NACCHO Aboriginal Health News Alert : Five ways that the $160m same sex plebiscite could be spent in health


PHAA chief executive Michael Moore said the money should be funnelled into areas that would benefit the community such as health and education instead.

“Essentially this is a waste of money at a time when governments are cutting health budgets – and particularly slashing prevention,” Mr Moore said.

Reporting in todays The Age

Photo Above Some in the health industry name Indigenous health as the top area worthy of investment. Photo: Michael Amendolia

The growing cost of health – powered by an ageing population and more expensive technology – presents an ongoing challenge to the federal government, but there is no shortage of people willing to offer Health Minister Sussan Ley some unsolicited advice on how to better spend her portion of the budget.

If the $160 million was diverted to health, here is where some health advocates believe it could be better invested, in no particular order.

  1. Preventative health

The latest Australian Institute of Health and Welfare report showed the proportion of health expenditure devoted to prevention had decreased to 1.4 per cent in 2013-14, down from 2.2 per cent in 2007-2008.

Although much of the preventative health dollar in that peak year went towards introducing the HPV vaccine, other evidence suggests a disinvestment in preventative health, including the termination of funding to the Australian National Preventative Health Agency [ANPHA].

Michael Moore said the re-opening of that agency and all the programs that it ran would be one good use of the funds, or campaigns on the harms associated with tobacco, alcohol or obesity.

“You could easily spend all of the money on this as we cannot hope to compete with industry bombardment,” he said.

The Heart Foundation has called for $35 million to be spent annually on addressing physical inactivity, which is estimated to cause 14,000 deaths every year.

General manager advocacy Rohan Greenland said Australia was in the bottom third of OECD nations in terms of the amount it spent on preventative health.

“While we are doing well on tobacco control, we should be putting the same, sustained effort into preventing obesity, tackling physical inactivity and addressing poor nutrition,” Mr Greenland said.

A Department of Health spokeswoman said the activities of ANPHA had been taken over by the department.

Preventative programs included projects centred on chronic conditions, a National Asthma Strategy, a National Diabetes Strategy, activities addressing healthy eating, physical activity, obesity, tobacco, alcohol, research, immunisation,  mental health initiatives and cancer screening, she said.

  1. Aged care

Nurses nominate aged care as the sector in most dire requirement of funding.

Aged care providers have long been predicting a shortage of places and qualified nurses as baby boomers move into their dotage, with lack of staffing blamed on an increase in violent incidents.

The Australian Nursing and Midwifery Federation federal secretary Lee Thomas said $160 million could replace some of the money that has been taken out of the sector in recent years.

“Currently, there is a shortage of 20,000 nurses in aged care,” Ms Thomas said.

“This needs to be fixed as a matter of urgency, given Australia’s rapidly ageing population.

“The restoration of funding for the health sector would also go toward supporting public hospitals in the states and Territories and allowing more graduate nurses to be employed.”

  1. Indigenous health

Australian Healthcare and Hospitals Association chief executive Alison Verhoeven has a wishlist that lasts pages (“Oh there’s so much you could do”) but indigenous health tops her list.

As a start, the money could be invested in closing the gap in diseases such as rheumatic heart disease and trachoma or addressing the high rates of suicide, drug and alcohol abuse.

“We could be looking beyond that at things like how we incorporate investment in safe housing and safe food supplies and ensure that kids growing up in indigenous, particularly remote and rural, communities actually get a good start in life,” Ms Verhoeven said.

  1. Chronic disease

The Heart Foundation has argued that there is an economic and social argument to address chronic disease, which cause 90 per cent of all deaths and 85 per cent of the burden of disease.

“The health minister has rightly said that chronic disease is our greatest health challenge,” Mr Greenland said.

“We need to be better at early detection of those at risk of having heart attacks, strokes or developing diabetes and kidney disease.”

The federal government unveiled in March a trial of “Health Care Homes”, whereby people with chronic disease would have all their care managed from a single GP practice, but Ms Verhoeven says the $21 million package would only cover education and training.

“It’s not enough to make a real change across Australia in the way we deliver primary care.”

A Department of Health spokeswoman said the $21 million was in addition to $93 million that would be redirected from the Medicare Benefits Schedule in 2017-18 and 2018-19 to support the management of patients with chronic conditions.

  1. Mental health

Many in the health sector are concerned that the angst caused by the plebiscite could actually contribute to its overall cost.

Michael Moore said the mental health impact of the plebiscite was estimated to cost $20 million and already there was more demand for counselling services.

The Royal Australian and New Zealand College of Psychiatrists has called for employment support for people with mental illness and improved services for people with borderline personality disorder, aged care residents, children and adolescents and Aboriginal and Torres Strait Islanders.


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


“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.



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 #ACCHO Aboriginal Health News : Sir Michael Marmot inspired by Aboriginal community controlled health


” I hold no illusions. There are deep-seated structural problems that account for the dramatic life expectancy gap between indigenous and non-indigenous Australians.

But I challenge anyone to come away from a visit to Tharawal and say it is all hopeless. I saw evidence of community empowerment: a community controlling the services needed for its population.

To repeat, funding for services is vital, as are good schools and job opportunities. But here was a centre dedicated to improving things for its own community.

Inspiring, indeed.”

Professor Sir Michael Marmot is Director of the UCL Institute of Health Equity, which works to reduce health inequities through action on the social determinants of health :

NACCHO Thanks Dr Tim Senior for ACCHO promotion

The Institute of Health Equity

It is easy to find accounts of Australian Aboriginal health – strictly Aboriginal and Torres Strait Islanders – that are lacking in hope. The standard narrative is that $billions have been spent, but aboriginal families are characterised by violence, alcohol, drugs, worklessness and high rates of crime.

Billions have been spent and Aboriginal health is bad compared to the non-indigenous population – 11 years shorter life expectancy for men and just under 10 years for women. But a different account says that when people’s lives are characterised by betrayal of trust and systematic destruction of identity and self-worth leading to powerlessness perhaps it is no surprise that this Spiritual Sickness can lead to destructive behaviours.

Money spent is not irrelevant. But the psychosocial issues are central. My starting position is that if communities and individuals are empowered it is more likely that money spent will lead to progress.

On my recent trip to Sydney to give the first Boyer Lecture for the ABC, the Australian Medical Association wrote to ask how could they help.

I said I would like to see examples of doctors in action on social determinants of health. Prof Brad Frankum, President, and Fiona Davies, Chief Executive of the New South Wales Branch of AMA took me to Tharawal Community Centre in Campbelltown, a suburb 50 km South-West of Sydney. Sydney spreads and spreads and spreads…

As I understand it, the two names are emblematic of Australian history. The Tharawal people were the original Aboriginal residents of the area. The Colonial Administration established a settlement named after the Governor Macquarie’s wife, Elizabeth Campbell. Indigenous people make up just over 3% of the Campbelltown population, compared to 1.2% of greater Sydney.

The Centre was an inspiration. I was shown around by two enthusiasts, Aboriginal women, who were key in the administration. I was also greeted by one of the doctors, Tim Senior, with a sign: #Fantasyland (Warren Mundine Q and A)


The evening before, on ABC Television’s national discussion programme, QandA, I had talked of a fairer distribution of power, money and resources, and was told I was in Fantasy Land. This aboriginal centre was making a difference. It was making fantasy a reality.

Among its many roles is providing medical care:

But it is a prime example of what we mean by doctors working in partnership. As I went round the Centre, I was shown where the ante-natal classes took place, and activities at every stage of the life course: from early childhood to older age:

“Bringing them home” is significant.

A psychologist at the Centre told me that she works with the psychological consequences for children and the family of a child’s removal from home. I asked if she was talking about the stolen generations – Aboriginal children taken from their families between the 1890s and 1970s with the presumed intent of destroying aboriginal culture.

The psychologist said that it is still going on. Children are removed because of family disruption but the consequences are severe.

There is also a variety of services that deal with the reality of people’s needs:

Not to mention subsidised fruit and vegetables to make healthy eating more of a possibility:


We then came to the part of the Centre that dealt with drug and alcohol problems:

I said to the woman in charge: you must have the toughest job in this whole centre.

No, she said, I have the most rewarding job.

She showed me a painting on the wall. The man who painted this had come to the centre with huge problems of drugs, alcohol and domestic violence. By the time he left, the centre had made a step difference to him. He came back with this painting to say thank you.

The Institute of Health Equity

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NACCHO Aboriginal Health News : Andrew Bolt V Linda Burney in Recognition: Yes or No


” You would have thought, why would an indigenous politician go anywhere near Andrew Bolt? The thing is, Linda Burney  was keen to do this. She wants to take on opponents. She thinks they’re wrong, and thinks she can convince them. Which she can use to convince other people.

She never hesitated … she didn’t hate Andrew Bolt. She judged him as an individual rather than a brand. She took quite a bit of heat from within the Indigenous community about doing this. As you can imagine people had a lot of suspicions … I admire her for that.”

Simon Nasht, the executive producer and writer of Recognition: Yes or No, September 20 at 8.30pm on ABC & iview.

See NACCHO Aboriginal Health and Racism articles

Andrew Bolt’s views on indigenous affairs are representative of those held by a lot of Australians, says Simon Nasht,  which will air on the ABC tonight.

This makes engaging with Bolt’s views necessary if a constitutional referendum on indigenous constitutional recognition has any hope of succeeding.

Recognition: Yes or No pits Bolt against Linda Burney, a newly elected member of federal Parliament and the first Aboriginal woman to be elected in the House of Representatives.

Over the course of a month, the two of them travelled across Australia and New Zealand, teasing out the many views and potential complications of the issue. Burney was a NSW politician when the documentary was filmed — her higher profile on the federal Labor frontbench is an unexpected benefit for the program.

The format mirrors that of an earlier program by the same production house, I Can Change Your Mind About Climate, in which climate change sceptic and former politician Nick Minchin starred alongside climate activist Anna Rose.

The idea is to “throw a bit of light on the issue, and not just heat,” Nasht says. He cites studies that have found when it comes to political issues such as this, people’s positions are often more informed by their values, rather than their knowledge about the subject itself; he hopes the in-depth, respectful examination of the issue from both sides can help overcome this.

Ms Burney and Bolt sit with Murrumu, a Yidinji man who renounced his Australian citizenship. Photo: ABC

When Bolt’s involvement in the program was revealed by Crikey last year, the question many had was: why him? Even within the ABC, the decision was controversial — the Bonner staff committee on indigenous affairs had many questions about the program earlier this year.

There are good reasons for the scepticism, given Bolt’s history with indigenous affairs. It’s a subject he’s devoted much coverage to, but generally not from any close association or careful study of indigenous Australia.

Within News Corp, where many commentators — particularly at The Australian — have expressed their views in favour of constitutional indigenous recognition, Bolt stands as one of the idea’s most persistent critics.

Bolt also has the distinction of being the only commentator found in breach of the Racial Discrimination Act — a judge in 2011 found he had breached the 18C provisions in two articles that criticised a handful of prominent Aboriginal people for identifying as such, despite their European heritage.

Bolt claimed they claimed Aboriginal identity for personal gain.

Given all this baggage, is Bolt really the best person to present the No case on constitutional reform? Nasht tells Crikey it’s not like there were many others he could approach.

One of the great proponents of recognition is former PM and conservative leader Tony Abbott, Nasht points out. Prominent conservatives have thrown their weight behind the reform, narrowing the field considerably. “The funny thing about those who oppose this case is, with all due respect, they’re not an impressive bunch,” Nasht said. “Andrew at least has an intellectual consistency.” “The usual suspects on the right”, Nasht says, are frequently not opposed to constitutional recognition.

Bolt’s involvement, he acknowledges, was difficult to handle. Bolt himself was rather sceptical about the whole thing. Perhaps it helped that Nasht and Bolt have a prior association: both were cadets at The Age in the late 1970s. “My proposition to him was … a hatchet job wouldn’t change anyone’s mind.”

As for Burney, she was keen to take Bolt on. “You would have thought, why would an indigenous politician go anywhere near Andrew Bolt? The thing is, she was keen to do this. She wants to take on opponents. She thinks they’re wrong, and thinks she can convince them. Which she can use to convince other people.

“She never hesitated … she didn’t hate Andrew Bolt. She judged him as an individual rather than a brand. She took quite a bit of heat from within the indigenous community about doing this. As you can imagine people had a lot of suspicions … I admire her for that.”

There were other challenges. Some Aboriginal groups were reluctant to participate. But most, Nasht says, welcomed the opportunity. “Andrew was welcomed into a couple of indigenous communities. I mean that, really welcomed. It’s a measure of what a remarkable culture it is … 200 years of being marginalised and still willing to sit down and talk. And I want more Australians to understand that … how lucky we are to have this culture in our midst.”

Bolt’s breach of the Racial Discrimination Act is mentioned at the start of the program, but the program does not dwell on that case. Burney doesn’t make it a part of her argument. Nasht says none of the indigenous groups Bolt met brought it up, which is “a measure of their willingness to have a proper discussion with the rest of Australia”.

Refusing to give Andrew Bolt a voice, Nasht says, makes no sense given his views are representative of a large number of Australians. “He has his audience, he has his monologue — in this film he’s forced into a dialogue,” Nasht said. “Here he’s forced to confront not only indigenous Australia … but a politician who’s widely experienced and not shy about expressing her own view.

The audience gets the benefit of seeing that. It’s also about the body language … people get to see him stretched, intellectually, emotionally, and from that they can take away their own judgement.

“I am fully aware that a lot of Australians have been offended by Andrew Bolt … but a grown-up democracy has to be prepared to confront this. And I’m thankful that the ABC thinks it should be in the middle of the argument, not on the edges.”

Nasht hopes indigenous Australia will view the program as part of the process towards indigenous constitutional recognition. Part of the issue, he says, is that mainstream Australia has yet to grapple with the idea or its consequences. The success rate of constitutional referendums is as low as it is, so success is impossible if more people do not educate themselves on the issue. “If it takes Andrew Bolt to get people to concentrate, so be it,” Nasht said.

NACCHO Aboriginal Health #SDoH #MarmotOz : ‘Aunty, with our prospects in life – what is the point of being healthy?’


” NACCHO encourages the Commonwealth to recognise that the social determinants of Aboriginal and Torres Strait Islander peoples and their ensuing health inequities are significantly influenced by broad social factors outside the health system.

NACCHO asserts that the Commonwealth is well positioned to identify those factors and act upon them through policy decisions that improve health – supported by current evidence – in housing, law & justice and mining & resource tax redistribution, for example.”

 To mark the historic occasion of Professor Sir Michael Marmot delivering the Boyer Lectures and putting a renewed public focus on the social determinants of health and health inequalities, Croakey is releasing an e-publication featuring 25 key #SDOH articles, out of more than 1,000 we have published over the past several years.”

Please download the publication: Croakey_SDOHCollection2016

“ Thank you, Mr. Menadue, for what you are trying to do to help indigenous people , but when I speak to young men in my mob about the importance of health, they say to me

Aunty, with our prospects in life, what is the point of being healthy?” 

Reading the Boyer Lectures, I was reminded of my experience in chairing the Generational Health Review in SA in 2003.

We held a discussion with Indigenous women about Indigenous health problems in SA. Towards the end of the discussion, a woman who was known affectionately and with respect as ‘aunty’ and who came from a well-known Indigenous family in SA

I have never forgotten”

John Laurence Menadue AO is an Australian businessman and public commentator, and formerly a senior public servant and diplomat.

John Menadue Blog .

The ABC Boyer Lecture series this year is being delivered by Sir Michael Marmot, the World Medical Association President and Professor of Epidemiology and Public Health at University College London .The main thrust of his lecture series has been about inequalities, poverty and social conditions – the social determinants – that have a major impact on health in the community.

In his lecture, Sir Michael said:

‘In my view, the reason why aborigines have worse health than the non-indigenous population is because of inequality.’   … ‘Isn’t health a matter of personal responsibility? If people fail to heed advice about smoking and healthy lifestyle, they have no one to blame but themselves.

I invite you to go into a deprived community in Sydney or Melbourne, let alone the fringes of a benighted country town and start lecturing people about healthy eating.

To put it politely, you would be given short shrift. It is not ignorance of the health consequences that lead to unhealthy behaviour. Making ends meet, avoiding violence and other crime all take priority. People are not responsible for the social forces in their life.

Get the social conditions right… and then of course people can be expected to take responsibility for their own health.’ 

There is a stark message here that we have got our priorities in health wrong, We have developed health services focusing on treating people when they get sick, a highly medicalised approach, rather than keeping them healthy from the beginning.

We have our financial incentives all wrong. We reward doctors for treating sick people on a fee-for-service basis rather than paying them by salary or contract, to keep people healthy.

We have a hospital-centric system when the objective should be to keep people out of hospital wherever and wherever possible. Hospitals are dangerous and expensive places. They should be a last rather than a first resort.

Many ministers in the ‘health’ field would be better described as ministers for hospitals. This is particularly true of many state ‘health’ ministers. These ministers focus almost exclusively on hospitals and the media does exactly the same. Ministers love iconic hospitals. They are great opportunities for public announcements about an expansion or laying a new foundation stone.

The fact is we have too many hospitals and too many hospital beds. But we refuse to accept that fact. Hospitals are like the family refrigerator, they will always be full.

An objective of good ‘health’ policy would be to reduce the focus on hospitals and beds by building healthcare in the community and the home.

Unfortunately, acute and urgent care in hospitals, displaces the important and money and effort is focused on hospitals and beds . This is a particular problem in Australia because of divided responsibilities in health – the states run the hospitals and the federal government provides most of the money for community care.

Until we address the dysfunction that arises because of different funding streams, we will continue to have major problems. Our emergency departments in state public hospitals are under great pressure in part because of the collapse of federally funded general practice in unsociable hours.

In addition to the over-focus on hospitals, ministers focus on health services rather than health. Many of the most important factors influencing health outcomes are outside the health portfolio. These include

  • Advertising of junk foods and alcohol, particularly to young people.
  • Poor employment prospects and high unemployment which directly affect health outcomes. Poverty and poor health go together.
  • Poor education and poor parenting reduces the prospects of children for an improved life, including good health.
  • Poor transport particularly affects country people and affects their health outcomes.
  • Poor housing affects health.
  • In urban areas particularly, there is a lack of open space and opportunities for exercise.

There are numerous ways in which health is affected significantly by what happens in portfolios beyond that of the Minister for Health. There is little consideration of ‘joined up government’ to address many health issues.

The real and basic problems that cause bad health are largely ignored. The social determinants of health have a major impact on health. The evidence is clear. Professor Fran Baum in The Conversation (September 1, 2016) drew attention to the social consequences of inequality. She said :

‘Men living in the Sydney suburb Fairfield East for instance, are twice as likely to die between ages 0 and 74 as those in the far richer Sydney suburb of Woollahra. The infant death rate in Fairfield is four per 1,000 live births, compared with 2.4 in Woollahra. Across Australia, low income people lose about six years of life compared to their better off compatriots. If policy makers want to reduce health inequities, one of the best ways is to create environments that promote better health. This is known as addressing the social determinants of health. ‘

 Sharon Field also in The Conversation on 1 September 2016 points to the way that class and wealth affect health in the community. She shows that poor people have much worse health outcomes than rich people. See table below.

Long term health conditions by socio-economic status. Comparing the lowest quintile of SES status with the highest quintile. 

Condition Lowest SES quintile – % Highest SES quintile – %
Mental and behavioural problems 21.5 15.0
Arthritis 19.7 12.1
Asthma 12.8 9.8
Cancer 1.9 1.6
Chronic obstructive pulmonary disease 4.1 1.5
Deafness 10.4 8.5
Diabetes 8.2 3.1
Heart, stroke, vascular 7.2 4.2
Hypertension 14.9 8.3
Kidney disease 1.3 0.8


We need to focus on several priorities that we choose to ignore.

First, the key to good health outcomes is focusing on the social determinants of health, such as poverty and inequality, that have such a dramatic affect on health outcomes.

Second, public health and prevention must have priority.

Third, health services are best delivered in the community and not through hospitals.

Fourth, many of the factors that dramatically affect health outcomes depend on action outside the health portfolio. Unfortunately, most ‘health ‘ ministers are really ministers for hospitals or health services – and not ministers for health.

Poverty and inequality are the major factors causing poor health across the Australian community and particularly in indigenous mental and rural health. We apply band aids in our highly medicalised model of care. We deal with the symptoms , not the cause.

Unless we focus on these issues, we will continue to be left with the question raised with me by indigenous people and others who say “With our prospects in life, what is the point of being healthy”.

That is what the social determinants of health are all about


” To mark the historic occasion of Professor Sir Michael Marmot delivering the Boyer Lectures and putting a renewed public focus on the social determinants of health and health inequalities, Croakey is releasing an e-publication featuring 25 key #SDOH articles, out of more than 1,000 we have published over the past several years.”

Melissa Sweet Editor Croakey

As the generators and implementers of policies that underpin improved population health outcomes (Marmot and Bell, 2012).

 “NACCHO encourages the Commonwealth to recognise that the social determinants of Aboriginal and Torres Strait Islander peoples and their ensuing health inequities are significantly influenced by broad social factors outside the health system.

NACCHO asserts that the Commonwealth is well positioned to identify those factors and act upon them through policy decisions that improve health – supported by current evidence – in housing, law & justice and mining & resource tax redistribution, for example.”

image1 - Copy

Please download the publication: Croakey_SDOHCollection2016

Or HERE  Croakey_SDOHCollection2016

Share it with your networks: encourage schools, universities, libraries, community groups, employers, businesses, and other organisations to engage with the issues raised. Also, please feel free to send copies to politicians in all jurisdictions – local, state/territory and federal!

Thanks to all authors of these articles, and to Professor Sir Michael Marmot and others who have contributed to the introduction. And a particular thanks to Mitchell Ward, for designing and producing the publication.

Meanwhile, follow the conversation at #MarmotOz.

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


” 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):


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%).


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.


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


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”.


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


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.


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


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)


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


NACCHO Welcomes Advertising and Articles

NACCHO Aboriginal Health #strokeweek : “No more stroke for our mob “: rap spreads awareness


Aboriginal and Torres Strait Islander are between two and three times as likely to have a stroke than non-Indigenous Australians which is why increasing stroke awareness is crucial.

Too many Australians couldn’t spot a stroke if it was happening right in front of them. We know that in Aboriginal and Torres Strait Islander communities this awareness is even lower. This Stroke Week we want all Australians, regardless of where they live or what community they’re from, to learn the signs of stroke.

Naomi and Rukmani’s stroke rap runs through vital stroke awareness messages, such as lifestyle advice, learning the signs of stroke, and crucially the need to seek medical advice when stroke strikes.

Music is a powerful tool for change and we hope that people will listen to the song and remember the FAST message – it could save their life,”

Stroke Foundation Queensland Executive Officer Libby Dunstan 

Naomi Wenitong  pictured with her father Dr Mark Wenitong Public Health Officer at  Apunipima Cape York Health Council  in Cairns:

Share the stroke rap with your family and friends on social media and celebrate Stroke Week in your community.

Listen to the new rap song HERE

                                       or Hear

A new rap song promoting stroke awareness and prevention is set to hit the airwaves across the country during National Stroke Week (12-18 September).

The song, written by Cairns speech pathologist Rukmani Rusch (pictured below)and performed by leading Indigenous artist Naomi Wenitong, was created to boost low levels of stroke awareness in Aboriginal and Torres Strait Islander communities.


This year National Stroke Week centres on the theme Speed Saves in recognition of the impact time has on stroke. Many stroke treatments can only be administered within a short time after stroke, which is why knowing the signs of stroke is so critical.

Read 34 Aboriginal Stroke related NACCHO Articles Here

Ms Dunstan said too many Australians continue to lose their lives to stroke each year.

“There will be more than 50,000 strokes in Australia this year and sadly many people miss out on accessing life-saving treatment as they don’t get to hospital on time,” Ms Dunstan said.

“We want the community to be aware that stroke is always a medical emergency. When you have a stroke, your brain cells start to die at a rate of almost two million per minute.

“Being aware of the signs of stroke and knowing to call 000 as soon as it strikes is crucial in the fight against this terrible disease.

“Aboriginal and Torres Strait Islander are between two and three times as likely to have a stroke than non-Indigenous Australians which is why increasing stroke awareness is crucial.

“This National Stroke Week you can help us make a difference.

Share the stroke rap with your family and friends on social media and celebrate Stroke Week in your community.

“It is all about bringing people together to have fun, while raising awareness of stroke.”

Think FAST this National Stroke Week and raise awareness of stroke.

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Find out more, register your event at

Free resource packs and information are available to assist with events; including posters fundraising ideas and information about stroke awareness.

National Stroke Week runs from September 12 to 18. It is an annual event which aims to raise the awareness of stroke within the community and encourage Australians to take action to prevent stroke.

Declaration of Interest Colin Cowell

acted F.A.S.T. and saved his life


Please note : The Editor of NACCHO News is a stroke survivor and is currently a board member of the Stroke Foundation and chair of the National Stroke Consumer Council Read his story


NACCHO Aboriginal Health Data : Aboriginal and Torres Strait Islander Social Health Atlas released


The Public Health Information Development Unit (PHIDU) has published an Aboriginal and Torres Strait Islander Social Health Atlas.

This presents a range of demographic, socioeconomic, health outcomes and service use data for Aboriginal and Torres Strait Islander peoples at the Indigenous Area level.

The  2016 release of the atlas includes updated data for the following:

  • Estimate Resident Population (ERP) data for 2015
  • Projected ERP data for 2016
  • Immunisation data for 2015
  • Deaths data now includes data for 2013

And new hospitalisations data for:

  • Hospitalisations by principal diagnosis and age
  • Ambulatory-sensitive hospitalisations

Maps for the Aboriginal and Torres Strait Islander  Atlas can be found at the link below:

For those who prefer the data in a spreadsheet format, the data can be found below:

If you have any questions regarding the Social Health Atlas, our contact details can be found at the link below:



NACCHO #5RRHSS Health Alert : Dr David Gillespie speech ” The challenges of delivery of health in rural and remote Australia “


 “Rural and remote health is a partnership effort. And the challenges inherent in the delivery of health in rural and remote Australia – are also genuine opportunities for finding the best ways, and the most innovative and tailored ways to deliver health that suits the client and the community.

And I really feel that I come here as one of you – and that I am here to work with you, and listen to you – so we can achieve the health outcomes we all want for the diverse rural and remote communities across Australia.”

The Assistant Minister for Rural Health, Dr David Gillespie opened the 5th Rural and Remote Health Scientific Symposium at Old Parliament House, Canberra on 6 September 2016 Minister site



First I would like to acknowledge the traditional custodians of the land where we are meeting today, and pay my respects to Elders past, present and future, and to acknowledge any Aboriginal and Torres Strait Islander people here this morning.

I am very pleased to be here to open your event this morning.

This Symposium brings together some very important people.

People who make an invaluable contribution to the health of Australians.

And particularly to a group of Australians who themselves make an invaluable contribution to the economic and cultural life of this country.

And they are the people who live in rural and remote Australia.

These are the communities that are the heart and soul of Australia.

And their health and wellbeing is my key responsibility, as the new Assistant Minister for Rural Health.

I am honoured to have been appointed to this role, and feel genuinely humbled to have been entrusted with a portfolio that is really so close to my heart.

Health is in fact the one portfolio in which every Australian – every single one of us – is a stakeholder.

And as a farmer and a rural doctor and specialist, and the son of a rural doctor and a rural nurse, I come with insider knowledge.

And a real understanding of the incredible merits and strengths of rural health and all the people who work in rural health, and also the real challenges we face.

This personal investment, and the personal understanding of the issues, I hope will mean a very strong, very collaborative approach to the work ahead we have to do together.

Rural and remote health is a partnership effort. And the challenges inherent in the delivery of health in rural and remote Australia – are also genuine opportunities for finding the best ways, and the most innovative and tailored ways to deliver health that suits the client and the community.

The challenges of delivery of health in rural and remote Australia

And I really feel that I come here as one of you – and that I am here to work with you, and listen to you – so we can achieve the health outcomes we all want for the diverse rural and remote communities across Australia.

Rural and remote health is built on the commitment, the expertise and the courage of the rural and remote health workforce.

It takes a special kind of energy – a toughness and a boldness coupled with a deep sensitivity – to work in health in rural and remote areas.

Without that kind of workforce – we just can’t deliver healthcare to Australians in rural and remote areas.

And by workforce I mean all the contributors – our doctors, our nurses, our Aboriginal Health workers, our midwives, our researchers, our scientists and social scientists, our specialists, our mental health workers, our ambulance drivers, aged care workers, cleaners, paramedical – everyone here.

Sometimes here in Canberra – life can be contained within the confines of the office and the chamber, meetings and car rides – but you only have to look out to the Brindabellas to be reminded, if you need reminding, of the incredible distances across our beautiful country, the ruggedness, and the diversity of the terrain.

And as I travel around, it is so striking how distance and remoteness are almost defining features of Australia.

Our history, our economy, our character – shaped by the rural and remote experience, the towns miles and miles from any others, the farming communities, the mining communities, the vibrant, culturally diverse Indigenous communities living on traditional lands and elsewhere.

The ties to land and place, the industry, the hard work, the resilience, the humour, the courage – rural and remote communities in all their shapes and colours – are defined by these truly ‘Australian’ characteristics.

And all of those special rural and remote communities need access to health care.

And it’s our job to ensure this.

The Government is very clear that we are in Health for the long game – pursuing bold reforms that put patients at the centre of a system that is both equitable and sustainable into the future.

Australia’s health system is world-class, and Australians believe in universal health. We all want a health system that can meet the diverse needs of Australia’s population.

In order to deliver sustainable universal health care into the future – we need to be clear-headed.

We need the research to give us the data to make sure our policy is strong, innovative, and able to respond in changing times.

We need to bring together the fundamental strengths, the skills and contributions from all areas of the health sector – and build on this, in cooperative and collaborative ways.

The Government has been methodically reviewing many aspects of the system – and the broader reform agenda is built on the principle of a strong and sustainable health system, a strong and healthy Medicare, patient-focussed, flexible and responsive.

Where decisions about health services are devolved out to regional Primary Health Networks, and local communities can commission the services that suit them best.

Integrated health care components working together – so that the individual patient has more say over the kind of care they get, and when and how they access it.

Primary health care for instance is undergoing transformative reform.

The Health Care Homes program – is a new way of managing chronic and complex conditions – with individuals assigned a health care home base – and a GP or Aboriginal Health Worker or other health professional taking the role of care coordinator.

They work with the patient to help them access different health care they need – educating them about their conditions and how to manage their own health – in a partnership with the individual.

And with bundled payments replacing a fee-for-service model.

People with chronic and complex conditions are some of the highest users of the health system – people who have some of the highest avoidable hospital admissions in the community.

And the Health Care Homes reforms are seeking also to address this – to free the system up – to better utilise the services available and to improve cost-effectiveness.

Sometimes it’s a matter of turning ideas on their head, and applying expertise but also innovation – this is where the real and valuable change can come.

The good ideas often come from the community, from the grassroots experience of health issues and different ways to address challenges.

Where necessity stimulates innovation – and the particularities of local situations produce ideas that we want to foster and encourage.

We want to create the conditions to support these ideas and help them proliferate.

In fact, the principles of the Government’s broad health reform agenda can be seen in action, and really are distilled, in the rural and remote setting.

Community driven, patient-focussed, adapted to particular community needs – using innovation to address the challenges of distance or meet cultural needs with culturally appropriate services, for instance.

I believe that the challenges of rural and remote health delivery – prompt the kinds of approaches and the kinds of ideas – that provide a real model for the broader health system.

That your ideas and your research into rural and remote health – can provide answers to the bigger questions about the health system as a whole.

If we are looking for innovation, devolution, integration, patient driven and patient focussed, streamlining and collaboration –

Then there is lots to learn from rural health practitioners, rural health service providers, rural communities, and rural health policy developers and researchers.

It’s at the intersection of the community experience and the local practitioners experience, the researchers and scientists and the policy makers – in conversation, exchanging ideas, combining different kinds of expertise – that’s how we will progress.

Two very important election commitments made by the government have arisen out of this kind of collaboration and sharing of knowledge and views.

One key one for me is establishing a Rural Health Commissioner.

The Commissioner will be an advocate and a leader – making sure rural and remote health is a central priority for government, and leading on the development of the first ever National Rural Generalist Pathway to increase the number of highly skilled doctors in rural, regional and remote areas.

The Commissioner will have a broad remit and will work with all of you.

With rural, regional and remote communities, the health sector, universities, specialist training colleges and across all levels of government to improve rural health policies and champion the cause of rural practice.

The Commissioner will work with the health sector and training providers to define what it is to be a Rural Generalist.

We all know that the Rural Generalists is a special kind of practitioner – as is often called for in rural and remote health.

Frequently with advanced training in areas such as general surgery, obstetrics, anaesthetics and mental health.

How do we adequately and appropriately recognise their substantial scope of practice and extended working hours?

This will also be part of the job of the new Commissioner – to develop options for increased access to training and appropriate remuneration for Rural Generalists, recognising their extra skills and hours and giving them more incentive to practise in the bush.

The Commissioner will also consult with stakeholders about the nursing and allied health workforce in rural and remote Australia.

This Government is committed to building a health workforce that meets the needs of rural communities. One example of this is the Rural Health Multidisciplinary Training Program – which ensures more doctors, nurses and allied health workers are being trained in rural and remote locations.

The Integrated Rural Training Pipeline, or the IRTP, is another key element of reform.

Nearly $94 million over four years to develop an integrated, prevocational, postgraduate medical training pathway in rural and regional areas.

More health practitioners completing the different stages of their medical training, from student to specialist, in rural areas.

The formation of up to 30 regional training hubs to better coordinate training opportunities across the stages of training for medical students.

The establishment of a Rural Junior Doctor Training Innovation Fund to provide general practice rotations for junior doctors undertaking their internship in a rural area.

An expansion of the Specialist Training Program to fund a further 100 training places in rural areas.

Young people in rural and remote areas often sacrifice so much to train away from their families and their communities.

Indigenous students, and non-Indigenous students, from rural and remote communities – often really want to be able to stay connected, and its only training that keeps them away from home.

Their commitment to giving back to their own communities – we can build on that – we can ensure they keep those ties, and do their training in the settings where they want to work, with the issues that they know and want to work with.

But also this initiative will help us draw people into communities who maybe did not grow up rural and remote, but will learn to love the life as many of us do, and bring new perspective and new blood into the regions – if we just make it easier for them to train there.

That’s why the government has committed this funding to integrated training – it’s innovative, but it’s also simple.

Another important aspect for me is to continue the rural and remote health stakeholder roundtable meetings.

This is fundamental – consultation and collaboration.

Buzzwords – but meaningful ones in this context.

I know the value of the contribution of rural and remote practitioners in developing policy. I was one.

It would be false economy to not take full advantage of this incredibly valuable resource – and again I want to emphasise the partnership approach that I expect, from my perspective, and I know the Minister’s perspective – will become business as usual for us all as we look ahead.

The third election commitment I want to mention this morning is to the Royal Flying Doctor Service – as well as extending current funding for the service until 2020, we have made a commitment to provide $11 million over two years to expand the delivery of outreach dental services to rural and remote Australians.

The $11 million will provide access to mobile dental services in areas where there are no private or state / Northern Territory government funded public dental services.

The additional services will address the gap in access to dental services for rural and remote Australians over the next two years.

Then the Child and Adult Public Dental (CAPD) Scheme will be implemented – expanding public dental services through funding to the states and territories.

The Royal Flying Doctor Service is such an institution in this country – and has saved so many lives – and the statement on their website about innovation summarises for me the rural and remote health experience:

      “Operating across vast distances, harsh landscapes, and in far from ideal conditions, necessitates resilience, resourcefulness, innovation and a continual striving for excellence.”

This is exactly my point – that the nature of rural and remote health delivery in Australia – the challenges and problems that you all grapple with in your work on a daily basis – attracts the very best people with that deep commitment and that ability to find solutions in the most difficult of circumstances – and it becomes a role model for the rest of the health system.

Research is fundamental to the conversation about how to improve rural and remote health services.

Strong reliable data – helps us allocate resources in effective ways.

Innovative, courageous research can force governments to rethink previous outdated assumptions.

I notice your planned conversation later in the Symposium around small rural hospitals, and local maternity services – such re-evaluation of the decisions of previous governments in previous times cannot be done without the science and research to help us understand the reality of impacts and prosecute our case for change.

Responding innovatively and respectfully to the health needs of Indigenous communities – can be greatly facilitated by strong research to back up taking the action we absolutely need to take.

The Prime Minister and the Health Minister recently announced the next stage of the National Suicide Prevention Strategy for example – and have identified the Kimberley as one of the trial sites.

Because we have the data – as shocking and devastating as it is – about the heartbreaking suicide statistics – it is clear that we need to make not a small difference, but a fundamental and transformative difference.

It is a health imperative, but it is also a moral and social imperative. The Kimberley has the highest concentration of remote Aboriginal and Torres Strait Islander communities in the nation.

The cultural and historical value of this region, the sacred sites, the complex traditional practices, the walking in two worlds, the depth and the richness – is a national treasure.
But our people, the people of the Kimberley are suffering.

There are complex reasons – mental, spiritual, economic, social and historical – why this is happening.

But the problem before us now is urgent, and the only way forward are culturally appropriate, tailored services developed in consultation with communities and community health workers and Elders – to reach people in the way they want and need to be reached, in ways that will save lives.

The new strategy is built on this principle.

Intelligent, respectful, compassionate and practical solutions – working together, responding to needs, in ways that work, based on local knowledge.

Consultation and collaboration.

I spent 33 years working as a doctor in regional and rural areas.

My wife and I have also run a beef cattle farm in the Hastings Valley and raised our kids there.

I love the rural life. I am a doctor, but I’m also a farmer, and I place enormous value on the contribution of our rural communities to our country.

As I mentioned at the beginning of my remarks, some of you may know that I also grew up in a country town, as the son of a doctor and a nurse – one of seven kids, with my father the local GP running his surgery in the front two rooms of the house!

They were busy times – lots of people coming and going from the house – and it provided fertile ground for me to hatch my dreams to follow Dad into medicine.

When I was appointed to this role as Assistant Minister for Rural Health I thought of my father.

The life we lived growing up – his time always belonging to the community as well as to all of us, his ability to show compassion and patience, to respond to the needs of people from all walks of life, the farmers and the labourers, and everyone in between.

And that country NSW culture that is still alive in the towns and villages of that state, and its different permutations in all the states and territories – the bush, and the coast, the Big Top End, the villages in Tassie, all over the country.

Technology and changing times and demographics have made some things easier since then, and some things give us new challenges.

E-health can help a lot to reach people who live remotely.

But nothing can replace the person-to-person contact.

The relationships.

The connections.

The sense of community.

The working together.

The local people finding their own solutions to their own needs.

With our support.

With the strong evidence base, and the right policy settings.

We are going to go from strength to strength.

I’m really looking forward to what we can achieve together.

And I thank you all for your incredible contribution to improving health outcomes for all Australians, regardless of where they live and where they come from.

Good luck with the Symposium, and I look forward to the outcomes.


NACCHO Aboriginal Health : New poll shows 76% Australians want increased funding for preventive health


“Australians are sending a message to Government – we need more preventive measures in place so we can improve our overall health.

The majority of Australian adults are either overweight or obese and they are recognising the fact that something needs to done early on to prevent this unhealthy way of life.

A sugar tax on soft drink is a clear way to reduce obesity and should be implemented in the context of a National Nutrition Policy in order to sensibly address chronic conditions caused by obesity

 Public Health Association of Australia (PHAA) CEO Michael Moore.

” Amata was an alcohol-free community, but some years earlier its population of just under 400 people had been consuming 40,000 litres of soft drink annually.

The thing that I say in community meetings all the time is that, the reason we’re doing this is so that the young children now do not end up going down the same track of diabetes, kidney failure, dialysis machines and early death, which is the track that many, many people out here are on now,”

Mai Wiru, meaning good health, and managed by long-time community consultant John Tregenza. SEE NACCHO POST this week

The Roy Morgan Research poll conducted for Research Australia shows 76% Australians rank investment into preventive health among the top ten priorities for the Australian Government.

Download the Research Report Here


Over 1000 people participated in the poll which suggests the Government needs to invest in preventive health programs with 83% of Australians trying to lose weight and/or improve their fitness. It also showed 90% of Australians view looking after and/or improving our health as very or extremely important.

“This data is another in the long line of evidence the Government has to invest more in prevention. Prevention is better than cure and the Australian public are tooting the same horn as public health experts. It’s time the Government listened to both,” continued Mr Moore also President of the World Federation of Public Health Associations (WFPHA).

The poll also asked if Australians were willing to support a sugar tax on soft drinks. 75% would support the tax with 48% definitely supporting a tax.

“A sugar tax on soft drink is a clear way to reduce obesity and should be implemented in the context of a National Nutrition Policy in order to sensibly address chronic conditions caused by obesity. The poll showed an overwhelming majority of Australians know it is a good move to reduce obesity and improve overall health,

“Mexico, the United Kingdom and some American states have implemented a sugar tax on soft drink with great results. Australia can make a difference to the health of the population by taxing a beverage with zero nutritional benefits consumed by adults and children,” said Mr Moore.

Australia’s Health Tracker by the Australian Health Policy Collaboration (AHPC), shows one in two Australians have a chronic disease yet the Government only invests 1.5% into prevention for chronic diseases.

“1000 Australians are calling on the Government to do more and improve the health of the population. This isn’t about losing votes, it’s about doing the right thing for the country and improving the overall health of the Australian people,” concluded Mr Moore.

The joint PHAA 44th Annual Conference and 20th Chronic Diseases Network Conference will be held from 18 – 21 September 2016 in Alice Springs, NT. The theme is Protection, Prevention, Promotion, Healthy Futures: Chronic Conditions and Public Health. #PHAACDN2016