NACCHO Aboriginal Research Health News : New @NHMRC project to implement and evaluate 715 annual health checks interventions designed to help Close the Gap

 “The prevalence of most chronic diseases increases with age and affects not only physical health, but also the broader contributors to the well-being of older Aboriginal people, including participation in family, community and cultural leadership roles and connection with community networks.

Aboriginal people often receive a diagnosis at a more advanced stage of chronic disease, which means there’s less opportunity to prevent their condition and health deteriorating “

Professor Sanson-Fisher said chronic diseases continue to be a major contributor to unhealthy ageing among Aboriginal and Torres Strait Islander people. Timely diagnosis and appropriate management was vital to improving health outcomes for Aboriginal and Torres Strait Islander people. See Website

Consider these facts

  • In 2016-2017 just 27 per cent of Indigenous adults aged 15 to 24 had an annual health assessment.
  • Only 30 per cent of 25-to 54-year-olds, and 41 per cent of Indigenous adults over 55 had one.
  • Around 37 per cent of the burden of disease in Aboriginal people could be prevented by reducing risk factors

Read previous NACCHO 715 Health Check Articles

Download resources to boost the rates of the 715 health check. Information available for patients and health professionals!

An intervention designed to help Close the Gap, by increasing the number of Aboriginal and Torres Strait Islander people who receive an annual health check by their GP, will be implemented and evaluated by a new National Health and Medical Research Council (NHMRC) project.

Renowned population health researcher, Laureate Professor Rob Sanson-Fisher of the University of Newcastle and Hunter Medical Research Institute, will lead a team of expert Aboriginal and non-Aboriginal researchers in the five-year research project – which was awarded $745,056 following a Targeted Call for Research** for Healthy Ageing of Aboriginal and Torres Strait Islander People.

Indigenous people die about eight years earlier than non-Indigenous Australians. For Aboriginal and Torres Strait Islander Australians born in 2015-17, the life expectancy is 71.6 years for men and 75.6 years for women – about 8.6 and 7.8 years less than non-Aboriginal men and women respectively.

Twenty-two mainstream general practice clinics within the central Coast and New England regions will participate in the research project.

The intervention package will comprise strategies such as continuing medical education, recall and reminder systems, and mailed invitations to patients.

The project will also test whether the intervention increases doctors’ adherence to best practice care and improves patient outcomes.

More than 60 per cent of Indigenous people regularly visit mainstream general practice services – a key opportunity to deliver an annual ‘715’ health assessment, which forms an integral part of the Australian Government’s Closing the Gap commitment.

The aim of the Aboriginal and Torres Strait Islander Health Assessment (Medicare Benefits Schedule item 715) is to help ensure Indigenous Australians receive primary health care matched to their needs, by encouraging early detection, diagnosis and intervention for common and treatable conditions that cause morbidity and early death.

The health assessment is an annual service and covers the full age spectrum..

Key contributing chronic conditions include cardiovascular diseases (19 per cent of the chronic disease prevalence gap), mental and substance use disorders (14 per cent), cancer (9 per cent), chronic kidney disease, diabetes, vision loss, hearing loss and respiratory, musculoskeletal, neurological and congenital disorders.

Around 37 per cent of the burden of disease in Aboriginal people could be prevented by reducing risk factors.

The risk factors causing the most burden are tobacco use (12 per cent of the total burden), alcohol use (8 per cent), high body mass (8 per cent), physical inactivity (6 per cent), high blood pressure (5 per cent) and high blood glucose levels (5 per cent).

“Mainstream general practice is a crucial setting to impact on prevention, timely diagnosis and appropriate management of chronic disease for Aboriginal people, which is imperative to help Close the Gap,” Professor Sanson-Fisher said.

 

NACCHO Aboriginal #MentalHealth @georgeinstitute Download new screening tool to help Aboriginal and Torres Strait Islander people combat depression

“ This tool, which was developed in conjunction with Aboriginal communities and researchers, will help us address easily treated problems that often go undiagnosed. It will also help us to assess the scale of mental health problems in communities.

Up until now, we couldn’t reliably ascertain this in a culturally appropriate way, which has remained a huge concern.

We need better resources and funding for mental health across Australia, but particularly for Aboriginal and Torres Strait Islander people and within under-resourced health services. We hope this tool will be a turning point.”

Lead researcher Professor Maree Hackett, of The George Institute for Global Health, said mental health problems experienced by Aboriginal and Torres Strait Islander peoples have been overlooked, dismissed and marginalised for too long. 

A culturally-appropriate depression screening tool for Aboriginal and Torres Strait Islander peoples not only works, it should be rolled out across the country, according to a new study.

Researchers at The George Institute for Global Health, in partnership with key Aboriginal and Torres Strait primary care providers conducted the validation study in 10 urban, rural and remote primary health services across Australia.

The screening tool is an adapted version of the existing 9-item patient health questionnaire (PHQ-9) used across Australia and globally accepted as an effective screening method for depression. The adapted tool (aPHQ-9) contains culturally-appropriate questions asking about mood, appetite, sleep patterns, energy and concentration levels. It is hoped the adapted questionnaire will lead to improved diagnosis and treatment of depression in Aboriginal communities.

The results of the validation study were published in the Medical Journal of Australia 1 July 2019

Download the 7 page study  mja250212

The aPHQ-9 is freely available in a culturally-appropriate English version, and can be readily used by translators when working with First Nation communities where English is not the patients first language.

It is estimated up to 20 per cent of Australia’s general population with chronic disease will have a diagnosis of comorbid major depression. [1]

Approximately similar proportions will meet criteria for moderate or minor depression. Mental illness and depression are also considered to be key contributors in the development of chronic disease.

Across the nation, chronic disease (cardiovascular disease, cerebrovascular disease, diabetes, chronic kidney disease and chronic obstructive pulmonary disease) accounts for 80 per cent of the life expectancy gap experienced by Aboriginal people [2]  

How the tool works

The adapted tool, which was evaluated with 500 Aboriginal and Torres Strait Islander peoples, contains culturally-appropriate questions.

For example, the original (PHQ-9) questionnaire asks:

  • Over the last two weeks, how often have you been bothered by any of the following problems: Little interest or pleasure in doing things?
  • Feeling down, depressed or hopeless

The adapted (aPHQ-9) tool instead asks:

  • Over the last two weeks have you been feeling slack, not wanted to do anything?
  • Have you been feeling unhappy, depressed, really no good, that your spirit was sad?

Download: Adapted Patient Questionnaire with scoring (PDF 117 KB)

Download: Adapted Patient Questionnaire without scoring(PDF 114 KB)

Professor Alex Brown, of the South Australian Health and Medical Research Institute, who was co-investigator on the study, said the importance of using culturally appropriate language with First Nations people cannot be underestimated.

“In Australia, as with many countries around the world, everything is framed around Western understandings, language and methods. Our research recognises the importance of an Aboriginal voice and giving that a privileged position in how we respond to matters of most importance to Aboriginal people themselves.

“What we found during this study was that many questions were being lost in translation. Instead of a person scoring highly for being at risk of depression, they were actually scoring themselves much lower and missing out on potential opportunities for treatment.

“It was essential that we got this right and that we took our time speaking with Aboriginal people and ascertaining how the wording needed to be changed so we can begin to tackle the burden of depression.”

Aboriginal psychologist Dr Graham Gee, of the Murdoch Children’s Research Institute, saidAboriginal communities have unacceptably high rates of suicide which need to be addressed. “Identifying and treating depression is an important part of responding to this major challenge. It’s clear this tool is much needed.”

The new tool will be available for use at primary health centres across Australia and will be available to download here from Monday July 1.

The George Institute for Global Health

The George Institute for Global Health conducts clinical, population and health system research aimed at changing health practice and policy worldwide.

Established in Australia and affiliated with UNSW Sydney, it also has offices in China, India and the UK, and is affiliated with the University of Oxford.  Facebook at thegeorgeinstitute  Twitter @georgeinstitute Web georgeinstitute.org.au

[1] https://www.aihw.gov.au/reports/mentalhealthservices/mentalhealthservicesinaustralia/reportcontents/summary/prevalenceandpolicies

[2] https://www.aihw.gov.au/reports/indigenousaustralians/contributionofchronicdiseasetothegapinmort/contents/summary

Additional Media 

Doctors can now use the new tool

Extract from the Conversation 1 July 2019

In 2014-15, more than half (53.4%) of Aboriginal and Torres Strait Islander peoples aged 15 years and over reported their overall life satisfaction was eight out of ten or more. Almost one in six (17%) said they were completely satisfied with their life. These positive data are testament to Aboriginal and Torres Strait Islander peoples’ ongoing endurance.

But over the years, events like colonisation, racism, relocation of people away from their lands, and the forced removal of children from family and community have disrupted the resilience, cultural beliefs and practices of many Aboriginal and Torres Strait Islander Australians. In turn, these factors have impacted their social and emotional well-being.

This may explain why Aboriginal and Torres Strait Islander peoples are twice as likely to be hospitalised for mental health disorders and die from suicide than their non-Aboriginal counterparts.

Teenagers aged 15 to 19 are five times more likely than non-Indigenous teenagers to die by suicide.

The importance of being able to more accurately identify those at risk can’t be understated.

While screening all Aboriginal and Torres Strait Islander peoples who present to general practice for depression is not recommended, the new questionnaire is a free, easy to administer, culturally acceptable tool for screening Aboriginal and Torres Strait Islander peoples at high risk of depression.

People who might be at heightened risk of depression include those with chronic disease, a history of depression and those who have been exposed to abuse and other adverse events.

Without a culturally appropriate tool, Aboriginal and Torres Strait Islander people with depression and suicidal thoughts might fly under the radar. This questionnaire will pave the way for important discussions and the provision of treatment and services to those most in need.

If this article has raised issues for you or you’re concerned about someone you know, call Lifeline on 13 11 14. Visit the Beyond Blue website to access specific resources for Aboriginal and Torres Strait Islander people.

Maree Hackett, Professor, Faculty of Medicine, UNSW and Geoffrey Spurling, Senior lecturer, Discipline of General Practice, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

NACCHO Aboriginal Health and #715HealthCheck 3 of 3 : @healthgovau Your Health is in Your Hands – Download resources to boost the rates of the #715healthcheck. Information available for patients and health professionals!

” A 715 it’s a health check that Aboriginal and Torres Strait on the people’s can have done on an annual timetable.

But it should be comprehensive in nature, and offer you not just the usual, hi, how are you?

What’s your name? Where do you live?

But take full consideration of your social background and social histories, ask you about your family history.

Is there anything important not just in your own personal medical background, but that of your family, so we can take that into consideration?

We know that we have many families with long backgrounds of chronic disease, for example, diabetes, cardiovascular risk, and they’re super important we’re considering how we tailor our history, our examination, our investigations, and then a treatment plan for you.

 It goes through the steps of that history and they’ll ask you questions about, you got a job at the moment, where are you working?

What are you exposed to? What are your interest? Do you play sport?

Are you involved in any other sort of social activities, cultural activities, for example, which I think is really important.

They’ll then make determinations around the kinds of examination if they need to tailor that at all, depending upon your age, and where you live and your access to services and what your history brought up, for example, male, female, young or old.

And then the investigations and X-ray, for example, or some bloods taken, and referrals as appropriate.

For allied health professionals, pediatrists, nutritionists, diabetes educators, but also perhaps you might need to see a cardiologist or a diabetes and endocrinologist as a specialist.

And then we wrap that all up in a specific and individualised kind of plan for you, that we discuss and we negotiate and we try to educate so that you then are able to play a part in your own health and take responsibility for some of those aspects.

But also you then get to choose what you share with family and the other providers.

It’s supposed to be a relationship and partnership for your health, that you understand, that you agree to and then together, you can move forward on how to be healthy and stay healthy.

From interview with Dr Ngaire Brown 

Download resources below or from HERE

Podcasts

Annual health checks for Aboriginal and Torres Strait Islander Australians

Aboriginal and Torres Strait Islander people can access a health check annually, with a minimum claim period of 9 months. 715 health checks are free at Aboriginal Medical Services and bulk bulling clinics to help people stay healthy and strong.

We acknowledge that many individuals refer to themselves by their clan, mob, and/or country. For the purposes of the health check, we respectfully refer to Aboriginal and Torres Strait Islander people as Aboriginal and Torres Strait Islander throughout.

Your Health is in Your Hands

Having a health check provides important health information for you and your doctor.

Staying on top of your health is important. It helps to identify potential illnesses or chronic diseases before they occur. It is much easier to look at ways to prevent these things from occurring, rather than treatment.

The 715 Health Check is designed to support the physical, social and emotional wellbeing of Aboriginal and Torres Strait Islander patients of all ages. It is free at Aboriginal Medical Services and bulk billing clinics.

What happens at the health check?

Having the health check can take up to an hour. A Practice Nurse, Aboriginal Health Worker or Aboriginal and Torres Starlit Islander Health Practitioner may assist the doctor to perform this health check. They will record information about your health, such as your blood pressure, blood sugar levels, height and weight. You might also have a blood test or urine test. It is also an opportunity to talk about the health of your family.

Depending on the information you’ve provided, you might have some other tests too. You’ll then have a yarn with the doctor or health practitioner about the tests and any follow up you might need. It’s also good to tell them about your family medical history or any worries you have about your health.

Information for patients

Only about 30 per cent of Aboriginal and Torres Strait Islander people are accessing the 715 health check. Resources have been developed to help improve the uptake of 715 health checks in the community.

These are available for patients, community organisations, PHNs and GP clinics to download or order

Read all NACCHO 715 Health Check articles Here

Frequently Asked Questions

What happens at the health check?

Health checks might be different depending on your age.

Having the health check should take between 40-60 minutes. A health practitioner might check your:

  • blood pressure
  • blood sugar levels
  • height and weight

You might also a have blood test and urine test.

It’s also good to tell your health practitioner about your family medical history or any worries you have about your health.

Follow up care

Once you finish the check, the Practice Nurse, Aboriginal Health Worker or Doctor might tell you about other ways to help look after your health. They might suggest services to help you with your:

  • heart
  • vision
  • hearing
  • movement
  • mental health

You may also get help with free or discounted medicines you might need. Your Doctor can give you information about Closing the Gap scripts if you have or at risk of having a chronic disease.

Where can you access a 715 health check?

You can choose where you get your 715 health check. If you can, try to go to the same Doctor or clinic.

This helps make sure you are being cared for by people who know about your health needs.

Do I need to pay for the 715 health check?

The health check is free at your local Aboriginal Medical Service. It is also free at bulk billing health clinics. If you are unsure whether it will be free at your local Doctor, give them a call to ask about the 715 health check before you book.

Why Should I Identify?

It’s important to tell the Doctor if you are Aboriginal and/or Torres Strait Islander so that they can make sure you get access to health care you might need. Medicare can help record this for you, and their staff are culturally trained to help.

Call the Aboriginal and Torres Strait Islander Access line on 1800 556 955.

Information for Health Professionals

For more information about for health professionals and medical practitioners delivering the 715 health checks please go to Supporting Aboriginal and Torres Strait Islander patients.

Video Case Studies

Social Media Tiles

2 boys stand with a woman in a school basketball court. They look happy and healthy/
An Aboriginal Health worker measures the weight of a child was part of the 715 health check.
A doctor takes a man’s pulse as part of the 715 health check.

NACCHO Aboriginal Health and #CancerAwareness : @JacintaElston @KelvinKongENT Hey you mob It’s ok to talk about #cancer – For assistance download #YarnforLife resources

“Yarn for Life aims to reduce feelings of shame and fear associated with cancer and highlights the importance of normalising conversation around cancer and encouraging early detection of the disease.

It also emphasises the value of support along the patient journey.”

Professor Jacinta Elston, Pro Vice-Chancellor (Indigenous), Monash University, said that finding cancer early gave people the best chance of surviving and living well.

“Yarn for Life seeks to empower Aboriginal and Torres Strait Islander people to participate in screening programs, discuss cancer with their doctor or health care worker openly, and if cancer is diagnosed, complete their cancer treatment.”

Australia’s first Australian Aboriginal surgeon Associate Professor Kelvin Kong, University of Newcastle : continued below 

Download Yarn for Life Resources HERE

Read over 80 Aboriginal and Torres Strait Islander Cancer Awareness articles published by NACCHO over past 7 years 

In a national first, Cancer Australia has launched Yarn for Life, a new initiative to reduce the impact of cancer within Aboriginal and Torres Strait Islander communities by encouraging and normalising discussion about the disease.

Cancer is a growing health problem and the second leading cause of death among Indigenous Australians who are, on average, 40 percent more likely to die from cancer than non-indigenous Australians.

The multi-faceted health promotion Yarn for Life has been developed by and with Indigenous Australians, and weaves the central message that it is okay to talk about cancer by sharing personal stories of courage and survivorship from Aboriginal and Torres Strait Islander people.

Yarn for Life features 3 individual experiences of cancer which are also stories of hope.

“While significant gains have been made with regard to cancer overall, Aboriginal and Torres Strait Islander people continue to experience disparities in cancer incidence and outcomes. Cancer affects not only those diagnosed with the disease but also their families, carers, Elders and community,” said Dr Helen Zorbas, CEO, Cancer Australia.

Associate Professor Kong said it was also important for health services to support better outcomes for Indigenous patients by being culturally aware.

“For Aboriginal and Torres Strait Islander people, health and connection to land, culture community and identity are intrinsically linked. Optimal care that is respectful of, and responsive to, the cultural preferences, sensitivities, needs and values of patients, is critical to good health care outcomes.”

The Yarn for Life initiative is supported by two consumer resources which outline what patients should expect at all points on the cancer pathway.

Yarn for Life will feature television, radio and social media resources designed to be shared with friends, family and the community, to carry on the Yarn for Life conversation online.

SEEING YOUR DOCTOR OR HEALTH WORKER

Finding cancer early gives you the best chance of getting better and living well. The good news is there are things you can do to find cancer early. If there are any changes in your body that could be due to cancer, it’s really important to have them checked out. Speak to your health worker about:

  • any new or unusual changes in your body
  • how you are feeling
  • whether you are in any pain
  • whether anyone in your family has or had cancer
  • any other problems that are worrying you.

Free screening programs

It’s also important that you and your family participate in screening programs for breast, bowel and cervical cancers.

You can find out more about these free programs including how old you need to be to participate at cancerscreening.gov.au. Remember most of us will need to go to a check-up or screening at some point in our lives—so there’s no shame in talking to family or friends about it as well as your health care worker.

 

NACCHO Aboriginal Health #Prevention2019 News Alert : Downloads @AIHW releases Burden of Disease study and an overview of health spending that provides an understanding of the impact of diseases in terms of spending through our health system.

 ” This report analyses the impact of more than 200 diseases and injuries in terms of living with illness (non-fatal burden) and premature death (fatal burden).

The study found that: chronic diseases such as cancer, cardiovascular diseases, and musculoskeletal conditions contributed the most burden in Australia in 2015 and 38% of the burden could have been prevented by removing exposure to risk factors such as tobacco use, overweight and obesity, and dietary risks.

The overall health of the Australian population improved substantially between 2003 and 2015 and further gains could be achieved by reducing lifestyle-related risk factors, according to a new report by the Australian Institute of Health and Welfare (AIHW). ‘

Download aihw-bod-22

The Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2015, measures the number of years living with an illness or injury (the non-fatal burden) or lost through dying prematurely (the fatal burden).

In 2015, Australians collectively lost 4.8 million years of healthy life due to living with or dying prematurely from disease and injury,’ said AIHW spokesperson Mr Richard Juckes.

The disease groups causing the most burden in 2015 were cancer, cardiovascular diseases, musculoskeletal conditions, mental and substance use disorders and injuries.

After accounting for the increase in size and ageing of the population, there was an 11% decrease in the rate of burden between 2003 and 2015.’

Most of the improvement in the total burden resulted from reductions in premature deaths from illnesses and injuries such as cardiovascular diseases, cancer and infant and congenital conditions.

‘Thirty eight per cent of the total burden of disease experienced by Australians in 2015 could have been prevented by reducing exposure to the risk factors included in this study,’ Mr Juckes said.

‘The 5 risk factors that caused the most total burden in 2015 were tobacco use (9.3%), overweight & obesity (8.4%), dietary risks (7.3%), high blood pressure (5.8%) and high blood plasma glucose—including diabetes (4.7%).’

For the first time, living with illness or injury caused more total disease burden than premature death. In 2015, the non-fatal share was 50.4% and the fatal share was 49.6% of the burden of disease.

Also released today is an overview of health spending that provides an understanding of the impact of diseases in terms of spending through the health system.

The data in Disease expenditure in Australia relates to the 2015–16 financial year only and suggests the highest expenditure groups were musculoskeletal conditions (10.7%), cardiovascular diseases (8.9%) injuries (7.6%) and mental and substance use disorders (7.6%).

‘Together the burden of disease and spending estimates can be used to understand the impact of diseases on the Australian community. However they can’t necessarily be compared with each other, as there are many reasons why they wouldn’t be expected to align,’ Mr Juckes said.

‘For example, spending on reproductive and maternal health is relatively high but it is not associated with substantial disease burden because the result is healthy mothers and babies more often than not.

‘Similarly, vaccine-preventable diseases cause very little burden in Australia due to national investment in immunisation programs.’

Reports

Table of contents

  • Summary
  • 1 Introduction
    • What is burden of disease?
    • How can burden of disease studies be used?
    • What can’t burden of disease studies tell us?
    • How is burden of disease measured?
    • What is the history of burden of disease analysis?
    • What’s new in the Australian Burden of Disease Study 2015 and this report?
  • 2 Total burden of disease
    • What is the total burden of disease in Australia?
    • How does total burden vary across the life course?
    • Which disease groups cause the most burden?
    • Which diseases cause the most burden?
    • How does disease burden change across the life course?
  • 3 Non-fatal burden of disease
    • What is the overall non-fatal burden in Australia?
    • How does living with illness vary across the life course?
    • Which disease groups cause the most non-fatal burden?
    • Which diseases cause the most non-fatal burden?
    • How does non-fatal disease burden change across the life course?
  • 4 Fatal burden of disease
    • What is the overall fatal burden in Australia?
    • How does years of life lost vary at different ages?
    • Which disease groups cause the most fatal burden?
    • Which diseases cause the most fatal burden?
    • How does fatal disease burden change across the life course?
  • 5 Health-adjusted life expectancy
    • HALE as a measure of population health
    • On average, almost 90% of years lived are in full health
    • Years of life gained are healthy years
    • HALE is unequal across states and territories
    • HALE varies by remoteness of area lived
    • HALE is unequal between socioeconomic groups
  • 6 Contribution of risk factors to burden
    • How are risk factors selected?
    • What is the contribution of all risk factors combined?
    • Which risk factors contribute the most burden?
    • How do risk factors change through the life course?
  • 7 Changes over time
    • How should changes between time points be interpreted?
    • How has total burden changed over time?
    • How have the non-fatal and fatal burden changed over time?
    • How have risk factors changed over time?

  • 8 Variation across geographic areas and population groups
    • Burden of disease by state and territory
    • Burden of disease by remoteness areas
    • Burden of disease by socioeconomic group
  • 9 International context and comparisons
    • What is the international context of burden of disease studies?
    • Can the ABDS 2015 be compared with international studies?
    • How does Australian burden compare internationally?
  • 10 Study developments and limitations
    • What are the underlying principles of the ABDS?
    • What stayed the same between Australian studies?
    • What changes were made in the ABDS 2015?
    • What are the data gaps?
    • What are the methodological limitations?
    • What opportunities are there for further analysis?
  • Appendix A: Methods summary
    • 1 Disease and injury (condition) list
    • 2 Fatal burden
    • 3 Non-fatal burden
    • 4 Total burden of disease
    • 5 Health-adjusted life expectancy
    • 6 Risk factors
    • 7 Overarching methods/choices
  • Appendix B: How reliable are the estimates?
    • ABDS 2015 quality index
  • Appendix C: Understanding and using burden of disease estimates
    • Different types of estimates presented in this report
    • Interpreting estimates
    • What can estimates from 2015 tell us about 2019?
  • Appendix D: Additional tables and figures
  • Appendix E: List of expert advisors
  • Acknowledgments
  • Abbreviations
  • Symbols
  • Glossary
  • References
  • List of tables
  • List of figures
  • Related publications

NACCHO Aboriginal Health and #ClosingTheGap : Aboriginal owned health promotion company @SparkHealthAus denied right to use Aboriginal flag and use of word ‘gap’for #ClothingTheGap : @theprojecttv

 

“ The flag represents much more than just a business opportunity. 

It’s been an important symbol to Aboriginal people for a really long time, a symbol of resistance, of struggle of pride, and that’s why we’ve got such a strong attachment.

One ( of the two companies ) is an international worldwide company [pursuing us] for using the word ‘Gap’ and the other is for trying to share our culture.

The purpose of Spark Health is to improve Aboriginal peoples lives.”

Spark Health founder and Gunditjmara woman Laura Thompson spoke to the The Australian and the ABC describing the two-pronged attack after the Koori Mail broke the story 

Koori Mail reporter Darren Coyne worked really hard over the past few weeks to break an important story about copyright of the Aboriginal flag : See Page 3 June 5 Edition

Read Download HERE 

Six weeks, six deadly health dares, six workouts, one grouse piece of merch! Spark Health Australia are proud to work with the ACCHOHealth Services team at the Wathaurong Aboriginal Co-Op in Geelong to deliver ‘I Dare Ya’, a six week health and well-being program

An Aboriginal business is fighting for the right to feature the Indigenous flag in its “Clothing the Gap” fashion designs, while also fending off a copyright attack from a global retail giant.

Spark Health, which is an Aboriginal-owned health promotion business, has been told by US-based retailer GAP INC that it cannot use the word “Gap’’ in its fashion line, which plays on the phrase “Closing the Gap’’ that is used to describe the efforts to improve the lives of Aboriginal and Torres Strait Islander Australians.

SAN FRANCISCO, CA – FEBRUARY 20: Gap clothing is displayed at a Gap store on February 20, 2014 in San Francisco, California. Gap Inc.

To add to its woes, the Preston-based profit-for-purpose outfit has been sent a “cease and desist” letter by Queensland-based WAM Clothing over its use of the Aboriginal flag in its clothing designs.

The copyright of the Aboriginal flag is owned by its designer, Harold Thomas, a Luritja man, who has licensed its use in clothing exclusively to WAM.

Ms Thompson said she wrote to Mr Thomas requesting permission to use the Aboriginal flag in August last year.

She said she was happy to pay a fee in order to replicate the design.

An online petition started by Spark Health, criticising the exclusive licensing of the flag to a non-indigenous company, has gathered more than 20,000 + signatures so far.

Sign the petition or see Part 3 Below

“This is a question of control,” the petition reads.

“Should WAM Clothing, a non-indigenous business, hold the monopoly in a market to profit off Aboriginal peoples’ identity and love for ‘their’ flag?”

Spark Health director of operations, Sarah Sheridan, who is not indigenous, said WAM was exploiting Aboriginal Australia.

“Non-indigenous Australians must listen to, and support the voices of Aboriginal people and back their self-determination,” she said.

“Rather than exploiting them in the way that WAM clothing currently are.”

A WAM spokesperson said it was obligated to enforce the copyright.

“In addition to creating our own product lines bearing the Aboriginal flag, WAM Clothing works with manufacturers and sellers of clothing bearing the Aboriginal flag — including Aboriginal-owned organisations — providing them with options to continue manufacturing and selling their own clothing ranges bearing the flag, which ensures that Harold Thomas is paid a royalty,” the spokesperson said.

WAM provided a statement from Mr Thomas, in which he said, as the designer, it was up to him to decide who could use the Aboriginal flag.

“As it is my common law right and aboriginal heritage right … I can choose who I like to have a licence agreement to manufacture and sell goods which have the Aboriginal flag on it,” he said.

WAM Clothing was co-founded by Ben Wootzer, whose previous company Birubi Art was found to be in breach of Australian consumer law after selling over 18,000 Aboriginal such as boomerangs and didgeridoos were in fact made in Indonesia.

GAP Inc did not respond to The Australian’s request for comment.

Part 2

New licence owners of Aboriginal flag threaten football codes and clothing companies

Indigenous reporter Isabella Higgins

From the ABC News

The Aboriginal flag is unique among Australia’s national flags, because the copyright of the image is owned by an individual.

A Federal Court ruling in 1997 recognised the ownership claim by designer Harold Thomas.

The Luritja artist has licensing agreements with just three companies; one to reproduce flags, and the others to reproduce the image on objects and clothing.

WAM Clothing, a new Queensland-based business, secured the exclusive clothing licence late last year.

Since acquiring it, the company has threatened legal action against several organisations.

The ABC understands WAM Clothing issued notices to the NRL and AFL over their use of the flag on Indigenous-round jerseys.

A spokesman for the NRL said the organisation was aware of the notices, but would not comment further.

The ABC has contacted the AFL, but no official response has been received.

WAM Clothing said simply it was “in discussions with the NRL, AFL and other organisations regarding the use of the Aboriginal flag on clothing”.

The Aboriginal flag has been widely used on the country’s sporting fields, carried by Cathy Freeman in iconic moments at the 1994 Commonwealth Games and 2000 Sydney Olympics.

It only became a recognised national flag in 1995 under the Keating government, but had been widely used by the Aboriginal community since the 1970s.

The Torres Strait Islander flag was also recognised as a national flag at this time, but the copyright is collectively owned by the Torres Strait Regional Council.

The move to adopt both flags as symbols of state was somewhat controversial at the time, with the then opposition leader John Howard opposing the move.

PHOTO: Indigenous artist Harold Thomas is the designer of the Aboriginal flag. (ABC News: Nick Hose)

Former head of the Australian Copyright Council Fiona Phillips said there could be an argument for the Government or another agency buying back the copyright licence from Mr Thomas.

“The fact that the flag has been recognised since 1995 as an official Australian flag takes it out of the normal copyright context and gives it an extra public policy element,” she said.

She said it was an image of significance to a large part of the nation and it was important there was some control to avoid potential exploitation.

“It’s quite unusual for copyright to be held by an individual and controlled by an individual rather than a government or statutory authority who, maybe for policy reasons, has other interests in mind,” Ms Phillips said.

“There has to be a way that Mr Thomas can be remunerated fairly but where other people can also have access to the flag.”

Fight to stop flag ‘monopoly’

A Victorian-based health organisation, Spark Health, which produces merchandise with the flag on it, was issued with a cease and desist notice last week and given three business days to stop selling their stock.

The flag represents much more than just a business opportunity, the organisation’s owner, Laura Thompson said.

“It’s been an important symbol to Aboriginal people for a really long time, a symbol of resistance, of struggle of pride, and that’s why we’ve got such a strong attachment,” Ms Thompson said.

PHOTO: Laura Thompson was given three days to cease and desist selling her merchandise. (ABC News: Loretta Florance)

The organisation started an online petition, that has attracted about 13,000 signatures, calling on Mr Thomas to stop the exclusive licensing arrangements.

“We want flag rights for our people, we’ve fought enough, we’ve struggled, we don’t want to struggle to use our flag now,” Ms Thompson said.

“We don’t want anyone to have a monopoly over how we use the Aboriginal flag. The fact they’re a non-Indigenous company doesn’t sit well with me.

WAM Clothing said it would work with all organisations, and provide them with options to continue manufacturing their own clothing ranges bearing the flag.

“WAM Clothing has obligations under its Licence Agreement to enforce Harold Thomas’ Copyright, which includes issuing cease and desist notices,” a spokeswoman for the company said.

Mr Thomas said it was his “common law right” to choose who he enters licensing agreements with.

PHOTO: Spark Health produced a range of clothing featuring the Indigenous flag to help fund its community programs. (ABC News: Loretta Florance)

Wiradjuri artist Lani Balzan designed the NRL’s St George Illawarra Indigenous jersey for four years.

She said it was a disappointing development and will make her reconsider her designs for the football club and other institutions in the future.

“Schools, when they buy their uniforms through me, we put the Torres Strait and the Aboriginal flag on both shoulders, so I don’t know if we will be allowed to do that anymore,” she said.

“It’s not just the flag, it’s what represents them and our culture and who we are, to have some non-Indigenous company get copyright, it’s really upsetting.

“It’s disappointing because it’s coming down to money and the flag doesn’t represent money, it represents us as Aboriginal people, and our culture and who we are.”

Conduct of WAM director’s former business ‘unacceptable’

One of the directors of WAM Clothing, Benjamin Wooster, is the former owner of the now defunct Birubi Arts, a company taken to court over its production of fake Aboriginal art.

In October last year, the Federal Court found Birubi Arts was misleading customers to believe its products were genuine, when in fact they were produced and painted in Indonesia.

At the time, the Australian Competition and Consumer Commission said Birubi’s conduct was “unacceptable”.

Weeks later Birubi Arts ceased operating, and the next month the director and a new partner opened a new business, WAM Clothing.

Birubi Arts company sold more than 18,000 fake boomerangs, bullroarers, didgeridoos and message stones to retail outlets around Australia between July 2017 to November 2017.

The case is due before court again this week, for a penalty hearing, which some lawyers expect could see a hefty fine handed down that could run into the millions.

The company is now in the hands of liquidators, and the ABC understands it “doesn’t have any capacity” to pay further debts.

The director of WAM Clothing is also in charge of another company, Giftsmate, which has the exclusive licence with Mr Thomas to reproduce objects with the Aboriginal flag on it.

Mr Thomas reiterated his support for all the companies he worked with.

“It’s taken many years to find the appropriate Australian company that respects and honours the Aboriginal flag meaning and copyright and that is WAM Clothing,” Mr Thomas said.

“I have done this with Carroll & Richardson [flag licensee], Gifts Mate and the many approvals I’ve given to [other] Aboriginal and Non-Aboriginal organisations.”

Part 3 Join us in the fight for #FlagRights, for #PrideNotProfit.

We’ve always said that our products are conversation starters. We never thought as tiny little Aboriginal-led business that we’d come under scrutiny for celebrating the Aboriginal Flag or using the word ‘gap’ in our name as we try to self-determine our futures while we work towards adding years to peoples lives.

Show your support, sign the petition

Part 4

 

Aboriginal Health and #ChronicDisease 1 of 2 #SaveADates Submissions Close 15 July for Reviewing the Practice Incentives Program Indigenous Health Incentive (PIP IHI). Register for Workshops 17 June to 3 July #NSW #QLD #VIC #SA #WA #NT#ACT


NACCHO Aboriginal Health Promotion #ClosingTheGap and the #AHW Workforce : Download Research : How can we make space for Aboriginal and Torres Strait Islander community health workers in health promotion ?

“Too many white Australians think the door opens to opportunity from the outside, when you’ve got to be let into the door from the inside’.

Noel Pearson, Aboriginal activist, The Australian, 7 May 2015. (Bita, 2015)

 “ The ‘AHW’ role was first established in the Northern Territory and recognized by the Western health system in the 1950s (Topp et al., 2018).

It was formally incorporated into Australia’s national health system in 2008 (National Aboriginal and Torres Strait Islander Health Worker Association, 2016).

Individuals can become an AHW if they are pursuing or hold a Certificate III, IV or higher degree diploma in, for example, primary health care, public health or a specific area of practice such as mental health.

In the mainstream health care sector, AHWs serve in ‘health worker’ or ‘outreach’ roles, providing clinical services, community outreach and education to improve access, health outcomes and the cultural appropriateness of services (McDermott et al., 2015).

Some also have specified AHW positions in prevention and health promotion. But the delivery of Indigenous health promotion in Australia is best exemplified by the work of Aboriginal Community Controlled Health Organisations (ACCHOs).

ACCHOs are primary health care services operated by the local Aboriginal community that they serve (NACCHO, 2018).

Their approach to providing comprehensive and culturally competent services draws on the cultural knowledge, beliefs and practices of their communities, and aligns with the Ottawa Charter principles aimed at enabling communities to take control of their own health care needs (WHO, 1986).

 AHW positions within ACCHOs may, therefore, reflect the full range of role types outlined in Table 1.

It is primarily within ACCHO-developed community programmes that other types of CHW roles and models for their delivery have been implemented, for example, lay-leader or peer-to-peer education models (McPhail-Bell et al., 2017).

 Yet many of these initiatives are only documented in programme reports within the ‘grey literature’ with much of the work undertaken in Aboriginal health promotion remaining under-researched and underreported ” 

Read over 290 Aboriginal Health Promotion articles published by NACCHO over the past 7 years 

Read this full research paper online HERE

Article Contents

Download the PDF Copy

Aboriginal Health Workers and Promotion

Photo top banner

 ” Mallee District Aboriginal Services health promotion co-ordinator Emma Geyer and MDAS regional tackling Indigenous smoking worker Nathan Yates are on the lookout for a local “deadly hero”. Picture: Louise Barker

MALLEE District Aboriginal Services (MDAS) is on the hunt for a “deadly hero” who will be the face of a campaign to encourage more Indigenous residents to visit the service for regular health check-ups.

MDAS regional tackling indigenous smoking worker Nathan Yates said the overarching aim of the campaign was to boost the health of the local indigenous population.

“Deadly Choices in our terminology is about making a good choice so for this it’s about making really healthy lifestyle choices because it’s all about trying to bridge the gap between life expectancy of indigenous and non-indigenous people,” Mr Yates said

Picture and story originally published Here

Abstract

Despite a clear need, ‘closing the gap’ in health disparities for Aboriginal and Torres Strait Islander communities (hereafter, respectfully referred to as Aboriginal) continues to be challenging for western health care systems.

Globally, community health workers (CHWs) have proven effective in empowering communities and improving culturally appropriate health services.

The global literature on CHWs reflects a lack of differentiation between the types of roles these workers carry out.

This in turn impedes evidence syntheses informing how different roles contribute to improving health outcomes.

Indigenous CHW roles in Australia are largely operationalized by Aboriginal Health Workers (AHWs)—a role situated primarily within the clinical health system.

In this commentary, we consider whether the focus on creating professional AHW roles, although important, has taken attention away from the benefits of other types of CHW roles particularly in community-based health promotion.

We draw on the global literature to illustrate the need for an Aboriginal CHW role in health promotion; one that is distinct from, but complementary to, that of AHWs in clinical settings.

We provide examples of barriers encountered in developing such a role based on our experiences of employing Aboriginal health promoters to deliver evidence-based programmes in rural and remote communities.

We aim to draw attention to the systemic and institutional barriers that persist in denying innovative employment and engagement opportunities for Aboriginal people in health.

Kirstin Kulka prepares fruit and salad wraps for children at Coen.

Selected extracts

Aboriginal and Torres Strait Islander cultures in Australia are acknowledged to be the oldest living cultures in the world (Australian Government, 2017a), maintaining thriving and diverse communities for over more than 60 000 years, and implementing land management practices that are exemplary in their sustainability and productivity (Pascoe, 2018).

Hereafter, we use the term Aboriginal to describe the many different clans that make up this diverse peoples, including those from the Torres Strait. Following the British invasion and subsequent colonization of Australia, Aboriginal people across the nation suffered a sudden and complete rupture to all aspects of life including kinship, language, spirituality and culture.

The resulting health disparities experienced by Aboriginal people since colonization, and the inequalities that contribute to them, are well documented (AIHW, 2015). Despite the preponderance of evidence as to these inequities there has been only marginal progress in implementing effective strategies to improve health (McCalman et al., 2016).

Not enough research has focused on how Aboriginal knowledge is reflected in health programmes and services, and there are continued calls for Aboriginal people to be leaders of health-promoting endeavours (National Congress of Australia’s First People, 2016; NHMRC, 2018).

However, combatting systemic racism and reorienting the institutions of the dominant non-Aboriginal culture—i.e. government, health care, education—to include Aboriginal people in decision making and to enable their leadership is proving to be an ongoing challenge in both global and local health settings (George et al., 2015). The opening quote of this paper draws attention to this often-contested issue.

Community ownership of decision making for health has long been recognized as key to addressing the social determinants of health that underlie health disparities (WHO, 1978). Internationally, community health workers (CHWs) enable community involvement in health systems—particularly among minority communities—and contribute to positive health outcomes in a variety of settings (Goris et al., 2013; Kim et al., 2016).

In the USA, for example, the Indian Health Service has funded American Indian ‘Community Health Representatives’ since 1968 (Satterfield et al., 2002).

These health workers provide links between communities and health services, and build trust, relationships and culturally appropriate education and care. Maori CHWs play a similar bridging role in New Zealand by linking community members with health interventions and clinical services, providing health education and also working alongside traditional healers and supporting tribal development (Boulton et al., 2009).

In Australia, CHWs are largely operationalized as Aboriginal Health Workers (AHWs), although there is considerable variation in the kinds of roles they perform. The result is that some AHWs experience inflated role expectations that can contribute to unmanageable workloads and stress, reduced job satisfaction, and barriers to integration with other members of the health workforce (Bailie et al., 2013; Schmidt et al., 2016).

Yet variations in role definition for CHWs, and the associated problems, are not unique to Australia (Topp et al., 2018) and are well documented in the broader global CHW literature (Olaniran et al., 2017; Taylor et al., 2017). This variation is problematic as it impedes research into how CHWs influence health outcomes.

In this paper, we explore the lack of differentiation in the global literature between the types of CHW roles both internationally and within the Australian context. Differentiating the various types of CHW roles has enabled us to articulate the need for a specific community health promotion role, one that is distinct from, but complementary to, that of AHWs in clinical settings.

The impetus for writing this paper came from the experiences of two of the authors (NT and JG), an Aboriginal and a non-Aboriginal woman, who have worked in partnership for more than 15 years delivering and evaluating health promotion programmes in Australia.

The challenges we experienced in creating Aboriginal CHW-type positions within two mainstream health promotion programmes caused us to question whether the focus on AHW roles had created unintended barriers to involving Aboriginal people in other opportunities to address health.

By detailing our experience in creating community-based, Aboriginal CHW positions in health promotion, we aim to draw attention to the systemic and institutional barriers that impede expanding employment opportunities for Aboriginal people wanting to work in health.

The National Tackling Indigenous Smoking Workers Workshop was held from Tuesday 2 April to Thursday 4 April 2019 in Alice Springs. This workshop was one of the largest gatherings of TIS workers, partners, experts and supporters of the TIS program.

CHWs AND AHWs

Broadly, CHWs are individuals who may or may not be paid, who work towards improving health in their assigned communities and who often share some of the qualities of the people they serve. These may include similar cultural, linguistic or demographic characteristics; health conditions or needs; shared experiences or simply living in the same area.

However, the degree to which CHWs demographic or experiential profiles ‘match’ the target population also varies. And while most bring cultural and community knowledge to the role, many CHWs have little or no training in Western medicine or in navigating its health systems prior to becoming CHWs (Olaniran et al., 2017).

There is less agreement on the specifics of the CHW role including what they do, how they are trained, how these parameters link to outcomes, and even the titles they are given. One review evidenced 120 terms used to describe CHW roles including variants of ‘lay health educators’, ‘community health representatives’, ‘peer advisors’ and ‘multicultural health workers’ (Taylor et al., 2017).

Syntheses of literature on CHWs illustrate that the tasks they undertake are highly varied but often inadequately or inconsistently defined (Jaskiewicz and Tulenko, 2012; Kim et al., 2016). These issues, coupled with a general lack of contextual information about the role of CHWs, make it difficult to determine patterns or predictors of success.

This lack of clarity is documented as an ongoing barrier to the sustainability of CHW programmes, sometimes causing negative impacts on the workers themselves including burnout due a lack of appropriate training and mentoring support (Jaskiewicz and Tulenko, 2012; Schmidt et al., 2016). One review concluded that ‘the [CHW] role can be doomed by overly high expectations, lack of clear focus, and lack of documentation’ [(Swider, 2002), p. 19].

Previous research has classified CHW roles into typologies of main tasks and activities performed (Olaniran et al., 2017; Taylor et al., 2017). These include providing: (i) social support, (ii) clinical care, (iii) service development and linkages, (iv) health education and promotion, (v) community development, (vi) data collection and research and (vii) activism.

In practice, CHW activities overlap substantially, and tasks regularly extend across categories—both formally and informally (Jaskiewicz and Tulenko, 2012). In Table 1, we present different CHW role types alongside the theoretical models that underpin each.

Linking roles to theory can help differentiate and specify the mechanisms by which CHWs are meant to influence health through the core tasks they perform, and the specific skills related to each task.

NACCHO Aboriginal #AusVotesHealth #VoteACCHO Will preventative health be on the #Election2019 agenda today at the @PressClubAust debate between health ministers @CatherineKingMP and @GregHuntMP? #npc #auspol @_PHAA_ @amapresident @CHFofAustralia @Prevention1stAU

” Labor has vowed to ramp up the Australian government’s efforts to prevent people from becoming unwell if it wins the upcoming federal election.

The pledge comes as Health Minister Greg Hunt will have the opportunity to spruik the coalition’s record on improving people’s health in a debate with Labor’s health spokeswoman Catherine King.

The pair will go head-to-head at the National Press Club today ;

You can watch the debate from 12.30 pm on ABC TV

See media report Part 1 Below

” The health of Australians is far more likely to be advanced by spending money on preventing disease than it is curing or treating illnesses.

With an aging population and chronic disease snowballing, the current focus on health through the prism of hospitals and drugs is unsustainable.

Many Australians would be shocked to learn that less than 2% of the health budget is spent on prevention. We are calling for that to change.

Most OECD countries commit around 5% of health spending to prevention. On this Australia is lagging behind.”

We have shown what can be done by driving down smoking rates. While more needs to be done on tobacco, there is an urgent and growing need to apply that lesson to obesity, physical activity and alcohol consumption. “

PHAA CEO, Terry Slevin from the Public Health Association of Australia (PHAA) who recently launched its election manifesto at its Justice Health conference in Sydney in an attempt to pivot the health conversation towards prevention. See Part 2 Below

Download the PHAA Election Priorities Here

PHAA Policy Priorities 2019

“ The AMA is calling on Health Minister, Greg Hunt, and Shadow Health Minister, Catherine King, to use today’s Health Policy Debate at the National Press Club to fill the gaps in their respective overarching visions for the future health system in Australia.

The Australian health system is one of the best in the world, if not the best. But it will take strong leadership, hard work, good policy with long-term strategic vision, and significant well-targeted funding to keep it working efficiently to meet growing community demand.

“The health system has many parts, and they are all linked. Governments cannot concentrate on a few, and neglect the others. Otherwise, patients will be the ultimate losers. Whole patient care cannot be done in silos, in parts, or in isolation.

“Health is the best investment that any government can make. We expect to hear more detail on their intended investment from the major parties at the National Press Club today,”

Dr Tony  Bartone AMA President See Part 3 Below

” We don’t need more reviews. Experience has shown stopgap health policies won’t pay in the long run. The evidence here and internationally tells us that the best overall returns for the health dollar will come from nationally co-ordinated preventive health measures to counter modern malaises of obesity and chronic illness.

Closely linked to the prevention drive should be better resourced primary health services — GP-led team care for the growing number of chronically ill and older patients. People want affordable, convenient and reliable care close to home “

Update

AMA President, Dr Tony Bartone, said today that Labor has announced a comprehensive framework to re-energise a coordinated national preventive health strategy to keep Australians fitter and healthier and out of hospital.

Dr Bartone said the broad range of initiatives is welcome, but will ultimately require significantly greater funding to be truly effective for the long term. “Investing in preventive health saves hundreds of millions of dollars in health costs and improves lives,”

See Press Release HERE

AMA Prevention

Leanne Wells is chief executive of the Consumers Health Forum of Australia. See Part 4

‘We urge Health Minister Greg Hunt and Shadow Minister Catherine King to outline how they are going to get better bang for the health buck at today’s National Press Club debate’, says Australian Healthcare and Hospitals Association (AHHA) Chief Executive Alison Verhoeven.

‘The Coalition, Labor, and the Greens are all promising welcome extra health dollars and reduced out-of-pocket costs for electors should they win government—but public commitment to getting better value for those dollars has been muted.

See AHHA Press Release Part 5

NACCHO has developed a set of policy #Election2019 recommendations that if adopted, fully funded and implemented by the incoming Federal Government, will provide a pathway forward for improvements in our health outcomes.

We are calling on all political parties to include these recommendations in their election platforms and make a real commitment to improving the health of Aboriginal and Torres Strait Islander peoples and help us Close the Gap.

With your action and support of our #VoteACCHO campaign we can make the incoming Federal Government accountable.

See NACCHO Election 2019 Website

NACCHO Recommendation 6.Allocate Indigenous specific health funding to Aboriginal Community Controlled Health Organisations

  • Transfer the funding for Indigenous specific programs from Primary Health Networks to ACCHOs.
  • Primary Health Networks assign ACCHOs as preferred providers for other Australian Government funded services for Aboriginal and Torres Strait Islander peoples unless it can be shown that alternative arrangements can produce better outcomes in quality of care and access to services

Part 1 Media Coverage 

Health has been a key battleground for the election campaign so far, with both major parties spending weeks trying to convince Australians they will be best placed to look after them when they’re sick.

Labor has vowed to spend $2.3 billion over four years on improving the coverage of cancer services on Medicare and wants to spend an extra $2.8 billion on public hospitals.

But the coalition says it has funded hospitals at record levels, because its strong economic management has given it the cash to do so.

Mr Hunt has also argued his government has made far more medicines affordable by listing them on the Pharmaceutical Benefits Scheme, which means they are subsidised by the government.

Improving the mental health of young and indigenous Australians is also in the coalition’s sights, with the party promising an extra $42 million for services that would do as much if it wins the national poll.

Labor has now turned its attention to stopping people from becoming ill in the first place, pledging $115.6 million worth of initiatives to promote health and prevent disease.

The prevention package includes implementing Australia’s first National Obesity Strategy.

That will involve spending $39 million over three years to roll out a national anti-obesity marketing campaign.

Smokers would be targeted by a separate $40 million anti-smoking campaign over four years to reduce cancer rates.

Money would also go toward a sun protection awareness campaign and initiatives to drive up early detection of bowel cancer.

Labor also wants to reduce harmful drinking, vowing $10 million worth of targeted campaigns, delivering warning labels on alcohol packaging and doing more to limit alcohol advertising to children.

Ms King stressed that almost a third of Australia’s burden of disease is preventable.

Every dollar spent on preventing people from becoming sick through lifestyle factors delivers almost $6 in health and productivity benefits, she said.

“Prevention is better than cure – both for our own health and the country’s.”

Part 2 PHAA

Australia invests a meagre 1.7% of the health system spending on preventative health – one of the lowest levels of the OECD economies. says we must match the world’s best practice of 5% to advance the health of Australians.

Download the PHAA Election Priorities Here

PHAA Policy Priorities 2019

The recent launch of the PHAA Immediate Priorities 5-point plan called for:

  • Setting the target of 5% of Australia’s health budget to focus on prevention
  • Protecting kids from marketing of tobacco, alcohol, junk food
  • Investing in sustained and effective community education programs on tobacco, healthy eating, alcohol and being physically active
  • Focusing on improved health for Aboriginal and Torres Strait Islander adolescents, and
  • Curbing climate change with clear and effective action to ensure a healthy planet.

This plan was launched at our Justice Health conference to emphasise the importance of focusing on the people of greatest need.

“Those who come in contact with the justice system are often the most vulnerable. People with mental health issues, drug and alcohol problems, Aboriginal and Torres Strait Islander people are all overrepresented in our jails. If we aim for a fair go for all Australians, that requires us to focus our attentions on those with the greatest need.”

“If we get this right, we can add at least five more good years to people’s lives so they can enjoy the fruits of their labour, the celebrations and successes of our families and the people we love for longer. Surely this is a goal we all must share and pursue.”

“Health experts have the solutions; parliamentarians simply need to act. ”

Part 3 AMA

The AMA is calling on Health Minister, Greg Hunt, and Shadow Health Minister, Catherine King, to use today’s Health Policy Debate at the National Press Club to fill the gaps in their respective overarching visions for the future health system in Australia.

AMA President, Dr Tony Bartone, said that the AMA has welcomed announcements from the major parties of new funding and strategies for public hospitals, cancer care, primary care, dental care for pensioners and seniors, Indigenous health, the lifting of the Medicare rebate freeze, and the Pharmaceutical Benefits Scheme (PBS), among others.

“The AMA will compare and contrast these policies and publicly rate them accordingly before election day,” Dr Bartone said.

“But we need to see the major parties announcing the missing pieces from their health care vision over the next two-and-a-half weeks, starting today.

“As the population ages and more people are living longer with multiple complex and chronic conditions, it is vital that Australia has a robust, connected, and holistic strategy to ensure improved health outcomes for patients throughout life.

“The big gaps include aged care, broad mental health strategies, comprehensive primary care and general practice investment, the private health sector, and prevention.

“The Australian health system is one of the best in the world, if not the best. But it will take strong leadership, hard work, good policy with long-term strategic vision, and significant well-targeted funding to keep it working efficiently to meet growing community demand.

“The health system has many parts, and they are all linked. Governments cannot concentrate on a few, and neglect the others. Otherwise, patients will be the ultimate losers. Whole patient care cannot be done in silos, in parts, or in isolation.

“Health is the best investment that any government can make. We expect to hear more detail on their intended investment from the major parties at the National Press Club today,” Dr Bartone said.

The AMA’s health policy wish list – Key Health Issues for the 2019 Federal Election – is available at https://ama.com.au/article/key-health-issues-2019-federal-election

The AMA will issue a health policy scorecard in the final week of the campaign.

Public Release. View in full here.

Part 4 Preventive measures the most effective health policy prescription

Health is once again a target for billions of taxpayer dollars in election promises that may soothe but never heal community concerns.

There has been no shortage of diagnoses about what ails the health system. A feature of Australia’s health policy in the past decade has been the preponderance of probes into various elements of the health sector, ranging from system-wide inquiries to more focused reviews of troubled areas.

The Coalition government, since coming to power in 2013, has instituted a clutch of reviews into key problem zones: primary care for the chronically ill, mental health, private health insurance, out-of-pocket medical costs, regulation and remuneration of pharmacies, and the efficacy of high-cost Medicare benefits.

These reviews produced various ideas for change and improvement, but community unease about health still creates a spike in public opinion surveys.

There were two recurring concerns raised by respondents to a recent survey conducted by the Consumers Health Forum. The issues were cost and uncertainty. These are worry points often reflected in the focus of the health policies announced so far in this federal election campaign.

The out-of-pocket costs dilemma confronting so many patients in Australia also is often connected to a widespread sense of uncertainty about healthcare and its co-ordination — what care is needed, its cost and where to go for appropriate treatment.

Our survey found most people were satisfied with the quality of the healthcare they received. However, a third encountered difficulties at every stage of the healthcare process, such as finding the right place to get care, deciding which provider to see and getting to see the provider they needed.

The unease about care costs and uncertain access to co-ordinated care have prompted a variety of responses from the political parties.

Labor has proposed a plan to reduce out-of-pocket costs for cancer patients; the Coalition is pledging support for streamlined access to integrated care for the over-70s and a new website detailing medical specialists’ fees. And both sides promise more hospital funding and a continuing stream of new drugs on the Pharmaceutical Benefits Scheme.

But there remains the reality that we are getting piecemeal measures when what is needed is a holistic approach with overarching strategies reflecting all of the modern world’s knowledge about the causes of ill health and our capacity to avoid ill health.

We are proposing that the next federal government give priority to three areas: childhood obesity, public dental services and primary healthcare. We don’t need more reviews. Experience has shown stopgap health policies won’t pay in the long run. The evidence here and internationally tells us that the best overall returns for the health dollar will come from nationally co-ordinated preventive health measures to counter modern malaises of obesity and chronic illness.

Closely linked to the prevention drive should be better resourced primary health services — GP-led team care for the growing number of chronically ill and older patients. People want affordable, convenient and reliable care close to home,

The political default on health is to offer more and bigger hospitals. We need to rebalance the investment to give more focus on comprehensive care in the community that reduces our dependence on hospitals.

Obesity is a dominant factor in chronic illness yet as a nation we have no coherent, effective strategy to counter poor diet and promotion to children of unhealthy food and drink, and to take other more practical measures, such as overcoming urban planning and transport obstacles to routine activities such as walking.

Modern economies and digital technology have brought new levels of consumer control and understanding to most corners of society. Yet health, despite the expertise of its practitioners and reliance on precision record-keeping elsewhere in healthcare, lags behind 21st-century potential when it comes to communications with patients. Instead, we as a wealthy country have hundreds of thousands of people each year putting off having scripts filled, seeing a specialist or living with the misery of toothache because they can’t ­afford a dentist.

Australia’s health system remains less efficient than it should be and federal-state divisions in health funding and the resistance of practitioners to change, or lack of support for practitioners to change, are significant impediments. We have seen in recent years welcome strides towards a more transparent and accountable health system. Consumers must be empowered with more government support for the development of consumer leadership and patient-centred care to improve not only health outcomes but also the working experience of clinicians.

Transforming services by encouraging consumer-influenced health services and patient engagement in healthcare can bring long-term benefits to Australia’s physical and fiscal health.

Leanne Wells is chief executive of the Consumers Health Forum of Australia.

Part 5

‘We urge Health Minister Greg Hunt and Shadow Minister Catherine King to outline how they are going to get better bang for the health buck at today’s National Press Club debate’, says Australian Healthcare and Hospitals Association (AHHA) Chief Executive Alison Verhoeven.

‘The Coalition, Labor, and the Greens are all promising welcome extra health dollars and reduced out-of-pocket costs for electors should they win government—but public commitment to getting better value for those dollars has been muted.

‘For example, do you really need that extra appointment with the doctor to renew a script or have a specialist referral updated? Do you really need to pay a GP to carry out a treatment or give an injection when a trained nurse can do it just as effectively? Why are some treatments still subsidised by Medicare when more effective evidence-based treatments are available? Why get that injury treated in hospital when it could be done just as well at your local primary care clinic for a fraction of the cost?

‘We need to shift the whole system to value-based healthcare—that is, better outcomes for patients relative to costs—or the right care in the right place at the right time by the right provider.

‘This will often involve teams of health professionals providing ongoing care for chronic conditions—this has been proven internationally to be more effective, more timely and better value than traditional care systems.

‘Integrated or “joined up” care driven by results is better for the patient than care driven by number of consultations attended and/or the size of the patient’s wallet.

‘To their credit, during its current term the Government initiated a review of all Medicare item numbers for relevance and effectiveness. Progress has been limited to date, but the review is ongoing.

‘The Government also initiated an inquiry into out-of-pocket costs—but included only one consumer representative in a sea of medical and private health interests. One proposed outcome of the inquiry—compelling specialists to publish their fees on a government website—while laudable, is yet to see the light of day.

‘The Government introduced the Health Care Home model of integrated care, which is a move toward value-based healthcare. But it failed to attract enough ‘buy-in’ from medical practitioners or consumers—in part because of insufficient funding and poor planning. The Coalition’s recently announced policy of rewarding GP practices for people over 70 signing up or registering with the practice for chronic disease care is a renewed step in the right direction. So is the commitment of both major parties to Primary Health Networks tasked with introducing innovative and value-based primary healthcare regimes tailored to local circumstances.

‘The $2.3 billion investment pledged by Labor to address out-of-pocket costs for people with cancer is a much-needed response to the significant and unexpected costs faced by many people with cancer. But, apart from a suggested oncology Medicare item number available only through bulk-billing of patients, there is little detail as yet on how the initiative will ensure real value for patients while sidestepping unnecessary low value care.

‘Labor’s proposed Health Reform Commission, and the Greens’ similar proposed single funding agency are encouraging signs of political will to achieve better value and less waste by ending the “blame game” between various levels of government—but we would like to see more concrete actions detailed in their policies.

‘As a nation we also need to invest in appropriate Australian research into best value care—AHHA has recently launched the Australian Centre for Value-Based Health Care to support this work.

‘We call on all parties and candidates to commit to better bang for the health buck—a revamped value-for-money health system focused on what matters to patients’, Ms Verhoeven said.

Visit the Australian Centre for Value-Based Health Care here. To follow AHHA commentary throughout the election campaign, visit www.ahha.asn.au/election. This release is also available online.

NACCHO Aboriginal Youth Health : ‘Dark days of old Don Dale’: John Paterson CEO @AMSANTaus and Human rights groups condemn #NT Government and Minister Dale Wakefield’s new youth justice laws

“ The NT government talks proudly about its commitment to Aboriginal-led solutions, to co-design and to collaboration,

So why was this bill kept from those who are part of those solutions and collaborations until the moment it was introduced into the parliament?

The bill went “far beyond” clarifying technical matters,

It does not reflect the royal commission recommendations or the government’s previous policy position to accept and implement those recommendations.

These amendments bring back the draconian treatment of young people and will see children restrained and isolated at the discretion of detention staff.

Far from reducing ambiguity as the minister claims, the amendments reintroduce ambiguity with subjective definitions and powers.

The Chief Executive Officer of AMSANT, John Paterson The Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) today condemned the Labor Government and Minister Wakefield in the strongest possible terms for its behaviour in avoiding debate and scrutiny in order to ram through retrograde changes to the Youth Justice Act for the operation of youth detention.

Read The Guardian Amnesty coverage 

Read full AMSANT Press Releases Part 1 Below

Read over 60 NACCHO Aboriginal Health and Don Dale detention articles 

“The Territory Labor Government is creating generational change and safer communities by overhauling the Youth Justice system and putting at-risk young people back on track.

“The safety of youth detention staff and detainees is absolutely paramount. These amendments will help to better manage security risks that puts lives in danger.

“Last year we amended the Youth Justice Act to ensure that force, restraints and isolation could not be used for the purpose of disciplining a young person in detention.

“The new amendments provide clarity by removing ambiguities in the Act to ensure that youth detention staff can better respond to serious and dangerous incidents. Laws often need adjusting to reflect operational realities

Minister for Territory Families, Dale Wakefield Read Full Press release Part 2 Below 

Part 1

Mr Paterson, said “The Minister has been misleading and disingenuous in her speeches and answers to the limited questioning that was allowed in the Legislative Assembly. Despite the Minister’s assertions, these amendments are not mere technical clarifications.

They are substantive changes that erode the small improvements that were made in 2018 in response to the Royal Commission.

They will allow harsh treatment of young people in detention to continue unopposed and unscrutinised.”

WATCH TV NEWS COVERAGE

Mr Paterson said that the Bill passed this afternoon with no scrutiny, is clearly intended to retrospectively make lawful, actions that were unlawful under the law as it existed until today. “We must ask ourselves whether this unseemly and undemocratic haste is intended to defeat legal actions currently on foot by young people who believe their treatment in detention has been unlawful.

Does the government know that unlawful treatment occurred and is now seeking to avoid accountability? It is difficult to draw any other conclusion despite the Minister’s obfuscation in the Assembly” said Mr Paterson.

AMSANT believes that the harsh treatment of young people now permitted under the law will lead to increased tensions and incidents in detention. When the next major incident occurs, the government, not the young people, must be held to account. “Let’s not forget” said Mr Paterson “that a large proportion of young people in detention have significant cognitive disabilities.

The government is condoning the use of restraint, isolation and physical force against young people with disabilities because they do not have the capacity to comply with the demands of the detention environment.

Right now, young people are being restrained in handcuffs and waist shackles to simply walk from one part of Don Dale to another under the control of a guard.”

“AMSANT is disgusted by this behaviour by a government and calls on the Chief Minister to withdraw this legislation prior to it receiving the assent of the Administrator. To do otherwise is to walk away from the Royal Commission recommendations.” said Mr Paterson. Mr Paterson seeks to remind the Chief Minister of his words and apparent distress when he responded to the Royal Commission.

The Chief Minister said in November 2017, “Our youth justice and child protection systems are supposed to make our kids better, not break them, they are supposed to teach them to be part of society, not withdraw”. “This legislation is not consistent with that statement”, Mr Paterson concluded

Protestor at Alice Springs Market yesterday 

1.2 Youth Justice Amendment Bill a return to the bad old days!

Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) Chief Executive Officer, John Paterson, today called on the Chief Minister to halt the progress of the Youth Justice Amendment Bill 2019 through the Legislative Assembly until Aboriginal people and organisations have the chance to have a say.

“The government talks proudly about its commitment to Aboriginal led solutions, to co-design and to collaboration” said Mr Paterson.

“So why was this Bill kept from those who are part of those solutions and collaborations until the moment it was introduced into the Parliament?”

“The Minister has said the Bill simply clarifies technical matters and keeps faith with 2018 amendments.” Mr Paterson said.

“The Bill goes far beyond that. It undoes the positive progress in the 2018 changes which were a start in implementing the Royal Commission recommendations. The government consulted with Aboriginal organisations and other youth advocates and we supported the 2018 amendments.”

Mr Paterson said that this Bill is a u-turn on the progress in 2018. It does not reflect the Royal Commission recommendations or the Government’s previous policy position to accept and implement those recommendations.

“These amendments bring back the draconian treatment of young people and will see children restrained and isolated at the discretion of detention staff. Far from reducing ambiguity as the Minister claims, the amendments reintroduce ambiguity with subjective definitions and powers.”

Mr Paterson also questioned the need for retrospective effect of these amendments. “The only reason for retrospective effect is to legalise actions that were illegal when they were taken.” AMSANT said that the safety of both staff and young people is important and called on the government to work with Aboriginal organisations and other experts to explore the safety concerns and solutions. The government needs to think more carefully about the way forward. “

If the workforce cannot safely deliver a detention system under current laws which give quite considerable powers over the young people, the government needs to look at the skills, training and support of the workforce to ensure that they can. Attacking the human rights of young people is not the solution” Mr Paterson emphasised.

Mr Paterson noted that under the Diagrama Foundation which runs 70% of youth detention in Spain, for example, highly qualified staff with expertise in youth development, trauma and de-escalation work with young people in a therapeutic way that does not involve restraint, force and isolation. “Diagrama facilities rarely experience incidents of the kind seen last year at Don Dale.

Mr McGuire from Diagrama told audiences in Darwin last year that it is at least 10 years since there was a significant incident at a Diagrama facility. And Diagrama experiences a reoffending rate of only 20% across all its residents compared to 80% in the NT.”

Part 2

Passage of Youth Justice Act Amendments to Manage Security

Risks in the Territory’s Youth Detention Centres

March 2019

Today the Territory Labor Government passed amendments to the Youth Justice Act which will clarify and tighten the existing framework for managing safety and security risks within the youth detention centres.

The amendments will provide youth detention centre staff with a clear and unambiguous framework for exercising their powers, and will enable them to have a very clear guideline in their decision making when responding to dangerous and challenging situations.

The amendments include:

  • Clarify the circumstances in which force and restraints may be used, to account for situations where detainees mayact in a way that threatens the safety or security of a detention centre, but not in a way that presents an imminent risk
  • Create a consistent test to determine what is a reasonable use of force and restraints
  • Clarify the meaning of an emergency situation, which is relevant to the general application of all uses of force • Clarify the definition of separation
  • Enable screening and pat down searches of detainees in a broader range of circumstances
  • Include an express power to transfer a detainee from one detention centre to another

The amendments will remove any uncertainty around the operation of existing powers in the legislation, for both youth detention centre staff and detainees.

The amendments will apply retrospectively to the date in which the original provisions of the Act commenced (May 2018). This will remove any doubt about the original intention of these key provisions in the legislation.