NACCHO coverage #NTElections #Aboriginal Health #DonDaleKids Policy document RACP

NT

#Aboriginal Health

” In the Northern Territory, as elsewhere in Australia, Aboriginal and Torres Strait Islander people disproportionately experience poor health – much of which stems from SDoH factors. Concerted action must be taken by the incoming government to address these.

For instance, overcrowded housing for Indigenous people is a major problem in the Northern Territory and contributes to increased rates of infectious diseases. It is associated with the spread of ear and eye diseases, skin infections, respiratory infection, and streptococcal infections causing rheumatic fever and rheumatic heart disease.

Education and literacy are strongly associated with lifestyle choices and health literacy. The incoming government must prioritise strategies which improve access to education and increase educational participation for Aboriginal and Torres Strait Islander people across the Northern Territory, including early childhood education. “

The RACP’s Northern Territory Committee

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#DondaleKids

“As in other Australian states and territories, Aboriginal and Torres Strait Islander youth and adolescents are hugely overrepresented in the Northern Territory justice system.

The special needs of these young people need to be considered. This should include the involvement of the Aboriginal Community Controlled Health sector in the provision of culturally specific and safe care. Culturally appropriate services and support programs are also needed post juvenile justice incarceration.

We welcome the Royal Commission into Child Protection and Youth Detention Systems of the Northern Territory; however we are calling for the Terms of Reference to be broadened to cover health. It is also crucial that all those who have been victims of any abuse receive immediate support and treatment for physical and mental health issues.

The disproportionate number of Indigenous young people in detention makes it essential that formal processes and mechanisms are put in place to facilitate the participation of Aboriginal and Torres Strait individuals and communities in the work of the Royal Commission and the overhaul of the Northern Territory’s incarceration culture.

The RACP’s Northern Territory Committee

Download this policy document

NT time-for-action-on-health-policy-nt-federal-election-statement-2016

INDIGENOUS AFFAIRS

The CLP abolished the Aboriginal Affairs portfolio, but reinstated it in 2015, has set public service Aboriginal employment targets and had pledged to invest more in remote housing, with a $1.65 billion program to build 240 houses a year for eight years in remote communities. Labor has pledged to give communities greater control over local government, education and training, health, childcare and justice, as well as promising a $1.1 billion 10-year remote housing program.

FROM AAP Summary see below part 2

 First Aboriginal eye doctor Kris Rallah-Baker working at Sunrise health clinic at Mataranka in the Northern TerritoryPhoto: Michael Amendolia

Overview

The Royal Australasian College of Physicians (RACP) is committed to working with all political parties to inform the development of health policies that are evidence-based and grounded in clinical expertise, that focus on ensuring the provision of high quality accessible healthcare. The Northern Territory Committee of the RACP utilises the knowledge and expertise of Northern Territory based members to develop policy positions and proposals which prioritise the health of all Territorians.

The RACP’s Northern Territory Committee has identified a number of policy priorities for the incoming government, accompanied by recommendations for action. These include:

  • Measures to address health inequity and the social determinants of health, as means to improve health outcomes and reduce rates of preventable diseases;
  • Improving access to specialist medical care for Aboriginal and Torres Strait Islander people and supporting the vital services of the Aboriginal Community Controlled Health sector;
  • Banning the use of lead shot for hunting;
  • Improving the provision of health, psychological and social services to adolescents in the juvenile justice system to facilitate rehabilitation and help detainees develop lifelong healthy behaviours;
  • Immediately ending the dangerous policy of open speed zones;
  • Implementing effective, community-led measures to reduce the harms of alcohol, including better utilisation of Alcohol Action Initiatives; and
  • Facilitating the provision of specialist medical services in community-based settings.

 

The RACP urges the incoming government to adopt strong policies which put the health of Territorians first, in line with the recommendations contained in this document.

Social Determinants of Health

Health is a matter that calls for a whole-of-government approach. The evidence is clear, an individual’s health is not only shaped by lifestyle choices but also by a range of socioeconomic factors which individuals often do not have direct control over. These are commonly referred to as the Social Determinants of Health (SDoH) and include housing, early childhood experience, economic status, transport, built and social environments and access to resources.

The evidence to date shows that:

  • Diseases and illness are exacerbated and disparately distributed in direct relationship to inequities in society.
  • Addressing the SDoH will reduce the burden of avoidable disease, resulting in savings to the health system as well as economic growth and development.

If action was taken to address the determinants of health at all levels of government, it is estimated that 500,000 Australians could avoid incurring a chronic disease.2

Governments can influence the SDoH by adopting an approach to policy-making that places health as a key decision-making factor in all areas of policy. This approach, referred to as Health in All Policies (HiAP), consists of systematically taking into account the health and health-system implications of all policy decisions, by seeking synergies between policy portfolios and avoiding harmful health impacts, in order to improve population health and health equity.3

In the Northern Territory, as elsewhere in Australia, Aboriginal and Torres Strait Islander people disproportionately experience poor health – much of which stems from SDoH factors. Concerted action must be taken by the incoming government to address these.

For instance, overcrowded housing for Indigenous people is a major problem in the Northern Territory and contributes to increased rates of infectious diseases. It is associated with the spread of ear and eye diseases, skin infections, respiratory infection, and streptococcal infections causing rheumatic fever and rheumatic heart disease. Education and literacy are strongly associated with lifestyle choices and health literacy. The incoming government must prioritise strategies which improve access to education and increase educational participation for Aboriginal and Torres Strait Islander people across the Northern Territory, including early childhood education.

In addition to adopting a Health in All Policies approach, a strong focus on health prevention is required. The absence of a clearly defined preventive health strategy in Australia is deeply concerning, especially with chronic conditions such as heart disease, kidney disease, cancer and type II diabetes, accounting for accounting for 83 per cent of premature deaths (deaths among people aged less than 75 years) and 66 per cent of the burden of disease in Australia. Investment in preventive health improves the population’s health and is critical to the long-term sustainability of the Northern Territory healthcare system.

Preventive health measures must address key contributing factors to chronic diseases in Australia, including alcohol consumption, obesity, poor nutrition and tobacco use. In order to effectively manage the preventive health risks posed by lifestyle factors and associated diseases, a coordinated approach is required.

The RACP calls on the incoming NT government to:

  • Adopt a ‘Health in All Policies’ approach to policy-making to place health as a key decision-making factor in all areas of policy which impact on individuals and communities’ health (i.e. housing, education, transport, built and social environments, etc.).
  • Develop a Northern Territory preventive health strategy which addresses and lowers the risk factors for preventable illnesses and diseases.
  • Support and contribute to the development and implementation of a national Australian Preventive Health Strategy.

Aboriginal and Torres Strait Islander Health

Data and experience shows that Aboriginal and Torres Strait Islander people access specialist services at a lower rate than needed, and they face many barriers in accessing specialist care – this is true whether they live in the city or in rural or remote areas.

For young Aboriginal and Torres Strait Islander people, access to sexual health information and services is critical. Concerted action is required to address the high levels of sexually transmitted infections (STIs) in Indigenous communities and to prevent increases in infection with blood borne viruses (BBVs). Aboriginal and Torres Strait Islander youth need to be empowered to promote and discuss good sexual health; supported to access timely, affordable and culturally appropriate sexual health services; with a target to reduce the incidence of STIs amongst Indigenous young people included in the Close the Gap objectives.

The RACP welcomed the launch of the Implementation Plan for The National Aboriginal and Torres Strait Islander Health Plan 2013-2023, with its recognition of the need for a national framework to improve access to specialist care that is needs-based, and initiated by and integrated with primary health care services. The RACP is committed to working with its partners to progress this work, including working with the NT government. It is vital that sufficient and sustained funding and resources are made available to drive this Implementation Plan, so that its aims become a reality.

Indigenous health leadership and authentic engagement of Aboriginal and Torres Strait Islander communities are crucial to achieving improved health outcomes. Service development and provision should be led by Aboriginal and Torres Strait Islander health organisations. The Aboriginal Community Controlled Health sector is of vital importance in delivering effective, timely and culturally appropriate care to Aboriginal and Torres Strait Islander people, and must have long-term and secure funding to not only retain, but grow their capacity to do so.

The RACP calls on the incoming NT government to:

  • Allocate sufficient and secure long-term funding to progress the strategies and actions identified in the Implementation Plan that are the responsibility of the NT government.
  • Engage and consult with the RACP in order to utilise specialist expertise and clinical knowledge in overcoming barriers to accessing specialist care for Aboriginal and Torres Strait Islander people in the NT Time for Action on Health Policy: RACP Northern Territory Election Statement 2016 5
  • Implement specific strategies and initiatives to address the disproportionately high incidence of STIs and BBVs in Aboriginal and Torres Strait Islander communities.
  • Support the Aboriginal Community Controlled Health Sector to support the sector’s continued provision of Indigenous-led, culturally sensitive healthcare.
  • Build and support the Indigenous health workforce to grow their numbers and integration within multidisciplinary teams.

Banning use of lead shot for hunting

It is of significant concern that elevated lead levels have been found in over half of children tested in three Top End remote communities and in 20 per cent of adults. Updated guidelines from the National Health and Medical Research Council (NHMRC) of Australia recommend elevated levels be investigated and reduced. Inhalation or ingestion of lead can produce neurodevelopmental dysfunction in children, resulting in learning difficulties, and behavioural problems. Elevated lead levels can also contribute to dysfunction in cardiovascular, renal, neurological, and haematological systems in adults.

Lead shot used in guns remains a key source of lead exposure among populations where it is still commonly used; through directly ingesting game that has been hunted and therefore contaminated with lead shot, as well as handling lead ammunition (or playing with lead ammunition in the case of children), and consuming lead dust and particles.

For many Aboriginal and Torres Strait Islander populations, hunting and fishing yields continue to make up a considerable proportion of their diet. High consumption of game meat is also typical for many individual recreational and vocational hunters and their families.

Lead shot is banned for hunting waterfowl in the Northern Territory however Indigenous Australians hunting on Aboriginal-owned land are exempt from this legislation and therefore exempt from the protection it affords.

The RACP calls on the incoming NT government to:

  • Immediately ban lead shot for hunting in line with recommendations from the World Health Organisation and the National Health and Medical Research Council, and support appropriate access to alternatives.

Incarceration of adolescents

Significant improvements are needed within the juvenile justice system in the Northern Territory. The health and healthcare needs of young people in juvenile detention are rarely seen as a priority, despite the fact that these adolescents are among the most vulnerable in our community.

As in other Australian states and territories, Aboriginal and Torres Strait Islander youth and adolescents are hugely overrepresented in the Northern Territory justice system. The special needs of these young people need to be considered. This should include the involvement of the Aboriginal Community Controlled Health sector in the provision of culturally specific and safe care. Culturally appropriate services and support programs are also needed post juvenile justice incarceration.

We welcome the Royal Commission into Child Protection and Youth Detention Systems of the Northern Territory; however we are calling for the Terms of Reference to be broadened to cover health. It is also crucial that all those who have been victims of any abuse receive immediate support and treatment for physical and mental health issues.

The disproportionate number of Indigenous young people in detention makes it essential that formal processes and mechanisms are put in place to facilitate the participation of Aboriginal and Torres Strait individuals and communities in the work of the Royal Commission and the overhaul of the Northern Territory’s incarceration culture.

It is recognised that incarcerated adolescents are more likely to experience poorer health and life outcomes and disproportionately high levels of disadvantage over that of the general population, and it is increasingly recognised that their health needs are greater than adolescents in non-custodial settings.

Adolescence is a critical time in a person’s development, and it is imperative that juvenile detention provides opportunities for young offenders to rehabilitate and develop healthy behaviours for life. We acknowledge that the interactions between disadvantage, incarceration, poor health and well-being and life outcomes are complex, however this should not deter us from ensuring these young people are able to access the healthcare, support services and rehabilitation opportunities to support them to lead a healthy and productive future.

The RACP calls on the incoming NT government to:

  • Improve provision of health, psychological and social services to adolescents in the juvenile justice system, including a health screening within 24 hours of entry into detention.
  • Reduce reoffending and recidivism in the juvenile justice system and increase vocational productivity by addressing the social determinants of health through a “whole of Government” approach.
  • Improve the training of health professionals and others who work with adolescents in the juvenile justice system.

End Open Speed Zones

The open speed zone on the Stuart Highway puts hundreds of thousands of road users, tourists and local residents at risk each year. Northern Territory road users suffer a road safety record that is far worse than any other Australian state or territory. Its fatality rate is among the worst in the developed world – between February 2013 and March 2014, the fatality rate (17.79) was more than three times the national average of 5.11 deaths per 100,000 people.

These figures underscore a real and pressing need for the incoming government to commit to ending the policy of open speed zones in the interests of the health and safety of all Northern Territory road users and pedestrians. Road safety requires a comprehensive approach, and a vital element is missing when speed limits are not in place.

Since the reinstatement of open speed zones on the Stuart Highway in February 2014, the Northern Territory Committee of the RACP has consistently warned of the risks associated with open speed zones and advocated for an end to this dangerous policy. Speed is a relevant consideration in all road accidents. Higher speeds lead to a greater risk of a crash and a greater probability of serious injury if a crash occurs.

The RACP calls on the incoming NT government to:

  • Immediately abolish open speed zones on the Stuart Highway
  • Permanently end the policy of open speed zones across the Northern Territory
  • Show leadership and commit to road safety policies that focus on safeguarding the lives and health of all Northern Territory road users and pedestrians, in line with the principles of the National Road Safety Strategy 2011-2020.

Alcohol

The harms of alcohol are difficult to overstate. It is the world’s third largest risk factor for disease and eighth largest risk factor for deaths. It is a causal factor in more than 200 disease and injury conditions, and can lead to lifelong problems associated with Fetal Alcohol Spectrum Disorders (FASD).

The social and economic costs of alcohol to the Northern Territory are particularly high. National statistics have recorded the Northern Territory as having the highest per capita consumption of alcohol and the highest percentage of deaths attributable to alcohol. And while the epidemiology of FASD remains unclear due to a lack of standardised data, estimates suggest higher rates of FASD in the Northern Territory than the rest of Australia, particularly among Aboriginal and Torres Strait Islander children.

The RACP is particularly concerned about the harms of alcohol to children and young people, with the peak age for the onset of alcohol use disorders being only 18 years. The tendency of young people to combine drinking with high risk activities (such as drink driving) increases their risk of alcohol-related injury or illness, and in some cases can prove fatal. Risky drinking behaviours, combined with open speed limits (see above), creates conditions for further increases in the incidence of devastating road trauma and fatalities on Northern Territory roads.

The RACP calls on the incoming government to make better use of Alcohol Action Initiatives, as a potent tool for addressing the availability of alcohol while empowering local communities to restrict access to alcohol as they see fit. The previous Alcohol Management Plan (AMP) framework was shown to achieve stronger and more sustainable outcomes in reducing alcohol-related harms in communities where AMPs were locally driven and owned, and where supply measures were integrated with complementary demand and harm-reduction measures.

The RACP encourages the incoming government to prioritise the implementation of proposed new Alcohol Action Initiatives, as a means for the Northern Territory to partner with the Commonwealth to empower local communities to tailor a suite of initiatives covering alcohol restriction as well as better treatment facilities and community education to reduce local alcohol-related harms.

The RACP notes that development of a Northern Territory Alcohol Action Plan is currently underway, with a whole of government response to FASD to be included in the plan. The RACP encourages the incoming government to utilise the RACP’s evidence-based Alcohol Policy in developing the plan and to consult with RACP Fellows to ensure physician expertise underpins strategies to reduce alcohol-related harm in the Northern Territory

The RACP calls on the incoming NT government to:

  • Take full advantage of the new Alcohol Action Initiatives to partner with the Commonwealth to facilitate locally owned and managed initiatives to reduce alcohol related harm through a combination of alcohol restriction measures, education and better addiction treatment facilities.
  • Increase funding for alcohol treatment services in order to reduce the incidence of alcohol use disorders
  • Increase funding to facilitate workforce development to address unmet demand for alcohol treatment services.

Integrated Care

For the growing number of Australians living with multiple, chronic health conditions, navigating the health system has become increasingly complex. This problem also impacts people with disability and mental health issues. The care of individuals with multiple health problems is often disjointed, with the patient’s different health conditions managed by different health professionals.

Fragmented health services delivery not only impacts the quality of patient care, but leads to inefficiencies, duplication and wastage across the health system. An approach to healthcare which places the patient at the centre is required to not only improve the management of patients with complex care needs, but ensure the Northern Territory healthcare system operates efficiently and effectively.

Of particular priority for the RACP is the need to support increased provision of specialist services in community-based settings, such as primary healthcare centres, community clinics, Aboriginal Medical Services, residential aged care facilities and people’s homes. Community-based settings allow patients with multiple, chronic or complex conditions to be seen in convenient location, and facilitate greater collaboration and coordination between the different health professionals involved in patient care.

The RACP calls on the incoming NT government to:

  • Engage and consult with the RACP in order to utilise specialist expertise and knowledge when developing integrated models of care for the NT, including any involvement in the Health Care Homes trial, to ensure a multidisciplinary approach is taken.
  • Implement policies that promote and support health professionals and service providers to work collaboratively.

WHAT THE TWO MAJOR PARTIES ARE FOCUSING ON FOR THE NT ELECTION: AAP Summary

COST OF LIVING

The CLP says it has reduced the cost of housing and petrol over its term, and increased family subsidies. It says it will continue to do so with more land release, will offer $500 study vouchers, and will work to reduce the cost of food in remote areas. Labor has accused the CLP of planning to sell off public utility PowerWater Corporation. Labor is offering up to $26,000 in stamp duty relief for home buyers, and will issue seniors with a $700 debit card every two years.

LAW AND ORDER

The CLP made its legislation to presume against bail for young property offenders an election issue. It’s also promising more CCTV camera funding. Meanwhile, Labor is focusing on early intervention, prevention and rehabilitation of young people, as well as promising more police on the streets. Both parties have pledged to close down the Don Dale centre and both have promised a new police station for Palmerston.

JOBS AND THE ECONOMY

Chief Minister Adam Giles has promised to create 24,000 jobs next term, a third of which would be in the onshore gas industry, and the rest across marine infrastructure development, tourism, horticulture, indigenous housing, aquaculture, construction and defence. Labor says it will repurpose $100 million from the current budget for infrastructure stimulus to create jobs.

INDIGENOUS AFFAIRS

The CLP abolished the Aboriginal Affairs portfolio, but reinstated it in 2015, has set public service Aboriginal employment targets and had pledged to invest more in remote housing, with a $1.65 billion program to build 240 houses a year for eight years in remote communities. Labor has pledged to give communities greater control over local government, education and training, health, childcare and justice, as well as promising a $1.1 billion 10-year remote housing program.

MINING AND THE ENVIRONMENT

The CLP says developing the onshore gas industry is key to a stable future and job security in the NT, while Labor says if elected it will institute an indefinite moratorium on fracking until the process is proven to be safe. The CLP will institute world’s best practice regulations in relation to mining and energy projects. Labor will follow a science-based and transparent water license process, will support indigenous rangers and environment groups, and will move to a 50/50 renewable energy target by 2030.

© AAP 2016

NACCHO #HIV News : Treatment as Prevention Roadshow included eight meetings with Aboriginal and Islander Community Controlled Health Services.

HIVED

” The potential exists for HIV to escalate rapidly in the Aboriginal and Torres Strait Islander population – as has been the experience in other Indigenous populations globally. This potential is due to three main issues:

  • very high rates of other sexually transmissible infections (STIs) exist in many communities, and the presence of these increases the chances that HIV can be transmitted
  • increasing rates of injecting drug use – including increasing rates of methamphetamine (ice) use in Aboriginal communities, and
  • the close proximity of Papua New Guinea (PNG) to the Torres Strait Islands, and the mobility and interaction of PNG nationals and Torres Strait Islanders. PNG has the highest recorded rates of HIV in the Asia-Pacific”

Associate Professor James Ward is Head, Infectious Diseases Research Aboriginal and Torres Strait Islander Health at South Australian Health and Medical Research Institute (SAHMRI) and a guest editor of HIV Australia.U And Me Can Stop HIV

SEE PREVIOUS ARTICLE

” Currently the lifetime cost of treating someone with HIV ranges from US $250,000 to US $500,000 (2006 figures).

Our Treatment as Prevention Strategy we have reduced new HIV cases in BC from 700 per year to less than 300 – which has provided savings of around $50 m per year.

We have also managed to nearly eliminate AIDS and there’s an important distinctions between AIDS and HIV – AIDS is the result of being infected with HIV for many years without treatment while HIV is an infection we can now treat and control the virus and prevent it from becoming AIDS.

In addition, people with AIDS can also be treated and become healthy and contribute to society like anyone else.”

Assistant Director, British Columbia Centre for Excellence in HIV/AIDS Dr Rolando Barrios

The Queensland HIV Treatment as Prevention (TasP) Roadshow took place over the last week of July and first week of August 2016.

The Roadshow, supported by the Queensland Aboriginal and Islander Health Council (QAIHC) and the HIV Foundation Queensland, engaged with health professionals working in Aboriginal and Torres Strait Islander and mainstream services across north –eastern Queensland.

Speakers included Assistant Director, British Columbia Centre for Excellence in HIV/AIDS Dr Rolando Barrios (also principal investigator of the Pharmacovigilance Program and Co-Chair of the Therapeutic Guidelines Committee), Director of Operations British Columbia Centre for Excellence in HIV/AIDS Ms Irene Day , Positive Living British Columbia Mr Glen Bradford and South Australia Health and Medical Research Institute Associate Head of Infectious Disease Research – Aboriginal and Torres Strait Islander Health Professor James Ward.

The Roadshow was aimed at educating health professionals and raising community awareness, a job made more urgent because of the spike in STI and HIV among Aboriginal and Torres Strait Islander people in Queensland over past 12 months.

The Queensland HIV TasP Roadshow included eight meetings with Aboriginal and Islander Community Controlled Health Services, and evening dinner meetings for health professionals in the same locations, starting in Brisbane on Monday, July 25.

The Roadshow brought together latest practice and evidence from around the globe in HIV prevention including the concept of treatment as a prevention and new medications such as pre-exposure prophylaxis (PrEP), both of which aim to significantly reduce the number of new HIV diagnoses.

Apunipima caught up with Irene Day and Dr Rolando Barrios at the Wuchopperen Health Service workshop on 1 August.

Apunipima: Tell me about the Roadshow

ID: The Roadshow is travelling throughout north – east Queensland talking about our concept of Treatment as Prevention (TasP) which was introduced by the British Columbia (BC) Centre for Excellence in HIV and AIDS in 2006. We’ve had a great deal of success with it in BC, in terms of driving down the rates of new cases of HIV. We’ve virtually eliminated AIDS, which is, of course different than HIV.

Apunipima: Is this both in the Aboriginal and mainstream populations?

ID: Both, but let me be clear we have not done as good a job in getting our Indigenous populations into care and treatment so that’s an area we are committed to working on more diligently. The good thing is that our provincial and federal government is very supportive and have made a commitment to working with the Indigenous population on HIV.

The virus is an issue not just in British Columbia but there is a significant increase in HIV in our Indigenous population in our prairie provinces, particularly Saskatchewan, as well so we definitely have more work to do there.

Apunipima: Break down Treatment as Prevention for me

So TasP means reaching out, engaging individuals (those who have been diagnosed and those who are at risk of contracting the condition) earlier into care and treatment. The key is getting people into testing, treatment and management early. Sustained treatment, that’s absolutely critical.

If you’re not being treated, the virus will replicate, your viral load will go up, your immune system will drop and you’ll become ill. Also, when you put good treatment in place you’re making spread of virus less likely.

The Treatment of Prevention strategy was introduced by us in 2006 and has been adopted in other countries including by the Queensland Government who signed an MOU with us in 2014.

We still have more work to do though, as BC is the only Canadian province that has adopted this Strategy.

Apunipima: Good treatments are available now – are they considered affordable?

RB: Currently the lifetime cost of treating someone with HIV ranges from US $250,000 to US $500,000 (2006 figures).

Our Treatment as Prevention Strategy we have reduced new HIV cases in BC from 700 per year to less than 300 – which has provided savings of around $50 m per year.

We have also managed to nearly eliminate AIDS and there’s an important distinctions between AIDS and HIV – AIDS is the result of being infected with HIV for many years without treatment while HIV is an infection we can now treat and control the virus and prevent it from becoming AIDS.

In addition, people with AIDS can also be treated and become healthy and contribute to society like anyone else.

Our Government has made the investment because, as our Director says, you make a decision now and pay it off or you mortgage your province and pay it off over many years. If we don’t do anything the infections will continue.

Apunipima: What are your key messages for Aboriginal and Torres Strait Islander populations when it comes to prevention, testing, treatment?

It’s no different than other parts of the world including BC, we experience the same issues in terms of marginalisation, low education, low income, drug use, mental health issues and so on. The key element, the message that we are giving to people is know your HIV status.

We know that when people know their HIV status they will immediately change their behaviour and there are studies in the US that show that 58 per cent of people who have been diagnosed immediately change their behaviour to lower risk behaviour.

Also, most people care about others so if you know that you are infected with HIV or you become aware you are HIV positive, you are going to try and prevent the transmission of the virus towards your loved ones.

And we know the importance of families for First Nations people, so it is an important area to consider and lastly, the earlier you are aware of your HIV status, the greater the benefits of the treatment so by starting treatment earlier, you prevent not only AIDS but other things as well as HIV may effect kidney, heart lungs and so on.

Apunipima: I’m old enough to remember what a big story this was in the 1980s , however things have changed since then and it is no longer a hot button issue or, in the West, a fatal disease. How hard is it to get HIV the attention it deserves?

ID: I think your comment is correct because people aren’t seeing the number of deaths related to AIDS. Unfortunately what people are missing is the issue HIV is having on particular populations. The Indigenous population, for sure, are on the cusp of a huge epidemic which needs to be addressed. Men who have sex with men, injecting drug users and sex workers also still experience have high rates of HIV.

RB: That said, what a wonderful situation we are in – in the late 80s, we had a condition we didn’t know the cause of. We now have extensive therapies and can extend the life of people with HIV so it’s not on top of the radar but things have improved and we are making a huge difference. We still have work to do but that is one of the reasons why we are here, the raise the profile and call people to action.

Apunipima: How did you link up with the Aussie mob?

ID: In 2014 we were in Melbourne for the International AIDS Conference but prior to that we were working with HIV Foundation for a strategy we could work collaboratively on and that was the treatment as prevention strategy.

So we signed an MOU with QLD who adopted the TasP strategy and as part of the MOU we committed to a knowledge exchange strategy. So we had a group that came from QLD to the BC Centre for Excellence in HIV and AIDS last year who stayed with us for about a week and a half and now we’re reciprocating and doing the roadshow with the HIV Foundation.

Apunipima: Is your goal to eliminate HIV?

ID: We will never eradicate it HIV because of human behaviour but what we want to do is to drive as many cases to undetectable levels as possible because if you are undetectable you don’t transmit.

Apunipima: And that’s doable now with the current treatments?

ID: I think it is doable now, yes.

RB: We have a toolkit of different interventions we can use and combined, this will help us control the HIV epidemic.

Apunipima: Do you think that because of things like PrEP, and effective treatments, people are taking condom use, not sharing needles and things like that less seriously as it’s not a deadly illness anymore?

RB: This was one of our early arguments in 2006 when we brought up the idea of treatment as prevention. If you think about on the back of decreasing HIV rates in BC, there was an outbreak of syphilis and other STIs and increasing rates of hepatitis C. This led us to believe that condom use and education alone are not effective when it comes to preventing HIV transmission. People who don’t want to use condoms and want to behave in certain ways will continue their trajectory in life.

Apunipima: Is this similar to the argument that if you put condoms in men’s jails you’re promoting homosexuality or if you provide safe injecting rooms you’re promoting drug use? But everyone knows that people will do these things anyway so you may as well do it safely? It’s not like if it’s not there it won’t happen.

RB: We know that condoms are highly effective in preventing HIV and STIs when used – the problem is if they are not used. Similarly what we would say, through using things like PrEP and Treatment as Prevention is that we are offering harm reduction. What we learn from sexual behaviour is that people don’t always carry that behaviour for the rest of their lives…

Apunipima: … so if you can just get them for that dangerous window?

ID: We look at the value of TasP in terms of four Ps.

Implementing TasP is good for public health policy, good for the public, good for politicians and good for the public purse because if you have people engaged in treatment, sustained on that treatment, and not transmitting, you are actually being cost averting to your healthcare system and I think there an opportunity when there’s limited healthcare dollars which have to be spread over a wide range of things, look at where we can have an impact in a short space of time – it’s like paying off a mortgage, you pay off a lump sum and then you’re able to move on to something else with that money down the road.

The other thing about TASP in BC, we’re applying that strategy to HIV but we’re also starting to apply it to Hepatitis C as well, and we think there’s an opportunity to expand that to addictions so we will be doing further work on that in the coming years.

RB: Treatment a Prevention is good for the person, good for public health in terms of avoiding transmission. Good for the purse because it saves cost for the healthcare system and good for the politicians, but in addition to that, antiretroviral therapy has shown to significantly decrease other medical conditions just because people are actually coming to treatment so we can diagnose diabetes earlier, we can diagnose high blood pressure earlier and several studies showing there is a decrease in co-morbidities particularly tuberculosis in Africa and actually there are a couple of studies in the US showing people with HIV are living longer than mainstream population because they are so engaged in care!

All our evidence points to TasP as a powerful preventative – people think that clients might not be adherent, they might not engage but we have proven this not to be the case with our program: people are highly adherent and committed to the program.

NACCHO Report Alert : $5.9 billion a year Indigenous spending but only 10% evaluated

Exp

It’s important to ask the communities involved what needs to be done, rather than just telling them what will happen,

“Then, one simple way of ­addressing (the evaluation) issue is that evaluations should be funded as a part of the programs, to be performed alongside the implementation of the programs. That way you build evidence as you go. Some programs do this, but far from enough. Without all of this we just can’t know how money should be spent.”

Researcher Sara Hudson Centre for Independent Studies

Download 4 page report Mapping Indigenous Funding Maze CIS 2016

From Stephen Fitzpatrick The Australian

Indigenous affairs spending worth $5.9 billion a year is not ­delivering results because few of the schemes being funded are properly evaluated, the assessment of what is needed is ­inadequate and some programs are poorly designed.

A landmark survey, which for the first time takes account of non-government organisation spending as well as that of federal, territory and state governments in indigenous affairs programs, has found that less than 10 per cent of a total 1082 programs had ever been evaluated.

Of these 88 evaluations, few used methods that could provide evidence of the program’s effectiveness, the Centre for Independent Studies found.

It documents annual spending on indigenous-specific programs by the federal government of $3.28bn, state and territory governments of $2.35bn and the indigenous not-for-profit sector of $224 million. It is expected that this third figure will be massively increased once further research takes into account non-indigenous NGO spending in the indigenous sector. Factoring in not-for-profit institutions such as universities could add billions of dollars to the total.

The report describes the figure of 1082 programs as “just the tip of the iceberg”.

The CIS study, by researcher Sara Hudson, has found instances such as an East Arnhem Land community with no notable history of suicides being required to undergo a suicide-awareness training program. Not only was the community not consulted about the need for the program, some of its young men had ­already been flown to a suicide-awareness program in another community at significant expense two years earlier.

In Western Australia, however, where there is desperate need for suicide prevention work, $107m earmarked for relevant programs in communities went unspent, the report finds. It documents massive duplication of services, with Roebourne in Western Australia having 67 local service providers and more than 400 state and federal funded programs for a population of 1150; Toomelah in NSW has more than 70 service providers for a population of only 300.

Poor program design had meant that the federal government’s Indigenous Home Ownership program’s success rate of approving only 75 loans in a year equated to one loan for each ­person employed to run the ­program. Further, most of these loans were delivered to people who could have qualified for a mainstream loan.

The review notes that of 550,000 indigenous Australians in the 2011 census, 65 per cent were in employment and living lives similar to other Australians; 22 per cent were welfare-­dependent and living in urban and regional areas with other welfare dependent Australians; and just 13 per cent, or 70,000, were welfare-dependent and living on indigenous land where education and work opportunities were often limited.

This third group needed the greatest focus and yet most indigenous affairs policy tended to treat the entire indigenous polity as a homogenous group, the ­review found.

“Funding must be allocated on the basis of need and not just of ­indigeneity,” it notes.

The report follows the ­Coalition government’s drastic reordering of indigenous affairs funding two years ago, when about 150 separate programs were ­rationalised from a range of agencies into five streams delivered from the Department of the Prime Minister and Cabinet, and $500m was cut from the indigenous affairs budget.

That process was harshly criticised in a Senate committee report in March that found the government’s new arrangements, known as the Indigenous ­Advancement Strategy, did not take enough account of indigenous needs, tended to award short-term and ad-hoc contracts to the detriment of the communities the programs were supposed to assist, and had not adequately informed indigenous Australians how the new arrangements worked.

An Australian National Audit Office assessment of the IAS is due in December.

The CIS report makes clear that without proper assessment of outcomes, it is impossible to know which programs are vital or productive, and it questions whether the federal government will be able to meet its budgeted expenditure under the IAS of $4.9bn over four years, given that $3.85bn will have been spent in the first two years.

It also notes that while NSW, with the highest Aboriginal population of any state or territory, had the highest number of grant recipients, the monetary value of these grants was lower than those allocated to Queensland, the Northern Territory and Western Australia combined.

 

NACCHO remains totally opposed to Medicare co-payments of any kind, according to CEO Pat Turner

ANOP

“NACCHO will fight any proposal to introduce changes or co-payments to Medicare tooth and nail. Aboriginal and Torres Strait islander communities are the most disadvantaged economically in Australia, and bear the burden of higher levels of chronic health conditions and lower life expectancy.”

“Aboriginal medical services are doing everything they can to close the gap in Aboriginal health and in many areas we are beginning to make inroads, despite chronic underfunding.”

“Any co-payment at all will undo that work. Quite simply, if people cannot afford to go to the doctor, they will not go. Healthcare is a basic human right, however much money you have, however sick you are and Australia must abide by that principle.”

NACCHO remains totally opposed to Medicare co-payments of any kind, according to CEO Pat Turner.

Today’s suggestion by the Australian Medical Association (AMA) that the Coalition’s abandoned general practice (GP) co-payments policy might be resurrected has been strongly condemned by the Australian Healthcare and Hospitals Association (AHHA), Public Health Association of Australia (PHAA), Consumers Health Forum of Australia (CHF), National Aboriginal Community Controlled Health Organisation (NACCHO) and Australian Council of Social Services (ACOSS).

While a government spokesperson says the Government has no intention of pursuing a co-payment, the Prime Minister and the Health Minister must come out and dismiss the idea once and for all.

Medicare is a key pillar of Australia’s universal healthcare system – it is not a safety net. Consumers must be at the centre of any health policy reforms.

AHHA Chief Executive Alison Verhoeven said the call from AMA President Michael Gannon to consider giving GPs discretionary ability to charge co-payments for patient visits could adversely affect Australians.

“GPs should not be in the position of making judgement calls about their patients’ finances. Co-payments impact affordability of care and emergency department use, and were rightly abandoned,” she said.

“While general practice must be well supported, the AMA has a vested interest in protecting its members’ income. Our focus is universal healthcare for all Australians regardless of where they live or how much money they earn.”

“Instead of resurrecting the co-payment, the Commonwealth Government should focus on a holistic, long-term vision for healthcare with appropriate funding commitments to support primary, acute, aged and disability care, to ensure all Australians can access quality care regardless of their income or where they live.”

PHAA CEO Michael Moore was shocked at a suggestion the Coalition might undermine Medicare.

“It would be incomprehensible that the Coalition has missed such clear messaging from the community. Any action to undermine Medicare is simply unacceptable. This was the real nub of the debate at the election and the issue that confronted Tony Abbott’s government when he and Joe Hockey introduced the concept of a compulsory co-payment,” he said.

“At a time when other countries are working towards ‘health for all’, the last thing we need in Australia is a government seeking to undermine basic human rights – the right to health and the equitable right to treatment. Medicare is about a fair go for all Australians. When this is properly understood all members of Parliament, as fair dinkum Australians, have an obligation to protect and enhance our system of universal healthcare”.

CHF CEO Leanne Wells said the government’s priority needed to be the development of a national health plan and moving to the “next stage” of Medicare based on sound policy.

“People are already hurting: Australians already face some of the highest out-of-pockets costs for their healthcare compared to other, equally wealthy OCED economies. The message from the electorate is that GP co-payments would be a financial burden that affects the community’s most vulnerable, first and foremost. “After over a decade of reviews, we don’t want to see status quo for the next three years. We want Medicare reform but it must be based on a wider debate about a national health care plan that puts patients first, and a new narrative that gets us back on to setting the health agenda based on good policy principles,” Ms Wells said.

“Health care should be available to all who need it regardless of income and a Medicare co-payment undermines that principle,” ACOSS CEO Dr Cassandra Goldie said.

“The best way to pay for an essential service like health care is through the tax system. The best way to ensure its sustainability is to reform the way governments purchase health services – for example by reducing spending on inefficient subsidies like the private health insurance rebate – not by shifting the cost to people who need health care.”

DOORSTOP SENATE COURTYARD PARLIAMENT HOUSE TODAY 2PM

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, Primary Health Networks, community and primary healthcare services, and advocates for universal, high quality and affordable healthcare to benefit the whole community.

The Public Health Association of Australia is recognised as the principal non-government organisation for public health in Australia and works to promote the health and well-being of all Australians. The Association seeks better population health outcomes based on prevention, the social determinants of health and equity principles.

The Consumers Health Forum of Australia is the peak organisation providing leadership in representing the interests of Australian healthcare consumers. CHF works to achieve safe, good quality, timely healthcare for all Australians, supported by the best health information and systems the country can afford.

The National Aboriginal Community Controlled Health Organisation is the national peak body representing over 150 Aboriginal Community Controlled Health Services across the country on Aboriginal health and wellbeing issues.

The Australian Council of Social Services is the peak body of the community services and welfare sector and the national voice for the needs of people affected by poverty and inequality.

NACCHO #NDW16 Aboriginal Health : New chronic disease portal provides quick access for workforce

Chronic Disease Portal

  ” The Aboriginal and Torres Strait Islander health performance framework 2014 report noted that chronic disease accounts for two-thirds of the health gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians.

The majority ( 70%) of Aboriginal and Torres Strait Islander deaths in 2008-12 were due to chronic diseases (e.g. circulatory disease, cancer, diabetes, respiratory disease, and kidney disease).

Our new portal will save busy health practitioners considerable time by providing them with up to date information and resources about chronic disease “

HealthInfoNet Director Professor Neil Drew,

Edith Cowan University’s Australian Indigenous HealthInfoNet has launched a new online portal for the Aboriginal and Torres Strait Islander chronic disease workforce. The portal at

CHRONIC DISEASE WORKFORCE PORTAL

is part of an ongoing commitment by the HealthInfoNet to keep the sector informed about health conditions affecting Aboriginal and Torres Strait Islander people.

The portal provides information about chronic conditions that are a problem for all Australians but particularly for Aboriginal and Torres Strait Islander people including: heart disease, diabetes, respiratory (lung) diseases, cancers and kidney disease.  It also covers physical activity and nutrition as these factors influence many chronic conditions.

Information has been chosen for the portal because it is written in plain language and has practical application in daily work with Aboriginal and Torres Strait Islander clients with chronic disease or disease risk.

The portal provides access to health promotion resources, health practitioner tools and information about programs that promote healthy lifestyles and chronic disease management for Aboriginal and Torres Strait Islander people.

It also highlights workforce opportunities for chronic disease workers, including job vacancies, events, training and funding.

There are five yarning places dedicated to specific chronic condition health topics which allow those working in each area to share ideas and information and are free to join.

CHRONIC DISEASE WORKFORCE PORTAL

DOWNLOAD the NACCHO Aboriginal Health Newspaper

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NACCHO #IndigenousVotes : AMA Indigenous #Healthelection16 platform launched

Page 13

“Achieving health equality for Aboriginal and Torres Strait Islander people is a priority for the Australian Medical Association (AMA).

It is simply not acceptable that in 2016, Australia’s Indigenous people continue to experience poorer health and a significantly lower life expectancy than their non-Indigenous peers.

Health is intricately woven within the social determinants of health.

The wider community’s limited understanding of Indigenous culture, and the history of the relationship between Australia’s first peoples and non-Indigenous Australians are issues that have yet to be adequately addressed.

For the AMA, Indigenous health has been and will remain a priority. It is a responsibility to advocate for better health outcomes for Australia’s Indigenous people.”

Dr Michael Gannon AMA President

See Page 13 Aboriginal Health News 24 Page FREE Download HERE

Over recent decades, we have seen some progress in improving Indigenous health and life expectancy, but there is still much more to be done. While there has been some success in reducing childhood mortality and smoking rates, the high levels of chronic disease among Aboriginal and Torres Strait Islander people continues to be of grave concern.

Chronic disease (primarily cardiovascular disease, cancer, diabetes, respiratory disease and kidney disease) accounts for two-thirds of the health gap between Aboriginal and Torres Strait Islander people and non-Indigenous Australians. With chronic disease being such a major impact on the health and life expectancy of Indigenous Australians, the AMA sees government investment in resourcing for culturally appropriate primary health care as paramount.

It is not credible that Australia, one of the world’s wealthiest nations, cannot address health and social justice issues affecting its first people who make up just three per cent of its population. It is not good enough to keep hearing the excuses and well-meaning, but unsupported, words of successive governments.

The next Federal Government must commit to and deliver, effective, high quality, appropriate and affordable health care for Aboriginal and Torres Strait Islander people, and develop and implement tangible strategies to address social inequalities and determinants of health.  Without this, the health gap between Indigenous and non-Indigenous Australians will remain wide and intractable.

The AMA, along with many others working in Indigenous health, has been campaigning for long-term funding and commitments from the Commonwealth to improve the health and wellbeing of Aboriginal and Torres Strait Islander people.

My predecessor, Professor Brian Owler, travelled to remote Aboriginal communities, as well as attending the Gama Festival in East Arnhem Land, to better understand the health issues and problems many Aboriginal and Torres Strait Islander people experience. Following his trip to Central Australia earlier this year, the AMA engaged with a number of key stakeholders on addressing diabetes and supporting the health services working in remote communities. This is something that the AMA will continue to do.

I have family roots in rural Western Australia and attended both primary school and high school with Aboriginal students. Sadly as an Obstetrician, I have broad personal experience of the increased burden of perinatal morbidity and mortality suffered by Aboriginal women in both my clinical work and my service on the Perinatal and Infant Mortality Committee (Health Department of WA).

Health is intricately woven within the social determinants of health.

The wider community’s limited understanding of Indigenous culture, and the history of the relationship between Australia’s first peoples and non-Indigenous Australians are issues that have yet to be adequately addressed.

For the AMA, Indigenous health has been and will remain a priority. It is a responsibility to advocate for better health outcomes for Australia’s Indigenous people.

Indigenous health issues were a prominent theme at the 2016 AMA National Conference and will continue to be a focus for many years to come.

The AMA benefits from the expert advice on Aboriginal and Torres Strait Islander health that comes through its Taskforce on Indigenous Health, from visiting Indigenous communities, and by partnering with groups such as the Close the Gap Campaign, NACCHO, and many others.

As a member of the Close the Gap Steering Committee, the AMA is supporting their election priorities and issues. One of these issues is to call on the next Federal Government to establish a closing the gap target to reduce the rates of Aboriginal and Torres Strait Islander people coming into contact with the justice system. This issue was a key recommendation of the AMA 2015 Report Card on Indigenous Health which highlighted the strong connection between health and incarceration.

Recently, the AMA also became a signatory to the Close the Gap Campaign’s Redfern Statement which called on the next Federal Government to meaningfully address the disadvantage experienced by Aboriginal and Torres Strait Islander people.

This reaffirms the AMA’s strong commitment to Indigenous health issues. The AMA set out its position on the health of Aboriginal and Torres Strait Islander People in its Key Health Issues for the 2016 Federal Election document delivered at the start of the 2016 election campaign. If we are to close the gap between Indigenous and non-Indigenous Australians, the next Government must strengthen their investment in Aboriginal and Torres Strait Islander health and make a genuine commitment to the following measures:

  • correcting the under-funding of Aboriginal and Torres Strait Islander health services;
  • establishing new or strengthening existing programs to address preventable health conditions that are known to have a significant impact on the health of Aboriginal and Torres Strait Islander people such as cardiovascular disease (including rheumatic fever and rheumatic heart disease), diabetes, kidney disease, and blindness;
  • increasing investment in Aboriginal and Torres Strait Islander community controlled health organisations.  Such investment must support services to build their capacity and be sustainable over the long term;
  • developing systemic linkages between Aboriginal and Torres Strait Islander community controlled health organisations and mainstream health services to ensure high quality and culturally safe continuity of care;
  • identifying areas of poor health and inadequate services for Aboriginal and Torres Strait Islander people and direct funding according to need;
  • instituting funded, national training programs to support more Aboriginal and Torres Strait Islander people become health professionals to address the shortfall of Indigenous people in the health workforce;
  • implementing measures to increase Aboriginal and Torres Strait Islander people’s access to primary health care and medical specialist services;
  • adopting a justice reinvestment approach to health by funding services to divert Aboriginal and Torres Strait Islander people from prison, given the strong link between poor health and incarceration;
  • increase funding for family violence and frontline legal services for Aboriginal and Torres Strait Islander people;
  • appropriately resource the National Aboriginal and Torres Strait Islander Health Plan to ensure that actions are met within specified timeframes; and
  • support for a Central Australia Academic Health Science Centre.  This part of Australia faces unique and complex health issues that require specific research, training and clinical practice to properly manage and treat and this type of collaborative medical and academic research, along with project delivery and working in remote communities, is desperately needed.

Closing the gap in health and life expectancy between Indigenous and non-Indigenous Australians is an achievable task. It is also an agreed on national priority.

With more than 200,000 Australians supporting action to close the gap, it is evident that the Australian public demand that government, in partnership with Aboriginal and Torres Strait Islander peoples and their representatives, meet this challenge.

The next government must ramp up its ambition to achieve health equality and take further steps in building on the existing platform.

In particular, the challenges of operationalising the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan, the work of the Primary Health Networks and strengthening the Closing the Gap Strategy.

These remain key tests of our nation’s future and our shared intergenerational will and commitment to Aboriginal and Torres Strait Islander peoples and their health and wellbeing.

Download Aboriginal Health Newspaper Here

Redfern Statement

 

 

NACCHO CEO #HealthElection16 :All political parties should not ignore the real needs of Aboriginal and Torres Strait Islander peoples

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“I call on all parties

  • for the freeze on Medicare indexation to be lifted because it impacts negatively on the funding of our Aboriginal Community Controlled Health Organisations (ACCHO’s) at the local level;
  • the need for clearly defined guidelines on how the Primary Health Networks would partner with our member ACCHO’s to ensure our peoples’ health care is culturally safe and of high quality and 
  • new thinking and a clear national strategy is needed to redress the social determinants of health.

We want all political parties to articulate how they will address these priorities to make sure we do “Close the Gap” in this generation.”

Pat Turner AO new CEO NACCHO (see bio below ) was among the senior representatives of 55 organisations signing the Redfern Statement.

To make sure the political parties do not ignore the real needs of Aboriginal and Torres Strait Islander peoples, key peak organisations came together  in a non-partisan way, to remind our political leaders what’s expected of the incoming Government. Co-Chairs of National Congress, Jackie Huggins and Rod Little, led the media event held in Redfern on 9 June.

They were joined by 54 other organisations in an unprecedented show of strength and unity to sign and issue the Redfern Statement.

The Redfern Statement will be given to the new Prime Minister and the Leader of the Opposition when parliament resumes.

This means that the new Federal government should negotiate with the State/Territory governments and NACCHO, and other key representative organisations to design, implement and evaluate a Social Determinants of Health Strategy.

Pat said that the evidence is available and has been known about for long enough, now it’s time for all Governments to work in a real partnership with key Aboriginal and Torres Strait Islander organisations to change these social determinants to positive outcomes within the next generation of 25 years.

Support for our Aboriginal Community Controlled Health Services was strong in acknowledging that it is our members who are the best placed to provide the health care our people need and ACCHOs should most definitely be the preferred providers. Calls were made for cuts to funding reflected in former Budget allocations to be restored.

The Government’s National Aboriginal and Torres Strait Islander Health Plan, now has an Implementation Plan, without additional funding. To rectify this, the call was made for the Implementation Plan to be properly funded.

It is supported by both the major political parties in Canberra, it is three years old, and still no new funding to do what is needed.

In understanding that suicide is all too common among our people, we also called for the funding of a National Aboriginal and Torres Strait Islander Suicide Prevention Strategy.

Basically, we called on the incoming Government to Close the Gap within the next generation.

Pat Turner’s call for a stand-alone Federal Department for Aboriginal and Torres Strait Islander people, with all senior executive staff being Aboriginal and Torres Strait Islanders, was strongly supported by everyone present.

Ms Turner said that if “Closing the Gap” is so important to the incoming government, they have to fund our community controlled sector properly.

The Australian health budget is 10 per cent of Australia’s GDP. $90 billion dollars is funded for Australians’ health by the Commonwealth Government alone. The Aboriginal and Torres Strait Islander sector only get $4 billion of that.”

Aboriginal and Torres Strait Islander Social Justice Commissioner, Mick Gooda, supported Ms Turner’s comments and said at the moment we as First Nations’ people did not have a relationship with government.

“We need a relationship, whether it’s in the form of a treaty, a compact or formal agreement, whatever title it is given, it’s the substance of a genuine formal relationship between the incoming Government and our own leadership that is missing.

They’ve defunded Congress, the only representative organisation we have. That’s our organisation. They’ve appointed an Indigenous Advisory Council who only represent themselves – and they’ll tell you that.”

“What we need is this relationship between our peoples and government, not with our peoples and government agencies and departments.”

The NACCHO CEO concluded her remarks by saying that despite the regular upheaval of major policy changes, significant budget cuts and changes of Government in the short election cycles at all levels, “we have still managed to see some encouraging improvements in Aboriginal and Torres Strait Islander health outcomes.

We want all political parties to articulate how they will address these priorities to make sure we do “Close the Gap” in this generation.”

AH

NACCHO TV HERE

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Background new NACCHO CEO Pat Turner AM

Pat Turner AM , the daughter of an Arrernte man and a Gurdanji woman, was born in 1952 and raised in Alice Springs.

Her long association with Canberra began with a temporary position with the Public Service Board, leading to the Social Policy Branch of the Department of Aboriginal Affairs (DAA) in 1979.

Joining the Australian Public Service (APS) in Alice Springs as a switchboard operator in the Native Affairs Department , she moved to Canberra in 1978, joining the senior executive ranks of the public service in 1985, when she became Director of the DAA in Alice Springs, N.T. (1985-86).

Pat then became First Assistant Secretary, Economic Development Division in the DAA, and in 1989, Deputy Secretary. She worked as Deputy Secretary in the Department of the Prime Minister and Cabinet during 1991-92, with oversight of the establishment of the Council for Aboriginal Reconciliation and with responsibility for the Office of the Status of Women among other matters.

Between 1994 -1998, Pat was CEO of the Aboriginal and Torres Strait Islander Commission, which made her the most senior Aboriginal government official in Australia at the Commonwealth level.. After stints in senior positions at the Department of Health and at Centrelink, Pat Turner left the APS and Canberra in 2006, returning to Alice Springs with her mother to live.

There, she has continued to advocate on the behalf of Aboriginal and Torres Strait Islander people, including taking on what she described as ‘one of the best working experiences of my life’ as Inaugral CEO of National Indigenous Television, NITV, from January 2007 until December 2010.

Other memorable experiences include the period when she was Festival Director of the 5th Festival of Pacific Arts in Townsville, Queensland (1987 -88) and when she held the Chair of Australian Studies at Georgetown University in Washington DC (1998-99).

Ms Turner retired from the APS in 2006, not particularly happy with the state of the organisation she was leaving, but happy about the prospect of spending more time with family and focusing on grass roots projects.

In 2011, she was appointed to the Advisory Council of the Australian National Preventative Health Agency.

In April 2016 2016 she was appointed CEO of NACCHO

Ms Turner holds a Masters Degree in Public Administration from the University of Canberra where she was awarded the University prize for Development Studies. She was awarded Membership of the Order of Australia (AM), in 1990 for her services to public service.

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NACCHO Aboriginal Health Newspaper

Download a free PDF copy 29 June

Wednesday : NACCHO Chair Matthew Cooke plus Members

Thursday : Labor Policy

Friday : Coalition Policy

 

 

NACCHO #HealthElection16 : Calls for Aboriginal and Torres Strait Islander staff to head new Federal Indigenous Affairs Department

Pat Turner2

“We need our own department re-established, with all senior staff working in the newly recreated department being Indigenous. It should be headed up by competent Aboriginal and Torres Strait Islander people in all of the senior executive positions so we can work more effectively, both with government and with our people.”

Former senior Indigenous public servant Pat Turner has called for a federal Indigenous affairs department to be re-established and headed by Aboriginal and Torres Strait Islander staff. Pictured above speaking at the press conference  for the #redfernstatement with Jackie Huggins Congress Co- chair : Article from ABC NEWS

“The Australian health budget is 10 per cent of Australia’s GDP. $90 billion dollars is funded for Australians’ health by the Commonwealth Government alone. The Aboriginal and Torres Strait Islander sector get $4 billion, so you do the sums.  If closing the gap is so important to the incoming government, they have to fund the implementation of the health plan”

Pat Turner believes health is one of the glaring areas in need of attention. ABC PM

READ or DOWNLOAD THE FULL #redfernstatement HERE

Key points:

  • Statement designed to apply pressure to prioritise Indigenous Affairs
  • We need our own department, Turner says
  • Turner, representatives take aim at Abbott government decisions

Ms Turner, who now runs the National Aboriginal Community Controlled Health Network, was among a group of health, education, legal and reconciliation representatives who jointly delivered the so-called Redfern Statement today.

The statement is designed to apply pressure to both major political parties to prioritise Indigenous affairs in the election campaign.

The group has primarily called for a series of Abbott government policies to be undone.

One of Tony Abbott’s most inflammatory bureaucratic decisions was to move the standalone Indigenous affairs department within the Department of Prime Minister and Cabinet, a move Ms Turner said must be reversed.

Ms Turner and other representatives also took aim at a string of other legacy decisions taken by Mr Abbott’s government.

Among the most pressing concerns were the 2014 budget cuts and the flaws in the new Indigenous funding system, the Indigenous Advancement Strategy (IAS).

“The Department of Prime Minister and Cabinet is a coordinating department, they have no idea how to deliver programs,” Ms Turner said.

“And that’s been reflected in the IAS, and how hopeless it is.”

Ms Turner was previously chief executive of the Aboriginal and Torres Strait Islander Commission (ATSIC) and former deputy secretary of the Department of Prime Minister and Cabinet.

‘Do not ignore us, we vote too’

Co-chairwoman of the National Congress of Australia’s First Peoples Jackie Huggins said change was a matter of urgency.

“We don’t want to be marginalised, and they say to government quite clearly, do not ignore us at your peril because we vote too,” she said.

“It’s about time the Government woke up to that and engage with us in a very real and meaningful genuine relationship that we have been screaming out for years.”

Aboriginal and Torres Strait Islander Social Justice Commissioner Mick Gooda said there was still a long way to go to improve ties between Indigenous Australia and government.

“At the moment, we don’t have a relationship with government; they’ve defunded congress, the only representative organisation we have that’s our organisation.

“They’ve appointed an Indigenous Advisory Council who only represent themselves, and they’ll tell you that.”

The coalition of some of the nation’s most well-respected Indigenous leaders said that in the last 25 years, they had seen prime ministers come and go, countless policies introduced and then changed, and promises of funding made only to be followed by cuts.

The group said the only political party to highlight Indigenous needs this campaign had been the Greens.

Minister for Indigenous Affairs Nigel Scullion issued a response to the Redfern Statement, saying the Coalition’s track record demonstrated their commitment to “improving outcomes for First Australians”.

Senator Scullion said the Coalition had put additional funds into the Indigenous Affairs budget, including $48 million to support land tenure measures through the Developing Northern Australia White Paper and $14.6 million for constitutional recognition.

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#HealthElection16 

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NACCHO Aboriginal Health News Alert : Major #Redfernstatement by leadership for #healthelection16

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55 leaders met today  9th of June 2016, in Redfern where in 1992 Prime Minister Paul Keating spoke truth about this nation – that the disadvantage faced by First Peoples affects and is the responsibility of all Australians.

Photo above NACCHO CEO Pat Turner addressing the national media

An urgent call for a more just approach to Aboriginal and Torres Strait Islander Affairs

“Social justice is what faces you in the morning. It is awakening in a house with adequate water supply, cooking facilities and sanitation. It is the ability to nourish your children and send them to school where their education not only equips them for employment but reinforces their knowledge and understanding of their cultural inheritance. It is the prospect of genuine employment and good health: a life of choices and opportunity, free from discrimination.”

Mick Dodson, Annual Report of the Aboriginal and Torres Strait Islander Social Justice Commissioner, 1993.

The Redfern Statement

Download the 18 Page document here

Redfern Statement June 2016 Elections 18 Pages

Redfern Statement

A call for urgent Government action

In the past 25 years – a generation in fact – we have had the Royal Commission into Aboriginal Deaths in Custody, the Bringing them home Report and Reconciliation: Australia’s Challenge: the final report of the Council for Aboriginal Reconciliation. These reports, and numerous other Coroner and Social Justice Reports, have made over 400 recommendations, most of which have either been partially implemented for short term periods or ignored altogether.

In the last 25 years we have seen eight Federal election cycles come and go, with seven Prime Ministers, seven Ministers for Indigenous Affairs, countless policies, policy changes, funding promises and funding cuts – all for the most marginalised people in Australia.

For the last quarter century, then, we’ve seen seminal reports which have repeatedly emphasised that our people need to have a genuine say in our own lives and decisions that affect our peoples and communities. This, known as self-determination, is the key to closing the gap in outcomes for the First Peoples of these lands and waters.

All of these reports call for better resourcing of Aboriginal and Torres Strait Islander organisations and services for Aboriginal and Torres Strait Islander communities.

All of these reports call for real reconciliation based on facing the truths of the past and creating a just and mature relationship between the non-Indigenous Australian community and the First Peoples.

The next Federal Government will take on the same responsibility to right this nation’s past injustices as the last eight Federal Governments have had. The next Government of Australia will take power with our First Peoples facing the same struggles as they were in 1992. But this next Federal Government also has an unprecedented nation-building opportunity to meaningfully address Aboriginal and Torres Strait Islander disadvantage. They have the mandate to act. We therefore call on the next Federal Government to:

  • Commit to resource Aboriginal and Torres Strait Islander led-solutions, by:
  • Restoring, over the forward estimates, the $534 million cut from the Indigenous Affairs portfolio in the 2014 Budget to invest in priority areas outlined in this statement; and
  • Reforming the Indigenous Advancement Strategy and other Federal funding programs with greater emphasis on service/need mapping (through better engagement) and local Aboriginal and Torres Strait Islander organisations as preferred providers.
    • Commit to better engagement with Aboriginal and Torres Strait Islander peoples through their representative national peaks, by:
  • Funding the National Congress of Australia’s First Peoples (Congress) and all relevant Aboriginal and Torres Strait Islander peak organisations and forums; and
  • Convening regular high level ministerial and departmental meetings and forums with the Congress and the relevant peak organisations and forums.
    • Recommit to Closing the Gap in this generation, by and in partnership with COAG and Aboriginal and Torres Strait Islander people:
  • Setting targets and developing evidence-based, prevention and early intervention oriented national strategies which will drive activity and outcomes addressing:
    • family violence (with a focus on women and children);
    • incarceration and access to justice;
    • child safety and wellbeing, and the over-representation of Aboriginal and Torres Strait Islander children in out-of-home care; and
    • increasing Aboriginal and Torres Strait Islander access to disability services;
  • Secure national funding agreements between the Commonwealth and States and Territories (like the former National Partnership Agreements), which emphasise accountability to Aboriginal and Torres Strait Islander peoples and drive the implementation of national strategies.
    • Commit to working with Aboriginal and Torres Strait Islander leaders to establish a Department of Aboriginal and Torres Strait Islander Affairs in the future, that:
  • Is managed and run by senior Aboriginal and Torres Strait Islander public servants;
  • Brings together the policy and service delivery components of Aboriginal and Torres Strait Islander affairs and ensures a central department of expertise.
  • Strengthens the engagement for governments and the broader public service with Aboriginal and Torres Strait Islander people in the management of their own services.
    • Commit to addressing the unfinished business of reconciliation, by:
  • Addressing and implementing the recommendations of the Council for Aboriginal Reconciliation, which includes an agreement making framework (treaty) and constitutional reform in consultation with Aboriginal and Torres Strait Islander peoples and communities.

The health and wellbeing of Aboriginal and Torres Strait Islander peoples cannot be considered at the margins.

It is time that Aboriginal and Torres Strait Islander voices are heard and respected, and that the following plans for action in relation to meaningful engagement, health, justice, preventing violence, early childhood and disability, are acted upon as a matter of national priority and urgency.

National Representation for Aboriginal and Torres Strait Islander Peoples

It is critical that Australia’s First Peoples are properly represented at the national level to ensure meaningful engagement with Government, industry and the non-government sectors to advance the priorities of our people.

Since 2010, the National Congress of Australia’s First Peoples (Congress) has gone some way to fill the gap in national representation since the demise of the Aboriginal and Torres Strait Islander Commission in 2005.

However, there remain too many gaps in adequate national level representation for Aboriginal and Torres Strait Islander people – particularly for employment and education. Without Congress or equivalent national bodies where Aboriginal and Torres Strait Islander leaders are supported to engage with Government it will be difficult for the next Federal Parliament to meet the multi-partisan priority and commitment to work ‘with’ Aboriginal and Torres Strait Islander people.

We call on the next Federal Government to commit to:

  1. Restoration of funding to the National Congress of Australia’s First Peoples

The National Congress of Australia’s First Peoples (Congress) was established in 2010 to be the representative voice of Aboriginal and Torres Strait Islander peoples and to advocate for positive change. The decision to defund Congress, just as it is beginning to emerge as a unifying element among Aboriginal and Torres Strait Islander groups, is a mistake.

Without support, Congress’ ability to do its job of representing Aboriginal and Torres Strait Islander interests is severely compromised. Congress must be supported to provide a mechanism to engage with our people, develop policy, and advocate to Government.

Congress should be supported to reach sustainability and independence as soon as possible.

 

  1. A national Aboriginal and Torres Strait Islander representative body for Education

Although there are many good quality Aboriginal and Torres Strait Islander organisations, and strong leaders, working at the State and local level in the education sector, there is currently no national body to promote and engage in education policy for Australia’s First Peoples.

The education sector is fragmented across early childhood, primary and secondary education, vocational education and training, and higher education, with each of state and territory having public, catholic and private school systems. In the absence of a single national education voice for Aboriginal and Torres Strait Islander people, Congress has been active in coordinating and promoting unity across these sectors. Congress has consulted widely with its members, educators and organisations, many of which have a long history of working in this area.

We call on the next Federal Government to establish a national body that can call for policies support Aboriginal and Torres Strait Islander students and communities across all of these educational systems.

  1. A national Aboriginal and Torres Strait Islander representative body for Employment

The highly disadvantaged employment and income status of Aboriginal and Torres Strait Islander peoples is well documented. While we appreciate attempts at advancing opportunities for Aboriginal and Torres Strait Islander peoples, the many issues around employment require a unified and expert voice.

Beyond skills training, mentoring and targeted employment services to enhance the job readiness of

Aboriginal and Torres Strait Islander peoples, concerted effort needs to be directed to creating jobs that are suitable and meaningful for our people. This is of particular concern in remote areas, where mainstream commercial and labour market opportunities are limited. In urban and rural areas, Aboriginal and Torres Strait Islander people are faced with issues of racism and discrimination in the workplace.

 

The next Federal Government should establish and fund a national representative body of Aboriginal and Torres Strait Islander leaders to drive employment and economic solutions for our people, in order to:

  • Work with our communities to develop their own strategies for economic development, and promote community participation and management;
  • Promote strategies to create Aboriginal and Torres Strait Islander-friendly workplaces; and
  • Work with Government to design welfare policy that encourages, rather than coerces, Aboriginal and Torres Strait Islander peoples into employment.
    1. A national Aboriginal and Torres Strait Islander representative body for Housing

Federal and State Government policies concerning Aboriginal and Torres Strait Islander housing is currently disjointed, wasteful and failing. For example, Aboriginal and Torres Strait Islander people in urban and regional markets face many barriers in accessing and securing safe and affordable housing, including discrimination and poverty.

The next Federal Parliament should support the development of a national representative body of Aboriginal and Torres Strait Islander leaders who can focus on housing security for Aboriginal and Torres Strait Islander peoples, and:

  • Advocate for the ongoing support for remote communities to prevent community closures;
  • Work with communities to develop a national Aboriginal and Torres Strait Islander housing strategy, with the aim of improving the housing outcomes for our people across all forms of housing tenure; and
  • Provide culturally appropriate rental, mortgage and financial literacy advice.

First Peoples Health Priorities

Closing the Gap in health equality between Aboriginal and Torres Strait Islander people and non-Indigenous Australians is an agreed national priority. The recognised necessity and urgency to close the gap must be backed by meaningful action.

All parties contesting the 2016 Federal Election must place Aboriginal and Torres Strait Islander affairs at the heart of their election platforms, recognising the health equality as our national priority.

Despite the regular upheaval of major policy changes, significant budget cuts and changes to Government in the short election cycles at all levels, we have still managed to see some encouraging improvements in Aboriginal and Torres Strait Islander health outcomes. But much remains to be achieved and as we move into the next phase of Closing the Gap, enhanced program and funding support will be required.

We appeal to all political parties to recommit to Closing the Gap and to concentrate efforts in the priority areas in order to meet our goal of achieving health equality in this generation.

We call on the next Federal Government to commit to:

  1. Restoration of funding

The 2014 Federal Budget was a disaster for Aboriginal and Torres Strait Islander people. This is not an area where austerity measures will help alleviate the disparity in health outcomes for Australia’s First Peoples.

The current funding for Aboriginal health services is inequitable. Funding must be related to population or health need, indexed for growth in service demand or inflation, and needs to be put on a rational, equitable basis to support the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan (2013–2023).

  1. Fund the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan (2013–2023)

Future Budgets must adequately resource the Implementation Plan’s application and operation. As a multi-partisan supported program, the Implementation Plan is essential for driving progress towards the provision of the best possible outcomes from investment in health and related services.

  1. Make Aboriginal Community Controlled Services (ACCHS) the preferred providers

ACCHS should be considered the ‘preferred providers’ for health services for Aboriginal and Torres Strait Islander people. Where there is no existing ACCHS in place, capacity should be built within existing ACCHS to extend their services to the identified areas of need. This could include training and capacity development of existing services to consider the Institute of Urban Indigenous Health strategy to self-fund new services. Where it is appropriate for mainstream providers to deliver a service, they should be looking to partner with ACCHS to better reach the communities in need.

  1. Create guidelines for Primary Health Networks

The next Federal Government should ensure that the Primary Health Networks (PHNs) engage with ACCHS and Indigenous health experts to ensure the best primary health care is delivered in a culturally safe manner. There should be mandated formal agreements between PHNs and ACCHS to ensure Aboriginal and Torres Strait Islander leadership.

  1. Resume indexation of the Medicare rebate, to relieve profound pressure on ACCHS

The pausing of the Medicare rebate has adversely and disproportionately affected Aboriginal and Torres Strait Islander people and their ability to afford and access the required medical care. The incoming Federal Government should immediately resume indexation of Medicare to relieve the profound pressure on ACCHS.

  1. Reform of the Indigenous Advancement Strategy

The issues with the Indigenous Advancement Strategy (IAS) are well known. The recent Senate Finance and Public Administration Committee Report into the tendering processes highlighted significant problems with the IAS programme from application and tendering to grant selection and rollout.

The next Federal Government must fix the IAS as an immediate priority and restore the funding that has been stripped from key services through the flawed tendering process.

  1. Fund an Implementation Plan for the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy

The National Aboriginal and Torres Strait Islander Suicide Prevention Strategy encompasses Aboriginal and Torres Strait Islander peoples’ holistic view of mental health, as well as physical, cultural and spiritual health, and has an early intervention focus that works to build strong communities through more community-focused and integrated approaches to suicide prevention.

The Strategy requires a considered Implementation Plan with Government support to genuinely engage with Aboriginal and Torres Strait Islander communities, their organisations and representative bodies to develop local, culturally appropriate strategies to identify and respond to those most at risk within our communities.

  1. Develop a long-term National Aboriginal and Torres Strait Islander Social Determinants of Health Strategy

The siloed approach to strategy and planning for the issues that Aboriginal and Torres Strait Islander people face is a barrier to improvement. Whilst absolutely critical to closing the gap, the social determinants of health and wellbeing – from housing, education, employment and community support – are not adequately or comprehensively addressed.

The next Federal Government must prioritise the development of a National Aboriginal and Torres Strait Islander Social Determinants of Health Strategy that takes a broader, holistic look at the elements to health and wellbeing for Australia’s First Peoples. The Strategy must be developed in partnership with Aboriginal and Torres Strait Islander people through their peak organisations.

Please note the balance of document can be read here

Redfern Statement June 2016 Elections 18 Pages

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NACCHO #HealthElection16 : Ongoing commitment required to close the gap says NACCHO CEO

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PHOTO ABOVE : Senator Rachel Siewert visiting the Broome Regional Aboriginal Medical Centre yesterday with Senator Richard Di Natale to announce the Greens Aboriginal Health policy. Prior to entering parliament, Richard was a general practitioner and public health specialist. He worked in Aboriginal health in the Northern Territory.

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“Perhaps the most important part of The Greens’ commitments is the restoring of over half a billion dollars in cuts since 2013 and their earlier promise to index Medicare rebates, which have been frozen for several years. This has been causing unnecessary hardship to medical services across Australia.

“The Greens policy is a very comprehensive plan for Aboriginal health and we challenge the other parties to outline in detail what their plans are in these areas of concern.”

NACCHO CEO Patricia Turner ( Pictured above ) has welcomed the release of The Greens’ Aboriginal Health policy yesterday.

Ms Turner said The Greens’ policy is so far the only one this election to focus specifically on Aboriginal health and make commitments in nearly all of the key areas in Aboriginal health.

Read Greens Press release HERE

Download the full Aboriginal Health Policy document

Greens Aboriginal Health platform 2016 Elections

“The Greens have touched on many issues of serious concern for the ACCHO sector,” Ms Turner said.

“Avoidable blindness accounts for 11 per cent of the gap between Aboriginal and non-Aboriginal health. $42.3 million will go a long way to providing spectacles and other eye health measures and implement the Roadmap to Close the Gap for Vision.

“Almost $100 million to Close the Gap in hearing is also very welcome. We know that educational outcomes improve when children can hear properly in class and the $4 million a year for sound field systems in classrooms will be a great help.

“There is a desperate need for mental health services for Aboriginal people and the $720 million The Greens have committed to this is very important.

“Hear our Voices -Aboriginal Health in Aboriginal Hands “

View our new NACCHO TV Interviews HERE

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#HealthElection16 

Advertising and editorial is invited from

All political parties

NACCHO 150 Members and Affiliates

Stakeholders/ Aboriginal organisations

Peak Health bodies

Editorial Proposals Close 10 June 2016

Closing 17 June for publishing election week 29 June

Contact for Advertising rate cards/bookings/editorial