NACCHO Aboriginal Health Research Alerts : Download @AIHW Report Indigenous primary health care results : Our ACCHO’s play a critical role in helping to improve the health of our mob

 ” Comprehensive and culturally appropriate primary health care services play a key role in improving the health and wellbeing of Indigenous Australians through prevention, early intervention, health education, and the timely identification and management of physical and psychological issues. “

Download the 77 Page AIHW Report HERE

Indigenous-primary-health-care-results-from-the-OSR-and-nKPI-collections

Primary health care organisations play a critical role in helping to improve the health of Indigenous Australians.

In 2018–19:

To this end, the Australian Government provides funding through the IAHP to organisations delivering Indigenous-specific primary health care services (referred to hereafter as organisations).

These organisations, designed to be accessible to Aboriginal and Torres Strait Islander clients, are administered and run by:

  • Aboriginal community-controlled health organisations (ACCHOs)
  • state/territory/local health services
  • non-government organisations (NGOs), such as women’s health services (a small proportion of services).

They vary in size, location, governance structure, length of time in operation, workforce composition, sources of funding, the services they offer, the ways in which they operate (for example, stand-alone or part of a consortium), and the needs of their clients.

What they all share in common is a holistic approach to meeting the needs of their Indigenous clients, which often involves addressing a complex mix of health conditions.

Each organisation provides contextual information about their organisation to the OSR once each financial year (covering the period July–June). The OSR includes all activities of the funded organisations, regardless of the percentage of those activities funded by IAHP.

This chapter presents a profile of organisations delivering Indigenous-specific primary health care services, including staffing levels, client numbers, client contacts, episodes of care and services provided. It excludes data from organisations that received funding only for maternal and child health services.

Trends over time are presented where possible, noting that the organisations providing data can vary over time which may limit comparability for some purposes (see Technical notes and Glossary for more information). Also, in 2018–19, the OSR collection underwent significant change and was scaled back to include only ‘core’ items. Plans are underway to reintroduce key items in a staged approach over the next few years.

The following boxes show key results for organisations providing Indigenous-specific primary health care in 2018–19.

Clicking HERE will go to more information on the selected topic.

Aboriginal Health #CoronaVirus #Nutrition News Alert No 69 : May 22 #KeepOurMobSafe #OurJobProtectOurMob : The #COVID19 pandemic has a silver lining with possible solutions to food affordability and availability in remote communities

Part 2 AIG Press Release

Originally published HERE

We know prices are too expensive in Aboriginal community stores around the NT. To prove the point however, we went shopping. The results from our Market Basket survey will shock you.

In April and May, 2020 our shoppers went into 9 stores in the Top End with the same shopping list made up of essential and popular products.

Shopping list:

  • Mi Goreng Fried Noodles 5pk
  • Weetbix 375g
  • Weetbix 575g
  • Deb Instant Potato Plain 115g
  • Bush Oven Bread 700g
  • Bushells tea bags rounds 200 pack
  • San Remo Spirals small No 15 500g
  • Palmolive soap gold 4pack
  • Colgate Toothpaste Maximum Floride Cool Mint 110g
  • Hazedenes Chicken Cuts 2kg Bag
  • Eggs Large Dozen 600g

And the results…..

Our key finding was the store managed by AIG has the cheapest prices for all products on the list – blue ribbon for us! For all the market basket results click here.

More importantly though, how is it possible that one store can charge almost $25 more for the same basket of products? Obviously, it’s because the prices are higher. The trickier and more important question to answer is why?

Lets just break it down a little, and look at chicken prices as an example of how prices influence food security.

Barunga store charges $9.40 for 2kg of Hazledene chicken cuts and Beswick store (which is run by the Commonwealth entity Outback Stores) charges $16.80. Its only 25km down the road! Another community store charges $24.60 for the same product.

Why the price difference?

There are three reasons why the prices are different between stores: rebates, ethics and freight.

Rebates

A rebate is money paid by the supplier to store management stock their products. Our research shows rebates can range between 1.5 and 25%. Rebates are calculated on each product and the higher the rebate, the more expensive the product becomes. Coke and tobacco reap the highest rebates in community stores. Rebates are given to the store management groups, and not the stores themselves.

Rebate revenue is worth millions of dollars in the Northern Territory alone. Look for example at the Commonwealth owned Outback Stores which last year made more than $2.6 million in rebates https://outbackstores.com.au/wp-content/uploads/2019/12/OS-Annual-Report-19-web-spread.pdf through raising the cost of products in store. That is a lot of tobacco and Coke!

AIG does not accept rebates because we believe it is unethical and drives up prices in the store which further disadvantages the vulnerable and threatens food security.

Freight

Usually listed as the primary reason for high prices in community stores, but in reality, has a far lesser impact on the actual prices of products in the store.

Freight is the cost of getting the products from the supplier to the store. If a store is very remote, then the freight is obviously going to be more expensive. Freight should be cheaper for the larger management groups because they order in bulk which reduces the actual freight costs further.

AIG is a small store management group and if we can have low prices while paying freight, it is proof that freight is not as expensive as people are led to believe.

Keep comparing food prices

We want to disrupt how community stores are managed in the NT through creating transparency about prices in stores. Its hard for people in remote communities to understand the situation they are in if they can’t compare prices in their stores to other communities.

AIG has created online shopping for the Barunga and Timber Creek communities which is a great service, but equally important is being able to provide transparency the prices we charge so others can compare to the prices in their stores. We don’t accept rebates from suppliers, and we don’t make a profit on fruit and vegetables. This is how our prices are low. If we can do it, other stores can do the same.

Check out the store and the prices https://barunga-store.myshopify.com or https://wirib-store.myshopify.com/

Aboriginal Health #CoronaVirus @NITV News Alert No 56 : May 6 #OurJobProtectOurMob : Travel bans to remote communities will stay put amidst easing COVID-19 restrictions elsewhere around Australia, but virus risks for Indigenous people living in cities and urban areas also remain high

 ” While COVID-19 restrictions are easing in some states and territories, remote Aboriginal communities in lockdown will remain off-limits to outsiders.

The Northern Territory, where almost 30% of the population is Indigenous, has begun a “roadmap to the new normal”, re-opening pools and parks and giving the green light to fishing with a mate.

As other states consider their own watered-down measures, there has been confusion around what this means for vulnerable Indigenous populations.

Shahni Wellington writing for NITV News

Pat Turner has been interviewed for NITV-The Point and the story will go on-air tonight, Wednesday 5 May at 8.30pm

In March, the federal government announced internal border controls that could restrict access to areas that include Indigenous communities under the Commonwealth Biosecurity Act.

The measures were an effort to protect vulnerable populations, with many Aboriginal communities opting to close their own borders, and were put in place until at least June 18.

While the enforcement of those restrictions are the responsibility of each jurisdiction, the lifting of the restrictions will be subject to a decision through the national cabinet.

Minister for Indigenous Australians, Ken Wyatt, confirmed to ABC radio on Tuesday that the lockdowns remain in place, including all 76 remote communities in the Northern Territory.

“You’re better off being patient than to end up with COVID-19 and possible death,” Minister Wyatt said.

“We only have to look at the aged care facility in New South Wales where the virus was brought into the facility and they’ve lost 15 people now, senior Australians, and we would run a similar risk in a community if somebody brought the virus in inadvertently and we end up losing, and when I say us, I mean our people, will lose Elders and senior people.”

The most at-risk areas to be placed in lockdown was identified by state and territory governments, with anyone entering those biosecurity boundaries needing to self-isolate for 14 days.

In Western Australia, there are fines up to $50,000 for entering a remote Aboriginal community without an appropriate reason.

Urban concerns

While remote Aboriginal communities can remain isolated to minimise the risks of catching COVID-19, the same options don’t exist for urban areas.

The federal government has partnered with the National Aboriginal Community Controlled Health Organisation (NACCHO) to combat potential outbreaks and ease socio-economic impacts.

Gudanji-Arrernte woman and head of NACCHO, Pat Turner, said people living in cities need to remain vigilant.

“The lifting of the restrictions remains a very grave concern in terms of what conditions need to be in place for us to lift the bio-security restrictions, particularly in the remote areas,” Ms Turner said.

“But I feel that the greatest risk for our people remains in the cities, where everyone is champing at the bit to have the restrictions lifted.”

According to the ABS, almost 80% of the Aboriginal population are living in urban areas, with a proportion of 35% living in capital cities.

Ms Turner said there are barriers for Indigenous people living in urban areas in accessing proper treatment or being able to properly self-isolate.

“State and territory governments have to assist with those processes, because of over-crowded housing, we just do not have the capacity within our communities to self isolate as many other Australians can do in their own homes,” she said.

“If we still have community transmission then our people – and there are many, many, many, First Nations people who live in Australian cities – I am extremely concerned.”

 

Aboriginal #CoronaVirus News Alert No 43 : April 21 #KeepOurMobSafe : #OurJobProtectOurMob #Rural #Remote The coronavirus supplement is the biggest boost to Indigenous incomes since the 1970’s . It should be made permanent

It would be misguided to think Indigenous Australians need only temporary relief.

The Indigenous economy has been in crisis since 1788. The unemployment rate in places like Palm Island was 60% before the coronavirus hit.

The average duration of unemployment for Indigenous Australians is 73 weeks.

For Australia as a whole, it is 11 weeks.

The unfavourable job market now facing many Australians for the first time has been the normal state of affairs for many Indigenous people.

For this reason, the temporary increase to income support should be made permanent, and the suspended mutual obligation requirements abolished.

Doing so, and normalising some of the anomalies of the current arrangement (such as the exclusion of disability support pensioners, age pensioners, and temporary residents) would provide all Australians with an income floor below which no one could fall.

For Indigenous Australians, it would lock in the biggest reduction in poverty rates since the 1970s.

It would be affordable — it’s only a question of our priorities.

The crisis has reminded us once again how much we depend on each other. We can use it to rebuild a society which is fairer and in which no one is forced to struggle in deep poverty.:” 

This article draws on the Francis Markam author’s contribution to the collection Indigenous Australians and the COVID-19 crisis: Perspectives on public policy, published by the Centre for Aboriginal Economic Policy Research at the ANU. From the Conversation 

 

On March 23 the government effectively doubled payments to the unemployed, single parents and students, introducing a new unconditional Coronavirus Supplement to go on top of existing allowances such as Newstart, Youth Allowance, Parenting Payment, Austudy and Abstudy.

From April 27 single unemployed adults will get around A$557.85 per week in income support, almost double the previous $282.85 per week.

This additional support is time-limited, applying for only six months.

As well as covering the newly unemployed, it’ll extend to existing recipients, meaning it’ll be paid to about 2.3 million Australians.


Read more: Coronavirus supplement: your guide to the Australian payments that will go to the extra million on welfare


At the same time, the onerous requirement for recipients in remote Australia to conduct “work-like activities” or face fines and suspensions, has itself been suspended because work-like activities carry added risk.

The temporary doubling is intended to shield those who find themselves unable to find work at a time when the government has shut down large sections of the economy.

But it will have another (welcome) unintended consequence: it will temporarily cut poverty among Indigenous Australia to new lows.

Most very remote Indigenous Australians live in poverty

Note graphic above added by NACCHO 

The income support system has failed for decades to keep Indigenous people out of poverty. At the time of the 2016 Census, 31% of Indigenous Australia lived below the poverty line of $404 per week.

And while the overall financial situation of Indigenous Australians improved over the decade from 2006 to 2016, in very remote Australia, poverty got worse.

Already alarmingly high in 2006 at 46%, by 2016 the proportion of very remote Indigenous Australians in poverty had climbed to 54%.


Percentage of Indigenous population living in poverty

Indigenous poverty rates using the ‘50% of median disposable equivalised household income’ poverty line. Markham and Biddle, 2018

Since then things have changed, for the worse.

According to Bureau of Statistics survey data, median Indigenous personal incomes fell from $482 per week in 2014-15 to $450 in 2018-19.

In remote Australia the fall was more precipitous.

Over those five years remote median Indigenous personal income fell from $375 per week to $310.


Median Indigenous income, 2014-15, 2019-19

Median gross personal weekly income, Indigenous population aged 15-64. Author’s calculations from the National Aboriginal and Torres Strait Islander Social Survey 2014-15 and National Aboriginal and Torres Strait Islander Health Survey 2018-19

The Coronavirus Supplement is set to dramatically change things.

Before the coronavirus outbreak about 27% of the Indigenous population aged 16 years or older were receiving payments that make them eligible for the Supplement.

The proportion who will actually get it be much greater, as many more will become unemployed or underemployed as a result of the crisis.


Read more: Three charts on: the changing status of Indigenous Australians


Indigenous workers are likely to be especially hit hard by the downturn due to discrimination and their more-precarious employment status.

The extra $225 per week is well-targeted at the poorest Indigenous Australians.

According to my estimates, around 38% of Indigenous adults in very remote areas will be eligible.

The biggest boost in 50 years

It is likely to be the most substantial increase in aggregate Indigenous incomes since Indigenous people won rights to equal wages and the full range of social security payments between 1969 and 1977.

In very remote areas, total community incomes are likely to increase by one quarter.

Indeed, so significant is the boost that remote community stores may run out of food as incomes start to catch up with people’s everyday needs, a concern expressed by the minister for Indigenous Australians Ken Wyatt.

It should be made permanent

NACCHO Aboriginal Health and #CoronaVirus News Alert No 21 #KeepOurMobSafe : What are the remote area travel restrictions? Frequently Asked 15 Questions

  1. What are the remote area travel restrictions?
  2. Why is this being done?
  3. What is happening everywhere in Australia?
  4. When to they start and when do they end?
  5. What are the areas? (see attached maps)
  6. How do the restrictions work? (see attached flow chart)
  7. How do they affect community people in community?
  8. How do they affect community people outside of the areas?
  9. How will services still being provided?
  10. Can I travel between my homeland and community?
  11. What about other essential services or activities?
  12. What about construction activities?
  13. Does this effect pastoralists and miners?
  14. Who can I talk to for more information?
  15. More information and resources

See NACCHO Corona Virus Home Page

Read all 21 NACCHO Aboriginal Health and Coronas Virus Alerts HERE

What are the remote area travel restrictions?

On 20 March 2020, the National Cabinet provided in-principle agreement to the Commonwealth Minister for Health taking action under the Commonwealth Biosecurity Act 2015 to restrict travel into remote Indigenous communities to prevent the spread of coronavirus (COVID-19).

States and territories have nominated areas in consultation with Indigenous communities, and emergency requirements determined under the Biosecurity Act 2015 will restrict persons from entering those nominated areas from 11:59pm AEDT Thursday 26 March 2020.

This follows the decisions of a number of Indigenous communities and Governments to implement similar measures.

State and Territory Hotlines and Contact Details

Northern Territory: 1800 518 189 remote travel hotline

Western Australia: Covid19rcr@communities.wa.gov.au

Queensland: 13 QGOV (13 7468)

South Australia: 1800 253 787

Why is this being done?

These restrictions are to protect some of our most vulnerable Australians.

The restrictions have been requested by many leaders, communities and organisations.

Isolation and remoteness offer opportunities for delaying or potentially preventing an outbreak of COVID-19 in remote communities. However, high mobility of community members and a reliance on visiting and outreach activities and services increase the risk of COVID-19 occurring in these communities.

These rules are aimed at preventing the spread of COVID-19 in remote communities and to rapidly address outbreaks.

What is happening everywhere in Australia?

Governments are focused on working together to slow the spread of COVID-19 to save lives. Every extra bit of time allows us to better prepare our health system and put measures in place to protect Australian lives.

We will be living with this virus for at least six months, so social distancing measures to slow this virus down must be sustainable for at least that long to protect Australian lives, allow Australia to keep functioning and keep Australians in jobs.

Practicing good hygiene and keeping a healthy physical distance between individuals is our most powerful weapon in fighting this virus and saving lives. Some members of the community who are disregarding social distancing measures are putting the lives of older and vulnerable Australians at risk.

To slow the spread, everyone must implement appropriate social distancing in accordance with state and territory laws. We need every Australian to do their bit to save the lives of other Australians.

When to they start and when do they end?

Restrictions to travel to remote areas to protect community members from COVID-19 came into effect at 11.59 PM AEDT Thursday 26 March 2020.

The restrictions currently end on 18 June 2020 under the Biosecurity Act. This period can be extended if considered necessary.

What are the areas? 

States and Territories have nominated areas in consultation with Indigenous communities where this was possible in the time available.

The designated remote areas include most of the Northern Territory, except the major urban centres and pastoral properties; north and east Western Australia; the north-west of South Australia and selected communities; and in Queensland Cape York Peninsula, the Torres Strait, western Gulf and other communities.

More areas may be added, including in other States.

The designated areas are indicated on the following maps:

How do the restrictions work? (see attached flow chart)

Consistent with expert health guidance, individuals will be required to undergo a minimum period of isolation (currently 14 days) before entry or re-entry into the area will be allowed.

There will be exemptions for essential activities. Exempted people still need to not have any of the signs or symptoms of COVID-19 and in the 14 days immediately before entry, not been outside Australia. All people must take all reasonable steps to minimise exposure to other people.

How do they affect community people in community?

The safest place for community people is in their community, homeland or outstation.

If people are in community, they are encouraged to stay there. If they are away in town or the city, they should return home before Friday 27 March 2020.

How do they affect community people outside of the areas?

If people want to enter community after the restrictions come into place, they will need to self-isolate for 14 days before return. Isolation is from the general public.

State and Territory Governments are making arrangements to assist isolation.

If people leave their community now, they will not be able to return for 14 days once the restrictions start at 11.59 PM AEDT on Thursday 26 March 2020.

How will services still being provided?

Once the restrictions start, only essential service personnel will be exempt so they can keep delivering essential services.

These essential services include health care, education, domestic violence prevention, child protection, policing, emergency, local government – such as rubbish collection, Services Australia, correctional, funerary and courts.

Essential services also include operating, maintaining or repairing equipment for providing electricity, gas, water or telecommunications services; other essential infrastructure; delivering food, fuel, mail or medical supplies; obtaining medical care or medical supplies; and transporting freight to or from a place in the designated area.

Remember, all people entering designated remote areas still need to not have any of the signs or symptoms of COVID-19 and in the 14 days immediately before entry, not been outside Australia. All people must take all reasonable steps to minimise exposure to other people.

Governments and community organisations are working hard to ensure essential services continue in these communities.

Can I travel between my homeland and community?

Designated areas are generally large and include groups of communities and homelands/outstations. Travel within the designated area (including between islands within that area) is permitted and will not be disrupted with these restrictions. However, it is important that everyone tries to minimise travel and practises social distancing.

Local regulations and norms still apply for travel within those areas.

What about other essential services or activities?

Under the emergency requirements have nominated decision-makers who will be empowered to permit additional people to enter the community in certain circumstances with the advice of a Human Biosecurity expert.

Remember, all people entering designated remote areas still need to not have any of the signs or symptoms of COVID-19 and in the 14 days immediately before entry, not been outside Australia. All people must take all reasonable steps to minimise exposure to other people.

What about construction activities?

Some construction of houses and roads is underway. These activities will be able to continue to completion as an essential activity.

Does this effect pastoralists and miners?

With most of the Northern Territory nominated as a designated area, all pastoral leases are excluded.

Mining, oil and gas and related operations are classed as an essential activity. However, there is an additional requirement to strictly minimise the extent to which other persons in the area are exposed to the persons carrying out those operations through agreed protocols with a relevant biosecurity officer.

Who can I talk to for more information?

Implementation of these restrictions will be the responsibility of each jurisdiction. Hotlines and contact details for your State or Territory Governments are below.

More information and resources

State and Territory Hotlines and Contact Details

Northern Territory: 1800 518 189 remote travel hotline

Western Australia: Covid19rcr@communities.wa.gov.au

Queensland: 13 QGOV (13 7468)

South Australia: 1800 253 787

NACCHO Aboriginal Remote Communities Health and #CoronaVirus News Alerts :  #APYLands  @Nganampa_Health @NLC_74 #CAAHSN @AMSANTaus @RACGP All ensuring remote communities are resourced , protected and provided with appropriate information #COVID19

 

“As health and medical research organisations, we are calling for an absolute priority to be given to minimising risk and preventing death in communities across central Australia.

A major priority in our endeavours is working with Aboriginal communities and support to the primary health services in the bush and our regional centres.

Things that might work in. the big cities simply won’t work out bush, so we need to focus on local solutions.

Both Aboriginal community-controlled and government primary health services face enormous day-to-day challenges—and we strongly support them as the real heroes of health care in remote Australia, from Aboriginal Health Practitioners, to nurses to allied health workers to doctors, to all staff doing such vital work “

CAAHSN would continue to be informed by COVID19  messaging from AMSANT Aboriginal Medical Services Alliance and the Department of Health.

AMSANT has already been supplying advice to member services, with a focus on updating vaccinations and a focus on day-to-day preventive measure such as had washing.

Read full press release Central Australia Academic Health Science Network Part 2 Below

Graphic above QAIHC

Read all NACCHO Corona Virus Articles HERE

” As GPs try to navigate national guidelines for coronavirus (COVID-19), a number of Aboriginal and Torres Strait Islander community leaders have stepped in to manage their own infection control.

For example, in the Northern Territory quite a few communities are putting in place their own procedures around how they’re going to manage it. ’ 

‘[They’re] isolating themselves from [the] outside and I gather even saying, “Actually, we don’t want health professionals coming in at the moment to keep ourselves safe”.’

Dr Tim Senior, Medical Advisor for RACGP Aboriginal and Torres Strait Islander Health, told newsGP. See report part 4 below

“We need to be vigilant and follow these guidelines in order to protect Anangu from this virus,

There have been no known COVID-19 cases among APY Lands residents to date, but the Prime Minister has expressed concern about the vulnerability of those in remote Indigenous communities, including the APY Lands.

During the 2009 A(H1N1) swine flu outbreak, Aboriginal and Torres Strait Islander people made up 11 per cent of all identified cases, 20 per cent of hospitalisations and 13 per cent of deaths. Indigenous people are 8.5 times more likely to be hospitalised during a virus outbreak.”

APY General Manager Richard King has issued the directive to all APY staff and contractors. The directive also has been issued to Nganampa Health Council and major allied non-government organisations. State and Commonwealth government agencies, that are not required to apply for a permit to enter the APY Lands, have been contacted seeking their co-operation.

Mr King said communities on the APY Lands were particularly vulnerable because of well-documented poor health and living conditions. See full press release part 3

Part 1 NLC

“ The NLC supports the NT Government’s call to cancel all non-essential trips to remote communities as it tries to prevent the spread of coronavirus to vulnerable populations and has taken steps to ensure that all NLC employees who have recently travelled overseas do not travel to remote communities unless they have been cleared to do so.

“We agree with the NT Government’s decision to ask all workers to cancel their trips if they are not essential and the same goes for NLC staff,”

NLC CEO Marion Scrymgour.

Part 1 :The Northern Land Council’s Executive Council met today with officials from the Northern Territory Department of Health and the Danila Dilba Health Service’s CEO Ms Olga Havnen to examine strategies and information focused on protecting Aboriginal communities in the NLC’s region from the risk of coronavirus.

The NLC supports the NT Government’s call to cancel all non-essential trips to remote communities as it tries to prevent the spread of coronavirus to vulnerable populations and has taken steps to ensure that all NLC employees who have recently travelled overseas do not travel to remote communities unless they have been cleared to do so.

“We agree with the NT Government’s decision to ask all workers to cancel their trips if they are not essential and the same goes for NLC staff,” said NLC CEO Marion Scrymgour.

Ms Scrymgour will meet with NT Tourism tomorrow (March 13) to discuss how tourism operators can minimise their potential impact on remote communities.

NLC chairman Samuel Bush-Blanasi said the NLC is working closely with the NT Government and health service providers to  working

“We want people to really think about their need to visit remote communities. Especially if they have returned from an at risk country they must not travel to Aboriginal communities and must take every precaution.”

NT Government website COVID19 Information for Aboriginal communities

  • There are currently no suspected cases of COVID-19 in any Territory communities.
  • Residents should stay alert but carry on with normal activities.
  • There is no risk to eating traditional animals and plants.
  • The virus is not spread by mosquito bites.
  • The virus is not spread on the wind.
  • The most important thing for everyone to remember is to maintain hygiene by:
    • Washing your hands
    • Avoid shaking hands with people who may be unwel
    • Stay at a distance of 1.5 m away from someone who is unwell
    • Coughing or sneezing into your elbow
    • Don’t go to crowded places if you’re unwell.
  • If you get sick, go to your health clinic.

Recordings in language

A Coronavirus (COVID-19) Public Health Remote Communities Plan has been developed and distributed to all remote Territory communities. This plan provides high level guidance and each community will tailor their individual plans to suit their specific circumstances and community requirements.

Part 2

At a Council meeting of the Central Australia Academic Health Science Network [CA AHSN] today, a call was made for decisive and urgent action on the prevention of COVID-19 spreading to remote Australian communities, Executive Director Chips Mackinolty said today.

“We are in this together, and we have a collective responsibility at all levels of government and health service delivery to keep people safe,” said Mr Mackinolty.

“As health and medical research organisations, we are calling for an absolute priority to be given to minimising risk and preventing death in communities across central Australia.

“A major priority in our endeavours is working with Aboriginal communities and support to the primary health services in the bush and our regional centres.

“Things that might work in. the big cities simply won’t work out bush, so we need to focus on local solutions.

“We believe it is critical that rapid and extensive testing be rolled out as soon as possible, so that such work is timely and localised. As a first step this should be located in Alice Springs, rapidly followed by other regional centres.

“Of paramount concern is that our health services—already severely under resourced—not be further burdened. Just as happened in the recent bush fire crises, we would see it as essential that Commonwealth-funded remote area health medical workers being brought in to help.

“Both Aboriginal community-controlled and government primary health services face enormous day-to-day challenges—and we strongly support them as the real heroes of health care in remote Australia, from Aboriginal Health Practitioners, to nurses to allied health workers to doctors, to all staff doing such vital work.

“Meanwhile, our research activities will limit fieldwork, and researchers recently overseas will not be allowed to travel remotely. This follows the initiatives already of some of our partner organisations

In any case, we will also seek to follow the recommendations of local Aboriginal community organisations in our work.

“A major priority, from the Commonwealth and NT governments should be a major effort in proving accurate and concise information to Aboriginal people—with a stron

Part 3 MEDIA STATEMENT: APY enacts border protection to reduce coronavirus risk

APY has introduced strict new rules for entry into its remote lands in response to the Federal Government’s concerns about the potential for coronavirus to spread in vulnerable Indigenous communities.

The Executive Board that governs the remote Anangu Pitjantjatjara Yankunytjatjara Lands, in South
Australia’s far northwest, addressed the threat of a coronavirus outbreak at its latest meeting.

The Board has resolved not to routinely issue entry permits for the next three months to anyone who has:

  • Been in mainland China from 1 February 2020.
  • Been in contact with someone confirmed to have coronavirus.
  • Travelled to China, Iran, South Korea, Japan, Italy or Mongolia.

If a person who wishes to enter the APY Lands has travelled to any of the affected countries, experienced coronavirus symptoms in the previous 14 days, been seen by a doctor and recorded a negative test, they must submit a copy of the test results along with a Statutory Declaration to be considered for an entry permit.

APY has the legal authority to exclude persons from entering the APY Lands pursuant to section 19 of the Anangu Pitjantjatjara Yankunytjatjara Land Rights Act. APY General Manager Richard King has issued the directive to all APY staff and contractors.

The directive also has been issued to Nganampa Health Council and major allied non-government organisations. State and Commonwealth government agencies, that are not required to apply for a permit to enter the APY Lands, have been contacted seeking their co-operation.

Part 4 RACGP 

Media report RACGP Dr Tim Senior : Chronic diseases and a lack of access to culturally appropriate care makes Aboriginal and Torres Strait Islander people vulnerable to coronavirus.

 

 

NACCHO Aboriginal and Torres Strait Islander #RuralHealth : @RuralDoctorsAus President and CEO says quality rural and remote health care essential to #ClosingtheGap

“Both Federal and State governments, right across the country, need to step up and invest in rural health if they are serious about this.

There have been numerous examples of initiatives developed to improve access to health care in rural and remote areas being extended into urban areas to prop up under-funded services in for the socially disadvantaged.

This has resulted in the unintended consequence of further disadvantaging Aboriginal and Torres Strait Islander people living in rural and remote Australia.

We need continued investment in health infrastructure and services aimed at addressing the disparity in health outcomes between those who live in the city and those who live in the bush… and this extends across both our Indigenous and non-Indigenous populations.

Without this, as a nation we are never going to close the gap, and the divide for the health outcomes of Aboriginal and Torres Strait Island people living in rural and remote Australia will never be addressed.”

Dr John Hall, President of the Rural Doctors Association of Australia (RDAA), said that without access to high quality health services in rural areas, the gap will never close.

Photo above : Here is what GPs said about working in Indigenous health

” I’m particularly concerned with successive government failure to halve Indigenous child mortality rates.

A lot of this is about access, it’s around health literacy.

It’s also about the holistic care, it’s also around education, housing and a whole range of other things”.

Australia needs to boost hospital and birthing facilities in rural and regional areas in order to overcome entrenched Indigenous health disadvantage, according to Rural Doctors Association of Australia CEO Peta Rutherford told SkyNews .

Watch SkyNews interview HERE 

Read over 70 Aboriginal Rural and Remote Health NACCHO Articles HERE

Another disappointing Closing the Gap Report, released this month [12 February 2020], demonstrates why health care in rural and remote Australia is a key driver to Closing the Gap in health.

“The Government’s Closing the Gap Report 2020 showed that the Gap between Indigenous and non-Indigenous Australians on key health indicators has not closed,” Dr Hall said.

“Two key health-related benchmarks were chosen by the

Government in 2008, with a target of halving the gap in child mortality by 2018, and to close the gap in life expectancy by 2031.

“Neither of these targets are on track.

“The main cause of Aboriginal and Torres Strait Islander child deaths are perinatal conditions such as complications of pregnancy and birth.

“With 85 per cent of these deaths occurring during the first year of life, maternal health and risk

factors during pregnancy play a crucial role.

“Access to quality, culturally safe, medical care is the most direct way of improving these outcomes,” Dr Hall said.

Similarly, life expectancy in Aboriginal and Torres Strait Islander people is strongly influenced by health and health care, with the report attributing 34 per cent of the gap to social determinants (such as education, employment status, housing and income), 19 per cent to behavioural risk factors (such as smoking, obesity, alcohol use and diet), leaving 47 per cent attributed to what is clearly a disparity in health outcomes and associated health care issues.

In rural and remote areas there is a noticeable difference of a more than six year reduction in life expectancy of Aboriginal and Torres Strait Islander males and females, when compared to those living in major cities.

This demonstrates a failure across the board in these key areas, all of which are influenced by the provision of quality health care.

“Clearly we can’t close the gap without a functional health system in rural and remote Australia,” Dr Hall said.

“And this cannot just be solved through funding Aboriginal Medical Services (AMS); the other parts of the health system need to be equally funded to service these communities in order to be able to provide the standard of care that will result in a reduction in the gap in health outcomes.

“We can’t have hospital services downgraded and expect to close the gap.

“We can’t have communities with no access to medical birthing services and expect to close the gap.

“We can’t have people needing to travel hundreds of kilometres to access cancer or surgical treatment and close the gap.

“We need quality rural hospitals, staffed by Rural Generalist doctors, with the skills needed to meet the needs of these communities in both the General Practice and hospital settings, if we are serious about improving health outcomes and actually closing the gap.

NACCHO Aboriginal Health and Remote Communities News : I. @SenatorDodson The Need to empower remote Communities 2.@abcnews Empowering Young Leaders’ in the Kimberley call for change to curb suicides

Indigenous people living in remote communities are still betrayed. The truth of this nationally is seen in the government’s “duck, dive” approach to entrenching a voice in the Constitution.

On the first day of parliament sittings next year, the Prime Minister will present the annual Closing the Gap report, an index of the disadvantage experienced by First Nations people.

It will be another recitation of government failures to improve their lives — lives that in remote communities end many years shorter than elsewhere.

Not only do they die younger, their existence also is miserable. It’s not just a matter of poor service delivery, it’s that their lives are not their own. Governments, unwilling to trust First Nations people to take charge of their own lives, continue to intrude and manage.

Patrick Dodson is the Labor senator for Western Australia writing in the Weekend Australian

See Part 1 Below

“The Empowered Young Leaders’ report, released last week, calls for more education for young people around social and emotional wellbeing and increased efforts to embed Indigenous culture in schools.

They also want a permanent forum for young people to voice their concerns.

It comes as the State Government considers a formal response to the WA coroner’s inquest into the suicides of 13 Indigenous young people in the remote region.” 

See Part 2 Below

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Part 1 : The nation’s treatment of remote indigenous communities is an international scandal. We need a Marshall Plan to end the squalor.

Labor MPs Murray Watt, Linda Burney, Warren Snowdon, Sharon Claydon and Patrick Dodson on their indigenous road trip. Picture: supplied

In January 1994, then Labor senator Graham Richardson, health minister in Paul Keating’s government, toured remote Aboriginal communities in Western Australia and the Northern Territory.

Conditions in those communities, he said, were “miserable”. He “saw things … that would barely be tolerated in a war-ravaged African nation”.

In August, with a party of fellow federal Labor parliamentarians, I did a big sweep through remote communities in WA and the Territory. From Port Hedland we dropped in at Marble Bar, Jigalong, Newman, Meekatharra, Wiluna, Leonora,

More than 25 years after Richardson’s expedition, I can attest that conditions for Aboriginal people in those places are still miserable and intolerable.

Last month WA Aboriginal Affairs Minister Ben Wyatt visited remote communities in his jurisdiction and wrote in The Australian of their “institutionalised ghetto status”.

How many inquiries or reports will it take, how often can the UN Special Rapporteur on the Rights of Indigenous Peoples declaim against this tragedy, before Australia confronts the crisis that cripples these communities, and sets about fixing things?

The people out there did not choose to live in those places. By and large, those communities were artificially designed by bureaucrats and Aboriginal people were shepherded there — sometimes for their protection (from Woomera rockets, for example), sometimes as a consequence of assimil­ationist policies. But, having plonked them there, governments have failed to maintain adequate basic services.

Forget the trumped-up national emergency John Howard and Mal Brough declared across the Northern Territory in June 2007 (although Aboriginal people will never forget).

The real emergency was staring them right in the face and they never dealt with it: the parlous plight of thousands of Aboriginal people forced to live in squalor and denied basic rights of citizenship.

It’s interesting to recall that back in 1994 when Richardson pledged to “clear up that mess” he said: “I hope perhaps out of the social justice package we’ve promised for Mabo, there will be scope to address some of these wrongs.”

The Keating government’s response to the High Court’s Mabo decision had three elements: the Native Title Act, the land fund — out of which grew the (now) Indigenous Land and Sea Corporation — and a social justice package.

Robert Tickner, Keating’s Aboriginal and Torres Strait Islander affairs minister, told the 12th session of the UN Working Group on Indigenous Populations in 1994: “The social justice package presents Australia with what is likely to be the last chance this decade to put a policy framework in place to effectively address the human rights of Aboriginal and Torres Strait Islander people as a necessary commitment to the reconciliation process leading to the centenary of Federation in 2001.”

Hollow words. The justice package was doomed: the Keating government did not press its pro­gress and passed to the Aboriginal and Torres Strait Islander Commission the job of consulting with First Nations about what it should embrace.

Keating’s successor, John Howard, rejected ATSIC’s visionary report in 1996 and went off on his own “practical reconciliation” frolic. ATSIC itself was dispatched by Howard a few years later, but it’s worth restating a few words from the ATSIC report on the social justice package because they continue to resonate: “Indigenous people have been too often betrayed over the last two centuries by fine words that have soon withered in the grim drought of inaction and indifference.”

Indigenous people living in remote communities are still betrayed. The truth of this nationally is seen in the government’s “duck, dive” approach to entrenching a voice in the Constitution.

On the first day of parliament sittings next year, the Prime Minister will present the annual Closing the Gap report, an index of the disadvantage experienced by First Nations people. It will be another recitation of government failures to improve their lives — lives that in remote communities end many years shorter than elsewhere.

Not only do they die younger, their existence also is miserable. It’s not just a matter of poor service delivery, it’s that their lives are not their own. Governments, unwilling to trust First Nations people to take charge of their own lives, continue to intrude and manage.

Remote communities, especially those in the desert region straddling the Territory,WA and South Australia, have the foundations of their customary law, kinship relationships and knowledge of country pretty much underpinning their continuing survival. It is the world of art, sport and ceremonial obligations that makes their world partly tolerable.

But, as long as we view these places through the prism of reform­ing public sector outlays, we will continue to contribute to their demise. They must have a real say in their destiny, and governments have a duty to reorder ideological and biased views about their futures.

In the Territory, the federal government wants to foist its cashless debit card on 23,000 people deemed to be “beneficiaries”, who are already subject to income management (a hangover from the intervention). There is no choice being offered here and the policy will impact severely on First Nations people living remotely.

As the Central Land Council has pointed out, the transfer to the CDC will require people to have an email address, access to mobile phone coverage and a smartphone, the skills to navigate online card activation, and access to the internet. But access to the National Broadband Network is limited in remote communities, home computers are rare, and most internet access through mobile phones is intermittent and unreliable. CDC holders will need to receive an activation number by post, but the post in remote communities is slow or non-existent.

The federal government’s plan to introduce the CDC is yet another example of top-down policy, and recipients in remote communities have not been consulted.

So much for the government’s mantra it wants to do things with First Nations people, not to them.

How will this card help build the capacity of people in these remote communities? How will it help them manage their lives?

We need new frameworks that enable people in remote communities to determine their destiny, and for governments to treat them as sovereign peoples.

These remote communities must be helped to lift themselves out of “institutionalised ghetto status”. Relief is beyond the capacity of states and territories. The federal government has the remit to avert disaster — after all, what was the 1967 referendum all about?

It will require a Marshall Plan to correct the decades of neglect.

However, until we grasp that sort of commitment and empower remote Aboriginal communities, the lives of their residents will be further accursed.

Part 2

Aboriginal youth leaders in Western Australia’s far north have made sweeping recommendations to curb the chronic rates of suicide among their peers.

PHOTO: The Empowered Youth Leader delegates have proposed a set of recommendations. (Supplied: WA Primary Health Alliance)

Key points:

  • Suicide remains the leading cause of death for Aboriginal and Torres Strait Islander children
  • The Empowered Young Leaders’ report calls for more education for young people around social and emotional wellbeing
  • It also recommends increased efforts to embed Indigenous culture in schools, and a permanent forum for young people to voice concerns

From Here

The Empowered Young Leaders’ report, released last week, calls for more education for young people around social and emotional wellbeing and increased efforts to embed Indigenous culture in schools.

They also want a permanent forum for young people to voice their concerns.

It comes as the State Government considers a formal response to the WA coroner’s inquest into the suicides of 13 Indigenous young people in the remote region.

Too many lost’

In an impassioned statement, the delegates put policy makers on notice, saying they would no longer accept the “normalisation of suicide”.

“We have lost too many loved ones to suicide,” the statement read.

“Through our own lived experience, we bear witness to the heavy burden our families and communities endure in grappling with the never-ending cycle of grief and loss.

“We no longer choose to be disempowered by the issues that continue to impact on us as a result of intergenerational trauma. The lives of our children and grandchildren are in our hands.”

Jacob Smith, 23, has been working in suicide prevention for two years.

As a member of the Empowered Young Leaders, he spent 12 months working intensely with 10 youth delegates across the Kimberley.

He said the recommendations were the starting point for creating generational change.

“There’s endless possibilities, there’s a lot more focus now on young people stepping up and getting involved,” he said.

“Our hope is to amplify our voice and be at the forefront of these conversations with our leaders.

“If we can better consult with our youth they will be way more inclined to engage in these conversations and initiatives.”

Efforts to meaningfully reduce the amount of Aboriginal youth taking their lives have largely failed, despite dozens of reports, inquests and millions of dollars in funding.

It remains the leading cause of death for Aboriginal and Torres Strait Islander children.

In the Kimberley, the rate of youth suicide is among the highest in the world.

In the aftermath of coroner Ros Fogliani’s 2017 inquest into 13 suicides, young people had been given a bigger role in helping governments at both levels forge a solution.

Mr Smith said the top priority was to ensure youth were permanently involved in the design and delivery of policy.

He said this would be achieved by establishing local Aboriginal youth action committees in each town.

“We need to invest and build the skills of our young people … to build a real peer-to-peer network in the Kimberley,” he said.

“There’s a few of us young people working in this space but we don’t feel like we have a strong network.

“There’s no real structure around that at the moment.”

Calls for better education and resources

Education was another key area in which the group wanted improvement.

They called for more social and emotional wellbeing training for young local people so they could support their peers with mental health difficulties.

There was also a push to better involve youth in developing targeted programs.

Delegates raised concerns about the lack of after-hours services, and proposed to establish 24-hour safe houses and a youth-focused rehabilitation centre.

“Delegates expressed frustration at the lack of local training and employment opportunities for Aboriginal people in the youth services sector,” the report stated.

They also identified the poor “cultural and community connection” between mainstream services and local Aboriginal families.

Government to respond to coroner’s inquest

The report is being considered by the WA Government.

Minister for Aboriginal Affairs Ben Wyatt said the recommendations were valued and would be treated with respect.

“The report will have an important role to play in the Government’s understanding of the perspective of young Aboriginal people in the region,” he said.

Mr Wyatt also outlined the McGowan Labor Government’s efforts to improve education and skills training.

“In 2019, there were 60 WA public schools teaching one or more of 21 Aboriginal languages to 5,611 students,” the Minister said.

“WA public schools are increasingly teaching children local Aboriginal languages, benefiting students and helping to keep the languages alive in our communities.

“The Aboriginal Cultural Standards Framework supports all Department of Education staff to reflect on their approaches to the education of Aboriginal students.”

Mr Wyatt pointed to a “range of regional partnerships” that ensured Aboriginal people received adequate skills training.

“A great success story is one of North Regional TAFE’s alumni, Soleil White, who was named the WA Aboriginal and Torres Strait Islander Student of the Year at the 2018 WA Training Awards.”

The State Government is expected to hand down its formal response to the coroner’s inquest in the coming weeks.

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NACCHO Aboriginal Health and #Remote Communities : #WA Minister @benwyatt It is time we have a genuine dialogue about securing the ­future of remote communities and work towards establishing a long-term partnership between Aboriginal communities and state and commonwealth governments

“ The commonwealth has shown it has no interest in sustaining remote communities in Western Australia. In recent years the commonwealth has transferred its long-held responsibilities for housing and essential and municipal services to the state. And its legal responsibility to administer social security payments for people living in remote communities is operated punitively through the CDP and cashless debit card scheme.

Promoters of this approach say it is the most effective way to address passive welfare and to protect children and women in communities — and, to a certain extent, I am attracted to this rationale. Removing the never-ending humbugging between generations is a worthy aim, but removing cash from a vast landmass with no supporting technology is not working.

It is time we have a genuine dialogue about securing the ­future of remote communities and work towards establishing a long-term partnership between Aboriginal communities and state and commonwealth governments.

That partnership should incorporate strategies that break the institutionalised ghetto status of these communities and also understand how communities interact with each other. It should also involve best-practice governance models and vastly improved service delivery.

 To me Ngaanyatjarra would be an ideal trial site for such an approach.”

Opinion article in The Australian from Ben Wyatt the West Australian Minister for Aboriginal Affairs

Last week I drove from Perth to Warburton and Warakurna, two of the most remote communities on Earth.

Arriving at Warburton, population about 500 people, I visited the community’s administration office and became instantly immersed in the madness people there were dealing with.

A single mother was desperately contacting a distant call centre hoping to have her bank account reactivated after keying the wrong pass code given to her.

Unable to produce the required evidence to identify herself she was told to travel a thousand kilometres to Alice Springs to front in person.

She was desperate and broken.

Another woman with children to feed sought emergency relief after her income was suspended by Centrelink for breaching her work-for-the-dole conditions un­der the Community Development Program. At the counter a range of community people queued, demanding that overwhelmed staff help them navigate a social security ­income and banking system that to anyone appears impossibly complex.

This happens regularly, I was told repeatedly, where people have their income cancelled if they fail to report to Centrelink fortnightly on any changes to their living circumstances, miss a monthly report to Jobactive, which runs the CDP scheme, or do not comply with the requirement to work 20 hours a week for the dole all year round.

Given that English is generally not Ngaanyatjarra people’s first language, lack of phone access and the real­ity that people move between communities for all sorts of cultural and social reasons, the numbers of people denied social security payments is, of course, growing.

Other people complained they could not access funds from their bank because they had been conscripted on to the commonwealth’s income management debit card scheme — usually while spending time in Kalgoorlie — without fully understanding the consequences.

The scheme, which quarantines 80 per cent of social security payments to a special bank card that can be used only at certain vendors and cannot be used to buy alcohol and gamble, is being rolled out in Kalgoorlie and the Goldfields as part of a national trial.

The grog-free Ngaanyatjarra lands are not part of the trial and Ngaanyatjarra people who have been ensnared in the scheme through their visits to Kalgoorlie and other Goldfields towns are joining the increasing number of destitute people who rely on their already impoverished families to survive.

A line of these cards is kept behind the office reception in an attempt by the community’s administration to, somehow, turn these cards, inoperable in the lands, into cash.

Clearly there has been significant problems in implementing the scheme, with its Canberra-based designers having no idea how the Goldfields and Ngaanyatjarra Lands operate as an integrated region.

  • Large red dot: 500 people or more
  • Medium red dot: 200 to 499
  • Small red dot: 50 to 199
  • Smaller back dot: less than 50 people

Visiting these communities I was struck by an overwhelming sense that people are disempowered and punished by a digital world of faceless and distant ­bureaucratic controllers.

Centrelink no longer posts cheques, and financial transfers to personalised bank accounts assume people have access to computers and banks. There are no banks in ­remote communities.

This, combined with declining finances coming into the lands through increased payment cancellations as punishment and the increasing conscriptions on to the cashless card scheme has meant the Warburton community council has had to establish its own quasi banking system through recirculating money from the community store.

This situation is unsustainable. There is already a crisis of ­financial security in Warburton and other Ngaanyatjarra communities.

I sense the next phase of this crisis is community implosion resulting in a major population relocation to towns such as Kalgoorlie and Laverton if policies aimed at supporting remote communities don’t change; a ­dynamic that would be replicated throughout remote Australia.

 

Aboriginal #Rural and #Remote Health #ClosingTheGap #HaveYourSayCTG : New @AIHW Report says the mob living in remote and regional areas are dying preventable deaths from treatable conditions because of a lack of access to health services

 “Australians living in remote and regional areas are dying preventable deaths from treatable conditions because of a lack of access to health services.

The damning assessment is contained in a new Australian Institut­e of Health and Welfare report on rural and remote health, which finds that those in the bush rely heavily on general practitioners to provide primary healthcare services in the absence of specialist doctors.

But patients most in need of GPs often can’t access them, with those in remote areas six times as likely as those in metropolitan centres to report they had no access­ to one.”

From Natasha Robinson The Australian October 24 Continued Part 1 below

Aboriginal and Torres Strait Islander people are more likely to have higher rates of chronic conditions, hospitalisations and poorer health outcomes than non-Indigenous Australians

The differences in health outcomes in Remote and Very remote areas may be due to the characteristics of these populations.

The proportion of the population that is Indigenous, is much higher in more remote areas

However, more Indigenous Australians live in Major cities and Inner regional areas (61% of Indigenous Australians) compared with Remote and Very remote areas (19%) “

From the AIHW Report see Part 2 Below

Download full report HERE

Rural & remote health

Part 1 The Australian media report 

The report comes as The Australian revealed yesterday that the numbers of domestically trained doctors entering GP training had fallen for the third year in a row, with rural areas relying heavily on overseas-trained doctors to fill the workforce shortfall.

The AIHW report finds people in remote areas die five years before­ their city counterparts, with a life expectancy of 76 years.

More than 70 per cent of those living in regional areas are overweight or obese, less than one in 10 eat the recommended number of serves of vegetables per day, and one-quarter have high blood pressure or mental health problems.

Rural Australians are dying of diabetes at much higher rates than city dwellers, and many cancers­ go undetected because of a lack of acces­s to screening programs.

“The rate of potentially avoidable deaths increased as remote­ness increased,” the report says. “These are deaths among people aged 75 and under from conditions considered potentially preventable through individualised care, and/or treatment through existing primary or hospital care.”

The Australian College of Rural and Remote Medicine said the situation was a “tragedy”.

“We have a rural health crisis that extends right across from our Aboriginal and Torres Strait Island­er people to our rural communities,” said college president Ewen McPhee.

“I think it’s a tragedy that rural communities continue to be neglec­ted.”

In many tiny towns across the country, residents rely on the Royal Flying Doctor Service to provide access to a GP.

Yesterday in Stonehenge in remote­ central Queensland, doctor­ Arthur Beggs and nurse Jo Mahony­ flew in to provide the fortnightly mobile GP service for the town and surrounding areas of about 50 people.

“A lot of people don’t want to bother us unless they are really unwell and that’s really typical of the stoic, outback approach,” Dr Beggs said.

The RFDS has introduced a chronic disease management plan to the town, tracking baseline health measurements and flying specialist allied health practitioners in every few weeks to provide extra services.

Dr Beggs knows the challenges of being a rural GP, but says the difficulties are outweighed by the satisfaction of the work.

“I find rural and remote medicine fascinating and much more fulfilling than I do city-based medicine,” he said.

A recent report published by the Medical Deans of Australia found only 15 per cent of medical students in their final year of study said they were interested in becomin­g GPs, the lowest figure in five years.

Dr Beggs said attracting GPs to rural and remote areas was key to improving health outcomes in the bush.

“Modern medicine is all about specialties,” he said.

“The specialties can seem a more lucrative and controlled environm­ent than the realms of general practice, which is unfortun­ate because general practice­ gives you a much better overview of people and their health.”

Part 2

Profile of rural and remote Australians

See AIHW Online version HERE

For more information on Aboriginal and Torres Strait Islander health by remoteness see: The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples: 2015 and the Aboriginal and Torres Strait Islander Health Performance Framework (HPF) report

Overall, more Australians live in Major cities compared with rural and remote areas

. In 2017, the proportion of Australians by area of remoteness was:

72% in Major cities

18% in Inner regional areas 8.2% in Outer regional areas 1.2% in Remote areas

0.8% in Very remote areas (ABS 2019b).

On average, people living in Remote and very remote areas were younger than those living in Major cities ( gures 1a and 1c).

Australians aged 25–44 were more likely to live in Remote and very remote areas and Major cities compared with Inner regional and outer regional areas. However, a higher proportion of people aged 65 and over lived in Inner regional and outer regional areas and Major cities, compared with Remote and very remote areas ( gures 1a, 1b and 1c).

Rural and remote Australia encompasses many diverse locations and communities and people living in these areas face unique challenges due to their geographic isolation.

Those living outside metropolitan areas often have poorer health outcomes compared with those living in metropolitan areas. For example, data show that people living in rural and remote areas have higher rates of hospitalisations, mortality, injury and poorer access to, and use of, primary health care services, compared with those living in metropolitan areas.

Health inequalities in rural and remote areas may be due to factors, including:

  • challenges in accessing health care or health professionals, such as specialists social determinants such as income, education and employment opportunities higher rates of risky behaviours such as tobacco smoking and alcohol use
  • higher rates of occupational and physical risk, for example from farming or mining work and transport-related accidents.

Despite poorer health outcomes for some, the Household, Income and Labour Dynamics in Australia (HILDA) survey found that Australians living in small towns (fewer than 1,000 people) and non-urban areas generally experienced higher levels of life satisfaction compared with those in urban areas (Wilkins 2015).

Rural and remote Australians also report increased community interconnectedness and social cohesion, as well as higher levels of community participation, volunteering and informal support from their communities (Ziersch et al. 2009).

Part 3 National : Closing the Gap / Have your say CTG deadline extended to Friday, 8 November 2019.

 

The engagements are now in full swing across Australia and this is generating more interest than we had anticipated in our survey on Closing the Gap.

The Coalition of Peaks has had requests from a number of organisations across Australia seeking, some Coalition of Peak members and some governments for more time to promote and complete the survey.

We want to make sure everyone has the opportunity to have their say on what should be included in a new agreement on Closing the Gap so it is agreed to extend the deadline for the survey to Friday, 8 November 2019.

This will help build further understanding and support for the new agreement and will not impact our timeframes for negotiating with government as we were advised at the most recent Partnership Working Group meeting that COAG will not meet until early 2020.

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/