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


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

Must watch Fri 6pm

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.


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


  • 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


  • 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


  • 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

NACCHO NT grog summit news: Four major outcomes on alcohol policy and its impact on Aboriginal people and communities


The summit heard also from expert speakers including Associate Professor, Ted Wilkes from the National Indigenous Drug & Alcohol Committee (pictured above recently presenting a NIDAC report the Minister Snowdon)

From 30 to 31 July 2013 a summit on alcohol policy and its impact on Aboriginal people and communities was held in Alice Springs, sponsored by the Aboriginal Peak Organisations Northern Territory [APO NT].

The summit was attended by around 100 people. This summit followed a similar grog summit sponsored by APO NT in Darwin in November 2012.

The summit heard from a number of speakers from Aboriginal communities and organisations across the Territory including: Anyinginyi Health Service; Central Australian Aboriginal Congress; Central Australian Aboriginal Alcohol Programmes Unit; Central Australian Aboriginal Family Legal Unit; Western Aranda Health Aboriginal Corporation; Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Women’s Council; Borroloola; Ntaria, Papunya and Beswick.

The summit heard also from expert speakers including Associate Professor, Ted Wilkes from the National Indigenous Drug & Alcohol Committee; Professor Dennis Gray from the National Drug Research Institute and June Oscar, Emily Carter and Professor Elizabeth Elliott AM, who have been involved in the successful Fitzroy Valley recovery plan.

The summit delegates agreed that there was an urgent need for action and better evidence to address alcohol related harm both in Alice Springs, and across the NT. All delegates of the summit were concerned about the children’s future and the need to act now.

The summit agreed on a number of priority areas for action including:

Reducing supply as a critical ‘circuit breaker’ in the fight against alcohol harm:

The summit supported stopping the flow of cheap grog through a floor-price and/or volumetric tax, banning alcohol advertising/sponsorship in sport, stronger enforcement of licensing conditions, and encouraging individuals to take a personal stand against grog running.

Focusing on holistic approaches in treatment, including addressing underlying causes:

The summit encourages further measures to support Aboriginal community controlled services providing treatment and other AOD programs; the important work needed to address underlying issues of alcohol misuse; need to increase services out bush; addressing social determinants of health which result in people drinking; examining holistic ways of treating alcohol misuse; focus on early childhood development; supporting development/evaluation of culturally appropriate treatment programs and promoting strong cultural identity as a means of preventing alcohol misuse.

The need to act now to address FASD:

The summit calls for more work on prevention, education and raising awareness of the condition; seek recognition of FASD as a disability, and enabling early diagnosis of fetal alcohol spectrum disorders; and

Building stronger community-based approaches to addressing alcohol related harm:

The summit requests a greater focus on supporting local community responses; ensuring alcohol management plans are representative of the whole community and driven by the community; investing in prevention rather than prisons; and engaging children and young people in education and solutions.

On 26 June 2013 APO NT called for a joint Territory/Commonwealth government Board of Inquiry into Alcohol in the Northern Territory to provide the evidence needed to create a roadmap for action so all sectors can work together to solve the problems of alcohol related harm in the NT.

On 31 July 2013, the Alice Springs Grog Summit delegates endorsed the call for a Board of Inquiry, and the proposed Terms of Reference framed to provide the data and evidence that is needed to develop a comprehensive, evidence-based blueprint for tackling alcohol harm. These will provide for the development of recommendations that include effective alcohol supply controls as well as strong preventative and early intervention measures that address harm minimisation and the need to reduce the demand for alcohol consumption.

APO NT will be producing a full report on the summit outcomes.

For further information contact Sarah Stoller on 0487 341 117.

NACCHO Aboriginal health alert:All Northern Territory prisons will be totally smokefree from Monday 1 July


Aboriginal and Torres Strait Islander people are more than twice as likely to smoke as other Australians, with those who have been incarcerated nearly four times more likely to smoke than other Indigenous people. 

Tobacco Action Workers from Aboriginal health services and the NT Department of Health have been involved in providing information and support for inmates in the lead up to 1 July


Current NACCHO projects include:

Talking About The Smokes (TATS)

Smoke Free Project

Many thanks to Associate Professor David Thomas for this article on the implementation of a health policy first, launched in the Northern Territory today.

AND CROAKEY subscribe here

All Northern Territory prisons will be totally smokefree from Monday 1 July.  No one will be able to smoke indoors or outdoors within these prisons, or on surrounding correctional centre land including carparks: neither prisoners, visitors nor staff.  Prison staff (and inmates) will now be protected from the dangers of secondhand smoke just like many other Australian workers.

The Northern Territory will be the first Australian jurisdiction to make all its prisons smoke free.  Other jurisdictions are watching and will probably follow this lead.   This will be challenging with very high smoking rates among both inmates and staff.

As always there are the skeptics who say this will not work, or more commonly that it will make other things worse.  Some staff have expressed concerns about increased tension and violence associated with nicotine withdrawal and because staff previously offered inmates a cigarette when trying to defuse tense situations.  What did they do in similar situations with non-smokers?

There are good signs that this new policy will work.  Some other correctional facilities are already smokefree.  The Don Dale Juvenile Detention Centre near the main Darwin prison has been smokefree for years, although until now staff have been able to smoke in the adjacent carpark.

The Northern Territory has also closely modelled its approach on the successful introduction of smokefree prisons in New Zealand in July 2011. An evaluation  identified three key elements in New Zealand’s success: careful and long preparation, increased access to services to help staff and inmates to quit smoking, and having a comprehensive rather than a partial smoking ban.

The comprehensive nature of the New Zealand’s policy has made it more straightforward to enforce than ‘indoor only’ smoking bans.  Some initial problems of smoking contraband tobacco or smoking nicotine patches and tea leaves have diminished.  It does appear that successful enforcement of the policy by prison staff was crucial to many other elements of the policy’s success, so close work with staff, and clear guidelines and training, will be essential in the NT.

A positive side effect of the New Zealand ban has been the dramatic reduction in arson-related prison fires, as matches and lighters are also banned, as they will be in NT prisons.

As in New Zealand, the Northern Territory Correctional Services have increased the availability of smoking cessation support services, including free Nicotine Replacement Therapy for staff and inmates since 1 January.

In the Northern Territory, more than 80% of prisoners are Aboriginal or Torres Strait Islander people.  Aboriginal and Torres Strait Islander people are more than twice as likely to smoke as other Australians, with those who have been incarcerated nearly four times more likely to smoke than other Indigenous people.  Tobacco Action Workers from Aboriginal health services and the NT Department of Health have been involved in providing information and support for inmates in the lead up to 1 July.

Smokefree prisons will protect the health of this particularly disadvantaged group of Aboriginal and Torres Strait islander Australians, but it will obviously continue to be much more important to reduce the disproportionate numbers of Aboriginal and Torres Strait Islander people in prisons.

Associate Professor David Thomas is a National Heart Foundation Fellow at the Menzies School of Health Research and the Lowitja institute in Darwin.

NACCHO health news: Aboriginal peak calls for joint Territory/Commonwealth Board of Inquiry into Alcohol

John Paterson

“Alcohol related harm is killing our people, and we urgently need an evidence-based approach on how to make real change,”

said APO NT spokesperson AMSANT CEO John Paterson (pictured above at NACCHO launch Parliament House)

Aboriginal Peak Organisations of the NT (APO NT) today called for a joint Territory/Commonwealth government Board of Inquiry into Alcohol in the Northern Territory to provide a roadmap for action by communities, professionals, and Government to work together to solve the problems of alcohol related harm in our communities.

“Alcohol related harm is killing our people, and we urgently need an evidence-based approach on how to make real change,” said APO NT spokesperson John Paterson.

“The way forward must be based on alcohol policy evidence not politics.

“This is a chance for both governments to dump the politics and work together to solve a social crisis which is killing our people, destroying our families and damaging the wider community.

The proposed terms of reference for the Inquiry are framed to provide the data and evidence that is needed to develop a comprehensive, evidence-based blueprint for tackling alcohol harm. They will provide for the development of recommendations that include effective alcohol supply controls as well as strong preventative and early intervention measures that address harm minimisation and the need to reduce the demand for alcohol consumption.

Since the last election, the current NT Government has taken a radical approach to laws relating to alcohol. This has included the abolition of the Banned Drinkers’ Register and the SMART Court. The Government is also introducing mandatory rehabilitation for people who are put into protective custody for drunkenness, and proposing the introduction of Alcohol Protection Orders (APOs).

The Commonwealth meanwhile has been working on the kinds of Alcohol Management Plans that were subject of a High Court decision last week.

“In November 2012, APO NT Grog Summit participants called on Governments to involve Aboriginal peoples in all levels of decision-making regarding alcohol policy, program development and resourcing in the NT.

“Alcohol is harming our communities, and having a devastating effect on the future for our children,” said Mr. Paterson.

“Our peoples must be supported to develop our own solutions to tackle issues around alcohol related harm.

APO NT is publically calling for a Board of Inquiry into Alcohol in the Northern Territory to be held jointly by the NT and Commonwealth Governments. A proposed Terms of Reference for the Board of Inquiry has been developed and is attached.

For further information, contact Sarah Barr on 0487 341 117.

NACCHO sex education news:New resource gives new life to sexual health education for Aboriginal youth-Donna Ah Chee


2013_CCHEP launch

“Congress Alice Springs fully understands that the task of supporting young people to develop in healthy ways and adopt a healthy lifestyle is complex and requires a multifaceted approach,” Congress Ms Donna Ah Chee

A new Aboriginal  youth sexual health education resource package was launched last week  in Alice Springs.

The package is part of the Central Australian Aboriginal Congress’ Community Health Education Program (‘CCHEP’). The CCHEP Program has been delivering holistic sexual health education to young Indigenous women living in and around Central Australia since 1998 and to young males since 2011.

CCHEP coordinator Donna Lemon says that the program has provided an insight into the way that sex education has changed.

“The CCHEP program provides awareness and basic holistic sexual health education to young people in our local schools,” Ms Lemon explained. “We also run educator training four times a year to enable community-based workers, such as Aboriginal health practitioners and teachers, to confidently deliver the program to their own target groups.”

As well as local schools, the program has been delivered to organisations such as Owen Springs Detention Centre, CAAAPU, Mission Australia, Tangentyere Council and the Midnight Basketball program.

Education is provided to young people through a series of learning activities in a way that is fun and interactive, so that the learning experience is memorable.

Congress CEO Donna Ah Chee said that the manuals will provide teachers with confidence to deliver health education, as part of a holistic approach.

“The new manuals will help ensure that teachers and other educators are really well prepared and confident in their ability to educate young people in areas that many find difficult and challenging.

“Congress fully understands that the task of supporting young people to develop in healthy ways and adopt a healthy lifestyle is complex and requires a multifaceted approach,” Ms Ah Chee commented.

“Healthy lifestyle education at age 12 and beyond is one part of this approach. However it’s also important to recognise the critical importance of the early years in the healthy development of young people as well.

“We know that the development of self-regulation and self-control by age four is crucial to the subsequent development of an active healthy lifestyle.

“We also know that interventions in early childhood that support responsive parenting and child stimulation can have a big difference on the subsequent development of a healthy lifestyle including fewer addictions, fewer sexual partners with safer sex and higher levels of physical activity.

“The resource that we are here to launch today is part of this overall, multifaceted approach.”

Recognition was given to the elders—including the Alukura women’s health Grandmothers and Aunties—who have provided input and cultural knowledge into the development of this and other health education resources throughout the years. Acknowledgment was also given to the Office for Aboriginal and Torres Strait Islander Health (OATSIH), the Northern Territory Sexual Health Program and the NT Sexual Health Advisory Group, all of which have provided support in the development and implementation of the resources.

NACCHO health news: Not under the influence of evidence: A sober critique of the NT Alcohol Mandatory Treatment Bill


Picture:John Paterson-CEO of NACCHO affiliate Aboriginal Medical Services Alliance NT (AMSANT),one of the driving forces behind the APO NT (full details of APO below)

APO NT does not support passage of the Alcohol Mandatory Treatment Bill (the Bill). Our organisations do not agree with key assumptions which underpin the Bill. We do not agree that mandatory treatment as provided for in this bill is an effective way to assist in reducing alcohol related harm in the NT.

Download APO NT submission

Download APO NT submission Appendix A

The mandatory rehabilitation scheme outlined in the Bill is not based on the best available evidence about what is effective to address alcohol dependence. The measures contained in the Bill will not be cost-effective and will not work.

The Bill in its current form would be a de facto re-criminalisation of public drunkenness which is contrary to the recommendations of the Royal Commission into Aboriginal Deaths in Custody. APO NT believes detaining problems drinks will lead to unnecessary tensions between Aboriginal people and police and is likely to result in more Aboriginal people entering the criminal justice system. Prisons in the NT are already overflowing with Aboriginal people.

We also believe that the Bill indirectly discriminates against Aboriginal people in the NT, particularly those Aboriginal people living remotely who are often more likely to drink in public places when they visit centres or towns.

APO NT believes that there may be a limited role for involuntary treatment in extreme circumstances where individuals are at very high risk of harm and unable to manage their circumstances, where clinically effective and culturally appropriate methods of engaging the patient into treatment have been tried and failed, and where strong safeguards and protections are in place, including that it does not criminalise, either directly, the behaviours it seeks to address.

The NT is a small jurisdiction with a finite amount of resources for programs and services. The budget allocation for the mandatory rehabilitation scheme is $45 million to set up and run the scheme for a year, which works out to an average spending of approximately $80,000 per problem drinker. APO NT believes that the NT, by investing in existing voluntary rehabilitation and other alcohol treatment programs including AOD treatment provided in Aboriginal primary health care, as part of a holistic suite of reforms which includes population supply reduction measures.

About APO NT

Aboriginal Peak Organisations of the Northern Territory – APO NT – is an alliance comprising the Central Land Council (CLC), Northern Land Council (NLC), Aboriginal Medical Services Alliance NT (AMSANT), North Australian Aboriginal Justice Agency (NAAJA) and Central Australian Aboriginal Legal Aid Service (CAALAS).

The alliance was created to provide a more effective response to key issues of joint interest and concern affecting Aboriginal people in the Northern Territory, including through advocating practical policy solutions to government. APO NT is committed to increasing Aboriginal involvement in policy development and implementation, and to expanding opportunities for Aboriginal community control. APO NT also seeks to strengthen networks between peak Aboriginal organisations and smaller regional Aboriginal organisations in the NT.


NACCHO Closing the Gap report: Analysis of provisions in the 2013-14 budget of the Indigenous Chronic Disease Package


Total government expenditure on Indigenous health has risen significantly since the commencement of the National Partnership Agreement (NPA) on Closing the Gap in Indigenous Health Outcomes in 2009-10 and now represents about 5.1% of total government health expenditure.


An analysis of provisions in the 2013‐14 Budget and implementation of the Indigenous Chronic Disease Package

Russell, Lesley
Menzies Centre for Health Policy


This paper presents the author’s analysis of the Indigenous provisions in the Australian Government’s 2013-14 Budget in the context of current and past strategies, policies, programs and funding support. It also looks at the implementation and impact of the Commonwealth’s Indigenous Chronic Disease Package. This work has been done using only materials and data that are publicly available. The opinions expressed are solely those of the author who takes responsibility for them and for any inadvertent errors. This work does not represent the official views of the Menzies Centre for Health Policy, the Australian Primary Health Care Research Institute (APHCRI) or the Commonwealth Department of Health and Ageing which funds APHCRI.

Report summary

This amounted to $4.7 billion in 2010-11; of this, the Commonwealth provided about one-third ($1.6 billion).

However while there is a significant effort underway to close the gap in Indigenous disadvantage and life expectancy, in most areas this effort has yet to show real returns on the investments. The disadvantages that have built up over more than 200 years will not disappear overnight, and sustained and concerted efforts are needed to redress them.

Chronicdiseases, which account for a major part of the life expectancy gap, take time to develop, and equally, it will take time to halt their progress and even longer to prevent their advent in the first place. Programs will need to be sustained over decades if they are to have an impact on improving health outcomes.

On this basis, it is worrying to see that continued funding for the NPA on Closing the Gap in Indigenous Health Outcomes, as announced in April, will be less over each of the next three years than in 2012-13.

At the same time, the Budget Papers show that expenses in the Aboriginal and Torres Strait Islander health sub-function will decline by 2.7% in real terms.

This comes as states such as Queensland and New South Wales have made damaging cuts to health services and Closing the Gap programs.

Education is a significant determinant of health status so it is also concerning to see a reduced level of funding provided for Indigenous education over the next six years, especiallywhen efforts to close the gap in education for indigenous students have stalled. These cuts inhealth and educations commitments cannot be justified by saying that Indigenous Australianscan access mainstream programs. In many cases these are absent, inappropriate, or perceived as culturally insensitive, despite recent efforts to improve these deficits.

It is a strength of the COAG commitment to close the gap on Indigenous disadvantage that it recognises that a whole-of-government approach is needed to deliver improvements in the lives of Indigenous Australians.

However tackling disadvantage is about more than building houses, providing job training, implementing welfare reform, community policing andincreasing access to health services; it requires that governments recognise and respect the complex social and cultural relationships that underlie the housing, economic, health and societal issues present in many Aboriginal


NACCHO political news:Report finds need for more effective leadership across government to tackle critical issues in Aboriginal affairs


Rob Oakey

Committee chair Rob Oakeshott MP said the need for more effective leadership across government to tackle critical issues in Aboriginal and Torres Strait Islander affairs was clear.

A parliamentary committee has recommended a high level review of leadership in Indigenous Affairs

The report, by parliament’s joint Public Accounts and Audit Committee, supports recommendations from the Auditor-General for a ‘refresh’ of the lead agency role for Indigenous affairs, and calls for particular attention to be given to strengthening the authority of the agency to better drive changes across government departments.


Committee chair Rob Oakeshott MP said the need for more effective leadership across government to tackle critical issues in Aboriginal and Torres Strait Islander affairs was clear.

“The Government needs a lead agency with authority and a clear mandate to oversee expenditure, monitor outcomes, define priorities and drive actions at whole-of-government level,” Mr Oakeshott said.

“We live in a time where the want to reconcile is high”, he added. “FaHCSIA has made commendable progress in improving coordination between government agencies, but the committee was not convinced that the current arrangements provide FaHCSIA with the authority needed to drive outcomes as effectively as possible.”

The committee’s report also recommended:

  • the development of an explicit whole-of-government strategy for capacity development —both within government and for not-for-profit Indigenous organisations;
  • improvements to the availability of location-based data on Indigenous expenditure and outcomes;
  • an update to be provided on efforts to measure outcomes in ‘priority’ remote service delivery communities; and
  • options to be examined for improving Aboriginal and Torres Strait Islander representation and involvement in decision-making processes.

The committee came to its conclusions upon reviewing three reports published by the Auditor-General in 2012 focusing on government coordination arrangements for Indigenous programs.

The committee held three public hearings related to its review of the reports, and received written submissions from the National Congress of Australia’s First Peoples and the Social Justice Commissioner for Aboriginal and Torres Strait Islander Affairs.

An electronic copy of the report can be downloaded

For media comment: please contact Committee Chair, Rob Oakeshott MP, on
(02) 6584 2911.

 For information about the report:

please contact the committee secretariat by telephone (02) 6277 4615, e-mail,

NACCHO health news:Healing the Fault Lines: uniting politicians, bureaucrats and NGOs for improved outcomes in Aboriginal Health.


Prominent Aboriginal Territorian and the current CEO of Danila Dilba Health Service Olga Havnen argues that the “fault lines” between politicians, bureaucrats and NGOs and the Aboriginal Community Controlled Health sector must unite to make a real difference.

A little known positive aspect of the Northern Territory Intervention was a significant increase in resources to Aboriginal Comprehensive Primary Health Care.

This, along with parallel initiatives under Closing the Gap, gave some hope that the decades long demands from our sector for substantial extra resources in primary health care was at last being heard.

However, while we have been making some advances in the Northern Territory, we face the potential for a “race to the bottom” in Aboriginal health where the interests of politicians, bureaucrats and NGOs potentially outweigh the evidence of Aboriginal community control.

 Prominent Aboriginal Territorian and the current CEO of Danila Dilba Health Service Olga Havnen argues that the “fault lines” between these groups and the Aboriginal Community Controlled Health sector must unite to make a real difference.

Extract from the 16 pages speech which can now be download from NACCHO

I am currently the CEO of Danila Dilba Health Service in Darwin, which has not long ago celebrated its 20th anniversary. We are an Aboriginal Community Controlled Health Service—and part of a broader, national movement of community controlled comprehensive primary health care that has its origins in Redfern some 42 years ago.

At the core of what we have achieved over those many years has been an aggressive approach to basing our work on evidence. Our accumulated achievements have always been based on what works—in clinical as well as social practice.

At the heart of what we have strived to achieve is the development of a practice—both clinical and social—that displays our strong and central commitment to comprehensive primary health care.

This model was codified at an international level at Alma Ata in 1978, and subsequently endorsed by the World Health Organisation (WHO) and the United Nations:

Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.

Primary health care is socially and culturally appropriate, universally accessible, scientifically sound, first level care.

You can download  Olga Havnen full speech 16 pages here

PRESS Coverage below and picture from the Australian May 29

REMOTE indigenous communities are suffering from a government culture of “risk intolerance” which has diverted funding from community-led organisations, a leading Aboriginal figure has said.

Olga Havnen, the Northern Territory’s former co-ordinator general for remote services, last night attacked successive governments for choosing large non-government organisations for service delivery ahead of smaller indigenous-led organisations.

Ms Havnen said many community-led service delivery organisations had “disappeared” since the Northern Territory Emergency Response in 2007.

“Aboriginal control of service delivery in many areas has withered on the vine,” she said in the Lowitja O’Donoghue Oration at the University of Adelaide.

“Despite jurisdictional, national and international evidence that community control over service delivery achieves better results, with control being a key element in the social determinants of health, for example, we have gone backwards.”

 Ms Havnen, whose position in the Territory was abolished by the new Country Liberal Party government in October, said there had been a “massive expansion” of NGO involvement in service delivery with “many millions of dollars” flowing to non-indigenous NGOs and multinational NGOs, regardless of their effectiveness.

She said in the past decade, only one new community controlled health service had been established in the Territory and only two remote health clinics handed across to community control.

“It is a process which has allowed government agencies to quarantine themselves from what they too often ascribe as risk in funding Aboriginal organisations,” she said.

“By this I mean that nothing is done, or can be done, that might in any way shape or form come back to haunt politicians or bureaucrats at a Senate estimates hearing or their state and territory equivalents.”

Ms Havnen, who is now chief executive of the Danila Dilba Health Service in Darwin, an Aboriginal community controlled health service, said that there needed to be a fundamental change in the relationship between Aboriginal service delivery in the Territory and elsewhere, and politicians, bureaucrats and NGOs who were involved in the process.

“The politicians and public servants can be agents of innovation and change if they abandon risk intolerance,” she said.

“Similarly, the response of NGOs to the last decade or so of reaping the benefits of government funding into Aboriginal service delivery must also change.

“Risk intolerance cannot be part of Closing the Gap.”

Ms Havnen said she remained concerned about many elements of the 2007 intervention into Northern Territory communities, which would continue to have a psychological impact “for many years”.