AMA President, Dr Tony Bartone has released its vision for the future of primary health care and general practice in post-COVID Australia – Delivering Better Care for Patients: The AMA 10-Year Framework for Primary Care Reform.
“General practice is the cornerstone of successful primary health care and the foundation of Australia’s world-class healthcare system.
However, despite agreeing with the rhetoric of the importance of properly funded general practice, successive Governments have overseen a rate of investment in general practice that has not matched the increase in the cost of providing high-quality patient care.
The AMA 10-Year Framework identifies immediate funding goals to ease the financial pressures on general practice, and long-term reforms that should be implemented as part of the Federal Government’s 10-year Primary Health Care Plan.”
“Government spending on GP services is about $391 per person annually, down from $395 in 2017–2018.
The Australian population is growing, ageing, and developing more complex health needs as chronic disease and mental ill-health continue to increase. General practice funding models must change to meet the needs of the community.
COVID-19 has highlighted the under-funding of general practice for decades. Large financial incentives were needed to keep many practices viable.
Teleheath – an innovation that the AMA has long advocated for – was implemented in the midst of the pandemic to assist access and connection of patients with their usual GP at this time of critical challenge.
The AMA is calling for Federal Government spending on general practice services to be increased to at least a mandated 16 per cent of total health spending as part of a range of reforms to support general practice and improve access to GP care for all patients.
The AMA has made four key recommendations:
Primary care reforms to build on the existing GP-led model of primary health care, which deliver high-quality, cost-effective outcomes for patients;
The Government to work closely with the AMA and medical profession to develop and implement a suitable funding model to enable the transformation of general practice into a medical home;
General practice to be adequately funded to reach its full potential and meet the increasingly complex healthcare needs of the community, involving a mandated 16 per cent of total health spending; and
Continued investment in long-term strategies to ensure a sustainable medical workforce.
NACCHO welcomes the new AMA President, Dr Omar Khorshid and Vice President, Dr Chris Moy.
The election of Dr Khorshid and Dr Moy at the AMA’s National Conference, follows the conclusion of the two-year term of President Dr Tony Bartone and Vice President Dr Chris Zappala.
Dr Khorshid, an orthopaedic surgeon in Perth and a former AMA WA President, said governments should increase medical, health, and aged care expenditure to combat both COVID-19 and help the economy avoid prolonged recession. “State and Federal Governments have rightly funded the response effort to COVID-19,” Dr Khorshid said.
NACCHO Chair and the NACCHO team congratulate Dr Khorshid and Dr Moy on their election. We look forward to working closely with you on Closing the Gap in Aboriginal and Torres Strait Islander health.
“We’ve now moved through all phases of implementing our co-designed programs, and are focusing on maintaining them with the support of school staff and the local Aboriginal Community Controlled Health Service.
Our research shows engaging communities to design and deliver oral health services was associated with reduced tooth decay and increased healthy behaviours.
The following elements of co-design in our project could readily be incorporated into the design and delivery of health-care services for Aboriginal Australians:
improved cultural safety— Aboriginal people feel safe and welcome
co-design and shared ownership— local Aboriginal people shape the service model
local employment— Aboriginal people work in the service and lead local delivery
skills development— Aboriginal people complete qualifications that are nationally recognised
long-term commitment— programs are designed and delivered with sustainable and reliable funding.
The gap in health outcomes between Aboriginal and non-Aboriginal Australians remains stubbornly wide.
Co-design enables much needed health-care services to be delivered in ways that strengthen communities, respect culture and build capacity.
Aboriginal children in rural Australia have up to three times the rate of tooth decay compared to other Australian children.
Tooth decay can affect a person’s overall health and nutrition because it can affect how they chew and swallow. Tooth decay can also reduce self esteem because of its effect on appearance and breath. And importantly, poor oral health increases the risk of chronic disease such as heart disease.
Broadly speaking, improving oral health is critical to closing the gap in health outcomes between Aboriginal and Torres Strait Islander Australians and Australians overall. Tackling this gap requires customised, community-led solutions.
Our research demonstrates co-design — that is, engaging communities to design and deliver services for their own communities — is associated with significantly improved oral health among Aboriginal primary school children.
This approach may also hold the answer for closing the gap in other areas of health care.
Oral health among Aboriginal children
In the middle of last century, Aboriginal children actually had significantly better oral health than other Australian children. But today, Aboriginal children have roughly double the rate of tooth decay compared to other Australian children.
A range of factors have contributed to this recent problem, starting with colonisation — the effects of which have been compounded over time — and the shift to a highly processed Westernised diet.
Where interventions to prevent common oral diseases like tooth decay have become available to most Australian children in recent decades, Aboriginal children in rural Australia have historically had limited access to public dental services.
The disparity is compounded by the cost of basic supplies like toothpaste and toothbrushes, which may be unattainable for some families, and poor availability of cool filtered drinking water in remote communities.
We sought to reduce consumption of sugary drinks by installing refrigerated and filtered water fountains in schools and communities. We also engaged teachers to encourage students to fill up their water bottles and drink from them throughout the school day.
As well as this, we sought to increase fluoride intake (a naturally occurring mineral that helps to prevent tooth decay) by establishing daily in-school tooth brushing programs, supplying toothbrushes and toothpaste for school and home, and applying fluoride varnish to the children’s teeth once each term.
We also provided treatment for existing tooth decay and gum disease.
In 2018, we looked at the oral health and oral hygiene behaviours of children from the participating schools. Our findings have recently been published and show the project is working well.
What we found
In just four years we found a reduction in tooth decay, plaque and gingivitis (gum disease).
The average number of teeth with tooth decay per child in 2018 was 4.13, compared to 5.31 in 2014. Notably, the proportion of children with no tooth decay increased from 12.5% in 2014 to 20.3% in 2018.
There was also a dramatic reduction in the proportion of children with severe gingivitis from 43% in 2014 to 3% in 2018.
We also saw an increase in positive oral hygiene behaviour including tooth brushing, consumption of drinking water and reduced consumption of sugar-sweetened beverages.
In 2014, 13% of children reported brushing their teeth on the morning they took the survey. This increased to 36% in 2018.
Collaborating with communities
Co-design means working alongside communities to establish the most effective ways to implement evidence-based strategies, and sustain these. It’s about sharing knowledge to enable long-term, positive change to complex problems.
In our project, the co-design process has been central to these outcomes:
local Aboriginal staff coordinate the programs and dental treatment services
“While news of two confirmed cases of COVID-19 in Ballarat is really concerning, it is an important reminder to remain vigilant in looking after ourselves and our families to stop the slow of the spread of this virus, especially now since it’s entered regional Victoria.
We know communities have been working hard to minimise any infections which has been quite successful to date, but we are entering a very challenging period. We are seeing alarming rates of community transmission – unlike the first lockdown period.
VACCHO CEO Jill Gallagher AO recognised that seeing triple digit spikes of COVID-19 was an anxiety provoking and uncertain time for many Aboriginal Communities in metropolitan Melbourne and now regional Victoria, but said support was available for those that need it. See Part 1 below
” We acknowledge the work of Black Lives Matter protest organisers in limiting the spread of COVID-19 in protests held so far, and do not link existing cases of COVID-19 to previous protests. Despite this, as doctors we are bound to remind everyone that social distancing is still the best way to prevent the further spread of this potentially deadly new virus.
COVID-19 is currently spreading through communities in Victoria and in New South Wales, and restrictions on mass gatherings need to be respected.”
Australian Indigenous Doctors Association press release See Part 2 Below
Part 1 VACCHO Press Release
The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) has strongly urged Aboriginal people to stay home where they can, to get tested, and to self-isolate at home for 14 days while waiting for test results after two confirmed cases of COVID-19 were detected in Aboriginal Communities in Ballarat.
While face coverings are now mandatory for people living in Melbourne and Mitchell Shire when leaving their home, Ms Gallagher said that face covering should also be considered in rural areas, especially in areas where social distancing cannot be maintained.
“We can’t force anyone to wear a mask outside of Melbourne and Mitchell Shire, but as the peak Aboriginal health and wellbeing organisation we strongly encourage our communities in rural Victoria to wear a face covering if they own one. Particularly when you cannot apply physical distancing. Face coverings have been shown to reduce the risk of transmission and should be considered earlier rather than later for our mob,” Ms Gallagher said.
If people have symptoms of COVID-19, Ms Gallagher said it was important that they remain home and get tested no matter how mild.
“Symptoms could include fever, chills, cough, sore throat, shortness of breath, runny nose, loss of sense of smell or taste,” Ms Gallagher said.
“Go home straight after your test and self-isolate while you wait for the results. This usually takes 1-3 days. No heading to the shops or fishing with your mates until you have your results.
“If you are a confirmed case of COVID-19, you must isolate at home for 14 days to stop the virus spreading to other people. That’s really important.”
During this uncertain time, Ms Gallagher said staying connected with family, friends and your community was important.
“Some ways you can do this are calling people for a yarn on the phone, talking about the community and checking if they are OK, talking about the virus and how to stop the spread, connecting with family and friends on social media and sharing your tips on social media #KeepOurMobSafe,” she said.
Aboriginal and Torres Strait Islander people are at greater risk of coronavirus if they:
A one-off payment of $1,500 is available to workers who are unable to work during their isolation, have no income during this period, and are not entitled to any paid sick leave, special pandemic leave or other income support.
The Victorian Government will now extend the scheme to ensure that as soon as a person is tested, they will be eligible for a $300 support payment from the Victorian Government – as long as they meet the eligibility of the existing scheme.
People should call 1800 675 398 (option 8) to register for support.
There are three main sites in Ballarat where people can get tested:
Ballarat & District Aboriginal Co-operative, 108 Armstrong Street Nth Ballarat, 03 5331 5344
Ballarat UFS Respiratory clinic, corner Merz St and Eleanor Dr, Lucas (ph. 4311 1571 for an appointment).
A pop up testing site is also available at the Ballarat Senior Citizens Centre, 16 Little Bridge Street (ph. 1800 054 172 for an appointment) operated by Ballarat Community Health.
Clinics around the country to assess people with fever, cough, a sore throat, or shortness of breath.
These are being rolled out gradually. If there is not one in your area yet visit your state or territory health department website for more information on fever clinics and other services.
Find out if there is a clinic near you and how to register for an appointment:
Part 2. The Australian Indigenous Doctors’ Association (AIDA) unreservedly supports peoples’ right to protest and acknowledges the historic and ongoing role that protest has played in changing laws and practices that have discriminated against Indigenous peoples.
From the 1938 Day of Mourning and the Freedom Rides to the Wave Hill Walk Off, the AIDA remembers those who stood up for equality between Indigenous and non-Indigenous Australians.
We also understand the historic devastation that unchecked viral contagions can bring to Aboriginal and Torres Strait Islander peoples.
For the sake of our Elders and most vulnerable, AIDA urges people not to attend the Black Lives Matter (BLM) protest marches in Sydney until the risks of further spread of COVID-19 can be mitigated.
We acknowledge the work of Black Lives Matter protest organisers in limiting the spread of COVID-19 in protests held so far, and do not link existing cases of COVID-19 to previous protests. Despite this, as doctors we are bound to remind everyone that social distancing is still the best way to prevent the further spread of this potentially deadly new virus.
COVID-19 is currently spreading through communities in Victoria and in New South Wales, and restrictions on mass gatherings need to be respected.
The Australian Indigenous Doctors’ Association recognises the legacy of racism and calls for greater commitment to justice reinvestment strategies, diversion programs and culturally appropriate approaches that address the core issues of injustice raised by the BLM movement.
We do not encourage any action that will increase the risk of COVID-19 entering Aboriginal and Torres Strait Islander communities.
We will continue to support the community’s rights to engage in advocacy and encourage people to protest by other means during this health crisis, due to the inherent danger posed by mass gatherings at this time.
“ ACCHOs, as comprehensive healthcare services whose core business is population‐level health, have the skills, expertise and knowledge to create and execute appropriate COVID‐19 prevention messages.
Part of their success has been the trust that Aboriginal and Torres Strait Islander people place in them primarily because they deliver culturally appropriate service. In a time of crisis, they are best placed to deliver health promotion and crisis communication to Aboriginal and Torres Strait Islander people.
ACCHOs and their peak bodies, therefore, need to be resourced appropriately to ensure that Aboriginal and Torres Strait Islander people have the best possible information to reduce the risk to themselves, their families and their communities. ”
Noting all images and videos below added by NACCHO
Health communication during a health crisis, such as the COVID‐19 pandemic, is vital to reduce the impact on populations. To ensure the communication is effective, audience segmentation is required with specific resources that have been developed for each segment.
In addition, the messages need to be clear, mutual trust between the communicator and the audience needs to be developed and maintained, and resources should focus on cultural values.
The evidence around effective crisis communication indicates that it needs to be timely, clear, concise and appropriate to the target audience. Communication is particularly important for those at higher risk during the crisis, such as people who are immunocompromised, the elderly, and Aboriginal and Torres Strait Islander people.
Aboriginal and Torres Strait Islander people are at increased risk from COVID‐19 due to a range of factors associated with higher rates of non‐communicable diseases and a lack of access to health services in remote communities.
Additionally, there are socio‐cultural factors that put Aboriginal and Torres Strait Islander people at risk, such as high mobility for family or cultural reasons.
Despite the increased risk to Aboriginal and Torres Strait Islander people from COVID‐19, there has been little specific communication tailored for them from governments since the pandemic commenced.
This is despite the overwhelming evidence that health promotion messages need to be tailored for Aboriginal and Torres Strait Islander people.
To fill the gap, Aboriginal Community Controlled Health Organisations (ACCHOs) have demonstrated their capacity to deliver scientifically valid, evidence‐based and culturally translated COVID‐19 prevention messages.
The ACCHO sectors’ understanding of population health has led to a strong history of culturally centred health promotion and social marketing materials.
Even before the World Health Assembly declared COVID‐19 a global pandemic (11 March ACCHOs and their peak bodies had developed messages for their communities.
The ACCHO sectors’ communications on COVID‐19 have been produced in addition to their usual service delivery and using existing funding.
Effective social marketing campaigns segment a target audience and develop resources that are culturally appropriate. Culturally appropriate resources include target specific language choices, imagery and an understanding of culturally specific behaviour change motivations.
Four examples of ACCHOs that have delivered tailored resources include the Aboriginal Health and Medical Research Council of NSW (AH&MRC), Apunipima Cape York Health Council (Apunipima), Aboriginal Health Council of Western Australia (AHCWA) and National Aboriginal Community Controlled Health Organisation (NACCHO).
Each of the examples provided resources that were tailored specifically for Aboriginal and Torres Strait Islander people by including Aboriginal vernacular, Aboriginal and Torres Strait Islander art and images of Aboriginal and Torres Strait Islander people, and some included Indigenous languages.
Additionally, the material reflected Aboriginal and Torres Strait Islander people’s kinship structures by promoting self‐isolation and good hygiene as a way of taking care of family and community.
The AH&MRC, the NSW ACCHO peak body, has disseminated existing and new resources promoting COVID‐19 prevention online via their website, Facebook Twitter YouTube and Instagram
Additionally, they created the Aboriginal Community Controlled Health Service Pandemic Response Tool Kit. The materials were either resources developed by their member services (ACCHOs) or mainstream materials that have been repurposed and contextualised for Aboriginal and Torres Strait Islander people.
Apunipima, a Cape York ACCHO in Queensland has also been communicating with Aboriginal and Torres Strait Islander people about how to protect themselves from COVID‐19 via Facebook and TikTok, and by distributing printed resources.
The first Facebook post (6 March 2020) used simple, evidenced‐based prevention messages about handwashing. Subsequently, they produced infographics and short localised video updates.
AHCWA, the Western Australian ACCHO peak body, has also developed infographics promoting prevention measures such as hand washing and COVID‐19 symptoms.
“It has been recognised that COVID-19 poses a serious risk to Aboriginal and Torres Strait Islander people due to higher levels of chronic conditions especially those aged 50 years and older.
“The specific advice of all health authorities is that while COVID-19 remains in Australia that everyone should take precautions including the social distancing and hygiene practices,” she said.
“People with coronavirus can spread the virus for at least 48 hours before showing symptoms. Those who attended the rally should take every precaution they can in terms of practical measures to protect themselves and their families.
“It is important you continue with social distancing, regular hand washing and cough hygiene. If you can, avoid contact with Elders and with people with chronic medical conditions as these people are at much higher risk of serious COVID-19 illness if they get infected.
If you develop even the mildest of symptoms, stay home and get a COVID-19 test. The symptoms that warrant a COVID-19 test include a sore throat, cough, shortness of breath, chills, night sweats or a temperature over 37.5°C.
“As per government’s health advice, people who marched don’t need to isolate unless they felt sick, in which case, they should get tested. The earlier we pick up infections, the quicker we can move to prevent further spread.”
1.Download the NACCHO submission to Senate hearing Governments response to COVID-19 response.
2.The “Unsung” Impacts of COVID-19 on the Aboriginal Community Controlled Health Services in Western Australia. Download
3.Full transcript this weeks Senate Select Committee on COVID-19 – Australian Government’s response to the COVID-19 pandemic. Indigenous health.
4.Updated list of operational ACCHO GPRC’s as at June 4
5.Minister Ken Wyatt opens Derbarl Yerrigan Health Service’s Respiratory Clinic in Perth .
6. KAMS ACCHO rolls out first COVID-19 point of care testing site in Kimberley.
7.WA Journey to health and healing video.
8. Summary of national easing of restrictions plus roadmap to easing restrictions in Queensland remote communities.
9.Download the COVIDSafe app :What you need to know about the #COVIDSafe app and how the app will help protect our communities.
10. ACCHO’s support Black Lives Matter marches in Brisbane and Melbourne by providing masks and hand sanitiser
1.Download the NACCHO submission to Senate hearing Governments response to COVID-19 response.
The COVID-19 virus has exposed the vulnerability of Aboriginal and Torres Strait Islander people to pandemics.
Generations of systemic and ongoing provision of inadequate housing and infrastructure, overcrowding, and social disadvantage, and the high prevalence of comorbidities among Aboriginal and Torres Strait Islander people contribute to higher mortality in Aboriginal and Torres Strait Islander people.
Over 50% of all Aboriginal and Torres Strait Islander adults have one or more chronic diseases which places them at high risk of serious COVID-19 infection.
During the COVID-19 pandemic, these factors make Aboriginal and Torres Strait Islander people one of the most vulnerable populations to the COVID-19 virus.
If COVID-19 gets into Aboriginal and Torres Strait Islander communities, the consequences could be catastrophic.
The Australian Government, along with its counterparts in the States and Territories, has recognised Aboriginal and Torres Strait Islander people are highly vulnerable and that it would be catastrophic if the COVID-19 virus was to spread to communities. This same recognition did not occur with the 2009 H1N1 influenza epidemic, during which Aboriginal and Torres Strait Islander peoples suffered a death rate of more than four times higher than non-indigenous Australians1,2.
The high level of collaboration by the National Cabinet has been instrumental in achieving the low number of COVID-19 cases among Aboriginal and Torres Strait Islander peoples, together with the leadership of Aboriginal and Torres Strait Islander people across our health sector and Ms Pat Turner’s leadership on negotiating a new National Agreement on Closing the Gap.
2.The “Unsung” Impacts of COVID-19 on the Aboriginal Community Controlled Health Services in Western Australia. Download
3.Full transcript this weeks Senate Select Committee on COVID-19 – Australian Government’s response to the COVID-19 pandemic. Indigenous health.
Senator McCARTHY: Could I go to funding for mental health. The government has allocated $3 million for Aboriginal and Torres Strait Island people for mental health through PHNs. I want to understand the process in which the government provided funding for mental health and why it’s gone to PHNs.
Mr Matthews: First Assistant Secretary, Indigenous Health, Department of Health
We don’t have anyone here from our mental health area, but I think you’re referring to the recent announcement around mental health, which did include $3½ million for Indigenous mental health, which will flow through the Primary Health Networks. So that will be injected into there. A significant amount of the Indigenous mental health funding does run through the PHNs, so that is a strengthening of an existing framework; it injects further funding into that system. The details will be worked through with the PHNs for the PHNs to use flexibly in providing mental health support in the regions.
Senator McCARTHY: It’s going through the PHNs. Why is it that it didn’t it go through the ACCHOs?
Mr Matthews: As I said, that one is a decision—it’s just the way the funding has worked. A lot of the mental health funding does run through the PHNs currently. The mental health work for Aboriginal and Torres Strait Islander people does work through PHNs now, so it is an additional injection into that existing process, noting that, obviously, a lot of what the PHNs do is to make arrangements with ACCHOs and Aboriginal community controlled health services locally. Quite a reasonable proportion of the funding does go to ACCHOs. Obviously, the sector has—for some time, I think—been looking to ask questions around those arrangements. That discussion is ongoing with government. But, at the moment, that is an additional injection into the existing funding.
Senator McCARTHY: Did funding for mental health in response to the bushfires go to the ACCHOs or to NACCHO?
Mr Matthews: There was funding, in the bushfire context, that did go directly to the Aboriginal community controlled sector. That was to support a limited number of areas that were directly affected by the bushfires. At the time, going through those Aboriginal community controlled health services was seen as the fastest way to provide support into those areas.
Senator McCARTHY: So you’re saying that, on one hand, you’re strengthening the system by going through PHNs when, in actual fact, you already had a precedent set by sending the mental health funding directly to the ACCHOs, yet you’re not doing it in this situation where it’s even faster for ACCHOs to be dealing directly with First Nations people as opposed to PHNs.
Mr Matthews: I think that, obviously, the majority of the mental health funding does run through the PHN system at the moment. There was some funding, in the bushfire context, provided directly through to the ACCHOs, but, as I said, it was a decision of government for the $3½ million to go into and through the PHN network, noting that a large amount of the money does find a way through to the Aboriginal community controlled sector through the PHNs. As I said, there is an ongoing discussion where the community controlled sector is seeking to discuss those arrangements more broadly. I’m sure that discussion will continue with government.
4.Updated list of operational ACCHO GPRC’s as at June 4
5. Minister Ken Wyatt opens Derbarl Yerrigan Health Service’s Respiratory Clinic in Perth.
The first Derbarl Yerrigan Health Service Respiratory Clinic opened Tuesday in the Derbarl Maddington Clinic, as part of the Australian Government’s $2.4 billion health package response to the COVID-19 outbreak. Derbarl provides holistic and culturally responsive health care to more than 10,000 active Aboriginal patients in the Perth metropolitan area.
Respiratory disease accounts for 8% of the burden of disease, and is the third leading cause of death for Aboriginal people. Aboriginal people are more than five times more likely to be hospitalised for influenza-related illnesses than non-Aboriginal people, with the highest rate of hospitalisation in children less than five years of age. Derbarl treats more than 1,500 patients each year with chronic respiratory illnesses alone.
The opening of the respiratory clinic is therefore fundamental to meeting the health needs of Aboriginal people.
Chairperson of Derbarl Yerrigan, Ms Francine Eades said “Considering these alarming statistics, I am pleased that Derbarl responded to the opportunity to provide this vital service to our patients and the wider community.
We have joined the growing number of Aboriginal Community-Controlled Health Services delivering GP-led respiratory clinics to our people.”
6.KAMS rolls out first COVID-19 point of care testing site in Kimberley.
KAMS CEO, Vicki O’Donnell, is excited to be the first service in the country to offer this testing capability.
“This will be a game changer for our communities. The fact that we will have an immediate test result will save us having to transport people to Broome, where they are separated from family and friends while they await their test result,” O’Donnell said.
“The new point of care tests will allow us to undertake contact tracing with that individual while they wait the 45 minutes for their test outcome.”
“If their result returns negative, they can be treated for the condition they presented at the clinic with and return home. If their result returns positive, we can make an immediate start on contacting anybody they have been in contact with.”
O’Donnell thanked the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Commonwealth Indigenous Health Division, with particular regard to Dr Lucas De Toca and his team. She also extended thanks to the Kirby Institute, whose support enabled the roll out of the point of care testing GeneXpert machines.
8. Summary of national easing of restrictions plus roadmap to easing restrictions in Queensland remote communities.
Updated June 5 Western Australia will join the Northern Territory in lifting travel restrictions across remote communities on Friday, 5 June 2020.
The Australian Government has taken this action in response to a request by the Deputy
Premier and Minister for Health and Mental Health of Western Australia, The Hon. Roger
Cook MLA, to lift the restrictions currently in place through the Emergency Determination
under the Biosecurity Act 2015.
9.Download the COVIDSafe app :What you need to know about the #COVIDSafe app and how the app will help protect our communities.
10. ACCHO’s support Black Lives Matter marches in Brisbane and Melbourne by providing masks and hand sanitiser
Thanks to the Victorian Aboriginal Community Controlled Health Organisation Inc, Victorian Aboriginal Health Service -VAHS Queensland Aboriginal and Islander Health Council and The Institute for Urban Indigenous Health they able to support the BlacK Lives Matter march in Melbourne and Brisbane by providing masks and hand sanitiser.
For all the mob in Melbourne VAHS will be present for tomorrow’s Black Lives Matter rally to hand out face masks and hand sanitisers to make sure we take a harm minimisation approach.
For the Melbourne mob : Come see VAHS Staff between 12pm to 2pm, next to Sir Doug Nicholls and Lady Nicholls statue in Parliament Gardens to receive free face masks
“As restrictions ease for some of us in the community, we must not forget that the risk of Covid-19 and human rights abuses within prisons remains extremely high.
We have heard reports of people in prisons being denied soap, having to spend their own money to make phone calls to family after visits were banned, not being able to speak confidentially with their lawyers and being stuck on remand because with the current restrictions it has been impossible for lawyers to prepare adequately for a hearing.
This means once again our people are spending longer in prison in potentially dangerous conditions.
The report also documents the devastating challenges our families are facing staying connected with their children. Our children are still being taken from their families and communities at far higher rates than the rest of the population.
The Covid-19 pandemic has put enormous stress on everyone, but for Aboriginal families the burden is even greater. We’ve heard stories of babies being removed at birth and families having to fight to see a photograph, mothers being denied visits withtheir young children and the fear that this will impact on their future ability to be reunified as a family.
When we reflect on Sorry Day this week, and the fact that children are still being taken from our families at unacceptable and disproportionate rates, we are calling on the Federal Government to not allow Covid-19 to be yet another excuse to tear our families apart.”
Aboriginal people in prisons are going without soap, and children in out-of-home care are being refused contact with their families under “punitive” restrictions enforced due to Covid-19, a report released on Wednesday has said.
Aboriginal people are disproportionately affected by Covid-19 policy responses at a state, territory and commonwealth level, the report by the Change the Record coalition, said.
Change the Record is the Aboriginal-led justice coalition including Amnesty International, the Law Council of Australia, the National Aboriginal and Torres Strait Islander Legal Services (Natsils) and National Aboriginal Community Controlled Health Organisations (Naccho), representing hundreds of services across Australia.
The report said there have been increased use of lockdowns and isolation within correctional facilities, and a reduced access to education, family and legal visits.
It cites the case of Daniel*, remanded in prison in Tasmania since early 2020 on his first time in custody.
“His matter was heard by telephone in April but he was refused bail. His lawyer sought an adjournment of his matter because they were unable to prepare a defence without being able to see him, properly take his instructions or go through the material with him.
“Daniel is not allowed any visits with his family or his lawyer because of Covid-19 restrictions. He also has health issues, asthma and has extreme anxiety about the virus getting into the prison.
“He reports having no access to any type of sanitiser in prison and was frequently without soap.”
The report calls on governments to release low-risk prisoners from prisons and youth detention centres, but says it has been“difficult” to get up-to-date information about conditions due to “the withdrawal of independent oversight bodies and external scrutiny in many states and territories”.
Recommendations
We urgently call on state, territory and federal governments to:
ReleaseAboriginal and Torres Strait Islander prisoners who are low-risk, have chronic health conditions, are on remand, are elderly, children or are for whatever reason at increased risk of Covid-19
Protectthe human rights of Aboriginal and Torres Strait Islander peoples in prison by ensuring access to oversight and monitoring agencies, family, legal services, mental health care, education and programs
Raisethe age of criminal responsibility from 10 to at least 14 years old and urgently release children and young people from youth detention centres during Covid-19
Enact a national Aboriginal and Torres Strait Islander child protection notification and referral scheme to reduce family violence driven child removal through proactive, culturally safe and holistic legal
Connect Aboriginal and Torres Strait Islander peoples who experience family violence, and who are engaged with the child protection system, with culturally appropriate services through their nearest Family Violence Prevention Legal
Increase support and access to safe accommodation for Aboriginal and Torres Strait Islander families fleeing family violence to stop further removals of Aboriginal and Torres Strait Islander children
Implement immediate short-term changes in legislation, where applicable, in relation to Aboriginal and Torres Strait Islander children in out of home care to ensure parents don’t lose their children to permanent care during Covid-19.
Resistpunitive policy responses to Covid-19 and the over-policing of already targeted communities, and require transparency and oversight in policing;
Ensure that Aboriginal and Torres Strait Islander peoples, including those with disability, are given equal access to high quality and culturally-appropriate health care during Covid-19; and
Rebuild our justice system after Covid-19 to focus on investing in community, not prisons, to increase community safety and prevent black deaths in
“As restrictions ease for some of us in the community, we must not forget that the risk of Covid-19 and human rights abuses within prisons remains extremely high,” the Change the Record co-chair, Cheryl Axleby, said.
The report also highlights the “distress and anxiety” about Covid-19 restrictions felt by Aboriginal children and parents in the out-of-home care system.
It cited the case ofBenjamin*, born in the Northern Territory in February and removed immediately.
In Tasmania, one Aboriginal legal service reported that “child safety will not facilitate face-to-face contact with children in out-of-home care and their Aboriginal parent”.
Julia* had been having multiple visits with her child every week but due to Covid-19 her contact has been reduced to one phone/video call a week.
“The Covid-19 pandemic has put enormous stress on everyone, but for Aboriginal families the burden is even greater,” Axleby said.
The report is one of two released to coincide with national reconciliation week. Amnesty International has renewed calls for state and territory governments to raise the age of criminal responsibility to 14. Currently, the minimum age is 10, which Amnesty and Change the Record said is well below international standards.
“The medical evidence is clear – kids are still developing at 10, 11, 12 years old and need to be in school, at home and with their peers, not behind bars,” Axleby said.
The report also details allegations of police surveillance of Aboriginal communities, under the guise of Covid-19 restriction enforcement.
It quotes a witness to an incident in inner Sydney: “Two police vehicles were coming in the opposite direction. The second vehicle stopped to talk to an Aboriginal man who was walking slightly ahead of me in the same direction. I stopped in case he needed help or a witness.
“He was agitated and told the police he’d already been stopped twice in the preceding 10 minutes and that he was on his way to the Glebe police station to lodge a complaint about racial profiling.
“He had been stopped 37 times in the past month. He had lived in the area for more than 30 years.”
“ This year’s #NRW2020 theme is ‘In this Together’ – reminds us whether in a crisis or reconciliation we are all #InThisTogether2020.
We have shown during these tough times that we can all do our part to stop the spread of a deadly disease and the results speak for themselves.
Aboriginal and Torres Strait Islander people continue to be impacted by the legacy of colonisation but what continues is our resilience amidst the adversity we face. When we face adversity together, we see stronger outcomes.
If we all can work together and support the journey of reconciliation, every step forward removes disadvantage and creates a more solid foundation for our country towards a better future for all Australians.”
“National Reconciliation Week draws our attention each year to the ongoing efforts to walk together with a shared purpose, and to build a stronger future for all Australians.
This year’s theme, In This Together, resonates in new ways in light of the current COVID-19 pandemic and reminds us we all share this land and rely on each other to build a better future.”
Minister for Indigenous Australians, the Hon Ken Wyatt AM, MP, has asked Australians to think about what reconciliation means to them and what practical steps they can take to build trust, mutual respect and opportunities for Indigenous Australians. Pictured above with NACCHO CEO Pat Turner
National Reconciliation Week 2020 is an invitation to all Australians to celebrate and deepen the bonds with Aboriginal and Torres Strait Islander peoples.
“The week commences 27 May marking the anniversary of the 1967 Referendum and concludes with the anniversary of the High Court’s Mabo decision on 3 June – both significant milestones in our shared history that had profound impacts on Aboriginal and Torres Strait Islander peoples.”
“These moments in our reconciliation journey remind us of the tireless campaigners who sought to bring us closer and the success that can be achieved when Australians come together as one.”
“This year also marks 20 years since Corroboree 2000 and the memorable Walk for Reconciliation across Sydney Harbour Bridge where close to a quarter of a million people demonstrated their commitment to reconciliation. The images from that day are still striking and it’s important we do not lose that enthusiasm.”
“While we are unfortunately not able to celebrate with gatherings this year due to COVID-19, there are many events happening online that people can get involved with.”
“From film screenings and book recommendations to panel discussions and streamed concerts, there are opportunities for people to learn about our history, engage with Indigenous culture and reflect on what it means to be in this together.”
“I also encourage all Australians to take part in the National Acknowledgement of Country. At midday on Wednesday 27th May, join Indigenous Australians across the nation by posting a video of an acknowledgement of the country you are on with the hashtags #InThisTogether2020 and #NRW2020.”
” Getting enough healthy food at all times is not something many Aboriginal and Torres Strait Islander people in remote communities can take for granted.
COVID-19 has exposed a decades-old issue that contributes significantly to the health gap between Aboriginal and Torres Strait Islander and non-Indigenous Australians.
Now is the time to support communities during this pandemic and to increase future resilience.
If the COVID-19 pandemic has a silver lining it is how this experience makes us think twice about what we want ‘normal’ times to look like. “
Dr Megan Ferguson is a Senior Lecturer in Public Health Nutrition at The University of Queensland. She manages a research program in partnership with Aboriginal community-controlled organisations that seeks to improve food security. See full story Part 1 below
” Charging high prices because people aren’t in a position to challenge it (or shop elsewhere) is another key reason why prices are high. Its called price gouging, and remains a very real problem in the NT.
There are ethical ramifications on food security for charging high prices. Like everyone the world over, shopping patterns are influenced by cost. If healthy products are expensive to buy, shoppers will choose the cheaper, less healthy product. A pie instead of a meat and vegetables for example or takeaway fried chicken instead of cooking at home with fresh produce.
The incidence of chronic disease in Indigenous populations is in large part due to the food availability and the prices in community.
Therefore the impact the store pricing has on community health is significant. Read more ”
” Indigenous Australians suffer a disproportionate burden of preventable chronic disease compared to their non-Indigenous counterparts – much of it diet-related.
Increasing fruit and vegetable intakes and reducing sugar-sweetened soft-drink consumption can reduce the risk of preventable chronic disease.
There is evidence from some general population studies that subsidising healthier foods can modify dietary behaviour. There is little such evidence relating specifically to socio-economically disadvantaged populations, even though dietary behaviour in such populations is arguably more likely to be susceptible to such interventions.
This study aims to assess the impact and cost-effectiveness of a price discount intervention with or without an in-store nutrition education intervention on purchases of fruit, vegetables, water and diet soft-drinks among remote Indigenous communities. ”
Healthinfonet have just released the Summary of #nutrition among Aboriginal and Torres Strait Islander people. This publication provides key information on food, diet and #nutritionalhealth among Aboriginal and Torres Strait Islander people in Australia.
Part 1 :Solutions to food affordability and availability in remote communities
One of the successes of Australia’s response has been the ubiquitous priority recognition given to our First Nations people in remote communities, and the swift response in protecting them.
They bear a disproportionate double burden of co-morbidity and economic inequality, and are among those most at risk of severe COVID-19 related symptoms.
The advocacy and leadership of Indigenous organisations, and the rapid response from government in declaring the Biosecurity Act, has thus far safeguarded people living in remote communities.
Pre-COVID-19, dietary risk factors and obesity contributed at least 18 per cent of the burden of disease experienced by Aboriginal and Torres Strait Islander people. In remote communities, 31 per cent are reported to experience food insecurity – the inability to regularly access enough healthy food, which leads to poor diet – compared to ONLY 4% of all Australians.
The true prevalence could be twice as high. Food insecurity is caused by a lack of food availability due at times to precarious supply, and a lack of food affordability, resulting from those with the lowest incomes paying the highest food prices in our nation.
Limited access to manufacturer deals and buying power, freight costs, challenging logistics, high operational and maintenance costs and supply to a small population are amongst the factors impacting on the cost of food. That was in ‘normal’ times – the times that led to this disproportionate level of co-morbidity.
The COVID-19 response travel restrictions and increased government allowances have increased demand on community stores, already feeling the squeeze on supply, due to the flow-on effects of major supermarket purchasing elsewhere.
Federal Minister for Indigenous Australians, Ken Wyatt recently created the Food Security Working Group to closely monitor issues specific to remote and regional Australia. Emergency food relief has been provided to communities, a necessity when there are abnormal pressures on the system.
This will not solve the problem though, that requires a systematic approach from government. We anticipate the Food Security Working Group will succeed in quarantining, what in the scheme of things is such a small volume of the nation’s food supply, to ensure sustainable food availability in remote stores.
But there has been no relief on the food affordability front. Remote community residents receiving government allowances have shared the benefits of the national economic package.
However, they continue to face disproportionately high food prices compared to those living in regional centres – on average 60% for healthy food in the Northern Territory and other remote jurisdictions. This comes at the same time as access to town supermarkets with their lower food prices, has been restricted.
Being able to purchase healthy food at regional centre prices will go a long way to supporting people in remote communities now. We need to address ongoing food price inequity to improve food security and diet quality, and ultimately reduce disease burden to ensure remote communities recover and build resilience.
It is time for real action on food price equity and food affordability. This pandemic is making us think deeply about what sort of society we want beyond this current crisis. Here is our opportunity to shape it. Healthy food price equity is a new normal we would like to see.
Dr Megan Ferguson is a Senior Lecturer in Public Health Nutrition at The University of Queensland. She manages a research program in partnership with Aboriginal community-controlled organisations that seeks to improve food security.
We know prices are too expensive in Aboriginal community stores around the NT. To prove the point however, we went shopping. The results from our Market Basket survey will shock you.
In April and May, 2020 our shoppers went into 9 stores in the Top End with the same shopping list made up of essential and popular products.
More importantly though, how is it possible that one store can charge almost $25 more for the same basket of products? Obviously, it’s because the prices are higher. The trickier and more important question to answer is why?
Lets just break it down a little, and look at chicken prices as an example of how prices influence food security.
Barunga store charges $9.40 for 2kg of Hazledene chicken cuts and Beswick store (which is run by the Commonwealth entity Outback Stores) charges $16.80. Its only 25km down the road! Another community store charges $24.60 for the same product.
Why the price difference?
There are three reasons why the prices are different between stores: rebates, ethics and freight.
Rebates
A rebate is money paid by the supplier to store management stock their products. Our research shows rebates can range between 1.5 and 25%. Rebates are calculated on each product and the higher the rebate, the more expensive the product becomes. Coke and tobacco reap the highest rebates in community stores. Rebates are given to the store management groups, and not the stores themselves.
Rebate revenue is worth millions of dollars in the Northern Territory alone. Look for example at the Commonwealth owned Outback Stores which last year made more than $2.6 million in rebates https://outbackstores.com.au/wp-content/uploads/2019/12/OS-Annual-Report-19-web-spread.pdf through raising the cost of products in store. That is a lot of tobacco and Coke!
AIG does not accept rebates because we believe it is unethical and drives up prices in the store which further disadvantages the vulnerable and threatens food security.
Freight
Usually listed as the primary reason for high prices in community stores, but in reality, has a far lesser impact on the actual prices of products in the store.
Freight is the cost of getting the products from the supplier to the store. If a store is very remote, then the freight is obviously going to be more expensive. Freight should be cheaper for the larger management groups because they order in bulk which reduces the actual freight costs further.
AIG is a small store management group and if we can have low prices while paying freight, it is proof that freight is not as expensive as people are led to believe.
Keep comparing food prices
We want to disrupt how community stores are managed in the NT through creating transparency about prices in stores. Its hard for people in remote communities to understand the situation they are in if they can’t compare prices in their stores to other communities.
AIG has created online shopping for the Barunga and Timber Creek communities which is a great service, but equally important is being able to provide transparency the prices we charge so others can compare to the prices in their stores. We don’t accept rebates from suppliers, and we don’t make a profit on fruit and vegetables. This is how our prices are low. If we can do it, other stores can do the same.
“We would need to ensure that strong border controls are maintained and that fully resourced and detailed national, jurisdictional and local outbreak plans are in place that ensure integration and coordination between the NT and Commonwealth governments”.
CEO of Aboriginal Medical Services Alliance NT (AMSANT), John Paterson, expressed support for the relaxation of the Biosecurity measures but noted that to do so safely would require a number of safeguards in place. Quote added by NACCHO / AMSANT
“Our mob living in remote communities want to come into major centres to get food, other essential items and medical treatment they cannot get out bush. We want to move about with our kids and family members without having to quarantine for 14 days,”
Northern Land Council CEO Marion Scrymgour said the act “adversely affected” the movement of Aboriginal people living on homelands and outstations in comparison to non-Aboriginal people. See further quotes below
“We all went into this together, and we’ll get out of this together.
We don’t want to see double standards emerging — where people could get a laksa at Parap Markets and a have bet at the pub from June 5, but the community mob are still locked in.”
Central Land Council CEO Joe Martin-Jard said he wanted the Biosecurity Act to be lifted on June 5, a date that coincided with stage 3 of COVID-19 restrictions easing in the NT.
“It is important that we remain cautious in our approach, we don’t want to see COVID-19 entering one of our communities.
Both Indigenous communities and the Government see this as critical. Many Aboriginal and Torres Strait Islander peoples have more complex health needs than other Australians and my primary concern is continuing to keep this virus out of our communities as much as possible.”
Indigenous Affairs Minister Ken Wyatt said Mr Gunner was able to request changes to the NT’s Biosecurity Act at any time, and discussions between the Federal and NT governments were ongoing.
Northern Territory Chief Minister Michael Gunner says travel to the NT’s 76 remote Indigenous communities may be permitted as early as June 5, following discussions with NT land councils and peak Aboriginal health bodies this week.
The Biosecurity Act, barring essential travel to remote NT communities, is scheduled to stay in place until June 18
Mr Gunner said land councils asked him yesterday to lift restrictions on June 5
But the Chief Minister confirmed easing border restrictions would be the last move by the Government
“The NT is the safest place in Australia,” Mr Gunner said.
“Because we are safe, and because we have strict border controls for the NT, we can look at bringing forward the date for the Biosecurity Act restrictions.”
Under the Biosecurity Act, all non-essential travel to remote Territory communities is currently banned and a 14-day isolation period applies for community residents wanting to return home from regional centres.
The restrictions are scheduled to stay in place until June 18 and align with a 90-day public health emergency declaration.
Mr Gunner said Land Councils asked him yesterday to lift restrictions on June 5 and he would now speak to the Commonwealth about the possibility.
Land councils back proposal
Central Land Council CEO Joe Martin-Jard said he wanted the Biosecurity Act to be lifted on June 5, a date that coincided with stage 3 of COVID-19 restrictions easing in the NT.
“We all went into this together, and we’ll get out of this together,” Mr Martin-Jard said.
“We don’t want to see double standards emerging — where people could get a laksa at Parap Markets and a have bet at the pub from June 5, but the community mob are still locked in.”
At the moment, Mr Martin-Jard said people were locked in their own communities with only one shop to visit, and as the weather cooled in Central Australia, it was important residents could leave to buy warmer clothes and other items they needed — without being forced to quarantine for 14 days upon their return.
Northern Land Council CEO Marion Scrymgour agreed.
“Our mob living in remote communities want to come into major centres to get food, other essential items and medical treatment they cannot get out bush. We want to move about with our kids and family members without having to quarantine for 14 days,” she said.
Ms Scrymgour said the act “adversely affected” the movement of Aboriginal people living on homelands and outstations in comparison to non-Aboriginal people.
“Despite the fact that the intent of the biosecurity measures was to protect Aboriginal people — and this was made clear by both the Prime Minister and the NT Chief Minister from the start — there were elements of the process that were unfair to some Aboriginal people, particularly those living on Community Living Areas — those small areas of land excised for the benefit of Aboriginal people from very large pastoral stations,” she said.
‘We should keep the borders to the NT closed’
Ms Scrymgour and Mr Martin-Jard both said they only supported lifting the Biosecurity Act on June 5 if the NT’s strict border restrictions remained in place.
“We want to see some easing of restrictions in the NT, but only if it’s safe and only if they keep the strong Territory border restrictions,” Mr Martin-Jard said.
“That’s a really positive indication it’s pretty safe for our mob to travel in and out of remote communities without needing to quarantine upon return. But I agree with the Chief Minister that we should keep the borders to the NT closed for a while longer,” she said.
Mr Gunner yesterday confirmed easing the NT’s tough border restrictions would be the last move by the Government.
He also said it was unlikely the Territory would open borders with WA and SA before the eastern states.
Feds to rule on the Biosecurity Act
The decision about when to lift the Biosecurity Act is one for the Commonwealth, and Mr Gunner will need to write to Federal Health Minister Greg Hunt asking him to sign off on the proposal.
Indigenous Affairs Minister Ken Wyatt said Mr Gunner was able to request changes to the NT’s Biosecurity Act at any time, and discussions between the Federal and NT governments were ongoing.
“It is important that we remain cautious in our approach, we don’t want to see COVID-19 entering one of our communities,” Mr Wyatt said.
“Both Indigenous communities and the Government see this as critical. Many Aboriginal and Torres Strait Islander peoples have more complex health needs than other Australians and my primary concern is continuing to keep this virus out of our communities as much as possible.”
