NACCHO CTG member response :NT only jurisdiction on track to close the gap by 2031: Congress Alice Springs

Donna Ah chee

Closing the Gap is working but requires long term commitment and investment

“The NT is the only jurisdiction currently on track to close the gap by 2031.

This achievement is in large part, the result of governments working in genuine partnership with Aboriginal community-controlled health services and investing new funds where they are most needed.

This is strong evidence that the significant investment in the NT, especially the investment in Aboriginal primary health care, is working”,

 Ms Donna Ah Chee (pictured above left )the CEO of Congress, NACCHO board member and former CEO of NACCHO

The Central Australian Aboriginal Congress Aboriginal Corporation welcomed the latest Closing the Gap report card, calling for an emphasis on continued commitment and long-term investment by the Council of Australian Governments to meet meaningful targets in Aboriginal disadvantage.

“Overall there has only been a small improvement across the nation in closing the life expectancy gap for Aboriginal people. However, looking at averages across the nation does not tell the story of significant improvement in Aboriginal life expectancy rates in the Northern Territory. The NT is the only jurisdiction currently on track to close the gap by 2031. This achievement is in large part, the result of governments working in genuine partnership with Aboriginal community-controlled health services and investing new funds where they are most needed. This is strong evidence that the significant investment in the NT, especially the investment in Aboriginal primary health care, is working”, said Ms Donna Ah Chee the CEO of Congress.

“The fact that the nation is on track to achieve its goal to halve the gap in year 12 educational attainment by 2020 is important. Achieving better educational outcomes is largely a precursor to stable, meaningful employment at a reasonable income level. However, the improvement in education is not uniform and a lot more needs to be done in remote communities across the NT.

“Although the addition of a new target on closing the gap in school attendance rates may be useful, Congress is disappointed that the new target was not more directly focused on closing the gap in actual Educational outcomes. Attendance at school is important but it it’s only a means to a successful outcome which is completing year 12 studies and being fully literate and numerate. If children have entered school without the developmental capacity to learn and do well then attendance alone will not be sufficient to address the gap in educational and employment outcomes.

“Congress suggested that the new target could have been to close the gap in the Australian Early Development Index scores of children aged five years, as this is the key to closing the gap in both school attendance and successful educational outcomes. We need a “bottom up” strategy to addressing school attendance which ensures our kids enter school capable and ready so that school is where they want to be not where they have to be.

“Congress also welcomed the improvement in Aboriginal child mortality rates.

“It is a concern that there has been no progress on some targets, especially the employment target, but there is a wide ranging review currently underway on this issue which will hopefully lead to some useful new approaches. In the meantime, it is vital that all Australian governments, through COAG, recommit to the long term cooperation and  investment that is clearly working though the Closing the Gap National Partnership Agreements”, said Ms Ah Chee.

For more information, contact Emily MacKenzie, Communications Officer, on 8953 7814 or by email at emily.mackenzie@caac.org.au.

NACCHO Aboriginal health debate : Chronic drinking problem in the NT costs about $642 million annually

Alice

One new policy that does appear effective is stationing police officers outside bottleshops. Regrettably this has also stirred up racial tension. The officers check drinkers’ IDs to see if they live in a proscribed area, and confiscate their purchases if they do. John Boffa (Congress Aboriginal Health ) a spokesman for the People’s Alcohol Action Coalition, estimates reductions in domestic violence of up to 50 per cent in Alice Springs when police cover all 11 liquor outlets at once.

Priscilla Collins, chief executive of the North Australian Aboriginal Justice Agency, thinks both AMT and APOs unfairly target the most disadvantaged, who are often also the most visible. “They will probably end up going back to the long grass,”

IF the Northern Territory were a country, it would rank alongside vodka-soaked ex-Soviet republics in terms of per capita alcohol consumption; not long ago it would have been second in the world.

 Refer NACCHO NT AMSANT grog summit news:

Four major outcomes on alcohol policy and its impact on Aboriginal people and communities

PICTURE :Police on duty outside a Northern Territory bottleshop. ‘The (alcohol) industry is now being propped up by the Alice Springs police force,’ says head of the police union Vince Kelly. Picture: Amos Aikman Source: News Limited

Alcohol abuse costs the NT about $642 million annually in police time, corrections, judicial support, medical treatment and lost productivity – equivalent to roughly $4000 per person or 4 1/2times the national average – according to research quoted by the government last year. The latest figures show per capita alcohol consumption is again on the rise, ending a six-year decline.

Territory drivers are 20 times more likely than the national average to be caught over the limit; booze is a factor in many road deaths. A majority of Territory assaults involve alcohol and the Territory’s assault victimisation rate is more than 50 per cent above the rest of the nation’s.

In 2011-12, indigenous women were 18 times more likely to be bashed than non-indigenous women, and four times more likely than the Territory average.

Last financial year saw almost 40 per cent more alcohol-related assaults and almost 60 per cent more domestic violence related assaults than the equivalent period five years ago.

Since the Country Liberals took office 18 months ago, Aboriginal groups and legal and health policy experts have accused the Territory government of criminalising drunkenness, ignoring evidence and favouring the interests of the alcohol industry.

The government insists its policies are both appropriate and working, though many cracks have emerged. The CLP campaigned on a pledge to cut crime by 10 per cent annually – which by a slip of the tongue quickly became 10 per cent in a four-year term once it took office. CLP backbencher Gary Higgins recently acknowledged MPs are receiving a “barrage of complaints” about alcohol abuse from the community. His comments drew a quick rebuke from Chief Minister Adam Giles, who said: “We know that there are issues with alcohol in our society, but anyone who has a good look at the statistics will see that things are getting better.”

After repeatedly dodging questions about the saga unfolding on his doorstep, federal Indigenous Affairs Minister and NT senator Nigel Scullion proposed a sweeping national inquiry into drinking habits. The following day he appeared to have been overruled by his colleagues in favour of a tighter probe into Aboriginal drinking that will scrutinise the CLP policies more closely. Giles has already suggested any inquiry would be “navel gazing”. Nevertheless, the process offers his government an opportunity to gracefully adjust its course.

The CLP’s first act in office was to abolish Labor’s Banned Drinker Register, a point-of-sale supply restriction designed to curb heavy drinking. For almost a year, while the new government convulsed with internal ructions, nothing replaced the BDR. Then less than a month after Giles took power in a coup in March, his government unveiled a forced alcohol rehabilitation program called Alcohol Mandatory Treatment. The scheme, which has been running for seven months, involves locking up habitual drinkers in treatment centres with fences and guards.

Associated legislation was passed in the face of vocal opposition. At about $43,000 per drinker treated, AMT is more expensive than many private rehabilitation clinics. Experts think 5 per cent success would be good going. More than 150 people have completed the program; the government has established 120 beds. Alcohol Rehabilitation Minister Robyn Lambley says some patients have had their lives changed, but others are known to have relapsed.

Before Christmas a system of on-the-spot alcohol bans, Alcohol Protection Orders, was also legislated, again despite opposition. These affect people charged with, but not necessarily convicted of, offences in which alcohol was deemed a factor.

The government argues these policies transfer responsibility from society to drinkers, but important figures, such as head of the NT police union Vince Kelly, argue that is a furphy. “If you’re an alcoholic you haven’t got (personal responsibility) in the first place, and if you’re an intergenerational alcoholic you probably don’t know what the concept means.”

Not long ago a doctor who played a key role in establishing AMT, Lee Nixon, walked out in disgust. “A large number of (AMT patients) had little understanding of the process, and at the end of the time when they were there, were still asking, ‘Why am I here?’,” Nixon told ABC’s Lateline. “At the outset it was clear that we were introducing a program with no evidential base for effectiveness.” One drinker had her treatment order overturned by a court on the grounds she received it without proper legal representation. Justice groups say few drinkers appear before the AMT Tribunal with a lawyer.

Priscilla Collins, chief executive of the North Australian Aboriginal Justice Agency, thinks both AMT and APOs unfairly target the most disadvantaged, who are often also the most visible. “They will probably end up going back to the long grass,” she says.

Shortly after taking up his post, Alcohol Policy Minister Dave Tollner openly acknowledged one of AMT’s goals was to push drinkers to “go and hide out in the scrub”. AMT is now being reviewed.

The CLP has trenchantly refused to contemplate imposing any new supply restrictions. Giles told a gathering of hoteliers drinking was a “core social value”, while Tollner said Labor had treated publicans “akin to heroin traffickers”. The latest round of annual political returns to the Australian Electoral Commission reveal the alcohol industry’s main lobby, the Australian Hotels Association, has emerged as the Territory’s largest political donor. The organisation contributed $300,000, split between the major parties in the lead up to the August 2012 Territory election. According to an analysis of declared donations, the lobby donated almost 14 times as much per head of population in the Territory while the BDR was in place than it has in any other jurisdiction in the past decade.

At the time it was abolished there was little evidence clearly supporting the BDR. However it has since become clearer that although policy did not turn around increases in alcohol-related harm and violence as promised, it may have blunted them. Some quite senior CLP figures talk privately about bringing the BDR back.

One new policy that does appear effective is stationing police officers outside bottleshops. Regrettably this has also stirred up racial tension. The officers check drinkers’ IDs to see if they live in a proscribed area, and confiscate their purchases if they do. John Boffa, a spokesman for the People’s Alcohol Action Coalition, estimates reductions in domestic violence of up to 50 per cent in Alice Springs when police cover all 11 liquor outlets at once.

However the approach is a de facto supply restriction, with responsibility for enforcement transferred from the liquor retailer to the public service, as Kelly points out: “The (alcohol) industry is now being propped up by the Alice Springs police force.”

Combined with AMT’s high price tag, the government’s measures do not look at all cost effective. Assuming the number of people taking up drinking is proportional to population growth overall, the government would need at least five times the present number of AMT beds just to keep the number of alcoholics stable. The cost of that would exceed $1 billion by the end of the decade, or roughly 20 per cent of last year’s Territory budget.

Higgins called for a bipartisan inquiry with measures his government officially opposes – an alcohol floor price, shorter opening hours and BDR-like supply controls – put back on the table. “While they do inconvenience a lot of people, all of them should be considered,” he said. Kelly thinks there is a “gaping hole” in public policy around alcohol supply issues. “Neither the Labor government or the CLP government has covered itself in glory when it comes to that type of thing because they’re simply too close to the industry,” he says.

“There has got to be some serious question about whether (an inquiry) is warranted.”

A serious investigation would need to consider not just the efficacy of a range of policies, but the circumstances in which they are applied. Alcohol bans in remote communities push drinkers into towns, where their drinking often worsens. Proscribed urban areas leave residents who can legally buy takeaway alcohol unable to legally drink it. Stationing police outside bottleshops increases familial pressure on those living in non-proscribed areas to become involved in the alcohol supply trade; anecdotal evidence suggests the black market is thriving.

Some federally administered draft alcohol management plans are stuck in limbo, in part because it is unclear what the basic requirements are for Aboriginal communities to responsibly manage alcohol themselves. Community leaders often blame disenfranchisement for their giving up on the task. Many people familiar with these issues say the solutions lie not in textbooks or boardroom chats, but in the lives of Aboriginal people; another desktop study will not help.

It is also worth considering whether alcohol-related harm can be reduced to acceptable levels soon, or just mitigated and hidden. Not even the last of those has been accomplished so far. NT Attorney General John Elferink argues for stricter controls on welfare to break the link between welfare dependency and drinking: “We can build massive institutions to deal with alcoholism, but while the federal government pours free money into our jurisdiction, spending millions of dollars every fortnight, we as a government are going to be spending millions of dollars every fortnight cleaning up the mess.” Without action on several of these fronts, the NT’s alcohol abuse crisis looks likely to get worse.

NACCHO Aboriginal health news; Aboriginal organisations to put communities back in control

131031 - Media Release re NGO principles endorsement (EMBARGOED UNTIL MIDNIGHT 30 October)_Page_1

An alliance of Aboriginal organisations and non-Aboriginal NGOs will today launch a set of principles aimed at empowering Aboriginal organisations and communities in the NT to take control of their futures.

DOWNLOAD THE PRINCIPLES HERE

“Today a number of local, national and international NGOs have publically endorsed a set of principles which will guide partnership centred approaches for NGOs working in Aboriginal communities” said Ms Priscilla Collins, spokesperson for Aboriginal Peak Organisations NT (APO NT). (A copy of the principles is attached.)

“These non-Aboriginal NGOs have agreed to work together with Aboriginal organisations and communities to promote Aboriginal community-control of service delivery. It’s about putting Aboriginal people back in the driver’s seat”, said Mr John Paterson, spokesperson for APO NT.

Organisations endorsing the principles include national and international NGOs engaged in delivery of health and community services in the Northern Territory. A full list of NGOs that have endorsed the principles is below.

Development of the principles was informed by a forum in Alice Springs in February that brought together sixty participants from twenty-seven non-Aboriginal NGOs and six NT Aboriginal representative organisations – the first gathering of its kind in the NT. The forum acknowledged that there are a number of NGOs that already have good working relationships with Aboriginal organisations, but this is not systematic.

The principles present significant opportunities for these organisations to learn from each other, create better partnerships and working relations with Aboriginal organisations operating at the ground level and achieve better outcomes for communities.

Organisations leading the initiative include APO NT, Strong Aboriginal Families, Together (SAF,T), the National Congress of Australia’s First Peoples, the Australian Council of Social Service (ACOSS) and the NT Council of Social Service (NTCOSS).

“It is important that Aboriginal and non-Aboriginal organisations work side by side in partnership to put Aboriginal people back in control of service delivery in their communities,” said Mr Lindon Coombes, CEO of The National Congress of Australia’s First Peoples (Congress).

The general consensus reached at the Alice Springs Forum was that the formal endorsement of the principles by organisations should effectively operate as a voluntary code.

“This work represents significant leadership and partnership from both the Aboriginal and non-Aboriginal NGO sector, in pioneering new ways to work together to get the best possible outcomes for Aboriginal people in remote NT communities,” said Mr Simon Schrapel, President of ACOSS.

The next stage of the collaboration will be to operationalise the principles.

“We look forward to working together to develop operational guidelines for how these important principles will work in practice,” said Ms Wendy Morton, Executive Director of NTCOSS.

“This is something that Aboriginal agencies have been wanting for a long time. These principles will guide the development of true partnerships that will result in better understanding and outcomes for all concerned,” said Terry Chenery, Acting CEO of SAF,T.

Need help about Aboriginal health or the location of your nearest ACCHO on your SMARTPHONE or IPAD

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NACCHO Aboriginal ehealth technology news: Telehealth,ehealth and the Aboriginal digital divide

Eh ealth

In this issue Telehealth

Roy Monaghan, national telehealth delivery officer at the National Aboriginal Community Controlled Health Organisation (NACCHO), says the lack of reliable broadband in remote and rural Australia has contributed to a digital divide.

Please note that NACCHO plans to launch an ABORIGINAL HEALTH APP this week as part of its Sports Healthy Futures Program ;

Followed by Ehealth below

The PCEHR will become the primary record for all new information, but the MeHR will also be accessible for historical documents.

The NT is also holding off until next year as the national PCEHR cannot yet receive pathology and diagnostic imaging reports, which the MeHR can. The NT is planning to go live just after the major upgrade of the PCEHR planned for April, when pathology reports are expected to be available.

TELEHEALTH: Slow NBN rollout contributing to digital literacy deficit

Roy
The slow roll out of the National Broadband Network is contributing an ongoing digital literacy deficit across Australia, especially in telehealth, according to speakers at the Connected Australia event in Sydney.

“There’s a lot of up-skilling to do, in particular at the home end or recipient end of healthcare. There’s a notion of build it and they will come: If you don’t have the NBN, you won’t generate the digital literacy to maximise the use of it. So it’s a little like chicken and egg,” said Professor Colin Carati, associate head of ICT at Flinders University.

Roy Monaghan, national telehealth delivery officer at the National Aboriginal Community Controlled Health Organisation (NACCHO), agreed, saying the lack of reliable broadband in remote and rural Australia has contributed to a digital divide.

“It’s like having a bike: you don’t really learn what the bike can do until you get on it. You may make a few mistakes, but essentially you have a vehicle that can take you faster than you can with your legs. If people don’t have the ability to jump onto a system and make those mistakes, adjust and learn on how to do things a bit better, we are not going to go places.”

Carati pointed to issues around the NBN rollout schedule not going according to plan, saying it has made the process of providing adequate teleheatlh services difficult.

A NACCHO survey showed that only 30 of about 100 members were actually engaging in telehealth services, with the lack of an effective Internet connection being the main reason why many weren’t engaging in telehealth, said Monaghan.

He added that the new government’s fibre-to-the-node broadband policy is “an incomplete solution”, but it could offer some flexibility in being able to make changes to the network as technology continues evolves over time.

“It could be that wireless technology does evolve and you may be able to [leverage] it at these nodes, and maybe there will be a Wi-Fi tower that can shoot out the information at a very high speed.”

A telehealth project that Carati is working on in South Australia is providing people at home with particular health conditions to have their health status monitored remotely on a regular basis through an iPad app and through video conferencing.

He said he was able to provide this without the need for a large amount of bandwidth; less than 1Mbps per video conference. However, he said he is still limited in the quality of service he can provide due to poor reliability of Internet.

“There are occasions, especially when you are using non NBN related technologies, where you are getting poor quality and reliability of service, primarily though the contention of those technologies where you are getting too many people trying to jump on the bandwidth.

“The NBN will improve access, especially pushing out to the home and the bandwidth demands are likely to increase.”

ehealth

States commit to rapid eHealth integration project

Written by Kate McDonald on 10 October 2013., Pulse IT magazine

The majority of states and territories will have the ability to begin allowing acute care clinicians to view clinical documents and send discharge summaries to the PCEHR system by the end of the year.

In a panel discussion at a recent ICT forum organised by the Department of Health and NEHTA, jurisdictional representatives provided an update on their respective eHealth strategies and how they planned to connect acute care to the PCEHR.

No representatives from South Australia and Western Australia were on the panel, although SA has already begun sending discharge summaries from nine public hospitals and has developed software called Healthcare Information and PCEHR Services (HIPS) that is being used by other states as part of NEHTA’s unfortunately named rapid integration project (RIP).

Paul McRae, the principal enterprise architect with Queensland Health, told the forum that the jurisdictions were all members of a RIP steering committee that he chairs. Mr McRae said the committee had agreed that the first steps to integrating with the PCEHR was to enable discharge summaries to be uploaded and to allow clinicians to view clinical documents.

Mr McRae said Queensland Health had linked with the HI Service in January this year, and those using it were achieving an 85 per cent match rate when pulling in batches of Individual Healthcare Identifiers (IHIs).

He said NASH certificates and HPI-Os were recently acquired for healthcare organisations to support the rapid integration program.

“We are looking to roll out statewide the ability to send discharge summaries to the PCEHR from all facilities that use our enterprise discharge summary application, which is all bar about three,” he said.

“And we are going to provide the ability to view PCEHR information from our clinical portal, which is called The Viewer . That will be available in around 200-plus facilities and that will all happen early in November.

“At the same time, discharge summaries in CDA format level 2 will be able to be sent point to point as well.”

Yin Man, manager of NSW Health’s RIP program – better known as HealtheNet – said CDA discharge summaries and event summaries had been able to be sent to GPs and the NSW clinical repository from within the Greater Western Sydney lead site since August last year.

Clinicians in Greater Western Sydney are now able to access the national system through a clinical portal , which Ms Man said would be rolled out to all public hospitals in the state over the next two years.

“Our clinicians in hospitals within Greater Western Sydney have been viewing CDA discharges since last August and this year we have been integrating with the national,” she said.

“All hospitals will be connected to this one portal. Things have been going quite well and we already have half a million CDA documents within our clinical repository, and we pretty much generate about 6000 a month. As soon as we connect, we will be sending a lot of documents to the national.”

Victoria’s representative on the panel, the Victorian Department of Health’s advisor on eHealth policy and engagement, Peter Williams, did not go into much detail on his state’s plans for integrating with the PCEHR as a review of the state’s health IT sector is currently with the health minister.

It is understood that some local health districts – particularly those that took part in the Wave 1 and 2 lead site projects – are soon to begin sending discharge summaries to the national system, but Victoria does not have the centralised approach that the other states are taking.

Mr Williams said Victoria had put a proposal to NEHTA to look at how to expand the viewing capacity of hospitals outside of the lead sites. “Once you have done it for some, you can extend it to others … using common software, and we have licences across Victoria,” he said.

“With the secure messaging project that is being done in SA, while they are using different technology, the design approach is adaptable in Victoria very quickly. That is absolutely the core of what the RIP project is about – fast-tracking some of those things.”

The Northern Territory is currently working through a major project that it is calling the M2N , in which it is transitioning its successful My eHealth Record (MeHR) system over to the national PCEHR. For that reason, it will not go live with full discharge summary and viewing capability until March or April next year.

Robert Whitehead, director of eHealth policy and strategy with the NT Department of Health, said the territory was probably going to follow Queensland and provide a combined view of both the MeHR and the PCEHR for its departmental staff.

The PCEHR will become the primary record for all new information, but the MeHR will also be accessible for historical documents.

The NT is also holding off until next year as the national PCEHR cannot yet receive pathology and diagnostic imaging reports, which the MeHR can. The NT is planning to go live just after the major upgrade of the PCEHR planned for April, when pathology reports are expected to be available.

“We have a unique set of circumstances in that we’ve been operating [the MeHR] now for eight years,” Mr Whitehead said. “We’ve got an established community of consumers and providers who have expectations about usability.

“We needed … for our clinicians in particular to be confident that what they see in [the PCEHR] matched what they currently are able to see. That has been the driver for asking DoHA and NEHTA to advance some aspects of PCEHR work in terms of a view that would support an aggregation of some key pieces of primary care information and event summaries.

“Our clinicians at the moment have access to a document that aggregates information … and that gives them a bit of a context about what has been going on with that patient in the last little while.

“The other thing is around pathology and diagnostic imaging reports in that our clinicians are used to being able to seeing pathology results that were ordered in a primary care context. Hospital stuff at the moment appears in the discharge summary and we are not arguing that should be changed.

“So our go live is a little later in that we are targeting around March-April next year as the go live date because of this need to do a hard transition from one to the other. We will still do a dual view of MeHR for people who are registered so that historical information is still accessible to our current participating healthcare providers.”

Like Victoria, Tasmania is also currently undertaking a review of its eHealth strategy. Tim Blake, deputy chief information officer with the Tasmanian Department of Health and Human Services, said Tasmania was “on the cusp” of releasing its updated eHealth strategy, which is expected to include more details about connecting to the national system.

Pulse+IT understands that Tasmania will adopt the South Australian technology to begin allowing discharge summaries to be sent and clinical documents to be viewed within its public hospitals.

The ACT has been very active in eHealth, with Calvary Hospital playing a large role in one of the Wave 2 projects and already having the ability to send CDA discharge summaries to the PCEHR and to GPs.

The ACT Health Directorate’s manager for the national eHealth project, Ian Bull, said the territory had been investigating how to quickly verify IHIs for newborn babies, so their parents can register them for a PCEHR from birth.

“Within our jurisdiction we are building a consumer portal , so consumers can log in and look at their appointments for outpatients services,” Mr Bull said.“We are also building a provider portal for clinicians in the region to be able to submit referrals and get bookings.”

He said the ACT was also in discussions with the federal Department of Human Services to investigate using Medicare’s Health Professional Online Services (HPOS) system more widely in the hospital environment.

****

Update 1.00 pm October 16

UGPA calls on Government to address clinical utility of the PCEHR as an urgent priority

Australia’s general practice (GP) leaders are calling on the Government to heed concerns raised by GPs regarding the significant clinical utility issues associated with the Personally Controlled eHealth Record (PCEHR) system and address them as an urgent priority.

At a recent United General Practice Australia (UGPA) meeting in Canberra, representatives of the GP sector unanimously agreed that the focus of the PCEHR needs to be redirected to clinical utility and standardisation to ensure seamless clinical adoption.

Significant issues have been identified and currently there is no alignment between consumer registration and meaningful use through engagement of the clinical community and assurance of improvement of patient health outcomes.

In August 2013 a number of key clinical leads resigned from National E-Health Transition Authority (NEHTA). This was amidst ongoing concerns and requests for NEHTA and the Department of Health and Ageing (DoHA) to review the PCEHR development cycle and re-establish meaningful clinical l input.

Since August, DoHA has become the PCEHR system operator and opportunities for clinical engagement have been less clear.

UGPA is calling on Government to implement strategies to ensure the PCEHR is best structured to improve the health outcomes of all Australians. The process should be profession led and include:

• GP input at every level of the PCEHR development life cycle; including planning through to implementation

• Ensuring the system is clinically safe, usable and fit for purpose

• Supported by an acceptable, and robust legal and privacy framework

• Secure messaging interoperability is a critical dependency priority.

E-health and the PCEHR have the potential to transform Australia’s health system and provide superior, safer and more efficient healthcare to all Australian patients. UGPA members believe that this potential will only be fully realised if there is meaningful clinical engagement at a grassroots level.

The Government has announced it will review implementation of the PCEHR. UGPA supports the review and look forward to contributing to the review and expect that the clinical voice and the concerns raised will be heard.

ENDS

UGPA comprises the Royal Australian College of General Practitioners (RACGP), the Australian Medical Association (AMA), the Australian Medicare Local Alliance (AMLA), the Australian General 2

Practice Network (AGPN), General Practice Registrars Australia (GPRA), the Australian College of Rural and Remote Medicine (ACRRM), and the Rural Doctors Association of Australia (RDAA).

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NACCHO Aboriginal health funding alert :Health Minister Peter Dutton to review troubled e-health

Peter Dutton

According to reports in The Australian  HEALTH Minister Peter Dutton has moved swiftly to initiate a review of the troubled $1 billion personally controlled e-health record system at the behest of Tony Abbott.

Mr Dutton has received initial briefings on the PCEHR from key stakeholders such as the Department of Health.

NACCHO has supported the introduction of a national eHealth record system. Through AMSANT our sector has directly experienced the benefits that have been gleaned from a shared electronic health record system (SEHR).

Our sector has been early adopters of eHealth initiatives for many years. More recent examples include: AMSANT and AHCSA integration with the NT Department of Health and Families eHealth site (wave 2) project, QAIHC adoption of the eCollaboratives project and the KAMSC regional linkage of Aboriginal Medical Services to hospitals in the Kimberley to name just a few examples.

As a result our sector has been in a  unique position to participate in the monitoring and evaluation of the PCEHR system as we have extensive knowledge and practice to draw from.

NACCHO and its affiliates are committed to the National eHealth agenda through the National ACCHS
eHealth Project (A new website will be released over the coming weeks)

The Coalition will undertake a comprehensive assessment of the true status of the PCEHR implementation as outlined in its health policy released in the lead up to the election. “In government, the Coalition implemented successful incentives to computerise general practice and will continue to provide strong in-principle support for a shared electronic health record for patients,” the policy says.

“The Coalition will again work with health professions and industry to prioritise implementation following a full assessment of the current situation.” A spokeswoman for Mr Dutton declined to say who was expected to lead the review or how long it would take.

“We all support an electronic health record,” she said. “However, we have grave concerns about the amount of money the previous government spent on e-health for very little outcome to date.

“At a cost of around $1bn, we should have a lot more to show for it.” In opposition, Mr Dutton and others criticised the PCEHR’s performance, saying that while more than 650,000 people had registered for an e-health record, only 4000-plus shared health summaries were created.

The summaries are generated by a patient’s GP and contain diagnoses, allergies and medications. The spokeswoman declined to say if Deloitte’s refresh of the 2008 national e-health strategy had begun. Medical Software Industry Association president Jenny O’Neill said her organisation was “very willing to assist the new Health Minister in a review and planning for a sustainable (e-health) future”.

“In a recent Q&A program on the ABC, former health minister Tanya Plibersek equated a $1.5bn investment by government as a ’rounding error’,”

Ms O’Neill said. “Had her department invested this ’rounding error’ in the e-health sector by strengthening the electronic bridges between all the parties, Australia would have achieved major and sustainable transformational change in this timeframe.

If all the important infrastructure supporting current data transfer had been strengthened and upgraded with the latest technologies, national security and safety standards would now exist.” She said the PCEHR was “a much advertised national system which is next to empty”. ”

Each transaction in this national system has to be routed through a national repository,” Ms O’Neill said. “It is like building a fast train system between the cities and towns of Australia and requiring every trip to go via Canberra.” She said taxpayers could not afford rounding errors in e-health.

The Consumers e-Health Alliance wants the government to establish a “truly independent” national e-health governing council that comprises medical experts, consumers, the local health IT industry and government agencies. Alliance convenor Peter Brown said the council would have oversight of a new entity tasked with implementation and operational responsibilities.

Last week the Pharmacy Guild told The Australian it would make a detailed submission to the e-health review centred on three areas: patient issues, pharmacy issues and system issues.

Pharmacy Guild national president Kos Sclavos said there had been “some significant mistakes and missed opportunities” with the PCEHR. Meanwhile, in an industry workshop prior to the election, Health chief information and knowledge officer Paul Madden said one area of improvement was communication.

“The advent of this forum probably lines up with a new era in consultation and communication with the IT industry across the whole health and ageing space,” Mr Madden told participants.

He said there wasn’t a single channel or co-ordinated approach to disseminate information on e-health but the department was determined to improve matters. “There is so much going on … so much overlapping … so much possibility for confusion, mis-messaging and I think we need to get better at communicating what’s happening next,” he said.

Mr Madden expects such industry workshops, where participants range from departmental officials to software providers, to occur three to four times a year. –

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NACCHO as the national authority in comprenhesive Aboriginal primary health care currently has a wide range of job oppportunities in the pipeline.

Register your current or future interest with our HR TEAM HERE

NACCHO political alert: How will the new Indigenous Affairs Minister Nigel Scullion be different ?

Nigel

“We’re bringing the functions of a whole range of Indigenous specific functions across to Prime Minister and Cabinet. Health will stay with Health, education will stay with Education, but there are a whole range of functions we’re taking out of the Department of Families, Housing, Community Services and Indigenous Affairs, and the Department of Education, Employment and Workplace Relations and out of other departments, functions that are either remote or Indigenous specific”

Nigel Scullion will today be sworn in as Indigenous Affairs Minister, in a series of interviews yesterday with ABC radio and the Alice Springs news he spelt out his plans for Indigenous Affairs within the department of Prime Minister and Cabinet

Interview transcript ABC radio

Nigel Scullion has been appointed Indigenous Affairs Minister, giving the NT its first Federal Cabinet Minister since the Country Liberals were formed.

Tony Abbott has announced that Senator Scullion is keeping the portfolio that he was spokesman on in the last parliamentary term, and it will sit within the department of Prime Minister and Cabinet.

Senator Scullion said his Government was giving Australia’s indigenous communities a new commitment to listen to their solutions to challenging problems.

“To work with communities, not make decisions and impose them on communities,” Senator Scullion said.

“Communities best know how to get their kids to school.

“Communities know the very best way to move some of their participants from welfare into work.

“Communities know how to make their own communities safe.”

The Federal Indigenous Affairs Minister-elect said he’d asked the Government’s Indigenous advisory committee to look at how to tackle reliance on welfare.

Senator Scullion said the Government planned to toughen the requirement for people to take available jobs in urban areas.

He said, in remote communities, the Government would consider if it was appropriate to expect people to stay on Newstart welfare payments if there were no jobs for them to do.

“Given that Newstart has an implication that this is a transitionary time from where they are to a job, well, if there are no jobs – and in the many communities there are no jobs, it’s simply a welfare community – I think that’s an unacceptable situation that we should pretend there are jobs there.”

Secondly he spoke this morning with Alice Springs News Online editor ERWIN CHLANDA.

masthead

Outback answers to bush welfare mess

NEWS: Is there a case for expanding the principle of stopping the dole for people rejecting offers of work, for expecting that people who have assets use them for projects that create work? Aborigines in The Centre own half a million square kilometres.

SCULLION: Receiving Newstart payments in an area that has no economy and no jobs is inappropriate. In these conditions governments have been taking the view that the dole is unconditional.

We know that is not acceptable in the long term. Newstart is for people between jobs, searching for jobs. We need to look at that more broadly.

The development of an economy such as tourism, broad-acre or pastoral industries, manufacturing – these are very important elements of the future and the government plays an important role.

NEWS: Is there a case for Aboriginal land trusts and land councils to look for joint ventures with job creation as a main focus?

SCULLION: I’ve had long conversations with land owners about a range of issues, from tenure to development. As areas are developed and jobs become available, and we move to an economy, then clearly we would have a reasonable expectation to involve people currently disconnected.

If they are able to work then they should be working. I’ve not heard anyone saying no, we don’t need economic development and we want to continue to receive welfare. Nobody’s told me that. We’ll be working closely with the land councils.

In the area you’re speaking off, places like Ali Curung, it has been disappointing that a melon farm is six kilometers up the road from able bodied men and women and they find it very difficult to get employment. That’s an issue. It’s a complex one.

Who’s currently making the decisions? This is an area where they are adjacent to an economy, and adjacent to jobs. If there is a job there, and you’re simply saying, I’m just not going to take that job, well, there’s no unconditional welfare.

The leverage of moving people away from the horrors of welfare into employment – it’s good enough for people in the mainstream. These opportunities should also be available to Aboriginal people.

NEWS: Is there a reluctance by the land trusts and land councils to enter into joint ventures that could create jobs?

SCULLION: The use of broad-acre land such as in other states is one of the low hanging fruits of economic development. Look over the fence! Whatever they’ve been doing there for the last 30, 40 years is probably a good indicator of how to use the land. As to the land councils, I’m always interested in hearing submissions. They should be assisting the land owners where they can.

Separate services: Congress gets big tick

NEWS: What’s the future of the big Aboriginal organisations in Alice Springs? Tangentyere and Congress, for example?

SCULLION: We don’t need duplication of services. We need very good services. If you talk about the application of municipal services in some of the town camps by Tangentyere, I have had a number of people telling me that they don’t believe the service they are getting is particularly good.

If you live in some areas of Alice Springs you shouldn’t be delivered a different service, you should be getting exactly the same service. And equally you should be expected to pay for it. For example, normalcy for the town council would be, who’s going to pay rates?

NEWS: What about Congress?

SCULLION: Congress in Alice Springs is probably one of the best health organisations in Australia, full stop. They have moved to a very good business model that has been picked up in other parts of Australia.

They’re fundamentally welded to Medicare, they ensure all of their clients have a Medicare card. It’s the same sort of [positive] index you get across Australia, particularly in demographics with larger areas of need.

NEWS: What’s on top of your agenda as the new Minister?

SCULLION: Talking with my partners in the other jurisdictions, discussions about structural changes in the departments, moving many of the instruments of government into Prime Minister and Cabinet, the formation of a new role.

NEWS: Which functions of Indigenous Affairs will be moved?

SCULLION: We’re bringing the functions of a whole range of Indigenous specific functions across to Prime Minister and Cabinet. Health will stay with Health, education will stay with Education, but there are a whole range of functions we’re taking out of the Department of Families, Housing, Community Services and Indigenous Affairs, and the Department of Education, Employment and Workplace Relations and out of other departments, functions that are either remote or Indigenous specific

NACCHO member news Press Release: Aboriginal health service in NT bringing all community together for mediation forum

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Historic images of Congress 2010  campaign to Stop the Violence in Centralia Australia

Des

“This is the start of a dialogue on a number of issues of concern, primarily violence, but not as an Aboriginal specific issue, but as an issue for the whole community.”

Congress Deputy CEO Des Rogers (picture above)

PRESS RELEASE

Tuesday September 10

from 6.30pm until 8.30pm in the Theatrette at Centralian Senior College.

Congress Alice Springs , who are the leading Aboriginal primary health care provider in  Central Australia, are holding the forum in partnership with CASSE to promote an interactive dialogue between all groups in the Alice Springs community.

The aim is find solutions that will make the region a happier, healthier, safer environment in which to live and raise a family.

CASSE, which stands for “creating a safe, supportive environment” are partnering with Congress, who also provide extensive social and emotional wellbeing services, to understand and address issues of violence and underlying trauma that currently exist within the community.

A respected and experienced panel made up of psychoanalysts and psychiatrists with experience in community mediation at an international level, together with Aboriginal leaders, the mayor and a local leader of business have been assembled for the forum.

Lord John Alderdice, Professor Stuart Twemlow and Justice Jenny Blokland will be visiting Alice Springs to participate as panel members, while William Tilmouth, Donna Ah Chee, Julie Ross and Damien Ryan make up the local contingent.

Lord Alderdice and Professor Twemlow will add a global perspective to the forum with their experience in peace negotiations in Northern Ireland and successful violence reduction projects in the USA respectively.

Facilitated by Ms Olga Havnen, the event will be recorded by NITV.

After hearing from the panel, members of the community will be invited to discuss their concerns in a question and answer session in an opportunity to look at what we have, where we are at and where we

The  televised public forum on Tuesday September 10 from 6.30pm until 8.30pm in the Theatrette at Centralian Senior College. The event is open to the public and will be enriched by attendance and representation from all sections of the community

For further information regarding the Walk In My Shoes Public Forum please contact:

Marah Prior, Executive Assistant, Central Australian Aboriginal Congress Aboriginal Corporation

PO Box 1604 Alice Springs NT 0871 | T. 08 8951 4401 | F. 08 8959 4717 | E. execsec@caac.org.au

A related public forum will be held in Melbourne on Saturday 7 September entitled

“Reconciliation Australia – Psychological Perspectives.”

Lord John Alderdice and Professor Stuart Twemlow will also be presenting at this forum.

Lord John Alderdice, psychiatrist and psychoanalytic psychotherapist, previously Speaker of the Northern Ireland Assembly, currently Convener of Liberal Democrat Party in the House of Lords, who played a significant role in initiating the dialogues that led to the Good Friday Accord and peace in Northern Ireland.

Professor Stuart Twemlow, Psychoanalyst, Professor of Mental Health Prevention, University of Kansas; an international authority in the application of psychoanalytic principles and systemic interventions to the prevention of bullying and violence.

NACCHO political news: How will our NACCHO members survive a change of government?

Ross river 2013 110

“Both major parties say they are committed to Aboriginal health care – the NGO’s major activity – but until the dollar numbers are made public, there’s a question mark over the size of their commitment.

There are something like 15 health providers. This is ridiculous. We need to be working in partnership. I don’t give a hoot who gets the kudos out of that, as long as the outcomes for our clients is better.” Des Rogers

Des Rogers pictured above left with Dr Mark Wenitong and Kevin from Jimmy Little Foundation making recommendations at a recent Male health summit.

The wish list of the Central Australian Aboriginal Congress, for whomever will gain power in Canberra, contains not what it wants to get, but what it doesn’t want taken away.

From Erwin Chlanda SUBSCRIBE HERE  Alice Springs News

In a swirl of rumored spending cuts, where will the money come from to drive the NGO’s newly chosen direction?

It is 40 years old, has a budget of $38m a year, for both town and “auspiced” services. More than 70% comes from the Feds. Congress has 300 employees, half of them Aboriginal. It has a new chairman (William Tilmouth), a new CEO (Donna Ah Chee) and a new Deputy CEO

The NGO has emerged from the bunker where the previous regime resided, until it got its marching orders after a string of scandals and a Federal review.

Both major parties say they are committed to Aboriginal health care – the NGO’s major activity – but until the dollar numbers are made public, there’s a question mark over the size of their commitment.

Congress now wants to go further, earning back a place in town it occupied decades ago, not only as the voice of Aboriginal people, but engaging with the broad community and economy.

On the health scene, care for children from conception to age four is a key part of the main mission, in tandem with an attack on domestic violence where the facts are horrendous, mostly “Aboriginal male violence on Aboriginal women,” says Mr Rogers.

“You only need to go to the hospital emergency department, or sit in the mall, and you’ll see young and old Aboriginal women who are bruised, battered and in some cases disabled because of violence.

“Because of customs, kinship and cultural law, particularly Aboriginal women on a community attract violence. They either end up dead or they walk into the desert and end up dead. We’ve got to do something about that.

“There are plenty of Aboriginal men who would love to stand up for Aboriginal women but they don’t get the opportunity.”

Mr Rogers quotes some figures from the Justice Department: mothers of NT children are 48 times more likely to be admitted to hospital for reasons of assault than all Australian women.

In 2009/10, more than 840 Aboriginal women had assault-related admissions to hospital in the NT, compared with 27 “other” women. In the year ending June 2012, the rate of “assault offences” recorded in Alice Springs was nearly six per 100 people (almost double the NT average). 68% of domestic violence is alcohol related. The rate of domestic violence assaults is 98% greater than the NT average.

Aboriginal women in the NT are 80 times more likely than other Australian women to be hospitalised as a result of assault.

But the news is not all bad, says Mr Rogers: “In the NT, in terms of Aboriginal health improvement, there has been a 30% decline in the all-cause mortality rate over the last decade or so, and we want to build on what is working, and not throw the baby out with the bathwater.”

Congress has a major clinic, open seven days a week; a male health unit, family partnership program, birthing centre and other programs. It has spread beyond the town limits, “auspicing” five bush clinics at Amoonguna, Santa Theresa, Areyonga, Hermannsburg and Mutitjulu.

Congress is seeking Aboriginal Benefits Account money for a truck carrying three small offices on the back for doctors, paramedics or social workers, which will do the rounds of communities, spending several weeks in each one, as long as it takes, finding out from the locals what their issues and concerns are.

“It could be alcohol, suicide, violence,” says Mr Rogers. “We’ll let the community come to us, encourage them through activities, kids, women, fellas.

“Then we would encourage other agencies which have the expertise to come out and talk to the community. It’s grassroots stuff. You might say it’s an Aboriginal problem. In fact it affects all of us, the town, the economy.”

Mr Rogers, currently on three months’ probation but willing to serve Congress for five years, says he has never been on the dole, has run a produce business for 13 years, “trained, employed and mentored more than 200 Aboriginal people” most of whom “went on to bigger and better things”.

He says some of his employees left because they didn’t like the hours – 4am starts: “On the Mondays, during footy season, I employed backpackers,” he says. “You needed to be flexible as an employer.”

He was briefly a town council alderman, and the Labor Party candidate last year in the NT seat of Namatjira. He’s had a hand in several other businesses, including hospitality and security services.

Mr Rogers spoke with Alice Springs News Online editor ERWIN CHLANDA.

NEWS: What about self-help to end the blight of welfare dependency? Drinking, not taking children to school, not feeding them properly – isn’t all of this up to the individual, or the community?

ROGERS: Yes and no. The main problem with Aboriginal children is neglect. It’s not deliberate neglect. It’s partly because young mothers and families don’t know how to look after young people, it is partly due to addictions and other mental health conditions and it is partly due to the often very adverse social environment that parents are trying to raise their children in. It is also a lack of knowledge caused by low levels of education.

A couple of my daughters are foster carers. Young babies, one or two years old, they certainly know what a straw is but you try to bottle feed them and they have never been bottle fed.

NEWS: How can that be changed?

ROGERS: It’s about education. We can blame us mob for everything – we drink and we fight and we argue, we smell and we’re untidy, we don’t want to be part of society. My view has been for a long time that it’s the system that has created that.

If you sit under that tree over there, regardless of what colour you are, and all the service providers come to you – as hard as it is to comprehend – you accept that as normal behaviour. And the media perpetuate that.

I’ve had a fortunate life, in a sense. I was sent to school down south, to Gawler, north of Adelaide. They were establishing Elizabeth at that time, for “ten pound Poms”. You go back there today, and you see four generations of welfare recipients.  And I would strongly suggest that if you went to any major city in this country, you would find suburbs with welfare recipients.

The media is quite quick to point the finger of blame at the blackfellas, look how lazy they are, ripping off the welfare system. But the system has created that, nationally.

NEWS: Isn’t this the litany we’ve heard for decades? Should the dole be withdrawn for people not reasonably accepting employment offered?

ROGERS: It’s hard when your mum and dad have never worked, your grandparents have never worked. As a welfare recipient – going back to Elizabeth, you learn to manipulate the system.

But the days of sitting on your bum and having all the services come to you are over. We’re not going to come and wake you up in the morning. But we can demonstrate we are a good employer, we have a good process in place, you show potential and we’ll mentor you into senior positions. I think that’s a great outcome.

NEWS: Could that be exported to other companies?

ROGERS: Yes, it can.

NEWS: Is such a process under way? Are you in touch with the Chamber of Commerce, for example?

ROGERS: I must say, no.

NEWS: This is the number one question today: How do you put an end to passive welfare, the issue often spoken of by Noel Pearson?

ROGERS: Sitting under that tree – if you start to withdraw some of those services, for example, the doctor and nurses, then I’ll have to get off my bum and go and see them.

What that does is instil a bit of responsibility. And I think that’s what we have to do, change the system, change the mentality. The Toyota dreaming – whitefellas coming in and out every day, yet making very little difference.

NEWS: How do you translate that into reality?

ROGERS: In this organisation, through the cross-cultural awareness program for staff.

NEWS: But these are people who have a job. What about the recipients of Congress services, how can they be motivated to help themselves?

ROGERS: Pre-birth to four, these are the formative years in terms of the development of responsibility and initiative, no matter what colour you are. We’ve got a number of generations out there who, to be honest, are a bit of a lost cause. And I’m not saying we should forget about them.

Congress does a whole bunch of stuff but we can drill it down to basically three things: we look after the elderly, we try to help the sick, and the other thing we do is preventative care. And it’s that which in the next couple of generations will make the difference. Give people a healthy upbringing then they can make choices.

NEWS: How grave is your fear that funding cuts will affect Congress work?

ROGERS: Taxation revenue is now less than 22% of GDP which is almost the lowest in the OECD and both sides want to reduce taxes further although the Coalition is planning bigger cuts than the ALP in this regard. Where is the money going to come from?

NEWS: Can the funding be streamlined?

ROGERS: There are something like 15 health providers. This is ridiculous. We need to be working in partnership. I don’t give a hoot who gets the kudos out of that, as long as the outcomes for our clients is better.

We are adopting the “collective impact” model, promoted here by Desert Knowledge here but in use world-wide now. It is about everyone working together. Here in Alice Springs, perhaps because of the funding models, we’ve had everyone working in parallel, especially Aboriginal organisations, diving into the same bucket, trying to get hold of the same money, being possessive about that as well, but serving the same clients.

That’s changing. For example, the Department of Families, Housing, Community Services and Indigenous Affairs is changing their funding model from something like 100 different funding contracts down to six. That alone is fantastic. Congress is currently dealing with some 160 projects with a string of agencies, this will cut down on a mountain of paperwork.

NEWS: Are there too many NGOs?

ROGERS: It’s up to the government. It’s a question of compliance. Are NGOs actually spending the money they get appropriately and effectively?

NEWS: How do they decide what’s working and what’s not?

ROGERS: We have an open book policy with our funding providers, and I think that needs to occur. If we get money for a specific program and we see it’s not working, we want to have the ability to say to the funding agency, we think you need to change the parameters, because we can get better results by doing it this way.

Congress is very good at presenting evidence data, we can back our outcomes or outputs with evidence. There are problems when funding agencies allow their money to be spent willy nilly. The Office for Aboriginal and Torres Strait Islander Health, which is part of the Commonwealth Department of Health and Ageing, have been very good with us. We have built a very good, honest, open relationship with them.

NEWS: What are the job opportunities right now? There used to be a cattle industry on what is now Aboriginal land, there are wild horses, camels, lots of land, idle labour and enough water. Road trains are going empty one way and could provide cheap transport of produce to markets. Should Congress develop some of these opportunities? Congress is picking up where people are already damaged. Is there not a case for that damage to be prevented?

ROGERS: Primary production has been tried here in the past but it has failed because it is a foreign industry, so to speak. We are hunters and gatherers. Where do you start? Is it housing, is it education? I’ve had a long time to think about this, and I think it starts from a health perspective. If you are a healthy child, regardless of your race, the other things will come.

NEWS: Could primary health care not include having a purpose in life, a job?

ROGERS: We are the largest primary health care provider in the NT but we’re not going to be able to fix all the problems.

NEWS: What changes is Congress making to its structure?

ROGERS: We now require people with tertiary qualifications to be in the top positions, not appointing Aboriginal people into management positions, irrespective of qualification, as a report 20 years ago recommended.

Unfortunately, that set some Aboriginal people up to fail. We are mentoring Aboriginal people into management roles. This is big business, and needs to be treated like big business.

IMAGES from the Congress annual report 2010-11, as published on the World Wide Web.

NACCHO political alert: Coalition Health Policy: Aboriginal health missing in action

Justin

Justin Mohamed and @NATSILS_ Shane Duffy at @NITV’s special election forum.

Must watch Fri 6pm http://t.co/24Bl5BIqam

Coalition Health Policy: Aboriginal health missing in action

Aboriginal people across the country today will be disappointed by the release of the Coalition’s health policy given the persistent appalling health gap between Aboriginal and non-Aboriginal Australians, said the Aboriginal primary health peak.

National Community Controlled Health Organisation (NACCHO) Chair, Justin Mohamed said the seventeen page Coalition Health Plan dedicated only one line to Aboriginal health and provided no detail on the initiatives they would support to specifically improve Aboriginal and Torres Strait Islander health outcomes.

“Tony Abbott has previously expressed a commitment to closing the shameful health gap between Aboriginal and non-Aboriginal Australians.

“The Coalition signed the Close the Gap Statement of Intent in 2008 and plans to elevate Aboriginal affairs directly to the Prime Ministerial office if Tony Abbott wins Government in three weeks.

“Given that, it is disappointing and somewhat surprising that he has not given a lot more focus in his Health Policy to solving the challenges in Aboriginal health.

“Focusing on bowel screening, diabetes management, dental health and building the medical workforce are welcome initiatives in the Coalition Policy but must be delivered by Aboriginal people to Aboriginal people if we are maximise their effect in Aboriginal communities.”

Mr Mohamed said that driving down the life expectancy gap – which in some areas is up to 17 years different – can only happen if we have long-term, Aboriginal-driven health programs which look beyond election cycles and politics.

“We know the Aboriginal community controlled health model is working – we are seeing both adult and child mortality rates slowly declining – but we can’t afford to be complacent.

“We would like to see all political parties commit to the NACCHO ten-point Investing in Healthy Futures for Generational Change plan which provides a policy road map to keep the momentum up.

“This includes a commitment to what works – Aboriginal community controlled primary health services – who are delivering real gains on the front line.

“It includes capacity building our communities, sustaining an Aboriginal medical workforce and supporting and expanding community controlled services to reach more of our people in more areas.”

Mr Mohamed said he hoped there was more to come from the Coalition before 7 September.

Media contact: Colin Cowell 0401 331 251, Anaya Latter 0432 121 636

NACCHO political debate alert :Aboriginal policy- check out where the parties stand

    Indigenous health   

According to the latest census figures from 2011, there are 548,370 people in Australia who identify as Aboriginal or Torres Strait Islander.

From the ABC website Anna Henderson CLICK here for page

NOTE: Provided for the information of NACCHO members and stakeholders but not endorsed in anyway

In the Northern Territory just under 27 per cent of the population identified as Indigenous.

Across the rest of the country, the proportion of the state or territory population who identified as Indigenous was 4 per cent or less.

But Aboriginal and Torres Strait Islander people remain over-represented in prison system, have lower average life expectancy, higher child mortality rates and a higher likelihood of living in poverty.

Earlier this year, then prime minister Julia Gillard delivered the latest report card on the Government’s efforts to close the Indigenous disadvantage gap. She said the Federal Government’s investment in the portfolio has been unprecedented but she noted eliminating disadvantage would take a sustained commitment over many years from all governments, the business sector, non-government organisations, Indigenous people and the wider community.

What aspects of Indigenous Affairs policy do the major parties agree on?

Constitutional Recognition of Indigenous People

The major parties have given in principle backing for this goal. Former prime minister Julia Gillard originally agreed to hold a referendum by the 2013 election but shelved that plan because of a lack of public awareness about the issue.  Instead an Act of Recognition was passed in Federal Parliament in February 2013 on the anniversary of the national apology with a two-year sunset clause for holding a referendum. The Coalition has also committed to put forward a draft amendment to the Constitution within 12 months of winning government and establish a bipartisan process to assess its success. There are some differences of opinion between the parties about the exact wording that should be used to make the constitutional amendment. Federal Parliament has established a Joint Select Committee on Constitutional Recognition of Aboriginal and Torres Strait Islander Peoples. They are working with the funded group Recognise.

Despite the bipartisan agreement to hold a referendum, the issue became political divisive in July when Kevin Rudd announced his intention to hold a referendum within two years and asked the Opposition Leader Tony Abbott to “join that journey”. Mr Abbott reacted by pointing out the Coalition’s one-year timeframe for an amendment means an Abbott government would act more quickly on the issue than a re-elected Labor government.

Closing the Gap

The major parties have backed Labor’s 2008 targets:

  1. Close the life expectancy gap within a generation.
  2. Halve the gap in mortality rates for Indigenous children under five within a decade.
  3. Ensure access to early childhood education for all Indigenous four-year-olds in remote communities within five years. The Government says this will be met this year.
  4. Halve the gap in reading, writing and numeracy achievements for children within a decade
  5. Halve the gap for Indigenous students to stay on for Year 12 or equivalent attainment rates by 2020
  6. Halve the gap in employment outcomes between Indigenous and non-indigenous Australians within a decade

Indigenous representation in Federal Parliament

All parties have expressed interest in ensuring there are Aboriginal and Torres Strait representatives holding seats in Federal Parliament. The Coalition welcomed the first Indigenous Lower House MP, the member for the WA seat of Hasluck Ken Wyatt at the last election. The former prime minister Julia Gillard intervened in local preselections in the Northern Territory this year to appoint a “captain’s pick” for the top spot on Labor’s NT Senate seat, Nova Peris. She will be the first Aboriginal woman to represent the party in the Federal Parliament if successful. The Greens have a policy aim to ensure Aboriginal people have political representation, and the party has recruited a number of Aboriginal candidates for this year’s election.

Economy and jobs

The major parties have all promoted the idea of ensuring Aboriginal people living in remote communities have access to a job. The high unemployment rates in the communities are partially due to the lack of economically viable industry in those areas. Labor has been promoting private investment to create jobs. The Coalition is also focused on the need for economic investment and has flagged the prospect of flying workers in and out of nearby resources projects so they remain connected to their home country but are also earning money to support their families. The Greens policy emphasises the importance of Aboriginal communities determining the kinds of economic projects they have in and around their communities.

What are the key differences between the major parties?

The Indigenous Affairs portfolio

Under Labor the portfolio has been held by Minister Jenny Macklin. The Coalition has appointed NT Senator Nigel Scullion as its spokesman. Opposition Leader Tony Abbott has announced that if elected, the portfolio would become part of Prime Minister and Cabinet. Senator Scullion would remain as spokesman but Mr Abbott says he would also effectively be the Prime Minister for Indigenous Affairs. The Greens have also had a spokeswoman Rachel Siewert appointed to oversee the portfolio.

The Northern Territory Intervention

The Coalition announced an Intervention into the Northern Territory under former Prime Minister John Howard. Labor changed some elements of it when it implemented the Stronger Futures legislation. The Greens want to rescind those laws.

Homelands (also known as outstations)

In the 1970s, family groups in the Northern Territory, Queensland, Western Australia and South Australia began to reject the mission and settlement communities where they had been relocated, and wanted to move back to their traditional and ancestral lands. The remote Homelands have been an ongoing political issue because it is expensive and inefficient to provide services to them. It is estimated that thousands of people are continuing to live in the Homeland environment, particularly in the Northern Territory. The Federal Government was responsible for Homelands until the former Liberal prime minister John Howard handed responsibility to the NT government as part of the Northern Territory Emergency Response in 2007.

As part of Labor’s 2012 Stronger Futures package, the Federal Government has committed $206 million for basic services in the NT, including water, power, roads, sewerage and other infrastructure. The Coalition’s Indigenous Affairs spokesman Nigel Scullion has criticised the Government for not providing enough funding for adequate service provision. He has also stated the Government should not be funding the services and they should be paid for with council rates. The Greens have a strong view that Aboriginal people should have government support to maintain a connection with their traditional lands.

Education

Labor is hoping to seal a deal with all the states and territories, along with the Catholic and independent sectors on its Better Schools package as recommended in an expert report conducted by David Gonski. The report outlines a funding formula with a base figure for all students and extra loadings. Some of those loadings are specific to remote areas and Indigenous students. The Coalition has sent mixed messages about whether it would honour the deal in government but it is unlikely unless most, or even all, schools sign up. The Coalition is more likely to extend the existing funding model if elected. The Greens say remote communities should have access to government services and the party advocates for culturally appropriate education incorporating language and culture.

What we know

ALP

  • Want to see parliament revisit a referendum on recognition of Indigenous people in the constitution within two years
  • Close the Gap targets, agreed to by COAG in 2008. Results collated and presented in parliament each year by the PM
  • Funding through national partnerships agreements for health, education and housing
  • Stronger Futures package of measures in the NT
  • Cape York welfare reform trial
  • Constitutional recognition of Aboriginal people – latest progress report
  • Funding land and sea ranger programs

Coalition

  • The Indigenous Affairs portfolio would be move into the Department of Prime Minister and Cabinet
  • Changing the constitution to acknowledge Aboriginal people – draft amendment would be put forward within 12 months
  • If elected Tony Abbott would spend a week each year in Aboriginal communities and take senior decision makers with him
  • Consideration of tailored governance processes for different communities
  • Concentration on creating economic opportunities
  • Look at fly in, fly out job prospects for Indigenous people in remote communities to work in the mining industry
  • Attendance data for all schools would be published (not just Indigenous schools, to avoid stigma)
  • Income quarantining- supported but not linked to school attendance. Instead it is proposed there would be on-the-spot fines for parents.
  • Encourage longer term postings at remote schools and clinics and aim to attract high quality teachers and health professionals
  • All larger Indigenous communities would have a permanent police presence

Greens

  • Compensation for the Stolen Generation
  • End the NT Intervention
  • Close the Gap targets
  • Recognise Aboriginal and Torres Strait Islander people in the Constitution
  • Respect the link between Indigenous people and the land
  • Comply with international agreements on Indigenous rights including he Declaration on the Rights of Indigenous Peoples
  • Aboriginal people have the right to self determination and political representation and must partner in programs and services that affect them
  • Aboriginal people should benefit financially from their cultural heritage and the biodiversity of their lands and waterways
  • Dispossessed Aboriginal people have a right to be assisted to acquire or manage land and waterways that belong to them
  • All Australians including those living in remote communities have the equal right to essential government services
  • Protection of Aboriginal cultural traditions
  • Culturally appropriate health, housing and infrastructure
  • Culturally appropriate education incorporating language and culture
  • Allowing Aboriginal people to control their own education system when they want to
  • Qualified interpreters at hospitals, courts and government meetings
  • Rescind Stronger Futures legislation
  • Full implementation of recommendations from key Indigenous Affairs reports
  • Strategies to deal with impacts of climate change on indigenous communities
  • Food security for Aboriginal people in remote areas
  • Long term sustainable funding for land and sea ranger programs

What don’t we know about the major parties’ policies?

Policy release

The major parties had not released their full Indigenous Affairs election policies by the middle of the year, though Mr Abbott and Ms Macklin have delivered key speeches outlining their vision for the portfolio this year. The Greens have a policy document on their website and have flagged the prospect of some further announcements before the election is held.

What we don’t know

  • Whether the Coalition would be open to changing the structure of the powerful land councils
  • How the Greens would fund the full suite of policies that have been put forward

Key reports on Indigenous Affairs

Bringing Them Home

The Royal Commission into Aboriginal Deaths in Custody

NT, WA and SA Coroner’s recommendations on petrol sniffing

The Little Children are Sacred report

HREOC reports on petrol sniffing, suicide

The Evatt Review