NACCHO Aboriginal Health and #WorldHypertensionDay @strokefdn High #bloodpressure – known to doctors as ‘hypertension’ – is a silent killer of our mob with 47% having high #stroke risk

 

 ” But high blood pressure – known to doctors as ‘hypertension’ – is a silent killer of our mob because there are no obvious signs or symptoms, and many people don’t realise they have it. “

A staggering 82 percent of those, found to have high blood pressure, were not aware prior to taking the health check and were referred to their doctor for a further assessment.

Aboriginal and Torres Strait Islander are between two and three times as likely to have a stroke than non-Indigenous Australians which is why increasing stroke awareness is crucial.

Too many Australians couldn’t spot a stroke if it was happening right in front of them.

We know that in Aboriginal and Torres Strait Islander communities this awareness is even lower.

We want all Australians, regardless of where they live or what community they’re from, to learn the signs of stroke.”

Stroke Foundation and Apunipima ACCHO Cape York Project

 ” Naomi and Rukmani’s stroke rap runs through vital stroke awareness messages, such as lifestyle advice, learning the signs of stroke, and crucially the need to seek medical advice when stroke strikes.

Music is a powerful tool for change and we hope that people will listen to the song and remember the FAST message – it could save their life,”

Stroke Foundation Queensland Executive Officer Libby Dunstan 

Naomi Wenitong  pictured with her father Dr Mark Wenitong Public Health Officer at  Apunipima Cape York Health Council  in Cairns:

Share the stroke rap with your family and friends on social media

Listen to the new rap song HERE

                                       or Hear

Research has shown the number of strokes would be practically cut in half (48 percent) if high blood pressure alone was eliminated

NACCHO has published over 90 articles Aboriginal health stroke prevention and recovery READ HERE

“It can happen to anyone — stroke doesn’t discriminate against colour, it doesn’t discriminate against age “

Photo above Seith Fourmile, Indigenous stroke survivor campaigns for culture to aid in stroke recovery

” Cardiovascular disease is the leading cause of death for Aboriginal and Torres Strait Islander people, who experience and die from cardiovascular disease at much higher rates than other Australians.

What you don’t know can hurt you. Heart disease and strokes are the biggest killers of Australians, and the biggest risk factor for both of them is high blood pressure.

But high blood pressure – known to doctors as ‘hypertension’ – is a silent killer because there are no obvious signs or symptoms, and many people don’t realise they have it. “

John Kelly CEO-National, Heart Foundation

Aboriginal and Torres Strait Islander people, when compared with other Australians, are:

  • 1.3 times as likely to have cardiovascular disease
  • three times more likely to have a major coronary event, such as a heart attack
  • more than twice as likely to die in hospital from coronary heart disease
  • 19 times as likely to die from acute rheumatic fever and chronic rheumatic heart Disease
  • more likely to smoke, have high blood pressure, be obese, have diabetes and have end-stage renal disease.

It was World Hypertension Day yesterday  and the Stroke Foundation is determined to slash stroke numbers in Australia – with your help.

Today kicks off Australia’s Biggest Blood Pressure Check for 2018 and communities are being urged to take five minutes out of their day for a potentially life-saving blood pressure check.

More than 4.1 Million Australians are living with hypertension or high blood pressure, putting themselves at serious and unnecessary risk of stroke.

Research has shown the number of strokes would be practically cut in half (48 percent) if high blood pressure alone was eliminated.

The major concern with high blood pressure is many people don’t realise they have it. It has no immediate symptoms, but over time, it damages blood vessels and increases the risk of stroke and heart disease.

How you can help?

  • Encourage your family and friends to take advantage of a free check.
  • Help spread the word via social media:  Research has shown the number of strokes would be practically cut in half if high blood pressure alone was eliminated.
  • Get your free health check today! https://bit.ly/2ps1UOn #WorldHypertensionDay

  • I am urging you – no matter what age you are – to have a blood pressure check regularly with your ACCHO GP (General Practitioner), pharmacist or via a digital health check machine.
  • Stroke strikes in an instant, attacking the brain. It kills more women than breast cancer and more men than prostate cancer and leaves thousands with an ongoing disability, but stroke is largely preventable by managing blood pressure and living a healthy lifestyle.
  • Stroke Foundation and SiSU Wellness conducted more than 520,000 digital health checks throughout 2017, finding 16 percent of participants had high blood pressure putting them at risk of stroke

Given there will be 56,000 strokes in Australia this year alone, if we can reduce high blood pressure we will have a direct and lasting impact on the rate of stroke in this country.Yours sincerely,

Sharon McGowan
Chief Executive Officer
Stroke Foundation

NACCHO Aboriginal Health and #CulturalSafety Debate : Media VS Health Sector : Should we have culturally appropriate spaces in hospitals ?

Once again the debate about cultural safety has escalated nationally thru News Ltd newspapers with the Daily Telegraph leading off on Tuesday (3 April ) with a front page “cultural safety expose “ and 4 hours nonstop coverage and commentary on SkyNews from the usual suspects Peta Credlin , Alan Jones , Andrew Bolt , Ben Fordham , Paul Murray, Troy Branston in addition to blanket radio coverage across Australia.

See 2 SkyNews Broadcasts below

The policy issue being heavily criticised by the media but not health authorities and experts is that the NSW Health has recommended its emergency departments to provide “culturally appropriate space’’ for the families of Aboriginal patients.

The new policy in NSW to provide a “culturally appropriate space’’ or “designated Aboriginal waiting room’’ was introduced after research found Indigenous patients were at least 1.5 times more likely to leave hospitals before emergency treatment.

In Victoria some hospitals and services have separate areas for Indigenous patients and their families to meet, rest or engage with specialist hospital staff.

See Part 1 Below for NSW Health policy extracts and download document

Above Editorial Daily Telegraph 3 April

Firstly those in favour of this cultural safety policy include

 ” Well, I think it’s good that issues like cultural safety are entering the popular narrative. We need to do better when it comes to delivering care to Aboriginal and Torres Strait Islander people, and I think we need to ask them what will and won’t work.

The truth is that health outcomes for Indigenous Australians are significantly worse than non-Indigenous Australians according to just about every possible metric.

The AMA strongly supports Aboriginal control when it comes to primary care and when it comes to Aboriginal and Torres Strait Islanders being in larger health facilities like our hospitals, I think we need to do everything we can to make them- the appropriate settings for them to seek care.

If that means spending a little bit of money on waiting areas, if that means making subtle changes to outpatient clinics or to inpatient wards to make Indigenous people feel more at home, I don’t think non-Indigenous people should find that threatening”

1.Dr Michael Gannon President AMA

For the Aboriginal and Torres Strait Islander population born in 2010–2012, life expectancy was estimated to be 10.6 years lower than that of the non-Indigenous population.

“Indigenous patients are over-represented in requiring public hospital services.

“In 2013-14, there were 392,142 public hospital emergency department presentations by Indigenous people, accounting for 5.4% of all such presentations.

As a doctor working in south western Sydney and at an Aboriginal Medical Service, I see every day the barriers to accessing healthcare faced by our Indigenous patients.

“Hospitals are complex, overwhelming places and care is too often fragmented.

“For this reason, everyone involved in healthcare has an obligation to break down the barriers to accessing care and to improve health outcomes.

2. AMA (NSW) President, Prof Brad Frankum

“ It isn’t mandatory in the sense they’ve got to do it, it’s mandatory in the sense you’ve got to think about what is culturally appropriate (and) what might help the local community,”

3.Health Minister Brad Hazzard­ said many hospitals had already decided to introduce a culturally appropriate­ space.

“Among other benefits, culturally competent care increases accurate and timely diagnosis and increases attendance rates at follow-up appointments

Positive results such as these worked to overcome reluctance to engage with mainstream healthcare services, as well as improving rates of self-discharge against medical advice.”

4.President Simon Judkins the Australasian College for Emergency Medicine said it believed emergency departments must move towards a place of respect and acknowledgment of Indigenous culture

The college also called for a focus on increasing the numbers of Aboriginal and Torres Strait Islander people working across all health professions, including emergency medicine.

“All healthcare providers need to consider the cultural dimension of the services they are providing, and embrace culturally safe care which is determined to be safe by Aboriginal and Torres Strait Islander patients and their families.

This includes making hospital waiting rooms a welcoming and supportive environment for Aboriginal and Torres Strait Islander people, which will help to build trust between them and their healthcare providers and enhance cultural sensitivity in medical treatment.

It is vitally important that these waiting areas are designed and implemented in close consultation with relevant local Aboriginal and Torres Strait Islander communities and Aboriginal Community Controlled Health Organisations.”

5.Carmen Parter, PHAA Vice-President (Aboriginal and Torres Strait Islander) affirmed PHAA’s support for such an initiative.

” The policy was about improving the health of Aboriginal people and people who are not Aboriginal should not be threatened by the fact we’re trying to look out for a very vulnerable part of our community ”

6.NSW Health deputy secretary Susan Pearce

” The policy is flexible, allowing local health districts to carry out initiatives in consultation with their local Aboriginal community to make their hospital settings more culturally inclusive, in ways that best suit the community,”

7.NSW Health spokeswoman .

“Within the hospital system Aboriginal and Torres Strait Islander people face racist barriers to gaining appropriate health care. Despite the increased burden of disease they carry, Aboriginal and Torres Strait Islander patients are only three-quarters (73%) as likely to undergo a procedure once admitted to hospital

Racism is a significant barrier to Aboriginal health improvement say Donna Ah Chee 2015 Read in full here or Part 4 Below

” Cultural safety requires embedding in not only course accreditation for each health profession — including measures to reduce resistance — but also in the standards governing clinical professionalism and quality, such as the Royal Australian College of General Practitioners Standards for general practices,19 and the Australian Commission on Safety and Quality in Health Care National safety and quality health service standards.20

Such commitment will need investment in clinician education and professional development, together with measures for accountability. The stewards of the National Aboriginal and Torres Strait Islander Health Plan5 (ie, the Department of Health and their expert implementation advisory group), accreditation bodies, and monitors of the existing frameworks of safety and quality standards in health care need to formally collaborate on a systematic revision of standards to embed culturally safe practice and develop health settings free of racism.”

Martin Laverty, Dennis R McDermott and Tom Calma see Part 5 Below

Part 1 NSW Policy

Download The Policy document in full

NSW Policy Doc

Local processes should be in place to monitor numbers of patients who ‘Did not Wait’ for treatment following triage, including rates for Aboriginal and non-Aboriginal patients.

Strategies to address issues identified should be implemented and evaluated

2.1.3 Considerations for Aboriginal patients

 Section 4.1 acknowledges the higher rates of Aboriginal patients who choose not to wait for treatment in ED when compared to non-Aboriginal patients.

An important contributor to this issue is Aboriginal patients feeling safe to stay and wait. The use of local Aboriginal art in ED waiting rooms can provide links to culture and community; advice should be sought on appropriate art from the local Aboriginal community.

If available in the hospital, relatives may access the designated Aboriginal waiting room for families and carers. If no room exists, a culturally appropriate space within the local hospital should be identified.

Patients identifying as Aboriginal people should be provided with information regarding access to Aboriginal Health Workers that may be available. Access to any of these services may

4.1 Monitoring of rates of patients who ‘Did not Wait’

 EDs should maintain a local auditing system to monitor trends in rates of DNW. Review of data should also be undertaken by Aboriginal and non-Aboriginal patients as there is significant evidence in the literature of higher rates of DNW among Aboriginal patients presenting to ED

Addressing this issue is in line with the Australian Commission on Safety and Quality in Healthcare’s guidance on Improving care for Aboriginal and Torres Strait Islander People.

Locally designed strategies to manage identified reasons for patients who DNW should be implemented with outcomes reviewed. Consideration may be given to follow up of patients who DNW who are considered to have high risk issues or are from a vulnerable patient group.

Part 2 AMA (NSW) President: culturally appropriate spaces in EDs are a welcome addition to NSW public hospitals

Access to healthcare is critical to the wellbeing of all Australians and removing barriers to it is important, AMA (NSW) President, Prof Brad Frankum, said.

“It is essential that hospitals and all healthcare facilities make an effort to provide safe and welcoming spaces to facilitate access to care.

“Public hospitals try to do this in a range of ways, including the design of spaces, the provision of information in different languages, access to translators and other services to ensure patients get the best from their healthcare.

“For this reason, AMA (NSW) applauds the NSW Government for encouraging hospitals to ensure that they consider the needs of Indigenous patients in creating a safe and welcoming environment in hospitals,” Prof Frankum said.

“Indigenous patients continue to suffer unacceptably poorer health outcomes compared to other Australians.

“For the Aboriginal and Torres Strait Islander population born in 2010–2012, life expectancy was estimated to be 10.6 years lower than that of the non-Indigenous population.

“Indigenous patients are over-represented in requiring public hospital services.

“In 2013-14, there were 392,142 public hospital emergency department presentations by Indigenous people, accounting for 5.4% of all such presentations,” Prof Frankum said.

“As a doctor working in south western Sydney and at an Aboriginal Medical Service, I see every day the barriers to accessing healthcare faced by our Indigenous patients.

“Hospitals are complex, overwhelming places and care is too often fragmented.

“For this reason, everyone involved in healthcare has an obligation to break down the barriers to accessing care and to improve health outcomes.

“It is disappointing to see those who clearly do not have the same personal experiences of navigating our healthcare system making inappropriate comments about such an important health policy,” Prof Frankum said

Part 3 : Culturally safe healthcare starts in the waiting room

The Public Health Association of Australia (PHAA) called for cultural safety in Aboriginal and Torres Strait Islander healthcare last week, along with a number of other leading health groups and medical practitioners.

As an extension of this, the PHAA supports all viable and suitable cultural safety measures in the provision of healthcare to Aboriginal and Torres Strait Islander people, including culturally appropriate waiting rooms.

Carmen Parter, PHAA Vice-President (Aboriginal and Torres Strait Islander) affirmed PHAA’s support for such an initiative, saying, “All healthcare providers need to consider the cultural dimension of the services they are providing, and embrace culturally safe care which is determined to be safe by Aboriginal and Torres Strait Islander patients and their families.”

 

“This includes making hospital waiting rooms a welcoming and supportive environment for Aboriginal and Torres Strait Islander people, which will help to build trust between them and their healthcare providers and enhance cultural sensitivity in medical treatment,” she said.

Ms Parter continued, “It is vitally important that these waiting areas are designed and implemented in close consultation with relevant local Aboriginal and Torres Strait Islander communities and Aboriginal Community Controlled Health Organisations.”

“The history of the stolen generations and the role that Australian hospitals held during these events has left a strong effect on Aboriginal and Torres Strait Islander people, and in order to overcome this and move toward Reconciliation we need to work together to ensure Australian hospitals are a safe space for all,” Ms Parter said.

Michael Moore, CEO of the PHAA supported Ms Parter’s statements, saying, “Evidence shows that healthcare has the best outcomes when the patient and provider can share knowledge and understanding in a respectful and welcoming environment.

We also know that Aboriginal and Torres Strait Islander patients are at least 1.5 times more likely to leave hospital before receiving treatment compared to non-Indigenous patients.”

“This resembles the gaps in health outcomes which Close the Gap campaigners are working hard to resolve, and a trial on the mid-north coast in NSW showed that culturally appropriate waiting rooms resulted in a 50% reduction in Aboriginal and Torres Strait Islander patients leaving before accessing treatment. This really demonstrates the strength of this type of cultural safety initiative in a tangible way,” Mr Moore said.

“We ensure that hospitals are safe environments for children, elderly people, disabled people, and other groups with certain needs, it’s now time we ensure that the cultural needs of patients are also taken into careful consideration,” Mr Moore said.

 

Part 4 Racism and the hospital system : Donna Ah Chee

 Read in full here

“Within the hospital system Aboriginal and Torres Strait Islander people face racist barriers to gaining appropriate health care. Despite the increased burden of disease they carry, Aboriginal and Torres Strait Islander patients are only three-quarters (73%) as likely to undergo a procedure once admitted to hospital (3).

This difference led one key study to conclude that ‘there may be systematic differences in the treatment of patients identified as Indigenous’ in Australia’s public hospitals (4), a conclusion supported by studies showing poorer survival rates for cancer for Indigenous people, due to their being less likely to have treatment, having to wait longer for surgery, and being referred later for specialist treatment (5). This is not good enough and we need to use the current spotlight on racism to look at these deeper issues as well”, she suggested.

“Such systemic differences in care provided by hospitals contribute to Aboriginal and Torres Strait Islander people’s low level of trust for hospitals as institutions – the 2008 National Aboriginal and Torres Strait Islander Social Survey found that little more than 60% of Aboriginal and Torres Strait Islander people said that they felt hospitals could be trusted (6).

This level of distrust is reflected in the fact that Aboriginal and Torres Strait Islander people are five times as likely to leave hospital against medical advice or be discharged at their own risk compared to other Australians (7).

“Addressing these institutional barriers to appropriate care is complex but possible and we can do it as a nation of we finally come to terms with the seriousness of the problem (8).

“It will take a strong commitment to action. There needs to be a greater awareness in the Australian community about the adverse health consequences of racism for Aboriginal people.

If any good is to come out of the racism shown towards Adam Goodes I hope it is an awareness of the harm this does to our people across the nation which is currently symbolised by the suffering of one man: Adam Goodes.

Racism is a serious problem that Australia is yet to properly address. It should never be trivialised. It needs to be dealt with”, she concluded.

References

  1. Paradies, Y., Harris, R. & Anderson, I. 2008, The Impact of Racism on Indigenous Health in Australia and Aotearoa: Towards a Research Agenda, Discussion Paper No. 4, Cooperative Research Centre for Aboriginal Health, Darwin.
  2. ANTaR website http://www.antar.org.au/node/2… accessed September 26 2011
  3. Australian Health Ministers Advisory Council (2012). Aboriginal and Torres Strait Islander Health Performance Framework 2012 Report. AHMAC. Canberra. page 131
  4. Cunningham J (2002). “Diagnostic and therapeutic procedures among Australian hospital patients identified as Indigenous.” Medical Journal of Australia 176(2): 58-62
  5. Condon J R, Barnes T, et al. (2005). “Stage at diagnosis and cancer survival for Indigenous Australians in the Northern Territory.” Medical Journal of Australia 182(6

 

 ” Cultural safety requires embedding in not only course accreditation for each health profession — including measures to reduce resistance — but also in the standards governing clinical professionalism and quality, such as the Royal Australian College of General Practitioners Standards for general practices,19 and the Australian Commission on Safety and Quality in Health Care National safety and quality health service standards.20

Such commitment will need investment in clinician education and professional development, together with measures for accountability. The stewards of the National Aboriginal and Torres Strait Islander Health Plan5 (ie, the Department of Health and their expert implementation advisory group), accreditation bodies, and monitors of the existing frameworks of safety and quality standards in health care need to formally collaborate on a systematic revision of standards to embed culturally safe practice and develop health settings free of racism.”

Martin Laverty, Dennis R McDermott and Tom Calma

Originally published by MJA here

Download a PDF of this Report Paper for references 1-20

MJA Cultural Safety

Read 20 + previous NACCHO articles Cultural Safety  

In Australia, the existing health safety and quality standards are insufficient to ensure culturally safe care for Indigenous patients in order to achieve optimum care outcomes.

Where “business as usual” health care is perceived as demeaning or disempowering — that is, deemed racist or culturally unsafe — it may significantly reduce treatment adherence or result in complete disengagement,1,2 even when this may be life-threatening.3

Peak Indigenous health bodies argue that boosting the likelihood of culturally safe clinical care may substantially contribute to Indigenous health improvement.4 It follows that a more specific embedding of cultural safety within mandatory standards for safe, quality-assured clinical care may strengthen the currently inadequate Closing the Gap mechanisms related to health care delivery.

The causes of inequitable health care are many. Western biomedical praxis differs from Indigenous foundational, holistic attention to the physical, emotional, mental and spiritual wellbeing of the person and the community.5 An article published in this issue of the MJA6 deals with the link between culture and language in improving communication in Indigenous health settings, a critical component of delivering cultural safety.

Integrating cultural safety in an active manner reconfigures health care to allow greater equity of realised access, rather than the assumption of full access, including procession to appropriate intervention.

As an example of the need to improve equity, a South Australian study found that Indigenous people presenting to emergency departments with acute coronary syndrome were half as likely as non-Indigenous patients to undergo angiography.7 More broadly, Indigenous people admitted to hospital are less likely to have a procedure for a condition than non-Indigenous people.8

Cardiovascular disease is the leading cause of death in Indigenous Australians.9 Cancer is the second biggest killer: the mortality rate for some cancers is three times higher for Indigenous than for non-Indigenous Australians.10 Clinical leaders in these two disease areas have identified the need for culturally safe health care to improve Indigenous health outcomes.

Cultural safety is an Indigenous-led model of care, with limited, but increasing, uptake, particularly in Australia, New Zealand and Canada. It acknowledges the barriers to clinical effectiveness arising from the inherent power imbalance between provider and patient,11 and moves to redress this dynamic by making the clinician’s cultural underpinning a critical focus for reflection.

Moreover, it invites practitioners to consider: “what do I bring to this encounter, what is going on for me?” Culturally safe care results where there is no inadvertent disempowering of the recipient, indeed where recipients are involved in the decision making and become part of a team effort to maximise the effectiveness of the care. The model pursues more effective practice through being aware of difference, decolonising, considering power relationships, implementing reflective practice, and by allowing the patient to determine what safety means.11

Along with an emphasis on provider praxis, cultural safety focuses on how institutional care is both envisaged and delivered.12 Literature on cultural safety in Australia is scant but growing.13 Where evidence is available, it identifies communication difficulties and racism as barriers not only to access but also to the receipt of indicated interventions or procedures.11

There is evidence of means to overcome these barriers. An Australian study undertaken across ten general practices tested the use of a cultural safety workshop, a health worker toolkit, and partnerships with mentors from Indigenous organisations and general practitioners.13 Cultural respect (significant improvements on cultural quotient score, along with Indigenous patient and cultural mentor rating), service (significant increase in Indigenous patients seen) and clinical measures (some significant increases in the recording of chronic disease factors) improved across the participating practices.

In addition, a 2010 study by Durey14 assessed the role of education, for both undergraduate students and health practitioners, in the delivery of culturally responsive health service, improving practice and reducing racism and disparities in health care between Indigenous and non-Indigenous Australians. The study found that cultural safety programs may lead to short term improvements to health practice, but that evidence of sustained change is more elusive because few programs have been subject to long term evaluation..

Newman and colleagues10 identified clinician reliance on stereotypical narratives of indigeneity in informing cancer care services. Redressing these taken-for-granted assumptions led to culturally engaged and more effective cancer care. In a similar manner, Ilton and colleagues15 addressed the importance of individual clinician cultural safety for optimising outcomes, noting that provider perceptions of Indigenous patient attributes may be biased toward conservative care.

The authors, however, went beyond the clinician–patient interaction to stress the outcome-enhancing power of change in the organisational and health setting. They proposed a management framework for acute coronary syndromes in Indigenous Australians.

This framework involved coordinated pathways of care, with roles for Indigenous cardiac coordinators and supported by clinical networks and Aboriginal liaison officers. It specified culturally appropriate warning information, appropriate treatment, individualised care plans, culturally appropriate tools within hospital education, inclusion of families and adequate follow-up.

Willis and colleagues16 also called for organisational change as an essential companion to individual practitioner development. Drawing on 12 studies involving continuous quality improvement (CQI) or CQI-like methods and short term interventions, they acknowledged evidence gaps, prescribing caution, and argued for such change to be undertaken in the service of long term controlled trials, as these would require 2–3 years to see any CQI-related changes.

Sjoberg and McDermott,17 however, noted the existence of barriers to change: the challenge (personal and professional) posed by Indigenous health and cultural safety training may not only lead to individual but also to institutional resistance.17 Dismantling individual resistance requires the development of a critical disposition — deemed central to professionalism and quality18 — but in a context of strengthened and legitimating accreditation specific to each discipline. The barriers thrown up by institutional resistance, manifesting as gatekeeping, marginalisation or underfunding, may require organisational change mandated by standards.

NACCHO Aboriginal Health Alcohol and Illicit Drugs : @AIHW 1 in 20 Australian deaths caused by alcohol and illicit drugs :burden due to alcohol use at 3.1 times and illicit drug use at 4.2 times the rate of non-Indigenous

 

” Alcohol and illicit drug use is also prevalent among Aboriginal and Torres Strait Islander persons.

Estimates reported from the ABDS 2011 indicated that Indigenous Australians had rates of attributable burden due to alcohol use at 3.1 times and illicit drug use at 4.2 times the rate of non-Indigenous Australians in 2011 (AIHW 2016b).

An analysis of the effect of alcohol and illicit drug use in the Indigenous population would be an important area of work for future burden of disease studies.”

From Page 24 AIHW Report

For example, there is more to learn about the links between alcohol and drug use and mental health problems or the health impact of fetal alcohol syndrome—using multiple data sources to understand these links and their impacts on people is critical to responding to people’s needs,’

‘It is important to continue to report using the latest available information as well as work towards filling gaps in the data. This is essential to improving the evidence base on this important issue.’

AIHW CEO Barry Sandison noted that the report demonstrated the value of using data to build the evidence base in important areas of public policy and service delivery.

Download here the 173 Page AIHW in PDF

aihw-bod-19.pdf

Read over 194 Aboriginal Health Alcohol and other Drugs articles published by NACCHO over the past 6 years

‘Alcohol and illicit drugs have a significant impact on the health of Australians, together responsible for nearly 1 in every 20 deaths, according to new analysis from the Australian Institute of Health and Welfare (AIHW).

‘The report, Impact of alcohol and illicit drug use on the burden of disease and injury in Australia, uses data from the 2011 Australian Burden of Disease Study published in 2016 (the next study due out in 2019) to calculate the health impact—or ‘burden’—of alcohol and illicit drugs.

‘This is calculated in terms of years of life lost from early death (the ‘fatal burden’), as well as the years of healthy life lost due to living with diseases or injuries caused by alcohol and drugs (the ‘non-fatal burden’).

‘The report shows that alcohol and illicit drugs were collectively responsible for 6.7% of Australia’s combined fatal and non-fatal disease burden. This compares to 9% from tobacco smoking and 2.6% from physical inactivity.

‘The burden was much higher in males than females—alcohol and illicit drugs were responsible for 9.1% of all disease burden in males, compared to 3.8% in females,’ said AIHW spokesperson Dr Lynelle Moon.

‘The report also shows that a higher proportion of the burden of alcohol and illicit drugs was ‘fatal’—that is, due to early death—than ‘non-fatal’.

‘Overall, 8.1% of Australia’s fatal burden was due to alcohol and illicit drugs, while 5.2% of all non-fatal burden was caused by alcohol and illicit drugs.

‘Combined, alcohol and illicit drugs were responsible for 4.5% of all deaths in Australia in 2011—equating to 6,660 deaths, or about 1 in every 20 deaths,’ Dr Moon said.

‘By itself, alcohol use was responsible for 4.6% of all disease burden. One-third of this burden was due to alcohol dependence.

‘Alcohol use was responsible for almost one-third of the burden of road traffic injuries.

‘On its own, illicit drug use was responsible for 2.3% of Australia’s disease burden. Opioids accounted for the largest proportion (41%) of the illicit drug use burden, followed by amphetamines (18%), cocaine (8%) and cannabis (7%). In addition, 18% of the burden was from diseases contracted through unsafe injecting practices.

‘Despite the significant contribution of alcohol to Australia’s disease burden, the report predicts improvements will be seen in the coming years. However, this does not look to be the case for many illicit drugs.

‘The burden from alcohol use fell by around 7% between 2003 and 2011 and further reductions are expected by 2020 based on these trends,’ Dr Moon said.

‘Between 2011 and 2020, burden from the use of amphetamines is expected to rise by 14%, while the burden of disease from cannabis use is expected to rise by 36% for females and remain steady for males. The burden of disease from cocaine use is expected to fall by 24% for males and remain steady for females.

‘The burden caused by unsafe injecting practices is expected to fall by 21% for males and 17% for females.

‘Projections are not yet available on the likely future impact of opioid use; however, AIHW analysis from last year highlighted the significant health consequences caused by the rising non-medical use of pharmaceuticals, including prescription opioids.

 

 

NACCHO Aboriginal Health #Socialdeterminants #ClosingTheGap @ANU_CAEPR Three charts on: the changing status of #Indigenous Australians

 ” The data do not tell us anything about the content or meaning of Indigenous identity, or who is or isn’t Indigenous. These data do not suggest changing identification in the census in any way leads to an improvement in outcomes, nor is that the motivation for people’s identification to change.

Rather, there are a range of social and familial reasons why some people may change their identification in the census. And the person who filled out a census form on behalf of someone in 2011 might be different to the person who filled out the form in 2016.

There should not be any intervention to reduce identification change; in fact it should be seen as a positive development. But identification change must always be always kept in mind when assessing the progress toward targets related to Indigenous Australians like Closing the Gap ”

The complexity of identification change

Dr. Nicholas Biddle is a quantitative social scientist, Senior Fellow at the Centre for Aboriginal Economic Policy Research (CAEPR)

Francis Markham Research Fellow, College of Arts and Social Sciences, Australian National University 

See Additional NACCHO ABS Aboriginal Health : 2016 CENSUS of Aboriginal and/or Torres Strait Islanders launched

Above chart added by NACCHO

Three charts on: the changing status of Indigenous Australians

Originally published in The Conversation

A new dataset has shed fresh light on the changing socioeconomic status of Indigenous Australians.

It shows that what appears to be slow progress or steady outcomes for the whole population may be masking worsening results.

This stems from how the Indigenous population is counted in the census and in surveys, and how that identification might change over time.

In each survey or census, people are asked to indicate if they are of Aboriginal or Torres Strait Islander origin. If they move in or out of the group classified as Indigenous, then this can appear in the aggregate as if people’s life-chances are changing. Rather, this may be an artefact of the group’s changing composition.

Flows into and out of the Indigenous population

Between 2011 and 2016, the best estimate of the Indigenous population grew by 128,500, or around 19%. This was due to a greater number of births than deaths, but also partly due to changes in how people were identified (either by themselves or others) as being of Indigenous origin.

There are many good reasons why Indigenous people may choose not to disclose their ancestry. These are often of a highly personal nature, especially given Australia’s history of discrimination against Indigenous people.

A decision to identify as Indigenous (or not) in the census should not be interpreted as a reflection on someone’s Indigenous identity, which is a separate matter from what box gets ticked on a census form.

But the box-ticking does inform the government’s understanding of the Indigenous population – including monitoring progress against Closing the Gap targets.


Read more: Three reasons why the gaps between Indigenous and non-Indigenous Australians aren’t closing


Using the data, we can identify three groups of Indigenous people in the 2011 and 2016 censuses:

  • the “always identified” – those who identified as Indigenous in both censuses;
  • the “formerly identified” – those who identified as Indigenous in the 2011 census but not the 2016 census; and
  • the “newly identified” – those who did not identify as Indigenous in the 2011 census, but who did identify as such in the 2016 census.

The figure below gives our best estimate of the flows that constitute these populations, and estimated births and deaths over the period.

Indigenous population flows, 2011-2016. Authors/Australian Bureau of Statistics

The largest of these three groups is the 572,400 people who identified as being of Indigenous origin in both the 2011 and 2016 censuses. This is the population we usually think about when analysing and interpreting Indigenous socioeconomic and demographic change.

However, two other groups were also quite large. There were 45,000 people in Australia who identified as Indigenous in the 2011 Census, but who didn’t identify as such in the 2016 Census. While this is a large number relative to the 2011 population estimate, the newly identified number is larger still (129,600).

The net increase from identification change was therefore estimated to be 84,600. This is equivalent to 13.7% of the Indigenous population in 2011.

The geography of identification change

The vast majority of those who changed how they identified their Indigenous origins in the census lived in urban parts of Australia in 2011.

There are significant differences in the level of change in each of Australia’s eight states and territories.

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Added by NACCHO

Added by NACCHO 2/2

Changing answers to the census question on Indigenous origin had a particularly pronounced impact on Indigenous population estimates in three jurisdictions – Victoria (21.5%), the Australian Capital Territory (20.9%), and New South Wales (20.8%).

However, because NSW had a relatively large Indigenous population in 2011 relative to Victoria and the ACT, net identification change in that state made up 48% of the total identification change. This is almost double the next greatest contribution – Queensland, which contributed 24.3%.

This may have implications for the distribution of GST revenue between the states and territories.

The relationship between socioeconomic and demographic change

Changes to the way people answer the census question on Indigenous origin has the potential to impact on the understanding of change in Indigenous socioeconomic outcomes.

If those who newly identified in the census had higher relative socioeconomic status before their identification changed, then this will tend to bias upward any measured change in socioeconomic outcomes.

Looking at all Indigenous adults aged 15 years and above at the time of each census, the employment rate in 2011 was 49.7%, while for the same measure in 2016 it was 50.4%.

If we only used repeated cross-sections, we would think that Indigenous employment is improving, albeit relatively slowly.

But when we look at the employment rates using the linked population, a very different picture emerges.

 

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The employment rate for “always identifiers” was 49.6% in 2011 and 48.7% in 2016. So, there was actually worsening employment outcomes between 2011 and 2016 for this group, rather than the small increase that might be concluded from looking at the two censuses separately.

The complexity of identification change

Changes to the way people answer the census question on Indigenous origin not only changes official estimates of the size of the Indigenous population – it also changes the composition.

Compared to those previously identified in the census, those who are newly identified are more likely to:

  • be young;
  • live in NSW, Victoria or ACT;
  • likely to live in a major city;
  • be employed;
  • live in higher-income households; and
  • have higher rates of education.

The data do not tell us anything about the content or meaning of Indigenous identity, or who is or isn’t Indigenous. These data do not suggest changing identification in the census in any way leads to an improvement in outcomes, nor is that the motivation for people’s identification to change.

Rather, there are a range of social and familial reasons why some people may change their identification in the census. And the person who filled out a census form on behalf of someone in 2011 might be different to the person who filled out the form in 2016.

There should not be any intervention to reduce identification change; in fact it should be seen as a positive development. But identification change must always be always kept in mind when assessing the progress toward targets related to Indigenous Australians like Closing the Gap

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cairns Post

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

FROM WEBSITE

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How did this happen?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What is being done

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

He is this week’s Changemaker

Job Vacancy  Manager Cultural Safety Training

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

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

Apply HERE of see below Part 2

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

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

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

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

Have you been involved with the community sector before?

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

What attracted you to work in the community sector?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Part 2 Manager Cultural Safety Training job opportunity

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

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

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

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

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

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

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

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

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

APPLY HERE


Luke Michael  |  Journalist |  @luke_michael96

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

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

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

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

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

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

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

WATCH TV COVERAGE HERE

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

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

Fact 1   

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

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

RFDS Website

Fact 2

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

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

Originally published ABC TV NEWS

Key points:

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

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

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

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

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

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

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

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

Mental health advocates call for greater commitment

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

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

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

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

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

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

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

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

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

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

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

Federal Labor response ( added comment )

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

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

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

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

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

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

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

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

For Help Contact your Nearest ACCHO

 

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

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

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

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

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

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

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

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

8. Tasmanian Aboriginal Centre : Kipli Kani Open nutrition sessions

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

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

Our next Deadly News Post is January 25

 Email to Colin Cowell NACCHO Media    

Mobile 0401 331 251

Wednesday by 4.30 pm for publication each Thursday

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Q:  What positions are currently available?

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

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

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

8. Tasmanian Aboriginal Centre : Kipli Kani Open nutrition sessions

 

 

 

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

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

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

AMA President, Dr Michael Gannon

Download the AMA Position Statement HERE

AMA Position Statement on Rural Workforce Initiatives

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

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

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

Extracts from AMA Submission

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

The AMA believes that:

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

Addressing the mal-distribution of the workforce

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

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

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

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

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

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

AMA Press Release 9 January 2018

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

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

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

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

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

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

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

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

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

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

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

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

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

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

·         Provide financial incentives to ensure competitive remuneration.

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

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

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

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

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

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

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

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

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

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

Background:

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

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

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

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

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

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

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

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

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

Part 2 Update

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

 

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

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

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

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

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

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

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

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

Download the NACCHO Press Release HERE

NACCHO URGES FEDERAL GOVERNMENT TO INVEST IN INDIGENOUS HOUSING 5 2018

 

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

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

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

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

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

21 Dec Combined WA QLD SA Response to Aboriginal Housing CRISIS

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

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

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

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

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

22 Dec Federal Labor Response to Aboriginal Housing CRISIS

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

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

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

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

Australian Healthcare and Hospitals Association Strategic Programs Director Dr Chris Bourke

Full Press Release 22 Dec AHHA Response to Aboriginal Housing CRISIS

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

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

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

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

21 Dec Response from Minister Scullion Aboriginal Housung Crisis

Part 1 NACCHO press release 8 January 2018

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

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

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

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

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

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

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

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

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

 Background 2 : Housing Issues Background ( PMC Charts above )

SOURCE PMC

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

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

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

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

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

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

Background 3  NPARIH/NPARH

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

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

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

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

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

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

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

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

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

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

Comments attributed to Housing Minister Peter Tinley:

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

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

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

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

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

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

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

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

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

Part 3 Federal Labour CUTTING REMOTE HOUSING FUNDING UNFAIR AND UNJUSTIFIED

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

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

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

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

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

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

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

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

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

Key recommendations to the government in the report include:

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

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

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

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

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

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

Part 4 Minister Scullion More Labor lies on remote housing

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

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

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

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

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

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

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

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

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

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

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

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

Background on NPARIH/NPARH

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