NACCHO Aboriginal Health News: Reconciliation Barometer shows heightened racism in 2020

feature tile reconciliation barometer 2020 and feet below marchers with flag we can health together

Reconciliation Barometer shows racism heightened in 2020

The 2020 Australian Reconciliation Barometer—a national research study conducted by Reconciliation Australia every two years—shows that the global and local Black Lives Matter movements have challenged  experiences and understanding of racism in Australia. “This year’s Barometer shows more Aboriginal and Torres Strait Islander people reporting an incident of racial prejudice than the 2018 barometer,” said Reconciliation Australia CEO, Karen Mundine. “Just over half of Aboriginal and Torres Strait Islander respondents reported to have experienced at least one form of racial prejudice in the last six months.”

“More Australians now agree with the statement that ‘Australia is a racist country’, a rise across the board in understanding how racism operates. In 2020 we have seen increasing political and social polarisation due to uncertainty and disruption from COVID-19. Through the 2020 Barometer we hear many more people speaking up, speaking the truth, asking the hard questions, seeing the hard facts, and moving from a space of safe to brave on issues affecting Aboriginal and Torres Strait Islander peoples.”

You can view the full 2020 Reconciliation Barometer report, including a summary of the report, by clicking here.

group of Aboriginal girls with Deadly choices t-shirts

Image source: Reconciliation Australia website.

Permanent telehealth model being developed

The AMA will work with the Federal Government to make Medicare-funded telehealth a permanent part of the Australian healthcare system. Health Minister Greg Hunt announced the partnership approach during a joint media conference with AMA President, Dr Omar Khorshid. “The AMA has been working with the Government on how to embed telehealth into the Australian healthcare system for months,” Dr Khorshid said. “The AMA has long advocated for telehealth consultations to be subsidised under the Medicare Benefits Schedule (MBS). “The temporary COVID-19 arrangements have allowed us to test the model, and shown where refinements can be made. MBS-funded telehealth has been embraced by doctors and patients alike.”

To view the AMA’s media release regarding the model click here.

man on mobile phone pointing to Aboriginal hand on computer screen

Image source: The Medical Journal of Australia.

Nurses support public drunkenness decriminalisation

Victoria is close to the decriminalisation of public drunkenness, three decades since the Royal Commission into Aboriginal Deaths in Custody first made the recommendation. The Australian Nursing and Midwifery Federation (Victorian Branch) has welcomed the Andrews Government’s decision to review all recommendations of its Expert Reference Group’s report Seeing the clear light of day. The report reinforces that no one should be in a police cell just because they are intoxicated. ANMF supports the two-year implementation period which will enable the Andrews Government to develop a public health model response to replace the jail cell. The implementation period will include trial sites before rolling the approach out across the state.

To view the ANMF (Victorian Branch) media release click here.

Daughters Apryl Watson and Kimberly Watson with photos of their mother Tanya Day outside Coroners Court.

Daughters Apryl Watson and Kimberly Watson with photos of their mother Tanya Day (who was arrested under the public drunkenness law in Victoria and latter died in custody) outside Coroners Court. Image source: The Age.

Mental health lessons from 2020

Menal Illness Education ACT will co-host a stimulating panel discussion on Wednesday 2 December 1.00pm–2.20pm (AEDT) to unpack how paid and unpaid workloads have changed in 2020 and the impacts on wellbeing, particularly for women. The discussion will cover the following topics:

  • We will look at the positives and challenges coming out of the current environment. 
  • Discuss how roles have changed from a range of perspectives and how we have and can respond to those changes as individuals, partners and organisations.
  • Provide strategies and resources on how to identify and respond to the shifting balance.

This session is for everyone, whether you are single, in a couple, a parent or a carer.

The event will be held on Teams. To register pleas click here.tile Lessons from 2020 strategies to balance the mental load

Stolen Generations bus back on healing mission

Bus operator CDC NSW has committed to a partnership in support of Australia’s indigenous people’s ‘Stolen Generations truth telling’. In cementing its partnership with Kinchela Boys Home Aboriginal Corporation (KBHAC) during its first KBHAC Mobile Education Centre (MEC) community visit post COVID-19, CDC NSW driver Mikhail Mikhail steered the MEC bus to a Healing Session at Aboriginal Health and Medical Research Council (AH&MRC) in Little Bay, where it was unveiled to a group of Kinchela Boy’s Home survivors and AH&MRC staff. The MEC – a converted commuter bus nicknamed ‘Benny’ featuring an audio-visual system and printed historical information on Stolen Generations – is the first of its kind and integral to helping KBHAC members tell their stories in a range of locations. To read the full article click here.

Stolen Generations bus

Image source: Australasian Bus & Coach website.

Urgent need to close digital divide

New analysis commissioned by the Australian Communications Consumer Action Network (ACCAN) shows that urgent action is needed to address the digital divide in remote Indigenous communities in the wake of COVID-19 lockdowns. While much of the nation turned to digital services such as videoconferencing and telehealth during the rolling lockdowns put into place during the COVID-19 pandemic, very few remote Indigenous communities were able to work or learn from home, or access government and health services online.

With access by service providers limited by travel restrictions, many people were left without access to essential services. In some remote communities, the Wi-Fi hotspot, the only point of access, was switched off to avoid people congregating. “COVID-19 saw communities without food and necessities of life because of the lack of access to adequate, reliable, and robust telecommunications,” said ACCAN Board Member and proud Torres Strait Islander, Dr Heron Loban.

To view the full article click here.

3 Aboriginal women and two Aboriginal children with iPad outdoors sand

Image source: sarahharroldblog wbsite.

Pius X win training awards

In a first for Moree, staff of Pius X Aboriginal Medical Service (AMS) have made a clean sweep of GP Synergy’s New England/North West GP training awards, taking out all three regional awards on offer. Pius X’s practice manager Ros Rose was named Practice Manager of the Year, GP supervisor Dr Hamze Hamze was named Supervisor of the Year and GP in training Dr Nada Abu Alrub was named Registrar of the Year in GP Synergy’s New England/North West GP training awards.

To read the full article click here.

3 Pius X staff holding bunch of flowers each and award certificates

Pius X’s GP in training Dr Nada Abu Alrub, practice manager Ros Rose and GP supervisor Dr Hamze Hamze. Image source: Moree Champion News.

COVID-19 vaccination survey

Do you provide immunisations? Do you transport vaccinations or receive them in your workplace? Do you work in rural or remote settings?

Finally, some good COVID-19 news, there have been some positive outcomes in the race outcomes in the race for the COVID-19 vaccine. Nurses, midwives, doctors and Aboriginal Health Practitioners working in primary health care will be very busy in 2021. They will be at the coalface of health promotion, allaying people’s fears, and organising the immunisation logistics to protect their communities. The focus will be on those most at risk, the elderly, men, and the health workforce.

Scaling-up rapid mass immunisation means more trained staff will be needed to administer the vaccinations and provide transportation logistics. The cold chain is only as effective as its ‘weakest’ link. There are many people involved in vaccine cold chain to rural and remote communities, some of whom do not routinely receive training in relation to medicines storage, such as transport drivers, Aboriginal Health Workers, and administration staff.

Central Australian Rural Practitioners Association have made a training video, telling the story of a vaccine’s journey from a supply centre to administration in a remote Aboriginal community, and would like your feedback. Please view the video here and then take 2–3 minutes to complete the 13 question survey here.

image from vaccine journey video. cartoon of cold box being handed between people

Image source: CARPA Inc. Vaccine Story video slide.

60% in remote communities have hearing loss

Chronic ear disease contributes to widespread hearing loss among Indigenous people in Australia. In 2020 it was found 40% of Indigenous people have hearing loss, 60% in remote communities with 79% of people with hearing loss not knowing they did not hear as well as others. Dr Damien Howard and Jody Barney have produced a new video on Indigenous hearing loss. To view the video click here. To take the 13 question survey (approved by the NT Department of Health and Menzies School of Health Research) click here.

cartoon of Aboriginal woman trying to hear on a telephone

Grow Local Cert IV in Mental Health

Despite the challenges this year due to COVID-19, Grow Local participants have worked hard towards completing their Grow Local Certificate IV in Mental Health, meaning communities throughout Western Australia will have additional mental health support available to those who may be struggling. The program has proven to not only be an effective way of meeting these community needs, but also a popular one, with more than 60 participants graduating in towns throughout the state in the coming weeks. The training is provided to community in partnership with the Australian Medical Association (WA), along with support from local organisations including Milligan House, who offered the use of their meeting rooms for the monthly workshops.

To view the WA Primary Health Alliance media release click here.

The World AIDS Day Parliamentary Breakfast is tomorrow

Event begins tomorrow at 7:20am AEDT (for 7:30am start) via Zoom (https://us02web.zoom.us/j/81494660983)

Each year we ask international and Australian HIV/AIDS experts to share their perspectives on HIV/AIDS in the world and our country, and the outlook for the future. We hope you will find their articles interesting and informative.

Please see the link to the World AIDS Day booklet here.

 

 

 

 

WA Primary Health Alliance logo

SA – can be based anywhere across SA – Nunyara Aboriginal Health Service Inc.

Systems Implementation Coordinator Aboriginal disAbility Alliance

SA West Coast ACCHO Network (SAWCAN) is a consortia supporting 4,976 Aboriginal people in a region that stretches from Whyalla in the east, right over to the WA border. Nunyara is acting as the lead agent of the consortia and is seeking to employ a suitably qualified person as the Systems Implementation Coordinator to apply a systems-focused approach in the capacity building of Aboriginal Community Controlled Health Organisation (ACCHO) staff to ensure the seamless integration of NDIS within the comprehensive primary health care model.

To view the job description click here.

Applications close 5.00pm Wednesday 9 December 2020.

SA – Whyalla – Nunyara Aboriginal Health Service Inc.

FT Community Activator – 12 month contract

The Nunyara Aboriginal Health Service is an RACGP accredited service that provides culturally appropriate health care, health promotion and education programs for the Aboriginal community in Whyalla. Nunyara is looking to engage an energetic and motivated person to work as a Community Activator within the Aboriginal disAbility Alliance project. This position will provide assertive outreach and advocacy to Aboriginal people living with a disability, their families and carers in a culturally sensitive manner, breaking down barriers to accessing the NDIS and developing trust and rapport.

To view the job description click here.

Applications close 5.00pm Friday 11 December 2020.Nunyara Aboriginal Health Service Inc. logo

ACT – Canberra – Bimberi Residential Services

FT Family Engagement Officer – temporary

Bimberi Residential Services is seeking an experienced, committed and suitably qualified person to fill the Family Engagement Officer role.

The Family Engagement Officer is designed to assist with the engagement of young people and their families and to promote Aboriginal and Torres Strait Islander practices and perspectives, in the day to day functions across Bimberi Residential Services. The role also is involved in promoting initiatives and developing innovative approaches to meeting client and program needs.

To view the job description click here.

Applications close Friday 11 December 2020.

external view of Bimberi Youth Dentention Centre ACT

Image source: ABC News website.

NSW – Dubbo – Coonamble Aboriginal Health Service

FT Psychologist – 2 year contract, possibility of extension

Coonamble Aboriginal Health Service (CAHS) is seeking an enthusiastic and committed person to fill a full-time position of Psychologist within the highly successful Aboriginal community-controlled organisation Dubbo Regional Aboriginal Health Service (DRAHS) Social & Emotional Wellbeing Department. This is a busy clinical role working with clients to prevent, diagnose and treat psychological issues within a health clinic in NSW.

To view the job description click here.

Applications close Friday 11 December 2020.

ACT – Canberra – OzChild

OzChild, an organisation established to support vulnerable children and young people by providing healing, preventing abuse and neglect, and strengthening families so all children and young people are safe, respected, and nurtured, and reach their full potential, is looking to employ a Family Practitioner and a Team Leader in their Functional Family Therapy (FFT) program. Both roles will strengthen the benefit of services to children, young people and their families in specified areas utilising an evidence based program. This evidence-based program has been developed to support families, with children and youth aged 12 to 18 years, in the home and the community. To view the position descriptions for the roles click on the role titles below.

Family Practitioner – Functional Family Therapy (FFT)

Team Leader – Functional Family Therapy

To apply, please contact the OzChild HR advisor Paul Ridley by phone 03 9695 2243 or to email click here.two Aboriginal young girls, one kissing the other on the cheek, OzChild logo

feature image text 'child protection system sets First Nations people with disability up to fail, photo of Aboriginal youth leaning on wire gate and broken wire fence in desert landscape

NACCHO Aboriginal Health News: Child protection system sets PWD up to fail

feature image text 'child protection system sets First Nations people with disability up to fail, photo of Aboriginal youth leaning on wire gate and broken wire fence in desert landscape

Child protection system sets PWD up to fail

First Nations people with disability (PWD) will tell the Disability Royal Commission this week about the structural violence they experience in the child-protection system around Australia. “We are among the most seriously disadvantaged members of the Australian community, and are also experts on the impact of policies on us,” says First Peoples Disability Network CEO Damian Griffis.

“This week, a number of First Nations people with disability will give evidence about the different racist and ableist systems that harm our children.” Mr Griffiths says the child protection system is “hostile and complicated.  Child removal is an ever present threat, and reality in our communities. It has become part of the community vernacular, and families live with the legacies of trauma from the removal of their parents and grandparents,” he says. 

Health Justice Australia CEO Donnella Mills says the current child protection system risks setting people with disability and their families up to fail, “First Nations people with disability and their families in contact with child protection systems face multiple, intersecting problems that result from intersectional and institutional discrimination,” she says. 

To view the full article click here.

placards against steps with Hands off our kids, black babies belong with black families

Image source: The Guardian.

Infectious skin diseases researcher awarded

The Australian Museum Eureka Awards (the “Oscars of science”) celebrate research and innovation, leadership, science engagement and school science. “Science is at the core of everything we do and we are committed to supporting and showcasing the work of Australian scientists,” Australian Museum Research Institute Professor Kristofer Helgen said.

The Emerging Leader in Science award went to Associate Professor Asha Bowen, who is Head of Vaccines and Infectious Diseases at the Telethon Kids institute. Her work over the years has significantly changed the way indigenous children with skin infections are treated.

To listen to Associate Professor Bowe being interviewed on ABC RN Breakfast with Fran Kelly click here.

portrait of Associate Professor Asha Bowen standing outside on path with trees in the background

Image source: RHD Action.

Parents fear child services

Treating mental health episodes more like a physical injury could help prevent the long-term removal of children of Indigenous parents with a disability, a national inquiry has heard. Mental health worker Christine May has told a hearing of the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability that when a parent with a mental illness had a psychotic episode and needed to stay in hospital it should be regarded as a period of treatment. “If I broke my leg I wouldn’t have an order taken out on my child,” she said.

Unless parents are deemed dangerous, Ms May said, they shouldn’t have to fight to keep their children when services could provide treatment for them to become well and be re-assessed. She recommended the Queensland Health program Cultural Healing she works for be expanded across the state.

To view the full article click here.

young Aboriginal child in shadows outside with tricycle and parts of other play equipment visible

Image source: SBS NITV website.

Increased clinical trial access for regional Australia

Much is riding on $125 million in Federal Government funding, announced in the recent budget and aimed at addressing this disparity and providing access to life-saving clinical trials in the regions. “This funding is our last chance to get it right, to deliver a higher level national health system,” said Sabe Sabesan, a doctor who was central to developing Queensland’s model of delivering medical support to regional communities via telehealth. His program has paved the way for the next step towards making clinical treatment trials available to all patients regardless of their location.

Oncologist Craig Underhill is hopeful the clinical trials would not only drive an improvement in cancer outcomes but enable research in other chronic health areas affecting regional patients, such as geriatric oncology, Indigenous health and palliative care.

To view the article in full click here.

health professional at desk conducting telehealth session

Image source: National Rural Health Alliance online magazine, Partyline.

Lung cancer signs free webinar

According to the Australian Institute of Health and Welfare (AIHW) estimated trend lines indicate a significant increase in the lung cancer incidence and mortality rates for Indigenous Australians over time. For non-Indigenous Australians, the age-standardised incidence rate for lung cancer has been relatively stable, while the mortality rate has fallen. Estimated trend lines indicate a significant decrease in the lung cancer mortality rate for non-Indigenous Australians.

Symptoms of lung cancer are often vague and can be overlooked, however, early and rapid investigation and referral is necessary for optimal patient outcomes. How can GPs give themselves the best chance of identifying possible lung cancer in busy primary care practice?

Cancer Australia invites you to join them in an upcoming webinar on investigating symptoms and signs of lung cancer in primary care: Symptoms and signs that might be lung cancer – a new guide to optimal investigation and referral in general practice – 7.00pm-8.00pm (AEDT) Wednesday 2 December 2020.

T join the FREE webinar click here and to learn about Cancer Australia’s new resource Investigation symptoms of lung cancer: a guide for all health professionals click here.

doctor's hand pointing to x-ray of lung

Image source: SBS News website.

Good Medicine Better Health resources survey

NPS MedicineWise is are seeking Aboriginal and Torres Strait Islander consumer input to assist the development of Good Medicine Better Health (GMBH) consumer resources. Lived experience, and preferred format and learning styles will help us to develop consumer driven, culturally appropriate and accessible resources that deliver key information about quality use of medicines. 

To view the invitation for consumers to share their lived experience and/or community experience of a range of health issues click here and to access the link to the consumer participation survey click here.

The purpose of the survey is to elicit information about age, region (metro, regional, rural or remote), education level, willingness to be involved and preferred contact details. The GMBH team will then contact willing participants to arrange one-on-one phone interviews, online focus groups or workshops.

portrait shot Aboriginal woman and Aboriginal boy and girl, Good Medicine Better Health banner

Image source: NPS MedicineWise.

Native millet could change lives

Native millet on Gamilaraay country in western NSW is the most economically viable native grain for future farm enterprises, a University of Sydney study has found. The University of Sydney Institute of Agriculture study is the most comprehensive trial of Indigenous paddock-to-plate produce in Australia and was done in consultation with local communities and Black Duck Foods, owned by Aboriginal foods expert Bruce Pascoe. The one-year research project into the environmental, economic and cultural viability of growing native grains for bread on Gamilaraay country near Moree and Narrabri was released on 9 November 2020.

“Gamilaraay and Yuwaalaraay country in north-west NSW is one of the largest Aboriginal language groups in Australia, and they are proudly known as grass people,” said Dr Angela Pattison, study leader from the University of Sydney Institute of Agriculture and Plant Breeding Institute at Narrabri.

To view the full article click here.

loaf of bread on breadboard, bread being broken between fingers, man and woman in crop field

Image source: The University of Sydney website.

NT  Darwin and Palmerston region – Danila Dilba Health Service

Multiple positions: Head of ICT, Dietitian, Occupational Therapist, Physiotherapist, Mental Health Nurse, Community Support Worker

Danila Dilba Health Service is going through a dynamic period of expansion and growth. As a result of robust growth in services and in order to meet increasing client need, they are looking for people to join their team and be part of delivering important services to the Darwin and Palmerston region.

These are important roles where you’ll be able to contribute to improving the health and wellbeing of Indigenous Australians. Danila Dilba will provide great learning opportunities and give you the chance to grow your skills and progress your career.

For further information and to apply click here. Applications close Monday 7 December 2020.Danila Dilba Health Service logo

NACCHO Aboriginal Health News: Support needed to close the mental health gap

feature tile: outline of face side on, filled with tree roots

Support needed to close mental health gap

To mark World Mental Health Day and World Mental Health Week 2020, NACCHO Chair Donnella Mills has issued a Media Statement emphasising that the commitment in the National Agreement on Closing the Gap needs continued funding support to close the mental health gap. In Australia, the rate of suicide in Aboriginal and Torres Strait Islander communities continues to grow. NACCHO Chair Donnella Mills states, “Our people experience very high levels of trauma at nearly three times the rate of other Australians and recent statistics point out that we are twice as likely to commit suicide.”

Image source: Department of Health

“The new targets in the National Agreement on Close the Gap focuses on 16 socio-economic targets which were not included in the previous Closing the Gap strategy such as suicide, children in out-of-home care, adult incarceration and juvenile detention. To meet these targets, NACCHO believes sustained funding support for Aboriginal led, culturally appropriate mental health and suicide prevention programs is critical. We will not stop advocating for appropriate funding to Aboriginal Community Controlled Health Organisations (ACCHOs) until the Mental Health Gap is closed. We need funding support for sustainable community-led solutions to expand their mental health, social and emotional wellbeing, suicide prevention, and alcohol and other drug services, which use best-practice trauma-informed approaches,” said Ms Mills.

To read the NACCHO Chair’s media statement click here and to read the media release from Mental Health Australia click here.

Innovative program helps reunite families

Almost 400 children have been safely restored to their parents thanks to an innovative program designed to drive down the number of children in out-of-home care, which is funded by an Australian-first Social Benefit Bond (SBB).  NSW Minister for Families, Communities and Disability Services Gareth Ward said the Newpin program has achieved unprecedented restoration results for vulnerable families across NSW. “Newpin is designed to reunite families by providing long-term therapeutic support that builds parenting skills and addresses issues like mental health, isolation, social disadvantage or family violence,” Mr Ward said.  “Over the course of the seven-year pilot, more than 60% of children returned to the care of their parents. Treasurer Dominic Perrottet said the program demonstrates what can be achieved when Government works with organisations that have the right expertise to deliver the best outcomes for communities.

To view the media release click here.

mother watching small child as he draws on chalkboard

Image source: Social Ventures Australia.

Donnella Mills reaction to the Budget 2020 on ABC NewsRadio

Listen to NACCHO Chair Donnella Mills providing a reaction to the Budget 2020 to ABC NewsRadio, welcoming the increase in funding for Aboriginal and Torres Strait Islander health and stating that NACCHO will continue to press the Government for targeted infrastructure investment in our clinics.

To listen to the interview click here.

VIC ACCHOs to lead local responses to COVID-19

More than $500,000 in grants under the first round of the $10 million Aboriginal Community Response and Recovery Fund has been announced. The Fund – announced in July – was set up to provide support for communities during the pandemic, including emergency relief, outreach and brokerage, social and wellbeing initiatives – as well as cultural strengthening and virtual celebration opportunities.

Four Aboriginal organisations were successful in the first round, including Wathaurong Aboriginal Corporation in Geelong, The Victorian Aboriginal Community Services Association Limited in North Melbourne, the Ballarat and District Aboriginal Corporation and the Willum Warrain Aboriginal Association in Hastings.

To read the Victorian State Government’s media release click here.

Image source: Victorian Government Twitter.

Culturally appropriate care for chronically ill

A program by Blacktown-based service, Western Sydney Integrated Team Care (ITC), is ensuring chronically ill Aboriginal and Torres Strait Islander people have improved access to quality holistic care in the greater Western Sydney region. The federally funded program is facilitated by Western Sydney Primary Health Network and is operated by WentWest. It has proven itself to be a success and over time tailored itself to the community’s needs. With the largest urban Aboriginal and Torres Strait Islander population in Australia and one of the highest diabetes rates compared to the national figure, as well as heart and respiratory diseases, hepatitis and asthma becoming increasingly common within community, the importance of the service is not lost on the Western Sydney ITC team.

To view the National Indigenous Times article in full click here.

Aboriginal health worker standing in front of window with words Western Sydney ITC Program

Image source: National Indigenous Times.

More needed to address eye health services backlog

The Fred Hollows Foundation has welcomed the Government’s six month extension to telehealth services announced in the Federal Budget, but said more must be done to address the backlog of eye health services caused by COVID-19. The Foundation’s CEO Ian Wishart said urgent action was needed to address the backlog of cataract surgeries and other ophthalmic treatments because of the pandemic. “Already long waiting lists are getting longer. Without targeted investment to support cataract surgery for Aboriginal and Torres Strait Islander Peoples, there is a real concern that gains made over the past decade in closing the eye health gap could be lost,” Mr Wishart said. “Aboriginal and Torres Strait Islander Peoples are three times more likely to be blind than other Australians and we know that more investment is needed to close the gap in eye health. We need commitment from all levels of government towards the implementation of Strong Eyes Strong Communities, a five year plan for Aboriginal and Torres Strait Islander eye health and vision care.”

To read the article in full click here.

Aboriginal artist Peter Datjin with eye patch in outdoor setting

Indigenous artist Peter Datjin. Image source: The International Agency for the Prevention of Blindness website.

Healing through connection and culture report launched

Lifeline Australia, in partnership with The Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, have launched the Wellbeing and Healing Through Connection and Culture Report. Authored by Professor Pat Dudgeon, Professor Gracelyn Smallwood, Associate Professor Roz Walker, Dr Abigail Bray and Tania Dalton, the report is the first literature review undertaken in Australia analysing the emerging research and knowledge, key themes and principles surrounding Aboriginal and Torres Strait Islander cultural perspectives and concepts of healing and social and emotional wellbeing as they relate to suicide prevention.

To read the Lifeline Australia media release regarding the launch click here.

nine Aboriginal people on beach at dusk, dance & digeridoo

Image source: SNAICC website.

Record investment in WA Aboriginal communities

More than $750 million has been committed in the 2020–21 WA State Budget to enhance the health and wellbeing of Aboriginal communities. This record amount of funding aims to build the resilience and capacity of Aboriginal communities and individuals. The funding is split over three key policy areas: building strong communities, improving health and wellbeing and delivering social and economic opportunities. An important component is $9.77 million for Aboriginal regional suicide prevention plans in each region of WA, prioritising Aboriginal-led and locally endorsed initiatives. Suicide affects the whole community, and a whole-of-community approach is required to prevent it.

To view WA Mental Health Minister Roger Cook’s media release click here.

Aboriginal woman and male youth in foreground against building in remote Australia

Image source: Government of WA Department of Communities website.

More can be done to prevent diabetes related vision loss

Diabetes-related vision loss is the leading cause of blindness for working-aged Australians, yet it’s almost entirely preventable. A recent Australian study found that only half of the people with diabetes get the recommended annual eye checks. Around 1.7 million Australians have diabetes, with Aboriginal and Torres Strait Islander people three times more likely to develop diabetes than non-Indigenous Australians. There is potential to prevent blindness in more people with diabetes if the ongoing improvement of eye care that involves and empowers people with diabetes, their health teams, and communities to develop services, systems, new technology, and policies that meet their needs is pursued.

To view the full Micky Newsletter article click here.

Aboriginal woman and male youth in foreground against building in remote Australia

Image source: Fred Hollows Foundation website.

Health care equity post graduate scholarships available

The Centre for Research Excellence – Strengthening systems for Indigenous health care equity’s (CRE-STRIDE) goal is equitable health care for Aboriginal and Torres Strait Islander communities through quality improvement (QI) and collaborative research to strengthen primary health care systems. CRE-STRIDE’s research approach is based on growing evidence of the importance of community-driven, culture-strengthening interventions in Indigenous primary health care settings. CRE-STRIDE’s way of working puts the strengths, needs and aspirations of Indigenous people at the centre of the research process informed by methodologies that reflect Indigenous ways of knowing, being and doing and advance international Indigenous scholarship.

CRE-STRIDE is offering scholarships to support honours, Masters of Research and PhD candidates. 

To view the CRE-STRIDE website click here and to view details about the scholarship program and how to submit an Expression of Interest click here.CRE-STRIDE banner - words CRE-STRICE in semi-circle, Aboriginal meeting symbols and yellow red grey dots in background against purple banner

NACCHO Aboriginal Health News: Aboriginal health funding boosted, but infrastructure overlooked

external view of medical clinic in slightly run down state

Aboriginal health funding boosted, but infrastructure overlooked

NACCHO has welcomed the increase in funding for Aboriginal and Torres Strait Islander health in the Budget with the Chair of NACCHO, Donnella Mills, saying, “I am heartened by the additional investment in the Indigenous Australians Health Program with $33m for our hard-working services over the next three years. I am also pleased to hear of the regional-and-remote health funding that will assist many of our clinics and the communities they serve as well as assistance for training and workforce development. These are all very welcome.”

NACCHO Conference 2017
Photo: Geoff Bagnall

“While these measures are significant, NACCHO will continue to press the Government for targeted infrastructure investment in our clinics. If stimulus is the main objective of the Budget, we believe that there is no better way to do so than to invest in local communities. There was a valuable opportunity here to invest in our 550 local clinics across the country where our 410,000 clients reside. This was an opportunity missed.”

To view NACCHO’s media release on the Budget click here.

new Armajun Aborignal Health Service Inverell being built

Armajun Aboriginal Health Service, Inverell. Image source: Adam Marshall MP website.

Mental health support extended in NPY region

Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women’s Council (NPYWC) and Smiling Mind have partnered to see crucial, prevention-focused mental health support extend even further into Australia’s Indigenous communities. Over the past two years, Smiling Mind has worked closely with NPYWC, translating its popular in-app mindfulness sessions into the region’s Indigenous languages, in order to support the communities’ youth with tools in their native language. To date, the programs have engaged more than 2,500 subscribers, and more than 5,000 meditations have been completed. Three remote schools in the central desert region have also benefited from mindfulness training, where educators were supported to foster positive mental health habits with their students and the wider school community. 

Envato Foundation, the philanthropic arm of leading technology business Envato, have donated $100,000 to give new life to the partnership, allowing for an extension to the tools and resources already created to infiltrate further across the NPY  region of Central Australia, a region spanning 28 remote communities in the tri state region of NT, SA and WA over an area covering 350,000 square kms.  

To view the full Mirage article click here.

Aboriginal woman on Country listening to podcast

Image source: NPYWC website.

Centre for Disease Control an urgent priority

‘The pandemic experience this year is a clear reason for the establishment of an Australian Centre for Disease Control,’ says Alison Verhoeven, Australian Healthcare and Hospitals Association (AHHA) Chief Executive. ‘The call for this has been long-standing, with a 2013 recommendation to the Government by the Standing Committee on Health and Ageing overlooked in favour of the development of a National Communicable Disease Framework. Such a Centre would position Australia well to demonstrate global leadership in communicable disease planning and response capabilities. ‘It would also support existing state and territory disease control measures through a cohesive approach to research, diagnosis, screening, reporting, case management, contract tracing, forecasting and trend monitoring.’

To read the AHHA media release click here.

scientist in laboratory with full PPE looking at a sample

Image source: The Conversation website.

Budget health response scale warranted

Federal AMA President Dr Omar Khorshid has commended the Federal Government’s $16 billion COVID-19 health response and further stimulus spending aimed at fending off a COVID-19 recession, saying ‘The health and economic impacts of COVID-19 warrant this scale of health response and stimulus spending directed toward restarting the economy. A safe, effective and widely available vaccine is not guaranteed for next year and if it doesn’t eventuate and a large outbreak occurs, economic recovery will be threatened, along with many Australian lives. Governments cannot drop the ball and must continue a broad range of strong policies to keep COVID-19 out of the community in order to ensure a sustained health and economic recovery.’

To view the AMA media release click here.

Aboriginal flat with stethoscope sitting on top

Image source: My South West Directory website.

Telehealth must be start of a health ‘revolution’

CEO of the Consumer Health Forum of Australia (CHF), Leanne Wells, says the use of telehealth during the pandemic shows transformative change is possible in healthcare. She went on to say ‘telehealth has been stimulated by the pandemic to trigger easier and safe access to doctors, we look forward to further developments after the six month extension to March 2021 expires and we hold great ambition for the scope of services that will be possible under the 10 Year Primary Health Care Plan currently in development.’

To view the CHF media release click here.

two Aboriginal men and health professional looking at monitor

Image source: The Fred Hollows Foundation website.

 

ACT – Canberra – National Aboriginal Community Controlled Health Organisation (NACCHO)

Social Media Communications Coordinator

As the Social Media Communications Coordinator within the NACCHO Communications team, you will manage and maintain NACCHO’s social media presence and the daily blog. You will report to the Director, Communications and seek direction and approval on content delivery. You will work cohesively with the NACCHO Communications teams towards the creation and the delivery of social media campaigns and driving key Aboriginal and Torres Strait Islander health sector news content across channels.

This position will be offered as a fixed contract on a full time or part time basis depending on the candidate. 

To view the full position description click here. Applications close 9.00am Friday 16 October 2020.

NSW – Narooma – Katungul Aboriginal Corporation Regional Health and Community Services

FT Systems Analyst

Katungul Aboriginal Corporation Regional Health and Community Services has a vacancy for a Systems Analyst. The focus of the role is to oversee the implementation, maintenance and upgrading of information technology systems to support the delivery of Katungul’s range of services and for related research, analysis and performance reporting functions. The Systems Analyst will be an integral member of a collaborative team that works closely with Katungul’s service areas to deliver the best outcomes for the community.

To view the position description click here. Applications close 5.00 pm Friday 16 October 2020.Katungul Log

 

Aboriginal hand with cannula on edge of hospital bed

NACCHO Aboriginal Health News: AMA says COVID-19 shows a need to reset health spending

COVID-19 shows a need to reset health spending

According to AMA President, Dr Omar Khorshid, Australia needs to reset it attitude to health expenditure, with a fundamental reassessment of the priority put on real increases to health spending. “The COVID-19 pandemic has challenged us to rethink many of our assumptions about the functioning of society. Absolutely fundamental to this is our understanding of what a health system that is fit for purpose looks like,” Dr Khorshid said. “The pandemic has shown the strains on so many parts of our health system, particularly aged care, mental health, and protections for our frontline healthcare workers, as well as the need to keep this deadly virus out of our Indigenous communities. There can be no avoiding it. A serious investment in health with a substantial real increase in spending is required.”

To view the AMA’s media release click here.

Sunrise Health Service worker checking heart of patient

Barunga Healthcare worker Desleigh Shields. Image Source: ABC News website.

Diagnosing otitis media with telehealth

Each year 650,000 Australian children suffer from recurrent or chronic ear infections called otitis media (OM). OM can cause permanent hearing loss but is entirely preventable when treated early. Aboriginal children are disproportionately impacted by middle ear disease with OM affecting one in four children in Australia – but one in every two Aboriginal children. The current average wait time of two years for assessment is too long for children who are in crucial key stages of language, behavioural and educational development. Struggling to understand what is happening to them, many may face long-term social or mental health impacts.

Paediatric audiologist Dr Chris Brennan-Jones is committed to finding solutions for ear health – like changing assessment wait times from two years to 10 days. Dr Bennan-Jones is working with an ear health partnership in metro Perth called Djaalinj Waakinj – ‘Listening, Talking’ in Noongar language. In a program that is the first of its kind in Australia Djaalinj Waakinj fuses telehealth technology with support from local Aboriginal health workers to facilitate remote diagnosis of OM.

To view the full article click here.

Dr Chris Brennan-Jones sitting outside with laptop

Dr Chris Brennan-Jones. Image source: Particle website.

Puggy Hunter Memorial Health scholarships

Aboriginal and Torres Strait Islander students studying, or intending to study, entry-level health courses could receive life changing financial assistance to follow their passion thanks to the Puggy Hunter Memorial Scholarship Scheme (PHMSS). The PHMSS is designed to encourage and assist undergraduate students in health-related disciplines to complete their studies and join the health workforce. The Australian Government established the Scheme as a tribute to the late Dr Arnold ‘Puggy’ Hunter’s outstanding contribution to Indigenous Australians’ health and his role and Chair of the NACCHO.

To read the full article about the PHMSS in the National Indigenous Times click here.

Applications for the PHMSS are now open and will close on Sunday 8 November 2020. For more information click here.

portrait of Ashleigh Ryan PHMSS recipient

PHMSS recipient Ashleigh Ryan. Image source: Australian College of Nursing website.

NCCRED Clinical Research Scholarship Program

The National Centre for Clinical Research on Emerging Drugs (NCCRED) has developed a Clinical Research Scholarship Program to build the scope and capacity of clinical research on emerging drugs across the drug and alcohol sector. This is a national program open to clinicians at all levels, anywhere in Australia. NCCRED is opening TWO new competitive rounds which will give financial and research support allowing recipients to conduct a new research project. The rounds will have a focus on the following areas:

  • Practicing Aboriginal and Torres Strait Islander health professionals (clinicians, nurses, allied health workers) in the AOD sector.
  • nursing and allied health professionals preferably practicing alcohol and other drugs nurses and allied health professionals, though applications are open to all clinicians working within the AOD sector.

For more information about the NCCRED scholarship program click here. 

Applications are now open and close on 6 November 2020.

Aboriginal health professional sitting in from of Aboriginal D&A banner

Image source: ABC News website.

National COVID-19 Clinical Evidence Taskforce Communique

You can read the full National COVID-19 Clinical Evidence Taskforce Communique #25 here.

National COVID-19 Clinical Evidence Taskforce logo

Image source: National COVID-19 Clinical Evidence Taskforce website.

COVID-19 transmission in educational settings

Since March 2020, the National Centre for Immunisation Research and Surveillance (NCIRS) has joined forces with the NSW Ministry of Health and NSW Department of Education to investigate COVID-19 cases in schools and early childhood education and care (ECEC) services.

You can view the webinar Learning together – Transmission of SARS-CoV-2 in NSW educational settings covering COVID-19 transmission in NSW educational settings, what the latest data show and how a multi-disciplinary approach has helped people learn together by clicking here.

Nawarddeken Academy school - 14 Aboriginal students sitting at a table

Nawarddeken Academy school. Image source: The Conversation website.

Melbourne workers of concern to Tennant Creek health groups 

Up to 10 gas pipeline workers from a coronavirus hotspot have begun quarantining in a Tennant Creek hotel under a Government-approved plan that Indigenous health groups are demanding be shared with them. The group from Melbourne has also been given permission to leave the hotel under an arrangement organised for maintenance work on Jemena’s Northern Gas Pipeline, which runs from Tennant Creek to Mt Isa. The vast majority of people arriving in the NT from coronavirus hotspots are ordered into a fortnight of supervised quarantine at designated facilities in Darwin or Alice Springs at a cost of $2,500.

Indigenous health groups are concerned the alternative arrangement risks coronavirus spreading to Tennant Creek’s majority Indigenous population and that of nearby communities. Barb Shaw from Anyinginyi Health, the region’s major Indigenous health service, said she had requested to see the company’s COVID-19 management plan early last week but never heard back.

To read the full ABC News story click here.

portrait of Anyinginyi Health CEO Barb Shaw

Anyinginyi Health CEO Barb Shaw. Image source: ABC News.

Keep Our Mob Safe from COVID-19

The latest update on COVID-19 for Aboriginal and Torres Strait Islander households, communities and organisations is available click here. Things can change quickly so it is important to stay up to date.

Keep Our Mob Safe, Stop The Spread banner

Image source: Australian Government Department of Health.

2021 seasonal influenza preparation required

During 2020 there was a significant demand for seasonal influenza vaccines in light of the evolving COVID-19 pandemic. It is anticipated that this demand is likely to continue and also be evident for future seasons. To this end, the Commonwealth Chief Medical Officer is encouraging key stakeholders to turn their minds to their preparations for next year’s season. To view the Commonwealth Chief Medical Officer’s letter to stakeholders click here.

text flu season syringe inserted in vial

Image source: 1011 Now News website.

PBS changes a win for palliative care

The Australian Medical Association (AMA) welcomes much needed improvements to the Pharmaceutical Benefits Scheme (PBS) listings for opioids, which will clarify their important role in alleviating suffering for palliative care patients. AMA President Dr Omar Khorshid said the Association supported important reforms to reduce the inappropriate use of opioids in Australia. Dr Khorshid said the original PBS changes implemented on 1 June 2020 caused significant confusion and concern from prescribers and their patients, unintentionally making prescriber access to opioids more difficult for palliative care patients with a legitimate clinical need. This was particularly difficult for non-cancer palliative care patients.

The AMA has been advocating to the Department of Health and the Therapeutic Goods Administration, providing feedback from AMA members on the 1 June 2020 changes. “The Pharmaceutical Benefits Advisory Committee (PBAC) has reflected this feedback in the 1 October 2020 PBS listing changes, so it’s pleasing that the vital advocacy work of the AMA has been heeded,” Dr Khorshid said. “Patients will be exempt from the 12-month pain management review by a second doctor or palliative care nurse practitioner if their clinical condition makes the review not possible. “This is an important change for palliative care patients who may be too unwell for this to occur.”

To view the AMS’s media release click here.

Aboriginal man with arms around Aboriginal woman looking out across river in Australian landscape

Image source: Palliative Care Victoria.

Social enterprise to tackle remote NT food inequities

An urgent food crisis is threatening remote Aboriginal communities across the country, with an estimated 1.2 million Australians unable to regularly access culturally appropriate, safe and nutritious food from a non-emergency source. Kere to Country, a new First Nations-led social enterprise, hopes they can make a difference, starting in Alice Springs/Mparntwe. Kere means ‘food from animals’ in Arrernte.

Three young Indigenous entrepreneurs—Jessica Wishart, 31, Jordan Wishart, 25, and Tommy Hicks, 24 (pictured below) —were inspired to do something about the crisis after visiting Alice Springs/Mparntwe. The trio saw Aboriginal communities couldn’t afford essential products that were necessary to keep their families healthy and safe. “It’s an urgent crisis—one that has been going on for a really long time, but it’s gotten worse since the pandemic,” CEO Jessica Wishart said.

The concept is simple: Kere to Country will provide remote communities with access to meat through bulk purchases or smaller packs. Aiming to eventually expand to all of central Australia, the team will distribute packs to Alice Springs/Mparntwe, both in and out of town, and the Tennant Creek region.

To visit the Kere to Country website click here.

Kere to Country entrepreneurs Jessica Wishart, Jordan Wishart, Tommy Hicks

Kere to Country entrepreneurs Jessica Wishart, Jordan Wishart, Tommy Hicks. Image source: National Indigenous Times.

Palkyu descendent 2020 Australia Mental Health prize finalist

Professor Helen Milroy is one of seven finalists in the running for the 2020 Australia Mental Health prize. The Prize, now in its fifth year, recognises Australians who have made outstanding contributions to the promotion of mental health or the prevention and treatment of mental illness.

Professor Milroy is recognised as the first Indigenous Australian to become a medical doctor, completing medical studies and specialist training in child and adolescent psychiatry. She is passionate about combining Aboriginal and western knowledge systems to improve outcomes. Her work and research in the areas of holistic medicine, child mental health, recovery from trauma and grief, application of Indigenous knowledge, and cultural models of care have made a significant difference to the lives of children and young people, particularly those with a trauma background. Her efforts in developing and supporting the Aboriginal medical workforce and cultural safety in health and mental health through curriculum development, education and training, implementation and evaluation, has had a lasting impact on Aboriginal health and mental health across Australia.

To view the full article about the 2020 Australia Mental Health prize finalists click here.

portrait of Professor Helen Milroy

Professor Helen Milroy. Image source: AusDoc website.

Breast cancer survivor fears many others won’t

Breast cancer is still the most commonly diagnosed cancer in Aboriginal and Torres Strait Islander women, but what’s more concerning is that not a lot of these women survive. It’s a hidden disease that shows no symptoms until it has developed into a lump some time down the track.

Aunty Joy was diagnosed with stage 4 breast cancer at the age of 48. She had a single mastectomy and says “I am a survivor and still a sufferer. Around the time of my diagnosis, there were no radiographers where I was. But if I had waited, who knows what the end result would’ve been? I went through the experience alone and it was traumatic, something that I don’t want to see other Aboriginal or Torres Strait Islander women go through. Every two weeks I would take myself to chemotherapy, the most grueling and horrible experience with side effects that were harrowing.”

portrait photo of Aunty Joy

Aunty Joy. Image source: MamaMia website.

To read the full article about Aunty Joy’s breast cancer journey click here.

ACT – Canberra

Social Media Communications Coordinator

NACCHO is seeking a Social Media Communication Coordinator to manage and maintain NACCHO’s social media presence and daily blog. The position requires working cohesively with the NACCHO Communications team towards the creation and delivery of social media campaigns and driving key Aboriginal and Torres Strait Islander health sector new content across channels. To view details of the position click here.

Applications close at 9.00 am Friday 16 October 2020.

AFL Indigenous All Stars coach Michael O'Loughlin with the “Aboriginal Health in Aboriginal Hands” app

AFL Indigenous All Stars coach Michael O’Loughlin with the “Aboriginal Health in Aboriginal Hands” app. Image source: Australian Government NIAA website.

NACCHO Aboriginal Health Resources Alert : NACCHO and @RACGP are pleased to launch the Aboriginal and Torres Strait Islander #715health assessment templates.

With support from the Department of Health, NACCHO and RACGP established a working group in 2019 to review and update Aboriginal and Torres Strait Islander annual health check templates.

Throughout 2020 we will be testing these templates for operability in a range of services.

We are keen to hear your feedback and will be conducting a survey later in the year.

A key recommendation was to update elements to better reflect age-appropriate health needs. This resulted in five new templates that span the life course:

  1. Infants and preschool (birth-5 years)  PDF  RTF
  2. Primary school age (5-12 years) PDF  RTF
  3. Adolescents and young people (12-24 years) PDF  RTF
  4. Adults (25-49 years) PDF  RTF
  5. Older people (50+ years) PDF  RTF

These are example health check templates that include recommended core elements.

The criteria for inclusion can be accessed in our template development information pack.

Adaptation of these templates to local needs and priorities is encouraged, with reference to current Australian preventive health guidelines that are culturally and clinically suitable to Aboriginal and Torres Strait Islander needs.

These templates are not intended to promote a tick box approach to healthcare, but rather to prompt clinicians to consider patient priorities, opportunities for preventive healthcare and common health needs.

As the Partnership Project continues, we are exploring opportunities for integration of health check activities into clinical software.

We are also interested to hear about your experiences of providing health checks via telehealth.

Contact aboriginalhealth@racgp.org.au to understand more or contribute your ideas and experiences.

Understand the purpose of the health check is to:

  • support initial and ongoing engagement in comprehensive primary healthcare in a culturally safe way
  • provide evidence-based health information, risk assessment and other services for primary and secondary disease prevention
  • identify health needs, including patient health goals and priorities
  • support participation in population health programs (eg immunisation, cancer screening), chronic disease management and other primary care services (eg oral health )

Know that a high-quality health check is:

  • a positive experience for the patient that is respectful and culturally safe
  • provided with a patient, not to a patient
  • useful to the patient and includes patient priorities and goals in health assessment and planning
  • supports patient agency
  • provided by the usual healthcare provider in the context of established relationship and trust
  • provided by a multidisciplinary team that includes Aboriginal and/or Torres Strait Islander clinicians
  • evidence-based as per current Australian preventive health guidelines that are generally accepted in primary care practice (eg National Aboriginal Community Controlled Health Organisation [NACCHO]–Royal Australian College of General Practitioners [RACGP] National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people, Central Australian Rural Practitioner’s Association [CARPA] Standard Treatment Manual, etc)
  • provided with enough time (usually 30–60 minutes, with a minimum of 15 minutes with the GP) and often completed over several consultations
  • followed up with care of identified health needs (ie continuity of care).

Make sure your practice is providing health checks that are acceptable and valuable to patients by:

  • identifying Aboriginal and Torres Strait Islander patients in a welcoming, hospitable manner
  • explaining the purpose and process of the health check and obtaining consent
  • enquiring about patient priorities and goals
  • adapting the health check content to what is relevant and appropriate to the patient
  • asking questions in ways that acknowledge strengths, that are sensitive to individual circumstances and that avoid cultural stereotyping
  • completing the health check and identifying health needs
  • making a plan for follow-up of identified health needs in partnership with the patient
  • making follow-up appointments at the time of the health check, where possible
  • considering checking in with the patient about their experience of the health check, in order to support patient engagement and quality

Potential pitfalls of health checks:

  • A poor health check can lead to non- or dis-engagement in healthcare and has the potential to do harm – establish engagement and trust
  • Health checks can have highly variable content and quality
  • use endorsed high-quality templates
  • Increasing the number of health checks without a focus on quality may undermine benefit for patients – avoid quantity over quality
  • Health checks are not proxy for all preventive healthcare – they are one activity in the range of health promotion and disease-prevention activities in primary care
  • No follow-up will have no or minimal impact on improving health outcomes – follow up identified health needs
  • Cultural stereotyping – acknowledge the health impacts of racism and build a culturally safe practice

 

NACCHO Aboriginal Health Pre- #Budget2019 -2020 : #RefreshTheCTGRefresh :The following #ClosingTheGap policy proposals are informed by NACCHO’s consultations with its Affiliates and our 145 Aboriginal Community Controlled Health Services:

 

The proposals included in this submission are based on the extensive experience NACCHO member services have of providing many years of comprehensive primary health care to Aboriginal and Torres Strait Islander peoples.

We have long recognised that closing the gap on Aboriginal and Torres Strait Islander health and disadvantage will never be achieved until primary health care services’ infrastructure hardware is fit for purpose; our people are living in safe and secure housing; culturally safe and trusted early intervention services are available for our children and their families; and our psychological, social, emotional and spiritual needs are acknowledged and supported.=

If these proposals are adopted, fully funded and implemented, they provide a pathway forward where improvements in life expectancy can be confidently predicted. “  

Pat Turner AM NACCHO CEO on behalf of our State and Territory Affiliates and 145 Aboriginal Community Controlled Health Services operating 302 ACCHO Clinics

Download this 20 Page NACCHO Submission

NACCHO Budget Submission 2019-20 FINAL

NACCHO is the national peak body representing 145 ACCHOs across the country on Aboriginal health and wellbeing issues.

In 1997, the Federal Government funded NACCHO to establish a Secretariat in Canberra, greatly increasing the capacity of Aboriginal peoples involved in ACCHOs to participate in national health policy development. Our members provide about three million episodes of care per year for about 350,000 people. In very remote areas, our services provide about one million episodes of care in a twelve-month period.

Collectively, we employ about 6,000 staff (56 per cent whom are Indigenous), which makes us the single largest employer of Indigenous people in the country.

The following policy proposals are informed by NACCHO’s consultations with its Affiliates and Aboriginal Community Controlled Health Services:

  1. Increase base funding of Aboriginal Community Controlled Health Services;
  2. Increase funding for capital works and infrastructure;
  3. Improve Aboriginal and Torres Strait Islander housing and community infrastructure;
  4. Reduce the overrepresentation of Aboriginal and Torres Strait Islander children and young people in out-of-home care and detention; and
  5. Strengthen the Mental Health and Social and Emotional Wellbeing of Aboriginal and Torres Strait Islander peoples.

NACCHO is committed to working with the Australian Government to further develop the proposals, including associated costings and implementation plans and identifying where current expenditure could be more appropriately targeted.

1. Increase base funding of Aboriginal Community Controlled Health Services

Proposal:

That the Australian Government:

  • Commits to increasing the baseline funding for Aboriginal Community Controlled Health Services to support the sustainable delivery of high quality, comprehensive primary health care services to Aboriginal and Torres Strait Islander people and communities.
  • Works together with NACCHO and Affiliates to agree to a new formula for the provision of comprehensive primary health care funding that is relative to need.

Rationale: 

The Productivity Commission’s 2017 Indigenous Expenditure Report found that per capita government spending on Indigenous services was twice as high as for the rest of the population. The view that enormous amounts of money have been spent on Indigenous Affairs has led many to conclude a different focus is required and that money is not the answer. Yet, the key question in understanding the relativities of expenditure on Indigenous is equity of total expenditure, both public and private and in relation to need.

The Commonwealth Government spends $1.4 for every $1 spent on the rest of the population, while Aboriginal and Torres Strait Islander people have 2.3 times the per capita need of the rest of the population because of much higher levels of illness and burden of disease. In its 2018 Report Card on Indigenous Health, the Australian Medical Association (AMA) states that spending less per capita on those with worse health, is ‘untenable national policy and that must be rectified’.1 The AMA also adds that long-term failure to adequately fund primary health care – especially Aboriginal Community Controlled Health Services (ACCHSs) – is a major contributing factor to failure in closing health and life expectancy gaps.

Despite the challenges of delivering services in fragmented and insufficient funding environments, studies have shown that ACCHSs deliver more cost-effective, equitable and effective primary health care services to Aboriginal and Torres Strait Islander peoples and are 23 per cent better at attracting and retaining Aboriginal and Torres Strait Islander clients than mainstream providers.2 ACCHSs continue to specialise in providing comprehensive primary care consistent with clients’ needs.

This includes home and site visits; provision of medical, public health and health promotion services; allied health, nursing services; assistance with making appointments and transport; help accessing child care or dealing with the justice system; drug and alcohol services; and providing help with income support.

                                                        

1https://ama.com.au/system/tdf/documents/2018%20AMA%20Report%20Card%20on%20Indigenous%20Heal th_1.pdf?file=1&type=node&id=49617, page 6.

2 Ong, Katherine S, Rob Carter, Margaret Kelaher, and Ian Anderson. 2012. Differences in Primary Health Care

Delivery to Australia’s Indigenous Population: A Template for Use in Economic Evaluations, BMC Health

Services Research 12:307; Campbell, Megan Ann, Jennifer Hunt, David J Scrimgeour, Maureen Davey and

Victoria Jones. 2017. Contribution of Aboriginal Community Controlled Health Services to improving Aboriginal

There are limits, however, to the extent that ACCHSs can continue to deliver quality, safe primary health care in fragmented and insufficient funding environments. This is particularly challenging to meet the health care needs of a fast-growing population.3 There is an urgent need to identify and fill the current health service gaps, particularly in primary health care, and with a focus on areas with high preventable hospital admissions and deaths and low use of the Medical Benefits Scheme and the Pharmaceutical Benefits Scheme.

An appropriately resourced Aboriginal Community Controlled Health sector represents an evidence-based, cost-effective and efficient solution for addressing the COAG Close the Gap and strategy and will result in gains for Aboriginal and Torres Strait Islander peoples’ health and wellbeing.

Strengthening the workforce

NACCHO welcomes COAG’s support for a National Aboriginal and Torres Strait Islander Health and Medical Workforce Plan. A long-term plan for building the workforce capabilities of ACCHSs is overdue. Many services struggle with the recruitment and retention of suitably qualified staff, and there are gaps in the number of professionals working in the sector.

NACCHO believes that the plan will be strengthened by expanding its scope to include:

  • metropolitan based services;
  • expanding the range of workforce beyond doctors and nurses; and
  • recognising that non-Indigenous staff comprise almost half of the workforce. While Aboriginal and Torres Strait Islander health staff are critical to improving access to culturally appropriate care and Indigenous health outcomes, consideration to the non-Indigenous workforce who contribute to improving Aboriginal and Torres Strait Islander Health outcomes should also be given.

An increase in the baseline funding for Aboriginal Community Controlled Health Services, as set out in this proposal will enable our sector to plan for and build workforce capabilities in line with the Health and Medical Workforce Plan objectives.

2. Increase funding for capital works and infrastructure upgrades

Proposal:

That the Australian Government:

  • Commits to increasing funding allocated through the Indigenous Australians’ Health Programme for capital works and infrastructure upgrades, and  Telehealth services; noting that at least $500m is likely to be needed to address unmet needs, based on the estimations of 38.6 per cent of the ACCHO sector, and we anticipate that those needs may be replicated across the sector (see Table A below).

Rationale: 

There is a current shortfall in infrastructure with a need for new buildings in existing and outreach locations, and renovations to increase amenities including consultation spaces. Additional funding is required for additional rooms and clinics mapped against areas of highest need with consideration to establishing satellite, outreach or permanent ACCHSs.

Many of the Aboriginal health clinics are 20 to 40 years old and require major refurbishment, capital works and updating to meet increasing population and patient numbers. The lack of consulting rooms and derelict infrastructure severely limits our services’ ability to increase MBS access.

Further, whilst there may be some scope to increase MBS billing rates for Aboriginal and Torres Strait Islander peoples, this cannot be achieved without new services and infrastructure. A vital priority is seed funding for the provision of satellite and outreach Aboriginal Community Controlled Health Services that Aboriginal and Torres Strait Islander people will access, and which provide the comprehensive services needed to fill the service gaps, to boost the use of MBS and PBS services to more equitable levels, and to reduce preventable admissions and deaths.

Improvements to the building infrastructure of ACCHSs are required to strengthen their capacity to address gaps in service provision, attract and retain clinical staff, and support the safety and accessibility of clinics and residential staff facilities. However, the level of funding of $15m per annum, under the Indigenous Australians’ Health Programme allocated for Capital Works – Infrastructure, Support and Assessment and Service Maintenance, is not keeping up with demand.

In our consultations with Affiliates and ACCHSs, NACCHO is increasingly hearing that

Telehealth services,[1] including infrastructure/hardware and improved connectivity, is required to support the provision of NDIS, mental health and health specialist services. A total of 22 out of 56 survey responses (see Table A below) identified the need for Telehealth to support service provision.

NACCHO believes that insufficient funding to meet capital works and infrastructure needs is adversely impacting the capacity of some ACCHSs to safely deliver comprehensive, timely and responsive primary health care; employ sufficient staff; to improve their uptake of Medicare billing; and to keep up with their accreditation requirements. In January 2019, we surveyed ACCHSs about their capital works and infrastructure needs, including Telehealth services. We received 56 responses, representing a response rate of 38.6 per cent.

 

Survey respondents estimated the total costs of identified capital works and infrastructure upgrades (see Table A below). The estimated costs have not been verified; however, they do

suggest there is a great level of unmet need in the sector. Please note that not all respondents were able to provide estimates.

Table A. Estimated costs of capital works and infrastructure upgrades identified by ACCHSs

Type Number of respondents Percentage of respondents Total estimated costs
Replace existing building 43 76.7% 207,559,043
New location/satellite clinic 21 37.5% 53,480,000
Extension 24 42.8% 18,310,000
Refurbishment 29 51.7% 35,251,000
Staff accommodation 25 44.6% 39,450,000
Telehealth services 22 39.2% 6,018,763
Total estimated costs of capital works and infrastructure upgrades $361,068,806

 

37 survey respondents applied for funding for infrastructure improvements from the Australian Government Department of Health during 2017 and/or 2018. Of the 11 that were successful, four respondents stated that the allocated funds were not sufficient for requirements.

ACCHSs believe that the current state of their service infrastructure impedes the capacity of their services as depicted in Table B, below:

Table B: Impact of ACCHSs’ infrastructure needs on service delivery

Infrastructure impeding service delivery Highly affected Somewhat affected
Safe delivery of quality health care 48.1% 51.9%
Increase client numbers 74.1% 25.9%
Expand the range of services and staff numbers 83.3% 16.7%
Increase Medicare billing 66% 34%

 

An extract of feedback provided by ACCHSs relating to their capital works and infrastructure needs is at Appendix A.

3. Improve Aboriginal and Torres Strait Islander housing and community infrastructure

Proposals:

That the Australian Government:

  • Expand the funding and timeframe of the current National Partnership on Remote Housing to match AT LEAST that of the former National Partnership Agreement on Remote Indigenous Housing.
  • Establish and fund a program that supports healthy living environments in urban, regional and remote Aboriginal and Torres Strait Islander communities, similar to the Fixing Houses for Better Health program. Ensure that rigorous data collection and program evaluation structures are developed and built into the program, to provide the Commonwealth Government with information to enable analysis of how housing improvements impact on health indicators.[2]
  • Update and promote the National Indigenous Housing Guide, a best practice resource for the design, construction and maintenance of housing for Aboriginal and Torres Strait Islander peoples.[3]

Rationale: 

Safe and decent housing is one of the biggest social determinants of health and we cannot overlook this when working to close the gap in life expectancy.

1. Remote Indigenous Housing

The National Partnership Agreement on Remote Indigenous Housing 2008-2018 was a COAG initiative that committed funding of $5.4b towards new builds, refurbishments, housing quality, cyclical maintenance, and community engagement and employment and business initiatives.

In 2016, the National Partnership Agreement on Remote Indigenous Housing was replaced by the National Partnership on Remote Housing. Under this new partnership, the Commonwealth Government committed:

  • $776.403m in 2016, to support remote housing in the Northern Territory, Queensland, South Australia, Western Australia, and the Northern Territory over a two-year period; and
  • $550m in 2018, to support remote housing in the Northern Territory, over a five-year period.

New South Wales, Victoria and Tasmania are not part of discussions with the Commonwealth Government on housing needs.

A review of the National Partnership Agreement on Remote Indigenous Housing (2018) found that:

  • An additional 5,500 homes are required by 2028 to reduce levels of overcrowding in remote areas to acceptable levels
  • A planned cyclic maintenance program, with a focus on health-related hardware and houses functioning, is required.
  • Systematic property and tenancy management needs to be faster.
  • More effort is required to mobilise the local workforces to do repairs and maintenance work.[4]

There is currently a disconnect between the levels of government investment into remote housing and the identified housing needs of remote communities. This disconnect is increasingly exacerbated by population increases in Aboriginal communities.[5]

There is a comprehensive, evidence-based literature which investigates the powerful links between housing and health, education and employment outcomes.[6] Healthy living conditions are the basis from which Closing the Gap objectives may be achieved. Commonwealth Government leadership is urgently needed to appropriately invest into remote housing.

2.Environmental health

The importance of environmental health to health outcomes is well established. A healthy living environment with adequate housing supports not only the health of individuals and families; it also enhances educational achievements, community safety and economic participation.10

Commonwealth and State and Territory Governments have a shared responsibility for housing. Overcrowding is a key contributor to poor health of Aboriginal and Torres Strait Islander peoples. In addition to overcrowding, poor and derelict health hardware (including water, sewerage, electricity) leads to the spread of preventable diseases for Aboriginal and Torres Strait Islander peoples. Healthy homes are vital to ensuring that preventable diseases that have been eradicated in most countries do not exist in Aboriginal and Torres Strait Islander communities and homes.

4. Reduce the overrepresentation of Aboriginal and Torres Strait Islander children and young people in out-of-home care and detention

Proposals:

That the Australian Government:

  • Establishes an additional elective within the existing Aboriginal Health Worker curriculum, that provides students with early childhood outreach, preventative health care and parenting support skills
  • Waives the upfront fees of the first 100 Indigenous students to undertake the Aboriginal Health Worker (Early Childhood stream) Certificate IV course.
  • Funds an additional 145 Aboriginal Health Worker (early childhood) places across ACCHSs.

Rationale:

The overrepresentation of Aboriginal and Torres Strait Islander children and young people in the child protection system is one of the most pressing human rights challenges facing Australia today.[7]

Young people placed in out-of-home care are 16 times more likely than the equivalent general population to be under youth justice supervision in the same year.[8]

Government investment in early childhood is an urgent priority to reduce the overrepresentation of Aboriginal and Torres Strait Islander children in out of home care and youth detention. Research reveals that almost half of the Aboriginal and Torres Strait Islander children who are placed to out of home care are removed by the age of four[9] and, secondly, demonstrates the strong link between children and young people in detention who have both current and/or previous experiences of out of home care.[10] There is also compelling evidence of the impact of repetitive, prolonged trauma on children and young people and how, if left untreated, this may lead to mental health and substance use disorders, and intergenerational experiences of out-of-home care and exposure to the criminal justice system.15

Despite previous investments by governments, the Aboriginal and Torres Strait Islander children and young people remain overrepresented in the children protection and youth detention systems. The Council of Australian Governments (COAG) Protecting Children is Everyone’s Business National Framework for Protecting Australia’s Children 2009–2020 (‘National Framework’) was established to develop a unified approach for protecting children. It recognises that ‘Australia needs a shared agenda for change, with national leadership and a common goal’.

One of the six outcomes of the National Framework is that Aboriginal and Torres Strait Islander children are supported and safe in their families and communities, with this overarching goal:

Indigenous children are supported and safe in strong, thriving families and communities to reduce the over-representation of Indigenous children in child protection systems. For those Indigenous children in child protection systems, culturally appropriate care and support is provided to enhance their wellbeing.16

Findings presented in the 2018 Family Matters Report reveal, however, that the aims and objectives of the National Framework have failed to protect Aboriginal and Torres Strait Islander children:

Aboriginal and Torres Strait Islander children make up just over 36 per cent of all children living in out-of-home care; the rate of Aboriginal and Torres Strait Islander children in out-ofhome care is 10.1 times that of other children, and disproportionate representation continues to grow (Australian Institute of Health and Welfare [AIHW], 2018b). Since the last Family Matters Report over-representation in out-of-home care has either increased or remained the same in every state and territory.17

Furthermore, statistics on the incarceration of Aboriginal and Torres Strait Islander children and young people in detention facilities reveal alarmingly high trends of overrepresentation:

  • On an average night in the June quarter 2018, nearly 3 in 5 (59%) young people aged 10– 17 in detention were Aboriginal and Torres Strait Islander, despite Aboriginal and Torres Strait Islander young people making up only 5% of the general population aged 10–17.
  • Indigenous young people aged 10–17 were 26 times as likely as non-Indigenous young people to be in detention on an average night.
  • A higher proportion of Indigenous young people in detention were aged 10–17 than non-Indigenous young people—in the June quarter 2018, 92% of Aboriginal and Torres

Strait Islander young people in detention were aged 10–17, compared with 74% of non-

Indigenous Islander young people.18

towardtraumainfo/Orygen_trauma_and_young_people_policy_report.aspx?ext=.; https://www.facs.nsw.gov.au/__data/assets/pdf_file/0016/421531/FACS_SAR.pdf

NACCHO believes an adequately funded, culturally safe, preventative response is needed to reduce the number and proportion of Aboriginal and Torres Strait Islander children in child protection and youth detention systems. It is vital that Aboriginal and Torres Strait Islander families who are struggling with chronic, complex and challenging circumstances are able to access culturally appropriate, holistic, preventative services with trusted service providers that have expertise in working with whole families affected by intergenerational trauma. The child protection and justice literature are united in that best practice principles for developing solutions to these preventable problems begin with self-determination, community control, cultural safety and a holistic response.[11] For these reasons, we are proposing that the new Aboriginal Health Worker (Early Childhood) be based within the service setting of the Aboriginal Community Controlled Health Service.

The cultural safety in which ACCHSs’ services are delivered is a key factor in their success. ACCHSs have expert understanding and knowledge of the interplays between intergenerational trauma, the social determinants of health, family violence, and institutional racism, and the risks these contributing factors carry in increasing Aboriginal and Torres Strait Islander peoples’ exposure to the child protection and criminal justice systems.

Our services have developed trauma informed care responses that acknowledge historical and contemporary experiences of colonisation, dispossession and discrimination and build this knowledge into service delivery.

Further, they are staffed by health and medical professionals who understand the importance of providing a comprehensive health service, including the vital importance of regular screening and treatment for infants and children aged 0-4, and providing at risk families with early support. Within the principles, values and beliefs of the Aboriginal community controlled service model lay the groundwork for children’s better health, education, and employment outcomes. The addition of Aboriginal Health Workers with early childhood skills and training will provide an important, much needed role in preventing and reducing Aboriginal and Torres Strait Islander children and young peoples’ exposure to child protection and criminal justice systems.

 

Aboriginal Peak Organisations of the Northern Territory, Submission to the Royal  

Commission into the Protection and Detention of Children in the Northern Territory, 2017

NACCHO supports the position and recommendations of Aboriginal Peak Organisations in the NT, that:

•        Aboriginal community control, empowerment and a trauma informed approach should underpin the delivery of all services to Aboriginal children and their families. This applies to service design and delivery across areas including early childhood, education, health, housing, welfare, prevention of substance misuse, family violence prevention, policing, child protection and youth justice.

•        The Australian Government develops and implements a comprehensive, adequately resourced national strategy and target, developed in partnership with Aboriginal and Torres Strait Islander peoples, to eliminate the over-representation of Aboriginal and Torres Strait Islander children in out-of-home care.

•        There is an urgent need for a child-centred, trauma-informed and culturally relevant approach to youth justice proceedings which ultimately seeks to altogether remove the need for the detention of children.

•        Early childhood programs and related clinical and public health services are provided equitably to all Aboriginal children (across the NT) through the development and implementation of a three-tiered model of family health care – universal, targeted and indicated – to meet children’s needs from before birth to school age. Services should be provided across eight key areas:  o quality antenatal and postnatal care;

o clinical and public health services for children and families; o a nurse home visiting program; o parenting programs; o child development programs; o two years of preschool; o targeted services for vulnerable children and families; and o supportive social determinants policies.

•        These services need to be responsive to, and driven by, the community at a local level.

5. Strengthen the mental health and social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples

Proposal:

That the Australian Government:

  • Provide secure and long-term funding to ACCHSs to expand their mental health, social and emotional wellbeing, suicide prevention, alcohol and other drugs services, using best practice trauma informed approaches.
  • Urgently increase funding for ACCHSs to employ staff to deliver mental health and social and emotional wellbeing services, including psychologists, psychiatrists, speech pathologists, mental health workers and other professionals and workers; and
  • Urgently increase the delivery of training to Aboriginal health practitioners to establish and/or consolidate skills development in mental health care and support, including suicide prevention; and
  • Return funding for Aboriginal and Torres Strait Islander suicide prevention, health and wellbeing and alcohol and other drugs from the Indigenous Advancement Strategy to the Indigenous Australians’ Health Programme.

Rationale: 

The Australian Institute of Health and Welfare has estimated that mental health and substance use are the biggest contributors to the overall burden of disease for Aboriginal and Torres Strait Islander peoples. Indigenous adults are 2.7 times more likely to experience high or very high levels of psychological distress than other Australians.[12] They are also hospitalised for mental and behavioural disorders and suicide at almost twice the rate of non-Indigenous population and are missing out on much needed mental health services.

Suicide is the leading cause of death for Aboriginal people aged 5-34 years, the second leading cause of death for Aboriginal and Torres Strait Islander men. In 2016, the rate of suicide for Aboriginal and Torres Strait Islander peoples was 24 per 100,000, twice the rate for non-Indigenous Australians.[13] Aboriginal people living in the Kimberley region are seven times more likely to suicide than non-Aboriginal people.

Many Aboriginal Community Controlled Health Services deliver culturally safe, trauma informed services in communities dealing with extreme social and economic disadvantage that are affected and compounded by intergenerational trauma and are supporting positive changes in the lives of their members. The case study provided by Derby Aboriginal Health Service demonstrates not only the impact that this ACCHS is having on its community. It also illustrates the rationale for each of the proposals described in this pre-budget submission.

Case Study: Derby Aboriginal Health Service, WA

Derby Aboriginal Health Service’s Social and Emotional Wellbeing Unit (SEWB) have partnered with another organisation to employ someone in our SEWB unit to work directly with families on issues that contribute to them losing their children to Department of Child Protection (DCP). This program is designed to help prevent the children from being removed by DCP by working one to one with families on issues such as budgeting, education, substance misuse, a safe and healthy home etc.

Our SEWB unit has a community engagement approach which involves working directly with clients and their families, counselling with the psychologist and mental health worker, the male Aboriginal Mental Health Worker taking men out on country trips as part of mental health activities for men, the youth at risk program (Shine), the Body Clinic, the prenatal program working directly with mums, dads and bubs around parenting, relationships between mums, dads and children etc. The team work directly with the community.

We are now introducing a new SEWB designed program into the Derby prison which focuses on exploring men and women’s strengths and abilities rather than looking at their deficits. Using a strengths based program was very successfully delivered with a group of 22 Aboriginal men and 16 Aboriginal women where, for many of the participants, they were told for the first time in their lives that they matter and that they have good things about them and they are strong men and women (this naturally brought in some behavior modification that they could attempt in making changes in their lives; e.g. one participant said that when he went home, he was going to make his wife a cup of tea instead of expecting her to make him tea – he said he had never thought of that before). The SEWB team presented this at the National Mental Health Conference in Adelaide, August last year.

Given the deep and respectful footprint the SEWB team has in the town and surrounding communities, they, and the people, deserve and need a new building in which to continue their important work. If we can help people deal with the issues above, then they will be much more empowered to prevent/deal with their own health issues – perhaps then we can Close the Gap.

Given the burden of mental, psychological distress and trauma that our communities are responding to and the impact this has on Aboriginal and Torres Strait Islander peoples’ life expectancy, educational outcomes, and workforce participation, NACCHO believes it is imperative that a funded implementation plan for the National Strategic Framework for Aboriginal and Torres Strait Islander Mental Health and Social and Emotional Wellbeing

2017-2023 (‘the Framework’) be developed as a priority. The following Action Areas of the Framework relate to this proposal:

  • Action Area 1 – Strengthen the foundations (An effective and empowered mental health and social and emotional wellbeing workforce);
  • Action Area 2 – Promote wellness (all outcome areas);[14] and
  • Action Area 4 – Provide care for people who are mildly or moderately ill (Aboriginal and Torres Strait Islander people living with a mild or moderate mental illness are able to access culturally and clinically appropriate primary mental health care according to need).

As the above case study suggests, our trusted local Aboriginal community controlled services are best placed to be the preferred providers of mental health, social and emotional wellbeing, and suicide prevention activities to their communities. Australian Government funding should be prioritised to on the ground Aboriginal services to deliver suicide prevention, trauma and other wellbeing services. Delivering these much-needed services through ACCHSs, rather than establishing a new service, would deliver economies of scale and would draw from an already demonstrated successful model of service delivery.

Further, NACCHO believes that the current artificial distinction between separating mental health, social and emotional wellbeing and alcohol and drug funding from primary health care funding, must be abolished. Primary health care, within the holistic health provision of ACCHS, provides the sound structure to address all aspects of health care arising from social, emotional and physical factors. Primary health care is a comprehensive approach to health in accordance with the Aboriginal holistic definition of health and arises out of the practical experience within the Aboriginal community itself having to provide effective and culturally appropriate health services to its communities.

The current artificial distinction, as exemplified by program funding for ACCHS activities being administered across two Australian Government Departments, does not support our definition of health and wellbeing. It also leads to inefficiencies and unnecessarily increases red tape, by imposing additional reporting burdens on a sector that is delivering services under challenging circumstances.     

APPENDIX A

Qualitative feedback from Aboriginal Community Controlled Health Services  capital works and infrastructure needs 

The following comments from ACCHSs have been extracted from a survey administered by NACCHO in January 2019:

  • Currently at capacity and as the government focusses more on Medicare earnings and less on funding we need the ability to expand into this area as well as the NDIS in order to meet our client service needs and build sustainability.
  • The facility that our service currently occupies is state government owned, on state crown land, is over 40 years old and is ‘sick’ – it is not fit for purpose with an irreparable roof, significant asbestos contamination, water ingress, mould and recurrent power outages. The maintenance costs are an unsustainable burden, it is unreliable, unsuitable and unsafe for clients and staff, and there is no room for expansion for program and community areas. We applied for funding from the Australian Government Department of Health, but the application was not successful. This figure is inclusive of early works transportable – temporary accommodation, building works, demolition works, services infrastructure, external works, design development contingency, construction contingency, builder preliminaries and margin, loose furniture and equipment, specialist/medical equipment, ICT & PABX, AV equipment, professional including.

disbursements (to be confirmed), statutory fees, locality loading, and goods and services tax.

  • We are in need of kitchen renovations to each of our community care sites that do meals on wheels. The WA Environmental Health unit has informed us that we need to upgrade all our kitchens to meet Food Safety requirements or they will enforce closure of some of our kitchens, which would then mean we are unable to do our Meals on Wheels service in some communities
  • Currently limited by space to employ support staff and increase our GP’s, our waiting room is around 3x4m and we are always having clients standing up or waiting outside until there is space for them. We currently have three buildings in the one township with two being rentals, if we could co-locate all services, we could offer a higher level of integrated care and save wasted money on rent.
  • Not currently enough space to house staff and visiting clinicians.
  • Have been applying for grants in infrastructure and included in Action Plan for quite a few years and still not successful.
  • We need a multi-purpose building to bring together our comprehensive range of services in a way that enables community to gather, express their culture and feel safe and welcome whilst receiving a fully integrated service delivery model of supports. We have more than doubled in staffing and program delivery and are still trying to operate out of the same space. The need for further expansion is inevitable and the co-operative welcomes the opportunity to bring more services to our community, but infrastructure

is a barrier and we have taken the strategic decision to acquire vacant land near our main headquarters with the view to obtaining future infrastructure funding – it is much needed.

  • The three sites we currently lease are all commercial premises and we have to make our business fit, the buildings are not culturally appropriate nor are they designed for a clinical setting.
  • For eight years we have struggled to grow in line with our community service needs and the requirement to become more self-sufficient in the face of a funding environment which is declining in real terms (not keeping pace with CPI and wages growth). Further to this, every time we add a building our running costs go up so even capital expansion comes at a cost to the organisation as it takes time to build up to the operating capacity that the new/improved buildings provide. This is the ongoing struggle in our space.
  • Our service was established in 1999 and has been operating from an 80 year old converted holiday house, with a couple of minor extensions. The clinic does not meet the contemporary set up for an efficient clinic from viewpoint of staff, medical services and for community members. Space is very limited, and service delivery is also limited due to room availability. Demand for services both for physical and mental health/SEWB is growing strongly. We have 425 Community Members (with 70 currently in prisons in our region) and our actual patient numbers accessing services over 12 months have increased 50%.
  • We never received support or funding to acquire a purpose-built facility from the outset and as there was no suitable accommodation for rent or lease, we acquired two small houses to deliver our services from. These were totally inadequate but all we could acquire at the time. We have 31 staff accommodated through three locations and require a purpose-built facility to deliver quality primary health care to our Community.
  • Over the last two years we have been able to purchase the site it is currently located on. This site is based on five contiguous residential properties, with each property containing a 2-3 bedroom, approximately 40 year old house. Two of these houses have been joined together to form the Medical Clinic, the other three houses have all been renovated and upgraded to various levels in order to make them usable by the service. The next step in the plan is to redevelop the entire site to build an all-in-one centre to replace the current four separate buildings. In our 12 years of service we have moved from renting at a number of locations to being able to purchase our current site. The current site of old, converted residential buildings while viable in the short term, does not allow for efficient use of the site nor capacity for growth. Parking is scattered around the site, staff are scattered and continually moving from building to building to serve clients. There is no excess accommodation capacity to allow for growth of services. Our intention is to re-develop the site to house all staff in one building, which will be configured for growth over the long term and allow efficient use of the available grounds for parking, an Elders shed, and so on.
  • We have run out of room. Every office is shared, including the CEO’s office. We can’t hire any staff – nowhere to house them. Whenever a visiting service is operating – GP clinic, podiatry, optometry, audiology, chiropractor etc, offices have to be vacated to house

them, displaced staff basically have nowhere to go. Fine balancing act to schedule things to displace as few people as possible.

  • We are currently located in two refurbished community buildings as there is no suitable accommodation for lease. Our organisation is growing very quickly, and we need all services located under one roof – one identity, one culture.
  • Rapidly reaching the point where services will be diminished because of failing infrastructure or insufficient housing for the nursing staff required.
  • Some clinical rooms are not fit for purpose. Clinicians working from rooms without hand washing facilities. Medical Clinic is old, out of date, some rooms not fit for purpose, ineffective air conditioning, clinical staff sharing rooms, no room for expansion, difficult to house students due to lack of appropriate space.
  • We have made a number of applications to improve infrastructure, and to replace current infrastructure, all have been unsuccessful, in some cases we have purchase buildings & land to try and demonstrate a commitment to ongoing growth and servicing of clients. We get little feedback in relation to funding applications.
  • Spread across three sites with some providers having to share rooms and staff being required to work outside on laptops at times. Desperately needing to build a purposebuilt facility in order to stop paying high amounts of rent and allow effective primary health care to an increasing client number.

Derby Aboriginal Health Service

The Derby Aboriginal Health Service (DAHS) Social and Emotional Wellbeing (SEWB) unit is housed in a 60+ year old asbestos building that was originally a family home. It has an old and small transport unit connected to the house by an exposed verandah. There are 6 staff working from the house who provide individual and family counselling and support. The clients who come to SEWB experience mental health issues, family violence, poverty, Department of Child Protection (DCP) issues around removal of children, alcohol and other drug issues and supporting those released from the Derby local Prison (approx. 200 prisoners). It is difficult to safely secure SEWB to the extent it is required given the age and asbestos nature of the building (security alarms etc). In the photos, you can see the buildings are old and are of asbestos. The transportable out the back houses the manager who is also the psychologist – this means she is in a vulnerable position when counselling should the session not go as planned (potential for a violent situation – see photo showing external verandah connecting to the donga).

The size of the house means that counselling clients privately is difficult as everything happens in close quarters. The number of clients the team work with exceeds the capacity of the building which impacts on the number of Aboriginal clients the team can help. The SEWB building has been broken into a number of times the last being during the long weekend in September 2018 where significant damage was done. Given the age of the house, during the past 18 months, parts of the internal ceiling including cornices have been falling away from the structures creating potential issues of asbestos fibre being released into the air. In addition, there are plumbing problems and the wooden floor is becoming a safety issue in one area of the building.

SEWB runs a vulnerable youth programme (the Shine Group) and a Body Shop clinic for youth who will not attend the main clinic for shame and fear reasons (special appointments are made with a doctor so that the young person doesn’t have to wait in the waiting area. In addition, a doctor runs a monthly session at the SEWB building with youth around health education and also sees them if there is a clinical need). These programmes run out of another 60+ year old asbestos family house some distance from the main SEWB house. Not only is the house not suitable but there may be security risks for the staff member working with vulnerable youth.  The Shine House was also broken into in September 2018 where significant damage was done (see photos).

The DAHS main building has no further office or other space to house staff.  This is particularly the case for 2019 as DAHS takes on new programmes (e.g. 2 staff for the new Syphilis Programme).  DAHS is acutely aware of the need to source funding to build new administration offices in order to release current admin offices for clinical and programme purposes.

DAHS requires a new or upgraded SEWB building. DAHS first applied for service maintenance funding in March 2017 but were unsuccessful. DAHS applied in June 2018 for Capital Works but were unsuccessful because it didn’t fit in with IAHP Primary Health Care as it was about mental health. DAHS also paid for an Architect to draw up the plans for a new SEWB building.  It is my view that one of the main issues is that the government separates SEWB from primary health care.

Social and emotional wellbeing issues CANNOT be separated from primary health care.  As is well known, a person’s SEWB impacts on the physical health of an individual.  Physical illhealth is frequently caused by the SEWB condition of an individual (i.e. historical and current experiences of trauma frequently commencing in the pre-natal phase of a child’s life, family violence, alcohol and other drug use, smoking, anxiety, removal of children, mental health issues etc). Aboriginal people suffer greatly from SEWB issues which impacts on their overall physical health.  Mental health in all its forms is part and parcel of physical health so it must be included in primary health care.

However, both state and commonwealth governments do not seem to prioritise or even support funding for SEWB (such as service and maintenance work, capital works or funding to continue key positions in the SEWB team – in fact, the government actively separates funding for SEWB and primary health care).  DAHS also provides clinical services to 7 remote communities most of whom are up to 400 kms away with Kandiwal Community 600kms away where we supply a fly in/fly out clinical service. There are many demands placed on a team of SEWB workers stationed in a working environment that does not allow them to function to the best of their abilities or offer increased services to our clients. Passion for the cause alone does not help in Closing the Gap. Working with one hand tied behind one’s back is not effective in reducing mental health issues and chronic diseases.

Part of an upgrade we requested was to renovate reception to make it safer for receptionist staff and to increase confidentiality when clients speak with reception staff (it also doesn’t meet the needs of disabled clients). There are a number of times throughout the year when receptionist staff are verbally abused with threats of physical harm. The current reception was designed prior to more recent events of aggression exhibited by clients under the influence of drugs.  The design now enables abusive clients to quite easily reach across the reception counter and hurt staff or can jump over the same counter to gain access to staff.  In addition, given there is no screen and the current open nature of the reception area, sharing confidential information can be compromised. DAHS applied for services and maintenance funding to make the changes but were unsuccessful.

[1] ACCHSs may apply for Telehealth funding through the Indigenous Australians’ Health Programme, Governance and System Effectiveness: Sector Support activity.

[2] https://www.anao.gov.au/work/performanceaudit/indigenoushousinginitiativesfixinghousesbetterhealthprogram  

[3] http://web.archive.org/web/20140213221536/http://www.dss.gov.au/sites/default/files/documents/05_201 2/housing_guide_info_intro.pdf  

[4] https://www.pmc.gov.au/resourcecentre/indigenousaffairs/remotehousingreview, page 3.

[5] https://www.caac.org.au/uploads/pdfs/CongressHousingandHealthDiscussionPaperFinalMarch2018.pdf

[6] https://www.pmc.gov.au/resourcecentre/indigenousaffairs/healthperformanceframework2017report; https://www.mja.com.au/journal/2011/195/11/closinggapandindigenoushousing;  https://probonoaustralia.com.au/news/2016/02/housingkeyclosinggap/; https://ama.com.au/positionstatement/aboriginalandtorresstraitislanderhealthrevised2015; https://www.caac.org.au/uploads/pdfs/CongressHousingandHealthDiscussionPaperFinalMarch2018.pdf. 10 https://www.anao.gov.au/work/performanceaudit/indigenoushousinginitiativesfixinghousesbetterhealthprogram  

[7] Australia Human Rights Commission Social Justice and Native Title Report 2015, cited in the Australian Law

Reform Commission publication, Pathways to JusticeInquiry into the Incarceration Rate of Aboriginal and Torres Strait Islander Peoples (ALRC Report 133)https://www.alrc.gov.au/publications/crossoverouthomecaredetention.

[8] https://www.alrc.gov.au/publications/crossoverouthomecaredetention; https://www.aihw.gov.au/getmedia/06341e00a08f4a0b9d33d6c4cf1e3379/aihwcsi025.pdf.aspx?inline=true  

[9] https://www.snaicc.org.au/ensuring-fair-start-children-need-dedicated-funding-stream-aboriginal-torresstrait-islander-early-years-sector/

[10] https://www.alrc.gov.au/publications/crossoverouthomecaredetention;

https://aifs.gov.au/cfca/publications/intersectionbetweenchildprotectionandyouthjusticesystems 15 https://aifs.gov.au/cfca/sites/default/files/publicationdocuments/cfcapracticebraindevelopmentv6040618.pdf; https://www.orygen.org.au/PolicyAdvocacy/PolicyReports/TraumaandyoungpeopleMoving

[11] http://www.familymatters.org.au/wpcontent/uploads/2018/11/FamilyMattersReport2018.pdf; Thorburn, Kathryn and Melissa Marshall. 2017. The Yiriman Project in the West Kimberley: an example of justice reinvestment? Indigenous Justice Clearinghouse, Current Initiatives Paper 5; McCausland, Ruth, Elizabeth McEntyre, Eileen Baldry. 2017. Indigenous People, Mental Health, Cognitive Disability and the

Criminal Justice System. Indigenous Justice Clearinghouse. Brief 22; AMA Report Card on Indigenous Health 2015. Treating the high rates of imprisonment of Aboriginal and Torres Strait Islander peoples as a symptom of the health gap: an integrated approach to both; Richards, Kelly, Lisa Rosevear and Robyn Gilbert. 2011.

Promising interventions for reducing Indigenous juvenile offending. Indigenous Justice Clearinghouse, Brief 10.

[12] Australian Institute of Health and Welfare. 2018. Australia’s Health 2018. Australia’s health series no. 16. AUS 221. Canberra: AIHW.

[13] Ibid

[14] Outcome areas: Aboriginal and Torres Strait Islander communities and cultures are strong and support social and emotional wellbeing and mental health; Aboriginal and Torres Strait Islander families are strong and supported; Infants get the best possible developmental start to life and mental health; Aboriginal and Torres Strait Islander children and young people get the services and support they need to thrive and grow into mentally healthy adults.

NACCHO NEWS ALERT: COAG Health Ministers Council Communique acknowledge the importance #ACCHO’s advancing Aboriginal health

 

  Included in this NACCHO Aboriginal Health News Alert

  1. All issues 11 included in  Communique highlighting ACCHO health
  2. Health Ministers approve Australia’s National Digital Health Strategy
  3. Transcript Health Minister Hunt Press Conference

” The Federal Minister for Indigenous Health, Ken Wyatt, attended the COAG Health Council discussed the Commonwealth’s current work on Indigenous health priorities.

In particular this included the development of the 2018 iteration of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 that will incorporate strategies and actions to address the social determinants and cultural determinants of health.

Ministers also considered progress on other key Indigenous health issues including building workforce capability, cultural safety and environmental health, where jurisdictions can work together more closely with the Commonwealth to improve outcomes for Aboriginal and Torres Strait Islander peoples.

Ministers acknowledged the importance of collaboration and the need to coordinate activities across governments to support a culturally safe and comprehensive health system.

Ministers also acknowledge the importance of community controlled organisations in advancing Aboriginal and Torres Strait Islander health. ”

1.Development of the next iteration of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 COAG Health Council 

Read over 50 NACCHO NATSIHP Articles published over past 50 years

INTRODUCTION

The federal, state and territory Health Ministers met in Brisbane on August 4 at the COAG Health Council to discuss a range of national health issues.

The meeting was chaired by the Victorian Minister for Health, the Hon Jill Hennessy MP.

Health Ministers welcomed the New South Wales Minister for Mental Health, the Hon Tanya Davies MP, the Victorian Minister for Mental Health, the Hon Martin Foley MP, the ACT Minister for Mental Health Mr Shane Rattenbury and the Minister for Aged Care and Minister for Indigenous Health, the Hon Ken Wyatt AM, MP who participated in a joint discussion with Health Ministers about mental health issues.

Major items discussed by Health Ministers today included:

2.Andrew Forrest and the Eliminate Cancer Initiative

Mr Andrew Forrest joined the meeting to address Health Ministers in his capacity as Chairman of the Minderoo Foundation to discuss the Eliminate Cancer Initiative. The Minderoo Foundation is one of Autralia’s largest and most active philanthropic groups. It has established the Eliminate Cancer Initiatve (the Initiative), a global initiative dedicated to making cancer non-lethal with some of the world’s leading global medicine and anti-cancer leaders.

The Initiative is a united effort to convert cancer into a non-lethal disease through global collaboration of scientific, medical and academic institutes, commercially sustained through the support of the philanthropic, business and government sectors worldwide.

Australia has a critical role to play in this highly ambitious and thoroughly worthwhile goal.

3.Family violence and primary care

Today, Health Ministers discussed the significant health impacts on those people experiencing family violence.

Health Ministers acknowledged that health-care providers, particularly those in a primary care setting, are in a unique position to create a safe and confidential environment to enable the disclosure of violence, while offering appropriate support and referrals to other practitioners and services.

Recognising the importance of national leadership in this area, Ministers agreed to develop a plan to address barriers to primary care practitioners identifying and responding to patients experiencing family violence.

Ministers also agreed to work with the Royal Australian College of General Practitioners to develop and implement a national training package.

Further advice will be sought from Primary Health Networks on existing family violence services, including Commonwealth, State and NGO service providers in their regions, with a view to developing an improved whole-of-system responses to the complex needs of clients who disclose family violence

4.Fifth National Mental Health and Suicide Prevention Plan

Health Ministers endorsed the Fifth National Mental Health and Suicide Prevention Plan 2017-2022 and its Implementation Plan.

The Fifth Plan is focused on improvements across eight targeted priority areas:

1. Achieving integrated regional planning and service delivery

2. Effective suicide prevention

3. Coordinated treatment and supports for people with severe and complex mental illness

4. Improving Aboriginal and Torres Strait Islander mental health and suicide prevention

5. Improving the physical health of people living with mental illness and reducing early mortality

6. Reducing stigma and discrimination

7. Making safety and quality central to mental health service delivery

8. Ensuring that the enablers of effective system performance and system improvement are in place

The Fifth Plan also responds to calls for a national approach to address suicide prevention and will be used to guide other sectors and to support health agencies to interact with other portfolios to drive action in this priority area.

Ongoing collaboration and engagement across the sector and with consumers and carers is required to successfully implement the Fifth Plan and achieve meaningful reform to improve the lives of people living with mental illness including the needs of children and young people.

Health Ministers also agreed that mental health workforce issues would be considered by the Australian Health Ministers’ Advisory Council.

5.The National Psychosocial Supports Program

Health Ministers agreed to establish a time-limited working group to progress the Commonwealth’s National Psychosocial Supports program. This will have the objective of developing bilateral agreements to support access to essential psychosocial supports for persons with severe mental illness resulting in psychosocial disability who are not eligible for the NDIS.

Those bilateral agreements will take into account existing funding being allocated for this purpose by states and territories.

6.Strengthened penalties and prohibition orders under the Health Practitioner Regulation National Law

Health Ministers agreed to proceed with amendments to the Health Practitioner Regulation National Law (the National Law) to strengthen penalties for offences committed by people who hold themselves out to be a registered health practitioner, including those who use reserved professional titles or carry out restricted practices when not registered.

Ministers also agreed to proceed with an amendment to introduce a custodial sentence with a maximum term of up to three years for these offences.

These important reforms will be fast tracked to strengthen public protection under the National Law. Preparation will now commence on a draft amendment bill to be brought forward to Ministers for approval, with a view to this being introduced to the Queensland Parliament in 2018. The Western Australian Parliament is also expected to consider legislative changes to the Western Australian National Law.

7.Amendment to mandatory reporting provisions for treating health practitioner

Health Ministers agree that protecting the public from harm is of paramount importance as is supporting practitioners to seek health and in particular mental health treatment as soon as possible.

Health Ministers agreed that doctors should be able to seek treatment for health issues with confidentiality whilst also preserving the requirement for patient safety.

A nationally consistent approach to mandatory reporting provisions will provide confidence to health practitioners that they can feel able to seek treatment for their own health conditions anywhere in Australia.

Agree for AHMAC to recommend a nationally consistent approach to mandatory reporting, following discussion paper and consultation with consumer and practitioner groups, with a proposal to be considered by COAG Health Council at their November 2017 meeting, to allow the amendment to be progressed as part of Tranche 1A package of amendments and related guidelines.

8.National Digital Health Strategy and Australian Digital Health Agency Forward Work Plan 2018–2022

Health Ministers approved the National Digital Health Strategy and the Australian Digital Health Agency Work Plan for 2018-2022.

Download Strategy and work plan here  

The Strategy has identified the priority areas that form the basis of Australia’s vision for digital health.

This Strategy will build on Australia’s existing leadership in digital health care and support consumers and clinicians to put the consumer at the centre of their health care and provide choice, control and transparency.

Expanding the public reporting of patient safety and quality measures

Health Ministers supported Queensland and other interested jurisdictions to collaboratively identify options in relation to aligning patient safety and quality reporting standards across public and private hospitals nationally.

Ministers agreed that the Australian Commission on Safety and Quality in Health Care (ACSQHC) would undertake work with other interested jurisdictions to identify options in relation to aligning public reporting standards of quality healthcare and patient safety across public and private hospitals nationally.

The work be incorporated into the national work being progressed on Australia’s health system performance information and reporting frameworks.

 

9.National human biomonitoring program

Health Ministers noted that human biomonitoring data can play a key role in identifying chemicals which potentially cause adverse health effects and action that may need to be taken to protect public health.

Health Ministers agreed that a National Human Biomonitoring Program could be beneficial in assisting with the understanding of chemical exposures in the Australian population.

Accordingly, Ministers agreed that the Australian Health Ministers’ Advisory Council will explore this matter in more detail by undertaking a feasibility assessment of a National Human Biomonitoring Program.

Clarification of roles, responsibilities and relationships for national bodies established under the National Health Reform Agreement

States and territories expressed significant concern that the proposed Direction to IHPA will result in the Commonwealth retrospectively not funding activity that has been already delivered by states and territories but not yet funded by the Commonwealth.

States and territories were concerned that this could reduce services to patients going forward as anticipated funding from the Commonwealth will be less than currently expected.

The Commonwealth does not agree with the concerns of the states and territories and will seek independent advice from the Independent Hospital Pricing Authority (IHPA) to ensure hospital service activity for 2015-2016 has been calculated correctly. The Commonwealth committed to work constructively and cooperatively with all jurisdictions to better understand the drivers of increased hospital services in funding agreements.

10.Legitimate and unavoidable costs of providing public hospital services in Western Australia

Health Ministers discussed a paper by Western Australia on legitimate and unavoidable costs of providing public hospital services in Western Australia, particularly in regional and remote areas, and recognised that those matters create a cumulative disadvantage to that state. Health Ministers acknowledged that Western Australia will continue to work with the Commonwealth Government and the Independent Hospital Pricing Authority to resolve those matters.

11.Vaccination

Health Ministers unanimously confirmed the importance of vaccination and rejected campaigns against vaccination.

All Health Ministers expressed their acknowledgement of the outgoing Chair, the Hon Ms Jill Hennessy and welcomed the incoming Chair Ms Meegan Fitzharris MLA from the Australian Capital Territory.

Health Ministers approve Australia’s National Digital Health Strategy

Digital information is the bedrock of high quality healthcare.

The benefits for patients are signicant and compelling: hospital admissions avoided, fewer adverse drug events, reduced duplication of tests, better coordination of care for people with chronic and complex conditions, and better informed treatment decisions. Digital health can help save and improve lives.

To support the uptake of digital health services, the Council of Australian Governments (COAG) Health Council today approved Australia’s National Digital Health Strategy (2018-2022).

Download Strategy and work plan here  

In a communique issued after their council meeting in Brisbane August 4 , the Health Ministers noted:

“The Strategy has identified the priority areas that form the basis of Australia’s vision for digital health. It will build on Australia’s existing leadership in digital health care and support consumers and clinicians to put the consumer at the centre of their health care and provide choice, control, and transparency.”

Australian Digital Health Agency (ADHA) CEO Tim Kelsey welcomed COAG approval for the new Strategy.

“Australians are right to be proud of their health services – they are among the best, most accessible, and efficient in the world.

Today we face new health challenges and rapidly rising demand for services. It is imperative that we work together to harness the power of technology and foster innovation to support high quality, sustainable health and care for all, today and into the future,” he said.

The Strategy – Safe, seamless, and secure: evolving health and care to meet the needs of modern Australia – identifies seven key priorities for digital health in Australia including delivery of a My Health Record for every Australian by 2018 – unless they choose not to have one.

More than 5 million Australians already have a My Health Record, which provides potentially lifesaving access to clinical reports of medications, allergies, laboratory tests, and chronic conditions. Patients and consumers can access their My Health Record at any time online or on their mobile phone.

The Strategy will also enable paper-free secure messaging for all clinicians and will set new standards to allow real-time sharing of patient information between hospitals and other care professionals.

Australian Medical Association (AMA) President Dr Michael Gannon has welcomed the Strategy’s focus on safe and secure exchange of clinical information, as it will empower doctors to deliver improved patient care.

“Doctors need access to secure digital records. Having to wade through paperwork and chase individuals and organisations for information is

archaic. The AMA has worked closely with the ADHA on the development of the new strategy and looks forward to close collaboration on its implementation,” Dr Gannon said.

Royal Australian College of General Practitioners (RACGP) President Dr Bastian Seidel said that the RACGP is working closely and collaboratively with the ADHA and other stakeholders to ensure that patients, GPs, and other health professionals have access to the best possible data.

“The Strategy will help facilitate the sharing of high-quality commonly understood information which can be used with confidence by GPs and other health professionals. It will also help ensure this patient information remains confidential and secure and is available whenever and wherever it is needed,” Dr Seidel said.

Pharmacy Guild of Australia National President George Tambassis said that technology would increasingly play an important role in supporting sustainable healthcare delivery.

“The Guild is committed to helping build the digital health capabilities of community pharmacies and advance the efficiency, quality, and delivery of healthcare to improve health outcomes for all Australians.

“We are working with the ADHA to ensure that community pharmacy dispensing and medicine-related services are fully integrated into the My Health Record – and are committed to supporting implementation of the National Digital Health Strategy as a whole,” George Tambassis said.

Pharmaceutical Society of Australia (PSA) President Dr Shane Jackson said that the Strategy would support more effective medicationmanagement, which would improve outcomes for patients and improve the efficiency of health services.

“There is significant potential for pharmacists to use digital health records as a tool to communicate with other health professionals, particularly during transitions of care,” Dr Jackson said.

The Strategy will prioritise development of new digital services to support newborn children, the elderly, and people living with chronic disease. It will also support wider use of telehealth to improve access to services, especially in remote and rural Australia and set standards for better information sharing in medical emergencies – between the ambulance, the hospital, and the GP.

Consumers Health Forum (CHF) Leanne Wells CEO said that the Strategy recognises the importance of empowering Australians to be makers and shapers of the health system rather than just the users and choosers.

“We know that when consumers are activated and supported to better self-manage and coordinate their health and care, we get better patient experience, quality care, and better health outcomes.

“Digital health developments, including My Health Record, are ways in which we can support that to happen. It’s why patients should also be encouraged to take greater control of their health information,” Leanne Wells said.

Medical Software Industry Association (MSIA) President Emma Hossack said that the Strategy distils seven key themes that set expectations at a national level.“The strategy recognises the vital role industry plays in providing the smarts and innovation on top of government infrastructure.

This means improved outcomes, research, and productivity. Industry is excited to work with the ADHA to develop the detailed actions to achieve the vision which could lead to Australia benefitting from one of the strongest health software industries in the world,” Emma Hossack said.

Health Informatics Society of Australia (HISA) CEO Dr Louise Schaper welcomed the Strategy’s focus on workforce development.

“If our complex health system is to realise the benefits from information and technology, and become more sustainable, we need clinical leaders with a sound understanding of digital health,” Dr Schaper said.

The Strategy was developed by all the governments of Australia in close partnership with patients, carers and the clinical professionals who serve them – together with leaders in industry and science.

The Strategy draws on evidence of clinical and economic benefit from many sources within Australia and overseas, and emphasises the priority of patient confidentiality as new digital services are implemented.

The ADHA has established a Cyber Security Centre to ensure Australian healthcare is at the cutting edge of international data security.

The ADHA, which has responsibility for co-ordinating implementation of the Strategy, will now be consulting with partners across the community to develop a Framework for Action. The framework will be published later this year and will detail implementation plans for the Strategy.

The National Digital Health Strategy Safe, seamless and secure: evolving health and care to meet the needs of modern Australia is available on

https://www.digitalhealth.gov.au/australias-national-digital-health-strategy (https://www.digitalhealth.gov.au/australias-national-digital-health-strategy)

Greg Hunt Press Conference

Topics: COAG Health Council outcomes; The Fifth National Mental Health and Suicide Prevention Plan; support for doctors and nurses mental health; hospital funding; same-sex marriage

GREG HUNT:
Today was a huge breakthrough in terms of mental health. The Fifth National Mental Health Plan was approved by the states.

What this is about is enormous progress on suicide prevention. It has actually become the Fifth National Mental Health and Suicide Prevention Plan, so a real focus on suicide prevention.

In particular, the focus on what happens when people are discharged from hospital, the group in Australia that are most likely to take their own lives.

We actually know not just the group, but the very individuals who are most at risk. That’s an enormous step.

The second thing here is, as part of that plan, a focus on eating disorders, and it is a still-hidden issue. In 2017, the hidden issue of eating disorders, of anorexia and bulimia, and the prevalence and the danger of it is still dramatically understated in Australia.

The reality is that this is a silent killer and particularly women can be caught up for years and years, and so there’s a mutual determination, a universal determination to progress on eating disorders, and that will now be a central part of the Fifth National Mental Health and Suicide Prevention Plan.

And also, as part of that, we’ve included, at the Commonwealth’s request today, a real focus on early intervention services for young people under 16. Pat McGorry has referred to it as CATs for Kids, meaning Crisis Assessment Teams, and the opportunity.

And this is a really important step because, for many families, when they have a crisis, there’s nowhere to turn. This is a way through. So those are all enormous steps forward.

The other mental health area where we’ve made big, big progress is on allowing doctors to seek routine mental health treatment.

There’s an agreement by all of the states and territories to work with the Commonwealth on giving doctors a pathway so as they can seek routine mental health treatment without being reported to the professional bodies.

JOURNALIST:
What has led to the increased focus on eating disorders? Has there been an uptick in the number of suicides resulting from that, or has there been an uptick in the number of cases?

GREG HUNT:
No, this has been silently moving along. It’s a personal focus. There are those that I have known, and then when we looked the numbers shortly after coming in, and dealt with organisations such as the Butterfly Foundation, they explained that it’s been a high level issue with the worst rate of loss of life amongst any mental health condition.

And so that’s a combination both of suicide, but also of loss of life due to physical collapse. And so it’s what I would regard as a personal priority from my own experience with others, but then the advocacy of groups like Butterfly Foundation has finally landed. It should’ve happened earlier, but it’s happening on our watch now.

JOURNALIST:
That would be my next question, is that I’m sure advocacy groups will say this is great that it’s happened, but it’s taken the Government so long. Why is it that you’re focussing on it now as opposed to…?

GREG HUNT:
I guess, I’ve only just become Minister. So from day one, this is one of the things I’ve wanted to do, and I’m really, personally, deeply pleased that we’ve made this enormous progress.

So I would say this, I can’t speak for the past, it is overdue, but on our watch collectively we’ve taken a huge step forward today.

Then the last thing is I’ve seen some reports that Queensland and Victoria may have been upset that some of their statistical anomalies were referred to what’s called IHPA (Independent Hospital Pricing Authority).

The reason why is that some of their figures simply didn’t pass the pub test.

The independent authority will assess them, but when you have 4000 per cent growth in one year in some services, 3300 per cent growth in some years in other services, then it would be negligent and irresponsible not to review them.

It may be the case that there was a more than 40-fold increase in some services, but the only sensible thing for the Commonwealth to do is to review it.

But our funding goes up each year every year at a faster rate than the states’ funding, and it’s gone up by $7.7 billion dollars since the current health agreement with the states was struck.

JOURNALIST:
Is that, sorry, relating to private health insurance, or is that something separate?

GREG HUNT:
No, that’s just in relation to, a couple of the states lodged claims for massive growth in individual items.

JOURNALIST:
Thank you. So was there a directive given today regarding private health policies to the states? Was that something that was discussed or something that …?

GREG HUNT:
Our paper was noted, and the states will respond. So we’ve invited the states to respond, they’ll respond individually.

JOURNALIST:
And regarding that mental health plan, besides their new focus on eating disorders, how is it different from previous mental health plans?

GREG HUNT:
So, a much greater focus on suicide prevention, a much greater focus on eating disorders, and a much greater focus on care for young children under 16.

JOURNALIST:
Is that something that you can give more specific details about? You’re saying there’s a much greater focus, but is there any specific information about what that would mean?

GREG HUNT:
As part of the good faith, the Commonwealth, I’ve written to the head of what’s called the Medical Benefits Schedule Review, so the Medicare item review, Professor Bruce Robinson and asked him and their team to consider, for the first time, specific additional treatment, an additional treatment item and what would be appropriate for eating disorders.

NACCHO Aboriginal Mental Health : Download report “Mental health in remote and rural communities “

 ” The poorer mental health of remote and rural Indigenous Australians is also impacted by the social determinants of Indigenous health, which are well recognised nationally and internationally.

These relate to the loss of language and connection to the land, environmental deprivation, spiritual, emotional and mental disconnectedness, a lack of cultural respect, lack of opportunities for self-determination, poor educational attainment, reduced opportunities for employment, poor housing, and negative interactions with government systems

The relationship of remoteness to health is particularly important for Indigenous Australians, who are overrepresented in remote and rural Australia (Australian Institute of Health and Welfare, 2014a).

The National Mental Health Commission (2014a, p. 19) identified that “the mental health needs of Aboriginal and Torres Strait Islander people are significantly higher than those of other Australians.”

Photo above

“ The women of Inkawenyerre, a small settlement in the Utopia community four hours by road north of Alice Springs, regularly take part in a different kind of mental health therapy, known as ‘narrative therapy.’

Narrative therapy taps into the centuries-old tradition among Aboriginal people of story-telling and expression through art. At the family Urapuntja Clinic, both women and children take part in narrative therapy.

They recreate what is commonly seen on any given evening in an Aboriginal community—people sitting around the fire, relating to one another and telling stories.

The activity is enjoyable for participants with group members often laughing and supporting one another as they tell stories and work on their painting—all while promoting good mental health living practice,”

Lynne Henderson, former RFDS Central Operations mental health clinician.

“People who live in the country get less access to care. And they become sicker,”

To increase the access to care, the RFDS said it needed a massive increase in funding. Country Australians see mental health professionals at only a fifth the rate of those who live in the city,

So there should be a five-fold increase in access to mental health care for country Australians.”

RFDS CEO Martin Laverty see story Part 2 below

Mental health in remote and rural communities

Mental health disorders are not more common in rural and regional Australia than they are in Australia’s cities, according to a new report from the Royal Flying Doctor Service (RFDS), but they are a lot harder to treat.

The report, Mental Health in Remote and Rural Communities, found about one in five remote and rural Australians — 960,000 people — experience mental illness.

Download the report HERE

RN031_Mental_Health_D5

But a combination of lack of access to facilities, social stigma, and cultural barriers present challenges to getting people the help they need.

AHCRA believes that’s something that everyone should be concerned about, with access to care regardless of location.

 

Part 1  Indigenous mental health and suicide

Data from the 2011 Australian Census demonstrated that 669,881 Australians, or 3% of the population, identified as Indigenous (Australian Bureau of Statistics, 2013b), and that 142,900 Indigenous Australians, or 21% of the Indigenous population, lived in remote and very remote areas (Australian Institute of Aboriginal and Torres Strait Islander Studies, 2014).

Around 45% of people in very remote Australia (91,600 people), and 16% of people in remote Australia (51,300 people) were Indigenous (Australian Bureau of Statistics, 2013b; Australian Institute of Aboriginal and Torres Strait Islander Studies, 2014).

In 2011–2012 around one-third (30%) of Indigenous adults reported high or very high levels of psychological distress—almost three times the rate for non-Indigenous Australians (Australian Bureau of Statistics, 2014).

In 2008–2012, in NSW, Queensland (Qld), WA, SA and the NT, there were 347 Indigenous deaths11 from mental health-related conditions (Australian Institute of Health and Welfare,

2015a). Specifically, age-standardised death data demonstrated that Indigenous Australians (49 per 100,000 population) were 1.2 times as likely as non-Indigenous Australians (40 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a). Age-standardised deaths from mental and behavioural disorders increased with increasing age in both Indigenous and non-Indigenous Australians in 2008–2012.

Very few Indigenous and non-Indigenous Australians under the age of 35 years died as result of mental and behavioural disorders in 2008–2012. However, Indigenous Australians aged 35 years or older were more likely to die from mental and behavioural disorders than non-Indigenous

Australians in 2008–2012. Specifically, Indigenous Australians (7.2 per 100,000 population) aged 35–44 years were 5.7 times as likely as non-Indigenous Australians (1.3 per 1200,000 population) to die from mental and behavioural disorders (Australian Institute of Health and

Welfare, 2015a). In 2008–2012, Indigenous Australians (14.7 per 100,000 population) aged 45–54 years were 4.9 times as likely as non-Indigenous Australians (3.0 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a).

In 2008–2012, Indigenous Australians (18.3 per 100,000 population) aged 55–64 years were 2.7 times as likely as non-Indigenous Australians (6.9 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a). In 2008–2012,

Indigenous Australians (91.2 per 100,000 population) aged 65–74 years were 2.9 times as likely

as non-Indigenous Australians (31.3 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a).

Further exploration of death data from mental and behavioural disorders illustrates the significant impact of psychoactive substance use (ICD-10-AM codes F10–F19) on Indigenous mortality (Australian Institute of Health and Welfare, 2015a). In 2008–2012, 29.1% of Indigenous deaths due to mental and behavioural disorders were the result of psychoactive substance use, such as alcohol, opioids, cannabinoids, sedative hypnotics, cocaine, other stimulants such as caffeine, hallucinogens, tobacco, volatile solvents, or multiple drug use. During this period, Indigenous Australians (7.3 per 100,000 populations) were 4.8 times as likely as non-Indigenous Australians to die as a result of psychoactive substance use (Australian Institute of Health and Welfare, 2015a).

Similarly, in 2006–2010, there were 312 Indigenous deaths from mental health-related conditions (Australian Institute of Health and Welfare, 2013a). Indigenous Australians living in NSW, Qld, WA, SA and the NT were 1.5 times as likely as non-Indigenous Australians to die from mental and behavioural disorders in 2006–2010 (Australian Institute of Health and Welfare, 2013a).

11 Deaths from mental and behavioural disorders do not include deaths from intentional self-harm (suicide). Intentional self-harm is coded under ICD-10-AM Chapter 19—Injury, poisoning and certain other consequences of external causes.

Age-standardised death data demonstrated that Indigenous males (49 per 100,000 population) were 1.7 times as likely as non-Indigenous males to die from mental and behavioural disorders. Indigenous females were 1.3 times as likely as non-Indigenous females to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2013a).

The greater number of deaths from mental and behavioural disorders with age may also represent the impact of conditions associated with ageing, such as dementia. For example, in 2014, Indigenous Australians (50.7 per 100,000 population) in NSW, Qld, SA, WA and the NT were 1.1 times as likely as non-Indigenous Australians (45.3 per 100,000 population) to die from dementia (including Alzheimer disease) (Australian Bureau of Statistics, 2016a).

In 2014–2015, Indigenous Australians (28.3 per 1,000 population) were 1.7 times as likely as non-Indigenous Australians (16.3 per 1,000 population) to be hospitalised for mental and behavioural disorders (Australian Institute of Health and Welfare, 2016a).

In 2011–2013, 4.2% of Indigenous hospitalisations were for mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a). Age-standardised data demonstrated that Indigenous Australians (27.7 per 1,000 population) were twice as likely as non-Indigenous Australians (14.2 per 1,000 population) to be hospitalised for mental and behavioural disorders in 2011–2013 (Australian Institute of Health and Welfare, 2015a).

In 2008–2009, Indigenous young people aged 12–24 years (2,535 per 100,000 population) were three times as likely to be hospitalised for mental and behavioural disorders than non-Indigenous young people (Australian Institute of Health and Welfare, 2011).

 

The leading causes of hospitalisation for mental and behavioural disorders amongst Indigenous young people were schizophrenia (306 per 100,000 population), alcohol misuse (348 per 100,000 population) and reactions to severe stress (266 per 100,000 population) (Australian Institute of Health and Welfare, 2011).

A preliminary clinical survey of 170 Aboriginal and Torres Strait Islander Australians in Cape York and the Torres Strait, aged 17–65 years, with a diagnosis of a psychotic disorder, was undertaken to describe the prevalence and characteristics of psychotic disorders in this population (Hunter, Gynther, Anderson, Onnis, Groves, & Nelson, 2011).

Researchers found that: 62% of the sample had a diagnosis of schizophrenia, 24% had substance-related psychoses, 8% had affective psychoses, 3% had organic psychoses and 3% had brief reactive psychoses; Indigenous Australians aged 30–39 years were overrepresented in the psychosis sample compared to their representation in the population (37% of sample versus 29% of population) with slightly lower proportions in the 15–29 years and 40 years and older age groups; almost three-quarters (73%) of the sample were male (versus 51% for the Indigenous population as a whole); Aboriginal males (63% in the sample compared to 46% for the region as a whole) were overrepresented; a higher proportion of males (42%) than females (5%), and Aboriginal (44%) than Torres Strait Islander patients (10%) had a lifetime history of incarceration; comorbid intellectual disability was identified for 27% of patients, with a higher proportion for males compared to females (29% versus 20%) and Aboriginal compared to Torres Strait Islander patients (38% versus 7%); and alcohol misuse (47%) and cannabis use (52%) were believed to have had a major role in the onset of psychosis (Hunter et al., 2011).

In 2015, Indigenous Australians (25.5 deaths per 100,000 population) in Qld, SA, NT, NSW and WA were twice as likely as non-Indigenous Australians (12.5 deaths per 100,000 population) to die from suicide (Australian Bureau of Statistics, 2016b). In their spatial analysis of suicide, Cheung et al. (2012) concluded that higher rates of suicide in the NT and in some remote areas could be explained by the large numbers of Indigenous Australians living in these areas, who demonstrate higher levels of suicide compared with the general population.

The poorer mental health of remote and rural Indigenous Australians is also impacted by the social determinants of Indigenous health, which are well recognised nationally and internationally.

These relate to the loss of language and connection to the land, environmental deprivation, spiritual, emotional and mental disconnectedness, a lack of cultural respect, lack of opportunities for self-determination, poor educational attainment, reduced opportunities for employment, poor housing, and negative interactions with government systems

Part 2 Flying Doctors fight barriers to treat mental illness in rural Australia

Source ABC

Like so many in the bush, Brendan Cullen has a lot on his plate.

He manages a 40,000-hectare property south of Broken Hill. There are 8,000 sheep to keep track of. And that’s just a fraction of the number he looked after previously at another station.

A few years ago, the mustering, the maintenance, juggling bills and family — it all caught up to him.

“You just bottle stuff up. And sometimes you can’t find an out,” he said.

“In the bush you have a lot of time by yourself.”

He spent a lot of that time thinking about his problems. But Mr Cullen was lucky.

He heard about a mental health clinic being run by the Royal Flying Doctor Service (RFDS) in a nearby community and decided to go along.

“Catching up with one of the mental health nurses gave me the tools to be able to work out how I go about living a day-to-day life,” he said.

“My life’s a hell of a lot easier now than what it used to be.”

Mental health disorders are not more common in rural and regional Australia than they are in Australia’s cities, according to a new report from the RFDS, but they are a lot harder to treat.

The report, Mental Health in Remote and Rural Communities, found about one in five remote and rural Australians — 960,000 people — experience mental illness.

But a combination of lack of access to facilities, social stigma, and cultural barriers present challenges to getting people the help they need.

“People who live in the country get less access to care. And they become sicker,” RFDS CEO Martin Laverty said.

To increase the access to care, the RFDS said it needed a massive increase in funding.

“Country Australians see mental health professionals at only a fifth the rate of those who live in the city,” Mr Laverty said.

“So there should be a five-fold increase in access to mental health care for country Australians.”

The impact of distance and isolation when it comes to treating mental disorders can be seen in suicide rates. In remote Australia, the rate is nearly twice what it is in major metropolitan areas — 19.6 deaths per 100,000 people.

The suicide rate is even greater in very remote communities.

If you or anyone you know needs help:

The RFDS has responded by increasing its mental health outreach. In communities like Menindee, about an hour’s drive from Broken Hill in the far west of New South Wales, a mental health nurse is on call once a fortnight.

“I have needed them in the past. I got down to rock bottom at one stage. Even now I appreciate that support,” Menindee resident Margot Muscat said.

Ms Muscat plays an active role in the remote community. But she has also felt pressure in the past to manage that role, her work, and family commitments.

Mental health counselling has given her a valuable outlet.

“Just to know that I wasn’t alone. And that you don’t have to take the drastic step of suiciding, so to speak,” Ms Muscat said.

Some the RFDS’s mental health counselling is done over the airwaves. From its regional base in Broken Hill, mental health nurse Glynis Thorp counsels patients over the phone. Often calls are simply people checking in.

“It’s critically important…often there might only be two people on the property. So no one to talk to maybe,” she said.

“We might get out to a clinic every fortnight, but we might have follow up phone calls to check how people are going. For myself it’s probably a ratio of four to one.”

The RFDS report reveals every year hundreds of serious mental illness incidents require airplanes to be dispatched to remote areas to fly patients out for treatment.

Over three years from July 2013 the RFDS conducted 2,567 ‘aeromedical retrievals’.

The leading causes for evacuation flights due to mental disorder are

The RFDS also uses airplanes to carry its mental health nurses to very remote areas. On a typical day in Broken Hill, the medical team takes off just after dawn to head to three communities hundreds of kilometres away: Wilcania, White Cliffs and Tilpa.

In the opal mining town of White Cliffs, the mental health nurse sees patients at the local clinic. One is “Jane”, who doesn’t want her full name used.

“Without them, we would really be lost here,” she said.

Jane has been counselled by the RFDS and was recently directed to mental health treatment in Broken Hill. But she’s still reluctant to talk openly in town about the help she’s getting.

“In a small community it’s not wise to talk to other people in town,” she said. “And mental health, it does carry a stigma.”

Back on his station south of Broken Hill, Mr Cullen believes that stigma over mental health is slowly changing in the bush.

“People get wind that someone’s had a mental health problem, people talk now. As opposed to, let’s go back five years even, 10 years. It was a closed book,” he said.

“With these clinics, once upon a time you might have had a dental nurse, a doctor, and the like.

“But now you have a mental health nurse…And these clinics are close by. So you’re able to go to them. They come to you.”

NACCHO Aboriginal Health : Delivery to @DaveGillespie of #RuralHealthConf priority delegate recommendations

 

 ” Rural and regional Australians have higher rates of major diseases including heart disease and stroke, chronic lung conditions, diabetes, asthma, and arthritis.

We also have a persistent and disturbingly large gap in health outcomes and life expectancy, between Indigenous and non-Indigenous Australians “

Minister Gillespie said Australia’s long life expectancy and good average health outcomes disguised unacceptable differences between population groups and communities, particularly in rural Australia : See Full Response press release from Minister below

After four action-packed days, the 14th National Rural Health Conference with its theme of ‘A World of Rural Health’, has concluded with the delivery of the priority recommendations to emerge from the event to Assistant Minister for Health, David Gillespie.

According to CEO of the NRHA, David Butt, “the Conference provided an excellent opportunity for learning and sharing the evidence of what works in rural and remote health.

“People who live and work in rural and remote Australia have the knowledge about what works and what needs to change to improve health and wellbeing.

“Very importantly, through the conference they have identified key recommendations for health systems reform, to improve the health and wellbeing of the seven million people who live in rural and remote Australia,” Mr Butt said.

Download a PDF Copy of all recommendations

Recommendations14NRHC

Aboriginal and Torres Strait Islander Health

Digital Health

Workforce

AUSTRALIA LEADS IN INNOVATION FOR RURAL HEALTH

Press Release

The Coalition Government’s innovative reforms to improve the health of rural, regional and remote communities were today showcased to the 14th World Rural Health Conference.

In his opening address to the conference in Cairns, Assistant Minister for Health, Dr David Gillespie, outlined a series of major changes to improve rural health which will start or bed down over the coming year.

These included:

  •  legislation to establish the first independent National Rural Health Commissioner;
  •  pathways to recognise rural GPs as “Rural Generalists”;
  •  Primary Health Networks across Australia commission health services to ensure that local health needs are met;
  •  federally funded mental health services including suicide prevention and drug and alcohol rehabilitation now managed at the regional level by PHNs;
  •  200 general practices and Aboriginal Community Controlled Health Services will soon start providing Health Care Home services, to coordinate care for people with chronic conditions.

Minister Gillespie said Australia’s long life expectancy and good average health outcomes disguised unacceptable differences between population groups and communities, particularly in rural Australia.

Rural and regional Australians have higher rates of major diseases including heart disease and stroke, chronic lung conditions, diabetes, asthma, and arthritis.

“We also have a persistent and disturbingly large gap in health outcomes and life expectancy, between Indigenous and non-Indigenous Australians,” he said.

Minister Gillespie also represented the Prime Minister, Malcolm Turnbull, at the National Rural Health Alliance Conference held as part of the World of Rural Health event.

“I know that it takes determination, resilience and flexibility to provide the care that your patients need, without the resources available to your counterparts in the cities,” Minister Gillespie said.

“The Prime Minister shares my passion – your passion – for rural Australia.

“Like you, and me, he believes that Australians have a right to high quality, affordable and accessible health care, wherever they live and whatever their circumstances.

“Meeting the needs of rural families and communities is one of the top priorities in the long term national health plan.”

Smile: $11m reduces gap in rural and remote dental services

Press Release 2

People living and working in rural and remote Australia will now have access to dental services that were previously unavailable.

Assistant Minister for Health, Dr David Gillespie, said today that the Coalition Government is providing $11 million to the Royal Flying Doctor Service (RFDS) to provide dental services.

“The Royal Flying Doctor Service is well-placed to provide these essential mobile outreach dental services in rural and remote Australia,” Minister Gillespie said.

“Where there is an identified market failure and there are gaps in services, it is important that the Government steps in to provide assistance. Today we deliver on our election commitment to ensure people outside our major cities have better access to high quality dental services.”

The Government provides funding to the RFDS under the RFDS Program, which aims to ensure access to essential emergency aeromedical and other primary health care services in rural and remote areas of Australia.

“The Flying Doctor welcomes this new funding for dental services in rural and remote Australia,” RFDS of Australia CEO, Martin Laverty, said.

“There are only one third the dentists in remote areas, with 72 dentists per 100,000 people in major cities, and less than 23 per 100,000 people in remote areas.”

“The research statistics are compelling, with more than one-third of remote area residents living with untreated decay. Essentially, when people from remote areas visit the dentist, they are more likely to require acute intervention – 1 in 3 had a tooth extraction in a year, compared with less than 1 in 10 in metropolitan areas.”

“This funding from the Federal Government will enable the Flying Doctor to expand its dental outreach program to start tackling the disparity that exists between city and the bush – and for that we are very, very thankful”.

On 28 June 2016, the Government announced it would continue to support the RFDS by extending its contract for continued delivery of aeromedical services until 30 June 2020.

The announcement included a commitment of an additional $11 million over two years for the RFDS to expand its existing non-Commonwealth funded dental services for the period 1 April 2017 to 31 March 2019.

Labor Party Response

Labor supports the development of a national rural health strategy and associated implementation plan, as part of ensuring there is clear and targeted action towards closing the gap in health outcomes between Australians living in rural areas and their metropolitan peers. 

Shadow Minister for Health Catherine King announced Labor’s support for a strategy at the National Rural Health Conference in Cairns, calling on the Government to join in bipartisan support.

“The impact of inequity on health and recognising the challenges that some groups face which require more targeted support – including rural and remote Australians – was a clear theme to emerge from Labor’s National Health Summit in March,” Ms King said

“We think that a national rural health strategy is an important step to ensuring we have a defined roadmap to improving health outcomes for Australians living outside our big cities and I hope the Government follows our lead.”

Shadow Assistant Minister for Medicare, Tony Zappia, said while Labor welcomes the implementation of the National Rural Health Commissioner, this single role will not be a cure-all.

“The National Rural Health Commissioner would aid in the implementation of a national rural health strategy, but we still need to have an understanding of where we are going, and what we are trying to achieve in rural heath,” Mr Zappia said.

“A national rural health strategy would help achieve this goal of all levels of Government working more closely together, to reduce fragmentation and duplication.”