NACCHO #HealthElection16 : AMA launches Key Health Issues / Aboriginal Health policy for 2016 Federal Elections

Brian

” The gap in health and life expectancy between Aboriginal and Torres Strait Islander people and other Australians is still considerable, despite the commitment to closing the gap.

The AMA sees progress being made, particularly in reducing early childhood mortality rates, and in addressing major risk factors for chronic disease, such as smoking. However, to close the gap in Indigenous health, Government must commit to improving resourcing for culturally appropriate primary health care for Aboriginal and Torres Strait Islander people, and the health workforce.

Including increased investment in Aboriginal and Torres Strait Islander community controlled health organisations. Such investment must support services to build their capacity and be sustainable over the long term;

Brian Owler AMA President pictured above Matthew Cooke Chair of NACCHO at recent NACCHO Event Parliament House Canberra : The Aboriginal Policy is part of a 16 Page AMA Health Issues Document  

“The Medicare freeze is not just a co-payment by stealth – it is a sneaky new tax that punishes every Australian family,”

Professor Owler said, with the elderly and chronically ill among those most affected see press release here AMA LAUNCHES NATIONAL CAMPAIGN AGAINST THE MEDICARE REBATE FREEZE (FED)

Putting Health First

Download the 16 Pages here AMA Key Health Issues Federal Election 2016

Health policy will be at the core of the 2016 Federal Election.

The AMA is non-partisan. It is our role during election campaigns, as it is throughout the terms of governments, to highlight the issues we think will be of greatest benefit to the health system, the medical profession, the community, and patients.

As is customary, the AMA will focus on the respective health policy platforms presented by the major parties in the coming weeks.

The next Government must invest significantly in the health of the Australian people.

Investment in health is the best investment that governments can make.

We must protect and support the fundamentals of the health system.

The two major pillars of the system that mean most to the Australian people are quality primary health care services, led by general practice, and well-resourced public hospitals.

The AMA has advocated strongly and tirelessly on these issues for the term of the current Government.

General practice and public hospitals are the priority health issues for this election.

The AMA is calling on the major parties to lift the freeze on the Medicare Benefits Schedule (MBS) patient rebate. The freeze was extended until 2020 in the recent Budget. The freeze means that patients will pay more for their health care. It also affects the viability of medical practices.

We also need substantial new funding for public hospitals. The Government provided $2.9 billion in new funding in the Budget, but this is well short of what is needed for the long term.

We must build capacity in our public hospitals. Funding must be better targeted, patient-focused, and clinician led.

The AMA is also calling for leadership and effective policy from the major parties on Indigenous health, medical workforce and training, chronic disease management, and a range of important public health measures.

The AMA will release a separate Rural Health Plan, responding to the unique health needs of people in rural and regional Australia, later in the election campaign.

Elections are about choices. The type of health system we want is one of those crucial decisions.

In this document, Key Health Issues for the 2016 Federal Election, the AMA offers wide-ranging policies that build on what works. We offer policies that come from the experience of doctors who are at the coalface of the system – the doctors who know how to make the system work best for patients.

The AMA urges all political parties to engage in a competitive and constructive health policy debate ahead of the election on 2 July.

Indigenous Health Policy Continued

Despite the recent health gains, progress remains frustratingly slow and much more needs to be done. A life expectancy gap of around 10 years remains between Aboriginal and Torres Strait Islander people and other Australians, with recent data suggesting that Indigenous people experience stubbornly high levels of treatable and preventable conditions, high levels of chronic conditions at comparatively young ages, high levels of undetected and untreated chronic conditions, and higher rates of co-morbidity in chronic disease. This is completely unacceptable.

It is not credible that Australia, one of the world’s wealthiest nations, cannot address health and social justice issues affecting just three per cent of its citizens. The Government must deliver effective, high quality, appropriate and affordable health care for Aboriginal and Torres Strait Islander people, and develop and implement tangible strategies to address social inequalities and determinants of health.

Without this, the health gap between Indigenous and non-Indigenous Australians will remain wide and intractable.

The AMA calls on the major parties to commit to:

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

Australian Medical Association joins campaign against Medicare rebate freeze

AMA POSTER

Download the AMA Press Release

AMA LAUNCHES NATIONAL CAMPAIGN AGAINST THE MEDICARE REBATE FREEZE (FED)

Article below originally published here

Tens of thousands of specialist doctors are joining GPs’ war against the Turnbull government’s extended freeze on Medicare rebates, increasing pressure on the Coalition’s health record ahead of the federal election.

The Australian Medical Association has distributed posters to its members, warning patients that they will be out of pocket because the cost of running the medical practice will continue to rise as Medicare rebates stay frozen until 2020.

“You will pay a new or higher co-payment every time you visit your GP, every time you visit other medical specialists, every time you need a blood test, and every time you need an X-ray or other imaging,” it says, alongside a photo of a woman comforting a crying child.

It comes a week after the Royal Australian College of General Practitioners announced its 32,000 members would urge their patients to lobby local MPs against the move. The groups share about 8000 members, adding about 22,000 more specialist doctors to the campaign.

The AMA’s campaign similarly encourages patients to contact their local MPs and election candidates, but goes further to directly blame the Turnbull government for the extra cost: “The government has cut Medicare and wants you to pay for it.”

While pathologists on Friday agreed to retain bulk-billing rates in exchange for reduced regulatory pressure on rents under a deal with Health Minister Sussan Ley, the AMA maintains that they and diagnostic imaging services will remain under pressure to charge patients, with the government’s cuts to bulk-billing incentive payments deferred till later in the year.

The AMA’s president, Professor Brian Owler, said many doctors had absorbed costs but the extension “has pushed them over the edge”. They may charge patients a $30 co-payment to cover costs associated with moving to a private billing system, more than triple the Abbott government’s failed and deeply unpopular $7 GP co-payment, he said.

“The Medicare freeze is not just a co-payment by stealth – it is a sneaky new tax that punishes every Australian family,” Professor Owler said, with the elderly and chronically ill among those most affected.

While most specialists (about 70 per cent) already charged patients a co-payment, having had their rebates frozen for decades, the extended freeze could reduce the bulk-billing rate further, an AMA spokesman said.

Labor froze indexation for eight months in 2013, lifting it briefly for GPs in 2014-15. The Coalition extended it for four years in 2014, and this year extended it a further two years to 2020, to save $925.3 million.

Opposition Leader Bill Shorten said Labor opposed the extended freeze at the leaders’ debate on Friday, but would not say whether it would commit to lifting it if elected.

Thirty per cent of 400 GPs surveyed by the College said they would stop all bulk-billing, including for concession card holders, due to the extended freeze. Another 18 per cent said the practice would start charging a co-payment, but cap annual out-of-pocket fees for concession card holders.

Thirty per cent said they would maintain a mixed billing policy, and 10 per cent would continue to bulk bill all patients. Twelve per cent said they were already privately billing all their patients.

The Turnbull government plans to cut bulk-billing incentives for pathology and diagnostic imaging services to save $650 million over four years. Pathology Australia, which had warned this would lead more doctors to charge patients for pap smears, blood and urine tests, has agreed to drop its public campaign against the cuts.

Ms Ley said: “The Coalition will increase Medicare investment to $26 billion per year by 2020-21, while introducing revolutionary reforms such as Health Care Homes that cement a GP’s role at the centre of patient care.”

While she appreciated many GPs’ efforts to keep costs down during the indexation freeze, she was disappointed that “there’s no reciprocal offer to assist taxpayers with the immediate financial challenges our budget faces while [Health Care Homes are] implemented”.

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NACCHO Aboriginal Health News Alert : AMA says stop the cuts -time for strong investment in health

Brian

The AMA recognises the early progress that is being made to close the gap, particularly in reducing early childhood mortality rates, and in addressing major risk factors for chronic disease, such as smoking. However, to maintain this momentum for the long term, the Government must improve resourcing for culturally appropriate primary health care for Aboriginal and Torres Strait Islander people, and the health workforce.

From the AMA Pre-Budget Submission 2016-17 Download here

Or full AMA indigenous health policy below

The AMA is urging the Government to use the May Budget to invest strongly in the future of the Australian health system to meet growing and changing demand from an ageing population and a surge in chronic and complex conditions, which is afflicting more and more Australians.

Picture above AMA President, Professor Brian Owler with NACCHO chair Matthew Cooke at Closing the Gap 2015

AMA President, Professor Brian Owler, said today that the Government must put a stop to its policies of funding cuts and program cuts from its first two Budgets, and instead invest heavily in the health system to build capacity to meet current and future needs.

Professor Owler said the Government must make public hospitals, primary care, and prevention the centrepiece of its election-year Budget.

“The first steps in the next Health Budget must be to lift the Medicare patient rebate freeze, reverse the cuts to pathology and radiology, and restore public hospital funding to proper levels,” Professor Owler said.

“The Government cannot be allowed to retreat from its responsibilities in funding and managing the core elements of health care delivery in Australia.

“There is an urgent need to put the focus back on the strong foundations of the health system – foundations that have served us well for decades, made our system one of the best in the world, and made the health of Australians among the best in the world.

“We need a strong balance between the public and private systems, properly funded public hospitals, strong investment in general practice, and a focus on prevention.

“When people are sick and injured, we need to provide them with affordable and easily accessible care in hospitals, in aged care, in general practice, in the community, and in their homes.

“And we need to educate and help people to achieve healthier lifestyles by being active, and avoiding harmful habits and substances. This will reduce the strain on health services.

“But our public hospitals are under pressure, and our primary care system, especially general practice, is facing huge challenges as more Australians are experiencing chronic and complex conditions that require ongoing care.

“Significant new health funding is needed, but governments also need to be more strategic about how they spend every health dollar.

“Health is the best investment that governments can make.”

Professor Owler said that Australia’s health spending is not out of control, as claimed by the Government to justify its savage 2014 and 2015 health Budgets.

“The Government’s ongoing justification for its extreme health savings measures, including cuts to public hospital funding, has been that Australia’s health spending is unsustainable,” Professor Owler said.

“This is not backed by the evidence.

“The Commonwealth Government’s total health expenditure is reducing as a percentage of the total Commonwealth Budget.

“In the 2014-15 Commonwealth Budget, health was 16.13 per cent of the total, down from 18.09 per cent in 2006-07.

“It reduced further in the 2015-16 Budget, representing only 15.97 per cent of the total Commonwealth Budget.

“Clearly, total health spending is not out of control. The health sector is doing more than its share to ensure health expenditure is sustainable,” Professor Owler said.

The AMA Pre-Budget Submission 2016-2017 covers the following key areas:

 MBS Indexation;

 Public Hospitals;

 Federation Reform;

 Efficient Medicare Claiming;

 Indigenous Health;

 Medical Workforce and Training;

 Chronic Disease;

 Pharmacists in General Practice;

 Rural GP Infrastructure Grants;

 Medical Care for Dementia, Palliative Care, and Aged Care Patients;

 Climate Change and Health;

 Prevention;

 Methamphetamine (Ice);

 Alcohol;

 Obesity;

 Physical Activity; and

 Immunisation.

The Submission is available at

https://ama.com.au/sites/default/files/budget-submission/Budget_Submission_2016_2017.pdf

INDIGENOUS HEALTH

The gap in health and life expectancy between Aboriginal and Torres Strait Islander people and other Australians is still considerable, despite the commitment to closing the gap.

The AMA recognises the early progress that is being made to close the gap, particularly in reducing early childhood mortality rates, and in addressing major risk factors for chronic disease, such as smoking. However, to maintain this momentum for the long term, the Government must improve resourcing for culturally appropriate primary health care for Aboriginal and Torres Strait Islander people, and the health workforce.

Despite recent health gains for Aboriginal and Torres Strait Islander people, progress is slow and much more needs to be done. A life expectancy gap of around ten years remains between Aboriginal and Torres Strait Islander people and other Australians, with recent data suggesting that Indigenous people experience stubbornly high levels of treatable and preventable conditions, high levels of chronic conditions at comparatively young ages, high levels of undetected and untreated chronic conditions, and higher rates of co-morbidity in chronic disease. This is completely unacceptable.

It is also not credible that Australia, one of the world’s wealthiest nations, cannot address health and social justice issues affecting just three per cent of its citizens. The Government must deliver effective, high quality, appropriate and affordable health care for Aboriginal and Torres Strait Islander people, and develop and implement tangible strategies to address social inequalities and determinants of health. Without this, the health gap between Indigenous and non-Indigenous Australians will remain wide and intractable.

AMA POSITION

The Government must strengthen its investment in Aboriginal and Torres Strait Islander health. This must include:

• correcting the under-funding of Aboriginal and Torres Strait Islander health services;

• establishing new or strengthening existing programs to address preventable health conditions that are known to have a significant impact on the health of Aboriginal and Torres Strait Islander people such as cardiovascular diseases (including rheumatic fever and rheumatic heart disease), diabetes, kidney disease, and blindness;

increasing investment in Aboriginal and Torres Strait Islander community controlled health organisations. Such investment must support services to build their capacity and be sustainable over the long term; Health – the best investment that governments can make

• developing systemic linkages between Aboriginal and Torres Strait Islander community controlled health organisations and mainstream health services to ensure high quality and culturally safe continuity of care;

• identifying areas of poor health and inadequate services for Aboriginal and Torres Strait Islander people and direct funding according to need;

• instituting funded, national training programs to support more Aboriginal and Torres Strait Islander people to become health professionals to address the shortfall of Indigenous people in the health workforce;

• implementing measures to increase Aboriginal and Torres Strait Islander people’s access to primary health care and medical specialist services;

• adopting a justice reinvestment approach to health by funding services to divert Aboriginal and Torres Strait Islander people from prison, given the strong link between health and incarceration; and

• appropriately resource the National Aboriginal and Torres Strait Islander Health Plan to ensure that actions are met within specified timeframes.

 

 

Close the gap health targets at risk under GP co-payment

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Exempting concession cards holders from the GP co-payment as suggested by the AMA today will not fix what is poor health policy for all Australians said the peak Aboriginal health organisation today.

National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson Justin Mohamed commended the AMA for their efforts to try to protect some of Australia’s most vulnerable but said it wasn’t enough to prevent a backward step for Aboriginal health.

“Aboriginal people have complex health needs and should to be encouraged to attend regular check-ups and see their GP as often as needed.

“There are many Aboriginal people who have very low disposable incomes who might not qualify for a concession card but would find it a stretch to pay any more to see a GP.

“There still exists a massive and shameful gap in the health of Aboriginal and non-Aboriginal people. The die earlier, they suffer high rates of chronic disease and they have much higher incidents of poor mental health.

“A concerted effort over a number of years has meant that in some areas, such as child and maternal health, that gap is closing – we are seeing a move to the generation change needed to secure the health of Aboriginal people.

“So why, at this critical point, would the Federal Government consider adding a barrier to Aboriginal people seeking primary health care?

“With a GP co-payment, struggling Aboriginal families are likely to delay seeing a doctor or not see one at all.

“The Federal Government needs to immediately abolish this policy and focus on what they can do to encourage Aboriginal people to use the health care system, not turn them away.”

Justin Mohamed urged the Federal Government to consult more widely on the impact of the GP co-payment and for the Senate to reject it outright.

“The AMA has one view, but there are many others in the health sector who both the Government and the Senate should be talking to about this and the PBS co-payment.

“We would like to see the Government abolish both co-payments altogether or at least have a transparent consultative process so they get a full understanding of impacts of these dangerous policies.”

NACCHO AMA political alert: Big “bang”gap in health policies to Close the Gap

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“No party has yet produced a comprehensive Indigenous health policy that would provide significant new funding and direction to build on the modest but welcome successes to date of the Closing the Gap strategy.

“The ideal health policy for this election would combine elements of each of the policies on offer from Labor, the Coalition and The Greens – topped with a ‘big bang’ Indigenous health policy and a well-articulated approach to dealing with the growing impact of chronic disease.

AMA President, Dr Steve Hambleton, (picture above left with NACCHO CEO Lisa Briggs, Chair Justin Mohamed and DoHA Department Secretary Jane Halton)

AMA PRESS RELEASE

AMA President, Dr Steve Hambleton, today urged the major parties to plug the gaps in their election health platforms before Saturday’s election.

Dr Hambleton said that there are lots of votes in positive, forward-looking health policies and there is still time for Mr Rudd and Mr Abbott to pitch more comprehensive health policies to the electorate.

“I set a health policy challenge at the National Press Club in July,” Dr Hambleton said.

“We currently have a new set of problems and challenges in meeting the health needs of the Australian community, and they require a new set of solutions – and that is the great task for the major parties.

“Any change must be tested against the reasons we need proper health reform – mainly our increasing burden of chronic disease and our ageing population.

“Proposals should be moving us toward a joined-up, strengthened primary health care system built on team-based solutions.

“The Labor emphasis to date in this campaign has been on hospital infrastructure, while the Coalition is concentrating on primary care, especially general practice.

“The Greens have focused on access to healthcare, public health and environmental health.  They have a policy that supports the AMA proposal for an independent panel to assess the health of asylum seekers.

“No party has yet produced a comprehensive Indigenous health policy that would provide significant new funding and direction to build on the modest but welcome successes to date of the Closing the Gap strategy.

“The ideal health policy for this election would combine elements of each of the policies on offer from Labor, the Coalition and The Greens – topped with a ‘big bang’ Indigenous health policy and a well-articulated approach to dealing with the growing impact of chronic disease.

“We encourage the major parties to commit to practical and affordable policies that would improve public health, help the most vulnerable and disadvantaged in the community, and ensure a strong, highly skilled medical workforce to meet the future health needs of the community.

“The AMA released a Key Health Issues plan in July, which set out achievable policies that would deliver health service improvements at the front line, directly to patients.

“Some elements have been addressed, but many haven’t.

“We remind our political leaders of what they can do to bolster their health credentials in the final days of the campaign.”

Indigenous Health No significant new funding or direction to build on the modest but welcome successes to date of the Closing the Gap strategy.

Scrap the Cap The Government deferred its ill-considered cap on the tax deductibility of self-education expenses, but no party has yet been prepared to dump this policy, which is bad for education, productivity, and the economy, as well as the safety and quality of our health services.

Medical Training The AMA remains committed to working with the next Government to come up with a long-term policy that supports medical education and training.

Despite the major parties announcing additional intern places in the private sector, which were welcomed, no party has tackled the need to better coordinate the medical training pipeline or address the looming shortage of prevocational and specialist training positions as predicted by Health Workforce Australia.

There needs to be a concerted effort through COAG processes to commit to additional prevocational and specialist training places, including in general practice, with funding to match, in order to ensure that Australia can properly address future community health needs

Chronic Disease The major parties need to do more to tackle the impact of chronic disease so that we can keep people well and out of hospital.  Current Medicare arrangements impose too much paperwork on GPs and limit access to services for patients with higher health care needs.

The major parties need to do more to support GPs in caring for these patients by streamlining current Medicare arrangements and by looking to adopt innovative approaches such as the Department of Veterans’ Affairs Coordinated Veterans Care program more broadly.

We note and welcome the proposed Australian Prevention Partnership Centre, launched today by Federal Minister for Health and Minister for Medical Research Tanya Plibersek, to research what works and what doesn’t in helping people make lifestyle changes to prevent chronic disease.

Rural Health Rural health has still missed out on the big funding boost it needs to address rural medical workforce shortages.

The AMA/RDAA Rural Rescue Package outlines the funding required to get more doctors into rural and remote Australia, with the right mix of skills to deliver services to these communities

Healthier Australian Families There has been no specific policy announcement from Labor or the Coalition on significant public health concerns around Better Environmental Health (effects of climate change, better standards for clean air, greater health monitoring of non-conventional gas mining projects), Preventing Harms of Alcohol (curbs on alcohol marketing to young people, minimum pricing for alcohol products), or Asylum Seeker Health (independent panel).

Dementia, Aged Care and Palliative Care We acknowledge and welcome recent policy announcements around palliative care and dementia, but they do not go to the key issue of access to medical care.

The major parties need to ensure that people with dementia, those who require palliative care, and older Australians with complex and multiple conditions can receive appropriate medical care.  The major parties need to do more to ensure the Medicare arrangements are geared to deal with the increasing numbers of these patients and the need to better manage these patients in the community.

Better recognition of and support for the time that doctors spend assessing patients, organising services and providing support to the patient’s family and carers would ensure that quality dementia, palliative and medical care for the elderly is provided inappropriate settings.  This would relieve the counterproductive use of acute services.

Affordable Medical Services Immediately restore indexation of MBS patient rebates.  Reverse the decision to raise the Extended Medicare Safety Net threshold from 2015.  Restore tax deductibility of out-of-pocket medical and health care gaps.

Authority Prescriptions While the major parties mention tackling red tape, no party has committed to reducing the time wasted by doctors having to telephone the Department of Human Services (DHS) to obtain an authority to write prescriptions for certain PBS medicines.  Based on DHS information, up to 25,000 patient consultations are lost while doctors wait for their calls to DHS to be answered.

AMA Key Health Issues for the 2013 Federal Election is available on the AMA website at https://ama.com.au/keyhealthissues

The AMA publication, Alcohol Marketing and Young People, is at https://ama.com.au/alcohol-marketing-and-young-people

NACCHO Blueprint 2013- 2030 news – AMA supports important initiatives to Improve the health of Aboriginal Males

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DOWNLOAD A COPY OF THE BLUEPRINT HERE

AMA President, Dr Steve Hambleton, said today that the National Aboriginal Community Controlled Health Organisation (NACCHO) Blueprint – Male Healthy Futures for Generational Change – contains important initiatives in national efforts to improve the health of Aboriginal men.

Dr Hambleton welcomed the focus on the health of Aboriginal men as part of broader approach to improving Indigenous health.

“Much of the health inequality between Aboriginal Australians and other Australians is due to the poor health and lower life expectancy of Aboriginal men,” Dr Hambleton said.

“The NACCHO Blueprint outlines a set of practical and achievable proposals for the delivery of culturally appropriate comprehensive primary health care to Aboriginal men.

“The AMA urges governments to support these proposals with long-term funding.

“The mental health of Aboriginal men must be a priority.

“Programs and services that address emotional and social wellbeing and suicide prevention
must be supported and enhanced.

“The AMA believes that mainstream health services should be attuned to the cultural needs of Aboriginal men.

“In mainstream health services where there is a significant potential Aboriginal patient population, governments should fund appropriate facilities to accommodate the cultural needs of Aboriginal male patients.

“The AMA congratulates NACCHO for producing this Blueprint and for its ongoing commitment to improving the health of Aboriginal Australians,” Dr Hambleton said.

CONTACT: John Flannery 02 6270 5477 / 0419 494 761
Kirsty Waterford 02 6270 5464 / 0427 209 753
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DOWNLOAD A COPY OF NACCHO’s PRESS RELEASE HERE

NACCHO kids health news: AMA – Give Aboriginal children a healthy start

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Article by: Motherpedia

The AMA President says health should be the priority for Indigenous children.

A healthy start for Indigenous children should be a priority for any Federal Government according to the AMA.

The peak medical association has called for increased efforts to improve the health of Indigenous children.

AMA President, Dr Steve Hambleton, said evidence showed the importance of a good start in life for future health, and improved early childhood development among Aboriginal and Torres Strait Islander peoples needed to be a policy priority for the Federal Government.

“Many Aboriginal and Torres Strait Islander children are growing up in circumstances that are no better than those experienced in Third World countries, rather than a wealthy nation such as ours,” Dr Hambleton said.

“This can set them up for a lifetime of poor health that costs them, their families and the broader community dearly.

“The Federal Government needs to show foresight in heading these problems off before they develop by investing in a healthy start for Aboriginal and Torres Strait Islander children.”

Dr Hambleton said the AMA would like to see the Government to develop a stronger and more sustained focus on early childhood development programs that had been shown to work.

He said the AMA was playing its role by sponsoring research to identify where the developmental needs of Aboriginal and Torres Strait Islander children were greatest, and recommend measures to achieve improvement.

The results of the AMA research will be included in a report to to be released later this year.

NACCHO health news: AMA-Good mental health and wellbeing essential to close Indigenous health gap

 

 

By AMA President Dr Steve Hambleton

By AMA ( Australian Medical Association) President Dr Steve Hambleton

Edition :

In recent years, Australians have become increasingly aware that poor mental health can affect any of us at any time. Government health policy has also sought a more concerted focus on this area of health.

There is less awareness, though, of the distinctive needs and vulnerabilities of particular groups in Australia concerning mental health and wellbeing.

The factors that contribute to poor mental health and social and emotional wellbeing among Aboriginal peoples and Torres Strait Islanders are complex, and their effects cross generations.

The AMA believes that the mental health and social and emotional wellbeing of Aboriginal peoples and Torres Strait Islanders should be given greater priority in the nation’s health policy agenda.

According to the latest research, nearly one-third of Aboriginal and Torres Strait Islander adults report high to very high levels of psychological distress in their lives – two and a half times the rate reported by other Australians.

There were more than 990 reported suicides of Aboriginal people and Torres Strait Islanders between 2001 and 2010, which is twice the rate of other Australians.

The situation is even more dire among Stolen Generation survivors, who have mental health conditions at twice the rate of other Aboriginal people and Torres Strait Islanders who were not removed from their families.

Young Aboriginal people and Torres Strait Islanders are particularly at risk.

Those between 18 and 24 years of age are twice as likely as other Australians to have experienced high levels of psychological distress, and those between 12 and 24 years of age are more than three times more likely to be hospitalised for mental and behavioural disorders than other Australians of that age.

The suicide rates for young Aboriginal and Torres Strait Islander men between 15 and 19 years of age are nearly six times that of other Australian men of that age.

Poor social and emotional wellbeing and psychological distress is associated with exposure to major life stressors, such as illness, disability, exposure to violence, unemployment, the death of a family member or friend and persistent economic struggle. Aboriginal people and Torres Strait Islanders experience these major life stressors, and their associated levels of psychological distress, at higher rates than other Australians.

Research shows that there is an association between in utero stressors and a child’s developmental outcomes.

Children whose mothers experience more than three major stressors while they are in utero are at higher risk of exhibiting difficult behaviours in childhood.

The quality of a child’s early life can also affect their resilience and mental health later in life.

The AMA reported in 2008 on the problematic life circumstances and health risks of Aboriginal and Torres Strait Islander children, and will report on the evidence around healthy early development for Aboriginal and Torres Strait Islander children later this year.

For Aboriginal peoples and Torres Strait Islanders, mental health and social and emotional wellbeing are very much bound up with strength of their cultural identity, and the amount of control they have over their own lives. That’s why, among other things, the AMA has advocated for the formal recognition of Aboriginal peoples and Torres Strait Islanders in the Australian Constitution (see Recognition a step toward closing Indigenous health gap, px).

The AMA also believes that a national strategic approach to Aboriginal and Torres Strait Islander mental health is needed which, among other things, ensures that:

  • there are enough culturally specific mental health and wellbeing services in the right locations, and built into the comprehensive primary care provided by Aboriginal community-controlled health services;
  • child and maternal health services have the capacity to support healthy early childhood development for Aboriginal people and Torres Strait Islanders; and
  • mainstream mental health services and general practices are supported to provide culturally competent services for Aboriginal people and Torres Strait Islanders.

Importantly, Indigenous leadership must be preserved in the development and implementation of this strategic approach.

A positive state of mental health and happiness can be a buffer against adverse circumstances and health conditions. The physical health and mental health of Aboriginal people and Torres Strait Islanders are therefore intertwined.

This means that, in measuring what it will take to close the gap in Indigenous health, it is critical to include mental health and social and emotional wellbeing in the equation

Early childhood key to closing health gap: AMA

 

Robust and properly targeted investment in the health and development of Indigenous children in their early years is “one of the keys” to breaking the cycle of ill-health and premature death afflicting Aboriginal and Torres Strait Islander peoples, according to AMA President, Dr Steve Hambleton.

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Dr Hambleton told a recent Health Conference that improving early childhood health should be a priority in efforts to close the gap in life expectancy and well being between Indigenous people and the rest of the community.

In his speech, the AMA President paid tribute to pioneering Indigenous health leader Puggy Hunter and his work to promote partnerships and information sharing in primary health care.

In this spirit, Dr Hambleton said there was already good evidence about what would work to boost the health of Aboriginal and Torres Strait Island children in their crucial formative years, and what was needed was the political will to make a “substantial funding commitment” to these measures.

“We know that robust and properly targeted and sustained investment in healthy early childhood development is one of the keys to breaking the cycle of ill-health and premature death,” Dr Hambleton told the conference.

He said that to be effective, efforts to improve child health had to encompass the conditions in which they live and develop, including the family environment, living conditions, access to culturally appropriate health care and opportunities for education and work.

“The timing for this investment is crucial. It needs to be in the early years, where a healthy childhood can lay the foundation for resilience [later in life],” the AMA President said.

Dr Hambleton said health at infancy was a “strong indicator” of how people would fare in later life, pointing out that the life of an Indigenous person born in the middle of the last decade was likely to be up to 11 and a half years shorter than that of a non-Indigenous person born at the same time.

He said Indigenous babies were twice as likely to die as those in the rest of the population, most commonly from complications during pregnancy or birth, as well as respiratory and cardiovascular disorders suffered just before or after delivery.

The AMA President told the conference that a number of factors contributed to these problems, including smoking, drinking and poor diet among pregnant women.

But Dr Hambleton said improving early Indigenous childhood health also involved addressing social problems that undermined well being, including family poverty, poor housing, low educational attainment and emotional stress.

He said there was “decades of evidence” that a number of early childhood programs were effective in helping protect the health of infants, particularly Nurse Home Visiting maternal health and Abecedarian programs.

For every dollar spent on regular home visits to mothers by registered nurses, $5.70 was saving in future health and social costs, Dr Hambleton said, while Abecedarian programs had been shown to be effective in helping disadvantaged children attain higher levels of education and lower instances of risky behaviour.

“It is true that neither of these successful long-term interventions is cheap,” he said. “They are quite costly to implement where they would be needed in Indigenous communities. [But], their success is manifest, and they will bring about health benefits and savings that far exceed their cost.”

Dr Hambleton said that although some progress had been made in improving Indigenous health, outcomes still remained very poor compared with the broader community, and warned that the current $1.6 billion Council of Australian Governments National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes was due to expire next year.

“There is a need to renew [it] with comparable funding, and build on the groundwork that has been established,” he said.

To help maintain the momentum of effort, the AMA plans to release a major report on early Indigenous childhood health and development next year.

Dr Hambleton said the AMA’s 2013 Aboriginal and Torres Strait Islander Health report card will “highlight the importance of healthy early development, and the role that tried and true interventions can play, [including] recommendations about how governments ought to be supporting these interventions more”.

AR