NACCHO Aboriginal Health NEWS : @AIHW report : The consumption of #alcohol, #tobacco and other #drugs is a major cause of preventable disease and illness in our communities

The consumption of alcohol, tobacco and other drugs is a major cause of preventable disease and illness in our comminities

There are a wide range of data sources available that contribute to our understanding of alcohol, tobacco and other drug use.

This web report from AIHW is intended to be a general reference for contemporary data on alcohol, tobacco and other drugs in Australia.

SEE Full Report 

This report consolidates the most recently available information regarding the use of tobacco, alcohol, cannabis, meth/amphetamines and other stimulants, the non-medical use of pharmaceutical drugs, illicit opioids (heroin) and new (and emerging) psychoactive substances (NPS).

Key trends in the availability, consumption, harms and treatment are identified and detailed data are presented for vulnerable populations.

These population groups include Aboriginal and Torres Strait Islander people, homeless people, older people, people from culturally and linguistically diverse backgrounds, people identifying as lesbian, gay, bisexual, transgender, intersex or queer (LGBTIQ), people in contact with the criminal justice system, people with mental health conditions, young people and people who inject drugs

Key findings Aboriginal and Torres Strait Islander people 

  • There has been significant declines in the proportion of Aboriginal and Torres Strait Islander people smoking and consume alcohol that exceeds lifetime risk guidelines (consuming more than two standard drinks per day on average).
  • The prevalence of smoking by Indigenous people has declined from 55% in 1994 to 45% in 2014–15.
  • The proportion of Indigenous people that consume alcohol as levels that exceed lifetime risk guidelines has reduced from 19% in 2008 to 15% in 2014–15.
  • In 2011, tobacco use accounted for 12% of the burden of disease for Indigenous Australians. This accounts for 23.3% of the health gap between Indigenous and non-Indigenous Australians.
  • In 2016, more than 1 in 4 (27%) Indigenous Australians used an illicit drug in the last 12 months. This was 1.8 times higher than for non-Indigenous Australians (15.3%).
  • The most commonly used illicit drug by Indigenous Australians is cannabis (16.7%), followed by the non-medical use of pharmaceutical drugs (11.0%).
  • Of clients of alcohol and other drug, treatment services, 15% were Indigenous Australians aged 10 and over, which is an overrepresentation relative to their population size.

Currently there are almost 800,000 Aboriginal or Torres Strait Islander people (see Box ATSI1) living in Australia, accounting for 2.8% of the Australian population [1]. There are substantial differences in measures of health and welfare between Aboriginal or Torres Strait Islander people and non-Indigenous Australians.

Box ATSI1: Aboriginal and Torres Strait Islander people

The terms ‘Aboriginal and Torres Strait Islander people’ is preferred in Australian Institute of Health and Welfare (AIHW) publications when referring to the separate Indigenous peoples of Australia. However, the term ‘Indigenous’ Australians is used interchangeably with ‘Aboriginal and Torres Strait Islander’ in order to assist readability.

The Australian Burden of Disease Study identified that Aboriginal or Torres Strait Islander people experience a burden of disease that is 2.3 times the rate of non-Indigenous Australians [2]. The gap in the disease burden is due to a range of factors including disconnection to culture, traditions and country, social exclusion, discrimination and isolation, trauma, poverty, and lack of adequate access to services [3]. Tobacco, alcohol, and other drugs are key risk factors contributing to the health gap between Indigenous and non-Indigenous Australians [2].

Box ATSI2. Data sources examining tobacco, alcohol and other drug use by Aboriginal and Torres Strait Islander people

There are a number of data sources that provide information about tobacco, alcohol and other drug use by Aboriginal and Torres Strait Islander people.

The National Aboriginal and Torres Strait Islander Social Survey (NATSISS) [4] and the Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) [5] collected by the ABS are designed to obtain a representative sample of Indigenous Australians. In relation specifically to tobacco smoking, the ABS has consolidated data from six large, national, multistage random household surveys to identify trends between 1994 and 2014–15 [6].

The AIHW’s National Drug Strategy Household Survey (NDSHS) uses a self-completion questionnaire to capture information about drug and alcohol use among the general Australian population; however it is not specifically designed to obtain reliable national estimates for Indigenous people. In 2016, 2.4% of the NDSHS (unweighted) sample aged 12 and over (or 568 respondents) identified as being of Aboriginal or Torres Strait Islander origin. The estimates produced by the NDSHS should be interpreted with caution due to the low sample size [7].

There are also other data sources that provide information relevant to Aboriginal and Torres Strait Islander people.

  • Australia’s Burden of Disease study analyses the impact of nearly 200 diseases and injuries in terms of living with illness (non-fatal burden) and premature death (fatal burden). In 2015, a report was released that provides estimates of burden of disease between Indigenous and non-Indigenous Australians [8].
  • The National Perinatal Data Collection covers each birth in Australia and includes information on Indigenous mothers and their babies [6].
  • The Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) contains information on treatment provided to clients by publicly funded alcohol and other drug services including Indigenous clients [9].
  • The Online Services Report (OSR) contains information on the majority of Australian Government-funded Aboriginal and Torres Strait Islander substance use services [6].

Tobacco smoking

While tobacco smoking is declining in Australia, it remains disproportionately high among Indigenous Australians. Data from the Australian Bureau of Statistics (ABS) has shown:

  • In 1994, the Indigenous Australian survey data showed that 55% of Indigenous Australians aged 18 and over were smokers; 20 years later, in 2014–15, this had declined to 45% (Table S3.4).
  • Over a similar 20-year period, the National Health Survey (NHS) the proportion of non-Indigenous smokers aged 18 and over declined, from 24% in 1995 to 16% in 2014–15 (Table S3.5).
  • There appears to have been no change to the gap in smoking prevalence between the Indigenous Australian adult population and the non-Indigenous Australian adult population from 1994 to 2014–15. Even though the Indigenous Australian smoking rates are declining, the non-Indigenous rate is declining at a similar rate, therefore the gap remained constant [6] (Figure ATSI1).

Most of the decline in smoking occurred in non-remote areas. Over the 20-year period, the proportion of Indigenous Australians aged 18 and over in non-remote areas who were smokers declined from 55% to 42%, while the proportion in remote areas remained relatively stable at between 54% and 56% (Table S3.4).

In 2014–15, Indigenous males were more likely than Indigenous females to be smokers (47% compared with 42%) [1].

Geographic trends

The 2014–15 NATSISS provides estimates of tobacco smoking for Indigenous Australians by jurisdiction. According to the 2014–15 NATSISS, 39% of Indigenous Australians aged 15 and over smoked daily. Those from the Northern Territory (45%) and Western Australia (42%) surpassed this national average, while Indigenous Australians from South Australia (35%) were the least likely to be a current daily smoker [4] (Table S3.3).

Tobacco smoking in pregnancy

Indigenous Australians are at an elevated risk of smoking during pregnancy compared with non-Indigenous Australians. The National Perinatal Data Collection showed that:

  • Indigenous mothers accounted for 19% of mothers who smoked tobacco at any time during pregnancy in 2015, despite accounting for only around 4% of mothers.
  • The age-standardised rate of Indigenous mothers smoking during pregnancy has decreased from 50% in 2009 to 45% in 2015.
  • Almost 1 in 2 (45%) Indigenous mothers reported smoking during pregnancy—compared with 12% of non-Indigenous mothers (age-standardised).
  • The age-standardised rate of Indigenous mothers quitting smoking during pregnancy (14%) is about half that of non-Indigenous mothers (25%) (based on mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy) [10].

Alcohol consumption

Abstinence (non-drinkers)

  • The 2016 NDSHS found that Indigenous Australians aged 14 and over were more likely to abstain from drinking alcohol than non-Indigenous Australians (31% compared with 23%, respectively) and abstinence among Indigenous Australians has been increasing since 2010 when it was 25% [7] (Table S3.1).
  • This pattern is consistent with data from the 2012–13 AATSIHS, where 28% of Indigenous Australians reported abstaining from drinking compared with 18% of non-Indigenous Australians [5].

Lifetime risk

  • The 2014–15 NATSISS found that the proportion of Indigenous Australians aged 15 years and over who exceeded the NHMRC lifetime risk guidelines for alcohol consumption (consuming more than 2 standard drinks per day on average) decreased between 2008 and 2014–15 (19% compared with 15%; non age-standardised proportions). The overall change is largely due to a decline in non-remote areas (19% in 2008 to 14% in 2014–15) [4] (Table S3.6).
  • Comparisons between Indigenous and non-Indigenous Australians are only available using age-standardised data from the 2012–13 AATSIHS and is not comparable to the 2014–15 NATSISS. The findings showed that lifetime risky drinking of Indigenous Australians aged 15 and over was similar to that of non-Indigenous Australians (9.8% compared with 9.7%; age-standardised) [5] (Table S3.7).

Single occasion risk

  • According to the 2014–15 NATSISS, 30% of Indigenous Australians aged 15 and over exceeded the single occasion risk guidelines for alcohol consumption (non age-standardised proportions), which is a decline since 2002 (35%).
  • Comparisons between Indigenous and non-Indigenous Australians are only available using age-standardised data from the 2012–13 AATSIHS and is not comparable to the 2014–15 NATSISS. The 2012–13 AATSIHS reported that 1 in 2 (50%) Indigenous Australians exceed the single occasion risky drinking guidelines (more than 4 standard drinks on a single occasion in past year). This was 1.1 times the rate that non-Indigenous Australians (44%) that exceeded these guidelines [5] (Table S3.7).

Risky alcohol consumption

  • According to the 2016 NDSHS, almost 1 in 5 Indigenous Australians (18.8%) consumed 11 or more standard drinks at least once a month. This was 2.8 times the rate that non-Indigenous Australians (6.8%) consumed this amount of alcohol [7] (Table S3.1).

Geographic trends

Between 2002 and 2014–15 there was a decline in the proportion of Indigenous Australians that resided in New South Wales Victoria, Queensland, South Australia, Western Australia and the Australian Capital Territory that exceeded the lifetime and single occasion risk guidelines (Figure ATSI2). Indigenous Australians residing in Tasmania (36%), the Australian Capital Territory (ACT) (35%), Queensland (33%) and Western Australia (33%) had higher rates of exceeding the single occasion drinking guidelines than the national average [4] (Table S3.8).

Indigenous Australians residing in Western Australia (16%), New South Wales (16%) and Queensland (15%) surpassed the national average for exceeding lifetime risk guidelines [4] (Table S3.9).

Illicit drug use

In the 2014–15 NATSISS, Aboriginal and Torres Strait Islander people aged 15 and over were asked whether they had used illicit substances in the last 12 months, and the types of illicit substances they had used during that period [4]. The data showed that:

  • Almost one-third (30%) of Indigenous Australians aged 15 and over reported having used illicit substances in the last 12 months, up from 22% in 2008.
  • Males were significantly more likely than females to have used illicit substances (34% compared with 27%), as were people in non-remote areas compared with those in remote areas (33% compared with 21%).
  • Cannabis was the most commonly reported illicit drug used by Aboriginal and Torres Strait Islander people in the last 12 months at 19% (25% of males compared with 14% of females).
  • The non-medical use of analgesics and sedatives (such as painkillers, sleeping pills and tranquilisers) was also relatively common (13%), with females (15%) being more likely than males (11%) to have used analgesics and sedatives.
  • One in twenty (5%) Indigenous Australians aged 15 and over reported having used amphetamines or speed in the last 12 months (6% of males compared with 3% of females) [4] (Figure ATSI3).

The 2016 NDSHS data showed that (other than ecstasy and cocaine), Indigenous Australians aged 14 and over recent used of illicit drugs was at a higher rate than non-Indigenous Australians (Table S3.1). Rates of illicit drug use in 2016 for Indigenous Australians aged 14 and older were:

  • Over one in four (27%) used any illicit drug in the last 12 months—1.8 times higher than non-Indigenous Australians (15.3%)
  • One in five (19.4%) used cannabis in the last 12 months—1.9 times higher than non-Indigenous Australians (10.2%)
  • Around one in 10 (10.6%) used a pharmaceutical for non-medical use—2.3 times higher than non-Indigenous Australians (4.6%) [7] (Table S3.1)
  • 3.1% used meth/amphetamines in the last 12 months—2.2 times higher than non-Indigenous Australians (1.4%).

The differences between Indigenous and non-Indigenous Australians were still apparent even after adjusting for differences in age structure (Figure ATSI4). There were no significant changes in illicit use of drugs among Indigenous Australians between 2013 and 2016, however due to the small sample sizes for Indigenous Australians, the estimates of the NDSHS should be interpreted with caution.

Geographic trends

Indigenous Australians aged 15 and over residing in the Northern Territory (22%) were the least likely to report substance use, while those from the Australian Capital Territory (41%) and Victoria (40%) were the most likely to report using substances.

Indigenous Australians from the Northern Territory (22%) and Queensland (29%) were the only jurisdictions below the national average (30%) [4] (Table S3.3).

Health and harms

The health status of Aboriginal and Torres Strait Islander people are considerably lower than for non-Indigenous Australians. For instance:

  • 35.1% of Aboriginal or Torres Strait Islander people compared with 58.3% of non-Indigenous Australia self-assessed their health as ‘excellent’ or ‘very good’ (age-standardised per cent).
  • 32.5% of Indigenous Australians compared with 12.3% of non-Indigenous Australians reported high/very high psychological distress (age-standardised per cent).
  • 71.0% of Aboriginal or Torres Strait Islander people reported having a long-term health condition compared with 55.3% of non-Indigenous Australians (age-standardised per cent) [4] (Table S3.6).

Almost 1 in 2 Indigenous Australians with a mental health condition were a daily smoker (46%) and about 2 in 5 (39%) to have used substances in the last 12 months. This was higher than for Indigenous  Australians with other long-term health conditions (33% and 24%, respectively) or those with no long term health condition (39% and 29% respectively) [4] (Table S3.11).

The Australian Burden of Disease Study provides an indication of the risk factors that contribute to the health gap between Indigenous and non-Indigenous Australians. In 2011, tobacco use accounted for 23.3% of the gap, and alcohol and drug use contributed to 8.1% and 4.1% of the gap, respectively [8] (Table S3.12).

Treatment

Indigenous Australians are also overrepresented in drug and alcohol treatment services. In 2016–17, the Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) showed that 15% of clients were Indigenous Australians aged 10 and over (Table S3.13). Indigenous Australians (3,313 per 100,000 population) were 7 times more likely to receive AOD treatment services than non-Indigenous Australians (430 per 100,000 population) were. Specifically where:

  • Amphetamines was the principal drug of concern, Indigenous Australians (1,204 per 100,000 population) were 8 times more likely than non-Indigenous Australians (155 per 100,000 population).
  • Heroin was the principal drug of concern Indigenous Australians (911 per 100,000 population) were 7 times more likely than non-Indigenous Australians (123 per 100,000 population) were.
  • Cannabis was the principal drug of concern Indigenous Australians (867 per 100,000 population) were 7 times more likely than non-Indigenous Australians (126 per 100,000 population) were.
  • Alcohol was the principal drug of concern Indigenous Australians (136 per 100,000 population) were 7 times more likely than non-Indigenous Australians (26 per 100,000 population) [9] (Table S3.14).

Dependence on opioid drugs (including codeine, heroin and oxycodone) can be treated with pharmacotherapy therapy using substitute drugs such as methadone or buprenorphine. The National Opioid Pharmacotherapy Statistics Annual Data collection (NOPSAD) provides information on clients receiving opioid pharmacotherapy treatment on a snapshot day each year. For jurisdictions where data was provided, in 2017:

  • Around 1 in 10 clients (9%) were Indigenous, an overrepresentation relative to their population size.
  • Indigenous Australians were almost 3 times as likely (70 clients per 10,000 population) to receive pharmacotherapy treatment as non-Indigenous Australians (26 clients per 10,000 population) [11] (Table S3.15).

Data from the OSR shows that 2015–16, there were 80 organisations around Australia that provided alcohol and other drug treatment services to around 32,700 Aboriginal and Torres Strait Islander clients [6]. The OSR data also shows that:

  • All 80 organisations reported that alcohol was one of the top five common substance-use issue, followed by cannabis (94%) and amphetamines (70%)
  • Treatment episodes were more likely to be to occur in non-residential settings (87%)
  • One third of all treatment episodes were in Very remote areas (32%) and the highest proportion of clients were located in Major cities (35%).

Policy context

The Aboriginal and Torres Strait Islander Health Performance Framework 2017

The Aboriginal and Torres Strait Islander Health Performance Framework 2017 includes a suite of products that give the latest information on how Aboriginal and Torres Strait Islander people in Australia are faring according to a range of 68 performance measures across 3 tiers: Tier 1—health status and outcomes, Tier 2—determinants of health, and Tier 3—health system performance. The measures are based on the Aboriginal and Torres Strait Islander Health Performance Framework and cover data that has been collected on the entire health system, including Indigenous-specific services and programs, and mainstream services [12].

National Aboriginal Torres Strait Islander Peoples Drug Strategy 2014–2019

The National Aboriginal and Torres Strait Islander Peoples’ Drug Strategy 2014–2019 was a sub-strategy of the National Drug Strategy 2010–2015 and remains a sub-strategy under the National Drug Strategy 2017–2025. The overarching goal of this sub-strategy is to improve the health and wellbeing of Aboriginal and Torres Strait Islander people by preventing and reducing the harmful effects of alcohol and other drugs (AOD) on individuals, families and their communities [13].

NACCHO Aboriginal Health and local #Adoption : @CAACongress @SNAICC and @AbSecNSW streamed live today August 14 from Canberra , public hearing local adoption : Plus @AMSANTaus full submission

 

We are aware that this Inquiry was called in the wake of recent media coverage relating to the issue of adoption of Aboriginal children, including the Minister’s own comments that adoption policies should be changed to allow more Aboriginal children to be adopted by non-Aboriginal families.

AMSANT would like to emphasise the importance of informed discussion on this issue and draws the Committee’s attention to the following, put forward in March of this year as part of a joint statement from Aboriginal and Torres Strait Islander leaders in response to media coverage:

We need to have a more rational and mature discussion aimed at achieving better social, community, family and individual outcomes for all Aboriginal and Torres Strait Islander children and young people. We must work to ensure that the drivers of child protection intervention are addressed, rather than continuing with a poorly designed and resourced system that reacts when it’s too late, after families have already reached breaking point and children have been harmed1

See Full AMSANT Submission Part 2 Below

 

“As detailed in our submission, AbSec is strongly opposed to the coerced adoption of Aboriginal children by statutory child protection systems. Adoption orders are characterised by the absence of key safeguards to ensure the safety and wellbeing of Aboriginal children.

They fail to uphold an Aboriginal child’s fundamental rights to family, community and culture, and the importance of these connections to our life long wellbeing and resilience. They are not in the best interests of our children.

In particular, it must be noted that past policies of the forced separation of Aboriginal children and young people from their families, communities, culture and Country is regarded as a key contributor to this ongoing over-representation. It is not a solution.

AbSec, alongside QATSICPP and SNAAICC, call for the development of Aboriginal and Torres Strait Islander community-led approaches to the care of our children “

ABSEC Submission Download Here

ABSEC Adoption submission

SNAICC Submission Download Here

Snaicc Adoption submission

 Part 1 Next public hearing for local adoption inquiry

The House of Representatives Standing Committee on Social Policy and Legal Affairs will hold a public hearing into a nationally consistent framework for local adoption in Australia.

The Committee will hear from the Central Australian Aboriginal Congress, the Secretariat of National Aboriginal and Islander Child Care – National Voice for our Children (also known as SNAICC), and the Aboriginal Child, Family and Community Care State Secretariat (NSW) (also known as AbSec).

A detailed program for the hearing is available from the inquiry webpage (www.aph.gov.au/localadoption).

Public hearing details: Tuesday 14 August, 4.40pm (approx) to 6.00pm, Committee Room 1R2, Parliament House, Canberra

The Central Australian Aboriginal Congress

SNAICC (Secretariat of National Aboriginal and Islander Child Care) – National Voice for our Children

AbSec – the Aboriginal Child, Family and Community Care State Secretariat (NSW)

The hearings will be streamed live in audio format at aph.gov.au/live.

Members of the public are welcome to attend the hearing however there will be limited seating available.

Further information about the inquiry, including the terms of reference and submissions published so far, is available on the inquiry webpage.

Part 2 AMSANT submission to The Standing Committee on Social Policy and Legal Affairs: Inquiry into local adoption

AMSANT welcomes the opportunity to provide a submission to the Inquiry into Local Adoption. As the peak body for the community controlled Aboriginal primary health care sector in the Northern Territory AMSANT advocates for equity in health, focusing on supporting the provision of high quality comprehensive primary health care services for Aboriginal communities.

This submission provides an overview of AMSANT’s position in relation to Aboriginal children in Child Protection, including Out of Home Care (OOHC) and potential adoption, and also responds directly to Terms of Reference 1 and 2 of the Inquiry.

Overview

AMSANT embraces a social and cultural determinants of health perspective which recognises that health and wellbeing are profoundly affected by a range of interacting economic, social and cultural factors. Accordingly, we advocate for a holistic and child-centred approach to Child Protection that seeks first and foremost to address the underlying causes of abuse and neglect through prevention and early intervention.

We are aware that this Inquiry was called in the wake of recent media coverage relating to the issue of adoption of Aboriginal children, including the Minister’s own comments that adoption policies should be changed to allow more Aboriginal children to be adopted by non-Aboriginal families.

AMSANT would like to emphasise the importance of informed discussion on this issue and draws the Committee’s attention to the following, put forward in March of this year as part of a joint statement from Aboriginal and Torres Strait Islander leaders in response to media coverage:

We need to have a more rational and mature discussion aimed at achieving better social, community, family and individual outcomes for all Aboriginal and Torres Strait Islander children and young people. We must work to ensure that the drivers of child protection intervention are addressed, rather than continuing with a poorly designed and resourced system that reacts when it’s too late, after families have already reached breaking point and children have been harmed1.

As captured in this statement it is essential that efforts to improve outcomes for children and families in contact with the Child Protection System stem from an understanding that abuse and neglect of children are most often the result of deeper family conflict or dysfunction, arising from social, economic and/or psychological roots.

In cases where children do need to be removed from family, decisions about what kind of placement, including adoption, is most appropriate for that child should occur in line with the following principles:

 Child-centred approach that allows for children to have a say in decisions that affect them

 OOHC for Aboriginal children delivered by Aboriginal Community Controlled Services (ACCSs)

 Adoption of a set of national standards for the rights of children in care

 Maintaining connection to family, community, culture and country, including prioritising adoption by extended family or if that is not possible, Aboriginal families who are not related.

 Improved support for kinship carers

1 See full statement here: http://www.snaicc.org.au/snaicc-statement-14-march-2018-joint-statement-aboriginal-torres-strait-islander-leaders-recent-media-coverage-around-child-protection-children/ Inquiry into local adoption

Stability and permanency for children in out-of-home care with local adoption as a viable option

Transition of OOHC to Aboriginal Community Control

Evidence clearly demonstrates that culturally competent services lead to increased access to services by Aboriginal children and their families2. Aboriginal led and managed services are well-placed to overcome the many barriers that exist for Aboriginal families and children to access services3, such as:

 a lack of understanding of the OOHC system and how to access advice and support;

 a mistrust of mainstream legal, medical, community and other support services;

 an understanding of the cultural or community pressures not to seek support, in particular perceptions of many Aboriginal families that any contact with the service system will result in the removal of their child4.

As the evaluation of child and family service delivery through the Communities for Children program identifies, “Indigenous specific services offer Indigenous families a safe, comfortable, culturally appropriate environment that is easier to access and engage with.”5 In addition, they are also going to be better at locating, training and supporting Aboriginal foster carers. This provides the opportunity to increase the quality of OOHC for Aboriginal children at significant lesser cost than the current “professional” foster care arrangements that are too often being put in place for Aboriginal children.

Following the lead of NSW, who in 2012 commenced a process of transfer to community control, there is a project currently being undertaken by the Aboriginal Peak Organisations NT (APO NT), in collaboration with the NT Government, to develop a strategy for the transition of OOHC to Aboriginal community control in the NT. Victoria has also confirmed that all OOHC service provision for Aboriginal children and families will be provided by community controlled services, with Queensland and Western Australia both exploring similar shifts.

AMSANT supports APO NT’s vision that Aboriginal children and young people in out of home care, as a priority, are placed with Kinship or Aboriginal foster carers and supported to retain culture, identity and language.

Strengthening the voice of children in decisions that affect them

Article 12 of the United Nations Convention on the Rights of the Child states; “Children have the right to say what they think should happen when adults are making decisions that affect them and to have their opinions taken into account” 6.

There is a need for Child Protection proceedings to be more responsive to the child’s aspirations and needs. An approach taken in Family Law known as child-inclusive family dispute resolution has been shown to produce better outcomes for families with parenting disputes, including greater stability of care and contact patterns, and greater contentment of children with those arrangements7. Central to this approach is the use of an independent, specially trained child health professional to conduct interviews before any decision is made about them.

There is no reason why a similar approach couldn’t be taken in terms of long term care arrangements for children but with specific provisions for continuing contact with family and community.

Maintaining connection with family, kin and country

In line with international convention, Aboriginal children and families have the right to enjoy their cultures in community with their cultural groups (UNCRC, article 30; UNDRIP, articles 11-13). This right has been enshrined in these conventions to reflect the wealth of evidence that show culture, language and connection to country are protective factors for at-risk communities8.

The Aboriginal Torres Strait Islander Placement Principle (ATSIPP) has been developed to ensure recognition of the value of culture and the vital role of Aboriginal children, families and communities to participate in decisions about the safety and wellbeing of children.

Despite the commitment from all States and Territories to fully implement this principle under the National Framework for Protecting Australia’s Children, in 2015 only 34.7% of Aboriginal children in the NT were placed in care in accordance with the Child Placement principle, compared with a national average of 65.6%, and only 3.3% of children were placed with relatives or kin, compared with 48.8% at the national average9.

This reflects the need for better practice relating to kinship care in the NT including;

– early identification of kinship networks when the child first comes to the attention of Child Protection, rather than when a crisis point has been reached;

– increased access to supports and training for kinship carers (see below);

– support services to birth parents to strengthen the option for reunification;

– development of cultural support plans for all Aboriginal children to ensure meaningful connection to family, culture and community is maintained.

Improved support for kinship carers

A lack of adequate support for kinship carers can contribute to placement breakdown, and escalation for children and young people in the statutory OOHC system, including entry into residential care.

Conversely, home based care and placement stability are associated with a range of better health, education, economic and wellbeing outcomes.

Improved access to the following would support kinship carers in maintaining more stable placements for the children in their care:

– Ensure a comprehensive assessment of the child has been conducted and a care plan, incorporating cultural supports for Aboriginal children, is developed and fully implemented.

– Ensure access to training courses across a broad range of issues (parenting solutions, behavioural management, understanding and responding to trauma etc.)

– Increased financial support to bring payments in line with foster carers.

It is important to note that even for many long-term, stable care arrangements, including for children in kinship care, adoption may not be seen as a viable option due to the loss of supports that would be incurred in transitioning from ‘carer’ to ‘parent’.

In this way it is clear that the type of placement reflects neither stability and permanency nor wellbeing for the child, but rather the particular vulnerabilities and needs of the child and their carer. Adequately meeting these needs should remain the paramount focus of any efforts to create stable, loving homes for children in care.

Appropriate guiding principles for a national framework or code for local adoptions within Australia

In order to ensure that the rights and needs of the child remain central to all Care and Protection operations, AMSANT advocates that Australia adopt a set of national standards that set out the rights of children in care, which would be modelled on the Council of Europe’s 2005 Recommendation on the Rights of Children Living in Residential Institutions10.

This recommendations sets out a list of basic principles, specific rights of children living in residential institutions and guidelines and quality standards in view of protecting the rights of children living in residential institutions, irrespective of the reasons for and the nature of the placement. It advocates that the placement of a child should remain the exception and that the placement must guarantee full enjoyment of the child’s fundamental rights.

 

NACCHO Aboriginal Health and #MyHealthRecord : @CHFofAustralia Do you have questions about #MyHealthPrivacy. ? Register for 6 webinars starting 8 August

My Health Record moving to an opt-out model is the most important digital health change for consumers in Australia in 2018.

To help people make an informed and considered decision about whether or not to opt-out of having a record created for them CHF are holding a series of 6 webinars, starting this week, that will cover the key information people need to understand the benefits and risks of My Health Record in the context of their own lives.

These interactive webinars will include knowledgeable panellists and provide a chance for questions from the public to be asked of them through the webinar service’s Q&A and chat functions.”

Full details and registrations Part 1 Below

 ” The Federal Government’s Health Care Homes is forcing patients to have a My Health Record to receive chronic care management through the program, raising ethical questions and concerns about discrimination.

The government’s Health Care Homes trial provides coordinated care for those with chronic and complex diseases through more than 200 GP practices and Aboriginal Community Controlled Health Services nationally, and enrolment in the program requires patients to have a My Health Record or be willing to get one

See Part 2 below for debate ACCHO Chronic care patients forced to have My Health Records to access government’s Health Care Homes program

  ” NACCHO endorses and supports the My Health Record system initiative provided patient information and privacy is protected. The patient is in control of what information is placed in their electronic record and who else has access to it.

But want an assurance from the Health Minister that all patient records will be protected and if that requires further legislation then so be it.’

Mr John Singer, Chairperson of the National Aboriginal Community Controlled Health Organisation (NACCHO)

Read over 35 NACCHO E- Health My Health Records articles published since 2012

Part 1

Before each webinar, we are also surveying and collating questions on each week’s topic through our website and on Twitter.

Over the coming weeks, the webinars will cover privacy and security, and overview of digital health in Australia, the benefits and risks, digital inclusion and health literacy.

You can find out more about the entire series here: https://chf.org.au/introduction-my-health-record-webinar-series

Details for Webinar 1: Privacy and Security of My Health Record

The first webinar is being held next Wednesday, 8 August at 12:30pm AEST and will focus on privacy and security.

Register here: http://www.webcasts.com.au/chf080818/

Questions and concerns on the topic can be submitted through the CHF website here: https://chf.org.au/introduction-my-health-record-webinar-series/webinar-1-privacy-and-security#questions

They can also be shared on Twitter using the hashtag #MyHealthPrivacy.

Your questions and concerns will be collated, edited and aggregated by CHF to put to the panellists at the webinar. It will also be possible to ask questions during the event.

Panellists

  • Kim Webber – General Manager, Strategy at the Australian Digital Health Agency
  • Karen Carey – Consumer Advocate, former chair of CHF and Chair of the NHMRC Community and Consumer Advisory Group
  • Dr Bruce Baer Arnold – Assistant Professor, Law at University of Canberra and Vice-chair of the Australian Privacy Foundation Board
  • Dr Charlotte Hespe M.B.B.S. Hons (Syd) DCH (Lon) FRACGP, FAICD – GP, Glebe Family Medical Centre and RACGP Vice President

My Health Record is an important reform that will only work and evolve in the right way if clinicians and consumers understand, trust, value, use and discuss the system. We hope that you will join us for these webinars as we discuss and question the key issues and information about My Health Record.

Part 2 Chronic care patients forced to have My Health Records to access government’s Health Care Homes program

FROM HERE

The Federal Government’s Health Care Homes is forcing patients to have a My Health Record to receive chronic care management through the program, raising ethical questions and concerns about discrimination.

The government’s Health Care Homes trial provides coordinated care for those with chronic and complex diseases through more than 200 GP practices and Aboriginal Community Controlled Health Services nationally, and enrolment in the program requires patients to have a My Health Record or be willing to get one.

But GP and former AMA president Dr Kerryn Phelps claimed the demand for patients to sign up to the national health database to access Health Care Homes support is unethical.

“I have massive ethical concerns about that, particularly given the concerns around privacy and security of My Health Record. It is discriminatory and it should be removed,” Phelps told Healthcare IT News Australia.

Under a two-year trial beginning in late 2017, up to 65,000 people are eligible to become Health Care Homes patients as part of a government-funded initiative to improve care for those with long-term conditions including diabetes, arthritis, and heart and lung diseases.

Patients in the program receive coordinated care from a team including their GP, specialists and allied health professionals and according to the Department of Health: “All Health Care Homes’ patients need to have a My Health Record. If you don’t have a My Health Record, your care team will sign you up.”

Phelps said as such patients who don’t want a My Health Record have been unable to access a health service they would otherwise be entitled to.

“When you speak to doctors who are in involved in the Heath Care Homes trial, their experience is that some patients are refusing to sign up because they don’t want a My Health Record. So it is a discriminatory requirement.”

[Read more: Greg Hunt announces legislative changes to tighten privacy and security protections for My Health Record | Opposition calls for My Health Record roll out to be suspended as AMA seeks greater privacy protections]

It has also raised concerns about possible future government efforts to compel Australians to have My Health Records.

“The general feedback I’m getting is that the Health Care Homes trial is very disappointing to say the least but, nonetheless, what this shows is that signing up to My Health Record could just be made a prerequisite to sign up for other things like Centrelink payments or workers compensation.”

Human rights lawyer and Digital Rights Watch board member Lizzie O’Shea claims patients should have a right to choose whether they are signed up to the government’s online medical record without it affecting their healthcare.

“It is deeply concerning to see health services force their patients to use what has clearly been shown to be a flawed and invasive system. My Health Record has had sustained criticism from privacy advocates, academics and health professionals, and questions still remain to be answered on the privacy and security of how individual’s data will be stored, accessed and protected,” O’Shea said.

[Read more: Technical chaos and privacy backlash as My Health Record opt out period begins | My Health Record identified data to be made available to third parties]

Health Minister Greg Hunt this week announced legislative amendments to restrict access to individuals’ My Health Records by law enforcement and government agencies following a privacy backlash that had grown in momentum since the three month opt out period began on July 16.

Records of those who have chosen to opt out of the system will also now be deleted. Previously, data would remain in the system until 30 years after a person’s death, or when date of death was unknown for 130 years after the date of birth.

The three-month opt out period has also been extended to November 12.

About 6 million people currently have a My Health Record and remaining Australians will have a record created for them by the end of the year unless they opt out.

The Opposition’s Shadow Health Minister Catherine King claimed the government’s changes don’t go far enough.

“Minister Hunt’s response to this fiasco that has become the implementation of the My Health Record is entirely inadequate. We’ve had weeks where the minister has been out there saying there is nothing to see here, there is no problem, particularly no problem when it comes to the legislative provisions relating to court orders and access by law enforcement bodies. We now see that, again, that was entirely untrue,” King said.

“We don’t believe that anything less than a suspension of the opt-out of the My Health Record, whilst the government rebuilds community trust in the My Health Record, will be sufficient. This government has presided over a failure of implementation, and it comes with a litany of other failures. When it comes to the National Disability Insurance Scheme implementation, when it came to Census fail, when it comes to the roll out of the National Broadband Network.”

According to O’Shea, the Health Care Homes revelation raises further concerns about a system that has been mired in recent controversy. She said Indigenous people may be particularly wary of My Health Record, penalising some of the most vulnerable Australian patients.

NACCHO Aboriginal Health celebrates #AMAFDW18 AMA Family Doctor Week : @amapresident Speech to @PressClubAust #NPC Includes support #ulurustatement #prevention investment #obesity #Chronic Disease funding #MentalHealth

 

” I am very pleased that one of my first announcements as AMA President was the AMA endorsement of the Uluru Statement from the Heart.

The Uluru Statement expresses the aspirations of Aboriginal and Torres Strait Islander people with regard to self-determination and status in their own country.

The AMA has for many years supported Indigenous recognition in the Australian Constitution.

The Uluru Statement is another significant step in making that recognition a reality.

The AMA is committed to improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

It is simply unacceptable that Australia, one of the wealthiest nations in the world, cannot solve a health crisis affecting fewer than three per cent of its citizens.”

AMA President Dr Tony Bartone speaking at the National Press Club 25 July 2018

 ” This week just happens to be AMA Family Doctor Week – a tribute to hardworking GPs.

GPs of Australia, I salute you. We all salute you.

Your hard work and dedication is highly valued. The AMA will always support you and promote you.

Your GP – your family doctor – will ensure that your health needs are met throughout all stages of your life.

Be it immunisation, preventative health care, age specific medical checks, chronic disease management, or aged care, the life long relationship with your GP underpins continuous and appropriate care.

This is especially the case for patients who are from culturally or linguistically diverse backgrounds. For them, GPs truly are their trusted health advocates.”

 ” The burden of chronic disease in Australia is significant.

Chronic disease is responsible for around 83 per cent of premature deaths and 66 per cent of the burden of disease.

Chronic disease has a significant impact on the health system, but the reality is that most of these conditions can be prevented.

It simply makes enormous sense to invest in prevention.

Taxes collected from tobacco and alcohol excise generate around $16 billion each year for the Government.

In return, total Government spending on prevention is around $2 billion a year, which equates to about $89 per person.

If we are to reduce the impact of chronic disease in Australia, all our governments must invest more in prevention.

Tackling obesity is a priority.

Doctors are well placed to identify and support patients who are overweight or obese. Two thirds of adults are either overweight or obese. ”

Full Speech : Health reform: Improving the patient journey

I acknowledge the traditional owners of the land on which we meet, and pay my respects to their elders past and present.

It is a humbling experience to be elected President of such a proud and respected organisation as the AMA.

It is an equally humbling experience to speak here at the National Press Club in Canberra. I thank the Press Club for this opportunity.

I am a GP, and I have been in practice in the northern suburbs of Melbourne for more than 30 years.

Some of you may know that I was inspired to become a GP by watching my own family doctor, who cared for my ill father when I was growing up.

Even now, my mother reflects on the care and dedication my family GP displayed in caring for her family. It’s no surprise that he became an early mentor in my professional life.

I have seen it all as I have looked after the health of my community and my patients, including generations of the same families.

I like to think that my experience has given me some credibility in knowing what works and what doesn’t work in the health system, especially in primary care.

My overarching concern has always been the patient journey – ensuring that people get the right care at the right time in the right place by the right practitioner.

The priorities for me are always universal access to care, and affordability.

Today, I will share my views on what can be done to make our great health system even better – how to improve the patient journey.

I will also introduce you to some of my patients, and reflect on the barriers in their access to timely care, to further illustrate our concerns.

General practice and primary care reform

On the day I was elected, I made it very clear that one of the hallmarks of my Presidency would be stridently advocating for significant investment in general practice.

This week just happens to be AMA Family Doctor Week – a tribute to hardworking GPs.

see intro for text

However, there is something really crook about how GPs have been treated by successive Governments.

They have paid lip service to the critical role GPs play in our health system, often borne out of ignorance and often in a misguided attempt to control costs.

General practice has been the target of continual funding cuts over many years. These cuts have systematically eaten away at the capacity of general practice to deliver the highest quality care for our patients.

They threaten the viability of many practices.

I talk to my GP members regularly, both metropolitan and rural.

The message is simple – some are at a tipping point and have a very bleak view of the future.

They see general practice becoming increasingly corporatised, burdened with more red tape, and GPs are less able to spend the necessary time with patients.

This is not the future that GPs want to see.

This is not the future that our patients want to see.

We can and must avoid these bleak predictions, but it requires significant real and immediate investment from the Government with a clear pathway to long-term reform.

Let me be very clear about this: we must put general practice front and centre in future health policy development.

We have seen too many mistakes. Too many poor policy decisions.

Despite the Government’s best intentions – and lots of goodwill within the profession – the Health Care Homes trial and implementation failed to win the support of GPs or patients.

Instead of real investment, the Trial largely shifted existing buckets of money around.

It has fallen well short of its practice enrolment targets, and it looks like only a small fraction of the targeted 65,000 patients will sign up.

There is no doubt that the challenge of transforming general practice was severely underestimated by policy makers. At least with this model.

But general practice still needs transformation and rejuvenation to meet growing patient demand and to keep GPs working in general practice.

The AMA has a plan for reform of general practice and primary care.

It is patient-centred and focuses on better access to long-term continuous quality care and managing patients more effectively in the community.

It takes the best elements of the ‘medical home’ concept and adapts them to the Australian context.

It is a plan that will require upfront and meaningful new investment, in anticipation of long-term savings in downstream health costs.

In the short term, the AMA plan for general practice will involve:

  • significant changes to Chronic Disease funding, including a process that strengthens the relationship between a patient and their usual GP, and encourages continuity of care;
  • cutting the bureaucracy that makes it difficult for GPs to refer patients to allied health services;
  • formal recognition in GP funding arrangements of the significant non-face-to-face workload involved in caring for patients with complex and chronic disease;
  • additional funding to support enhanced care coordination for those patients with chronic disease who are at risk of unplanned hospital admission – a similar model to the Coordinated Veterans Care Program funded by the Department of Veterans Affairs;
  • a properly funded Quality Improvement Incentive under the Practice Incentive Program – the PIP;
  • changes to Medicare that improve access to after-hours GP care through a patient’s usual general practice;
  • support for patients with chronic wounds to access best practice wound care through their general practice;
  • better access to GP care for patients in residential aged care; and
  • annual indexation of current block funding streams that have not changed for many years … including those that provide funding to support the employment of nursing and allied health professionals in general practice.

In the longer term, we need to look at moving to a more blended model of funding for general practice.

While retaining our proven fee-for-service model at its core, the new funding model must have an increased emphasis on other funding streams, which are designed to support a high performing primary care system.

This will allow for increasing the capability and improving the infrastructure supporting general practice to allow it to become the real engine room of our health system.

It is about scaling up our GP-led patient-centred multidisciplinary practice teams to better provide the envelope of health care around the patient in their journey through the health system.

A good example is the Blacktown Hospital Diabetes Outpatient Clinic in New South Wales.

This Clinic has a waiting time of less than a week because the service is distributed to its catchment GPs with the appropriate funding and support for both personnel and infrastructure.

This is a small example, but a significant one when you consider the scale and prevalence of diabetes across Australia, let alone the western suburbs of Sydney, and the average access times for outpatient hospital clinics.

We cannot continue to do things the way we always have.

The bulk-billing rate should not be the metric by which we judge the performance of general practice.

Chronic conditions have become more prevalent in Australia. The ones causing most concern are:

  • arthritis;
  • asthma;
  • back pain and problems;
  • cancer;
  • cardiovascular disease;
  • chronic obstructive pulmonary disease;
  • diabetes; and
  • mental health conditions.

One in two people now report having at least one of these eight common chronic conditions.

These conditions account for around 60 per cent of the total disease burden, and they contribute to nearly 90 per cent of deaths in Australia.

We must reshape our primary care system to meet these challenges.

We must put in place the funding support that general practice needs to better manage patients in the community – and keep people out of hospital.

Our plan is a smarter and more sustainable blueprint … a better plan for general practice. A better plan for Australians.

Public hospitals

We also need a better plan for public hospitals.

In an election year, voters tend to focus very closely on public hospitals when they are comparing health policies.

Public hospitals are a critical part of our health system. They are highly visible. They are greatly loved institutions in the community. They are vote changers.

The doctors, nurses, and other staff who work in our public hospitals are some of the most skilled in the world.

In 2016-17, public hospitals provided more than six and a half million episodes of admitted patient care. They managed 92 per cent of emergency admissions.

If the state of general practice is crook, then our public hospitals are on permanent code yellow.

Despite their importance, and despite our reliance on our hospitals to save lives and improve quality of life, they have been chronically underfunded for too long.

Between 2010-11 and 2015-16, average annual real growth in Federal Government recurrent funding for public hospitals has been virtually stagnant – a mere 2.8 per cent.

The AMA welcomes that, between 2014-15 and 2015-16, the Federal Government boosted its recurrent public hospital expenditure by 8.4 per cent.

But a one-off modest boost from a very low base is not enough.

I deal with the results of stressed public hospitals every day and manage the impact it has on my patients.

Ollie is a patient with well-controlled Parkinson’s disease. He now also has a recently diagnosed lung cancer, which has been caught early, resected, and appropriately managed.

But he has been denied care for his resulting poor control of his Parkinson’s disease in the same hospital’s neurology outpatient department and referred back to me.

I have been advised that I must source an alternative option for his neurological care.

Another of my patients, Carlo, is a victim of the never ending Federal-State buck passing when it comes to health.

Having developed poorly controlled reflux and having been referred to the local hospital outpatient department for a gastro consult, Carlo was referred back to me.

I was advised that I had to arrange a referral at the same hospital’s diagnostic imaging service for a possible coordination and swallowing problem, which ultimately proved correct.

He was then referred back to the gastroenterology department to manage his newly diagnosed oesophageal condition.

Barbara is another very common example of the funding chaos.

She is a very active 68-year-old lady who was troubled by severe osteoarthritis of the knee for many years. She was placed on a waiting list for surgery two years ago.

She has had to attend our practice regularly for pain management and supportive referrals for physiotherapy, while I continued to manage the consequences of her inability to lose weight due to her exercise restrictions and worsening diabetes and blood pressure profile.

She has just finally had her knee joint replaced.

These are the experiences of everyday patients.

They underpin the troubling headlines that came from the AMA’s 2018 Public Hospital Report Card. Our hospitals are stretched to the limit.

Likewise, the AMA’s Safe Hours Audit is a window into the lived experience of dedicated doctors, struggling to deliver quality care in over-crowded, under-funded hospitals.

But instead of helping the hospitals improve safety and quality, governments decided to financially punish hospitals for poor safety events.

There is no evidence to show that financial penalties work.

Health care is complex. Not all patient complications can be avoided.

The 2020-25 hospital funding agreement does little to improve the situation.

Funding levels stay the same, but public hospitals will have to do more with it to help coordinate patient care post-discharge.

The AMA supports better discharge planning and integrated care, especially for patients with complex and chronic disease.

But this will cost money – and public hospitals need extra funding.

The AMA calls on the major parties to boost funding for public hospitals beyond that outlined in the next agreement.

There must be a plan to lift public hospitals out of their current funding crisis, which is putting doctors and patients at risk.

Governments must stop penalising hospitals for adverse patient safety events.

We need policies to fully fund hospitals. We must help them improve patient safety and build their internal capacity to deliver high value care in the medium to long term.

They must link up and work with primary care to deliver better coordinated care.

I note that Labor has pledged an extra $2.8 billion for public hospitals.

I expect that the Coalition will match that as the election draws nearer.

They do not want another Medi-scare style campaign.

Medical care for older Australians

Older Australians are voters, too.

Aged care was, until very recently, one of the highest profile segments of the health system – but for all the wrong reasons.

It is now emerging as an area in need of significant reform as the population ages and lives longer.

Older Australians all too frequently do not have the same access to medical care as other age groups – a longstanding result of inadequate funding in the aged care system.

This inequity will likely only grow as the Australian population ages with more complex, chronic medical conditions requiring more medical attention than ever before.

We have witnessed numerous consultations and reviews.

Enough! Now is the time for action.

There is already sufficient information to underpin the final recommendations. It is simply unfair and unjust to delay this any further.

An increase in funding for GP visits to aged care facilities would result in many savings, including from reduced ambulance transfers to hospital emergency departments.

Changes to after-hours care remuneration must consider services that are currently provided under ‘urgent’ item numbers to patients in aged care facilities.

We also need to ensure that the critical role that nurses play in caring for older Australians is recognised in those facilities.

The AMA wants to see Medicare rebates that adequately cover the time that doctors spend with the patient assessing and diagnosing their condition and providing medical care.

We want new telehealth Medicare items that compensate GPs, and other medical specialists, for the time spent organising and coordinating services for the patient.

This includes the time that they spend with the patient’s family and carers to plan and manage the patient’s care and treatment.

There must be funding for the recruitment and retention of quality, appropriately trained aged care staff.

And we must reverse the decline in the proportion of Registered Nurses in aged care.

The AMA Aged Care Survey, released today, shows that AMA members who work in aged care have identified the shortage of Registered Nurses – who should be available 24 hours a day – as the biggest priority for aged care reform.

The survey also shows that one in three doctors are planning to cut back on, or completely end, their visits to patients in aged care facilities over the next two years.

This is largely because the Medicare rebates are inadequate for the amount of time and work involved.

The AMA will ensure that aged care gets the attention and profile it deserves in the election campaign.

Private health insurance:

Private health insurance has been in the headlines for much of the past year – again, for all the wrong reasons.

The AMA has always called for a simpler and fairer private health insurance system.

Without the private system, the public system would likely collapse.

But we cannot expect the private system to thrive – or even survive – if there is not value in insurance policies.

Patients are smart – they know there is no point outlaying thousands of dollars every year if the coverage isn’t there.

Affordability means very little without value.

We are clearly at a crisis point in private health insurance. And the Government knows it.

Hence the latest Review, and the recent announcement by the Minister of new categories of policies … and greater transparency.

We support the concept of developing Gold, Silver, and Bronze insurance categories.

We can’t expect consumers to understand the many different definitions, the carve outs, and exclusions of some 70,000 policy variations.

Australians want reasonable and simple things from their insurance.

They want coverage.

They want a choice of the practitioner, and a choice of the hospital.

They want treatment when they need it.

We can’t have patients finding out they aren’t covered after the event, or when they require treatment and it’s all too late.

To that end, we have been very clear – we don’t support the use of restrictions in Gold, Silver, and Bronze.

Restrictions lead people to believe they are covered, when in reality they are exposed to additional costs.

We don’t support junk policies. If a Basic policy category doesn’t provide much coverage, that should be made crystal clear.

We don’t support dismantling community rating. This must be protected to maintain equity of access to private health treatment.

When the objective is to support a strong private health sector to take pressure off the public sector, it makes no sense to financially discourage the patients who are most likely to need access to private health.

We support standard clinical definitions. Whatever is involved for coverage for heart conditions should not vary between insurers and policies.

I urge the Government to continue to work with the Colleges to ensure that these definitions are robust.

There is increasing corporatisation of private health and the market power is shifting in favour of private health insurers.

Insurers, whether private or via Medicare, cannot determine the provision of treatment in Australia.

They cannot and must not interfere with the clinical judgement of medical practitioners.

Australians do not support a US-style managed care health system. Neither does the AMA.

One area we are disappointed with in the recent announcements is pregnancy cover.

It does not make sense to us, as clinicians, to have pregnancy cover in a higher level of insurance only.

Many pregnancies are unplanned – meaning people are caught out underinsured when pregnancy is restricted to high-end policies.

Pregnancy is a major reason that the younger population considers taking up private health insurance.

They are less likely to be able to afford the higher-level policies. We need to make sure it is within reach.

I having female reproductive services at a different level to pregnancy coverage is, to us, problematic, and will leave a lot of people caught out.

There will be much more to talk about as the private health reforms are finalised and bedded down.

Mental Health

As a suburban GP who sees the whole range of health ailments and conditions, an area of special interest to me is mental health.

I do not think the unique role and special skills of GPs are used enough at the front line of mental health care.

The AMA earlier this year called for a national, overarching mental health “architecture”, and proper investment in both prevention and treatment of mental illnesses.

Almost one in two Australian adults – that is more than seven million people – will experience a mental health condition in their lifetime.

Almost every Australian will experience the effects of mental illness in a family member, friend, or work colleague.

The statistics are startling. For example:

  • More than half a million children and adolescents, aged four to 17, experienced mental health disorders in 2012-13.
  • Australians living with schizophrenia die 25 years earlier than the general population, mainly due to poor heart health.

And yet mental health and psychiatric care are grossly underfunded.

Strategic leadership is needed to integrate all components of mental health prevention and care.

For mental health consumers and their families, navigating the system and finding the right care at the right time can be difficult and frustrating.

There is no vision of what the mental health system will look like in the future.

Poor access to acute beds for major illness leads to extended delays in emergency departments.

Poor access to community care leads to delayed or failed discharges from hospitals.

And poor funding of community services makes it harder to access and coordinate prevention, support services, and early intervention.

Significant investment is urgently needed to reduce the deficits in care, fragmentation, poor coordination, and access to effective care.

We have repeatedly called for support for carers of people with mental illness, which is often the result of necessity, not choice.

Access to respite care is vital for many people with mental illness and their families, who are the ones who bear the largest burden of care.

Indigenous health

I am very pleased that one of my first announcements as AMA President was the AMA endorsement of the Uluru Statement from the Heart.

The Uluru Statement expresses the aspirations of Aboriginal and Torres Strait Islander people with regard to self-determination and status in their own country.

The AMA has for many years supported Indigenous recognition in the Australian Constitution.

The Uluru Statement is another significant step in making that recognition a reality.

The AMA is committed to improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

It is simply unacceptable that Australia, one of the wealthiest nations in the world, cannot solve a health crisis affecting fewer than three per cent of its citizens.

Prevention

There is not enough time today to cover all the issues I would like to cover in one speech.

I could deliver a whole speech on each of the following topics – medical workforce, rural health, medical research, genetic testing, e-cigarettes and vaping, opioids, medicinal cannabis, scope of practice, asylum seeker health, the NDIS, or palliative care, to name just a few.

I could probably manage a few words about the My Health Record, too. No doubt there will be questions about that.

But I have to talk to you about prevention, if only briefly.

The burden of chronic disease in Australia is significant.

Chronic disease is responsible for around 83 per cent of premature deaths and 66 per cent of the burden of disease.

Chronic disease has a significant impact on the health system, but the reality is that most of these conditions can be prevented.

It simply makes enormous sense to invest in prevention.

Taxes collected from tobacco and alcohol excise generate around $16 billion each year for the Government.

In return, total Government spending on prevention is around $2 billion a year, which equates to about $89 per person.

This amounts to a measly 1.34 per cent of all health spending. This is considerably less than comparable countries such as Canada, the United Kingdom, and New Zealand.

If we are to reduce the impact of chronic disease in Australia, all our governments must invest more in prevention.

Tackling obesity is a priority.

Doctors are well placed to identify and support patients who are overweight or obese. Two thirds of adults are either overweight or obese.

The evidence shows that advice to lose weight given by a doctor increases the motivation to lose weight. It also increases engagement in weight loss behaviours.

But the support and advice from doctors can only achieve so much.

Population level measures are needed. We need to see action on a sugar tax, banning junk food advertising to kids, and improving urban planning to help get people moving and active.

Governments have the tools to implement these measures. A sugar tax would be a good start.

In closing, I know the challenges ahead for the health system.

I will dedicate my Presidency to improving health policy so that we have a system that delivers the best possible care to our patients.

The AMA will be a very strong and loud advocate.

There is nothing like a Federal election to help our political leaders share the public’s interest in good health policy.

The election will happen within twelve months, possibly this year.

Along with the members of the National Press Club, the AMA will be watching the political events of this weekend and the coming months with very close interest.

NACCHO #NAIDOCWEEK #BecauseofherWeCan #WeCan18 @RecAustralia Interview with NACCHO CEO Pat Turner “A reconciled nation will be when Aboriginal and Torres Strait Islander peoples have self-determination over their own lives without the constraints of poverty and the burden of disease “

“ A reconciled nation will be when Aboriginal and Torres Strait Islander peoples have self-determination over their own lives without the constraints of poverty and the burden of disease. We will be in charge of our own affairs and in control over decisions that impact on us.

Our past will be fully acknowledged and our collective future celebrated without reservation. There will be no more debates over our shared history and Aboriginal and Torres Strait Islander peoples’ land ownership.

Racism will not be a barrier to Aboriginal and Torres Strait Islander people accessing education, employment and health services.

There will be complete acceptance of our unique cultural heritage and identities by all Australians enabling our languages, our connection to land and our cultural practices to flourish without restraint and be incorporated in all aspects of our nationhood “

Pat Turner AM NACCHO CEO interview with Reconciliation Australia when asked  : What does a reconciled Australia look like to you?

“They’ve allowed us to retain our identity”

NACCHO Aboriginal Health Australia CEO Pat Turner tells National Rural Health Alliance  Di Martin about the importance of Aboriginal grandmothers guarding language and culture #BecauseOfHerWecan

VIEW HERE

Background Pat Turner AM

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

After her father’s death in an accident at work, Ms Turner’s family experienced extreme financial hardship. Her mother’s courage and leadership in the face of such difficult circumstances was a constant inspiration.

Ms Turner joined the Australian Public Service in the early 1970s and joined the senior executive ranks by the mid-1980s. She worked in a range of prominent roles, including as Deputy Secretary in the Department of the Prime Minister and Cabinet during 1991-92, where she had oversight of the establishment of the Council for Aboriginal Reconciliation. In 1994-98, Ms Turner was the CEO of the Aboriginal and Torres Strait Islander Commission, making her the most senior Indigenous government official in the country.

Over the years, Ms Turner became more committed to the politics of self-determination. At a professional level, this meant being a firm supporter of community-based service delivery of health and welfare programs for Aboriginal people.

Today, Ms Turner is the CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO). NACCHO is the peak body representing 144 Aboriginal community-controlled health services across the country on Aboriginal health and wellbeing issues.

Interview continued: What or who got you involved in reconciliation? 

I first started thinking about reconciliation and the place of Aboriginal people in Australia after attending the graduation ceremony of Uncle Charlie Perkins from Sydney University with Nanna Hetty Perkins. I was thirteen at the time, and listening to Charlie speak, I started to understand the importance of education if I wanted to make a difference.

After joining the Australian Public Service and moving from Alice Springs to Canberra, I was later appointed Deputy Secretary, Department of Prime Minister and Cabinet. It was here I had a specific role in working for the Government on the legislation and establishment of the Council of Aboriginal Reconciliation. I was the inaugural National Secretary to the Council.

After returning to Alice Springs in 2006 I held the position of CEO of National Indigenous Television where I supported the celebration of Indigenous culture and helped challenge perceptions and fears of many non-Indigenous Australians about Aboriginal and Torres Strait Islander peoples that are a continuing barrier to reconciliation.

What do you see as the biggest challenges to national reconciliation?

Our biggest challenges are twofold:

Firstly, making both Federal and State Governments truly accountable to eliminate poverty and disadvantage endured by our people.

Secondly, acceptance and respect by all Australians of our unique cultural heritage and identities, our relationship with land, our languages and our cultural practices, so that those areas and the essence of our beings are incorporated into all aspects of Australian life and government efforts to eliminate our disadvantage.

NACCHO Aboriginal Health #ACCHO #Becauseofherwecan #NAIDOCWEEK Job Opportunities Inc @VACCHO_org #NT Deputy CEO @DanilaDilba @MiwatjHealth @CAACongress #QLD @ATSICHSBris @DeadlyChoices @IUIH_ @Apunipima #VIC MDAS Mildura @NATSIHWA #Aboriginal Health Workers @IAHA_National Allied Health @CATSINaM #Nursing

This weeks #ACCHO #Jobalerts

Please note  : Before completing a job application please check with the ACCHO that the job is still open

This weeks #ACCHO #Jobalerts

Please note  : Before completing a job application please check with the ACCHO that the job is still open

Job of the Week-  Permanent General Practitioner – Gladstone

Description:

Gladstone on the Central Queensland Coast.

Gladstone sits at the start of the Great Barrier Reef, and our beautiful Harbour is surrounded by a multitude of easily accessible islands, for camping, fishing or resort style. Gladstone incorporates the seaside towns of Boyne Island and Tannum Sands, as well as Calliope. Gladstone is easy driving distance to Rockhampton, one hour to the north, or southeast to historic Bundaberg, Agnes Waters and the town of 1770 is a two hour drive away.

The position is within a group Practice for a full time General Practitioner at the local Aboriginal and Islander Community Controlled Health Service. The practice is in the central business district of the town, in a new, purpose built facility. It is a bulk billing practice with online claiming. The role is fully supported by a an experienced, multidisciplinary health team consisting of a Clinical Practice Manager, Registered Nurses, Aboriginal Health Workers and Medical Receptionists.

The Practice is further supported by visiting allied health professionals – podiatry, exercise physiology, diabetic educator and visiting specialists in mental health, endocrinology, paediatrics and cardiology. The health service provides comprehensive primary health care services, with targeted programs for Aboriginal and Torres Strait Islander health, preventative health, chronic disease management, maternal and child health, tobacco cessation, aged care and healthy lifestyles. There is a desire to open for a half day Saturday.

There are no scheduled out of hour’s requirements. Attendance at community events may be required on an occasional weekend. This position is 40 hours per week, Monday to Friday. No on call requirements.

Attractive salaried remuneration package with salary sacrifice, four weeks annual leave and one weeks professional development paid leave per year. Accommodation paid for 6 – 12 months in a fully furnished house/apartment – negotiable on longevity of placement.

There is a large range of both public and private schools for primary and secondary schooling, a campus of Central Qld University/CQ Tafe offering a wide variety of higher education as well as a dedicated Technical College at Gladstone State High School.

The area offers plenty of sporting and recreational activities and opportunities, and has a dedicated entertainment and restaurant precinct. With parks, playgrounds, sporting venues, islands, beaches and beautiful weather, this town offers you everything.

Requirements of the position:

  • Current and unconditional registration with AHPRA
  • Fellowship with RACGP or ACRRM
  • Ability to pass a federal police check

If you are an enthusiastic General Practitioner who would like to make a real difference in people’s lives, would like to be part of an experienced, supportive team of health care providers, this Medical Health Service is for you.

Job ID 1777

Following successful placement eligible candidates may be entitled to receive support and financial assistance through Health Workforce Queensland’s comprehensive workforce attraction and retention incentives.

Contact: 07 3105 7800

APPLY HERE

QAIHC Sexual Health Coordinator

QAIHC is a non-partisan peak organisation representing 28 Aboriginal and Islander Community Controlled Health Organisations (AICCHOs) across Queensland at both state and national level. Our members deliver comprehensive and culturally appropriate, world class primary health care services to their communities.

Role Overview

  • Based in the QAIHC Cairns office
  • Salary $82,500 + superannuation + attractive health promotion charity salary packaging
  • Temporary role contracted till 31st December 2019

The Sexual Health Coordinator Role is a project-based role that is being funded by Queensland Health under their Making Tracks Indigenous Investment Strategy. As part of this project, the Sexual Health Coordinator would assist with the coordination of sexual health service delivery across AICCHO’s within North Queensland and provide support and resources in developing and delivering their Sexual Health programs at the local level.

The Sexual Health Coordinator will be a central role in a project designed to:

  • Implement a coordinated response to ensure the reduction of STIs among Aboriginal and Torres Strait Islander people in North Queensland.
  • Improve the knowledge and awareness of STIs and protective behaviours among Aboriginal and Torres Strait Islander people in North Queensland particularly those under 30 years of age, through the delivery of evidence based, culturally appropriate sexual health promotion.
  • Improve access to and delivery of culturally secure STI services, including best practice STI testing and management.
  • Improve the knowledge and skills of the workforce to provide culturally secure services and appropriate models of care for delivery of STI services to Aboriginal and Torres Strait Islander people.
  • Establish data collection and surveillance systems to enable the effective review of progress and improvement towards achieving the goals of the action plan.

Pre-requisite skills & experience

    • High level knowledge of sexual health issues, treatment and prevention
    • Qualifications in health promotion, public health, social science (with a health promotion major), health education or related field or relevant experience.
    • Ability to build relationships and engage with a broad range of stakeholders.
    • High level communication, collaboration and interpersonal skills.
    • Understanding of the Aboriginal and Torres Strait Islander Community Controlled Health Organisations and the issues facing them.
    • Ability to work with Aboriginal and Torres Strait Islander communities and their leaders, respecting traditional culture, values and ways of doing business.
    • A current drivers licence
  • Aboriginal and Torres Strait Islander people are strongly encouraged to apply for this position

To apply, obtain an application pack or any query, please email – applications@qaihc.com.au.

Please apply only via this method.

Applications are required by midnight on Sunday 29th July 2018

Clinical Trainer – Aboriginal Health Primary Healthcare Practice

VICTORIAN ABORIGINAL COMMUNITY CONTROLLED HEALTH ORGANISATION

VACCHO is Victoria’s peak representative Aboriginal health body 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.

Our Education and Training Unit (ETU) is a Registered Training Organisation (RTO) and VACCHO strives to operate as a dynamic and responsive provider of vocational education and training to the Aboriginal Community Controlled Health sector.

We are looking for someone to deliver training and assess competency against the Aboriginal Health Care qualifications from AQF level II to Diploma. This is a fantastic opportunity for someone passionate about health to educate the next generations of practitioners and assist in improving community health, well-being and contributing to promoting healthier lifestyles.

Aboriginal and/or Torres Strait Islander people are strongly encouraged to apply, but also suitable for someone with relevant experience working in community.

You will need:

  • Certificate IV in Training and Assessment (although we can assist in obtaining this for the right candidate)
  • Qualifications in health or primary health care related fields to a minimum of ACF level V
  • Clinical experience or practice in Aboriginal health or non-Aboriginal health, acute, primary or community health settings
  • Current registration with Australian Health Practitioner Regulation Agency (AHPRA).

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 Helen Grose on 9411 9411. Applications close on Tuesday 24 July.

DYHSAC is currently seeking suitably experienced Governance Support Officer

About the Organisation

The name Derbarl Yerrigan is the Wadjuk Noongar name for the Swan River. Derbarl Yerrigan Health Service Aboriginal Corporation (DYHSAC) has a proud history of providing Aboriginal health services within the Perth metropolitan area and in 1974 was the first Aboriginal Community Controlled Health Service to be established in Australia. DYHSAC has now grown to have four successful, busy clinics across the Perth metro area, delivering comprehensive healthcare and specialised programs along with an accommodation centre for clients requiring medical treatment away from home or Country. Our mission is to provide high quality, holistic and culturally secure health services for Aboriginal and Torres Strait Islander people and communities in the Perth metropolitan region.

About the Opportunity

DYHSAC is currently seeking suitably experienced Governance Support Officer to join our team on a 12 months Fixed term Full time contract . Reporting to the Chief Executive Officer, the Governance Support Officer is responsible for providing administrative support to the CEO, Board Secretariat and Executive Officer as a crucial part of the Office of the CEO.

Please note: Aboriginal and/or Torres Strait Islander people are highly encouraged to apply for this position.

Primary responsibilities include but are not limited to:

  • Provide administrative support to the Board Secretariat in the conduct of DYHSAC Board and Sub-committee meetings and assist with the implementation and follow up of Board and Sub-Committee resolutions, recommendations and actions.
  • Accurately maintain governance and Board information including Board decision and information papers, registers, policies, procedures and associated documents including those required under the Corporations (Aboriginal and Torres Strait Islander) Act 2006 (CATSI Act).
  • Contribute to the successful operation of the Office of the CEO through the provision of high quality support services.
  • Attend and take minutes of other internal meetings.

 

About the Successful Person

You will have:

  • Demonstrated understanding of the unique issues affecting and impacting on the health and wellbeing of Aboriginal people.
  • Highly developed communication skills, including an ability to communicate effectively and sensitively with Aboriginal people.
  • Demonstrated ability to manage and maintain strict confidentiality at all times.
  • High level verbal and written communication skills with strong attention to detail.
  • Demonstrated ability to use computers and related software packages, specifically MS Word, Outlook, Excel and Power Point.
  • Ability to take minutes in a formal meeting environment.
  • Ability to work with minimum supervision to meet deadlines and daily work commitments.
  • Ability to undertake basic research and prepare draft correspondence, reports and written documentation.
  • It is an essential requirement for this position to undertake a National Police Check.

About the Benefits

  • Competitive salary + superannuation + salary sacrificing.

All applications are to be submitted via the below link only. Email and hard copy applications will not be accepted.

Closing date: Friday 20 July 2018

ONLY short-listed applicants will be contacted. Interviews may commence prior to the advertisement closing.

Please note that the Derbarl Yerrigan Health Service Aboriginal Corporation is an equal opportunity institution, providing educational and employment opportunities without regard to race, colour, gender, age, or disability.

Community Support Officer MAMU HEALTH SERVICE LIMITED

Mamu Health Service Limited is an Aboriginal community controlled health service providing comprehensive primary health care services to the Aboriginal and Torres Strait Islander communities in Innisfail and surrounding districts. We are recruiting the following position:-

 

Community Support Services Manager – Providing leadership within the Community Support Services programs and working collaboratively with Senior Management Team. Minimum qualification – Diploma level or higher and previous Management in Counselling/Drug and Alcohol

All applicants must be willing to undertake an AFP Criminal History Check, and a Blue Card with Commission for Children and Young People and Child Guardian.

To apply for this vacancy, a full application package can be obtained from our website on www.mamuhsl.org.au, or please don’t hesitate to contact Julie Browne on 07 4061 9988 or jbrowne@mamuhsl.org.au to register your interest.

Please submit your resume and written responses addressing the Knowledge, Skills and Personal Attributes outlined in the Position Description to:

The Chief Executive Officer

Mamu Health Service Limited

PO Box 1537

INNISFAIL Q 4860

Applications close at 5.00 pm on Friday 20th July 2018

It is a genuine occupational requirement that that the position be filled by an Aboriginal or Torres Strait Islander person as permitted by Section 25, 105 & 106 Queensland Anti-Discrimination (1991) Act.

Deputy CEO Danila Dilba ACCHO Darwin Closing 15 June

About the Organisation

Danila Dilba Health Service is an Aboriginal community-controlled organisation providing culturally-appropriate, comprehensive primary health care and community services to Biluru (Aboriginal and Torres Strait Islander) people in the Yilli Rreung (greater Darwin) region of the Northern Territory.

The mission of DDHS is to improve the physical, mental, spiritual, cultural and social wellbeing of its clients through innovative comprehensive primary health care programs that are based on the principles of equity, access, empowerment, community self-determination and inter-sectoral collaboration.

About the Opportunity

Danila Dilba now has an exciting leadership opportunity for a full-time Deputy CEO to join their team in Darwin.

Working closely with the CEO, this role will see you responsible for providing strong internal leadership and day to day management to Corporate Services, enabling the organisation to achieve its strategic and operational goals. You will also ensure the effective communication of the organisation’s vision and strategies.

Some key duties will include (but will not be limited to):

  • Leading an advocacy agenda to influence decision makers on policy issues related to Aboriginal health and wellbeing;
  • Assisting the Board and CEO in implementing the strategic and business plans including engagement of stakeholders and delivering organisational objectives;
  • Providing line management to the HR, Finance, Audit and Compliance, Facilities Management, and ICT functions of the business;
  • Leading growth and sustainability through development and implementation of a Business Development Strategy targeting emerging opportunities, innovations and potential income streams;
  • Developing and strengthening strategic stakeholder relationships and partnerships; and
  • Taking responsibility for service quality and continuous improvement.

This is an identified Aboriginal position; exemption is claimed under Section 8 (1) of the Racial Discrimination Act 1975.

About the Benefits

This is a fantastic opportunity to take on a new leadership challenge within a fast-paced and expanding organisation!

Danila Dilba Health Service offers a stable, safe and supportive work environment with plenty of challenges and variety as you interact with people from a wide range of cultural and social backgrounds.

Danila Dilba Health Service is an organisation that truly values its team, and is committed to improving employee knowledge, skills and experience. Staff development programs are both encouraged and provided by the organisation.

You will receive a competitive remuneration (negotiable with experience and qualifications)PLUS super, phone, laptop, salary sacrificing options and a range of benefits including:

  • 6 weeks annual leave per year (with the opportunity to cash-out up to two weeks annual leave in any financial year);
  • Relocation assistance (negotiable) when relocating to Darwin;
  • Fully maintained vehicle for private use;
  • Up to 2 weeks paid study leave per annum;
  • Professional development and training provided; and
  • Entertainment benefits (up to $2,550).

Most importantly, you’ll be joining a team of passionate and dedicated individuals who contribute to the positive impact made on the local community. Here you will be able to voice your thoughts and opinions, as the organisation embraces opportunity and encourages its people to initiate action and follow through on the outcome.

How to Apply

Take on a new challenge in your executive career, with a progressive Aboriginal community-controlled organisation – Apply Now!

 

Mallee District Aboriginal Services Victoria

MDAS has opportunities for highly-motivated and organised individuals looking to work as part of a professional team committed to improving Aboriginal health and wellbeing.

Aboriginal and Torres Strait Islander People are strongly encouraged to apply for all positions.

MDAS is committed to protecting children and young people from harm.  We require all applicants who are to work with children and young people to undergo an extensive screening process prior to appointment, a process that includes, but is not limited to, comprehensive reference checks, an identity check, a ‘working with children’ check and/or a ‘national criminal history record’ check.

MDAS is proud to be a LGBTI-friendly workplace.

This page is updated weekly.

This page is updated weekly.

 

How to submit a Indigenous Health #jobalert ? 

NACCHO Affiliate , Member , Government Department or stakeholders

If you have a job vacancy in Indigenous Health 

Email to Colin Cowell NACCHO Media

Tuesday by 4.30 pm for publication each Wednesday

There are 3 JOBS AT Apunipima Cairns and Cape York

The links to  job vacancies are on website

 

 

As part of our commitment to providing the Aboriginal and Torres Strait Islander community of Brisbane with a comprehensive range of primary health care, youth, child safety, mental health, dental and aged care services, we employ approximately 150 people across our locations at Woolloongabba, Woodridge, Northgate, Acacia Ridge, Browns Plains, Eagleby and East Brisbane.

The roles at ATSICHS are diverse and include, but are not limited to the following:

  • Aboriginal Health Workers
  • Registered Nurses
  • Transport Drivers
  • Medical Receptionists
  • Administrative and Management roles
  • Medical professionals
  • Dentists and Dental Assistants
  • Allied Health Staff
  • Support Workers

Current vacancies

NT Jobs of the week 40 positions in the NT Alice Spring ,Darwin East Arnhem Land and Katherine

There are 13 JOBS at Congress Alice Springs including

 

 

 

More info and apply HERE

More info apply HERE

There are 17 JOBS at Miwatj Health Arnhem Land

 

More info and apply HERE

There are 2 JOBS at Wurli Katherine

More info and apply HERE

 

NACCHO Aboriginal Children’s Health : Read @keenan_mundine’s powerful speech to @UNHumanRights Council calling for Australian Governments to end injustice of Indigenous kids in prison #RaisetheAge Plus #IndigenousX 8 things the government can do right now to end this injustice “

“I have spent more than half of my life behind bars, and I want to make sure this will not be the same future for my children.

Right now, children as young as ten are still being locked away in prisons across Australia.

This year alone, around 600 children under the age of 14 were taken from their families and imprisoned. This injustice must end.

”In joining this Council, the Australian Government promised to uphold human rights and champion Indigenous peoples’ rights. For as long as Indigenous children are 25 times more likely to be sent to prison than non-Indigenous children, these will be hollow promises “

Indigenous advocate, Keenan Mundine, a former youth prisoner and principal consultant of Inside Out Aboriginal Justice Consultancy, has travelled to Geneva to address the UN Human Rights Council about the Turnbull Government’s failure to stop ten year old children being sent to prison.

 ” The justice system is stacked against Aboriginal and Torres Strait Islander kids at every stage, from police through to the courts. It is undeniable that racism is a factor, whether it’s institutional or direct.

It is also clear that invasion and past policies of dispossession of land, stolen children and discrimination has led to this shocking statistic, with a direct link proven between contact with the justice system and the entrenched poverty, homelessness, child removal, lack of education, family violence, substance abuse, disability, mental and other health issues.

But there are solutions. Here are 8 things the government can do right now to end this injustice “

Cheryl Axleby Chair of NATSILS From Indigenous X

Two years after the ABC’s Four Corners program exposed horrific abuse of children in the Don Dale prison, pressure is mounting on Australian state and territory governments to raise the age of criminal responsibility from 10 to 14 years.

Mr Mundine told the Council – the world’s peak human rights body of which Australia is now a member – that the Turnbull Government must stop ignoring human rights abuses at home.

“I have travelled from across the world to address this Council because I want my sons to grow up in a country that treats them fairly. This one simple change to our laws, will make a very big difference. Indigenous children in Australia deserve what I was denied – equality and freedom,” said Mr Mundine.

The Turnbull Government called for the Northern Territory Royal Commission into the horrors of Don Dale in 2016, but has failed to deliver a key recommendation for reform – raising the age at which children can be charged, hauled before the courts and sent to prison.

Australia has one of the lowest ages of criminal responsibility in the democratic world. The average age in Europe is 14 years.

The National Aboriginal and Torres Strait Islander Legal Services, the Human Rights Law Centre, Amnesty International and other medical, Indigenous and human rights organisations have been pushing all Australian governments to commit to raising the age of criminal responsibility.

Cheryl Axleby, Co-Chair of the National Aboriginal and Torres Strait Islander Legal Services, said in addition to raising the age to 14 years, more support was needed for Indigenous-led programs.

“Australian youth prisons are institutional racism in action. Criminalising the behaviour of young, vulnerable children – who are mostly Aboriginal or Torres Strait Islander – creates further disadvantage and traps children in the criminal justice system. It’s time to raise the age to 14 and fund wrap-around Indigenous-led supports that keep kids strong in culture and community,” said Ms Axleby.

When seeking election to the Human Rights Council, the Turnbull Government pledged to put Indigenous rights front and centre and progress the realisation of human rights through the implementation of UN recommendations and resolutions.

In the last five years, the UN has demanded Australia uphold children’s rights and raise the age of criminal responsibility on numerous occasions.

Ruth Barson, a Director of Legal Advocacy at the Human Rights Law Centre, said children should be in classrooms not courtrooms.

“No child should be strip searched, hand cuffed, or locked in a prison cell. The Turnbull Government cannot defend human rights on the world stage, while allowing primary school aged children to be sent to prisons at home. Raising the age is a simple reform that would make a world of difference. What we need is for our governments to show some leadership,” said Ms Barson.

Across Australia, Aboriginal and Torres Strait Islander children make up over 50% of the children locked away in youth prisons. Western Australia, the Northern Territory and South Australia have the highest Aboriginal and Torres Strait Islander youth imprisonment rates in the country.

Belinda Lowe, Indigenous Rights Campaigner at Amnesty International, said the criminal justice system is failing kids and it’s failing communities.

“Children thrive best with their families and in their communities. Let’s instead focus on prevention not detention. Let’s raise the age that kids can be put behind bars, and provide early support to children and their families who are facing difficulties in their lives, so children don’t offend in the first place,” said Ms Lowe.

This session of the Human Rights Council session will run until 6 July.

The Human Rights Law Centre will attend every day of the Council session and provide regular updates on the Australian Government’s actions.

Read: Keenan Mundine’s statement

Watch: Keenan Mundine’s statement

Plus Indigenous X post

Cheryl Axleby Chair of NATSILS From Indigenous X

Every single child in prison in the Northern Territory is Indigenous.

This is systemic racism in action.

This damning fact is causing outrage across Australia, two years after we saw the torture and abuse coming out of Don Dale Youth Detention Centre in the nightmarish Four Corners Report. A Royal Commission followed, with hundreds of recommendations to end the over-representation of Aboriginal and Torres Strait Islander kids in prison, yet here we are.

But the Northern Territory is not alone; Aboriginal and Torres Strait Islander kids are over-imprisoned in every state and territory in Australia, and are locked up at a rate 25 times higher than that of other youth.

We know the reasons why, and it’s not because there are no “bad” non-Indigenous children in the Northern Territory.

The justice system is stacked against Aboriginal and Torres Strait Islander kids at every stage, from police through to the courts. It is undeniable that racism is a factor, whether it’s institutional or direct.

It is also clear that invasion and past policies of dispossession of land, stolen children and discrimination has led to this shocking statistic, with a direct link proven between contact with the justice system and the entrenched poverty, homelessness, child removal, lack of education, family violence, substance abuse, disability, mental and other health issues.

But there are solutions. Here are 8 things the government can do right now to end this injustice:

1. Support children, families and communities to stay strong and together

No child belongs in prison.

Prison doesn’t “work” – many kids come out damaged and more likely to go back in. Children need love and support and the care of their communities, so they can be brought up strong in their identity and connection with country.

There is a large cross-over between experiencing child removal, disability, family violence, mental health issues, and the justice system. But families need culturally appropriate wrap-around supports in place to stay strong and together. Policies need to change to stop forced child removals, reduce family violence and help heal the ongoing trauma of the Stolen Generations.

2. Raise the Age of Criminal Responsibility

Australia is far behind the rest of the world in locking up very young children – the global median age of criminal responsibility is 14, but the Australia-wide age is 10.

Science shows these young children are not yet able to understand the long-term consequences of their actions, or to control their impulses. It is often the most vulnerable and disadvantaged children who come to the attention of the justice system at a young age.

Once in the system, younger children are more likely to be return to prison. Aboriginal and Torres Strait Islander kids are hugely over-represented in this age bracket, so raising the age will help to end their over-representation in the system.

The NT Royal Commission recommended for government to raise the age. The UN has repeatedly criticised Australia for locking up kids as young as 10, which is below minimum international standards and recommended age, and a breach of their rights under the Convention on the Rights of the Child. It’s time for all Australian governments to #RaisetheAge to 14.

3. Get children who are not sentenced out of prison

Most kids in prison are not sentenced and may not even have had their trial yet. This goes against international standards and can be incredibly damaging for kids, leading to further contact with the justice system.

This can be due to police and courts not granting children bail, as well as delays in court processes and legal representation. Compliance with and over-policing of bail conditions is a huge issue for Aboriginal children, or not having a “suitable” address to be bailed to, or a guardian available to come to court.

This can be fixed by having better family supports in place so bail isn’t denied due to welfare reasons, amending unfair bail legislation, increased funding and access to Aboriginal and Torres Strait Islander Legal Services, bail support programs, having custody notification services in place and investing in community alternatives to prison.

4. Adequately fund Aboriginal and Torres Strait Islander community-controlled legal and other support services

Aboriginal and Torres Strait Islander Legal Services and Family Violence Legal Prevention Services are the preferred and often only option for legal representation for Aboriginal and Torres Strait Islander people.

These services are community-controlled and culturally safe, and understand the systemic issues that stack the system against Indigenous people. However, these are desperately under-resourced to meet legal need, and despite the reversal of further fundings cuts in 2017, budget papers show that Aboriginal and Torres Strait Islander Legal Services will face a further $5m cut from 2020.

It’s not just legal services that struggle for funding, but most Aboriginal Community-Controlled Organisations across health, disability, education, housing and youth justice diversion.

In the Northern Territory, Bushmob had to end its bush camp program – where the government could have been sending kids to learn life skills and reconnect with culture, rather than to prison.

Another example is Balit Ngulu – the only Aboriginal youth specific legal service in Australia – is facing closure this year due to lack of funding. Our communities have the answers but they need Government support.

5. End abusive practices in prisons

Whether it’s Don Dale, Cleveland, Banksia Hill, Bimberi, Parkville, Cobham – children in prisons around Australia are subject to solitary confinement, strip searches, assaults, spit hoods, hog-tying, sedating, deprivation of food, hygiene, exercise and education. These abuses are an indictment on Australia and they are continuing to happen right around the country. This year it was revealed that one young man in Banksia Hill spent over a year in isolation.

Independent oversight is needed so these human rights abuses end and perpetrators are held accountable.

6. Set targets to end the overrepresentation of Aboriginal and Torres Strait Islander children in prison

Decades have gone by without any progress on the rates of overrepresentation of Aboriginal and Torres Strait Islander kids in prison.

The Federal Government must set national justice targets on ending rates of imprisonment and violence as part of the Closing the Gap framework so it can measure, track, report and be held accountable for achieving national progress on ending the overrepresentation of Aboriginal and Torres Strait Islander children in prison.

There is currently a refresh of the targets – now is the time to add them in.

7. Improve collection and use of data

It is amazing how much we simply do not know about children being deprived of their liberty, because governments are either not tracking or refuse to be transparent about youth justice data.

Data is necessary to inform smart and effective policy choices, and to fully understand the over-representation of Aboriginal and Torres Strait Islander kids by different age groups, genders, disability, socio-economic groups, LGBTIQ+ identity and geographic locations.

8. Work through COAG to reform State and Territory laws that breach children’s rights

The Australian Government must accept that this is a national shame which demands national leadership.

The solutions are in the recommendations of the avalanche of commissions and inquiries stemming back to the Royal Commission into Aboriginal Deaths in Custody over 27 years ago.

Most recently, solutions were set out in the Northern Territory Royal Commission Report and the Australian Law Reform Commission’s ‘Pathways to Justice’ Report – neither of which have received an adequate national response.

The Australian Government can set minimum youth justice standards to make sure that all laws are compliant with human rights and do not disproportionately affect Indigenous kids.

NATSILS, as part of Change The Record Coalition, called for these changes last year in response to the NT Royal Commission as part of a National Plan of Action. The Australian Government must hear our voices and adopt our recommendations so that our children are no longer abused in prison, and instead are supported to thrive in their communities.

NACCHO partners with @Mayi_Kuwayu and key Indigenous peak bodies to survey 200,000 Aboriginal and Torres Strait Islander people in national Wellbeing study

“The Aboriginal-led and governed study will be larger than any previous study of Aboriginal and Torres Strait Islander adults.

It aims to provide information for communities, services and policy makers to improve Aboriginal and Torres Strait Islander health and wellbeing.”

Dr Mark Wenitong, study co-investigator from the Apunipima Cape York Health Council.

In an Australian first, the Australian National University will partner with key Aboriginal and Torres Strait Islander peak bodies to conduct a national study of Aboriginal and Torres Strait Islander wellbeing.

The study name, ‘Mayi Kuwayu’ means ‘to follow Aboriginal people over time’ in Ngiyampaa language, the family language of the study’s director, Associate Professor Ray Lovett from the National Centre for Epidemiology and Population Health at ANU.

Download Mayi Kuwayu Study_Protocol

“The survey includes questions that people have told us matter to them as Aboriginal and Torres Strait Islander people.

Those things include connection to country, cultural beliefs and knowledge, language, family, kinship and community, cultural expression and continuity and self-determination and leadership, along with health”, Associate Professor Ray Lovett said.

 

The study will be rolled out in the second half of 2018 and will provide much needed evidence on Aboriginal and Torres Strait Islander culture and its impact on health and wellbeing.

The team has developed the survey questions with Aboriginal and Torres Strait Islander people from across the country over the last three years.

An Aboriginal and Torres Strait Islander governance committee will oversee the study, and ensure that it adheres to principles of Indigenous data sovereignty and governance.

All Aboriginal and or Torres Strait Islander people aged 16 years or older can be part of the study.

 

Potential participants can contact the team at mkstudy@anu.edu.au, at the study website www.mkstudy.com.au, or by free call on 1800 531 600.

The study received funding from the Lowitja Institute and the National Health and Medical Research Council.

A protocol paper describing the study has recently been published in the journal BMJ Open: https://bmjopen.bmj.com/content/8/6/e023861.share.

Our study partners include:

NACCHO Aboriginal Health : Download the ANAO Report : Primary Healthcare Grants under the IHAP Indigenous Australians’ Health Program : Effective high quality, comprehensive, culturally appropriate, primary healthcare services in urban, regional, rural and remote locations

” The bulk of IAHP expenditure is via grants. Since 2015, IAHP primary healthcare grants totalling approximately $1.44 billion have been awarded with 85 per cent of this funding going to Aboriginal Community Controlled Health Organisations.

The audit objective was to assess the effectiveness of the Department of Health’s design, implementation and administration of primary healthcare grants under the IAHP.”

Download the report HERE

ANAO Report PHC Grants Under IAHP – DoH

Summary and recommendations

Background

1. The Indigenous Australians’ Health Program (IAHP) was established in 2014 through the consolidation of four existing Indigenous health funding streams administered by the Department of Health (the department).

The IAHP aims to provide Aboriginal and Torres Strait Islander people with access to effective high quality, comprehensive, culturally appropriate, primary healthcare services in urban, regional, rural and remote locations across Australia.1

Primary healthcare services are usually the ‘entry point’ for persons into the broader health system and can be contrasted to services provided through hospitals or when people are referred to specialists.

The IAHP access to effective high quality, comprehensive, culturally appropriate, primary healthcare services in urban, regional, rural and remote locations

2. The bulk of IAHP expenditure is via grants. Since 2015, IAHP primary healthcare grants totalling approximately $1.44 billion have been awarded with 85 per cent of this funding going to Aboriginal Community Controlled Health Organisations.

3. As at March 2018, a total of 164 organisations are receiving IAHP primary healthcare grant funding. In 2016–17, IAHP-funded services provided primary healthcare services to an estimated 352,000 Indigenous Australians. This represents 54.2 per cent of the estimated total Indigenous population.

Rationale for undertaking the audit

4. The IAHP was selected for audit because it is intended to contribute towards achieving the Indigenous health-related ‘Closing the Gap’ targets regarding life expectancy and infant mortality. The program represents the Australian Government’s largest direct expenditure on Indigenous primary healthcare.

Audit objective and criteria

5. The audit objective was to assess the effectiveness of the Department of Health’s design, implementation and administration of primary healthcare grants under the IAHP.

6. To form a conclusion against this objective, the ANAO adopted the following high-level criteria:

  • Did the department design the IAHP primary healthcare components consistent with the Government’s objectives in establishing the IAHP?
  • Has implementation of the IAHP primary healthcare components been supported through effective coordination with key Government and non-Government stakeholders?
  • Has the department’s approach to assessing primary healthcare funding applications and negotiating funding agreements been consistent with the Commonwealth Grant Rules and Guidelines?
  • Has the department implemented a performance framework that supports effective management of individual primary healthcare grants and enables ongoing assessment of program performance and progress towards outcomes?

Conclusion

7. The department’s design and implementation of the primary healthcare component of the IAHP was partially effective as it has not yet achieved all of the Australian Government’s objectives in establishing the program. The department has not implemented the planned funding allocation model and there are shortcomings in performance monitoring and reporting arrangements. However, the department has consolidated the program, supported it through coordination and information-sharing activities and continued grant funding.

8. The Government’s original objectives in establishing the IAHP are due to be fully achieved in 2019–20, four years later than originally planned. The majority of IAHP primary healthcare grant funding to date has been allocated in essentially the same manner as previous arrangements rather than the originally intended needs based model. Program implementation has been supported through appropriately aligning funding streams to intended outcomes and coordination and information-sharing with relevant stakeholders.

9. Most aspects of the department’s assessment of IAHP primary healthcare funding applications and negotiation of funding agreements were consistent with the Commonwealth Grants Rules and Guidelines (CGRGs). The exception to this was the poor assessment of value for money regarding the majority of grant funds. The grant funding agreements were fit for purpose, but the department has not established service-related performance benchmarks for funded organisations that were provided for in most of the agreements.

10. The department has not developed a performance framework for the Indigenous Australians’ Health Program. Extensive public reporting on Indigenous health provides a high level of transparency on the extent to which the Australian Government’s objectives in Indigenous health are being achieved. However, this reporting includes organisations not funded under the IAHP and, as such, it is not specific enough to measure the extent to which IAHP funded services are contributing to achieving program outcomes.

11. In managing IAHP primary healthcare grants, the department has not used the available provisions in the funding agreements to set quantitative benchmarks for grant recipients. This limits its ability to effectively use available performance data for monitoring and continuous quality improvement. Systems are in place to collect performance data, but systems for collecting quantitative performance data have not been effective. Issues with performance data collection limit its usefulness for longitudinal analysis.

Supporting findings

Program design and implementation

12. The design of the IAHP was consistent with the Government’s objectives of achieving budget savings and reducing administrative complexity through consolidation of existing grant programs. The objective of allocating primary healthcare grant funding on a more transparent needs basis will not be achieved until 2019–20, four years behind the timetable agreed by Government in establishing the IAHP.

13. Three outcomes were established for the program and set out in published IAHP grant guidelines. One of the outcomes does not clearly identify the desired end result. IAHP funding, including the primary healthcare component, are appropriately aligned to the outcomes.

14. The department uses a wide variety of forums and networks to share information and seek feedback about its current and planned Indigenous health activities, including the IAHP. Some coordination and joint planning activities relating to primary healthcare have also been undertaken through the Aboriginal Health Partnership Forums.

Awarding Grants

15. Ninety eight per cent of IAHP primary healthcare grant funding has been provided through non-competitive processes. The department obtained Ministerial agreement for these processes.

16. Most aspects of the assessment of funding proposals were undertaken consistently with the CGRGs and IAHP guidelines. The exception was assessment of value for money. Assessment records for some funding rounds, including the $1.23 billion ‘bulk’ round undertaken in 2015, lacked evidence of substantive analysis of value of money considerations. The department was also unable to provide evidence it had undertaken a value for money assessment regarding the $114 million grant to the Northern Territory Government. In virtually all cases, risk assessments formed part of the assessment process.

17. Departmental delegates were provided with sufficient advice to enable them to discharge their obligations under the Public Governance, Performance and Accountability Act 2014 in approving IAHP grant proposals. The timeliness of the advice varied, but was provided relatively quickly for the larger 2015 funding rounds.

18. Funding agreements are fit for purpose, using a grant head agreement and an IAHP-specific schedule. The specific services to be provided by each funded organisation are set out in separate Action Plans, which are appropriately referenced in the agreement schedule. The agreements with Aboriginal Community Controlled Health Organisations allow for the setting of individual performance targets, but no targets have been set. All agreements also clearly set out reporting requirements.

Monitoring and Reporting

19. The department has not established a performance framework for the primary healthcare component of the IAHP.

20. Systems are in place to collect performance data, but systems to collect quantitative performance data have not been effective. Several changes to data collection processes have resulted in an increased reporting burden on IAHP grant recipients and two six-monthly data collections being discarded or uncollected. These breaks in the data series limit its usefulness for longitudinal analysis of performance trends. The department has commenced projects to improve the quality of data, but has limited assurance over the quality of data collected before 2017 as it has not been validated.

21. The department relies on public reporting of a range of Indigenous health indicators to monitor achievement of program outcomes. The reporting includes data about services not funded under the IAHP. As such, it is not specific enough to measure the extent to which IAHP funded services are contributing to achieving program outcomes. The department was also unable to demonstrate how it used the data to inform relevant policy advice and program administration.

22. The department is not effectively using available performance data to monitor IAHP grant recipient performance and has not set quantitative national key performance indicator (nKPI) based benchmarks for grant recipients. The department’s ability to set performance expectations and assess actual performance is limited by the currency of data and variability in the content of Action Plans.

Recommendations

Recommendation no.1

Paragraph 3.21

The Department of Health improve the quality of IAHP primary healthcare value for money assessments, including ensuring their consistency with the new funding allocation model.

Department of Health response: Agreed.

Recommendation no.2

Paragraph 4.10

The Department of Health assess the risks involved in IAHP-funded healthcare services using various clinical information software systems to support the direct online service reporting and national key performance indicator reporting process, and appropriately mitigate any significant identified risks.

Department of Health response: Agreed.

Recommendation no.3

Paragraph 4.30

The Department of Health ensure that new IAHP funding agreements for primary healthcare services include measurable performance targets that are aligned with program outcomes and that it monitors grant recipient performance against these targets.

Department of Health response: Agreed.

Summary of entity response

23. The Department of Health (‘the Department’) notes the findings of the report and agrees with the recommendations.

It is pleasing that the report finds: the program has been consolidated and supported through coordination and information sharing activities; programme implementation has appropriately aligned funding streams to intended outcomes; and the objective of reducing administrative complexity has been achieved.

Work is already underway within the Department which aligns with the report’s recommendations, and the report provides a platform to continue these efforts. In particular, the Department has introduced more robust assessment processes for primary health care grants under the Indigenous Australians’ Health Programme and has also commenced development of enhanced performance measurements of program outcomes, supported by an outcomes-focussed policy framework. The Department’s responses to the individual recommendations provide further detail.

The report identifies that the introduction of a new funding allocation model for the distribution of primary health care funding as announced in the 2014–15 Budget is yet to be completed and finds that this deferral has contributed to a partially effective implementation of the Australian Government’s objectives in establishing the programme. The Government announced in the 2018–19 Budget that the model will be implemented from 1 July 2019 and the Department will continue to work closely with Aboriginal Community Controlled Health Services to deliver this important initiative. The Department notes that this deferral occurred in the context of extensive stakeholder engagement together with significant data improvement activities designed to support a robust and well-developed funding model.

Whilst the Department is committed to continuous improvement of the administration of the Indigenous Australians’ Health Programme, the Department wishes to acknowledge and recognise the significant contribution our network of Aboriginal Community Controlled Health Services are making to improve the health of their communities under the Australian Government’s Closing the Gap agenda

1. Background

Indigenous health and government funding

1.1 In 2008, the Council of Australian Governments set targets aimed at reducing or eliminating differences in specific outcomes between Indigenous and non-Indigenous Australians. These Closing the Gap targets covered three broad areas, of which health was one. In 2013, the Australian Government released the National Aboriginal and Torres Strait Islander Health Plan 2013–23, which set out a 10 year plan for the direction of Australian Government Indigenous health policy. This was followed in 2015 by an Implementation Plan for the Health Plan. The Implementation Plan outlines the actions to be taken by the Australian Government, the Aboriginal community controlled health sector, and other key stakeholders to give effect to the Health Plan. Progress under the Implementation Plan is measured against 20 goals and 106 deliverables that were developed to complement the existing Closing the Gap targets.

1.2 While the 2018 Prime Minister’s Closing the Gap report and the 2017 Aboriginal and Torres Strait Islander Health Performance Framework report show gains have been made in some areas, Indigenous Australians continue to experience significantly poorer health outcomes than the general population.2 Life expectancy is about 10 years lower. Rates of chronic disease are higher, with some tending to occur at a younger age in Indigenous Australians compared to the general population. The overall burden of disease3 for Indigenous Australians is also 2.3 times higher. Some factors potentially impacting on health, such as smoking and obesity, are higher: the overall smoking rate is 2.7 times higher and Indigenous Australians are 1.6 times as likely to be obese as the general population. Some health interventions can have a long lead time before measurable impacts are seen across the target population—for example, up to three decades in the case of many smoking-related diseases.

1.3 The Australian and state and territory governments all fund Indigenous health. Estimated total direct funding on Indigenous health4 has increased since the setting of the Closing the Gap targets: from $4.76 billion in 2008–09 to $6.30 billion in 2015–16.5 Of this, expenditure specifically targeted at Indigenous Australians was $1.44 billion in 2015–16. The remainder is expenditure on ‘mainstream’ services used by Indigenous Australians, notably hospitals, and the cost of various Australian Government subsidies, including the Medicare Benefits Scheme and the Pharmaceutical Benefits Scheme. Indigenous-related expenditure on public and community health services6 in 2015–16 is estimated at $1.73 billion. The Australian Government contributes 59 per cent of the total 2015–16 government expenditure on the Indigenous public and community health services category.

1.4 Measured on a per-person basis, total direct health funding on Indigenous Australians in 2015–16 by all Governments in Australia is 1.83 times greater than the direct health funding on non-Indigenous Australians. Funding on the public and community health services category of Indigenous health is 3.59 times higher.

The Indigenous Australians’ Health Program

1.5 The Department of Health (the department) has had primary responsibility for Commonwealth Indigenous health policy and funding since 1995. Since that time, the department’s role has been to improve both Indigenous Australians’ access to mainstream primary healthcare and increase the capacity of the Indigenous-specific sector to provide comprehensive primary healthcare.7

1.6 In the May 2014 Budget, the Australian Government announced the establishment of the Indigenous Australians’ Health Programme (IAHP). It was formed by consolidating four existing funding streams administered by the department, which between them included around 30 discrete funding components.8 The consolidation was intended to reduce administrative complexity and enable an improved focus on basic health needs (including clinical primary healthcare) at a local level to improve health outcomes. The stated high-level objective for the IAHP is:

to provide Aboriginal and Torres Strait Islander people with access to effective high quality, comprehensive, culturally appropriate, primary health care services in urban, regional, rural and remote locations across Australia.

1.7 A new primary healthcare grant funding allocation model was also to be developed for implementation from 2015–16. As discussed in Chapter 2, development and implementation of the new allocation model has been delayed.

1.8 With the exception of ‘social and emotional wellbeing’ activities being transferred to the Department of Prime Minister and Cabinet9, the range of activities funded by the department under IAHP are broadly similar to those under the pre-IAHP arrangements and funding levels have increased. In 2013–14, funding under predecessor grant programs was $682.3 million (excluding social and emotional wellbeing activities). The budget allocation for IAHP funding in 2017–18 is $856.1 million.

1.9 The bulk of IAHP expenditure is via grants. As at March 2018, $743.5 million of 2017–18 grant funds had been expended or committed.10 The largest component is grants to provide primary healthcare services to Indigenous Australians, which account for $461.5 million (62 per cent) of total IAHP 2017–18 expended and committed grant funding.11 Other significant grant funding areas under the IAHP relate to activities intended to increase Indigenous Australians’ access to mainstream services12 ($108 million, or 15 per cent) and funding for various maternal/early childhood health and anti-smoking activities (about five per cent each).

1.10 As at March 2018, 164 organisations are receiving IAHP primary healthcare grant funding. Around 140 of these organisations are Aboriginal Community Controlled Health Organisations (ACCHOs), which collectively account for 85 per cent of total IAHP core primary healthcare grant funding in 2017–18. The remaining primary healthcare grant recipients include the Northern Territory Government, various public sector regional health bodies across several states, and a small number of private sector providers and non-government organisations.

1.11 The geographical distribution of the healthcare facilities receiving IAHP primary healthcare funding is shown in Figure 1.1.

Figure 1.1: Distribution of IAHP primary healthcare funded facilities

Source: Department of Health.

1.12 The 2017–18 primary healthcare grant funding amounts according to jurisdiction and remoteness index is shown in Table 1.1.

 

NACCHO Aboriginal Health and #MensHealthWeek 3 of 3 #OchreDay2018 News 1. @GregHuntMP announces a National Male Health Strategy to support the health of men and boys 2. @MyHealthRec Men encouraged to connect with their health with a #Myhealthrecord

During 2018 Men’s Health Week it is important to remember that in Australia, like most countries, males have poorer health outcomes on average than females.

More males die at every stage of life. Males have more accidents, are more likely to take their own lives and are more prone to lifestyle-related chronic health conditions than women and girls at the same age.

This is why I am announcing today, the beginning of a process to establish a National Male Health Strategy for the period 2020 to 2030. “

The Hon. Greg Hunt Minister for Health full press release Part 1

The AMA welcomes today’s announcement of the establishment of a 10-year National Male Health Strategy that will target the mental and physical health of men and boys.

The AMA called for a major overhaul of men’s health policy in April this year, including a new national strategy to address the different expectations, experiences, and situations facing Australian men.

Australian men are less likely to seek treatment from a general practitioner or other health professional, and are less likely to have the supports and social connections needed when they experience physical and mental health problems

We look forward to engaging with the Turnbull Government to develop initiatives to address the reasons why men are reluctant to engage with GPs, and the consequence of that reluctance, and to invest in innovative models of care than overcome these barriers “

AMA President, Dr Tony Bartone, said the AMA was pleased that the Federal Government recognised that Australian males have poorer health outcomes, on average, than Australian females. In full Part 2 below

Encouraging men to discuss their health with their doctor, pharmacist, or other healthcare specialist can be difficult.

My Health Record supports and assists men to have these conversations, enabling better connected care and, ultimately, better health outcomes,”

My Health Record gives men and the broader community the capacity to upload important health information including allergies, medical conditions and treatments, medicine details, test results and immunisations; supporting them in remembering the dates of tests, medicine names, or dosages “

Australian Digital Health Agency Chief Medical Adviser Clinical Professor Meredith Makeham said My Health Record provided many valuable benefits for men. in full Part 3 Below

NACCHO Aboriginal #MensHealthWeek and #OchreDay2018 Launch :

Download 30 years 1988 – 2018 of Aboriginal Male Health Strategies and Summit recommendations

To celebrate #MensHealthWeek NACCHO has launched its National #OchreDay2018 Mens Health Summit program and registrations

The NACCHO Ochre Day Health Summit in August provides a national forum for all Aboriginal and Torres Strait Islander male delegates, organisations and communities to learn from Aboriginal male health leaders, discuss their health concerns, exchange share ideas and examine ways of improving their own men’s health and that of their communities

The two day conference is free: To register

Part 1 Greg Hunt press release

The Australian Government will establish a decade-long National Male Health Strategy that will focus on the mental and physical health of men and boys.

During 2018 Men’s Health Week it is important to remember that in Australia, like most countries, males have poorer health outcomes on average than females.

More males die at every stage of life. Males have more accidents, are more likely to take their own lives and are more prone to lifestyle-related chronic health conditions than women and girls at the same age.

This is why I am announcing today, the beginning of a process to establish a National Male Health Strategy for the period 2020 to 2030.

Building on the 2010 National Male Health Policy, the strategy will aim to identify what is required to improve male health outcomes and provide a framework for taking action.

The strategy will be developed in consultation with key experts and stakeholders in male health, and importantly, the public will be invited to have a say through online consultation later this year.

Australian men and boys are vital to the health and happiness of their families and communities, but need to pay more attention to their own mental and physical wellbeing.

During Men’s Health Week, men are encouraged to talk about their health with someone they trust.

I encourage all men to take time this week to think about their own health and wellbeing and participate in events happening across the country.

The Turnbull Government provides funding to a number of organisations that focus on the health of men and boys including Men’s Health Information Resource Centre at Western Sydney University, Andrology Australia and the Australian Men’s Health Forum.

The National Male Health Strategy builds on and complements the National Women’s Health Strategy 2020 to 2030 I announced at the National Women’s Health Summit in February.

Part 2 AMA WELCOMES NATIONAL MALE HEALTH STRATEGY

The AMA welcomes today’s announcement of the establishment of a 10-year National Male Health Strategy that will target the mental and physical health of men and boys.

AMA President, Dr Tony Bartone, said the AMA was pleased that the Federal Government recognised that Australian males have poorer health outcomes, on average, than Australian females.

“In Australia, men have a life expectancy of approximately four years less than women, and have a higher mortality rate from most leading causes of death,” Dr Bartone said.

“Australian men are less likely to seek treatment from a general practitioner or other health professional, and are less likely to have the supports and social connections needed when they experience physical and mental health problems.

“An appropriately-funded and implemented National Male Health Strategy is needed to deliver a cohesive platform for the improvement of male health service access and men’s health outcomes.

“This does not mean taking funding away from women’s health strategies. Initiatives that address the health needs of one gender should not occur at the expense of the other.

“Men and women should be given equal opportunity to realise their potential for a healthy life.

“The AMA congratulates Health Minister, Greg Hunt, for his decision to begin the process to establish a National Male Health Strategy for the period 2020 to 2030.

“We look forward to engaging with the Turnbull Government to develop initiatives to address the reasons why men are reluctant to engage with GPs, and the consequence of that reluctance, and to invest in innovative models of care than overcome these barriers.

“Compared to women, Australian men not only see their GP less often but, when they do see a doctor, it is for shorter consultations, and typically when a condition or illness is advanced.

“Men’s Health Week is an opportune time for Australian men to do something positive for their physical or mental health – book in for a preventive health check with a trusted GP, get some exercise, have an extra alcohol-free day, or reach out to check on the wellbeing of a mate.”

The AMA Position Statement on Men’s Health 2018 is at https://ama.com.au/position-statement/mens-health-2018

Background

  • Australian men are more than twice as likely to die in a motor vehicle accident than Australian women.
  • Men have a lower five-year survival rate for all cancers than women.
  • Australian men experience approximately 75 per cent of the burden of drug-related harm.
  • More than three in four suicide deaths in Australia are men, and intentional self-harm is the leading cause of death in men under 54 years of age.
  • Men are more likely to be in full-time work and may have less time for medical appointments.
  • Men are traditionally employed in high-risk jobs, especially in the trades, transport, construction, and mining industries.
  • Australian men are twice as likely as Australian women to exceed the lifetime risk guidelines for alcohol consumption, with one in four men drinking at a rate that puts them at risk of alcohol-related disease.

 

Part 3

Creating a My Health Record is one way men can be proactive about their health and make it a priority this Men’s Health Week, running between June 11 – 17.

My Health Record is a secure online summary of a person’s health information that can be accessed at any time by the individual and their healthcare providers.

Australian Men’s Shed Association Executive Officer David Helmers said My Health Record will make it easier for men who may find visiting healthcare professionals difficult or uncomfortable.

“We know that men often avoid having conversations about their health – particularly when those conversations involve visiting a healthcare provider.

“My Health Record takes some of the pain out of keeping a consistent record of our health and is a great platform for ongoing health management.

“Right from the get-go males are more likely to be involved in accidents or become ill, so as we age, it becomes even more important to stay on top of health information,” Mr Helmers said.

33 year-old Nick Morton was forced to take a serious look at his overall health after suffering a heart attack while working in North Queensland.

“I had a rupture in my artery wall – it was a big wake-up call going into cardiac rehab and I was the youngest by 20 years. I ended up really thinking about my health and becoming more aware of my medical history so I registered with My Health Record,” Mr Morton said.

After Nick returned to the family doctor back in his home state, his Melbourne based doctor was able to securely log onto My Health Record and view Nick’s Queensland medical history.

“It helped me having a digital copy of everything instead of having to go to my GP or cardiologist with a binder full of all my records,” Mr Morton said.

All Australians will have the benefit of receiving a My Health Record before the end of 2018, unless they choose not to have one.

Getting familiar with what is included in an individual’s personal record can assist in being prepared in an emergency like the one Nick Morton experienced. Nick now advocates a more proactive approach.

“I thought I was in control of my health and took it for granted like most blokes my age. There’s no excuse not to keep track of your health. Go to your GP and ask about my Health Record.”

Australian Digital Health Agency Chief Medical Adviser Clinical Professor Meredith Makeham said My Health Record provided many valuable benefits for men.

“Encouraging men to discuss their health with their doctor, pharmacist, or other healthcare specialist can be difficult.”

“My Health Record supports and assists men to have these conversations, enabling better connected care and, ultimately, better health outcomes,” Dr Makeham said.

My Health Record gives men and the broader community the capacity to upload important health information including allergies, medical conditions and treatments, medicine details, test results and immunisations; supporting them in remembering the dates of tests, medicine names, or dosages.

A major advantage of having a My Health Record is individuals having 24-hour, 7 day per week access to their own health information.

For further information visit www.myhealthrecord.gov.au or call 1800 723 471