NACCHO Aboriginal Health supports the @Lungfoundation first ever Australia-wide #Indigenous Lung Health Checklist

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 ” Lung Foundation Australia in collaboration with the Queensland Government’s Indigenous Respiratory Outreach Care Program (IROC) have developed the Checklist specifically for the Indigenous community.

It only takes a few minutes to answer 8 questions that could save your or a loved one’s life.

It can be completed on a mobile phone, tablet or computer.

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The Indigenous Lung Health Checklist is narrated by the Lung Foundation’s Ambassador and Olympic Legend Cathy Freeman.

Read or Download the PDF Brochure

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Please go to the site as Indigenous peoples are almost twice as likely to die from a lung-related condition than non-Indigenous Australians.

# Indigenous Lung Health Checklist at

http://indigenouslungscheck.lungfoundation.com.au/.

NACCHO Aboriginal Health #ACCHO Member News : Funding boost for Aboriginal Community Controlled Health Services in NSW #Yerin #Armajan

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“The aim of the funding is to provide Aboriginal and Torres Strait Islander people with access to primary health care services that are culturally appropriate and safe.

Our services designed in collaboration with our local community so they are sensitive to specific needs of Aboriginal and Torres Strait Islander people at the local level.”

Belinda Field, Yerin CEO -NACCHO Member : Yerin Aboriginal Health Services Inc. is a community controlled integrated primary health care service located at Wyong on the NSW Central Coast, Darkinyung country. 

Pictured above L-R Kamira Farm (Natalie), The Glen (Joe Coyte), Yerin (Belinda Field), HNECCPHN (Richard Nankervis)

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“It’s a special meeting place that should be respected and cherished by the local Aboriginal community.

Its a place of learning , wellbeing and healing. And it belongs to you, the mob. It’s worth protecting,”

Armajan practice manager Dr Gleeson described an Aboriginal controlled health service as a contemporary sacred site. Armajun Aboriginal Health Service will be Walcha’s primary health care provider for Aboriginal people in the 2017-2018 year, after receiving almost $2.6 million of federal funding : see Article 2 below

Article 1 Eleanor Duncan Aboriginal Health Centre

Funding for Aboriginal health services on the NSW Coast are to receive a large boost thanks to significant new funding from the Primary Health Network (PHN).

Speaking this morning at the Eleanor Duncan Aboriginal Health Centre Richard Nankervis, CEO for the PHN said” The Primary Health Network is pleased to be providing more than $2.7M in funding to three of the leading primary health care providers on the Coast, namely Ngaimpe Aboriginal Corporation (operating The Glenn), Kamira and Yerin Aboriginal Health Services”.

“We look forward to working with these organisations to improve access to culturally appropriate primary health services for Aboriginal and Torres Strait Islander people and help close the gap in Aboriginal health disadvantage.”

The programs being funded cover a wide variety of primary health care services including care coordination, drug & alcohol rehabilitation and mental health programs such as peer navigation, counselling and suicide prevention.

Joe Coyte CEO of the Glen said, “We’re delighted that the PHN has recognised the fantastic outcomes we have been achieving at the Glen and they are supporting us to deliver these vital services. The funding will allow us to empower more Aboriginal and Non-Aboriginal men take control of their lives and to become active members back in their families and the community as a whole.”

Kamira CEO, Catherine Hewett said, “This new funding is providing us with necessary funds to extend the reach of our services and help us provide more opportunities for Aboriginal women to access quality treatment.

We are looking forward to working with more women and helping them build strong relationships with their family and significant others so they have the necessary foundations for a long and lasting recovery”.

Funding for all of these programs and services have been allocated through the PHN’s commissioning process. The commissioning of health services is undertaken following a transparent tendering process that is informed by the PHN’s baseline needs assessment and associated market analysis. Commissioning is a holistic process that enables the PHN to plan and contract health care services that are appropriate and relevant to the needs of local communities

Article 2  : Armajun to take over local Aboriginal health services

A meeting was held in the offices of Amaroo  recently between the Walcha Aboriginal community and two representatives from Armajun Aboriginal Health Service.

Armajun chief executive officer Debbie McCowen and practice manager GP Keith Gleeson addressed the group to explain what services Armajun offered and find out what was needed in Walcha.

“We don’t believe in telling communities what they need,” said Ms McCowen.

“Our purpose today is to ask you what you think you need and outline what services we have and then investigate what we can do to provide anything else you might need.”

Armajun Aboriginal Health Service will be Walcha’s primary health care provider for Aboriginal people in the 2017-2018 year, after receiving almost $2.6 million of federal funding.

The Inverell-based company provides medical services out of the old Medicare Local building in Rusden Street, Armidale.

Mrs McCowen said the new funding secured Armajun’s services to Armidale and the region.

“This means we’re here to stay,” she said.

Armajun recently formed a regional advisory committee to inform the Inverell-based board on important local issues.

Amaroo chief executive Mark Davies and Kerry Griffin will represent Walcha.

The federal government cut more than $2 million from Aboriginal health provider, HealthWISE’s budget.

HealthWISE New England North West had been servicing more than 7500 Aboriginal and Torres Strait Islander people in the region with about $2.6 million of Commonwealth funding.

But late last year the government announced HealthWISE would only receive $477,053 for the 2017-2018 year. “The level of funding received is insufficient [for us] to continue the same level of services across the region,” chairwoman Lia Mahoney told Fairfax Media at the time.

Meeting attendees raised concerns regarding the inadequate transport service between Walcha and  Armidale.

While Mr Davies queried whether a doctor who only treated Aboriginal patients would become an issue in the community, the mayor, Eric Noakes, and other attendees said it would not.

Dr Gleeson said they would not do anything without the agreement of other medical services in Walcha.

Dr Gleeson described an Aboriginal controlled health service as a contemporary sacred site.

“It’s a special meeting place that should be respected and cherished by the local Aboriginal community.

Its a place of learning , wellbeing and healing. And it belongs to you, the mob. It’s worth protecting,” he said.

Have you got a similar good news story about one of our ACCHO members ?

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NACCHO has announced the publishing date for the 9 th edition of Australia’s first national health Aboriginal newspaper, the NACCHO Health News .

Publish date 6 April 2017

Working with Aboriginal community controlled and award-winning national newspaper the Koori Mail, NACCHO aims to bring relevant advertising and information on health services, policy and programs to key industry staff, decision makers and stakeholders at the grassroots level.

And who writes for and reads the NACCHO Newspaper ?

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While NACCHO’s websites ,social media and annual report have been valued sources of information for national and local Aboriginal health care issues for many years, the launch of NACCHO Health News creates a fresh, vitalised platform that will inevitably reach your targeted audiences beyond the boardrooms.

NACCHO will leverage the brand, coverage and award-winning production skills of the Koori Mail to produce a 24 page three times a year, to be distributed as a ‘lift-out’ in the 14,000 Koori Mail circulation, as well as an extra 1,500 copies to be sent directly to NACCHO member organisations across Australia.

Our audited readership (Audit Bureau of Circulations) is 100,000 readers

For more details rate card

Contact : Colin Cowell Editor

Mobile : 0401 331 251

Email  : nacchonews@naccho.org.au

#NACCHOagm2016 Launch speech @KenWyattMP NACCHO #HealthyFutures Report Card

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

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

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

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

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

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

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

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

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Download copy NACCHO Healthy Futures Report Card Here

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

See NACCHO TV Interviews

          Donna Ah Chee

           Julie Tongs

          Dr Mark Wenitong

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Thank you.

For further reading

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

ken-news

 

NACCHO Aboriginal Health News: Better aim needed to hit bullseye in mental health

help  ” Young Aboriginal and Torres Strait Islander people take their own lives at a rate five times that of other Australians,”

“This is devastating Aboriginal communities and we must do everything in our power to try to save these young lives.

If we can train up young people and others in our communities to recognise and react to the warning signs in their peers, there is a good chance we can support those who are suffering before they reach the point of no return.

This is a good initiative which empowers communities to be part of the solution.’

Matthew Cooke NACCHO Chair Press Release May 2016

Understanding how many people in each community need hospital treatment for mental health conditions, helps to identify local areas that may require more ACCHO services and support.”

NACCHO Mental Health Articles 117 in total

NACCHO Suicide Prevention articles 87 in total

“Are people living in rural and remote Australia more likely to be hospitalised for mental health conditions than their city counterparts?

The report, Healthy Communities: Hospitalisations for mental health conditions and intentional self-harm in 2013-2014, recently released by the Australian Institute of Health and Welfare gives some insight into this issue.

The report looks at hospitalisations for five mental health conditions: schizophrenia and delusional disorders, anxiety and stress disorders, depressive episodes, bipolar and mood disorders and dementia as well as drug and alcohol use and intentional self-harm.”

The National Rural Health Alliance is Australia’s peak non-government organisation for rural and remote health. Its vision is good health and wellbeing in rural and remote Australia

The report, Healthy Communities: Hospitalisations for mental health conditions and intentional self-harm in 2013–14, looks at local-level variation in populations across Australia’s 31 Primary Health Network (PHN) areas and 330 smaller local areas.

Download the report aihw_hc_report_mental_health_september_2016

‘Overnight hospitalisations for mental health conditions varied across PHN areas, from 627 per 100,000 people in the ACT to 1,267 per 100,000 in North Coast NSW. Overall, regional PHN areas had higher rates of hospitalisations than city-based PHNs,’ said AIHW spokesperson Michael Frost.

The disparity between regional and metropolitan PHN areas was more pronounced for hospitalisations related to intentional self-harm.

‘Across all PHN areas, rates ranged from 83 per 100,000 people in Eastern Melbourne PHN area to 240 per 100,000 in Central Queensland, Wide Bay and Sunshine Coast – a three-fold variation,’ Mr Frost said.

The report also looks at hospitalisations for six sub-categories of mental health: drug and alcohol use, schizophrenia and delusional disorders, anxiety and stress disorders, depressive episodes, bipolar and mood disorders, and dementia. Hospitalisations for these sub-categories varied across PHN areas.

For the 330 smaller local areas, the report examined variation in overnight mental health hospitalisations within and across socioeconomic and remoteness areas. It found significant disparities – up to four-fold variation – when comparing similar local areas.

The report will be also available on the MyHealthyCommunities website (http://www.myhealthycommunities.gov.au).

The website is now managed by the AIHW, following the transfer of functions from the former National Health Performance Authority in June.

Updated information is also available on the website for a range of Medicare Benefits Schedule statistics in 2014–15, and life expectancy and potentially avoidable deaths’

This report focuses on the mental health of populations in small areas across Australia. It aims to assist Primary Health Networks and others in making informed decisions about resources required in providing effective primary mental health care.

The report finds:

  • In 2013–14 across the 31 Primary Health Network (PHN) areas that cover Australia, the age-standardised rate of mental health overnight hospitalisations was twice as high in some PHN areas compared to others. Across more than 300 smaller local areas called SA3s, the rates were almost six times higher in some local areas compared to others. Rates of hospitalisation include admissions to both public and private hospitals
  • The most common group of mental health conditions requiring hospitalisation was from drug and alcohol use (38,636 hospitalisations). These overnight admissions accounted for 299,829 bed days nationally. In 2013–14 the age-standardised rate of hospitalisations varied more than three-fold, from 87 admissions per 100,000 people (in North Western Melbourne PHN area) to 275 per 100,000 people (in Western Queensland PHN area)
  • The second most common group of mental health conditions requiring hospitalisation was schizophrenia and delusional disorders (36,562 hospitalisations). These overnight admissions accounted for 813,514 bed days nationally – the most bed days for any of the groups of conditions in the report. The age-standardised rate of hospitalisations varied more than two-fold, from 102 admissions per 100,000 people (in Australian Capital Territory PHN area) to 234 per 100,000 people (in North Coast NSW PHN area)
  • In 2013–14, there were 33,956 hospital admissions (including overnight and same-day) for intentional self-harm, which accounted for 184,332 bed days nationally. The age-standardised rate of hospitalisations for intentional self-harm varied from 83 per 100,000 people (in Eastern Melbourne PHN area) to 240 per 100,000 people (in Central Queensland, Wide Bay and Sunshine Coast PHN area).

Better aim needed to hit bullseye in mental health

Overall, overnight hospitalisation rates were 13 per cent higher in rural and remote areas (971 hospitalisations per 100 000 population) as compared to metropolitan areas (857 per 100 000 population).

While data indicates significant difference in the rates of hospitalisation in rural and remote Australia compared with major centres, it also reveals significant variation within regions – the rates of hospitalisation in some towns can be almost 8 times higher than for other towns of the same remoteness.

The NSW north coast had the lowest overall rate of overnight hospitalisations for health conditions. For drug and alcohol hospitalisations, western Queensland had the highest rates. Country South Australia had the highest hospitalisation rate for depressive episodes. Central Queensland/Sunshine Coast had the highest hospitalisation rate for intentional self-harm.

The very large variations in mental illness hospitalisation within cities, within rural Australia and within remote communities underlies the importance of targeting programs to specific towns and communities, rather than our current approach of treating all rural areas and all remote areas as if they have the same needs.

The variation in rates could be due to a number of factors including differences in the prevalence in mental illness, variable access to mental health services and programs or even differences in hospital admissions processes in rural and remote hospitals.

The National Rural Health Alliance is Australia’s peak non-government organisation for rural and remote health. Its vision is good health and wellbeing in rural and remote Australia.

The data will be invaluable to funders and health services in identifying and targeting areas of poor health to ensure that efforts and resources are targeted to the areas of greatest need.

The National Rural Health Alliance looks forward to working with the Rural Health Commissioner, when they are appointed, to address such poor health outcomes within rural and remote Australian communities.

If you or anyone you know needs help,

you can call Lifeline on 13 11 14.

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NACCHO #Health Press Release : #AIHW reveals the extent of the health crisis facing Aboriginal communities

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“In a wealthy country such as Australia, I am appalled by the unacceptable gap in the health of Aboriginal people and non-Aboriginal people.  More than one-third (37%) of the diseases or illness experienced by Aboriginal people are preventable.

“We need to act before another generation of young Aboriginal people have to live with avoidable diseases and die far too young.

If we are serious about turning this crisis around we need sustained investment in evidence-based programs for Aboriginal people, by Aboriginal people, through Aboriginal community controlled health services –  a model we know works.

Matthew Cooke Chair of NACCHO pictured above with Vice Chair Sandy Davies 

New figures show that Aboriginal and Torres Strait Islander people experience ill health at more than double that of non-Indigenous Australians.

The peak Aboriginal health organisation, the National Aboriginal Community Controlled Health Organisation (NACCHO) said the report highlights the urgent need for a rethink on actions to address the already known and growing crisis in Aboriginal health.

The report from the Australian Institute of Health and Welfare (AIHW) released today shows Aboriginal Australians experience a burden of disease at 2.3 times the rate of non-Indigenous Australians.

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Download the report aihw-australian-burden-of-disease-study

NACCHO Chair, Matthew Cooke, said it is the first ever in-depth study of the scale of disease in Indigenous communities.

See AIHW Press Release

“It’s given us a clearer picture of the real impact for Aboriginal communities of poor health in terms of years of health lives lost, quality of life and wellbeing and what the risks factors really are,” Mr Cooke said.

“It’s shown that we still have a massive challenge to address the overwhelming level of non-fatal burden in mental health in particular – which makes up 43 per cent of non-fatal illness in men and 35 per cent of these conditions in women.

The AIHW report found that injuries, including suicide, heart disease and cancer are the biggest causes of death in Aboriginal people. Levels of diabetes and kidney disease are five and seven times higher in Aboriginal people than non-Aboriginal people.

Mr Cooke said the report must trigger a rethink on how health programs are funded and delivered to Aboriginal people.

“The risk factors causing health problems include tobacco use, alcohol use, high body mass, physical inactivity, high blood pressure, high blood glucose and dietary factors – all of which can be addressed with the right programs on the ground and delivered by the right people.

“All levels of government should urgently act on this evidence; we need to see these findings translated into programs, policies and funding priorities that are proven to work. Too many programs aimed at addressing Aboriginal health are still fragmented, out of touch with local communities, unaffordable or inaccessible.

“If we are serious about turning this crisis around we need sustained investment in evidence-based programs for Aboriginal people, by Aboriginal people, through Aboriginal community controlled health services –  a model we know works.”

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

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

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

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

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

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

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

AHHA Chief Executive Alison Verhoeven

Download the report here australias-health-2016

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

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

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

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

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

The gap for women was slightly lower at 9.5 years.

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

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

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

Indigenous sobriety rate higher than non-Indigenous Australians

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

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

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

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

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

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

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

Reports below from the Conversation

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


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

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

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


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

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

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


AIHW

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


Lifestyle choices

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

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

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


AIHW

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


AIHW

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

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

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

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

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

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

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

Proportion of the burden attributable to the top five risk factors


AIHW

Preventing chronic disease

Rob Moodie, Professor of Public Health, University of Melbourne

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

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

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


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


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

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

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

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


Inequities

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

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

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


AIHW

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


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


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

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

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

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


AIHW

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

Coverage with private health insurance and government health-care cards


AIHW

Cost of care

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

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

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

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

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

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


Annual growth rates in health expenditure AIHW

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

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

Health expenditure by area (adjusted for inflation)


AIHW

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

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

NACCHO Aboriginal Health Newspaper Next AGM Edition

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NACCHO Aboriginal Health News: PM and Health Minister take action on Indigenous #suicideprevention

PM

” In any other country, in any other part of the world these statistics would be a cause of national shame and soul searching,

“And quite frankly, if these numbers applied to any group of non-indigenous kids in Sydney or Melbourne, there would be pages of newspaper print and no amount of money, resources or political effort spared to address the issue.

It’s time there was a full Royal Commission into failings in the system that are driving so many people in our communities to such levels of despair that suicide is the only answer; and into what systemic changes we need to put in place to reverse such appalling statistics.”

Matthew Cooke NACCHO Chair Press Release

” The rate of suicide among young Indigenous men is the highest in the world, according to a new report highlighting the challenges facing young Australians.

The index helps formulate youth development policy in the domains of education, health and wellbeing, employment as well as political and civic participation, measured across 16 key indicators “

The first ever Australian Youth Development Index (YDI) was compiled as part of International Youth Day.

Download the report here Australian_Youth Index 2016

“We must, as a nation, address the tragic over-representation of suicide rates in remote and indigenous communities such as the Kimberley, where the age-adjusted rate of suicide is more than six times the national average.

The Kimberley trial site will help us develop a model of suicide prevention we can tailor specifically to the unique and often culturally-sensitive requirements of remote and indigenous communities “

Health Minister Sussan Ley Press Release : Suicide prevention trial for Kimberley region Press Release :

Photo above : The Prime Minster “tweeting” his meeting with Professor Pat Dudgeon in Perth last week the challenge of Indigenous suicide

The Turnbull Government will establish a landmark suicide prevention trial site in Western Australia’s remote Kimberley region, helping lead the way in tackling suicide rates in indigenous communities across the country.

This is part of the additional $192 million we committed during the election and is one of 12 suicide prevention trial sites, and is on top of the bold reforms we had already set in motion last term.

We are a Government dedicated to action on improving the mental health of the nation and reducing suicide rates, and our announcements supporting indigenous and remote communities, youth and veterans in recent days demonstrates that.

We must, as a nation, address the tragic over-representation of suicide rates in remote and indigenous communities such as the Kimberley, where the age-adjusted rate of suicide is more than six times the national average.

The Kimberley trial site will help us develop a model of suicide prevention we can tailor specifically to the unique and often culturally-sensitive requirements of remote and indigenous communities

The Country WA Primary Health Network (PHNs) will commission the Kimberley suicide prevention trial, and follows on from the appointment of the Perth South PHN to lead similar trials into youth and indigenous suicide.

These trials will bring together best practice, expertise and local knowledge to tailor mental health solutions specific to their community needs. Commissioning them through local PHNs will ensure a focus on community education, integrating services at the local level and post-discharge follow up.

Consultation and collaboration is critical, with involvement from communities, elders, carers, local services, state government programs, health professionals and community health workers all essential if we are going to seriously tackle suicide prevention in high risk groups.

Health is a number one priority for the Coalition and we will leave no stone unturned in our effort to address the causes and impacts of suicide on our communities.

It is part of the Turnbull Government’s broader reform agenda to deliver stronger, more effective primary health care with a focus on person-centred care, delivering services that start with early intervention and prevention, regionally focussed, integrated and utilising digital technology.

Suicide rate for young Indigenous men highest in world, Australian report finds

The rate of suicide among young Indigenous men is the highest in the world, according to a new report highlighting the challenges facing young Australians.

The first ever Australian Youth Development Index (YDI) was compiled as part of International Youth Day.

The index helps formulate youth development policy in the domains of education, health and wellbeing, employment as well as political and civic participation, measured across 16 key indicators.

It rates a state or territory’s performance with a score between zero and one, with one being a perfect score.

Among the reports findings were alarming statistics on youth suicide, which showed Aboriginal and Torres Strait Islander men between 25 and 29 had the highest suicide rates in the entire world.

“What that says is that we as a country are failing that particular group of young men,” Youth Action chief executive Katie Acheson said.

“When we look at all the countries that are measuring suicide rates it is shocking that Aboriginal males are so stigmatised and that number is so high.

“We have to do something now.”

If you or anyone you know needs help:

The index found Tasmania and Queensland recorded an increase in suicide rates despite national rates remaining steady.

Health and wellbeing registered the most significant deterioration over a 10-year period, with the index’s authors attributing that to mental health issues and the increasing use of alcohol and other drugs.

Overall, the Australian Capital Territory had the highest YDI score at 0.851, while the Northern Territory had the lowest score at 0.254.

Research finds youth are struggling to gain employment

The report also found employment opportunities for young people had declined in every state and territory, with the NT recording a drop of 80 per cent since 2006.

It also found that in all states and territories, the percentage of young people not engaged in education, employment or training was significantly higher for rural youth than for those in the cities.

“What was really interesting is that there’s a really huge gap between rural and urban areas, so young people in urban areas are more likely to get a job and have education opportunities,” Ms Acheson said.

“Young people in regional areas have far greater inequality in that their access to education and employment is much worse than those young people in the city.”

However, the report suggested political participation by young Australians had grown.

“The data is saying that in some areas we’re doing pretty well, so political participation in Australia has gone up since 2006,” Ms Acheson said.

“Pretty much everywhere we’ve seen an increase in young people having more of a voice and taking more action.”

Australia’s Youth Development Index ‘very high’ in global terms

The index took information from the Australian Bureau of Statistics, including census data, as well as figures from health and education departments, such as NAPLAN data.

The report also found that despite a high level of youth development in Australia compared to other nations, there were gaps at a regional level, between city and country and Indigenous and non-Indigenous youth.

It also found that many important youth issues were not measured by data or were measured but those figures were not readily available or comprehensive enough for analysis by indexes such as the YDI.

Nonetheless, in a global context, Australia’s YDI was considered “very high”.

The report also found that Australia had improved in all domains except youth health and wellbeing, where it had gone backwards, against the global trend.

The report said the Northern Territory had the highest proportion of young people in its population out of any state or territory — around one in every three people — but had managed to register the biggest improvement in its performance over the 10-year period, with a 30 per cent increase in its overall YDI score.

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NACCHO #PCHCH Health Care Homes News : What can #PCHCH learn from our #ACCHO model ?

health

“Learning from Aboriginal Community Controlled Health Organisations:

ACCHOs have very successfully looked beyond the biomedical approach to health and reduced cultural and financial barriers to primary care. We should not ignore local examples of what works but rather look to implement them more widely.

Building the take-up of evidence-based models: A commitment to the continued development and implementation of the PCHCH model beyond the three-year pilot is essential. What is needed is an embedded commitment to innovation and a culture of continuous improvement, rather than the stop-start approach of a limited pilot program.”

Lesley Russell is an Adjunct Associate Professor at the Menzies Centre for Health Policy at the University of Sydney.

Originally published INSIDE STORY

See NACCHO HOME CARE Articles HERE

Copyright Congress

Earlier this week a diverse panel of healthcare stakeholders – including medical professionals, academics and consumer representatives – released a report spelling out how a “patient-centred health care home” model, or PCHCH, should develop in Australia.

The “home” in this case is a healthcare practice of primary care providers (usually headed by GPs), and the aim is to provide care that is patient-centred, team-based, comprehensive, and coordinated. These characteristics are what we all want; they are especially important for people with complex medical problems.

The panel was responding to sketchy details the Turnbull government has released in recent months about its Health Care Homes plan, which was originally proposed in a report by its own Primary Health Care Advisory Group in December last year. That group had been asked to examine opportunities for better management of people with complex and chronic diseases, and had put forward just one option: an Australian version of the PCHCH scheme operating in the United States. (It’s not clear whether the group was asked to focus on this option and, if so, why use wasn’t made of earlier work on such a proposal commissioned by the Department of Health when Tanya Plibersek was health minister.)

Reflecting the push for change, the April meeting of the Council of Australian Governments, or COAG, coupled an increased federal government focus on primary care services with extra funding for hospitals as a way of preventing unnecessary hospitalisations for people with complex and chronic diseases. The accompanying heads of agreement contained the first mention of Health Care Homes, providing details of a pilot program that would begin in July 2017 and run for three years. A contemporaneous media release from the prime minister and the health minister made the broad details public.

In May, the initiative was funded to the tune of $21.3 million in the 2016–17 budget, but no further details were released. Although the proposal was positively received, important questions remained about how the model (or models) would be developed, implemented, funded, evaluated, adjusted and expanded. Those questions are still unanswered. What we do know is that whatever the federal health department has in mind has been developed with minimal public consultation. The timelines for the pilot are unreasonably short, and the process of getting stakeholders involved is now urgent.

It’s this sequence of events that drove the panel to hold its roundtable in early July and produce this week’s report. Clear definitions and goals will be essential if we are to know whether this new model of care is working, and perhaps the most important thing the panel did was to define the core elements of an Australian PCHCH. This model of care is already operating elsewhere, especially in the United States, but the approach must be adapted to Australian needs.

The roundtable saw the key elements as:

  • patient-focused care with patients as informed and active partners,
  • comprehensive multi-disciplinary team-based care,
  • coordination of care across the care delivery system,
  • accessibility for patients using multiple communication modes,
  • evidence-based care and data-driven quality improvement,
  • payment models that support all of these elements.

Given that none of these elements exists comprehensively at the moment, the task of transforming general practices to PCHCHs will be significant. New infrastructure and improved e-health services are needed, as are additional staff with better training and skills in multidisciplinary care, increased patient and community involvement, and new Medicare payment mechanisms. The model/s to be tested should be sufficiently flexible to meet local needs, and increased resources will be needed in underserved areas.

The size of the task is greater than the federal government might imagine because the panel made important recommendations about the scope of the scheme. It recommended that PCHCH should be available to all Australians, not just those with chronic and complex conditions. This is sensible: it makes no sense for practices to wait until patients are really sick before offering them the best model of care.

The panel also highlighted the need to go beyond simply providing clinical services, and to ensure that patients have access to the social determinants of health: safe housing, good nutrition, home-based care as needed, transport and social interactions. And it argued that PCHCHs should be embedded in the local healthcare systems, with strong links to the Primary Health Networks and hospitals.

Delivering this new model of care will require fundamental changes. PCHCHs are not just general practices with add-ons. The two biggest barriers are likely to be finding a payment system that works and is acceptable to providers, and driving the necessary changes in culture.

The roundtable panel argued that a new payment system must reward quality, comprehensiveness and continuity of care, respond to context, and safeguard against cost-shifting and other perverse incentives such as under-treatment and “cherry picking” patients. Regrettably, it didn’t take the next step and outline the details of such a scheme. While there is a willingness on the part of medical professionals to look beyond fee-for-service, in reality there will be many challenges and barriers – and there are no great success stories to draw on from earlier Australian trials or from overseas.

All of which highlights how important cultural change will be. Partly, it will be a matter of developing a common language that is relevant to patients. Innovative leaders in the clinical world and the community must be used to be exemplars and advocates, and the government will need to invest additional resources to assist those areas where there are low levels of change readiness.

The panel’s report did not address a number of areas where more work will be needed. These include:

Encouraging enrolment: The government’s original proposal was to allow voluntary enrolment in a Health Care Home. To achieve the goals of coordinated and continuous care, though, there needs to be a formal doctor–patient relationship. This could be achieved by giving patients incentives to enrol rather than making it compulsory.

Outlining the full range of services to be provided, and dealing with out-of-pocket costs: If the focus of the PCHCH is to be on the whole patient, then integrating mental health and substance-abuse services is essential. Other needed services include pharmacy, dental, eye and hearing and a range of allied health care. These need not be co-located, but must be readily accessible and affordable. The roundtable report doesn’t mention the need to link in community-based specialist services, and it fails to address the consequences for the effective implementation of the PCHCH model if patients’ out-of-pocket costs for primary and specialist care continue to grow at the current rate.

Working with the wider health and social welfare system: The panel recognises the need to provide these services but doesn’t detail how this could be facilitated. One approach is to use Community Health Workers: these frontline public health workers have a close understanding of the communities in which they work and generally share the language and culture. Because they have trust and relationships, they can act as advocates and intermediaries between health and social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.

Learning from Aboriginal Community Controlled Health Organisations:

ACCHOs have very successfully looked beyond the biomedical approach to health and reduced cultural and financial barriers to primary care. We should not ignore local examples of what works but rather look to implement them more widely.

Building the take-up of evidence-based models: A commitment to the continued development and implementation of the PCHCH model beyond the three-year pilot is essential. What is needed is an embedded commitment to innovation and a culture of continuous improvement, rather than the stop-start approach of a limited pilot program.

Using data effectively and measuring success: The Australian healthcare system is notorious for collecting data and failing to use it to maximum effect. In designing the PCHCH model/s it will be imperative to have agreement on the most appropriate performance indicators. The data can then measure improved patient outcomes, indicate where efforts should be targeted, and benchmark quality and safety. This information can be fed back into the system at all levels.

Meeting reasonable expectations about funding and the time needed to deliver results: The roundtable didn’t comment on the government’s unrealistic funding and timing expectations. Even given the limited scope of the proposed trial (65,000 patients in 200 practices), $21 million over four years is minimal. A draft version of the COAG agreement, which doesn’t appear to be publicly available, stated that the Commonwealth would keep back $70 million annually for efforts to reduce avoidable hospitalisations and improve quality and safety, and intimated that the states and territories and private health insurers would also make contributions. This has not been further discussed, however.


The federal government expects to have an evaluation of the PCHCH pilot available to inform the next agreement on public hospital funding in 2018. That’s far too soon for any meaningful results. Done well, this is a more expensive model of primary care and the investment will be returned through reductions in costs in other sectors, especially in acute care. Moreover, the American experience shows that changes in outcomes and savings in costs will take time.

While it is essential that this initiative has a solid and evidential foundation, there is no need to start this work anew – and clearly no time to waste. The foundations have been laid by the roundtable report, by the work of the Primary Health Care Advisory Group, by the Royal Australian College of General Practitioners and other groups, and, as far back as 2009, by the National Health and Hospital Reform Commission. The health department’s archives contain other relevant papers, some of them specifically commissioned on this topic.

It’s time for engaged leadership at the top and enthusiastic healthcare workers at the coalface to get started on this much-needed project to transform Australian healthcare. •

NACCHO Aboriginal Health News Alert : Five tips to get the government started on real #health reform

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” The health and well-being of the population depend on issues well beyond the health portfolio and require a health-in-all policy approach in all government portfolios. This is a matter of leadership and cultural change, not new expenditures and regulations.

“Wicked” issues such as obesity, mental health, healthy ageing and Closing the Gap on Indigenous disadvantage can only be effectively addressed through such whole-of-government approaches “

Indigenous disadvantage can only be reduced with effective, whole-of-government responses

Lesley Russell  Adjunct Associate Professor, Menzies Centre for Health Policy, University of Sydney writing in the Conversation

Since the election, the Turnbull government has received a great deal of advice on how to counter the pervasive public scepticism about its ongoing commitment to the universality of Medicare.

While the impacts of the so-called Mediscare campaign, the Medicare rebate freeze and the “zombie” policies left over from the 2014-15 budget have driven these calls for Coalition action, the real issue is that the previous Abbott-Turnbull government had no health policy agenda, other than budget cuts and the covert exploration of privatisation and competition in the delivery of health-care services.

In this new term, the government must do more to deliver the health-care system we need for the 21st century – not just to improve its standing with voters, but to meet the health needs of all Australians. Much of this can be achieved through new ways of thinking about policy development and implementation rather than new spending.

Even so, some new funds will be needed. The government and its bean counters must move beyond seeing the health-care budget as a drain on finances and treat it as an investment in the health, productivity and prosperity of the nation. This approach will help concentrate efforts on evidence and value rather than ideologically based, slash-and-burn approaches.

1. Patients must be the centre of the health system

The health-care system exists primarily for the benefit of patients, but their voices are so rarely heard. Every policy, budget measure and proposal must be considered through the patient lens.

That does not mean the impacts on providers (hospitals, clinicians and health insurers) should not be considered; they are also stakeholders and usually the decision-makers. But the government’s first instinct has been to consult with privileged groups such as the Australian Medical Association and private health insurers, rather than with the public, patients and providers at the coalface.

Importantly, viewing health reform through a patient lens will help policymakers identify disadvantaged groups so they can target their specific needs.

2. Invest in health promotion, not just illness treatment

Prevention is as much a responsibility of government as it is for individuals. This is particularly the case for obesity.

As a nation, we all bear the substantial and growing economic and social costs of obesity and its consequences, especially diabetes. Every day, 12 Australians have an amputation related to diabetes at a cost of A$875 million a year. Almost all of this is preventable.

The investments made in prevention must be proportional to the burden of disease in terms of resources and commitment. Concerns about sensible budget policies must override ideological concerns about the nanny state.

3. Make health-care reforms sustainable

This means ceasing the start-stop approach of small-scale pilot programs that never go beyond three years and are evaluated only after they are concluded in reports that never see the light of day. Real reforms will also require time frames well beyond those of the election cycle.

Labor has proposed a promising way forward: a permanent Australian Healthcare Reform Commission, which would include a new Centre for Medicare and Healthcare System Innovation to embed continuous reform into the health-care system.

This type of approach – where models can be seamlessly developed, implemented, assessed, adjusted and expanded – is essential for reforms such as the government’s proposed Health Care Homes trial to better manage chronic disease, and for complicated issues such as mental health reforms.

 

4. Apply a whole-of-government approach to health

The health and well-being of the population depend on issues well beyond the health portfolio and require a health-in-all policy approach in all government portfolios. This is a matter of leadership and cultural change, not new expenditures and regulations.

“Wicked” issues such as obesity, mental health, healthy ageing and Closing the Gap on Indigenous disadvantage can only be effectively addressed through such whole-of-government approaches.

5. Data is key

Research, data analyses and evaluation are key to health-care reforms.

The antipathy of the previous government to evidence-based policymaking was exemplified by the scrapping or downgrading of key agencies and the defunding of the Primary Health Care Research, Evaluation and Development (PHCRED) Strategy and the Better Evaluation and Care of Health (BEACH) study.

These losses must be rectified, but it is also time for the Department of Health to start mining the archives. There are mountains of reports, papers and evaluations, together with significant, policy-relevant primary health care research commissioned by the department through the Australian Primary Health Care Research Institute, to be used in improving the delivery and financing of health-care services.

At the same time, there should be a moratorium on shunting off difficult problems to committees as an excuse for inaction. There will be occasions when it is necessary to convene advisory groups. That should be done using the experts who will provide the advice that is needed, not the usual hacks who provide the advice the government wants.

So where do we start?

I rate the following as the key issues:

In 2007, my colleagues and I outlined the challenges to health care facing the incoming Rudd government. Regrettably this nine-year-old document could serve the same purpose today, so little has changed.

Will Prime Minister Malcolm Turnbull now bring to the health-care sector the innovation he says holds the key to Australia’s future?

 

NACCHO #HealthElection16 : Coalition invests $192 Million mental health reforms and suicide prevention

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“As a society we need to be alert to mental illness and remove the taboo on discussing it, which is why we are talking more often and openly about mental health issues,” he said.

“We have to learn to recognise depression in family, friends and work mates and reach out to them – before it is too late.

“This is why my Government is investing more in mental health and making services far more accessible, including through our smart phones.

Our National Suicide Prevention Strategy will draw together the current fragmented approach to suicide prevention and build on what is working well to focus on effective strategies to prevent suicide and reduce suicidal behaviour.”

Malcolm Turnbull Coalition launch 26 June

“Investing in non-Aboriginal services and organisations to deliver Aboriginal health and social services is widely acknowledged as failed policy.

NACCHO will keep building the capacity and responsiveness of the ACCHO Sector, and work to further demonstrate that investing in self-determination, and empowering Aboriginal people delivers better health outcomes and value for money.”

Matthew Cooke NACCHO Chair

Editorial Opinion NACCHO Newspaper out 29 June

A re-elected Turnbull Coalition Government will invest $192 million towards a bold package of mental health reforms to ensure help for individuals and their families across Australia, including key commitments in suicide prevention.

This is in addition to a series of important steps already undertaken in our first term, including the commissioning of regionally-delivered mental health services through Primary Health Networks (PHN’s) in partnership with state, territory and local service providers.

Our National Suicide Prevention Strategy will draw together the current fragmented approach to suicide prevention and build on what is working well to focus on effective strategies to prevent suicide and reduce suicidal behaviour.

Under a Coalition Government, we will prioritise $26 million for 10 PHN Mental Health lead sites to trial innovative approaches in mental health services. These will include establishing regional service pathways, evolving models of stepped health care and increasing use of digital technology.

Four of these locations will specifically focus on suicide prevention.

We will invest a further $24 million to add a further eight Suicide Prevention Trial sites throughout regional Australia, bringing the total number to 12.

These trial sites will build on best practice and community models and adopt new digital technologies to assist in crisis support, clinical intervention and ongoing support for individuals.

The Prime Minister said he was passionately committed to addressing the challenges of mental illness and suicide.

“And why we as leaders are talking more often and more openly about mental health.”

The Coalition will also:

  • Guarantee funding for youth mental health services, including headspace and six Early Psychosis Youth Services
  • Spend $30 million to trial new digital technologies to ensure access to mental health services wherever and whenever needed 24/7.
  • Strengthen the National Mental Health Commission, which will provide independent oversight of our mental health reforms.

Minister for Health Sussan Ley said the Coalition would also establish a $12 million Suicide Prevention Research Fund to support targeted research to develop and evaluate regional suicide prevention models and provide a best practice hub of resources.

“The Coalition Government understands the impact of depression, anxiety and poor mental health on both individuals and our productivity as a nation, is significant,” Ms Ley said.

“Our mental health reforms will result in better personalised support and care, greater opportunity and better lives for Australians.

“We are a Government that made mental health a first term priority and this announcement demonstrates our commitment to ensure it remains front and centre

Peak body welcomes Coalition plans and funding pledges to support Australians to stay alive

Suicide Prevention Australia welcomes The Coalition’s $192m suicide prevention and mental health plan announced today. This follows last weekend’s announcement of support for suicide prevention and mental health by the Australian Labor Party.

SPA CEO Sue Murray says of the announcement, “Lives depend on us recognising suicide prevention as a key national issue which requires the commitment of all parties supporting Australians to stay alive. At this time, when we face the highest suicide rate in 10 years, the commitment to funding and action is exactly what is needed.”

“The Coalition has not at this stage endorsed the goal of a 50% reduction in suicide deaths. We believe that setting this goal is essential to galvanise government, business and community action as has occurred in Scotland and other countries. That said, we welcome the commitments announced today that are, in the most part, aligned to our Election Manifesto for Suicide Prevention and the Mental Health Commission Review Report recommendations.”

Key points include:

  • $12M to establish a fund for targeted suicide prevention research, as suggested in the National Research Plan for Suicide Prevention
  • Commitment to funding 12 regional suicide prevention trials, as suggested in the National Mental Health Commissions Review
  • Support for a Crisis Text service design and trial led by SPA member Lifeline
  • Funding to open an additional 10 headspace centres to support our youth
  • Investment into Synergy project to advance technology capability
  • Continued funding for six early psychosis centres
  • Grant to College of Mental Health Nurses to fund workforce development strategy
  • National Mental Health Commission reprising its role as the independent statutory authority.

What are other parties saying about suicide prevention? Read our summary.

What are our members and colleagues saying? Read our summary.

Download the Suicide Prevention Australia 2016 Election Manifesto

New investments in mental health welcome

Mental Health Australia has welcomed today’s announcement that a re-elected Turnbull Government would make significant new investments in mental health.

“$192 million of new investment in mental health represents a welcome boost to programs and services,” said Mental Health Australia CEO Frank Quinlan.

“This kind of investment will save lives.”

“Australia faces major challenges in mental health and suicide prevention and the investments announced today will have a significant impact.”

“An independent National Mental Health Commission (NMHC) could also provide much needed accountability to a system undergoing unprecedented reform.”

Today’s announcements include the following measures:

  • Independent status for the NMHC
  • Implementation of the twelve suicide trial sites recommended by the NMHC Review
  • A new $12 million suicide research fund
  • Investment to support the further development of the Mental Health Digital Gateway
  • An additional ten headspace centres
  • Secure funding for Early Psychosis Centres until 2019
  • Funding for Lifeline for “follow up text messaging”
  • Funding for the Australian College of Mental Health Nurses to explore “workforce issues”

Mental Health Australia has updated its report card detailing the mental health commitments from all three major parties contesting the forthcoming election.

“It is encouraging the leaders of the major parties have all made specific commitments to mental health during this election campaign,” said Mr Quinlan.

Regardless of who wins the 2 July election, the process of mental health reform will require a decade long commitment to improving mental health services and programs.

Mental Health Australia’s updated report card, along with each of the parties’ full responses, can be downloaded here – https://mhaustralia.org/election-2016

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NACCHO Aboriginal Health Newspaper

Download a free PDF copy 29 June

Tuesday : NACCHO CEO plus The Greens

Wednesday : NACCHO Chair Matthew Cooke plus Members

Thursday : Labor Policy

Friday : Coalition Policy