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

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

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

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

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

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

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

Alice Springs Declaration

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

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

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

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

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

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

This declaration was unanimously endorsed

Download PDF Copy

CTG19 ALICE SPRINGS DECLARATION

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

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

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

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

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

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

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

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

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

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

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

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

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

It is a story of self-determination.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Read all 50 plus NACCHO Aboriginal Eye Health Articles Here

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

More info Register 

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

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

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

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

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

And now to eyes.

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Thank you.

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

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

Further, while we acknowledge the scourge of Trachoma, cataract is the leading cause of blindness for Aboriginal and Torres Strait Islander adults and is 12 times more common than for non-Indigenous Australians. We have seen inroads in the rates of trachoma, many thanks to people in this room.

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

Today I want to discuss three things:

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

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

One in 10 Aboriginal and Torres Strait Islander adults is at risk of Diabetic Retinopathy, which we all know can lead to irreversible vision loss. Aboriginal and Torres Strait Islander people wait on average 63% longer for cataract surgery than non-Indigenous Australians. Almost two-thirds of vision impairment among Aboriginal and Torres Strait Islander people is due to uncorrected refractive error- often treatable with a pair of glasses.

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

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

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

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

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

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

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

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

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

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

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

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

Including: Ear infections and otitis media

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

And I think most markedly

  • Rheumatic Heart Disease

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

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

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

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

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

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

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

Under a Shorten Labor government we will be prioritising:

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

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

I think that’s enough from me.

Thank you for your time this morning.

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

” The 2019 World Indigenous Housing Conference on the Gold Coast will bring together over 2,000 Indigenous leaders, government, industry and academia representing Housing, health, and education from around the world including:

  • National and International Indigenous Organisation leadership
  • Senior housing, health, and education government officials Industry CEOs, executives and senior managers from public and private sectors
  • Housing, Healthcare, and Education professionals and regulators
  • Consumer associations
  • Academics in Housing, Healthcare, and Education.

The 2019 World Indigenous Housing Conference is pleased to announce the following invited speakers who bring their expertise and knowledge to share with attendees at 2019WIHC.

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

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

See details of all speakers HERE

Download the WIHC Conference Brochure and share

2019WIHC_Overview_Feb2019

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

Key points:

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

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

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

Treated like a political football’: John Patterson AMSANT 

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

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

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

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

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

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

Read todays NT media coverage here

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

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

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

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

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

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

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

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

The 2019 World Indigenous Housing Conference #2019WIHC is the principal conference to provide a platform for leaders in housing, health, education and related services from around the world to come together.

Up to 2000 delegates will share experiences, explore opportunities and innovative solutions, work to improve access to adequate housing and related services for the world’s Indigenous people.

Event Information:

Key event details as follows:

Venue: Gold Coast Convention and Exhibition Centre
Address: 2684-2690 Gold Coast Hwy, Broadbeach QLD 4218
Dates: Monday 20th – Thursday 23rd May, 2019 (24th May)

Registration Costs

  • After 1 February FULL CONFERENCE & TRADE EXHIBITION REGISTRATION $2245 AUD plus booking fees

PLEASE NOTE: The Trade Exhibition is open Tuesday 21st May – Thursday 23rd May 2019

Please visit www.2019wihc.com for further information on transport and accommodation options, conference, exhibition and speaker updates.

Methods of Payment:

2019WIHC online registrations accept all major credit cards, by Invoice and direct debit.
PLEASE NOTE: Invoices must be paid in full and monies received by COB Monday 20 May 2019.

Please note: The 2019 WIHC organisers reserve the right of admission. Speakers, programs and topics are subject to change.

Please visit http://www.2019wihc.com for up to date information.

Conference Cancellation Policy

If a registrant is unable to attend 2019 WIHC for any reason they may substitute, by arrangement with the registrar, someone else to attend in their place and must attend any session that has been previously selected by the original registrant.

Where the registrant is unable to attend and is not in a position to transfer his/her place to another person, or to another event, then the following refund arrangements apply:

    • Registrations cancelled less than 60 days, but more than 30 days before the event are eligible for a 50% refund of the registration fees paid.
    • Registrations cancelled less than 30 days before the event are no longer eligible for a refund.

Refunds will be made in the following ways:

  1. For payments received by credit or debit cards, the same credit/debit card will be refunded.
  2. For all other payments, a bank transfer will be made to the payee’s nominated account.

Important: For payments received from outside Australia by bank transfer, the refund will be made by bank transfer and all bank charges will be for the registrant’s account. The Cancellation Policy as stated on this page is valid from 1 October 2018.

Terms & Conditions

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

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

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

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

END RHD Press Release see 2.30 below for full release 

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

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

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

Vision 2020 Australia CEO Judith Abbott:

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

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

Major items discussed by Health Ministers today included:

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

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

2.1 Renal Health 

2.2 Eye Health 

2.3 Rheumatic Heart Disease 

2.4 Hearing Health

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

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

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

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

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

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

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

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

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

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

2.1 Renal Health 

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

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

2.2 Eye Health 

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

Vision 2020 Press Release

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

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

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

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

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

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

2.3 Rheumatic Heart Disease 

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

RHD Press Release

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

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

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

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

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

2.4 Hearing Health

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

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

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

Other Issues 

National Health Reform Agreement – Resolving reconciliation and back casting

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

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

Australian National Breastfeeding Strategy: 2019 and Beyond

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

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

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

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

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

Professional Indemnity Insurance for Privately Practicing Midwives

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

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

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

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

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

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

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

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

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

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

Update on National Missions under the Medical Research Future Fund 

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

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

The five missions are

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

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

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

Resolving outstanding National Disability Insurance Scheme (NDIS) implementation issues

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

Mental Health Services

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

Regulation of misleading public health information

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

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

Tobacco industry issues

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

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

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

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

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

National Medical Workforce Strategy

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

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

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

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

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

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

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

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

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

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