NACCHO Aboriginal #SexualHealth #GetTested : #Syphilis epidemic claims life of Cape York baby for first time in 5 years : Commitment and investment needed to address epidemic

THE syphilis epidemic in the Far North which has claimed the life of a baby is tragic for our Aboriginal and Islander communities and is a major concern for both Apunipima and our partner health organisations in the North.

Rates of infectious syphilis in indigenous communities across Australia in 2016 were five times that of non-indigenous people, with rates in the Far North reflecting this.

There was a need for constant surveillance and resources to ensure any increases in STI rates in the Far North were being addressed in a timely way.”

Apunipima Cape York Health Council public health advisor Dr Mark Wenitong said the stillborn baby was a rare, but tragic consequence of high rates of the infection see Cairns Post Media coverage Part 1 below

Read over 37 Aboriginal Sexual Health articles published over the past 6 years

We are extremely concerned about the growing number of Aboriginal and Torres Strait Islander people who are contracting these infections.

The prevalence of syphilis is highest in rural Indigenous populations and in some parts of Australia, the disease is now endemic.

“Pregnant women are particularly at risk because if they contract syphilis it can result in serious and sometimes fatal complications for their baby. It shouldn’t be this way, we can prevent and treat these infections through routine screening and treatment programs.

We understand that the Commonwealth has developed an Action Plan to deliver short term responses to high rates of syphilis, with a focus on increasing testing, treatment, education, antenatal care and supporting an appropriately trained workforce.

The recent death from congenital syphilis underlies the need to fund and implement this Action Plan without further delay “

Royal Australasian College of Physicians (RACP) President, Dr Catherine Yelland see full press release Part 2 below

Doctors are urging the Federal Government to make a long-term investment in sexual health programs and services, including prevention, testing and treatment initiatives to address the ongoing syphilis outbreak affecting northern parts of Australia.

Part 1 Syphilis epidemic claims life of FNQ baby for first time in 5 years

THE syphilis epidemic in the Far North has claimed the life of a baby for the first time in the region in five years, with the amount of cases doubling in the past two years.

Cairns Post

New figures from the Cairns and Hinterland Hospital and Health Service show the amount of cases of infectious syphilis in the Cairns health district has continued to rise in the past 12 months.

So far this year, there has been 12 cases of infectious syphilis in the health district, which is already higher than the year-to-date average.

CHHHS public health medical officer Dr Annie Preston-Thomas confirmed a notification of a congenital stillborn baby in the Far North, but was unable to give further details due to confidentiality.

“These cases are rare with only one other case occurring in the Cairns and Hinterland region since 2013,” she said.

“This relates to an ongoing syphilis outbreak among young Aboriginal and Torres Strait Islander people in North Queensland. Syphilis infection during pregnancy can cause congenital syphilis, with serious outcomes for the baby.”

Dr Wenitong said there was a need for constant surveillance and resources to ensure any increases in STI rates in the Far North were being addressed in a timely way.

“There is a comprehensive response to STIs happening in our Far North region, however more needs to be done at the primary health level, with increased resources and with more effective cross-cultural approaches to ensure better access to screening for this sensitive issue,” he said.

“One of the screening programs is carried out by Apunipima’s maternal health teams, where 95 per cent of antenatal women have the test to screen out infection.”

Part 2 Commitment and investment needed to address syphilis epidemic says RACP

Doctors are urging the Federal Government to make a long-term investment in sexual health programs and services, including prevention, testing and treatment initiatives to address the ongoing syphilis outbreak affecting northern parts of Australia.

It follows confirmation earlier this month of another congenital syphilis death in Far North Queensland, the sixth fatality from congenital syphilis that has occurred in Northern Australia since 2011.

 

As detailed in its pre-budget submission, the RACP is recommending long-term investment in sexual health programs to accompany the Action Plan. It also wants to see a funded implementation plan for the Fifth National Aboriginal and Torres Strait Islander Blood-Borne Viruses and Sexually Transmitted Infections Strategy.

Dr Yelland said there needs to be a greater investment in Aboriginal and Torres Strait Islander sexual health services to improve people’s sexual health in the long-term.

“Aboriginal and Torres Strait Islander people must be pivotal in the development and implementation of these strategies. They are the ones who understand the health issues impacting their communities and can help ensure the services delivered are culturally safe.”

There were 28 new notifications of syphilis in North Queensland during October 2017, up from 12 notifications in the same period last year.

Sexual health crisis: Syphilis epidemic rages as doctors sound alarm on rising HIV rates

FROM WEBSITE

Since 2011 a syphilis epidemic has swept across northern Australia, spreading across multiple states and hitting Indigenous communities hard.

Figures obtained by NITV News show the rate of infections is rising fast.

Now, stretched health services are warning a rise in HIV cases could be the next epidemic to hit the region.

By Robert Burton-Bradley  Source: NITV News. 20 Oct 2017

Indigenous Australia is in the grip of a serious health crisis as skyrocketing rates of syphilis have seen five babies die and hundreds of new cases appear. Now, rates of HIV are on the rise too. Doctors and health professionals working on the frontline have said more resources are urgently needed to stop the outbreak which is now in its seventh year.

Professor James Ward from the South Australian Health and Medical Research Institute told NITV News the situation was all the more concerning because it was preventable.

“We had a very good opportunity to eliminate it, we missed it, and now we’re in this situation,” he said. “It is unacceptable in this day and age to have any congenital death related to an STI in a country like Australia, where we’ve got very good testing and very good treatment for these STIs.”

“If this had occurred in non-Aboriginal communities there would have been a national outcry.”

Figures obtained by NITV News reveal that as of August this year, Queensland has had almost 1000 cases of syphilis among its Indigenous population since the outbreak began there in 2011. The Northern Territory has seen a dramatic rise in infections more than doubling from 229 cases last year to 588 cases since 2013. Western Australia has had 134 cases since 2014, mainly in the Kimberley region, and the now the epidemic has spread to South Australia, which has had 26 cases since late last year. In most cases, the victims are under 29-years-old. There have been five cases of babies dying after being born with congenital syphilis and an unknown number of babies born with congenital abnormalities.

Cairns is the epicentre of the epidemic with the highest number of cases. Cairns Sexual Health Service Director, Dr Darren Russell, said he has never seen a syphilis outbreak like this before.

“It is concerning. We don’t know where it will end up, but it’s worse than it ever has been and the rates around the country are increasing, not decreasing,” he told NITV News. “We’ve seen is this incredible resurgence of syphilis and now we are seeing HIV where we have never seen it before. There is real concern.”

“Cairns and surrounds is really the main area of concern. In North Queensland itself, up to August 2017, there have been 941 cases and five deaths of babies from congenital syphilis.”

“There is a lot of work going on to try and prevent further deaths, but it is very difficult when you have so many cases and you tend to get syphilis in young sexually active people.”

“Initially, you can talk about an epidemic where an infection gets into a community and then what happens after a time is the infection can become endemic, more established in that community – that’s probably what is going on now in the Cairns area and the top end of the Northern Territory, and possibly even Townsville too”,” he said.

He warns of rising HIV notifications in and around Cairns, which he says could be linked to the syphilis epidemic. Now, there has been a spike in HIV infections, particularly in the Indigenous population, says Dr Russell.

“The syphilis epidemic started in 2011 and there was always a concern that HIV could piggyback on that because HIV and syphilis tend to go together,” he said. “Around Australia, HIV notifications in Indigenous people used to be about the same as non-Indigenous people, but they are now twice the rate and it looks like they are continuing to increase.”

In Cairns, it is up to 50 per cent of infections, said Russell. “I don’t think we know at this stage if it is too late”

A public health alert sent to Queensland health workers last month warned the rising rates of HIV are tied to the syphilis outbreak and that a majority of the cases are among younger Indigenous people, under 40 years of age.

It came after an emergency HIV roundtable of around 80 clinicians and community leaders to discuss the crisis in Cairns earlier this week.

Professor Ward, a sexual health expert, who attended the conference as a speaker said the number of Indigenous HIV infections is not huge, but warns that could change unless extra resources are brought in.

“It used to be relatively stable. We’d have say 20 (Indigenous) cases a year nationally, we’re almost double that now, perhaps, even more, when you look at the most recent data, and that’s very problematic because once it reaches a tipping point, it will move into an endemic state and I think now is the time to put lots of effort into preventing HIV.”

The other issue, said Dr Russell, is that diseases like syphilis and HIV can be sleeper infections and people could be unaware for lengthy periods of time they have been exposed, and in turn, pass it on to others.

“One of the problems is we don’t know what we don’t know, there will be individuals who haven’t been diagnosed yet, and if they are not aware they have HIV, then onward transmissions will continue.”

“I think we have always been concerned in Australia that there would be an epidemic of HIV in the Indigenous community and we’d almost eliminated infectious syphilis a few years ago – what we’ve seen is this incredible resurgence of syphilis and now we are seeing HIV where we have never seen it before. There is real concern at this stage and we don’t know where the HIV epidemic is going to go, whether it will continue or be brought under control.”

How did this happen?

A decade ago, syphilis in Queensland was on track to being eradicated, but then in 2010, the number of cases diagnosed started drastically increasing. By 2011, it was being called an epidemic. By 2014 it had spread into the Northern Territory, before moving into the Kimberley region of WA and reaching South Australia last year. Many of the cases are in remote Indigenous communities.

Indigenous Australians are six times more likely to catch syphilis than the non-Indigenous population. Staggeringly, this increases to 132 times higher in remote areas. Rates of HIV infection are twice as high for Indigenous people than the rest of the population.

“These things take you by surprise, there is no way of pre-empting some of this kind of outbreaks but a fast response is really necessary.”

Dr Russell warns that HIV is now looming as a follow up threat. He points to Canada’s experience, where Indigenous people account for as much as 11 per cent of new HIV infections, despite making up just 4.3 per cent of the total population.

“We appear to be heading in that direction,” he warned.

Dr Mark Wenitong, Public Health Medical Advisor at the Apunipima Cape York Health Council, said a large part of the blame resides with the drastic cuts to public health spending made by the incoming government of former Queensland Premier Campbell Newman in early 2012, and a failure by health services to recognise the threat early on.

“Very unfortunate that five women have lost their babies but there have been a number of other babies born with congenital syphilis abnormalities which is problematic and why we are desperate to get message out there for that target age group.” said Professor James Ward.

“The thing is there were resources going into North Queensland through the health department, but after the election, that got cut a fair bit, and from the perspective of primary health care, that really did leave a hole in education. Screening and particularly sexual health teams, that has definitely had an impact,” he said.

Dr Wenitong said this compounded the already large challenges health providers face in the Indigenous community in an area like Cape York.

“There are limited resources because everything is a priority in Aboriginal communities because of the prevalence of a lot of different illnesses,” he said.

Dr Russell said previous outbreaks of STI’s like HIV had largely bypassed these communities, meaning that some were caught off guard.

“It’s a whole range of things. You have a population that is quite marginalized and disadvantaged, has poor access to health care, you’ve also got a group in whom traditionally there hasn’t been a lot of HIV, so the health services aren’t really geared up for thinking about HIV and testing for it.”

Dr Wenitong conceded the outbreak had now spread beyond the control of some health providers.

“These things take you by surprise, there is no way of pre-empting some of this kind of outbreaks but a fast response is really necessary.”

“I think one of the things we feel is a bit of a sense of failure in a way, that things like syphilis which is preventable and controllable, that that got away from us across the Top End of Australia.

What is being done

In response to growing calls for action, the Government has committed more resources, says Liberal senator Dean Smith, who is chair of the Chair of the Parliamentary Liaison Group for HIV/AIDS, Blood Borne Viruses and Sexually Transmitted Infections.

“The evidence of the alarming disparity in the rates of STIs between Indigenous and non-Indigenous Australians is very credible.

“I am aware that over the last four years, $15 million has been spent on a variety of specific STI and BBV prevention and education activities across northern Australia, including  trialling “point-of-care” testing for certain diseases and surveying the sexual health and lifestyle behaviours of Aboriginal and Torres Islander communities,” he tells NITV News.

He said everyone needs to be worried by the current crisis and urged his own Government to do more.

“As an immediate action, I firmly believe there must be a stronger response from the Federal Government and that it must take a more proactive leadership role in coordinating the activities of State and Territory Governments on the issue.”

Indigenous Health Minister Ken Wyatt said the government was aware of the problem and is taking steps to combat the spread of syphilis and HIV.

“In August, I raised the syphilis issue with the Australian Health Ministers’ Advisory Council’s (AHMAC) Australian Health Protection Principal Committee (AHPPC), which is currently intensifying the national response to the current outbreak, including short-term actions to reduce infection,” Minister Wyatt told NITV News in a statement.

“A governance group has been established and will report on the proposed action plan to the Health Minister and myself in December 2017. The response will also focus on a long-term and sustainable response to combating other blood-borne viruses and sexually transmitted infections.

“The Commonwealth continues to fund targeted activities and a national network of approximately 140 Aboriginal Community Controlled Health Services (ACCHSs) and around 40 other providers to deliver comprehensive, culturally appropriate primary health care services, including sexual health and maternal health services.”

A new awareness campaign called Young Deadly and Syphilis Free has been rolled out over the last few months targeting Indigenous communities and urging regular resting and treatment of infections.

This week, the Queensland Government announced an expansion of the number of places for people to PrEP (Pre-Exposure Prophylaxis) a medication that can dramatically reduce the risk of HIV transmission in HIV negative people.

Queensland Health Minister, Cameron Dick, acknowledged working with communities would be crucial in combating the further spread of the outbreak.

“If we are to achieve our shared goal of the virtual elimination of HIV in Queensland by 2020, we must reach out to Aboriginal and Torres Strait Islander people in every community.”

A spokesman for Queensland Health said the government was committing $15.8 million over three years to support the actions of the North Queensland Aboriginal and Torres Strait Islander Sexually Transmissible Infections Action Plan 2016-2021, in addition to millions being spent more broadly on sexual health.

Despite the promises of increased resourcing, the problem, more than seven years after the first outbreak in Queensland, remains for the time being.

Professor Ward said he believed the slow response was in part because the affected population was Indigenous.

“If this had occurred in non-Aboriginal communities there would have been a national outcry.”

Dr Russell from Cairns Sexual Health says it may already be too late to resolve the outbreak anytime soon.

“That’s the million dollar question. I don’t think we know at this stage if it is too late, but clearly, there are worrying signs and it is certainly not controlled at this stage

NACCHO Aboriginal Health Leadership News : New @VACCHO_org CEO Has a Vision for a Culturally Confident Aboriginal Community

 

” Look it would be easy to say that we haven’t got anywhere, but the fact is with Aboriginal health, I look at this holistically.

So there’s health in the traditional notions of health, that is physical well-being and mental health well-being, and then there’s the broader concept of health which is the whole of the person’s life and all the things that impact on that.

I think we’re making gains, but given our starting point and where we’re coming from, things don’t change quickly. It will take a number of generations for us to get to what I’d call self-equity.

It’s taken us 200 years to get where we are now, so to turn it around and get on a level par with everybody else is going to take quite a while as well. So I think we are trending in the right direction, but it will require a sustained and increased effort over many years to come, to get us really on the path or to reach the point of health equity.”

Ian Hamm has just been appointed CEO of the Victorian Aboriginal Community Controlled Health Organisation (VACCHO), after more than 30 years’ experience working with the Indigenous community.

He is this week’s Changemaker

Job Vacancy  Manager Cultural Safety Training

• Be a part of the change you want to see in the world
• Take on a leadership role
• This is an Aboriginal and/or Torres Strait Islander identified position

VACCHO is the peak body for Aboriginal health in Victoria and champions community control and health equality for Aboriginal communities.

Apply HERE of see below Part 2

Hamm was appointed CEO of VACCHO for 18 months, while Jill Gallagher AO takes a leave of absence to commence as Victorian Treaty Advancement Commissioner from February.

He described himself as a proud Aboriginal man, who has extensive experience in the public service, including as executive director of Aboriginal Affairs Victoria.

Hamm currently serves as chair of the Koorie Heritage Trust, the First Nations Foundation and Connecting Home Ltd (Stolen Generations Service).

In this week’s Changemaker, Hamm speaks about his plans for VACCHO in the next 18 months, details his sister Cherie’s special connection to the organisation, and explains what keeps him motivated to serve the Indigenous community.

Have you been involved with the community sector before?

I’ve been in government for a bit over 31 years. So this is my first time working in the community sector itself, but I have worked closely with the community sector over that time. I’ve worked for federal and state governments, mostly around Indigenous community stuff. But I’ve also worked in education, in health justice economics and so forth.

What attracted you to work in the community sector?

I suppose it was the opportunity to get to work in the sector that I’d always worked with, if you like. So over the period of 31 years, I’ve worked across a range of different things to do with the Aboriginal community. I’ve worked closely with the sector. So when the opportunity came along to be CEO of one of the leading community organisations for 18 months, you get asked these things once and once only and you don’t say no.

What are your plans for VACCHO during your term as CEO?

At the moment there are a lot of developments going on in Victoria on Aboriginal matters. So quite clearly, the predominant one at the moment is the treaty discussions which are which are about to take off. The person whose role I’m taking, Jill Gallagher, is going to be the treaty commissioner for 18 months. So that’s the big piece of work in Victoria, in fact Australia to be honest.

Victoria is also doing work around self-determination and how do we bring self-determination to life. So those are two really big things going on. So clearly I want to make sure that VACCHO is well engaged in those two pieces of work and also continues to prosecute the efforts around improvement in Aboriginal health outcomes and also ensuring that our members are best practice organisations, in terms of their administration, their governance, their workforce development and all that kind of stuff as well. So there’s a fair bit I want to do and obviously looking at VACCHO itself, is there an opportunity for VACCHO to improve? I mean everywhere can improve over time and develop its operating and business models. So I want to look at VACCHO itself and how we work as an organisation.

How do you see a typical day going for you as CEO of the organisation?   

A lot of my background has been around [strategic] long-term outcome focus, around where we want to be in a number of years from now as opposed to where we are now. So my type of day as I see it, [will involve] a lot of time spent with an external focus, building up critical relationships and ensuring we’re well engaged with the members, because VACCHO exists by right of its membership. So ensuring that we have good and productive relationships with our members [is vital] and we’re supporting them in what they do.

I’ll obviously be having an oversight of the organisation but leaving the day-to-day operating, the daily grind as you might call it, to the people who are much better and much more skilled at that type of work than I am within the organisation. So a typical day for me will probably be in a number of meetings, making sure that at a higher level I’m across stuff around the operating of the organisation and probably talking to the chair of the organisation once a week or a fortnight just to make sure that the leader of the board is across stuff. So it’ll be a mixed bag of things that CEOs do, that you can never quite put your finger on when somebody asks you “what is it that you do exactly?”

You have spoken in the past about how your sister Cherie has a special connection to VACCHO, what does this mean to you?

My sister Cherie worked at VACCHO for many years, for 10 years if not longer. She not only was a worker there but she was part of the soul of the place. And she did a lot of work particularly around palliative care. She confronted the difficult issue of when Aboriginal people are passing and not just looking at health improvement, but dealing with the dreadful reality that people die.

She herself died of breast cancer in 2014. She was well loved by the VACCHO people, the VACCHO staff and the VACCHO community as a whole. So to be CEO of the organisation that she was such an intimate part of, not just in a work sense but in a soul sense, is an additional thing for me that was one of the reasons I took this job.

Amongst all the work that you do, how do you find time for yourself and what do you like to do in your spare time?

I learnt a new word in 2017. It’s called “no”, as in “no I cannot go onto another board, no I cannot do this”. I’m actually on seven boards in addition to being CEO of VACCHO now, and I do other stuff outside of that. So when I do find the time just to myself, I like to cook, and I still play cricket at the age of 53. So I’m still going around on a Saturday playing in a 4th XI as a wicketkeeper, which I should have given away many years ago, but I get to play cricket with a bunch of blokes who have no idea what I do for a living.

So there’s that kind of stuff. Obviously my pride and joy are my children Jasper and Isabel. I have a special relationship with my niece Narita, Cherie’s daughter, and she’s just had a little boy. So I enjoy being part of his life, [even though] he’s only about three months old. That’s the type of thing I do privately and is my little piece of paradise.

You’ve been advocating for Indigenous causes for a long time. How do you remain motivated and optimistic despite all the challenges that arise?

It’s just a fundamental thing inside me that I can’t stand inequity, I can’t stand people not being given the opportunity to be the best that they can be. I can’t actually describe it any deeper than that, but particularly with our own community, I have a deep commitment to us finding what I believe is our rightful place in the great Australian community. That to me is what drives me. It’s something that I find hard to describe. It just is. It’s just what makes me get out of bed in the morning.

It’s what makes me do work which is essentially really hard. But I wouldn’t do anything else. There are a lot easier ways to make more money than this, but for me and everyone else in this sector, it’s not just about job satisfaction or what you get out of it as a job. It’s a much deeper thing, this isn’t about me this is about everyone. So that’s what gets me out of bed in the morning and makes me do what I do.

What kind of future would you like to see for the Indigenous community in the years ahead?

One of the things which I’ve always had in my mind around what I try to do with anything [regarding] the Aboriginal community, is not just looking at what are the problems we have now and how do we fix them. If you just focus on that you never get ahead. I’ve always said in my mind, “What does Aboriginal Victoria look like in 20 years from now?” So if I jump forward a generation, Aboriginal Victoria will have equity on most things which we measure.

So economic equity, health equity, education equity etc. Most critically, Aboriginal community identity will be a confident one. It will be not only culturally strong, but culturally confident in itself and its place in the wider Victorian community. It will be universally respected and in fact, may even be the thing that the rest of the Victorian community aspires to. That is where I want to see Aboriginal Victoria as a whole 20 years from now.

Do you have any particular people that inspire the work that you do?

Oh there’s a number of people. So William Cooper, my great uncle, he inspires me. There’s Doug Nicholls, and Alf Bamblett who I knew quite well. Those three people inspire me. I went into government 30 years ago and decided to stay there to work for Aboriginal people. Charlie Perkins, he inspires me to no end. And he got sacked a couple of times, but he did what he thought was right for the Aboriginal community.

I got sacked once for doing what I thought was right for the Aboriginal community, and getting sacked from high profile positions is never fun, but you know what, I could sleep at night because I knew I had done the right thing. So those type of people inspire me and there’s a whole range of others. My own family inspire me, my aunty Claire, she’s one of those people who inspired me and there’s a whole range of people.

Part 2 Manager Cultural Safety Training job opportunity

• Be a part of the change you want to see in the world
• Take on a leadership role
• This is an Aboriginal and/or Torres Strait Islander identified position

VACCHO is the peak body for Aboriginal health in Victoria and champions community control and health equality for Aboriginal communities. We are a centre of expertise, policy advice, training, innovation and leadership in Aboriginal health. VACCHO advocates for the health equality and optimum health of all Aboriginal people in Victoria.

VACCHO’s cultural safety training incorporates cultural awareness training and builds on this learning to provide practical tips and skills that can be utilised to improve practice and behaviour, which assist in making Aboriginal people feel safe. In shifting the focus to health systems, our participants begin to learn how to strengthen relationships with Aboriginal people, communities and organisations so that access is improved.

We are looking for someone to provide leadership in the sustainability, development, coordination and delivery of our Cultural Safety training.

You will need to be comfortable presenting to other people, be good at networking and building relationships and have an understanding of cultural awareness issues as it relates to Aboriginal communities and individuals as well as experience in managing and leading a team.

You will be joining a great team and will be provided with guidance and support to learn the training packages.

If this sounds like the job you are looking for then you can download the Position Description and Application Form from our website http://www.vaccho.org.au/jobs.

To apply please email a copy of your resume and application form to employment@vaccho.org.au.

For queries about the position please contact Paula Jones-Hunt on 9411 9411 Applications close on Monday 12 February.

APPLY HERE


Luke Michael  |  Journalist |  @luke_michael96

Luke Michael is a journalist at Pro Bono News covering the social sector

NACCHO Aboriginal #MentalHealth and #Suicide : @RoyalFlyingDoc says mental health services in rural and remote Australia are in a state of “crisis”.

 “We see [more remote] people only accessing mental health services at … 20 per cent the rate of those who access services in the city.

If that’s not a crisis, I don’t know what a crisis is.

We provide 24-hour medical care to people in rural and remote Australia, but our doctors are finding themselves overwhelmed by the amount of psychological support they need to provide to their patients.

Last year the Flying Doctors saw 24,500 people to provide mental health counselling, but we could double or triple that service tomorrow and still not touch the surface,” .

The RFDS chief executive Martin Laverty said major disparities between country and city services still existed, despite numerous government reviews designed to address the problem

WATCH TV COVERAGE HERE

Read over 169 NACCHO Mental Health Articles published over past 6 years

Read over 119 NACCHO Suicide Prevention articles published over past 6 years

Fact 1   

“Roughly half the people the Flying Doctor cares for in our health or dental clinics or transports by air or ground are Indigenous.

“The Flying Doctor RAP, agreed with Reconciliation Australia, contains tailored actions for tangible improvements in the health of Aboriginal and Torres Strait Islander people.”

RFDS Website

Fact 2

Each year, around one in five, or 960,000, remote and rural Australians experience a mental disorder. The prevalence of mental disorders in remote and rural Australia is the same as that in major cities, making mental disorders one of the few illnesses that does not have higher prevalence rates in country Australia compared to city areas.

The Royal Flying Doctor Service says mental health services in rural and remote Australia are in a state of “crisis”.

Originally published ABC TV NEWS

Key points:

  • There are no registered psychologists in 15 of Australia’s rural and remote areas
  • “There should be no excuse in a country of universal access to healthcare,” RFDS CEO says
  • Mental health advocates are calling for a bigger financial commitment from the Government in this year’s budget

Data from the Department of Health showed the number of registered psychologists across the country increased in 2015/16. But there were no registered psychologists in 15 rural and remote areas.

Mr Laverty said areas like west coast Tasmania, central Australia, western Queensland and the Kimberley in Western Australia missed out.

“Areas where perhaps you’re not surprised to see that there aren’t health professionals in abundance,” he said.

“That should be no excuse in a country of universal access to healthcare.”

Mental Health Australia chief executive Frank Quinlan said doctors were not always the best people to provide mental health support.

“It is not necessarily the best way for us to be spending our resources — to have GPs with 10 years or more of training — delivering basic brief interventions and counselling interventions that could be delivered by other professionals and trained peer workers,” he said.

Suicide rates in rural areas are 40 per cent higher than in major cities, and in remote areas, the rate is almost double.

Mental health advocates call for greater commitment

The Coalition allocated $80 million for psychosocial support services in last year’s federal budget.

The program would help people suffering from severe mental illness — who are not eligible for the National Disability Insurance Scheme (NDIS) — find housing, education and better care.

But the Government will not release the money unless states and territories stump up funds too, and Mr Quinlan said that was yet to happen.

“That’s in spite of the fact that we know that with the roll-out of the NDIS and the roll-back of previous Commonwealth programs, people are already starting to fall into the gaps,” he said.

Health Minister Greg Hunt has acknowledged more assistance is needed for people in the bush.

“I do believe there is a very significant challenge and this is because there are four million Australians every year who have some form of mental health challenge and in the rural areas this is a significant challenge which is precisely why we are looking at additional services,” he said.

The Federal Government recently announced more than $100 million for the youth mental health service Headspace.

It is also spending $9 million improving tele-health services in rural areas.

But mental health advocates are calling for a bigger commitment to such initiatives in this year’s federal budget.

“The Minister — Greg Hunt — was relatively new to the ministry when the 2017 budget was released,” Mr Quinlan said.

“So I think the sector quite broadly and quite rightly, now, 12 months on, will be looking to the 2018 budget to see whether the Government is actually able to prioritise a lot of the concerns and issues that have been addressed.”

Federal Labor response ( added comment )

The Turnbull Government must break its silence over growing concerns about the quality of mental health services being delivered across Australia.

The Royal Flying Doctors Service is the latest organisation to raise the alarm about mental health service issues in rural and remote Australia. These comments today should be a wake-up call for Malcolm Turnbull.

It is vitally important the Turnbull Government gets this right. The mental health gap between the city and country is already too wide.

Today’s comments follow the Australian Medical Association’s position statement on mental health last week on the ‘gross’ underfunding of mental health services.

The Turnbull Government must prioritise greater funding for mental health services in the lead-up to the Budget.

Labor knows there is more work to be done to improve the mental health of all Australians and find ways to further reduce the thousands of lives lost to suicide each year.

It is only by working together that we will be able to finally reduce the impact of mental health issues in our society .

Mental health services need more than lip-service from Malcolm Turnbull and his Government.

For Help Contact your Nearest ACCHO

 

NACCHO Aboriginal Health Mob : Our first 2018 #NACCHO Members #Deadly good news stories @KenWyattMP #NT #NSW #QLD #WA #SA #VIC #ACT #TAS

1.WA : AHCWA team helps with a Meningococcal vaccination campaign to protect the people living in Central WA Desert Communities

2. QLD: Gurriny Yealamucka Health Service : Hearing loss surgery sounds great for 16 children from Yarrabah FNQ

3.ACT : Winnunga AHCS Healthy Weight Program Epitomises Holistic Health Philosophy

4 .NSW : Riverina Medical and Dental Aboriginal Corporation call for more Indigenous health care professionals to help close the gap

5.VIC : Victorian Aboriginal Health Service VALE GARRY (“GILLA”) JOHN McGUINNESS

6.SA : What is the “Nganampa Health Council Difference”?

7. NT : Katherine West Health , Congress Alice Springs , Anyinginyi Health and Miwatj ACH More Indigenous Health Leaders for Remote Australia

8. Tasmanian Aboriginal Centre : Kipli Kani Open nutrition sessions

 View hundreds of ACCHO Deadly Good News Stories over past 5 years

How to submit a NACCHO Affiliate  or Members Good News Story ?

Our next Deadly News Post is January 25

 Email to Colin Cowell NACCHO Media    

Mobile 0401 331 251

Wednesday by 4.30 pm for publication each Thursday

 

1.WA : AHCWA team helps with a Meningococcal vaccination campaign to protect the people living in Central WA Desert Communities

AHCWA staff members, Stacee and Veronica recently visited the Central Communities including, Warburton, Warakurna, Blackstone, Jameson, Tjirrkarli, Tjukurla, Wanarn, Wingellina, Cosmo Newberry, Punmu, Jigalong, Parnngurr, Kunawarritji, and Kiwirrkurra to help with a vaccination campaign planned to protect the people living in Central Communities from the recent outbreak of Meningococcal W and to help prevent further spread of the disease.

Under this program, the Meningococcal A, C,W,Y vaccine was offered to all people aged 2 months and older living in these communities.

The team involved were truly amazed at the way the Communities got behind the campaign and encouraged all people, young and old, to have their Meningococcal needles.

The children were incredibly brave and if upset, the families would speak in language to the children.

It was obvious to the team that the children were really listening and took in what the family was saying about how important the needle was.

AHCWA would like to thank all the people from Communities in the NG Lands and Pilbara for the wonderful support that was shown in response to the Meningococcal vaccination campaign.

Also a big thank you to the WACHS teams who invited AHCWA
to participate in this campaign.

2. QLD: Gurriny Yealamucka Health Service : Hearing loss surgery sounds great for 16 children from Yarrabah FNQ

 Up to 16 Aboriginal and Torres Strait Islander kids from Yarrabah will have life-changing hearing health surgery this week at Cairns Day Surgery. Registered Nurse Karen Leeman prepares 7 year old Dallas Sands for surgery on a perforated eardrum. Cairns Post Story and PICTURE: STEWART McLEAN

THE sounds of their tropical home will become much more clearer for 16 children from Yarrabah who have gone under the knife to improve their hearing.

Several health organisations united yesterday to assist the indigenous children with day surgery in Cairns under the federally funded Eye and Ear Surgical Support Services program.

Children ranging from 2-15 years of age were treated for a series of hearing impairments, including perforated eardrums and middle-ear infections.

Aboriginal and Torres Strait Islander children experience some of the highest levels of ear disease and hearing loss in the world. Rates are up to 10 times more than those for non-indigenous Australians.

Gurriny Yealamucka Health Service Aboriginal Corporation nurse Dannielle Gillespie said, due to Yarrabah’s relatively remote location, it was difficult for parents to get their children to doctors.

She said an initial list of 200 children needing hearing loss surgery had to be whittled down to the list treated at Cairns Day Surgery yesterday.

“Hearing loss in Yarrabah is right across all kids,” she said.

“Basically, if the perforations in the ear are not fixed, then that has a future roll-on effect with their speech, their education, their learning abilities – even their social skills, it starts affecting that, too.”

Yarrabah mum Zoe-Ann Sands’ daughter Dallas, 7, had surgery yesterday.

Ms Sands said she was thankful her daughter would finally have better hearing.

Funding for the surgery was provided to health advocacy group CheckUP by the Commonwealth Government

3.ACT : Winnunga AHCS Healthy Weight Program Epitomises Holistic Health Philosophy

Long serving CEO Julie Tongs couldn’t help reminiscing that Winnunga AHCS ACT Government funded Healthy Weight Program replicated the sector’s bedrock philosophy of truly Aboriginal community controlled holistic health services.

‘It means that you can work with a person individually, get to know their real needs, monitor and refer them for support in various ways through the holistic approach to health care that underpins how Winnunga AHCS works,’ Ms Tongs said.

‘This has been a major initiative,’ Ms Tongs said ‘with funding of $640,000 provided over a three year period.’

‘We are confident getting closer to the end of this Program, we will prove decisively that the program has worked and worked brilliantly. It is a preventative health program.’

Ms Tongs said the program which has been operating for over two years now, has achieved a number of significant outcomes, such as:

– Significant participation in the program with over 100 people being monitored on a regular basis

– The employment of a full-time Aboriginal person, Leeton-born, but Cowra raised Christine Saddler as program co-ordinator

– The creation of regular full-time gym training program with a regular clientele

– The training of numerous Winnunga AHCS staff members with the skills to identify at risk clients and to then ensure that once identified they are contacted regularly

‘There is absolutely no doubt this Program works well, within the confines of our sector’s holistic and culturally safe health and wellbeing environment,’ said Christine Saddler. ‘It’s about trust and the ability to work with clients,’ she added.

Christine noted that Winnunga AHCS pushed for the introduction of a Healthy Weight Program with the knowledge that many clients struggled with their weight.

‘There are many reasons why this happens and almost in each case the circumstances are never quite the same’, said Chris, who has worked in the Aboriginal community controlled health sector for many years including at Newcastle’s Awabakal Health Service before joining Winnunga AHCS five years ago.

Chris also explained that once a person joined the program a range of resources were provided, including regular sessions at a local gymnasium. ‘We are running these gym sessions three times a week with each session lasting for one hour. We have tried various formats and tailor the sessions to each person’s needs and capabilities.

‘We have employed personal trainers to assist some of our clients. This has worked. Many of our Program participants have lost a significant amount of weight as well as improved other health factors’ Christine said.

 

Mother and daughter Lorna and Tammy Cotter, participants of the program from day one, were quick to explain what it has meant for them. Said Mum Lorna ‘Once I heard of this program I joined because I believed it would help me to control my diabetes and to prevent chronic sickness.’

‘I enjoy the program but more importantly it has worked. I have lost 10.5 kilograms and 8 centimetres from my waist and my Hb1Ac diabetes reading has fallen from 10.3 to 8.2.

I have also met many people in our community whom I hadn’t met before. The thing I like most is that I do the program with my daughter and now my granddaughter’.

For daughter Tammy the weight loss figures are also dramatic. ‘I have lost 10.5kg and 16cm from my waist while by BMI (body mass index) has fallen by 3.4kg/m2’.

Tammy said because of the guidance on eating habits the program provided she was eating healthier and her overall health and lifestyle had also improved. ‘It’s something I now will be passing on to my children,’ she said.

Both Tammy and mum Lorna said neither would have been able to afford to access any other health programs and very specifically would definitely not have been able to afford a gym membership or the usually very high cost of personal trainers.

Julie Tongs noted the community feedback on the program had been very positive, adding she had a letter from one male client congratulating Winnunga AHCS on the program while also saying it had made a huge difference to his level of health.

The weight loss factor and its associated many health benefits was also highlighted by Winnunga AHCS’s Executive Director of Clinical Services, Dr Nadeem Siddiqui.

‘Diabetes is a huge health problem within Indigenous communities. We know the Program has helped clients lower the risks of diabetes,’ Dr Siddiqui said. ‘Because we have a dedicated and experienced Aboriginal health worker co-ordinating the program we can make sure participants are not only monitored but directly referred to other Winnunga services as required, be they from our GP’s, nurses, dieticians, psychologists or even our tobacco control workers.’

‘It is by working holistically and just as importantly within a culturally safe Aboriginal health service that this program is succeeding.’ And both he and Christine emphasised that they firmly believed it would not work in other environments.

Dr Siddiqui said strong links had also been established with external mainstream services, for example with The Canberra Hospitals’ Chronic Disease Management Unit, to provide in-reach services to support program clients.

Both emphasised that as many Indigenous people within the ACT suffered from social isolation the fact that they could meet regularly and openly discuss and share issues that impacted on their daily lives, that in itself was a major factor in play to reflect the Program’s overall acceptance and take up within the local Aboriginal community.

And another very simple initiative that had assisted enormously in breaking down barriers was the simple introduction of a post-gym cup of coffee. ‘The Healthy Weight Program is one that works. Not only does it encourage empowerment it also provides support, feedback and guidance that has seen numbers attending gym classes remain high’.

‘We will continue to be innovative’ stated Julie Tongs ‘and have demonstrated this by introducing hypnotherapy sessions and trauma informed yoga, as intergenerational trauma remains a significant factor for many of our people’.

Dr Nadeem noted ‘As a non-Indigenous person and a doctor it opens your eyes as to how holistic medicine in a truly supportive and sensitive environment can work where purely clinical responses don’t.’

4 NSW : Riverina Medical and Dental Aboriginal Corporation call for more Indigenous health care professionals to help close the gap

The key to improving health in Indigenous communities may be to train more Indigenous doctors and health professionals.

CEO of the Riverina Medical and Dental Aboriginal Corporation Darren Carr said Indigenous communities have a mistrust of medical professionals stemming from the Stolen Generations.

“When you look at the Stolen Generations, a lot of removals of kids happened in a health care setting – so if a child had gone to hospital for some reason, that’s where the child would be taken from their parents,” Mr Carr said.

“There is an understandable historical suspicion and mistrust of health services, and that’s why you need Aboriginal health professionals and services – people know they will feel safe going to them, so they’re more likely access those health services.”

Tina Pollard is one of the only Indigenous nurses in Wagga; she said increasing the number of Indigenous health care professionals is vital if we want to close the gap in life expectancy.

“It’s because we come from the same backgrounds and we have more of an understanding of what the issues are for our people, so we can relate to them a lot better and make our clients feel safe,” Ms Pollard said.

“I see it pretty well every day, especially during hospital visits – they feel very uncomfortable when they go to the hospital, so I will go with them to make sure they’re okay, because they’re more likely to come back for followups if they have a good experience.”

Tina hopes she can be a role model for other Indigenous students.

“If we have more people out there showing that this is what aboriginal people can do, then they’ll know they can do it too.”

5.VIC : Victorian Aboriginal Health Service VALE GARRY (“GILLA”) JOHN McGUINNESS

The Victorian Aboriginal Health Service is sad to learn of the passing of Garry (Gilla) John McGUINNESS on the evening of Tuesday 9 January 2018.

Gilla (as he is better known in the community) died peacefully at St Vincent’s Hospital in Melbourne after several days. He is a member of a large family and he leaves behind him a son, John (JBL) and a granddaughter, sisters and brothers and many nieces and nephews.

Gilla graduated from Koori Kollij in the mid-1980s as an Aboriginal Health Worker. He has been associated with the Victorian Aboriginal Health Service for many years as a patient, a member and for several years as a Director on the VAHS Board. Many will remember and talk about Gilla and his family and their close association with the Victorian Aboriginal Health Service. Even as a young person frequenting Fitzroy where VAHS first commenced, Gilla was closely linked in some way.

Gilla always talked about the 3CR Radio Station based in Smith Street, Fitzroy and how he brought Radio participation through the airways for prisoners. He spoke of his long association with 3CR (over 30 or more years) and about being a member of the local ATSIC Melbourne Aboriginal Regional Council where he was part of an elective representation of Aboriginal people in Melbourne.

In his latter years Gilla used the VAHS Healthy Lifestyle Gym and the services of VAHS until he became too sick to come to continue.

Board of Directors and staff pay their condolences to the family of Gilla

6.SA : What is the “Nganampa Health Council Difference”?

A: The Nganampa Health Difference is a term we use to describe the experience that is on offer when you’re working at NHC. We strive to empower people to make a difference on the frontline of primary healthcare for Indigenous Australians. Working and living remotely can be challenging but our people tell us that this is where their sense of fulfilment comes from! They also value the learning culture at NHC, our professional practice and processes, and the support that they feel we provide, to give them what they and their patients need. You will feel a part of our close, collaborative community and have the opportunity to make a direct impact on our communities! The work we do really improves the lives of the communities we work for. Read more about our accomplishments in the regions here

Q: What are some of the benefits of working for NHC?

A: In return for your professionalism, commitment and care, Nganampa Health brings you a truly unique and satisfying career opportunity. We offer excellent financial rewards and the chance to develop a remarkable skill set and experience a different side to Australia. Working remotely can be challenging, so we’re pleased to be able to provide great financial benefits. For example, people working for us on the APY lands tend to earn a higher salary than they would in more mainstream contexts, and they live in rent-free, fully furnished housing with paid electricity, internet and phone line. Please note though – the real benefit is making a difference in the community so if money is your only motivation, you won’t last long!

Q: What if I am not looking for a permanent role?

A: A Locum role could be for you! With highly competitive remuneration and the flexibility of a fly-in-fly-out locum role you can have the opportunity to make a positive impact and also spend time with your family back home. The level of flexibility and diversity offered by these positions means that there is still autonomy in the services you can provide and you’re not limited to supporting only one particular patient type. In all our roles at NHC, you can work with everyone from newborns to the elderly and see all kinds of medical conditions including emergencies, elderly issues, chronic disease as well as the opportunity to provide health advice and disease prevention.

Q: What qualifications or skills do I need to have?

A: NHC employs people in roles from nurses, doctors and aboriginal health workers to personal carer’s at our aged care facility and corporate staff in environmental health, logistics and finance. All of our people come to NHC with a diverse range of skills and we are always in support for people who want to further their education even more! If you have the relevant qualifications listed in our job ads and a particular interest or passion within the areas NHC covers, then please get in touch with us.

Our people all share the desire to make a real difference on the frontline of primary health, whether working directly with clients or in the office. Our people are professional, committed and really care.

Q:  What positions are currently available?

A: Please see our current opportunities page for positions that are currently advertised.  If you don’t see a suitable position right now, you can also express your interest by contacting us here. If you want to find out more about the different career opportunities at NHC, read some of our staff stories and hear about their journey so far!

7. NT : Katherine West Health , Congress Alice Springs , Anyinginyi Health and Miwatj ACH More Indigenous Health Leaders for Remote Australia

 The Turnbull Government will support a further 14 Northern Territory Aboriginal health services staff members to undertake specialised leadership and management training, as it continues moves to bolster the indigenous health workforce.
The Minister for Indigenous Health, Ken Wyatt AM, said the new participants would bring the total number of people supported by the Indigenous Remote Service Delivery Traineeship program to 66.
 
Customised training will help equip these outstanding nominees to become future leaders in the Aboriginal community controlled health sector,” Minister Wyatt said. 
 
Building a strong indigenous health workforce is a key factor in closing the gap.
“Increasing Aboriginal and Torres Strait Islander people representation at all levels of the health system, including administration, service delivery, policy, planning and research is crucial.”
The Turnbull Government’s $715,535 commitment brings the total Commonwealth investment in the Northern Territory traineeship program to more than $5 million since 2012.
 
“Strong local leaders will help ensure Aboriginal and Torres Strait Islander people living in remote communities in the NT have access to high-quality, culturally appropriate and comprehensive primary health care,” said Minister Wyatt.
The successful trainees will receive a nationally accredited Diploma of Leadership and Management. The new funding will be shared between four health services:
  • Katherine West Health Board Aboriginal Corporation
  • Central Australian Aboriginal Congress Aboriginal Corporation
  • Anyinginyi Health Aboriginal Corporation
  • Miwatj Aboriginal Health Corporation

8. Tasmanian Aboriginal Centre : Kipli Kani Open nutrition sessions

 

 

 

NACCHO Aboriginal Health Workforce : @AMAPresident launches 5 point plan to build #Ruralhealth workforce

 ” About one third of Australia’s population, approximately 7 million people, live in regional, rural and remote areas. These Australians often have more difficulty accessing health services than urban Australians, leading them to have a lower life expectancy and worse outcomes on leading indicators of health.

Death rates in regional, rural, and remote areas (referred to as ‘rural’ in this document unless otherwise specified) are higher than in major cities, and the rates increase in line with degrees of remoteness.”

AMA President, Dr Michael Gannon

Download the AMA Position Statement HERE

AMA Position Statement on Rural Workforce Initiatives

Picture above AIDA : South Australian University’s past and present Australian Rotary Health Indigenous Health scholarship recipients.

(From left: Ian Lee, Jessica Beinke, Bodie Rodman, Olivia O’Donoghue, Kali Hayward, Jonathan Newchurch, Dr Helen Sage and Cheryl Deguara).

 ” Indigenous medical students have three weeks left to apply for the 2018 AMA Indigenous Medical Scholarship.
 
Applications close on 31 January for the Scholarship, a program that has supported Aboriginal and Torres Strait Islander students to study medicine since 1994.  The successful applicant will receive $10,000 each year for the duration of their course.
Fewer than 300 doctors working in Australia identify as Aboriginal and/or Torres Strait Islander – representing 0.3 per cent of the workforce – and only 286 Indigenous medical students were enrolled across the nation in 2017.”
 
THREE WEEKS LEFT TO APPLY FOR 2018 AMA INDIGENOUS MEDICAL SCHOLARSHIP see Part 2 Below

Extracts from AMA Submission

There is a strong link between the health of Indigenous people in rural communities and their access to culturally appropriate health services.

The AMA believes that:

  • greater effort should be made to encourage Indigenous people to undertake medical or health professional training, and incentives provided to encourage Indigenous and non-Indigenous doctors and medical trainees to work in rural and remote Indigenous communities;
  • Aboriginal Medical Services should be resourced to offer mentoring and training opportunities in rural Indigenous communities to Indigenous and non-Indigenous medical students and vocational trainees; and
  • training modules, resource material and ongoing advice should be developed for, and delivered to, all medical schools and rural and remote medical practices on Indigenous health issues, Indigenous-specific health initiatives and culturally appropriate service delivery.

Addressing the mal-distribution of the workforce

There are a number of fundamental reasons why rural areas are not getting their fair share of the medical workforce. These include:

  • inadequate remuneration;
  •  work intensity including long hours and demanding rosters;
  •  lifestyle factors;
  •  professional isolation and lack of critical mass of similar doctors;
  •  reduced access to professional development;
  • reduced access to locum support;
  •  hospital closures and downgrading or withdrawal of other health services;
  •  under-representation of students from a rural background;
  •  poor employment opportunities for other family members, particularly partners;
  •  limited educational opportunities for other family members; and
  •  withdrawal of community services, such as banking, from such areas.

In 2016 the AMA conducted a Rural Health Issues Survey, which sought input from rural doctors across Australia to identify key solutions to improving rural health care.

The almost 600 doctors who took part in the survey said extra funding and resources to support the recruitment and retention of doctors and other health professionals was their top priority in trying to meet the health care needs of their patients.

Doctors also said that for there to be genuine improvements in access to health care for rural patients, there needed to be:

  •  funding and resources to support improved staffing levels and workable rosters for rural doctors;
  •  access to high speed broadband;
  •  investment in hospital facilities and equipment and practice infrastructure;
  •  expanded opportunities for medical training and education in rural areas;
  • improved support for GP proceduralists; and
  •  better access to locum relief.

AMA Press Release 9 January 2018

At least one-third of all new medical students should be from rural backgrounds, and more medical students should be required to do at least one year of training in a rural area to encourage graduates to live and work in regional Australia, the AMA says.

The AMA today released its Position Statement – Rural Workforce Initiatives, a comprehensive five-point plan to encourage more doctors to work in rural and remote locations, and improve patient access to care.

The plan proposes initiatives in education and training, rural generalist pathways, work environments, support for doctors and their families, and financial incentives.

“About seven million Australians live in regional, rural, and remote areas, and they often have more difficulty accessing health services than their city cousins,” AMA President, Dr Michael Gannon, said today.

“They often have to travel long distances for care, and rural hospital closures and downgrades are seriously affecting the future delivery of health care in rural areas. For example, more than 50 per cent of small rural maternity units have been closed in the past two decades.

“Australia does not need more medical schools or more medical school places. Workforce projections suggest that Australia is heading for an oversupply of doctors.

“Targeted initiatives to increase the size of the rural medical, nursing, and allied health workforce are what is required.

“There has been a considerable increase in the number of medical graduates in recent years, but more than three-quarters of locally trained graduates live in capital cities.

“International medical graduates (IMGs) make up more than 40 per cent of the rural medical workforce and while they do excellent work, we must reduce this reliance and build a more sustainable system.”

The AMA Rural Workforce Initiatives plan outlines five key areas where Governments and other stakeholders must focus their policy efforts:

·         Encourage students from rural areas to enrol in medical school, and provide medical students with opportunities for positive and continuing exposure to regional/rural medical training;

·         Provide a dedicated and quality training pathway with the right skill mix to ensure doctors are adequately trained to work in rural areas;

·         Provide a rewarding and sustainable work environment with adequate facilities, professional support and education, and flexible work arrangements, including locum relief;

·         Provide family support that includes spousal opportunities/employment, educational opportunities for children’s education, subsidies for housing/relocation and/or tax relief; and

·         Provide financial incentives to ensure competitive remuneration.

“Rural workforce policy must reflect the evidence. Doctors who come from a rural background, or who spend time training in a rural area, are more likely to take up long-term practice in a rural location,” Dr Gannon said.

“Selecting a greater proportion of medical students with a rural background, and giving medical students and graduates an early taste of rural practice, can have a profound effect on medical workforce distribution.

“Our proposals to lift both the targeted intake of rural medical students and the proportion of medical students required to undertake at least one year of clinical training in a rural area from 25 per cent to 33 per cent are built on this approach.

“More Indigenous people must be encouraged to train and work in health care, as there is a strong link between the health of Indigenous people in rural areas and their access to culturally appropriate health services.

“Fixing rural medical workforce shortages requires a holistic approach that takes into account not only the needs of the doctor, but also their immediate family members.

“Many doctors who work in rural areas find the medicine to be very rewarding, but their partner may not be able to find suitable employment, and educational opportunities for their children may be limited.

“The work environment for rural doctors presents unique challenges, and Governments must work collaboratively to attract a sustainable health workforce. This includes rural hospitals having modern facilities and equipment that support doctors in providing the best possible care for patients and maintaining their own skills.

“Finally, more effort must be made to improve internet services in regional and rural areas, given the difficulties of running a practice or practising telehealth with inadequate broadband.

“All Australians deserve equitable access to high-speed broadband, and rural doctors and their families should not miss out on the benefits that the growing use of the internet is bringing.”

The AMA Position Statement – Rural Workforce Initiatives is available at https://ama.com.au/position-statement/rural-workforce-initiatives-2017

Background:

·         Most Australians live in major cities (70 per cent), while 18 per cent live in inner regional areas, 9 per cent in outer regional areas, and 2.4 per cent in both remote and very remote areas.

·         Life expectancy is lower for people in regional and remote Australia. Compared with major cities, the life expectancy in regional areas is one to two years lower, and in remote areas is up to seven years lower.

·         The age standardised rate of the burden of disease increases with increasing remoteness, with very remote areas experiencing 1.7 times the rate for major cities.

·         Coronary heart disease, suicide, COPD, and cancer show a clear trend of greater rates of burden in rural and remote areas.

·         The number of medical practitioners, particularly specialists, steadily decreases with increasing rurality. The AIHW reports that while the number of full time workload equivalent doctors per 100,000 population in major cities is 437, there were 272 in outer regional areas, and only 264 in very remote areas.

·         Rural medical practitioners work longer hours than those in major cities. In 2012, GPs in major cities worked 38 hours per week on average, while those in inner regional areas worked 41 hours, and those in remote/very remote areas worked 46 hours.

·         The average age of rural doctors in Australia is nearing 55 years, while the average age of remaining rural GP proceduralists – rural GP anaesthetists, rural GP obstetricians and rural GP surgeons – is approaching 60 years.

·         International medical graduates (IMGs) now make up over 40 per cent of the medical workforce in rural and remote areas.

·         There is a health care deficit of at least $2.1 billion in rural and remote areas, reflecting chronic underspend of Medicare and the Pharmaceutical Benefits Scheme (MBS) and publicly-provided allied health services.

Part 2 Update

THREE WEEKS LEFT TO APPLY FOR 2018 AMA INDIGENOUS MEDICAL SCHOLARSHIP
 
Indigenous medical students have three weeks left to apply for the 2018 AMA Indigenous Medical Scholarship.
Applications close on 31 January for the Scholarship, a program that has supported Aboriginal and Torres Strait Islander students to study medicine since 1994.
The successful applicant will receive $10,000 each year for the duration of their course.
Fewer than 300 doctors working in Australia identify as Aboriginal and/or Torres Strait Islander – representing 0.3 per cent of the workforce – and only 286 Indigenous medical students were enrolled across the nation in 2017.
 
“The significant gap in life expectancy between Indigenous and non-Indigenous Australians is a national disgrace that must be tackled by all levels of Government, the private and corporate sectors, and all segments of our community,” AMA President, Dr Michael Gannon, said today.
 
“It’s evident that Indigenous people have a greater chance of improved health outcomes when they are treated by Indigenous doctors and health professionals.
 
“Indigenous people are more likely to make and keep medical appointments when they are confident that they will be treated by someone who understands their culture, their language, and their unique circumstances
“The AMA strongly encourages Indigenous students to apply for the Scholarship, which, along with the AMA’s annual Report Card on Indigenous Health and the work of the AMA Taskforce on Indigenous Health, is part of the AMA’s commitment to improving the health of Aboriginal and Torres Strait Islander Australians.”
 
Previous winners have gone on to become prominent leaders in health and medicine, including Associate Professor Kelvin Kong, Australia’s first Aboriginal surgeon.
 
Applicants must be currently enrolled at an Australian medical school, be in at least their first year of medicine, and be of Aboriginal and/or Torres Strait Islander descent. Further information, including the application form, can be found at https://www.ama.com.au/indigenous-medical-scholarship-2018
 
The AMA Indigenous Medical Scholarship was established in 1994 with a contribution from the Commonwealth Government. The AMA is seeking further donations and sponsorships from individuals and corporations to continue this important contribution to Indigenous health.
 
More information is available at https://ama.com.au/donate-indigenous-medical-scholarship. For enquiries, please contact the AMA via email at indigenousscholarship@ama.com.au or phone (02) 6270 5400.

 

NACCHO Aboriginal Health #Housing and #Socialdeterminants Debate : @NACCHOChair urges Federal Government to invest in remote housing

Closing the Gap in health disadvantage requires action on many fronts.

One of these is to improve living conditions for Indigenous people. Housing facilities needs to improve to raise Indigenous health outcomes.

I have been to many communities where the housing for Indigenous people is actually a driver of poor health and creates a cycle of disadvantage .

 Ministers from South Australia, Queensland and Western Australia have recently expressed concern that the Federal government will not renew the current Commonwealth State funding agreement for Indigenous Housing.

We call on the Federal government to invest in remote Indigenous housing.”

 Mr John Singer, Chairperson of NACCHO see in full Part 1 below

Picture above : The community of Mimili in the Anangu Pitjantjatjara Yankunytjatjara lands, an Aboriginal local government area in northwest South Australia. Picture: Lyndon Mechielsen

Download the NACCHO Press Release HERE

NACCHO URGES FEDERAL GOVERNMENT TO INVEST IN INDIGENOUS HOUSING 5 2018

 

 ” The Federal Coalition Government of Malcolm Turnbull has turned its back on the National Partnership Agreement on Remote Housing (NPARH) – leaving Western Australia, South Australia and Queensland facing a funding shortfall totalling hundreds of millions of dollars.

The pre-Christmas decision of Federal Indigenous Affairs Minister Nigel Scullion leaves some of Australia’s most vulnerable communities with dramatically reduced funding for housing and other essential services – creating an increased risk of marginalisation.

Notably, the decision flies in the face of the Commonwealth’s own review into remote housing and directly contravenes the ‘Closing the Gap’ report which clearly states that safe and appropriate housing is fundamental to achieving the COAG targets.

The Commonwealth had previously committed $776 million over two years to the NPARH but will now only fund the Northern Territory component of the agreement. Mr Scullion is a NT Senator. “

Download the WA QLD and SA press release or read in full Part 2 below

21 Dec Combined WA QLD SA Response to Aboriginal Housing CRISIS

”  Any decision to cut funding by the Turnbull government will contribute to an increase in chronic disease, and inevitably lead to poorer health outcomes, more indigenous deaths and widening of the gap between the general community and indigenous communities.

Safe and healthy housing is fundamental to the wellbeing of all Australians and contributes to providing shelter, privacy, safety and security, supports health and education, and has a significant impact on workforce participation.

Malcolm Turnbull and Minister Nigel Scullion must take immediate steps to ensure the continuation of funding for remote and indigenous housing. Failure to do so will be another example of a government that is out of touch and only concerned with their internal disputes and dysfunction.

Rather than $65 billion in tax cuts for big business and the banks, the Turnbull government should immediately commit to the recommendations in its own report and close the gap by continuing funding of the National Partnership on Remote Housing.”

Download Federal Labor Party press release or read in full part 3 below  

22 Dec Federal Labor Response to Aboriginal Housing CRISIS

We share the concern of state governments, the Close the Gap campaign and the National Congress of First Peoples at the recent cuts by the Australian Government to the National Partnership Agreement on Remote Housing’

The cut will see funding from the federal government drop from $776 million over two years to just $100 million, with that $100 million going only to the Northern Territory.

Our major concern is that overcrowded housing in remote Aboriginal and Torres Strait Islander communities is the primary cause of rheumatic fever in Australia.

Indigenous Australians suffer from this completely preventable disease at 26 times the rate of non- Indigenous Australians. Australia is one of the few countries in the world where rheumatic fever is still a serious problem, and it’s a national disgrace.”

Australian Healthcare and Hospitals Association Strategic Programs Director Dr Chris Bourke

Full Press Release 22 Dec AHHA Response to Aboriginal Housing CRISIS

 ” Misleading and outrageous statements from Western Australian Labor Housing Minister Peter Tinley as well as South Australian Labor Housing Minister Zoe Bettison are undermining good faith negotiations between the Commonwealth and state governments about the future of remote housing.

Minister for Indigenous Affairs, Nigel Scullion, said despite claims by the state Labor ministers, and despite the fact that housing still remains a state responsibility (last time we checked) no announcement or decision has been made by the Commonwealth Government to cease funding for remote housing.

“It is complete and utter nonsense to suggest that Commonwealth funding for housing is ceasing. This is a fiction created by certain Labor state ministers who are clearly trying to abrogate their own responsibility to their Indigenous housing tenants and it should be called out “

 Download Minister Nigel Scullion Press Release or read in full Part 4 Below

21 Dec Response from Minister Scullion Aboriginal Housung Crisis

Part 1 NACCHO press release 8 January 2018

The National Aboriginal Community Controlled Health Organisation (NACCHO) which represents 143 Aboriginal Community Controlled Health Organisations across Australia today urged the Federal government to invest in remote Indigenous housing.

Mr John Singer, Chairperson of NACCHO said, “the recent review of the current agreement provided to the Department of Prime Minister and Cabinet highlights the key role of safe and effective housing for Indigenous health.

In fact, it makes this point in its very first sentence,” said John Singer. The review documents progress in the provision of Indigenous housing by the current funding agreement.

It stresses the need for funded long-term maintenance programs to sustain the gains made as well as further investment to address the continued need.

It also proposes ways to better monitor whether new funding is making a difference.

As acknowledged by the Turnbull government last month in their publication My Life, My Lead housing is just one well known and understood social cultural determinant factor along with education, employment, justice and income that impact on a person’s health and wellbeing at each stage of life.

“NACCHO believes that the evidence both in Australia and from international experts such as the UN Human Rights Council, Report of the Special Rapporteur on the rights of indigenous peoples is very clear, that a lack of adequate and functional housing as well as overcrowding remains a significant impediment to improving all aspects of Aboriginal and Torres Strait Islander health. It is critical to fix this situation now,” said John Singer

Background 1 : My Life My Lead – Opportunities for strengthening approaches to the social determinants and cultural determinants of Indigenous health: Report on the national consultations December 2017, 2017 Commonwealth of Australia December 2017.

NACCHO Aboriginal Health : @KenWyattMP #MyLifeMyLead Report: Tackling #SocialDeterminants and Strengthening Culture Key to Improving #Indigenous Health

 Background 2 : Housing Issues Background ( PMC Charts above )

SOURCE PMC

Housing is an important mediating factor for health and wellbeing. Functional housing encompasses basic services/facilities, infrastructure and habitability.

These factors combined enable households to carry out healthy living practices including waste removal; maintaining cleanliness through washing people, clothing and bedding; managing environmental risk factors such as electrical safety and temperature in the living environment; controlling air pollution for allergens; and preparing food safely (Bailie et al. 2006; Nganampa Health Council 1987; Department of Family and Community Services 2003).

Children who live in a dwelling that is badly deteriorated have been found to have poorer physical health outcomes and social and emotional wellbeing compared with those growing up in a dwelling in excellent condition (Dockery et al. 2013).

Comparisons between Indigenous and non-Indigenous children in the Longitudinal Study of Australian Children (LSAC) show improvements in housing can be expected to translate into gains for Indigenous children’s health, social and learning outcomes (Dockery et al. 2013).

As expected, housing variables are closely associated with socio­ economic status, including: crowding, renting rather than owning, and being in financial stress (see measures 2.01 and 2.08).

Infectious diseases are more common in households with poor housing conditions. For example, trachoma and acute rheumatic fever are present almost exclusively in the Indigenous population in remote areas (see measures 1.06 and 1.16). Domestic infrastructure, along with overcrowding and exposure to tobacco smoke increases the risk of otitis media in children (Jervis-Bardy et al. 2014) (see measures 1.15, 2.01 and 2.03).

Background 3  NPARIH/NPARH

  • The Commonwealth Government provided $5.4 billion over ten years to 2018 through the National Partnership Agreement on Remote Indigenous Housing and the National Partnership for Remote Housing. This was a one-off National Partnership Agreement to assist states to undertake their own responsibilities for the delivery of housing to reduce overcrowding and increase housing amenity.
  • Expires 30 June 2018

Part 2 WA SA and QLD Govt : Commonwealth abandons indigenous Australia; axes remote housing deal

  • ​Federal Government’s decision will create a shortfall of hundreds of millions of dollars
  • States demand Federal Indigenous Affairs Minister reverse decision
  • McGowan Government calls on Federal WA Ministers, Julie Bishop, Christian Porter, Mathias Cormann and Michaelia Cash to exert influence in Turnbull Cabinet

The Federal Coalition Government of Malcolm Turnbull has turned its back on the National Partnership Agreement on Remote Housing (NPARH) – leaving Western Australia, South Australia and Queensland facing a funding shortfall totalling hundreds of millions of dollars.

The pre-Christmas decision of Federal Indigenous Affairs Minister Nigel Scullion leaves some of Australia’s most vulnerable communities with dramatically reduced funding for housing and other essential services – creating an increased risk of marginalisation.

Notably, the decision flies in the face of the Commonwealth’s own review into remote housing and directly contravenes the ‘Closing the Gap’ report which clearly states that safe and appropriate housing is fundamental to achieving the COAG targets.

The Commonwealth had previously committed $776 million over two years to the NPARH but will now only fund the Northern Territory component of the agreement. Mr Scullion is a NT Senator.

Housing Minister Peter Tinley has demanded senior figures in the Turnbull Cabinet from WA – notably Foreign Affairs Minister Julie Bishop, Attorney-General Christian Porter, Finance Minister Mathias Cormann, Jobs and Innovation Minister Michaelia Cash and Indigenous Health Minister Ken Wyatt, as well as WA’s Nationals Party, stand up for their State and get the decision reversed.

The original 10-year NPARH, brokered by the Federal Labor Rudd government, has seen an average annual Federal Government contribution of about $100 million to WA.

A recent expert panel review commissioned by the Federal Government acknowledged the Federal Government had an ongoing role as a key funding partner with the States and Territory for housing in remote communities.

Comments attributed to Housing Minister Peter Tinley:

“This latest decision, especially the way the Turnbull Government has tried to sneak it through during the festive season, is absolutely appalling and demonstrates its lack of concern for indigenous Australia.

“The Commonwealth has a responsibility to support Australians living in isolated and remote areas. They cannot just walk away from this duty of care.

“This situation is yet another test for those Western Australian MPs with senior positions in the Turnbull Cabinet who are habitually missing in action when it comes to protecting the interests of WA.

“Further, all Western Australian Nationals MPs, both State and Federal, need to stand up for regional WA and send a clear message to their Canberra colleagues that these cuts are unacceptable. WA Nationals leader Mia Davies must outline her position.

“I sincerely hope the Liberals and Nationals will step up their game and get this decision reversed.

“The McGowan Government inherited a financial disaster from the previous Liberal National Government that governed WA so incompetently for eight years.

“Because of that mess, there is no way we can afford to pick up a funding shortfall from the Commonwealth that will equate to hundreds of millions of dollars over the coming years.

“The Commonwealth has a responsibility to help fund essential services in remote communities and in doing so to protect an important element of our national cultural heritage.

“If Turnbull, Scullion and the rest of them fail to fulfil this fundamental duty they will be demonstrating to the entire nation, and to other countries around the globe, exactly how much they value Australia’s First People.”

Part 3 Federal Labour CUTTING REMOTE HOUSING FUNDING UNFAIR AND UNJUSTIFIED

Media reports and comments by the Western Australian Housing Minister Peter Tinley indicate that the Turnbull government is proposing massive cuts to the National Partnership on Remote Housing, which has replaced the National Partnership Agreement on Remote Indigenous Housing and the Remote Housing Strategy (2008- 2018).

The reports indicate that the financial commitment by the Commonwealth will be reduced from $776 million to $100 million and will only be available to remote communities in the Northern Territory.

The Turnbull government must immediately clarify these reports and, if true, reconsider this cruel and outrageous cut to housing and homelessness funding in remote and indigenous communities.

In recognition of the serious problems in indigenous housing, $5.4 billion of funding has been invested since 2008 by Commonwealth governments in an attempt to close the gap in indigenous housing.

The Turnbull government’s own remote housing review demonstrated that this long term strategy had delivered over 11,500 more liveable homes in remote Australia, 4000 new houses, and 7500 refurbishments. This has resulted in a significant but necessary decrease in the proportion of overcrowded households.

The report also estimates that an additional 5500 homes are required by 2028 to reduce levels of overcrowding in remote areas to acceptable levels. The report shows that 1,100 properties are required in Queensland, 1,350 in Western Australia, and 300 in South Australia by 2028 to address overcrowding and meet population growth.

“If these reports are true, remote communities in Western Australia will continue to be overcrowded for the decade to come,” Senator Dodson said.

The report debunks the myth that Aboriginal and Torres Strait Islander families cause the majority of damage to remote indigenous housing. The report shows that only nine percent of household damage is caused by tenants, with the majority of damage coming from lack of programmed maintenance and in 25 per cent of cases the cause is poor specifications or faulty workmanship in the original build.

Rather than cutting funding, the Turnbull government’s own report has concluded that capital plans should be set for a minimum five years. This is on the basis that government procurement practices would support small, emerging businesses, and provide greater opportunities for training and employment of local people.

Key recommendations to the government in the report include:

  • That there be a recurrent program funded to maintain existing houses, preserve functionality and increase the life of housing assets.
  • The costs of a remote Indigenous housing program to be shared 50:50 between the Commonwealth and the other jurisdictions.
  • Investment for an additional 5500 houses by 2028 is needed to continue efforts on closing the gap on indigenous disadvantage.
  • Additional recommendations include improved governance structures, increased transparency, the development of the local workforce, and tenancy education programs.

The report also found overcrowding and poor quality housing leads to poor health outcomes and makes it harder to manage chronic disease. In addition, the report indicates that indigenous communities experience high rates of infectious diseases.

As such, any decision to cut funding by the Turnbull government will contribute to an increase in chronic disease, and inevitably lead to poorer health outcomes, more indigenous deaths and widening of the gap between the general community and indigenous communities.

Safe and healthy housing is fundamental to the wellbeing of all Australians and contributes to providing shelter, privacy, safety and security, supports health and education, and has a significant impact on workforce participation.

Malcolm Turnbull and Minister Nigel Scullion must take immediate steps to ensure the continuation of funding for remote and indigenous housing. Failure to do so will beanother example of a government that is out of touch and only concerned with their internal disputes and dysfunction.

Rather than $65 billion in tax cuts for big business and the banks, the Turnbull government should immediately commit to the recommendations in its own report and close the gap by continuing funding of the National Partnership on Remote Housing.

Part 4 Minister Scullion More Labor lies on remote housing

Thursday 21 December 2017
Misleading and outrageous statements from Western Australian Labor Housing Minister Peter Tinley as well as South Australian Labor Housing Minister Zoe Bettison are undermining good faith negotiations between the Commonwealth and state governments about the future of remote housing.

Minister for Indigenous Affairs, Nigel Scullion, said despite claims by the state Labor ministers, and despite the fact that housing still remains a state responsibility (last time we checked) no announcement or decision has been made by the Commonwealth Government to cease funding for remote housing.

“It is complete and utter nonsense to suggest that Commonwealth funding for housing is ceasing. This is a fiction created by certain Labor state ministers who are clearly trying to abrogate their own responsibility to their Indigenous housing tenants and it should be called out for what this is,” Minister Scullion said today.

“In fact, the Commonwealth commenced discussions with Western Australian Government officials only yesterday about a future funding contribution to remote Indigenous housing – clearly the hapless Peter Tinley is unaware of what his own department is doing.

“It is disappointing that after the first day of discussion, this incompetent Minister has decided to play politics rather than work cooperatively on future funding arrangements.

“The Commonwealth already supports public housing, which is a state and territory responsibility, to the tune of $6 billion per year including $1.5 billion per annum in direct payments to states and around $4.5bn per annum through Commonwealth rent assistance.

“The states should prioritise some of the social housing funding for remote Indigenous residents. Why is there one standard for Indigenous residents and another for non-Indigenous residents?

“The National Partnership on Remote Housing was always scheduled to cease on 30 June 2018. Under the NPARH the Commonwealth paid the states $5.4 billion to reduce overcrowding yet they abjectly failed to achieve this – this is why we are once again in negotiation with the states.

“But the Commonwealth does not believe that the Western Australian Government should not take it’s responsibility for housing in Indigenous communities just like it does for housing of every other citizen in its state.

“Why is there one approach for Indigenous citizens and another for every other community?”

In contrast, the Northern Territory Government has taken responsibility and committed ongoing funding to remote Indigenous housing. That commitment, and the severe overcrowding in the Northern Territory, has meant the Commonwealth has been able to offer longer term funding.

Instead of playing politics with ‘indigenous Australia’, Peter Tinley and Zoe Bettison should take the time to work constructively with the Commonwealth on future funding arrangements.

Background on NPARIH/NPARH

  • The Commonwealth Government provided $5.4 billion over ten years to 2018 through the National Partnership Agreement on Remote Indigenous Housing and the National Partnership for Remote Housing. This was a one-off National Partnership Agreement to assist states to undertake their own responsibilities for the delivery of housing to reduce overcrowding and increase housing amenity.

 

NACCHO Aboriginal Health and Update #HealthCareHomes : Download info for Aboriginal Community Controlled Health Services (ACCHS)

A Health Care Home is an existing Aboriginal Community Controlled Health Service (ACCHS) — or Aboriginal clinic or health service — that cares for people with long-term conditions such as diabetes, arthritis, heart and lung conditions.

Mainstream general practices can also be Health Care Homes.

Under a two-year trial beginning in late 2017, up to 200 practices around Australia, including ACCHS, will become Health Care Homes.”

Download the Health Care Homes brochure for Indigenous patients

 Read over 18 NACCHO Health Care Homes Articles

” Up to 65,000 Australians will soon be receiving improved care for their ongoing chronic conditions, with the expansion of the Turnbull Government’s trial of Health Care Homes.

An additional 168 general practices and Aboriginal Community Controlled Health Services (ACCHS) will offer Health Care Home services from today, building on the 22 clinics already in the trial.

Additional practices are expected to sign on in the coming weeks.

Patients with two or more chronic conditions – such as diabetes, arthritis and heart and lung conditions – are eligible to enrol at a Health Care Home to receive integrated, team-based care.”

The Hon Greg Hunt Minister for Health

Download Press Release

Hon Greg Hunt Press release Health Care Homes

 

Health Care Homes underway

In an important reform for primary care in Australia, close to 200 Health Care Homes around Australia are now enrolling patients.

These practices and Aboriginal Community Controlled Health Services (ACCHS) will provide better coordinated and more flexible care for up to 65,000 Australians who are living with chronic and complex health conditions.

The stage one trial of Health Care Homes will run until November 2019.

What is a Health Care Home?

A Health Care Home is an existing Aboriginal Community Controlled Health Service (ACCHS) — or Aboriginal clinic or health service — that cares for people with long-term conditions such as diabetes, arthritis, heart and lung conditions.

Mainstream general practices can also be Health Care Homes.

Under a two-year trial beginning in late 2017, up to 200 practices around Australia, including ACCHS, will become Health Care Homes.

Health Care Homes is an Australian Government-funded program. It’s about giving people with long-term conditions the best possible care for their health needs.

Here are some of the good things about Health Care Homes:

My own care plan — my doctor talked to me about my health needs. Then we came up with a plan which suits me and my health.

My own care team — my care team at my clinic are there for me if I want to have a yarn or if I have any health worries.

Connecting my care — I still see my doctor and Aboriginal health worker. When I need to, I go to the physio or my heart or kidney doctor. But my care team makes sure that all the care I receive is connected.

Care that’s right for you

If you have long-term health conditions, there are a lot of things to keep an eye on symptoms, your medicines, visits to the clinic and to other doctors, like your heart or kidney doctor.

Wouldn’t it be good if there was one team looking after all this for you?

That’s what Health Care Homes is all about. If you become a Health Care Homes’ patient, you will have your own care team.

Your care plan

The care team will talk to you about a care plan. This plan contains all the care you receive from your usual doctor, Aboriginal health worker and others. It includes health goals — like eating healthy food, quitting smoking or keeping an eye on your diabetes.

With this plan, all the people who look after you can see the same information about your health anytime they need to.

So can you and your family members or carers.

That way, when you see your heart doctor or kidney doctor you won’t have to explain about any new medicines or anything that’s changed since your last visit. Your doctor can see it all on your care plan.

What if I like everything just the way it is?

You can keep going to your clinic and still see the doctors and Aboriginal health workers who know you.

You don’t have to change anything that you like about your care.

But if you become a Health Care Homes’ patient, your care will be better organised. And if something changes in the future, you and your care team can change your care or medicines in a way that works for you.

For more information:

Talk to your Aboriginal health worker or clinic about Health Care Homes.

health.gov.au/healthcarehomes-consumer

Coordinated care for people with chronic conditions

Inforgraphic illustrating the 'Better Coordinated' Health Care Homes process

One in four Australians have at least two chronic health conditions1. For these people, our health system can seem hard to navigate and disjointed. Different health professionals and services work in isolation from each other; care is often un-coordinated; and patients can find it difficult to get to different services and appointments.

A Health Care Home is a general practice or Aboriginal Community Controlled Health Service (ACCHS) that coordinates care for patients with chronic and complex conditions.

People with chronic and complex conditions, who could benefit from Health Care Homes’ flexible, coordinated care can enrol as Health Care Homes patients.

What are the benefits for patients?

Inforgraphic illustrating 'Your Care Team' under the Health Care Homes trial

  • My care team — you have a committed care team, led by your usual doctor.
  • My shared care plan — with the support of your care team, you will develop a shared care plan. This plan helps you have a greater say in your care; and makes it easier for all the people who look after you, both inside and outside the Health Care Home, to coordinate your care.
  • Better access and flexibility — with a care team behind you, you have better access to care. Health Care Homes can also be more responsive and flexible. If you want to talk to someone in your care team, you won’t always need an appointment with your GP. You might call or message the practice team. Or they might call you to see how you’re going.
  • Better coordinated — your care team will do more to coordinate all your care from your usual doctor, specialists and other health professionals.

Inforgraphic illustrating 'Your Shared Care Plan' under the Health Care Homes program for easier coordination of your chronic conditions

Can I become a Health Care Home patient?

If you

  • have a Medicare card
  • have a My Health Record or are willing to get one
  • would benefit from the Health Care Home model of care
  • and are assessed as eligible by a participating Health Care Home

then you could enrol as a patient.

If you would like to become a Health Care Home patient, ask your GP if their practice is a Health Care Homes.

More about Health Care Homes

What will it cost me if I become a Health Care Homes’ patient?

Ask your doctor or practice receptionist about this. Some people don’t have any out-of-pocket expenses when they go to see their doctor; while others are asked to pay a contribution. This will be the same under Health Care Homes.

What if I don’t want to change my care? I like everything just the way it is.

Joining Health Care Homes is voluntary. You don’t have to become a Health Care Home patient.

If you do sign up for Health Care Homes, you can keep seeing the doctors you know and trust.

The benefit of Health Care Homes is that it makes it easier for all the people who look after you — from your doctor to your specialist doctors and others — to share information about your health and to coordinate care based on your needs.

My doctor and my usual clinic already coordinate my care. Why should I sign up for Health Care Homes?

Doctors and practices already work hard to coordinate care for their patients.

The Health Care Homes’ trial gives practices the opportunity to improve the services they provide and the flexibility of these services.

For example, Health Care Homes’ patients can see their practice nurse, without needing to see their GP for every visit.

Health Care Homes will also give patients better access to appointments with either their GP or another member of their care team.

No two patients are the same. Health Care Homes helps doctors and clinics tailor care to each patient.

The government pays Health Care Homes in a different way, to reflect the responsive, flexible way in which they look after their patients.

I already have a GP management plan, a team care management plan or mental health treatment plan. What will happen to these if I join Health Care Homes?

These plans will form the basis of your new shared care plan. For example, if you have a GP management plan, you will continue to be eligible for up to five allied health services each calendar year.

With Health Care Homes, can I see my doctor whenever I want to?

Some Health Care Homes will keep their appointment schedules free at certain times, so that Health Care Homes’ patients can drop in, or get an appointment that day.

But every Health Care Home will be different. Ask your doctor or practice receptionist how this will work in your practice.

If after-hours access is important to you, ask about this too.

Another advantage of Health Care Homes is that patients may not always have to physically come in to the practice to receive care. Instead, patients may be able to Skype, call or email the practice.

If I am enrolled in a Health Care Home can I see another doctor?

When you are at home, you should always try to go to your Health Care Home. If you are travelling, however, you can see another doctor.

What if I get really sick? Or go to hospital?

If you get really sick, your care team will continue to care for you. They may also work with you to adjust your care plan as needed.

If you go to hospital, the care team will follow up with the hospital.

How does Health Care Homes fit in with state-funded isolated travel and accommodation allowance payments?

Being a Health Care Homes’ patient will not affect your eligibility for any state-based isolated travel and accommodation allowance payments.

Can I stop being a Health Care Homes’ patient?

Yes, you can withdraw from your Health Care Home. However, it is a good idea to first talk to your care team if you are unhappy about any aspect of your care. They might be able to help.

If you withdraw from Health Care Homes, you will not be eligible to reapply during the stage one trial, which runs from October 2017 to December 2019.

I am Aboriginal/Torres Strait Islander. Will my care change under Health Care Homes?

If your local ACCHS or the practice you usually visit becomes a Health Care Home you can ask your doctor or practice receptionist for more information about Health Care Homes.

A brochure for Indigenous consumers is also available Fact sheets and brochures web page.

If you enrol as a Health Care Home patient then your care team at the practice will coordinate your care, from visits to the GP, through to specialist visits, scripts, blood pressure checks, physiotherapy, podiatry and other health services.

Aboriginal Community Controlled Health Services around Australia will also become Health Care Homes.

Each Health Care Home will also work with the integrated team care (ITC) program arrangements for chronic care; and will coordinate other health services provided by state, territory and local governments or by community groups.

More information for consumers is available on the fact sheets and brochures web page.

For health professionals’ information, go to Health Care Homes for health professionals.

NACCHO Aboriginal Health @IndigMaraProjct : 10 Indigenous runners #RunSweatInspire to finish the #NewYorkMarathon

 “I’m hoping to show other Aboriginal and Torres Strait islanders that anything is possible when you put in the hard work

I joined a walking to running program and this is a great example of what you can achieve out of something as small as that.

Growing up I wasn’t a sport person but it’s not all about sport, it’s about a holistic view and making a change for the better, I want people to think ‘if Cara can do it than so can I’.”

Queanbeyan mother Cara Smith has just completed a remarkable journey at the New York marathon on Sunday (see her Story Part 2 below )

“The running the New York Marathon  has given me a lot of discipline.

The main reason why I joined the squad was to be a positive role model for my family and for my community. People see me doing this and hopefully it gets them on the right; if you put in hard work you get rewarded for it.”

Speaking from Central Park New York Roy Tilmouth said the IMF running project had inspired him to be a positive role model for his community in Alice Springs.(see story Part 1 Below )

Update 9.00 am good news all 10 completed #NYM

Background news coverage Part 1 of 2

GROUP of indigenous Australians planning to participate in this weekend’s New York City marathon say the terror attack in Manhattan will not deter them from the race.Indigenous Marathon Foundation director Rob de Castella said the squad never considered pulling out.

“Absolutely not – I refuse to change my way of life and my aspirations and dreams based on what some radical, rat bag people do because once you start doing that, then terrorism wins,” he said.

The IMF project turns indigenous Australians from beginners to marathon runners within six months in an effort to promote healthy lifestyle choices, resilience and success.

“Most of them have done no running and they’ve gone from struggling to run three kilometers or five kilometers to six months later running 42 kilometers non-stop,” he said.

Participants also have to complete an education component, which this year featured an Aboriginal and Torres Strait Islander Mental Health and First Aid course.

De Castella said the runners, many from remote and regional areas, have experienced profound transformations as a result of the program.

“They realize that they’re so much stronger than what they were,” he said. “They want to make life better for their community because they are exposed to so much dysfunction and suicide, loss, suffering, abuse and alcoholism and they want it to stop.

“They realize that it has to start with them so this experience transforms them and makes them realize they are strong and that they have the capacity to drive change and address those issues they want stopped,” he said.

Twelve indigenous Australians will run in the world-famous New York City marathon, thanks to de Castella’s mentoring program. In the lead up to the marathon, the participants had to complete several challenges, including a 30-kilometere run in Alice Springs.

Speaking to News Corp Australia in Central Park before a practice run, Roy Tilmouth said the IMF running project had inspired him to be a positive role model for his community in Alice Springs.

“The running has given me a lot of discipline,” he said.

“The main reason why I joined the squad was to be a positive role model for my family and for my community. People see me doing this and hopefully it gets them on the right; if you put in hard work you get rewarded for it.”

Another mentee of De Castella, Layne Brown, said that his daughter had inspired him to prove something to himself.

“I’ve lost 20 kilos on this journey and I’m trying to live a better way than I have in the past,” he said.

“I stuffed a lot of things up and I want to be a better person and keep working towards that and running has been my vehicle for that over last six months”.

For Perth’s Luke Reidy, the running project offered an avenue to tackle his depression.

“I had a few deaths in the family and got depressed and I just want to highlight how physical exercise can also help with mental exercise,” he said.

Mr Reidy said he was humbled by the amount of people who had followed his progress and given their support throughout the process.

“The amount of people that watch your journey that you don’t know and they come up to you – it’s really humbling.”

Queanbeyan mother Cara Smith will complete a remarkable journey at the New York marathon on Sunday. Photo: Rohan Thomson

Smith has been part of a gruelling six-month training program under the tutelage of Australian marathon legend Rob de Castella as part of the Indigenous Marathon Foundation.

The 30-year-old was one of 12 people selected from more than 150 applicants after sharing her story with de Castella of wanting to fight a long family history of diabetes and obesity.

Smith has braved 4am training sessions in the the Canberra winter said she has herself through it to be part of something special and inspire her one-year-old son.

Smith said she was couldn’t wait to arrive in New York and soak up the atmosphere ahead of one of the biggest challenges of her life.

“I’ve been looking forward to this all year, I’m super excited and really nervous too so it’s a good mix but I just want to get started,” Smith said.

“I don’t know what to expect but I just want to soak up atmosphere and I can’t wait see my son’s face when I show him the New York marathon medal and talk to him about it one day.”

There will be unprecedented security at the event following the recent terrorist attack in New York which claimed six lives.

Smith prepared with five training camps which included a 30km effort in Alice Springs last month, the longest the group have run in preparation for the 42km epic.

“The final 12km will be pure willpower, I have a strong purpose and that is my son and setting up a healthy active lifestyle for him to aspire to,” Smith said.

“I want to set an example and I’ve done the training so I’m confident I’ll get there, I know it’s going to be tough but I’m really looking forward to the challenge.

“I want to see what the infamous wall throws at me, I’m really pumped for the final hurdle and I just hope the body and mind will hold up.”

De Castella said Smith’s sense of purpose is what will carry her the final 12km when her body is screaming to stop.

“In the marathon you always get to a point when you ask yourself ‘why am I doing this’ and it’s really important to have a really strong answer to that question,” de Castella said.

“The marathon doesn’t start until 30 km and that’s as far as they’ve ever run so they just have to get themselves to starting line and then it’s about hitting the wall and pushing through soreness and fatigue and blisters and exhaustion and pain.

“The only reason you keep going because is the reason of why you’re doing it and Cara’s reason is she wants to be a great model for her child and a leader for the community.

“These are everyday people, mums and dads and single parents, they’re not elite athletes, not high-flying academics and doctors and lawyers, they’re just everyday people that have basically had a gutful of all of the struggles and the problems in life and they just want to be part of a change going forward.”

Smith hopes her performance will inspire those in the indigenous community who are looking to make positive changes in their lives.

“I’m hoping to show other aboriginal and Torres Strait islanders that anything is possible when you put in the hard work,” Smith said.

“I joined a walking to running program and this is a great example of what you can achieve out of something as small as that.

“Growing up I wasn’t a sport person but it’s not all about sport, it’s about a holistic view and making a change for the better, I want people to think ‘if Cara can do it than so can I’.”

Press release from Federal Government

 

 

Aboriginal Maternity Health Program : #CATSINaM17 @IUIH_ Million-dollar boost for groundbreaking #Indigenous maternity program

“It is informed by Indigenous knowledge and community control with a redesigned health service to provide 24/7 continuity of midwifery care and birthing in an Indigenous birth centre,

“With Indigenous leadership and a team with expertise in Indigenous health and research we can translate what we know works in other settings, and other countries, into practice here in Australia.”

Institute for Urban Indigenous Health CEO Adrian Carson said a key component of the project was the Indigenous control and governance of services.

A maternity program designed to achieve better health outcomes for Aboriginal and Torres Strait Islander women and their babies has received a $1.1 million grant from the National Health and Medical Research Council (NHMRC).

The project, led by The University of Queensland’s Professor Sue Kildea and researchers from the University of Sydney and the Institute for Urban Indigenous Health, will implement Birthing on Country on a number of sites with a view to an Australia-wide roll out.

The NHMRC grant will help determine the sustainability of a Birthing on Country service model in each community, along with the impact on Aboriginal and Torres Strait Islander women, their communities and health services.

“The Birthing On Country program has a strong emphasis on culturally and clinically safe care, strengthened support for families, growing a culturally capable workforce and the Indigenous maternal and infant workforce,” Professor Kildea said.

“This program focuses on the year before and the year after birth, as the most important time in life.

“It also allows us to review the effect on three of the most costly health outcomes across the lifespan for Aboriginal and Torres Strait Islander peoples: preterm birth, low birth weight and hospital admissions in the first year of life.”

Professor Kildea said the project team was calling on all Australian governments and health organisations to work with them to implement Birthing On Country programs.

“After two decades of research, including consultation with Indigenous elders and communities, we can now enact State and Federal health policy and put into practice national and international evidence of the safety, benefits and cost-effectiveness of culturally safe care,” she said.

“With Indigenous leadership and a team with a wealth of cross-disciplinary expertise in Indigenous and health services, we can translate what we know works in other settings and other countries into practice here in Australia.”

The project, entitled ‘Building on Our Strengths (BOOSt): Developing and Evaluating Birthing On Country Primary Maternity Units’, also includes the Aboriginal and Torres Strait Islander Community Health Service (ATSICHS) Brisbane, the Waminda South Coast Women’s Health and Welfare Aboriginal Corporation, the Australian College of Midwives, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, and the Rhodanthe Lipsett Indigenous Midwifery Charitable Fund.

The NHMRC grant builds on previous funding from the Ian Potter Foundation in Melbourne, the Institute for Urban Indigenous Health, ATSICHS Brisbane, the Mater Health Service, Queensland Health and an earlier NHMRC grant.

 

Aboriginal Health and Children in detention #NTCOSS2017 Speech @NTRoyalComm Mick Gooda reports ” What children have told us “

 

” There is a strong perception that that the system of detention in the Northern Territory is failing. It is failing our young people, it is failing those who work in the system and it is also failing the people of the Northern Territory who are entitled to live in safer communities.

We have heard that where detention systems are effective they are smaller centres with a therapeutic focus.

An approach that is appropriately child centred for children and young people, who at this critical time of their development, including their brain development, are not mini adults and should not be treated as such.

If a child must be removed then they must be provided with the care, support and stability that any child is undeniably entitled. “

Speech to the NT Council of Social Service 26 September 2017 Commissioner Mick Gooda see in full Part 2 Below

Read over 48 NACCHO articles NT Royal Commission #Dondale

 ” Yesterday we published a booklet which gives voice to the children who have experienced the child protection system – they have told us their stories either in evidence or by way of recorded story.

When we asked one boy  about what he had experienced and we asked him if there was any place out there that would be suitable for you to be placed into care?

He simply told us I only want to be with my Mother “

Download ” What children told us -Child protection  It’s time our children’s voices were properly heard.”

voices-what-children-have-told-us

Part 1 SNAICC calls for a response to the voices of children in the Northern Territory

SNAICC welcomes the recent report from the Royal Commission into the Protection and Detention of Children in the Northern Territory for its ability to promote the voices of children and young people affected by a child protection system that is in crisis, which, vitally, provides an insight into the real impact of ongoing failures of government to appropriately respond to children in need.

The report, Voices: What children have told us – Child Protection, captures what is often lost in discussions about the best interests of our children – the voices of our children.

What these powerful stories demonstrate is a pattern of denial of basic rights, ongoing policy and practice failures from successive NT governments, and – bluntly – an uncaring approach to caring for our most vulnerable children.

Aboriginal and Torres Strait Islander children make up 89.1 per cent of all children in out-of-home care in the Northern Territory. This is completely unacceptable.

The experiences courageously shared by children and young people interviewed by the Royal Commission further evidence the extensive reform that is required in the NT child protection system, echoing recommendations from SNAICC’s submission to the Royal Commission submitted in February 2017.

This is the time for genuine partnership between Aboriginal and Torres Strait Islander communities and the Federal and Northern Territory Governments.

We are hopeful that the voices captured in this report go someway to inspire an authentic response to the calls of children to create a new system that enables them to thrive, replacing the current system that perpetuates harm.

Part 2 Speech to the NT Council of Social Service 26 September 2017 Commissioner Mick Gooda

Thanks for that nice introduction Wendy and really thanks for making time for us to come along today and talk to NTCOSS about the Royal Commission.

We are now entering the phase leading into the handover of the report when a lot of work is coming together and gelling towards a set of recommendations that we hope will change the whole nature of how we treat children in the Northern Territory and hopefully like Wendy said show the way for the rest of Australia.

I acknowledge the Larrakia people the traditional owners of this place we now call Darwin, both personally as a Gangulu fella from Central Queensland and on behalf of the Royal Commission for making us welcome to base our work on your country.

I wasn’t here for the Welcome to Country but I saw the young ladies outside and isn’t it great to see the young people do a Welcome to Country.

It is a handing over of that particular ceremony, and I was reminded of a tweet the other day about the only thing we do in Australia that represents any cultural aspect of Australian culture is the Welcome to Country.

And I thought about that and again it shows that if we pay respects to Aboriginal people we pay respects to everyone in Australia.

I’d like to think of Australian culture as being a bit more than football, meat pies and Holden cars.

Like I said we are about eight weeks away from our reporting date of the 17th November and it is time for us to bring people together to talk about how we have done our work as a Royal Commission.

The first thing we found is that our Royal Commission isn’t remarkable.

There have been more than 50 inquiries, reports and reviews on issues of child protection and detention that go to the things we’re looking at.

Commissioner White and I understand that people are cynical and fatigued.

They told us that in pretty clear and unambiguous terms.

Once again another Inquiry had arrived to look at issues of long standing when the overwhelming experience of other inquiries had only seen the situation worsen.

Yet this community has continued to provide us with information, to attend community consultations, community forums and meetings.

During our time we have witnessed a tremendous desire of people not only to ensure that there is reform, but also as communities to accept responsibility for ensuring the safety of our children.

Commissioner White and I were taken aback when we had a meeting with the full Councils of the Northern Land Council and the Central Land Council where half of our time was taken up by communities getting up and saying we’ve got to stop blaming government, we’ve got to start taking responsibility for what we have contributed to as parents.

And that tells me that there is a great appetite within the Aboriginal community for change and to take responsibility.

As we head to that 17th November deadline we are focused on presenting a pathway for children, families and communities across the Northern Territory.

A plan – with a big caveat – if implemented, that will deliver the necessary widespread reform and change for which Territorians have waited for so long.

Since the Commission was established we have:

  • held three months of public hearings in Darwin and Alice Springs covering both youth detention and child protection
  • heard from over 210 witnesses
  • received more than 480 witness statements and more than 430 personal stories
  • received over 250 submissions
  • taken site visits to detention centres
  • visited and engaged with communities including via our community engagement team
  • held open and private forums and meetings including with victims of crime, youth justice officers, police officers, foster carers, care and protection workers, organisations and peak bodies.
  • heard hundreds of stories from children, families and communities who have had firsthand experience of child protection and detention in the Northern Territory.

Commissioner White and I thank everyone who has provided information to us because without this we would not have been able to fully investigate and ultimately to formulate our recommendations.

We have to make particular mention of those children and young people who have had experiences of the youth detention and child protection systems who have courageously shared their experiences with us.

Their evidence, and that of their families, frontline workers and worker and others involved in the system, has at times been very confronting.

I think this Commission has changed all of us.

I was talking to Tony McEvoy our first Aboriginal QC the other day and he told me of a recent experience where just the issue of child protection in another jurisdiction just made him tear up at the memories of what we went through up here, people like us, imagine the young people inside that system.

So we’re committed to ensuring that their voices are heard throughout our report.

Earlier this year we published a booklet which set out what we were told by communities when we met with them last year.

Yesterday we published a booklet which gives voice to the children who have experienced the child protection system – they have told us their stories either in evidence or by way of recorded story.

This booklet is available on the ( NACCHO )  website.

Please feel free to distribute it far and wide.

It’s time our children’s voices were properly heard.

It comes as no surprise that one of the first things we say is that the detention and child protection systems appear to be broken

    • Chief Minister Gunner has publicly acknowledged that the systems are broken
    • Those in the frontline – current and former youth justice, case workers, foster carers, lawyers, judiciary, representatives and agencies and government past and present – as well as the children, families and communities impacted, have told us detention and child protection in the NT is failing.
    • In our Interim Report in March we said –

“There is a strong perception that that the system of detention in the Northern Territory is failing. It is failing our young people, it is failing those who work in the system and it is also failing the people of the Northern Territory who are entitled to live in safer communities”

All the evidence we have received indicates that locking children up in Don Dale like conditions does not lead to good outcomes.

It doesn’t rehabilitate young people, it doesn’t reduce recidivism and it does not make our community safer.

What we have seen is that if you pursue a punitive based approach, these goals of rehabilitation, of reducing recidivism and safer communities, are likely to be unattainable.

What we have also found is that we cannot fix the problems within detention centres if we don’t fix the pathways into those places.

What we have heard is that many young people can be diverted from this ‘inevitable path’ through changes to legal processes, early intervention and more young people going into diversion programs when they first encounter the youth justice system.

Not surprisingly the first contact a young person has with the justice system is generally with the police and is one of the first opportunities to set them on the right path.

We have heard that if their initial contact with police is handled appropriately, the young person can be guided towards rehabilitation rather than towards a detention centre.

That doesn’t mean a go easy approach – what it does mean though is recognising that the chance is there at an early stage to change the course of a young person’s life for good.

For the small number of children who will need to be kept in secure detention, we have heard about very different models to those which currently operate in the NT.

Experts here in Australia and overseas have told the Commission that purely punitive approaches are no longer effective nor successful in managing young offenders.

Further, we have heard that where detention systems are effective they are smaller centres with a therapeutic focus.

An approach that is appropriately child centred for children and young people, who at this critical time of their development, including their brain development, are not mini adults and should not be treated as such.

Commissioner White and I have said before that we will not be recommending to the Northern Territory Government that they build another big detention centre.

For the small number of children who require secure detention a different approach is needed – with education and training at its core, that provides well-resourced health and wellbeing programs for the children, so that when they do re-enter the community they are more likely not to reoffend.

Just as a new approach is needed for youth justice and detention what we have heard during the Commission about the child protection system in the Northern Territory also signals the need for a paradigm change.

The Commission has heard much evidence from those with experience of the child protection or welfare system – both personally and professionally.

From the children and families we have heard about the impacts of separation from culture, family and kin, resulting from the placement of children into care.

DF – one of our Vulnerable Witnesses – as a matter of fact the last witness to this Royal Commission – told us in out last public hearing he and his siblings were placed into care when he was the age of 10.

At the time he was removed he understood he would be placed into respite care for just two weeks – he was told it would be just enough time for his Mum to get a house and make some arrangements.

He described the heartbreak at the prospect of being separated from his Mum for two weeks. He didn’t know at the time but it would be much longer.

DF told us that some months after going into respite he found a ‘care order’ in his foster carer’s house. He said he took it into his room and read it.

It was the first time that he understood that he wouldn’t be going back to his mum any time soon. The order placed him into protection until the age of 18.

He told us that no one had bothered to speak to him, not his carer, not his case worker, not anyone. He found out about this life changing decision accidentally.

Not surprisingly, he absconded from care many times, he was reported to police just a many times.

So the system that was set up to protect him actually facilitated his entry into the youth justice system.

When we spoke to him about what he had experienced and we asked him if there was any place out there that would be suitable for you to be placed into care?

He simply told us I only want to be with my Mother.

Challenges in communication, with multiple placements, changes in foster and respite care arrangements, separation from families, interruption to education and a lack of continuity of case management are just some of the issues we have heard.

We have heard also of experiences which suggest that the placement into care has delivered poorer outcomes than if a child had remained within their community and within their family.

We also heard of cases where we were told that a child, in the care of the CEO, was in need of care.

If a child must be removed then they must be provided with the care, support and stability that any child is undeniably entitled.

We know that those who enter the child protection system have a higher chance of ending in the detention system – we call them the ‘Cross Over’ kids.

This speaks to the need for early intervention and to seek to close off that seemingly inevitable pathway.

Our goal should be to help prevent children entering protection by having greater capacity to identify the triggers that indicate a family is in need, that needs support early and well before the statutory system intervenes.

It is the early actions which will have the greatest impact for them and their communities.

For example, it has been found that pathways into juvenile justice can often stem from childhood trauma that remains unaddressed.

There are huge demands on child protection systems across Australia and too often children end up languishing in such systems and any assistance is provided too late.

And successive inquiries have repeatedly found that child protection systems are based on out of date assumptions yet we have failed to see reform efforts that are based on an understanding of the scale of child abuse and neglect.

We have had experts analyse the Niland Report Inquiry and they tell us the kids that were screened out for intervention in that State mostly me the benchmark for intervention.

We are also told that it is easy to translate those figures to the Northern Territory.

From our perspective that means that there is this great wave of children out there and families out there in dire need of support.

And the statutory child protection system, no matter how good you make it, won’t be able to cope.

The emphasis on early intervention and early support will be the cornerstone of our recommendations.

The goal for us all must be a system that is child focused, community involved, evidence based, locally tailored and providing support for children and families as early possible.

It is fitting I close with what a couple of stories from children and I’ll go to the second one first.

And they are positive stories and I think we have to be positive.

Commissioner White and I decided early in this Commission that if we can’t think positively about the future of children we should resign and let someone else do this job.

Because we have got to remain positive because if we don’t remain positive then I think it is all lost.

In all the negative stories we got told about child protection one young woman described her case worker taker her out to lunch and talking with her for about an hour.

This was apparently such an unusual occurrence for this young woman that it stuck in her mind for years.

Commissioner White and I made a habit of ensuring that we ask every vulnerable witness who came before us, particularly in the youth detention system, were there any good guards?

Were there any good youth workers?

Because we had heard plenty abut the negative youth workers.

And every one of those children said of course there were good youth justice workers and they were in the majority.

And then we asked a follow up question – what made a good youth justice worker?

And every one said the same thing.

They spoke to us, they treated us like humans.

And what does that tell us about the needs and wants of young people?

They just want people to talk to them and treat them like humans.

I have to end by acknowledging the work of the hundreds of people and organisations – many represented here today – who have contributed to the work we are undertaking.

Like I said we received more than 320 submissions from individuals, community organisations, peak bodies, academics, government, non-government and other organisations.

In the face of the challenges that children and young people confront in the NT, this is so encouraging and shows Commissioner White and I that there are so many people willing to work towards change and improvements in the system.

And indeed put the kids of the Northern Territory in the centre of all of our considerations.

Thank you Ladies and Gentlemen