impact on the risk of chronic disease; an estimated 31% of the burden of disease in Australia could have been prevented by reducing risk factors such as smoking, excess weight, risky drinking, physical inactivity and high blood pressure.

Proportion of the burden attributable to the top five risk factors

AIHW

Preventing chronic disease

Rob Moodie, Professor of Public Health, University of Melbourne

This report outlines a number of positives in Australia’s health – our life expectancy, the health services at our beck and call, major declines in tobacco and road deaths. We’re doing well, it says, but we could do better.

If we took prevention and health promotion far more seriously, we could do a lot better.

The report nominates tobacco use, alcohol, high body mass and physical inactivity as the chief causes of preventable illness and the chief causes of our increasing level of chronic illnesses. Yet national investment in prevention is declining.


Further reading: Focus on prevention to control the growing health budget


Tobacco use is rapidly declining because of really effective measures (plain packaging, advertising bans and increasing price through taxes) that save lives and enormous amounts of money over a lifetime for people who used to smoke.

However, we can’t seem to make any major dent in the commercial, industrial and lifestyle diseases related to junk food and drinks, harmful consumption of alcohol and car dependency.

We’ve known what will work for many years but the power of some of these unhealthy industries is still overwhelming – a situation in which our politicians fear these industries and their associations more than they fear the voters.

Our collective health would have been much better if we’d been able to follow the guidance of our own national task forces and learnt from other countries. The report card should read, “Doing well, but could have done a lot better”.


Inequities

Fran Baum, Matthew Flinders Distinguished Professor and Foundation Director at the Southgate Institute for Health, Society & Equity, Flinders University

Australia’s Health 2016 shows many Australians are not getting a fair go at health. There is a gradient across society whereby the richer the area you live in, the longer you can expect to live. The difference between the highest and lowest is four years.

Deaths by socioeconomic group: 1 = lowest; 5 = highest

AIHW

The gradient is evident from early life. Children most at risk of exclusion – those from poor areas who experience problems with education, housing and connectedness – are most likely to die before they reach 15 years from potentially preventable or treatable causes.


Further reading: Want to improve the nation’s health? Start by reducing inequalities and improving living conditions


Our most glaring inequity is the ten-year life gap between Aboriginal and Torres Strait Islander Australians and others. Indigenous life expectancy is 69.1 years for males and 73.7 years for females.

Compared with the non-Indigenous population, Indigenous Australians are:

  • 3.5 times as likely to have diabetes and four times as likely to be hospitalised with it or to die from it
  • five times as likely to have end-stage kidney disease
  • twice as likely to die from an injury
  • twice as likely to have heart disease.

Australians living outside major cities have higher rates of disease and injury. They also live in environments that make healthy lifestyles choices harder (such as more difficulties buying fresh fruit and vegetables) and so their risk of chronic diseases is increased.

AIHW

The data on who has private health insurance coverage points to the emergence of a two-tiered health system, where those who can afford to pay receive better access and quality of care. Just 26% of those in the lowest socioeconomic group have cover compared to about 80% of the top group.

Coverage with private health insurance and government health-care cards

AIHW

Cost of care

Professor Stephen Duckett, Director of the Health Program at Grattan Institute

Over the last decade, health expenditure grew about 5% each year, above the 2.8% average growth in Gross Domestic Product (GDP). As a result, health took up an increasing share of GDP.

Spending more on health means Australia spent less on other things. This is not necessarily bad, as long as the benefits from that increased expenditure – such as increasing life expectancy or increased quality of life – are worth the increased costs.

But spending above GDP growth cannot continue indefinitely. And the last few years saw an increase in rhetoric about health spending increases being “unsustainable” from so-called “futurists” and politicians.

Informed commentators have generally rejected the unsustainability claim, some labelling it a “myth”, while others take a more nuanced view.

Australia’s Health 2016 shows a slowing of the real growth rate in the most recent two years to about half that of the previous decade – 1.1% from 2011-12 to 2012-13 and 3.1% from 2012–13 to 2013–14.

Annual growth rates in health expenditure AIHW

This suggests the “unsustainability” rhetoric is at least overblown and potentially prompting budget decisions which are counter-productive, such as introducing a co-payment for general practice.

Commonwealth government expenditure was more or less stable over these most recent two years, declining 2.5% initially then increasing 2.4% in the last year.

Health expenditure by area (adjusted for inflation)

AIHW

Savings to the government came from shifting costs to consumers, by slowing the growth in government subsidies to private health insurers, and also by slowing spending on pharmaceuticals.

This latter slowdown was achieved through tighter controls on payments to drug manufacturers and because some big-selling drugs came off patent, resulting in falls in prices.

NACCHO Aboriginal Health Newspaper Next AGM Edition

agm

NACCHO Welcomes Advertising and Articles

NACCHO Aboriginal Health Alert : #AIHW and Minister Sussan Ley launch #AustraliasHealth2016 report

sl

 ” A new snapshot of Australia’s health has found we are living longer than ever before, but the rise of chronic disease still presents challenges in achieving equal health outcomes for Indigenous Australians and people living outside metropolitan areas.

Minister for Health Sussan Ley pictured above with Dr Mukesh Haikerwal

Download the Report Here

australias-health-2016

As well as looking at factors influencing individuals’ health, today’s report also examines the health of particular population groups, and shows considerable disparities.

‘For example, while there have been some improvements overall in the health of Aboriginal and Torres Strait Islander Australians—including falls in smoking rates and infant mortality—Indigenous Australians continue to have a lower life expectancy than non-Indigenous.

Indigenous Australians, at 69.1 years for males and 73.7 for females, more than 10 years shorter than for non-Indigenous Australians,’

Indigenous Australians also continue to have higher rates of many diseases, such as diabetes, end-stage kidney disease and coronary heart disease.”

AIHW Director and CEO Barry Sandison

                     AIHW website Australia’s Health 2016

aus-2016

The Minister today launched the Australian Institute of Health and Welfare’s (AIHW) publication Australia’s health 2016, which provides an update on the health of Australians and the performance of Australia’s health system.

“Australia’s health 2016 shows us that about 85 per cent of Australians rate their health as good, very good or excellent, which is a testament to the significant investment of the Turnbull Government into the health of our nation, with about one-quarter of total government revenue attributed to health spending,” Minister Ley said.

“Our Government’s priority is to ensure the high performance and sustainability of our health system over the long term. This is why the Turnbull Government is working closely with stakeholders to progress a range of health system reforms.”

Total Commonwealth investment in health will grow to more than $71 billion in 2015-16 and this will increase to $79 billion within four years. The Turnbull Government’s investment in Medicare is at $23 billion per year and this will increase by $4 billion over the next four years.

“The report indicates that health outcomes for Australians have improved over time with life expectancy at an all-time high of 80.3 years for males, while a baby girl could expect to live for 84.4 years. Survival rates for cancer are also improving,” Minister Ley said

Minister Ley said that despite plenty of good news on health in the report, managing chronic conditions and their impact on Australia’s health system remained one of our greatest health challenges.

“The report shows that half of Australians have a chronic disease – such as cardiovascular disease, arthritis, diabetes or a mental health disorder – and one-in four have two or more of these conditions,” Minister Ley said.

“This is why our initial investment of almost $120 million in the Health Care Homes initiative is so important. It will help to keep those with chronic conditions healthier and out of hospital. It will give GPs the flexibility and tools they need to design individual care plans for patients with chronic conditions and coordinate care services to support them.

“We recently announced the 10 geographic regions that will deliver Stage One of this important initiative from 1 July next year, and we hope the results will lead more broadly to a better, consumer-focused approach to health care.”

Australia’s health 2016 is available on the Australian Institute of Health and Welfare’s website.

85 out of 100 Australians say they’re healthy—but are we really? AIHW Press Release

Most Australians consider themselves to be in good health, according to the latest two-yearly report card from the Australian Institute of Health and Welfare (AIHW).

The report, Australia’s health 2016 is a key information resource, and was launched today byfederal Health Minister, the Hon. Sussan Ley.

AIHW Director and CEO Barry Sandison said the report provided new insights and new ways of understanding the health of Australians.

‘The report shows that Australia has much to be proud of in terms of health,’ he said.

‘We are living longer than ever before, death rates continue to fall, and most of us consider ourselves to be in good health.’

If Australia had a population of just 100 people, 56 would rate their health as ‘excellent’, or ‘very good’ and 29 as ‘good’.

‘However, 19 of us would have a disability, 20 a mental health disorder in the last 12 months, and 50 at least one chronic disease.’

Mr Sandison said the influence of lifestyle factors on a person’s health was a recurring theme of the report. ‘13 out of 100 of us smoke daily, 18 drink alcohol at risky levels, and 95 do not eat the recommended servings of fruit and vegetables.

‘And while 55 do enough physical activity, 63 of us are overweight or obese.’

Mr Sandison said that while lifestyle choices were a major contributor to the development of many chronic diseases, other factors such as our income, education and whether we had a job—known as ‘social determinants’—all affected our health, for better or worse.

‘As a general rule, every step up the socioeconomic ladder is accompanied by an increase in health.

‘Compared with people living in the highest socioeconomic areas, people living in the lowest socioeconomic areas generally live about 3 years less, are 1.6 times as likely to have more than one chronic health condition, and are 3 times as likely to smoke daily.’

As well as looking at factors influencing individuals’ health, today’s report also examines the health of particular population groups, and shows considerable disparities.

‘For example, while there have been some improvements overall in the health of Aboriginal and Torres Strait Islander Australians—including falls in smoking rates and infant mortality—Indigenous Australians continue to have a lower life expectancy than non-

Indigenous Australians, at 69.1 years for males and 73.7 for females, more than 10 years shorter than for non-Indigenous Australians,’ Mr Sandison said.

Indigenous Australians also continue to have higher rates of many diseases, such as diabetes, end-stage kidney disease and coronary heart disease.

For people living in rural and remote areas, where accessing services can be more difficult, lower life expectancy and higher rates of disease and injury—particularly road accidents— are of concern.

In Australia, health services are delivered by a mix of public and private providers that includes more than 1,300 hospitals and about 385,000 nurses, midwives and medical practitioners.

Of the $155 billion spent on health in 2013–14, $145 billion was recurrent expenditure. Hospitals accounted for 40% of recurrent expenditure ($59 billion), primary health care 38% ($55 billion), with the remaining 22% spent on other health goods and services.

For the first time, the report examines how spending by age for people admitted to hospital has changed over time.

Mr Sandison said the analysis showed that the largest increase in spending between 2004–05 and 2012–13 was for Australians aged 50 and over.

‘This was due to more being spent per person in the population as well as the increased number of people in these age groups.’

Mr Sandison also said that while Australia’s health 2016 provides an excellent overview of Australia’s health at a point in time, there is still scope to expand on the analysis.

New to this edition is information on the changing nature of services provided by publicand private hospitals over the last 10 years; information about how geography affects

Indigenous women’s access to maternal health services; and about the increasing role ofinstitutions such as hospitals and residential aged care in end-of-life care.

‘Good data is essential to inform debate and policy and service delivery decision-making— and improving its quality and availability is at the core of the AIHW’s work.

‘We’re committed to providing meaningful, comprehensive information about Australia’s health and wellbeing—to help create a healthier Australia.’

  • Preliminary material
    • Title and verso pages
    • Contents
    • Preface
    • Acknowledgments
    • Terminology
  • Body section
    • Chapter 1 An overview of Australia’s health
      • Introduction
      • What is health?
      • Australians: who we are
      • How healthy are Australians?
    • Chapter 2 Australia’s health system
      • Introduction
      • How does Australia’s health system work?
      • How much does Australia spend on health care?
      • Who is in the health workforce?
    • Chapter 3 Leading causes of ill health
      • Introduction
      • Burden of disease and injury in Australia
      • Premature mortality
      • Chronic disease and comorbidities
      • Cancer
      • Coronary heart disease
      • Stroke
      • Diabetes
      • Kidney disease
      • Arthritis and other musculoskeletal conditions
      • Chronic respiratory conditions
      • Mental health
      • Dementia
      • Injury
      • Oral health
      • Vision and hearing disorders
      • Incontinence
      • Vaccine preventable disease
    • Chapter 4 Determinants of health
      • Introduction
      • Social determinants of health
      • Social determinants of Indigenous health
      • Biomedical risk factors
      • Overweight and obesity
      • Illicit drug use
      • Alcohol risk and harm
      • Tobacco smoking
      • Health behaviours and biomedical risks of Indigenous Australians
    • Chapter 5 Health of population groups
      • Introduction
      • Health across socioeconomic groups
      • Trends and patterns in maternal and perinatal
      • health
      • How healthy are Australia’s children?
      • Health of young Australians
      • Mental health of Australia’s young people and adolescents
      • Health of the very old
      • How healthy are Indigenous Australians?
      • Main contributors to the Indigenous life expectancy gap
      • Health of Australians with disability
      • Health of prisoners in Australia
      • Rural and remote health
    • Chapter 6 Preventing and treating ill health
      • Introduction
      • Prevention and health promotion
      • Cancer screening
      • Primary health care
      • Medicines in the health system
      • Using data to improve the quality of Indigenous health care
      • Indigenous Australians’ access to health services
      • Spatial variation in Indigenous women’s access to maternal health services
      • Overview of hospitals
      • Changes in the provision of hospital care
      • Elective surgery
      • Emergency department care
      • Radiotherapy
      • Organ and tissue donation
      • Safety and quality in Australian hospitals
      • Specialised alcohol and other drug treatment services
      • Mental health services
      • Health care use by older Australians
      • End-of-life care
    • Chapter 7 Indicators of Australia’s health
      • Introduction
      • Indicators of Australia’s health
  • End matter
    • Methods and conventions
    • Symbols
    • Acronyms and abbreviations
    • Glossary
    • Index