NACCHO Aboriginal Health and #refreshtheCTGRefresh Campaign : 13 peak Aboriginal and Torres Strait Islander bodies propose meeting  with COAG reps to determine a framework for reaching agreement on a refreshed #ClosingtheGap strategy

We understand that at this stage it is intended that new Closing the Gap targets will be settled at COAG’s December meeting,

We are calling on COAG to hold off doing this and instead put in place a proper partnership mechanism with us. The new targets haven’t been published and Indigenous peaks are uncertain what the targets will be and therefore we cannot provide our support.

NACCHO and the peak bodies engaged with the process, took time to submit written submissions and attend workshops to discuss refreshing the Closing the Gap strategy earlier this year. But we can’t see how our input has been taken into account,

As a first step we propose a meeting with COAG representatives and the peak bodies to discuss a way forward that includes a genuine partnership approach.

Aboriginal people need to be at the centre of the Closing the Gap Refresh policy; the gap won’t close without our full engagement and involvement.

Having Aboriginal people involved in the design of the Refresh and proposed revised targets will lead to Aboriginal people taking greater responsibility for the outcomes. It’s been proven that Aboriginal community control is vital and delivers better outcomes for our people.” 

NACCHO Chief Executive Pat Turner AM see interview Part 3 below 

Download the NACCHO Press Release Here

NACCHO media release Refresh The CTG Refresh

Part 1 NACCHO Press Release continued 

The National Aboriginal Community Controlled Health Organisation (NACCHO) and other Aboriginal peak bodies across Australia have written to COAG First Ministers seeking a full partnership approach between Indigenous people and governments in refreshing the Closing the Gap Strategy, scheduled to be put to COAG for consideration in Adelaide on 12 December.

The letter, signed by 13 peak bodies, proposes an urgent meeting of Aboriginal and Torres Strait Islander peak bodies to meet with COAG representatives to determine a framework for reaching agreement on a refreshed Closing the Gap strategy.

It’s the second letter the group has written to COAG after failing to receive a response to their initial letter in early October from any government except the Northern Territory.

Part 2 Letter to Council of Australian Government First Ministers

Dear Council of Australian Government First Ministers 16/11/2018

We write again, further to our letter of 4 October 2018, concerning the Closing the Gap Refresh, a joint initiative of the Council of Australian Governments (COAG), to seek a formal partnership mechanism between Aboriginal and Torres Strait Islander peoples and governments in the Closing the Gap Refresh policy. We have only received a response from the Northern Territory Government.

As stated in our original letter, all of us believe it is essential that agreement is reached on the Closing the Gap Refresh policy between Indigenous organisations, on behalf of communities across Australia and Australian governments. What we propose is entirely consistent with the commitment made by COAG to set a new relationship with our communities based on a partnership.

If governments alone, continue to make decisions about the Closing the Gap, without an opportunity for us to be at the table, it will not be possible to advocate with any confidence or motivate our communities to support Closing the Gap and to take joint responsibility with governments for achieving the targets.

Pictures above and below from our #refreshtheCTGRefresh Campaign

The evidence is strong that when Indigenous people are included and have a real say in the design and delivery of services that impact on them, the outcomes are far better. We are certain that Indigenous peoples need to be at the centre of the Closing the Gap Refresh policy: the gap won’t close without our full involvement and COAG First Ministers, who are responsible for the Closing the Gap framework, cannot expect us to take responsibility and work constructively with them to improve outcomes if we are excluded from the decision making.

We have proposed a reasonable way forward to Australian Governments in our original letter without making it public to give everyone a reasonable opportunity to consider it. However, we understand that it is the intention of Australian Governments to still settle on targets at the forthcoming meeting of COAG on 12 December 2018.

We also understand that implementation arrangements are to be left over for COAG to agree in 2019. We make the points that neither ourselves nor anyone else outside government have seen the proposed targets which we think is way short of being partners and transparent and we cannot see how the targets can be agreed without considering at the same time how they are to be achieved.

We assume that Australian Governments will justify agreeing to targets by referring to the consultations earlier this year. Those consultations were demonstrably inadequate. They were conducted at a very superficial level without an opportunity for Indigenous interests to be prepared for the workshops held across Australia.

They were based on a discussion paper produced by the Department of the Prime Minister and Cabinet in December 2017 and which stated that only one of the seven targets was on track which two months later was contradicted by the former Prime Minister who said that three targets were on track. Critical elements of the original Closing the Gap framework, particularly COAG’s National Indigenous Reform Agreement, were not referred to at all in the consultations and the focus was on new targets instead of how we could make sure that this time around they were achieved.

There was no independent report prepared on the outcomes of the consultations and there is no way of telling if what was said in the consultations is reflected in the proposed Refresh policy including the targets.

The consultations started far too late which has left us with 4 targets having expired in June 2018. We do not accept that we have been properly consulted let alone given the opportunity to negotiate a mechanism that allows a proper partnership to be put in place in relation to the design, delivery and monitoring of Closing the Gap.

There is a now a significant opportunity to put this disappointing process back on track and in particular to establish a robust Closing the Gap framework founded on a genuine partnership between Indigenous people and governments.

It is open to governments on 12 December 2018, to endorse a partnership approach and establish a mechanism to initiate negotiations between representatives of COAG and Peak organisations with a view to developing a genuine partnership as part of the Closing the Gap Refresh. This would be endorsed by the Peak Organisations across Australia.

Subject to COAG endorsing a partnership approach, we propose a meeting of Aboriginal and Torres Strait Islander Peak bodies to meet with COAG representatives to determine a framework for reaching agreement on a refreshed closing the gap strategy.

We stand ready to do this quickly and would work with COAG on having a partnership framework in place in early 2019 with a revised approach agreed by the middle of the year.

Ms Pat Turner AM, the CEO of the National Aboriginal Community Controlled Health Organisation, is our contact for the purpose of responding to this vital matter and we ask that you contact her.

We look forward to working with you on the Closing the Gap Refresh through an established partnership mechanism.

Yours sincerely,


Part 3 Going backwards’: Aboriginal bodies take aim at Closing the Gap

Aboriginal peak organisations have slammed federal, state and territory governments for failing to give Indigenous leaders an effective role in re-energising the faltering Closing the Gap process.

In a letter written jointly to Prime Minister Scott Morrison, chief ministers and premiers, the leaders of the 13 peak bodies say they have been shut out of meaningful consultation about refreshed targets to overcome Aboriginal disadvantage.

By Deborah Snow SMH 19 November

Pat Turner, chief executive of the National Aboriginal Community Controlled Health Organisation, said "it's all gone backwards".
Pat Turner, chief executive of the National Aboriginal Community Controlled Health Organisation, said “it’s all gone backwards”. CREDIT:GLENN CAMPBELL

And they want the Coalition of Australian Governments – due to consider an update to Closing the Gap next month – to defer setting new targets until a fresh pact is hammered out giving “full partnership” to Aboriginal bodies.

“I think it’s all gone backwards,” the chief executive of the National Aboriginal Community Controlled Health Organisation (NACCHO), Pat Turner,  told the Herald.

“In the last few years, governments seem to have dropped the ball a lot. I hope they are giving serious consideration to our letter. They can’t go on having two bob each-way. They are there to lead and they have to have a bit of backbone. [The state of] Aboriginal affairs is a national shame, it is something that they should be wanting to get fixed.”

Ms Turner said only one government – the Northern Territory – had bothered replying to the group when they first wrote a letter a month ago seeking better consultation over new targets and implementation strategies.

“NACCHO and the peak [Indigenous] bodies engaged with the process took time to submit written submissions and attend workshops to discuss refreshing the Closing the Gap strategy earlier this year” she said. “But we can’t see how our input has been taken into account.”

The peak bodies decided on Sunday to release a second letter they wrote to all governments at the end of last week.

The letter says the “disappointing” Closing the Gap process has to be put “back on track” with Indigenous people taking part in the design and delivery of services on the basis of “genuine partnership”.

“As a first step we propose a meeting with COAG representatives and the peak bodies to discuss [such an] approach” Ms Turner said.

The Herald sought a response from Aboriginal Affairs minister Nigel Scullion but was unable to contact his office on Sunday.

Closing the Gap was first conceived of a decade ago as a way to measure Aboriginal disadvantage and set clear targets to redress it.

Earlier this year a report from the Department of Prime Minister and Cabinet said three of seven targets were “on track”: to halve the gap in year 12 attainment and halve the gap in child mortality by 2018, and to have 95 per cent of Indigenous four-year-olds enrolled in early childhood education by 2025.

However it said that other targets, including halving the gap in reading and numeracy, and halving the gap in employment, as well as closing the gap on life expectancy, were not on track.




NACCHO Aboriginal Women’s Health #SistersInside #imaginingabolition : Our CEO Pat Turner address to @SistersInside 9th International Conference Decolonisation is not a metaphor’: Abolition for First Nations women

NACCHO supports the abolition of prisons for First Nations women. The incarceration of Aboriginal and Torres Strait Island women should be a last resort measure.

It is time to consider a radical restructuring of the relationship between Aboriginal people and the state.

Aboriginal and Torres Strait Islander people and their communities must be part of the design, decision-making and implementation of government funded policies, programs and services that aim to reduce – or abolish –the imprisonment of our women.

Increased government investment is needed in community-led prevention and early intervention programs designed to reduce violence against women and provide therapeutic services for vulnerable women and girls. Programs and services that are holistic and culturally safe, delivered by Aboriginal and Torres Strait Islander organisations.

NACCHO calls for a full partnership approach in the Closing the Gap Refresh, so that Aboriginal people are at the centre of decision-making, design and delivery of policies that impact on them.

We are seeking a voice to the Commonwealth Parliament, so we have a say over the laws that affect us. “

Pat Turner NACCHO CEO Speaking at  Sisters Inside 9th International Conference 15 Nov

See Pats full speaking notes below

Theme of the day: ‘Decolonisation is not a metaphor’: Abolition for First Nations women

About Sisters Inside

  • Sisters Inside responds to criminalised women and girls’ needs holistically and justly. We work alongside women and girls to build them up and to give them power over their own lives. We support women and girls to address their priorities and needs. We also advocate on behalf of women with governments and within the legal system to try to achieve fairer outcomes for criminalised women, girls and their children.
  • At Sisters Inside, we call this ‘walking the journey together’. We are a community and we invite you to be part of a brighter future for Queensland’s most disadvantaged and marginalised women and children.

Sisters Inside Website Website 

In Picture above Dr Jackie Huggins, Pat Turner, Jacqui Katona, Dr Chelsea Bond and June Oscar, Aunty Debbie Sandy and chaired by Melissa Lucashenko.

Panel: Why abolition for First Nations Women?

Panel members:

  • Dr Jackie Huggins AM FAHA (Co-Chair, National Congress of Australia’s First Peoples)
  • Pat Turner AM (CEO, National Aboriginal Community Controlled Health Organisation)
  • Dr Chelsea Bond (Senior Lecturer, University of Queensland)
  • Jacqui Katona (Activist & Sessional Lecturer (Moondani Balluk), Victoria University)
  1. Imprisonment, colonialism, and statistics
  • The Australian justice system was founded on a white colonial model that consistently fails and seeks to control and supress Aboriginal and Torres Strait Islander peoples.
  • Indigenous peoples are overrepresented in the prison system:
    • Aboriginal and Torres Strait Islander adults are 12.5 times more likely to be imprisoned than non-Indigenous Australians.[i]
    • Our women represent the fastest growing group within prison populations and are 21 times more likely to be imprisoned than non-Indigenous women.[ii]
  • Imprisonment is another dimension to the historical and contemporary Aboriginal experience of colonial removal, institutionalisation and punishment.[iii]
  • Our experiences of incarceration are not only dehumanising. They contribute to our ongoing disempowerment, intergenerational trauma, social disadvantage, and burden of disease at an individual as well as community level.
  1. Aboriginal and Torres Strait Islander women’s experiences of imprisonment
  • The Change the Record report found that most Aboriginal and Torres Strait Islander women who enter prison systems:
    • are survivors of physical and sexual violence, and that these experiences are most likely to have contributed to their imprisonment; and
    • struggle with housing insecurity, poverty, mental illness, disability and the effects of trauma.
  • Family violence must be understood as both a cause and an effect of social disadvantage and intergenerational trauma.
  • Risk factors for family violence include poor housing and overcrowding, substance misuse, financial difficulties and unemployment, poor physical and mental health, and disability.[iv]
  • Imprisoning women affects the whole community. Children are left without their mothers. The whole community suffers.
  1. Kimberley Suicide Prevention Trial
  • The Kimberley Suicide Prevention Trial, of which NACCHO is a member, provides a grim example of the link between trauma, suicide, incarceration and the social determinants of health.
  • The rate of suicide in the Kimberley is seven times that of other Australian regions.
  • Nine out of ten suicides involve Aboriginal people.
  • Risk factors include imprisonment, poverty, homelessness and family violence.
  • Western Australia has the highest rate of Aboriginal and Torres Strait Islander imprisonment.
  1. Imprisonment and institutional racism
  • The overrepresentation of Aboriginal peoples in prison systems is not simply a law-and-order issue.[v] The trends of over-policing and imprisoning of Indigenous peoples are examples of institutional racism inherent in the justice system. [vi]
  • Institutional racism affects our everyday encounters with housing, health, employment and justice systems.
  • Institutional racism is not only discriminatory; it entrenches intergenerational trauma and socioeconomic disadvantage.[vii]
  • Exposure to racism is associated with psychological distress, depression, poor quality of life, and substance misuse, all of which contribute significantly to the overall ill-health experienced by Indigenous people. We are twice as likely to die by suicide or be hospitalised for mental health or behavioural reasons.
  1. Ways forward see opening quote Pat Turner 
  2. The role of ACCHSs in supporting Indigenous women

Increasing access to the health care that people need

  • Racism is a key driver of ill-health for Indigenous people, impacting not only on our access to health services but our treatment and outcomes when in the health system.
  • Institutional racism in mainstream services means that Indigenous people do not always receive the care that we need from Australia’s hospital and health system.
  • It has been our experience that many Indigenous people are uncomfortable seeking help from mainstream services for cultural, geographical, and language disparities as well as financial costs associated with accessing services.
  • The combination of these issues with racism means that we are less likely to access services for physical and mental health conditions, and many of our people have undetected health issues like poor hearing, eyesight and chronic conditions.

Early detection of health issues that are risk factors for incarceration

  • The Aboriginal Community Controlled Health model provides answers for addressing the social determinants of health, that is, the causal factors contributing to the overrepresentation of Indigenous women’s experiences of family violence and imprisonment.
  • Aboriginal Community Controlled Health organisations should be funded to undertake comprehensive, regular health check of Aboriginal women so that risk factors are identified and addressed early.

Taking a holistic approach to health needs and social determinants of health and incarceration

  • Overall, the Aboriginal Community Controlled Health model recognises that Aboriginal and Torres Strait Islander people require a greater level of holistic healthcare due to the trauma and dispossession of colonisation which is linked with our poor health outcomes.
  • Aboriginal Community Controlled Health is more sensitive to the needs of the whole individual, spiritually, socially, emotionally and physically.
  • The Aboriginal Community Controlled Model is responsive to the changing health needs of a community because it of its small, localised and agile nature. This is unlike large-scale hospitals or private practices which can become dehumanised, institutionalised and rigid in their systems.
  • Aboriginal Community Controlled Health is scalable to the needs of the community, as it is inextricably linked with the wellbeing and growth of the community.
  • The evidence shows that Aboriginal Community Controlled organisations are best placed to deliver holistic, culturally safe prevention and early intervention services to Indigenous women.
  1. About NACCHO
  • NACCHO is the national peak body representing 145 ACCHOs across the country on Aboriginal health and wellbeing issues. In 1997, the Federal Government funded NACCHO to establish a Secretariat in Canberra, greatly increasing the capacity of Aboriginal peoples involved in ACCHOs to participate in national health policy development.
  • Aboriginal Community Controlled Health first arose in the early 1970s in response to the failure of the mainstream health system to meet the needs of Aboriginal and Torres Strait Islander people and the aspirations of Aboriginal peoples for self-determination.
  • An ACCHO is a primary health care service initiated and operated by the local Aboriginal community to deliver holistic, comprehensive, and culturally appropriate health care to the community which controls it, through a locally elected Board of Management. ACCHOs form a critical part of the Indigenous health infrastructure, providing culturally safe care with an emphasis on the importance of a family, community, culture and long-term relationships.
  • Our members provide about three million episodes of care per year for about 350,000 people. In very remote areas, our services provided about one million episodes of care in a twelve-month period. Collectively, we employ about 6,000 staff (most of whom are Indigenous), which makes us the single largest employer of Indigenous people in the country.


[ii] Human Rights Law Centre and Change the Record Coalition, 2017, Over-represented and overlooked: the crisis of Aboriginal and Torres Strait Islander women’s growing over-imprisonment: NB: The foreword is written by Vicki Roach, a presenter in the next session of the Abolition conference

[iii] file://nfs001/Home$/doris.kordes/Downloads/748-Article%20Text-1596-5-10-20180912.pdf – John Rynne and Peter Cassematis, 2015, Crime Justice Journal, Assessing the Prison Experience for Australian First Peoples: A prospective Research Approach, Vol 4, No 1:96-112.

[iv] Australian Institute of Health and Welfare. 2018. Family, domestic and sexual violence in Australia. Canberra.


[vi] ‘A culture of disrespect: Indigenous peoples and Australian public institutions’.


NACCHO CEO Pat Turner and @END_RHD_CRE Co- Chair @jcarapetis call for a commitment to eliminate #RHD in Australia and clear plan of action and targets to measure progress

” Aboriginal and Torres Strait Islander children are 55 times more likely to die of rheumatic heart disease than other Australian children. We’re here today seeking a commitment from all political parties to stop this preventable disease from ever taking the life of another child in Australia.”

Aboriginal leaders are here to let politicians know that we are ready to partner with them, and that with their support, ending the disease is achievable,”

Ms Pat Turner AM, Co-Chair of END RHD and CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO), says comprehensive and collaborative action to tackle the disease is needed to ensure Aboriginal and Torres Strait Islander children are given the chance to reach their full potential.


See Pat Turner speech in full Part 4 Below

Three Aboriginal brothers – the youngest only three – who are living with deadly rheumatic heart disease (RHD) will today join community representatives, health workers and medical experts at Parliament House, asking for a commitment to end the disease in Australia.

Virtually eliminated from the rest of Australia and most wealthy countries decades ago, rheumatic heart disease remains a scourge in developing countries and remote Aboriginal and Torres Strait Islander Communities, where rates are among the highest in the world. RHD starts with a sore throat or skin sores but can end with permanent heart damage, open-heart surgery and death at a very young age.

Also speaking at the event is one of the world’s leading rheumatic heart disease researchers, Professor Jonathan Carapetis AM, Co-Chair of END RHD and Director of the Telethon Kids Institute, who says a nonpartisan commitment is the next step needed to tackle the disease in Australia.

“I’ve spent 25 years researching rheumatic heart disease, and I truly believe that we’ve never been in a stronger position to eliminate the disease in this country.”

“Aboriginal and Torres Strait Islander organisations are taking the lead and working hand in hand with communities. We researchers are bringing the evidence to support them. If there is one country in the world that should be able to eliminate RHD, it is Australia,” Professor Carapetis said.

The Snow Foundation CEO, Georgina Byron, said event participants are pleased that RHD has become a priority for the Australian Government.

“The Government’s commitment to developing a roadmap to eliminate RHD is a great start, but we need an urgent allocation in the 2019 Federal Budget to commit to immediate action, fund comprehensive primary health care and appropriate educational activities in communities at high risk of RHD. We need to continue to ensure Aboriginal and Torres Strait Islander leadership, and set stretch targets to end RHD,” Ms Byron said.

Aboriginal Communities are taking local action to stop the devastating effects of the disease through community-led solutions. A unique program highlighted today engages Aboriginal Health Practitioners to use traditional languages and new technology, to create a comprehensive local effort to identify and stop RHD.

“With the engagement and participation of traditional owners in Maningrida, the local school, the health clinic, and Malabam Health Board, 13 new cases of RHD were discovered among 450 children, and two children – aged 8 and 12 – needed emergency heart surgery,” says Dr Bo Reményi, paediatric cardiologist and NT Australian of the Year. “At the same time, teachers and health workers were educating children and families about prevention in traditional language and through local metaphors. As one traditional owner recently remarked, ‘it’s been the greatest community collaboration I’ve ever experienced.’”

A comprehensive, community strategy, led by Aboriginal and Torres Strait Islander people, is critical to ending RHD. With strong leadership and political support, we will meet Australia’s commitment earlier this year at the World Health Assembly to prevent, control and eliminate rheumatic heart disease, but we need to take action now so that no child born in Australia from this day forward will develop rheumatic heart disease.

 Part 2 About The Snow Foundation

The Snow Foundation is the creation of brothers Terry and George Snow who have a straightforward view—if you see someone struggling, give them a helping hand.

Since it was established in 1991, the foundation has helped more than 250 groups, more than 240 individuals and provided more than $27 million in funds. Every dollar donated was given with the aim to enable individuals and organisations introduce positive improvement in their lives and their communities.

The foundation has helped with projects big and small, in a broad range of areas such as education, belonging, social change and health. Projects include purchasing vital equipment for people with disabilities, developing microloans to help women escape domestic violence, funding scholarships, providing a home for the homeless, advocating for marriage equality, broadening the impact of excellent palliative care and partnering with community organisations, philanthropy, businesses and governments to improve and save lives whenever possible.

Part 3 About END RHD

END RHD is an alliance of health, research and community organisations seeking to amplify efforts to end rheumatic heart disease in Australia through advocacy and engagement.

END RHD is the first time such a broad-based alliance has come together to pool their collective expertise. END RHD is:

  • Working with the communities most at risk of rheumatic heart disease in Australia. Only through Indigenous-owned, community-led strategies will we be able to successfully tackle the disease.
  • Securing funding and the political will to turn the world class research conducted by the End Rheumatic Heart Disease Centre of Research Excellence (END RHD CRE) into action.
  • Educating and empowering Australians about the role they can play in ending rheumatic heart disease

The founding members of END RHD are the Australian Medical Association, Heart Foundation, National Aboriginal Community Controlled Health Organisation (NACCHO), RHD Australia based at Menzies School of Health Research, Aboriginal Medical Services Alliance Northern Territory (AMSANT), Aboriginal Health Council of Western Australia (AHCWA), the END RHD Centre of Research Excellence based at Telethon Kids Institute, The Aboriginal Health Council of South Australia (AHCSA), the Queensland Aboriginal and Islander Health Council (QAIHC) and the Aboriginal Health and Medical Research Council (AH&MRC).

Part 4 Ms Pat Turner, CEO of NACCHO and Co-Chair END RHD

Thank you and I too wish to acknowledge the traditional owners. It is wonderful to join you on the country of Ngunnawal and Ngambri peoples. Thank you for your welcome, and to the traditional owners of this land. We are coming together today with Aboriginal and Torres Strait Islander people from around the country, including from remote Maningrida in the Northern Territory. I also want to welcome and acknowledge Minister Wyatt for his leadership on rheumatic heart disease.

Let me begin by saying I believe that today can be the beginning of the end of rheumatic heart disease. Our shared vision is that no child born in Australia from this day forward should die of RHD. We are here – now – to ask for your help in bringing that vision to life.

Rheumatic heart disease begins with a sore throat or a skin sore. For our children, these are common infections – but the impact can last a lifetime. A lifetime which, too often, is cut short.

We are going to hear today about the impact of these infections and the complications they can cause when RHD develops. I will let families and health workers tell their stories about why that happens, and what it means for them.

I want to tell you first why this matters for me.

As the CEO of NACCHO, I spearhead the Aboriginal Community controlled Health Sector where we employ over 6000 staff people working across 300 clinics at the community level to deliver comprehensive primary health care.

Comprehensive care means that we do everything – immunisations and iron infusions, injuries and ischaemic heart disease. Doing everything means that we rarely choose to focus on a single disease. There is so much to be done, we can’t afford to have ‘favourite’ diseases.

But RHD sticks out. It’s the greatest cause of cardiovascular inequality for Aboriginal and Torres Strait Islander people in this country. Non-Indigenous people, literally, just don’t contract it. 98% of people who get RHD in Australia are Aboriginal and Torres Strait Islander people.

We get it because of crowded houses, because – despite our best efforts – showers don’t work, taps don’t run, and clothes don’t get washed. We get it because our clinics are overwhelmed with demand and sometimes skin sores and sore throats go untreated. We get it because rheumatic fever gets missed and sometimes it is too late for treatment.

At NACCHO, we became a founding partner of END RHD not because this disease is a simple fix, but because it is hard. Because it spans from housing to clinics to open heart surgery.

It exemplifies the gaps in prevention in the health system and in outcomes. We are focusing on this because the only possible solution is a comprehensive, Indigenous-led primary care-based strategy of both prevention and treatment.

In pursuing this goal we have an opportunity to work together, collaboratively, in new ways. We believe in that way of working and we believe that it can end RHD.

We’ve been worried about RHD for decades. Young people kept dying and researchers kept writing papers about the problem. We’ve had some dribs and drabs of progress but it was always fragmented – some projects on echo screening, on improving needles for kids with RHD, some on better registers of people living with the disease.

In 2015 the National Health and Medical Research Council funded the END RHD Centre of Research Excellence – the END RHD CRE. The END RHD CRE said they were going to write an Endgame Strategy for RHD. We thought they’d picked a weird name for yet another report on yet another disease.

We carried on with comprehensive primary health care delivery.

But the drum beat about the need to tackle RHD has grown louder, and today, we are at a tipping point.

We heard about the work of Take Heart to tell the stories of people living with RHD.

We saw that movie and we knew that sharing the reality of RHD was going to help everyone see what we already knew – RHD has an enormous impact in community. Then we started to hear about plans for the World Health Organisation to call for action on RHD globally – we know that Australia is one of the few wealthy countries where RHD still exists, and has a real opportunity to show international leadership in ending our domestic disparity.

In 2016, the Australian Medical Association focused their Indigenous Report Card on the issue of RHD and called for targets to tackle RHD by 2031. At the launch of that document, we announced the formation of END RHD – an alliance of organisations working to address the disease together. NACCHO was pleased to be a founding partner – alongside

The Australian Heart Foundation

The Australian Medical Association

Menzies School of Health Research

Telethon Kids Institute

And, critically, NACCHO affiliates in the 5 jurisdictions with high rates of RHD – ACHWA, AMSANT, QAICH, AHSCA and AH&MRC.

The interest of these groups made it clear that RHD isn’t something that we just have to live with or die from. It’s something we can take collective action about.

In May this year we heard that a resolution on RHD was passed at the World Health Organisation in Geneva. All countries must report on their actions to address RHD. The world will be watching Australia particularly closely.

Momentum since then has continued to grow. Minister Wyatt has shown great leadership in convening two roundtables on RHD, discussing the issue at COAG twice this year. Funding has been allocated to begin pilot programs in a small number of communities to prevent new cases of RHD. Other projects supported by philanthropic organisations, including our co-hosts, the Snow Foundation, demonstrate the power of community leadership.

END RHD has been joined by a whole network of supporters who have signed up as charter signatories to END RHD (name or indicate logo – TBD). We are working closely with the END RHD CRE to make sure that their Endgame Strategy isn’t just another report on a shelf, but a really tangible roadmap of what we need to do to tackle this disease.

And so we are here today – at the beginning of the end. And we need you to make it happen. Not just in a report – but in real world.

So we are asking you today:

  • For a commitment to eliminate RHD in Australia.
  • For a clear plan of action and targets to measure progress.
  • For a commitment to achieve those targets through the COAG process.
  • To appoint an Indigenous-led Steering committee to oversee that work.

And I need to let you know what we’re asking you to sign up to:

  • We estimate that it will take two decades to end RHD.
  • It’s going to take money. Some now, and more later. Probably much more – my research friends are running up the numbers to estimate the cost.
  • It’s going to mean working beyond the health sector. We need action on housing and environmental health, which drives this disease.

So there is a long road ahead of us – but that road is transformative. Not just because we can save lives and prevent the human suffering of RHD. That is important. But also, because a comprehensive, community-led approach to primary care and environmental health will help address so much more: ear disease, eye disease, childhood lung infections. RHD is just the start of this new way of working.

END RHD and our partners stand ready to put that new way into practice. We are already working with individuals, families, and communities most impacted by the disease. We are working with researchers to develop the best, and most effective recommendations. We are working with allies outside of health, in business, and in philanthropy to combine our efforts on this disease and all the preventable suffering it represents.

Today we come as a community, to Canberra, to seek a political commitment to support these efforts. Make no mistake – the financial ask is brewing and we expect that to be accounted for – but today, we ask that you hear the RHD story from the people who live it – and ask that you join us to commit, publicly, to end rheumatic heart disease in Australia. To resource that. And to let us lead the way.




NACCHO Aboriginal Health Workforce and Training News : Our peak bodies @KenWyattMP and @CPMC_Aust Building the Aboriginal and Torres Strait Islander health workforce and strengthening alliances to address the health priorities of Indigenous Australians.


” NACCHO stresses the importance of continuing to grow the depth and number of Indigenous people in the health sector.

Improving the health of our people can only occur through partnership, and integrating health care providers with community controlled services is the key.

Ms Patricia Turner, CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO)

 “Background :  On 31 May 2017 the Australian Government joined with the Council of Presidents of Medical Colleges, the Australian Indigenous Doctor’s Association and the National Aboriginal Community Controlled Health Organisation as partners to improve the good health and wellbeing for Aboriginal and Torres Strait Islander peoples.

Focussing on Tier Three of the National Aboriginal and Torres Strait Islander Health Plan, partners are working in collaboration to improve system performance by focussing on two key comprehensive areas for collective strategic action: increase the health workforce and embed cultural safety and competency in the system

Download a full copy of the signed agreement 

Signed Agreement

Australia’s peak bodies for Indigenous health and specialist medicine have reaffirmed their commitment to working with the Australian Government as partners in reducing the current gap in health outcomes and life expectancy between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians under the Closing the Gap strategy.

Introducing the forum held on Wednesday 12th September at Parliament House, Minister Ken Wyatt AM, welcomed the opportunity to continue discussions under the National Partnership, highlighting the Australian Government’s commitment to Closing the Gap as the platform for improving the health and wellbeing for Aboriginal and Torres Strait Islander peoples.

The decision by Australian Health Ministers through the Council of Australian Governments Health Council to develop a National Aboriginal and Torres Strait Islander Health Workforce Plan by 2019 was welcomed by the collaborative partners.

Discussing the key areas of the partnership, cultural safety and access to services remain top priorities.

The Chair of the Council of Presidents of Medical Colleges (CPMC) Dr Philip Truskett AM reported that the key focus area of increasing the Indigenous specialist medical workforce by focussing on support, mentoring, role modelling was core business for Australia’s specialist Medical Colleges.

Indigenous Health Minister Ken Wyatt AM said the collaborative group was ideally placed to play an essential role in the COAG Health Council resolution to develop a National Aboriginal and Torres Strait Islander Health and Medical Workforce Plan – to ensure more Aboriginal doctors, nurses and health workers on country and in our towns and cities, local warriors for health among our families and communities.

Dr Kali Hayward, President Australian Indigenous Doctor’s Association (AIDA) reflected on building culturally appropriate health workforce and the need to discover champions in the system to support training.

Ms Janine Mohammed, CEO Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) highlighted the merit in greater coordination of services to deliver improvements in health outcomes.

Mr Karl Briscoe, CEO, National Aboriginal and Torres Strait Islander Health Workers Association (NATSIHWA) highlighted the importance of building the Aboriginal and Torres Strait Islander health workforce and strengthening alliances to address the health priorities of Indigenous Australians.

All partners acknowledged a National Aboriginal and Torres Strait Islander Health Workforce Plan will form the framework for furthering collective action to increase the Indigenous health workforce and embed a cultural safety capability in Australia’s health system.


NACCHO #NAIDOCWEEK #BecauseofherWeCan #WeCan18 @RecAustralia Interview with NACCHO CEO Pat Turner “A reconciled nation will be when Aboriginal and Torres Strait Islander peoples have self-determination over their own lives without the constraints of poverty and the burden of disease “

“ A reconciled nation will be when Aboriginal and Torres Strait Islander peoples have self-determination over their own lives without the constraints of poverty and the burden of disease. We will be in charge of our own affairs and in control over decisions that impact on us.

Our past will be fully acknowledged and our collective future celebrated without reservation. There will be no more debates over our shared history and Aboriginal and Torres Strait Islander peoples’ land ownership.

Racism will not be a barrier to Aboriginal and Torres Strait Islander people accessing education, employment and health services.

There will be complete acceptance of our unique cultural heritage and identities by all Australians enabling our languages, our connection to land and our cultural practices to flourish without restraint and be incorporated in all aspects of our nationhood “

Pat Turner AM NACCHO CEO interview with Reconciliation Australia when asked  : What does a reconciled Australia look like to you?

“They’ve allowed us to retain our identity”

NACCHO Aboriginal Health Australia CEO Pat Turner tells National Rural Health Alliance  Di Martin about the importance of Aboriginal grandmothers guarding language and culture #BecauseOfHerWecan


Background Pat Turner AM

Ms Pat Turner AM is the daughter of an Arrernte man and a Gurdanji woman, and was born and raised in Alice Springs.

After her father’s death in an accident at work, Ms Turner’s family experienced extreme financial hardship. Her mother’s courage and leadership in the face of such difficult circumstances was a constant inspiration.

Ms Turner joined the Australian Public Service in the early 1970s and joined the senior executive ranks by the mid-1980s. She worked in a range of prominent roles, including as Deputy Secretary in the Department of the Prime Minister and Cabinet during 1991-92, where she had oversight of the establishment of the Council for Aboriginal Reconciliation. In 1994-98, Ms Turner was the CEO of the Aboriginal and Torres Strait Islander Commission, making her the most senior Indigenous government official in the country.

Over the years, Ms Turner became more committed to the politics of self-determination. At a professional level, this meant being a firm supporter of community-based service delivery of health and welfare programs for Aboriginal people.

Today, Ms Turner is the CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO). NACCHO is the peak body representing 144 Aboriginal community-controlled health services across the country on Aboriginal health and wellbeing issues.

Interview continued: What or who got you involved in reconciliation? 

I first started thinking about reconciliation and the place of Aboriginal people in Australia after attending the graduation ceremony of Uncle Charlie Perkins from Sydney University with Nanna Hetty Perkins. I was thirteen at the time, and listening to Charlie speak, I started to understand the importance of education if I wanted to make a difference.

After joining the Australian Public Service and moving from Alice Springs to Canberra, I was later appointed Deputy Secretary, Department of Prime Minister and Cabinet. It was here I had a specific role in working for the Government on the legislation and establishment of the Council of Aboriginal Reconciliation. I was the inaugural National Secretary to the Council.

After returning to Alice Springs in 2006 I held the position of CEO of National Indigenous Television where I supported the celebration of Indigenous culture and helped challenge perceptions and fears of many non-Indigenous Australians about Aboriginal and Torres Strait Islander peoples that are a continuing barrier to reconciliation.

What do you see as the biggest challenges to national reconciliation?

Our biggest challenges are twofold:

Firstly, making both Federal and State Governments truly accountable to eliminate poverty and disadvantage endured by our people.

Secondly, acceptance and respect by all Australians of our unique cultural heritage and identities, our relationship with land, our languages and our cultural practices, so that those areas and the essence of our beings are incorporated into all aspects of Australian life and government efforts to eliminate our disadvantage.

NACCHO Aboriginal Health News Alert :@sunriseon7 finally shines light on Indigenous issues, but is it a real awakening (for all media)? Report from @croakeyblog

” In an era of fake news it was surprising that a popular breakfast news program would stop a live feed and resort to a green screen when confronted with Indigenous outrage over the comments of a few self-appointed white social media commentators from the other day.

That the Seven Network’s breakfast program Sunrise realised its mistake and offered to have a panel of three experts explain in lucid details the issues around the media storm they had generated was welcomed by NACCHO and our members.

Sunrise journalist David Koch asked well considered questions and the expert panel was able to respond in-depth regarding the removal of Indigenous children, the importance of  early intervention with increased funding for family support services and that multi-disciplinary teams should be invested in to work with Indigenous families urgently.

Unfortunately time did not permit discussion about other issues like extra resources devoted to early children’s education and the social determinants of health.

However, it should not just be about Aboriginal experts correcting the media record when the government has known about the health concerns of Aboriginal children for years: they are not listening to us and they give plenty of cash for their own pet projects. It’s time to resource our sector appropriately to reduce the numbers of children presenting in out of home care and juvenile detention as it has become a national scandal that needs to be fixed now. ”


” It shouldn’t be occurring in this day and age to have such insensitive comments made in mainstream domains and media about Aboriginal people, even if the person making them thinks they are doing it with best intentions in mind.

I think that the arrogance in not acknowledging what had gone down in the first panel until the community protested outside Channel Seven is an issue. I think it’s very good that Channel Seven convened a new panel but maybe they wouldn’t have done that if it that pressure wasn’t applied.

What should be occurring from here on is recruiting a panel of Aboriginal experts so that they call on these if they want to discuss Aboriginal issues. They should be convening an Aboriginal panel with expertise in the content matter and that way non-Indigenous Australians will have a broader exposure to the issues on the ground rather than through the few who are called in to talk about issues they have no expertise in.

It needs to be done on a regular basis. TV stations will have much more credibility for seeking informed commentary. A good journalist will seek alternative views or expert commentary and publish informed commentary. It’s never what happens.

The more we can have visibility in the Australian mainstream media, the more informed the Australian population will be. Currently they are too often informed by a minority that hold polarising views for Aboriginal people. They don’t get enough expertise to talk about these complex issues in Aboriginal health and they need to do it much more regularly ”

SAHMRI researcher James Ward

Our thanks to Croakey for this comprehensive coverage of Sunrise’s second effort on the issue, for their reflections and what needs to be done going forward. Subscribe view HERE

Sunrise finally shines light on Indigenous issues, but is it a real awakening (for all media)?

Editor: Marie McInerney

Channel Seven’s Sunrise program has finally shone a little light on complex Aboriginal and Torres Strait Islander child protection issues in the face of major criticism, formal complaints, distress and protests over an ill-informed, offensive panel discussion it aired last week.

Aboriginal community members protested for three days outside Seven’s Sydney studio over the segment that South Sea Islander and Darumbal journalist Amy McQuire and Yorta Yorta writer and public health consultant Summer May Finlay said “regurgitated mistruths” and was “sensationalist and frankly incorrect”.

Media Watch declared it was “A Sunrise to forget”.

It took a week but on Tuesday the breakfast TV show had a lengthy (by its standards) interview with three Indigenous health leaders: National Aboriginal Community Controlled Health Organisation (NACCHO) CEO Pat Turner, Danila Dilba CEO Olga Havnen and South Australian Health and Medical Research Institute (SAHMRI) researcher James Ward.

You can watch the six minute segment here.

“We’ve got to talk about it, we’ve got to do something about it,” vowed anchor David Koch at the end of the discussion that highlighted the failure of governments to listen to Indigenous health experts, problems with government funding, systemic failures in health and child protection services, lack of community control and the conflation of sexually transmitted infection (STI) figures with child abuse.

But what Sunrise apparently didn’t feel the need to discuss was its own performance, its own journalistic standards, and the distress unleashed by last week’s ignorant and ill-informed discussion between Sunrise co-anchor Samantha Armytage and white shockjock commentators Prue MacSween and Ben Davis.

Armytage was no objective player or considered/informed moderator in the session, opening the two-minute ‘Hot Topic’ with: “Post-Stolen Generations there’s been this huge move to leave Aboriginal children where they are, even if they’re being neglected in their own families…”

(See the bottom of the Croakey  post for important reading on the placement of Indigenous children in out of home care from Victoria’s Commissioner for Aboriginal Children).

Thus it took just a minute for MacSween to follow this premise to declare it was “perhaps” time to consider a new Stolen Generation approach.

By the weekend Sunrise was clearly stung or shamed or embarrassed enough, with protesters assembling outside its studios at dawn and social media enraged, to finally do what it should have in the beginning, and invite Indigenous experts to the discussion.

“We don’t need confected outrage and anger”

But there was no mea culpa.

The show ignored the many calls for an apology, with ‘Kochie’ neatly sidestepping any culpability by referring only to how a “complex and emotional” discussion had been prompted by a newspaper report, headlined “Save Our Children”.

There was no mention of where it got it wrong, nor that it ignored three days of protests against the segment outside its Sydney studios last week, to the point of switching to a pre-recorded loop of a very quiet Martin Place for its studio backdrop on one day.

There was nothing about how, as ABC’s Media Watch revealed,  it had to take down the segment from its website because footage used to illustrate the “dangerous environment” that Indigenous children were allegedly subject to included a child getting a skin check in a film commissioned by Indigenous charity One Disease, used without permission.

It was left to Olga Havnen to have to interject at the end:

“What we need is intelligent informed discussions and looking for solutions rather than the confected outrage and anger.”

As my Croakey colleague Dr Ruth Armstrong said:

Kochie should have picked up on Olga’s comment, and asked (at least himself if not out loud) if there is any place in 2018 for a segment like ‘Hot Topic,’ where ‘social commentators’ are trotted out to shoot from the hip on issues that are far too nuanced and sensitive to be dealt with so flippantly. And will Sunrise develop a policy of going to Indigenous experts when they want to discuss Indigenous issues?

Kochie said “Let’s work together to try and get some of those changes through. It is a real issue affecting Indigenous people around the country.”

Does he know that he and his media buddies can actually have a role in improving Indigenous health and welfare? If only they will ask the right questions of the right people instead of amplifying sensationalism and misinformation.

With that in mind, the Croakey connective has come up with a few of the questions that ‘Kochie’ could have asked the panel – and/or himself and his colleagues (because many of these are surely not questions that Aboriginal and Torres Strait Islander people must be expected to explain over and over again).

Questions Kochie could have asked

  • Why is it, do you think, that mainstream media reports so badly on Indigenous issues as we did on this last week?
  • What impact does it have on Aboriginal and Torres Strait children and families when we talk about communities like that?
  • What impact does it have on the Stolen Generations?
  • What should we have done on the day?
  • Why is it, do you think, that we won’t hold the Minister and other media to account over clumsy/inaccurate/uninformed/misleading/inflammatory comments but we will target Aboriginal and Torres Strait Islander people instead?
  • What was the impact from us showing archive footage of Aboriginal people with the implication they were somehow responsible/involved/at risk in abuse?
  • What should we have shown?
  • Who should hold media outlets like us to account: regulators, (white) journalists, advertisers, politicians?
  • How can we ensure that we include Indigenous voices in our stories in the future?
  • Can you suggest cultural safety training that all Australian journalists should undertake (and what the main issues are to address), as outlined in this submission to the recent Senate public interest journalism inquiry?
  • What’s the next most important Indigenous health topic we should cover in depth?
  • Can we book you all for a regular spot on the show so we can highlight these issues properly more often?

And Qs from the Croakey connective on child protection:

  • How do we best keep Aboriginal kids safe while maintaining their ties with family and culture?
  • What are the problems with the current system?
  • What can be done to better support Aboriginal families?
  • Data shows Aboriginal people frequently experience racism in hospitals and healthcare and it leads to worse outcomes – to what extent do you think racism and bias occurs in the child protection system? What would the impacts of this be?
  • What cultural safety training do child protection workers undergo? Best practice in learning recommends immersion in Aboriginal settings and learning from Aboriginal people – how much time do staff get for this professional development?

“Mopping up the mess”

The trouble is, of course, the Sunrise segment is no isolated example, but reflects ongoing, broader issues about representation and racism in the media and widespread media practices that harm the health, wellbeing and lives of Aboriginal and Torres Strait Islander people.

They not only promote racist stereotypes but also divert the public spotlight from failures in government policies and processes, and consume the focus and energy of Aboriginal and Torres Strait Islander people, communities, and organisations.

“Black people had to do a lot of work last week and it wasn’t even Invasion Day, Sorry Day, or NAIDOC Week,” said University of Queensland senior lecturer, Dr Chelsea Bond, an Aboriginal (Munanjahli) and South Sea Islander Australian, in this must-read piece at IndigenousX.

The implications of that also came out, she wrote, at a session she chaired last week at Converge, a First Nations National Media Conference.

Turns out the dilemma for First Nations news media is deciding how much of their little resources is exhausted on mopping up the mess created by mainstream news media and how much is invested in taking charge of the narrative and producing real Indigenous news content that has context and relevance to a local and/or national audience.

Indigenous journalist Amy McQuire  also had a revealing anecdote in her IndigenousX article: Spare us your false outrage.

She remembered being outside Parliament House in Canberra in 2015, on the day of the Abbott-Turnbull leadership spill, when Armytage and all the other mainstream TV stations were broadcasting live, with an unanticipated backdrop.

In a protest planned for months, Grandmothers Against Removals campaigners had come to Canberra from across the country to draw attention to skyrocketing rates of Aboriginal child removal. McQuire wrote:

The response from ‘journalists’ Armytage and David Koch was worse than silence. In one of the ad breaks, they turned around and admonished those who had assembled behind them. Rather than listen to their stories, rather than hearing about their children, they castigated them for daring to interrupt their broadcast. As Armytage ‘tsked tsked’, Koch told them to look at the charities he donated to before addressing him.

Where to from here?

Some other things (than Sunrise) to watch:

Which TV station will be first to take up James Ward’s challenge to set up a panel of Aboriginal experts so that they call on these if they want to discuss Aboriginal and Torres Strait Islander issues?

How will Sunrise handle its next complex Indigenous issue?

What can the wider public health field can learn from Indigenous resistance, activism and critique/demolition of mainstream narratives?

And what will the wider mainstream media learn from Sunrise’s awakening?

The early signs may not be good, judging from this tweet.

Watch Here

NACCHO Aboriginal Women’ Health #NWHS18 Read full Keynote Address Pat Turner CEO NACCHO @RANZCOG National Women’s Health Summit

RANZCOG National Women’s Health Summit

2 March 2018

Patricia Turner, CEO NACCHO

Keynote address “Aboriginal and Torres Strait Islander Women’s Health”

Read over 300 NACCHO Aboriginal Health Articles we have published over the past 6 years : SUBSCRIBE HERE


I begin by paying my respects to members of the Gadigal of the Eora Nation as the traditional custodians of this place we now call Sydney.

It is proper that I acknowledge the different Aboriginal groups when I travel to various parts of Australia because it should never be forgotten that our people have lived here for over 65,000 years. In those days Australia was a truly liveable place for our people.

So, thank you very much for the warm welcome Julia and to RANZCOG for inviting me to speak today.

It was important to hear from Minister Hunt, to listen to Professor Baum articulate the social determinants of women’s health and Professor Gannon discuss the economic impact of women’s health.

It is an honour to be asked to address an audience of 100 successful and influential women from the health care sector.

Today this summit is an opportunity to highlight health challenges facing Aboriginal women today. To help them live healthier, longer lives, supported by better, more targeted health services across the nation.

But first, I think this morning is an opportunity for all of us in this place to celebrate the contribution women make in our lives.

It is important to acknowledge how far we have all come together over the last 100 years.

The new medical technology now saves countless lives, the testing regimens are first rate, surgical care has been enhanced and women now have pathways to a multitude of careers and thrive in the health workforce. Some are even in positions of ‘real power’ to advocate for reforms.

Now let’s be clear that Australia has a world-class health system, but not for all of us! Yes, I could mention issues around pay, promotion, mentoring, bullying and harassment but that’s not why we are here today! So, let’s focus today on the fact that health outcomes for Aboriginal and Torres Strait Islander women in Australia are a long way from those of non-Indigenous women.

Whilst it is very flattering to be counted as one of the 100 influential women in this room.

It is important that you know how I became the person I did. I know that my experience was gained from and influenced by my mother.

She was the first medical person I knew. She cared for me and my family as a healer and she helped make me the woman I am today. Education just knocked off my rough edges!

Now, let’s not forget that Aboriginal people invented Bush Medicine which they still use today. They had ready access to bush tucker and led a healthy way of life before colonisation. We still have remnants of our past practice that continue today like using traditional healers and have access to very advanced Western medical models of health care.

I have had a long, varied and distinguished career in the Australian Public Service including as Deputy Secretary of Prime Minister and Cabinet, Centrelink and was the longest serving CEO of ATSIC. I was also the inaugural CEO of the National Indigenous Television (NITV). So, I know how to argue for a change in women’s health policy. I’ve had a lot of experience in dealing across bureaucracy, Ministers, budget cycles, developing public health initiatives and campaigns and essentially dealing with governments at every level in this country.

Now, NACCHO is the national peak body representing 144 Aboriginal Community Controlled Health Services in over 304 clinics and health settings. Our very first AMS started in Redfern and has 47 years of experience to draw upon.

We provide about three million episodes of care each year for about 350,000 people which is provided by almost 6,000 staff. In very remote areas, our services provided about one million episodes of care. Over 50 per cent of the workforce is Aboriginal and we are working at increasing that.

There are many gaps in our Aboriginal Community Controlled Health Services and their holistic approach in delivering comprehensive primary care to our people, no matter where they live. We are mapping those gaps. Our aim is to ensure full coverage for our people.

We are funded by the Australian Government to support improvements in Indigenous health through the Aboriginal Community Controlled Health Services network and to bring the voices of those services into health policy decisions in Canberra.

NACCHO is independent of, trusted by and offers a strong voice to the federal government for the provision of specific community sector health care needs for Aboriginal people that is controlled by Aboriginal people. This ensures a strong voice in policy work and participation in policy development and legislation advocating and dealing with the issues as they arise or as reforms are discussed.

I coordinate 25 staff who sit on some 60 national committees and bodies. Historically NACCHO has a proud tradition and has developed over the last 20 years a strong coalition of support with other NGO’s working across a diverse range of areas.

We offer an alternative point of view enhanced by years of dedicated experience. Aboriginal perspectives from our governing bodies and staff about culturally appropriate healthcare needs are admired and respected by government.

According to the Australian Bureau of Statistics Aboriginal and Torres Strait Islander peoples represented 2.8 per cent of the population counted in the 2016 Census or 649,200 people of whom 326,996 were females. The median age of an Aboriginal is 23 years and only one in ten reported speaking one of the 150 Australian Indigenous languages at home.

There were 18,560 births registered in Australia during 2016 (6% of all births) where at least one parent reported themselves as being an Aboriginal or about 2.12 babies per woman. Births to women aged under 30 years contributed three-quarters (73%) of the total fertility rate for Aboriginal women with the median age of 25.5 years when having their first child.

This is important, especially when you realise that our Aboriginal population will increase to one million people by 2030.

As many of you would know, the state of Aboriginal health continues to be cause for both national shame and requires national action. I’m still as frustrated as some of you are that we have not Closed the gap for Indigenous people, had meaningful reconciliation in this nation and enhanced Aboriginal women’s health.

I believe there is no agenda more critical to Australia than enabling Aboriginal people to live good quality lives while enjoying all their rights and fulfilling their responsibilities to themselves, their families and communities. Aboriginal people should feel safe in their strong cultural knowledge being freely practiced and acknowledged across the country. This should include the daily use of our languages, in connection with our lands and with ready access to resources.

Aboriginal people should feel free from racism, empowered as individuals and have educational opportunities, careers, and health services to meet their needs and overcome inequality, poverty and increase life expectancy.

Now the Australian Government’s 2007 commitment to close the gap between Indigenous and non-Indigenous life expectancy within a generation was welcome. But the Close the Gap agenda did not deliver on a fundamental change to the way governments work with Aboriginal people.

I want to be very clear that progress against the closing the gap targets is now stalling and, in many cases, is going backwards.

I am also concerned that the Government is now shifting the focus to ‘prosperity’ targets, when we don’t even have the basic targets on track.

The figures paint a staggering reality. The Australian Institute of Health and Welfare tells us that the mortality gaps are actually widening.

No government can preside over widening mortality gaps and maintain goals to improve life expectancy and child mortality rates. On average Indigenous men and women die 15 years earlier than other Australians. Indigenous people suffer chronic diseases that are entirely preventable and have virtually been eliminated in the non-Indigenous population: trachoma, rheumatic heart disease and congenital deaths as a direct result of the current Syphilis outbreak across Australia, are but three examples.

The Closing the Gap target to halve the gap in child mortality by 2018 is not on track. Our children are dying at almost three times the rate of non-Indigenous children and there is a clear disparity in birth outcomes for my people. So, we now all appreciate and understand that our services are on the frontlines of women’s healthcare every day.

But of course, it’s not all bad news, NACCHO, its affiliates and our hardworking member services have had recent success with various national health programs. As you know Alcohol consumption during pregnancy can result in birth defects and behavioural and neurodevelopmental abnormalities including Fetal Alcohol Spectrum Disorder (FASD).

NACCHO recently provided advice to mothers that included practical advice and assistance with breastfeeding, nutrition and parenting, monitoring of developmental milestones, immunisations status and infections controls in 85 health service sites in remote, regional and urban locations. The FASD Prevention and Health Promotion Resources worked and did help to reduce the impacts of FASD in Aboriginal and Torres Strait Islander communities. The information also provided an opportunity to engage our local communities about other health issues like tobacco smoking, substance misuse and improving diets.

On the ground, Through Better Start to Life campaign, our Northern Territory member Danila Dilba has recently begun offering home nurse visits, meaning Darwin children and families now have more culturally appropriate access to antenatal and postnatal care resulting in better pregnancy outcomes which is vital in the first 1,000 days of a child’s life.

We now know that Mums participating in this program have fewer low birth weight babies, higher rates of breastfeeding and very high infant immunisation rates. We are also seeing women accessing antenatal care earlier in their pregnancies.

As you are aware a key component of improving pregnancy outcomes is early and ongoing engagement in antenatal care through culturally appropriate and evidence based care suitable to the local community. Investment in the early years is the best way to improve disadvantage over the longer term.

RANZCOG and NACCHO members understand this, evaluations have shown success in improving uptake of care earlier in pregnancy, for the duration of the pregnancy and in post-natal care allows other opportunistic healthcare interventions, such as family planning, cervical screening and improving breastfeeding rates.

So, by wrapping services around families, locally focused programs like this are also important in helping guard against the development of chronic conditions in later life, such as rheumatic heart disease and kidney failure.

While in Alice Springs, the Central Australian Aboriginal Congress is targeting at-risk Indigenous children before they even start preschool. The Preschool Readiness Program has up to 10 places for children between the ages of three and four who have been identified as having developmental delays or come from challenging home environments.

The foundations for health are laid early in life and there is much to be done in the early years to give our kids the best chance of succeeding at school and throughout their life.

If services cater for their needs, Aboriginal women will use them. However, not all Aboriginal women have access to these programs and many still rely on mainstream services such as GPs and public hospital clinics. That’s why it’s so important that mainstream services embed cultural competence into health care delivery across the care continuum.

Aboriginal culture has many strengths that can provide a positive influence, such as a supportive extended family networks, connection to country, and language. This is where the community controlled health sector and Aboriginal Health Workers are uniquely placed.

Our services build ongoing relationships to give continuity of care so that chronic conditions are managed and preventative health care can be effectively targeted.

Studies have shown that Aboriginal community controlled health services are 23% better at attracting and retaining Aboriginal clients than mainstream providers. Through local engagement and a proven service delivery model, our clients ‘stick’.

The cultural safety in which we provide our services is a key factor of our success. They can help to create relationships and understanding between our women and healthcare providers, practical assistance for attending appointments and coordinating care.

Many frontline clinicians and policy makers feel it is beyond their role to deal with these issues, but understanding some of these concepts will lead to greater empathy in the interactions with Aboriginal women.

We must acknowledge that Closing the Gap is not only a technical policy matter, but is also a political issue. We are disadvantaged, we are marginalised, we are poor, we do not have the numbers to influence government to the extent that others do, but we keep on trying.

The statistical gaps arise from voicelessness, powerlessness and a historical and significant lack of resources.

Firstly, the funding myth must be confronted as it stands like a rock in the way of progress.

As my good friend Professor Ian Ring tells us the commonly held view that enormous amounts of money have been spent on Indigenous Affairs has led many to conclude that money is not the answer and a different focus is required.

The recent Productivity Commission Report found that per capita government spending on Aboriginal services was twice as high as for the rest of the population. But higher spending on Aboriginal people should hardly be a surprise. We are not surprised, for example, to find that per capita health spending on the elderly is higher than on the healthier young because the elderly have higher levels of illness.

Nor is it a surprise that welfare spending is higher for Indigenous people who lag considerably in education, employment and income and there would be something very wrong with the system if it were otherwise.

The key question in understanding the relativities of expenditure on Indigenous is equity of total expenditure, both public and private, in relation to need, but the Productivity Commission’s brief is simply to report on public expenditure. In relation to government expenditure on health services the picture is quite different. State and Territory governments spend on average $2.6 per capita on Indigenous people for every $1 spent on the rest of the population.

By contrast, the Australian Government spends $1.4 for every $1 spent on the rest of the population, notwithstanding that, on the most conservative assumptions, Indigenous people have at least twice the per capita need of the rest of the population because of much higher levels of illness. The Commonwealth, in particular, needs to do much more. This is massive market failure.

The health system serves the needs of the bulk of the population very well but the health system has failed to meet the needs of the Indigenous population. And the Australian Government knows this, that’s why, for over 40 years they have been funding ACCHSs because they know the evidence shows these services better meet those needs, but the coverage of these services is patchy and needs to be expanded.

Secondly, Aboriginal communities need to be properly resourced, and Aboriginal people need to be in control. Let’s put Aboriginal health in Aboriginal hands.

It is imperative that a person’s health be considered in the context of their social, emotional, spiritual and cultural wellbeing, and that of their community. We know that being able to better manage and control your own affairs is directly linked to improved wellbeing and mental health.

This is why Aboriginal Community Controlled Health Services are essential to closing the health gap. Often Aboriginal people are uncomfortable seeking medical help at hospitals or general practices and therefore are reluctant to obtain essential care.

For example, the policy of forcibly removing children from Aboriginal families until the 1960s may still engender distrust of the ‘system’ in Aboriginal mothers. Access to healthcare is extremely difficult due to either geographical isolation or lack of transportation.

Many Aboriginal people live below the poverty line so that services provided by practices that do not bulk bill are unattainable. The most well-intentioned mainstream services struggle to provide appropriate healthcare to Aboriginal patient’s due to significant cultural and language disparities. Aboriginal Community Controlled Health Services bridge these gaps.

Their focus on prevention, early intervention and comprehensive care has reduced barriers to access and unintentional racism, progressively improving individual health outcomes for Aboriginal people.

 And thirdly, greater access to education, employment and participation in the economy.

So, for those three reasons, NACCHO continues to call on the Australian Government to invest in the expansion of the Aboriginal Community Controlled Health Services, to reach more people living in isolated areas, and to provide more care options for women, including mental health and psychology services.

Recently NACCHO, RANZCOG and other college Presidents met with the Minister for Indigenous Health and other ministers in Canberra who are all determined to do everything possible to close the gap in health outcomes. Now your stated mission is in providing excellence in women’s health. Well let’s do that by including Aboriginal women with new practical measures advocated to government and policy makers.

By all means let us together develop new statements and guidelines, by contributing effectively to health policy debate, in providing representation on various external committees and advisory groups, and responding to requests for submissions with expert evidence-based opinion.

Together lets us continue to drive policy development for the betterment of all women’s health with a view to developing a set of policy imperatives that must be addressed by Governments. It is through Aboriginal community controlled health service delivery that we can best close the gap. But we need your assistance.

We need your help with community-developed programs, that accept our cultural beliefs and traditions about health issues like contraception, termination, or pregnancy.

Currently Sexually Transmitted Infections rates have increased; the current syphilis outbreak has now reached four states predominantly infecting 15-29-year old’s with 12 cases of congenital syphilis causing five deaths.

In this day and age this is unacceptable! NACCHO seeks your assistance to insist on regular STI testing, a national public STI education campaign, with enhanced and clear antenatal guidelines, supported by a workforce with mobile local team’s conducting health checks and testing for other STI’s like gonorrhoea, chlamydia, HIV, Hepatitis C and B. This is the best way for you as individuals and organisations to contribute to improved Aboriginal women’s health outcomes and wellbeing.

As a group of 100 pioneering passionate women I know we have all earnt the accolades, enjoyed the press coverage and have a certain status in life. Let’s make a difference by today by being outspoken advocates for Aboriginal women and inspiring the next generation of women to not ask but demand better access to health care. Aboriginal women are the best advocates and leaders for health and wellbeing in their own families and in the broader community.

Please help bring about change, please make a contribution to improving the lives of Aboriginal women by lobbying governments.

We need your capabilities and skill, the energy and drive to make an impact, your commitment of time to our cause, your ingenuity and passion. Help us by proving to be effective role models, mentors and influencers for the next generation of Aboriginal female leaders.

I hope that today is seen as an opportunity to reflect on these vital Aboriginal women’s health issues. I urge you to act and commit to real sustainable practical change.

Don’t wait for government, don’t wait for them to provide the solutions. Work it out ourselves and just move on. So, to all you people here today I invite you to get in touch with your local Aboriginal Controlled Health Services and our Aboriginal health workers and to all your policy makers you can call me at NACCHO.

I have lost count of the number of speeches I have given over the years on this subject regarding Aboriginal women’s health to numerous gatherings, meetings, conferences, roundtables and symposiums. I will continue to speak for up all of our sisters, aunties, mothers and grandmothers.

I don’t expect or desire any consensus today but I expect robust discussion leading to identify policy reform that can be implemented. We must advocate for more action, adopt new policy positions and increase investment in the Aboriginal community controlled sector.

I know that the fight for Aboriginal rights continues and that the future is looking brighter for our mob with your support.

Thank you again for having me here today and I welcome any questions that you may have.

NACCHO Aboriginal Health #CloseTheGap Press Release : Download a 10 year Review : The #ClosingTheGap Strategy and 6 Key Recommendations to #reset

The life expectancy gap has in fact started to widen again and the Indigenous child mortality rate is now more than double that of other children.

This is a national shame and demands an urgent tripartite health partnership. This must be high on the agenda at tomorrow’s COAG meeting.”

In a departure from the campaign’s usual report, this year’s review focusses on the decade since the 2008 signing of the Close the Gap Statement of Intent.”

Close the Gap Campaign Co-Chair and Aboriginal and Torres Strait Islander Social Justice Commissioner, June Oscar AO, said the Close the Gap strategy began in 2008 with great promise but has failed to deliver.

 Read  CTG call for urgent action to address national shame press release Part 2

Download the 40 Page review HERE



“ The Close the Gap refresh being considered by the COAG provides an opportunity to reflect upon and reform current policy settings and institutionalised thinking,

The Close the Gap targets should remain, as should the National Indigenous Reform Agreement framework and associated National Partnership Agreements. They serve to focus the nation and increase our collective accountability.

What we need however is radically different action to achieve the targets

This starts with Aboriginal and Torres Strait Islander peoples, their community controlled health organisations and peak representatives having a genuine say over their own health and wellbeing and health policies.

“Increased funding is needed for ACCHOs to expand in regions where there are low access to health services and high levels of disease, and in areas of mental health, disability services and aged care.

ACCHOs have consistently demonstrated that they achieve better results for Aboriginal and Torres Strait Islander peoples, at better value for money.

NACCHO Chairperson, Mr John Singer.

Download NACCHO Press Release

1. NACCHO media release CtG – FINAL

Download NACCHO Press Background Paper

2. NACCHO media release ATTACH CTG – FINAL 10 Years On

Part 1 NACCHO Press Release : Increased support to Aboriginal Community Controlled Health Organisations needed to Close the Gap in life expectancy gap

The National Aboriginal Community Controlled Health Organisation (NACCHO) calls for urgent and radically different action to Close the Gap.

“The Council of Australian Governments’ (COAG) commitment to Close the Gap in 2007 was welcome.

It was a positive step towards mobilising government resources and effort to address the under investment in Aboriginal and Torres Strait Islander peoples’ health”, said NACCHO Chairperson, Mr John Singer.

“But ten years on the gap in life expectancy between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians is widening, not closing.

Jurisdictions currently spend $2 per Aboriginal and Torres Strait Islander for every $1 for the rest of the population whereas the Commonwealth in the past has spent only $1.21 per Aboriginal and Torres Strait Island person for every $1 spent on the rest of the population. NACCHO calls for the Commonwealth to increase funding to Close the Gap”, said John Singer.

NACCHO is a proud member of the Close the Gap Campaign and stands by its report released today: ‘A ten-year review: the Closing the Gap Strategy and Recommendations for Reset’.

The review found that the Close the Gap strategy has never been fully implemented. Underfunding in Aboriginal and Torres Strait Islander health services and infrastructure has persisted – funding is not always based on need, has been cut and in some cases redirected through mainstream providers.

The role of Aboriginal Community Controlled Health Organisations (ACCHOs) in delivering more successful care for Aboriginal and Torres Strait Islander peoples than the mainstream service providers is not properly recognised.

A health equality plan was not in place until the release of the National Aboriginal and Torres Strait Islander Health Plan Implementation Plan 2015, and this is unfunded.

And despite the initial investment in remote housing, there has not been a sufficient and properly resourced plan to adequately address the social determinants of health.

The framework underpinning the Close the Gap strategy – a national approach and leadership, increased accountability, clear roles and responsibilities and increased funding through National Partnership Agreements – has unraveled and in some cases been abandoned altogether.

A comprehensive and funded Indigenous health workforce is required to improve the responsiveness of health services to Aboriginal and Torres Strait islander peoples and increase cultural safety.

A boost in disease specific initiatives is urgently needed in areas where Aboriginal and Torres Strait Islander peoples have a high burden of disease or are particularly vulnerable, like ear health and renal disease, delivered through ACCHOs.”

“There also needs to be a way in which NACCHO and other Indigenous health leaders can come together with COAG to agree a ‘refreshed approach’ to Close the Gap”, said Mr Singer.

NACCHO has proposed to Government a way forward to Close the Gap in life expectancy and is looking forward to working with the Australian Government on the further development of its proposals.

The only way to close the gap is with the full participation of Aboriginal and Torres Strait Islander peoples. Until Aboriginal and Torres Strait Islander peoples are fully engaged and have control over their health and wellbeing any ‘refresh’ will be marginal at best, and certainly won’t close the gap


Australian governments must join forces with Aboriginal and Torres Strait Islander organisations to address the national shame of a widening life expectancy gap for our nation’s First Peoples.

“It’s time for each State and Territory government to affirm or reaffirm their commitments made via the Close the Gap Statement of Intent.

“Until now, the scrutiny has rightly been on the Federal Government regarding the need for it to lead the strategy and to coordinate and resource the effort.

But it’s now time for state and territory governments to step up.

“We want to see Premiers, Chief Ministers, Health and Indigenous Affairs Ministers in every jurisdiction providing regular and public accountability on their efforts to address the inequality gaps in their State or Territory.

“No more finger pointing between governments. A reset Closing the Gap Strategy should clearly articulate targets for both levels of government and be underpinned by a new set of agreements that include Aboriginal and Torres Strait Islander peoples, their leaders and organisations.”

Last year, the Prime Minister reported that six out of the seven targets were ‘not on track’. Since then, the Federal Government has announced that the COAG agreed

Closing the Gap Strategy would go through a ‘refresh’ process.

Close the Gap Co-Chair and Co-Chair of the National Congress of Australia’s First Peoples Rod Little, said the refresh process is the last chance to get government policy right to achieve the goal of health equality by 2030.

“The Close the Gap Campaign is led by more than 40 Aboriginal and Torres Strait Islander and non-Indigenous health and human rights bodies,” Mr Little said.

“No other group can boast this level of leadership, experience and expertise. We stand ready to work together with Federal, State and Territory governments. We have the solutions.

“You must get the engagement on this right. No half measures. No preconceived policies that are imposed, rather than respectfully discussed and collectively decided.”

The Close the Gap Campaign Co-Chairs have warned that, without a recommitment, the closing the gap targets will measure nothing but the collective failure of Australian governments to work together and to stay the course.

“While the approach has all but fallen apart, we know that with the right settings and right approach, including Aboriginal and Torres Strait Islander Peoples leading the resetting of the strategy, we can start to meet the challenge of health inequality, and live up to the ideals that all Australians have a fundamental right to health,” the Co-Chairs said.

Part 3 :This review’s major findings are:

1.First, the Close the Gap Statement of Intent (and close the gap approach) has to date only been partially and incoherently implemented via the Closing the Gap Strategy:

An effective health equality plan was not in place until the release of the National Aboriginal and Torres Strait Islander Health Plan Implementation Plan in 2015 – which has never been funded. The complementary National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023 needs an implementation plan and funding as appropriate. There is still yet to be a national plan to address housing and health infrastructure, and social determinants were not connected to health planning until recently and still lack sufficient resources.

The Closing the Gap Strategy focus on child and maternal health and addressing chronic disease and risk factors – such as smoking through the Tackling Indigenous Smoking Program – are welcomed and should be sustained.

However, there was no complementary systematic focus on building primary health service capacity according to need, particularly through the Aboriginal Community Controlled Health Services and truly shifting Aboriginal and Torres Strait Islander health to a preventive footing rather than responding ‘after the event’ to health crisis.

2.Second, the Closing the Gap Strategy – a 25-year program – was effectively abandoned after five-years and so cannot be said to have been anything but partially implemented in itself.

This is because the ‘architecture’ to support the Closing the Gap Strategy (national approach, national leadership, funding agreements) had unraveled by 2014-2015.

3.Third, a refreshed Closing the Gap Strategy requires a reset which re-builds the requisite ‘architecture’ (national approach, national leadership, outcome-orientated funding agreements).

National priorities like addressing Aboriginal and Torres Strait Islander health inequality have not gone away, are getting worse, and more than ever require a national response.

Without a recommitment to such ‘architecture’, the nation is now in a situation where the closing the gap targets will measure nothing but the collective failure of Australian governments to work together and to stay the course.

4.Fourth, a refreshed Closing the Gap Strategy must be founded on implementing the existing Close the Gap Statement of Intent commitments.

In the past ten years, Australian governments have behaved as if the Close the Gap Statement of Intent was of little relevance to the Closing the Gap Strategy when in fact it should have fundamentally informed it.

It is time to align the two. A refreshed Closing the Gap Strategy must focus on delivering equality of opportunity in relation to health goods and services, especially primary health care, according to need and in relation to health infrastructure (an adequate and capable health workforce, housing, food, water).

This should be in addition to the focus on maternal and infant health, chronic disease and other health needs. The social determinants of health inequality (income, education, racism) also must be addressed at a fundamental level.

5.Fifth, there is a ‘funding myth’ about Aboriginal and Torres Strait Islander health – indeed in many Indigenous Affairs areas – that must be confronted as it impedes progress.

That is the idea of dedicated health expenditure being a waste of taxpayer funds.

Yet, if Australian governments are serious about achieving Aboriginal and Torres Strait Islander health equality within a generation, a refreshed Closing the Gap Strategy must include commitments to realistic and equitable levels of investment (indexed according to need).

Higher spending on Aboriginal and Torres Strait Islander health should hardly be a surprise.

Spending on the elderly, for example, is higher than on the young because everyone understands the elderly have greater health needs.

Likewise, the Aboriginal and Torres Strait Islander population have, on average, 2.3 times the disease burden of non-Indigenous people.[i] Yet on a per person basis, Australian government health expenditure was $1.38 per Aboriginal and Torres Strait Islander person for every $1.00 spent per non-Indigenous person in 2013-14.[ii]

So, for the duration of the Closing the Gap Strategy Australian government expenditure was not commensurate with these substantially greater and more complex health needs.

This remains the case. Because non-Indigenous Australians rely significantly on private health insurance and private health providers to meet much of their health needs, in addition to government support, the overall situation for Aboriginal and Torres Strait Islander health can be characterised as ‘systemic’ or ‘market failure’.

Private sources will not make up the shortfall. Australian government ‘market intervention’ – increased expenditure directed as indicated in the recommendations below – is required to address this.

The Close the Gap Campaign believes no Australian government can preside over widening mortality and life expectancy gaps and, yet, maintain targets to close these gaps without additional funding. Indeed, the Campaign believes the position of Australian governments is absolutely untenable in that regard.


In considering these findings, the Close the Gap Campaign are clear that the Close the Gap Statement of Intent remains a current, powerful and coherent guide to achieving Aboriginal and Torres Strait Islander health equality, and to the refreshment of the Closing the Gap Strategy in 2018.

Accordingly, this review recommends that:

Recommendation 1: the ‘refreshed’ Closing the Gap Strategy is co-designed with Aboriginal and Torres Strait Islander health leaders and includes community consultations.

This requires a tripartite negotiation process with Aboriginal and Torres Strait Islander health leaders, and the Federal and State and Territory governments. Time must be allowed for this process.

Further, Australian governments must be accountable to Aboriginal and Torres Strait Islander people for its effective implementation.

Recommendation 2: to underpin the Closing the Gap Strategy refresh, Australian governments reinvigorate the ‘architecture’ required for a national approach to addressing Aboriginal and Torres Strait Islander health equality.

This architecture includes: a national agreement, Federal leadership, and national funding agreements that require the development of jurisdictional implementation plans and clear accountability for implementation.

This includes by reporting against national and state/territory targets.

Recommendation 3: the Closing the Gap Strategy elements such as maternal and infant health programs and the focus on chronic disease (including the Tackling Indigenous Smoking program) are maintained and expanded in a refreshed Closing the Gap Strategy.

Along with Recommendation 2, a priority focus of the ‘refreshed’ Closing the Gap Strategy is on delivering equality of opportunity in relation to health goods and services and in relation to health infrastructure (housing, food, water).

The social determinants of health inequality (income, education, racism) must also be addressed at a far more fundamental level than before. This includes through the following recommendations:

Recommendation 4: the current Closing the Gap Strategy health targets are maintained, but complemented by targets or reporting on the inputs to those health targets.

These input targets or measures should be agreed by Aboriginal and Torres Strait Islander health leaders and Australian governments as a part of the Closing the Gap Strategy refresh process and include:

  • Expenditure, including aggregate amounts and in relation to specific underlying factors as below;
  • Primary health care services, with preference given to Aboriginal Community Controlled Health Services, and a guarantee across all health services of culturally safe care;
  • The identified elements that address institutional racism in the health system;
  • Health workforce, particularly the numbers of Aboriginal and Torres Strait Islander people trained and employed at all levels, including senior levels, of the health workforce; and
  • Health enabling infrastructure, particularly housing.

Recommendation 5: the National Aboriginal and Torres Strait Islander Health Plan Implementation Plan is costed and fully funded by the Federal government, and future iterations are more directly linked to the commitments of the Close the Gap Statement of Intent; and, an implementation plan for the complementary National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023 is developed, costed and implemented by the end of 2018 in partnership with Aboriginal and Torres Strait Islander health leaders and communities

This will include:

  1. A five-year national plan to identify and fill health service gaps funded from the 2018-2019 Federal budget onwards and with a service provider preference for Aboriginal Community Controlled Health Services (ACCHSs). This includes provision for the greater development of ACCHS’s satellite and outreach services.
  2. Aboriginal and Torres Strait Islander health leadership, Federal, State and Territory agreements clarifying roles, responsibilities and funding commitments at the jurisdictional level.
  3. Aboriginal and Torres Strait Islander health leadership, Primary Health Network and Federal agreements clarifying roles, responsibilities and funding commitments at the regional level.

Recommendation 6: an overarching health infrastructure and housing plan to secure Aboriginal and Torres Strait Islander Peoples equality in these areas, to support the attainment of life expectancy and health equality by 2030, is developed, costed and implemented by the end of 2018.





[i]      Australian Institute of Health and Welfare 2016. Healthy Futures—Aboriginal Community Controlled Health Services: Report Card 2016. Cat. no. IHW 171. Canberra: AIHW, p. 40.

[ii]     Australian Health Ministers’ Advisory Council, 2017, Aboriginal and Torres Strait Islander Health Performance Framework 2017 Report, AHMAC, Canberra, p. 192.

NACCHO Aboriginal Health CEO Pat Turner 20 minute Interview with @abcspeakingout where she offers some guarded optimism and some advice for 2018.

“I think everything is so low, bottom of the scale, that 2018 can only be better in my view.

“I think that what our people and our communities have to do is just take total control of their own affairs. Don’t wait for government, don’t wait for them to provide the solutions. Work it out ourselves and just move on.”

Pat Turner AM CEO NACCHO 20 Minute interview ABC Speaking Out

” Despite there being a number landmark occasions in 2017, one of the country’s most senior Aboriginal Bureaucrats says there has been little to celebrate in the Indigenous Affairs sector in 2017.

In a frank and honest Discussion, Pat Turner, CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO) reflects on the key advances and shortcomings over the past 12 months.

We talk Aboriginal Health, Northern Territory Royal Commission, Deaths in Custody and Indigenous funding.”

On Speaking Out with Larissa Behrendt

Duration: 20min 40sec

Listen HERE

2017 forced us to ask how far we have come in Indigenous affairs

2017 was a year of several significant anniversaries in Indigenous affairs.

The 50th anniversary of the 1967 referendum.

The 25th anniversary of the High Court’s Mabo decision.

The 20th anniversary of the Bringing Them Home report.

The 10th anniversary of the NT Intervention.

An auspicious combination of anniversaries, each giving pause to reflect on the impacts of these events, and to ask the obvious question — how far have we come in 50 years? In 25, 20 or 10 years?

The age-old Western belief in the inexhaustible march towards progress would make many assume that these issues have been addressed, or at the very least improved.

This belief is evident every time you see someone say, “I can’t believe this is happening in 2017!” in reference to something they believe should now be a relic of a bygone era.

It was hoped that 2017 would enter the history books as another significant year in Indigenous affairs, with the passing of a referendum to ‘recognise’ Indigenous people in the Australian constitution.

Not only did this not come to pass, but the relationship between government and Indigenous groups feels like it may have reach a new low, unseen in decades.

Australia’s most successful referendum

In 1967 Australia passed its most successful ever referendum, with 90.77 per cent of Australians voting “Yes for Aborigines”. This allowed for Aboriginal people to be counted in the census, and the Federal Government was given the power to make laws for Indigenous people.

Right Wrongs

Up until that point, Indigenous people were the responsibility of the states, who each had their own laws and legislation defining and controlling the lives of Aboriginal people.

Fifty years later, many people believe that this momentous occasion gave Indigenous people citizenship rights and the right to vote. It did not.

It was also believed that the Federal Government would use their new powers solely to the benefit of Indigenous people. This too would prove to be false.

Larissa Behrendt wrote in detail about these myths as part of the ABC’s Right Wrongs site, which explored the impacts of the 1967 referendum.

Twenty-five years later, in 1992, the High Court handed down the Mabo decision determining that Australia was not Terra Nullius in 1770 when Captain Cook claimed the east coast of Australia.

Terra Nullius was the legal justification for the very existence of the Australian state, so it as hoped this decision would bring about significant Aboriginal land rights.

But it led to Native Title legislation instead.

The Mabo case itself took over a decade, and the man who instigated it, Eddie Koiki Mabo, would not live to see its conclusion.

Twenty-five years later though, his family are still fighting to keep his story alive and strong.

Bringing Them Home

Bringing Them Home was the name of the final report of the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families.

It was tabled in Parliament on the May 26, 1997. The following year this date would become known as Sorry Day, and would provide a call to action for governments to implement the 54 recommendations of the report.

The surviving members of the Stolen Generations still hold the stories from that shameful era. And members of each new generation of Aboriginal people forcibly removed from their families have their trauma compounded by this unaddressed history.

The recommendations from the Bringing Them Home report are still largely unimplemented, and the rate of child removal has steadily grown in the 20 years since.

The rate has doubled in the past decade, and every other month we see a headline warning of a “second Stolen Generation”. It’s a news story that has been on repeat for almost 20 years.

The NT Intervention

The NT Intervention has largely failed to bring about positive changes around the issues raised in the Little Children Are Sacred report, which was used as the key justification for the NT Emergency Response Act.

A group of eminent Australians from law, health, academia and the arts have called on the Federal Government to bring an immediate end to the Northern Territory Intervention and Stronger Futures policies.

Listen to Speaking Out

This disconnect between stated goals of respect, inclusion and Closing the Gap, and the actions and outcomes actually achieved, has come to embody Indigenous affairs in 2017.

This has been personified by Prime Minister Malcolm Turnbull, since he took over the reins of government in September 2015. The end of 2017 seems to show a very different Mr Turnbull than the one who shed tears for the Stolen Generations at the start of 2016.

Despite his inclination to open Indigenous affairs speeches speaking in Indigenous languages, this has failed to translate to an ability to listen to Indigenous people. Given the long history of government failure to listen to Indigenous peoples, few held out hope that Mr Turnbull would make good on his stated desire to do things with Indigenous people, instead of to them.

At the release of the ninth Closing the Gap report, six of the seven targets were not on track to meet their goals.

“It has to be a shared endeavour. Greater empowerment of local communities will deliver the shared outcomes we all seek,” Mr Turnbull said, at the time.

Now, months before the 10th report is due, the Federal Government has put out a call for community input into Closing The Gap.

This prompted Referendum Council member Megan Davis to ponder on Twitter: “If they didn’t listen to what community said on Uluru and meaningful recognition, why would the government listen to input on this?”.

The call for consultation coincides with a decision to remove over $600 million in federal funds for remote housing.

Safe and appropriate housing is regarded as an essential criteria for governments to meet the Closing the Gap targets.

While 2017 may not have given much hope for the immediate future of Indigenous affairs, National Aboriginal Community Controlled Health Organisation chief executive officer Pat Turner, offered some guarded optimism and some advice for 2018.

.@NACCHOChair Season’s Greetings and a very Happy and #Healthy New Year from all the NACCHO mob

Season’s Greetings and a Happy New Year from the National Aboriginal Community Controlled Health Organisation

On behalf of NACCHO, the Board and our staff we wish you a safe, happy and healthy festive season.

Please note : Our Canberra Office Closes  21 December and Re Opens 3 January 2018

2017 has been a year of change, with many new members joining the NACCHO Board.

We have also welcomed a new ACCHO, Moorundi Aboriginal Community Controlled Health Service, to our membership.

With change comes opportunity, 2018 will see many new and exciting developments as NACCHO continues to enhance better service for the sector.

We look forward to building strong relationships with you, maintain Aboriginal community control and work together in the new year to improve health and well-being outcomes for Aboriginal and Torres Strait Islander peoples.

I hope you all have good health, happiness and a safe holiday season

John Singer