NACCHO Aboriginal Health : Why the @NRHAlliance needs a new Rural and Remote Health Strategy

 

” The National Rural Health Alliance has been leading advocacy to the Government that it is time to develop a new Rural and Remote Health Strategy, together with a fully funded Implementation Plan. 

In developing its thoughts on the need for a new Strategy and its contents, the Alliance is developing a series of discussion papers, with the first now available – considering the reasons why we need a new Strategy and what has been achieved under the 2011-12 Strategy.”

This paper has been prepared to stimulate discussion on an issue of importance to rural and remote health.

The views and opinions in the paper do not necessarily represent those of the National Rural Health Alliance or any of its Member Bodies.

For  The National Rural Health Alliance’s new own Strategic Plan just released and spanning  the period 1 July 2017 – 30 June 2019

The Alliance intends to focus on seven priority areas including: Improving the health outcomes for Aboriginal and Torres Strait Islander Peoples;

 See background 2 below

Download 19 page PDF   need-new-rr-health-strategy

How submit comments

Comments on the paper can be directed to

nrha@ruralhealth.org.au .

A new strategy and plan ?

There is no point in continuing to reference a Framework that is not in use and that is deeply flawed (see background 1 below and in download ) . Whatever document replaces the Framework, it must include outcome measures and set indicators to measure progress against the most pressing needs.

And there must be annual reporting against those outcomes to enable jurisdictions to consider how they are progressing and fine tune their responses as necessary.

Ideally, a new National Rural and Remote Health Strategy should be developed with stakeholder input and introduced with a fully funded Implementation and Evaluation plan.

This should include, but not be restricted to, a rural and remote workforce plan – as pointed out throughout this report, the solutions needed to bridge the divide in the health and wellbeing of the city and the bush deserves and requires far more.

We need concrete, on-the-ground actions, which make a positive difference in the lives of individuals, families and communities in rural and remote Australia.

The Alliance has been an active participant and co-signatory in the development of previous strategies and plans, and stands ready to fulfil that role again.

We must learn from the past and strive to address the inequity of health outcomes that are experienced by the seven million people living outside Australia’s major cities

Background 1 of 2

The National Strategic Framework for Rural and Remote Health (the Framework) was developed through the Rural Health Standing Committee, a committee of the Australian Health Ministers’ Advisory Council, and agreed by the Standing Council on Health, the committee of Ministers of Health, in late 2011. It was launched in 2012. The Framework was developed through a consultative process that included significant input from the National Rural Health Alliance (the Alliance) and other rural and remote health stakeholders, including State and Territory governments.

While the Framework can be accessed through the Department of Health website, it is not in use. No reporting has ever been undertaken to present an update on progress, recognition of the range of policies and programs implemented by Commonwealth, State or Territory Governments to address the goals of the Framework, or to examine the effectiveness of the Framework in addressing those goals.

Further, the health workforce strategy developed as a companion document to the Framework – National Health Workforce Innovation and Reform Strategic Framework for Action 2011–2015 – is also no longer in use, having been archived when the Health Workforce Agency was disbanded in 2014.

At the time, the Alliance called for a National Rural and Remote Health Plan to be developed to operationalise the Framework, but this never eventuated.

The role of a comprehensive Framework to guide and direct better health outcomes in rural and remote communities is critical. Where players from communities, jurisdictional and private health providers and federally-funded organisations come together to meet the challenges of delivering health services in rural and remote communities, it must be through a shared understanding of the issues and a clear vision for the future.

At the outset, the Framework acknowledged that the people who live in rural and remote Australia “tend to have lower life expectancy, higher rates of disease and injury, and poorer access to and use of health services than people living in Major cities”.

Drawing on the Australian Institute of Health and Welfare publication Australia’s Health 2010, the Framework identified key areas of concern with regard to the health of people in rural and remote communities, particularly:

  •  higher mortality rates and lower life expectancy;
  •  higher road injury and fatality rates;
  •  higher reported rates of high blood pressure, diabetes, and obesity;
  •  higher death rates from chronic disease;
  •  higher prevalence of mental health problems;
  •  higher rates of alcohol abuse and smoking;
  •  poorer dental health;
  •  higher incidence of poor ante-natal and post-natal health; and
  •  higher incidence of babies born with low birth weight to mothers (in very remote areas).

The Framework does not include data quantifying these concerns. In referring back to Australia’s Health 2010, the data used to describe the health of people in rural and remote Australia is from 2004-2006 – it was already up to six years old at the time the Framework based on it was launched. It is very difficult to plan appropriately to address inequality when data is this out of date.

Perhaps the biggest gap in the Framework is that it does not link the inequities it identifies in rural and remote health generally to the five goals it develops. While this is largely due to a lack of narrative, what this lack of narrative does is lose the unifying rationale for the five goals and how they will work together to make a difference to the inequities identified in the Framework. If this was simply a lack of a coherent narrative to drive the needed policy responses, it may be excusable. But unfortunately, the lack of this coherent narrative has resulted in:

  •  lack of recognition of the need for baseline indicators against which progress can be measured and reviewed;
  •  loss of the connectedness of the goals – at the Commonwealth level we now see rural health reduced to workforce policy responses without a clear understanding of how those responses will actually lead to improvements in health outcomes and the range of health inequities in rural and remote communities; and
  •  undermining one of the most crucial needs underpinning the Framework as a whole – the need for quality and TIMELY data. The lack of good quality, current, data is apparent as soon as you begin to seek answers to the question “what has the Framework achieved?”

In developing this Discussion paper, the Alliance is seeking to undertake a high level, selective assessment using publicly available data to ascertain to what extent progress is being made in addressing health concerns and inequities in rural and remote Australia, referencing back to the goals and outcomes set out in the Framework.

Where related specific programs stemming from the Framework can be identified and their outcomes assessed, this will be included in the discussion. Given there are nine specific issues identified in the Framework and set out in dot point format above, the Alliance will seek information on only three to discuss whether any change in outcomes following the implementation of the Framework can be assessed accurately, and if so, what outcomes were achieved.

Background 2 of 2

The National Rural Health Alliance’s new Strategic Plan has been released and spans the period 1 July 2017 – 30 June 2019.

Download PDF Copy NRHA_Strategic-Plan

It is a high-level document to set directions, priorities and key areas of activities over the coming two years.  It also includes measures of success and effectiveness, identified as process, impact and health outcomes.

The Alliance intends to focus on seven priority areas including:

  • Unlocking the economic and social potential of the 7 million people living in rural and remote Australia;
  • Improving the health outcomes for Aboriginal and Torres Strait Islander Peoples;
  • Integrating teaching, training, research and development to attract and retain the right workforce;
  • Strengthen prevention, early intervention and primary health care;
  • Developing  place-based, community and individualised local approaches to respond to community needs;
  • Reducing the higher burden of mental ill-health, suicide and suicide attempts; and
  • Securing long-term, sustainable funding  to extend our core work.

These seven priority areas have been strongly influenced by the recommendations coming out of the recent 14th National Rural Health Conference held in Cairns.  Further, these are all areas in which the Alliance believes further efforts and advocacy is required to improve the health and wellbeing of people living in rural and remote Australia.

A common link across all these priority areas is the need for a National Rural and Remote Strategy and associated Implementation Plan. The Alliance will work with members and other stakeholders in the pursuit of such a Strategy and Plan.

The Alliance is currently developing a workplan that will guide specific work streams.

NACCHO Aboriginal Health : Delivery to @DaveGillespie of #RuralHealthConf priority delegate recommendations

 

 ” Rural and regional Australians have higher rates of major diseases including heart disease and stroke, chronic lung conditions, diabetes, asthma, and arthritis.

We also have a persistent and disturbingly large gap in health outcomes and life expectancy, between Indigenous and non-Indigenous Australians “

Minister Gillespie said Australia’s long life expectancy and good average health outcomes disguised unacceptable differences between population groups and communities, particularly in rural Australia : See Full Response press release from Minister below

After four action-packed days, the 14th National Rural Health Conference with its theme of ‘A World of Rural Health’, has concluded with the delivery of the priority recommendations to emerge from the event to Assistant Minister for Health, David Gillespie.

According to CEO of the NRHA, David Butt, “the Conference provided an excellent opportunity for learning and sharing the evidence of what works in rural and remote health.

“People who live and work in rural and remote Australia have the knowledge about what works and what needs to change to improve health and wellbeing.

“Very importantly, through the conference they have identified key recommendations for health systems reform, to improve the health and wellbeing of the seven million people who live in rural and remote Australia,” Mr Butt said.

Download a PDF Copy of all recommendations

Recommendations14NRHC

Aboriginal and Torres Strait Islander Health

Digital Health

Workforce

AUSTRALIA LEADS IN INNOVATION FOR RURAL HEALTH

Press Release

The Coalition Government’s innovative reforms to improve the health of rural, regional and remote communities were today showcased to the 14th World Rural Health Conference.

In his opening address to the conference in Cairns, Assistant Minister for Health, Dr David Gillespie, outlined a series of major changes to improve rural health which will start or bed down over the coming year.

These included:

  •  legislation to establish the first independent National Rural Health Commissioner;
  •  pathways to recognise rural GPs as “Rural Generalists”;
  •  Primary Health Networks across Australia commission health services to ensure that local health needs are met;
  •  federally funded mental health services including suicide prevention and drug and alcohol rehabilitation now managed at the regional level by PHNs;
  •  200 general practices and Aboriginal Community Controlled Health Services will soon start providing Health Care Home services, to coordinate care for people with chronic conditions.

Minister Gillespie said Australia’s long life expectancy and good average health outcomes disguised unacceptable differences between population groups and communities, particularly in rural Australia.

Rural and regional Australians have higher rates of major diseases including heart disease and stroke, chronic lung conditions, diabetes, asthma, and arthritis.

“We also have a persistent and disturbingly large gap in health outcomes and life expectancy, between Indigenous and non-Indigenous Australians,” he said.

Minister Gillespie also represented the Prime Minister, Malcolm Turnbull, at the National Rural Health Alliance Conference held as part of the World of Rural Health event.

“I know that it takes determination, resilience and flexibility to provide the care that your patients need, without the resources available to your counterparts in the cities,” Minister Gillespie said.

“The Prime Minister shares my passion – your passion – for rural Australia.

“Like you, and me, he believes that Australians have a right to high quality, affordable and accessible health care, wherever they live and whatever their circumstances.

“Meeting the needs of rural families and communities is one of the top priorities in the long term national health plan.”

Smile: $11m reduces gap in rural and remote dental services

Press Release 2

People living and working in rural and remote Australia will now have access to dental services that were previously unavailable.

Assistant Minister for Health, Dr David Gillespie, said today that the Coalition Government is providing $11 million to the Royal Flying Doctor Service (RFDS) to provide dental services.

“The Royal Flying Doctor Service is well-placed to provide these essential mobile outreach dental services in rural and remote Australia,” Minister Gillespie said.

“Where there is an identified market failure and there are gaps in services, it is important that the Government steps in to provide assistance. Today we deliver on our election commitment to ensure people outside our major cities have better access to high quality dental services.”

The Government provides funding to the RFDS under the RFDS Program, which aims to ensure access to essential emergency aeromedical and other primary health care services in rural and remote areas of Australia.

“The Flying Doctor welcomes this new funding for dental services in rural and remote Australia,” RFDS of Australia CEO, Martin Laverty, said.

“There are only one third the dentists in remote areas, with 72 dentists per 100,000 people in major cities, and less than 23 per 100,000 people in remote areas.”

“The research statistics are compelling, with more than one-third of remote area residents living with untreated decay. Essentially, when people from remote areas visit the dentist, they are more likely to require acute intervention – 1 in 3 had a tooth extraction in a year, compared with less than 1 in 10 in metropolitan areas.”

“This funding from the Federal Government will enable the Flying Doctor to expand its dental outreach program to start tackling the disparity that exists between city and the bush – and for that we are very, very thankful”.

On 28 June 2016, the Government announced it would continue to support the RFDS by extending its contract for continued delivery of aeromedical services until 30 June 2020.

The announcement included a commitment of an additional $11 million over two years for the RFDS to expand its existing non-Commonwealth funded dental services for the period 1 April 2017 to 31 March 2019.

Labor Party Response

Labor supports the development of a national rural health strategy and associated implementation plan, as part of ensuring there is clear and targeted action towards closing the gap in health outcomes between Australians living in rural areas and their metropolitan peers. 

Shadow Minister for Health Catherine King announced Labor’s support for a strategy at the National Rural Health Conference in Cairns, calling on the Government to join in bipartisan support.

“The impact of inequity on health and recognising the challenges that some groups face which require more targeted support – including rural and remote Australians – was a clear theme to emerge from Labor’s National Health Summit in March,” Ms King said

“We think that a national rural health strategy is an important step to ensuring we have a defined roadmap to improving health outcomes for Australians living outside our big cities and I hope the Government follows our lead.”

Shadow Assistant Minister for Medicare, Tony Zappia, said while Labor welcomes the implementation of the National Rural Health Commissioner, this single role will not be a cure-all.

“The National Rural Health Commissioner would aid in the implementation of a national rural health strategy, but we still need to have an understanding of where we are going, and what we are trying to achieve in rural heath,” Mr Zappia said.

“A national rural health strategy would help achieve this goal of all levels of Government working more closely together, to reduce fragmentation and duplication.”

NACCHO Aboriginal Health : Parliamentary Speech @DaveGillespieMP Why we need a Rural / Remote Health Commissioner

 nash-and-gillespie

” Around one third of Australians live outside metropolitan areas, and about two per cent of the population live in remote and very remote locations.

Compared to metropolitan areas, rural and remote Australians generally:

  • Experience higher rates of chronic disease;
  •  Have a shorter life expectancy;
  •  Face higher health risk factors such as higher rates of smoking, drinking and obesity;
  •  Have lower incomes, and fewer educational and employment opportunities;
  •  Are, on average, an older population with a greater proportion living with a disability;
  •  Face some higher living costs, difficulties sourcing fresh food, harsher environmental conditions and relative social isolation;
  •     Have higher rates of preventable cancers such as melanoma and lung cancer; and
  •  Have lower levels of health literacy.

For those living in rural, regional and remote Australia, finding services can often be difficult, if not impossible.

 People living in these communities make an enormous contribution to our national economy, and to the culture and character of Australia. Access to a quality standard of health care is what they deserve and are entitled to expect.”

The Hon Dr David Gillespie MP  Assistant Minister for Health pictured above with former Minister for Rural Health, Senator Fiona Nash, now Deputy Leader of the Nationals  ” who made this bold and historic commitment.”

Download the Ministers Press Release HERE : press-release-rural-health-commissioner

I am proud to introduce the Health Insurance Amendment (National Rural Health Commissioner) Bill, which amends the Health Insurance Act 1973 for the purpose of establishing Australia’s first National Rural Health Commissioner.

This, Mr Speaker, is an incredible and historic occasion.

Watch NACCHO TV Here

An historic occasion for the Coalition, the National Party, and the third of our population that call regional, rural and remote Australia home.

This, Mr Speaker, is an historic occasion for our nation.

Improving access to quality health care for people, no matter where they live is a priority of this Coalition Government.

As a medical practitioner, who has worked for more than 20 years as a doctor in regional Australia, I am so proud and privileged to be here today to deliver this crucial commitment.

From my professional background, I understand the many pressures facing our hard working members of the broad health sector.

Our doctors, our nurses, dentists and allied health workers.

Our Indigenous health workers, mental health workers, our midwives – we understand these people, what they are up against and we understand the needs of Australians in regional, rural and remote Australia.

We understand that it takes a toughness and a boldness, coupled with a deep sensitivity, to work in health in rural and remote areas.

Since Australia’s pioneering days, before telecommunications, we found ways to overcome isolation between the new colonies. We did that – we are a nation that has overcome geographic challenges, having one of the largest land-masses in the world, and the largest search and rescue regions in the world.

As our Deputy Prime Minister, the Leader of the National Party, says, ‘we will continue to make sure that for the people out there doing it tough, that you don’t make their life tougher.’

And it was the then Minister for Rural Health, Senator Fiona Nash, our Deputy Leader of the Nationals who made this bold and historic commitment.

Mr Speaker, I commend to the house these two incredible leaders, who are champions for regional and rural communities in their own right.

As a member of the National Party and the Assistant Minister for Health, I have reiterated that this Government is committed to bridging the city-country divide.

For more than 20 years I served in areas many hours’ drive away from a major metropolitan city. I was a consultant specialist Gastroenterologist through regional hospitals for much of this time, and I have felt the demand that is on regional health services and staff.

The common problems encountered in the bush necessitate the development and application of a dedicated framework which supports a nationally coordinated approach that is also adaptable to local conditions.

Our commitment today is to ensure that regional, rural and remote communities will have a champion to advocate on their behalf so they are able to receive the support they need to deliver health services to local people.

This is guided by a deep lying principle that every Australian should have the right to access a high quality standard of health care, no matter where they live.

To this end, this Bill will pave the way to establish Australia’s first-ever National Rural Health Commissioner. The Commissioner is an integral part of our broader agenda to reform rural health in this nation.

Establishing this role will be achieved by amending the Health Insurance Act 1973, which will provide for the Commissioner to be a statutory position, enabling them to carry out their duties independently and transparently.

The Commissioner will work with regional, rural and remote communities, the health sector, universities, specialist training colleges and across all levels of government to improve rural health policies and champion the cause of rural practice.

The position will be independent and impartial. A fearless champion.

The Commissioner will be someone who has extensive experience within the rural health sector, who is capable of collaborating and consulting closely with a broad range of stakeholders, and who has a passion for improving health outcomes in regional, rural and remote Australia.

The Commissioner will be appointed for a period of two years, with a reappointment up until 30 June 2020.

As a part of the role, the Commissioner will be required to submit a report to the responsible Minister. This will outline findings and recommendations for consideration by Government.

The Commissioner will not be able to delegate his or her powers to anyone else, they will not hold any financial delegation powers, nor will they have any specific employment powers.

The Commissioner will be assisted by staff from the Department of Health throughout the duration of their term.

Once appointed, the Commissioner’s first priority will be to develop National Rural Generalist Pathways. The aim of these Pathways will be to address the most serious issue confronting the rural health sector- the lack of access to training for doctors in regional, rural and remote communities. Attracting and retaining more doctors and health professionals into country areas is essential if we are to improve access to health care in the bush.

Rural Generalists are faced with a unique set of challenges, and the Commissioner will examine these while developing the generalist pathways.

It is widely recognised that Rural Generalists often have advanced training and a broader skill-set than is required by doctors in metropolitan centres. In many instances, they perform duties in areas such as general surgery, obstetrics, anaesthetics and mental health. They not only work longer hours but are frequently on-call afterhours in acute care settings, such as accident and emergency hospital admitted patient care.

However, despite the Rural Generalists’ multidisciplinary skill-set, demanding workload and geographic isolation, there is no national scheme in place which properly recognises this set of circumstances.

In developing the National Rural Generalist Pathways, the Commissioner will consult with the health sector and training providers to define what it means to be a Rural Generalist.

The Commissioner will also examine appropriate remuneration for Rural Generalists, to ensure their extra skills and working hours are recognised. By addressing these areas, the Pathways will help to encourage more doctors to practice in regional, rural and remote Australia.

While the development of the Pathways will be the Commissioner’s first priority, the needs of nursing, dental health, Indigenous health, mental health, midwifery and allied health stakeholders will also be considered.

Health care planning, programs and service delivery models must be adapted to meet the widely differing health needs of rural communities and overcome the challenges of geographic spread, low population density, limited infrastructure and the significantly higher costs of rural and remote health care delivery.

In rural and remote areas, partnerships across health care sectors and between health care providers and other sectors will help address the economic and social determinants of health that are essential to meeting the needs of these communities.

The Commissioner will form and strengthen these relationships, across the professions and for communities.

Mr Speaker, it is worth noting that this Government’s commitment has been shared and welcomed by the sector. These are organisations that have been crucial in its development and I would like to thank:

 Allied Health Professionals Australia

 Australian College of Rural and Remote Medicine

 Australian Indigenous Doctors Association

 Australian Medical Association Council of Rural Doctors

 Australian Rural Health Education Network

 Congress of Aboriginal and Torres Strait Islander Nurses and Midwives

 CRANAplus

 Federal Council of the Australian Dental Association

 Federation of Rural Australian Medical Educators

 Indigenous Allied Health Australia=

 National Aboriginal and Torres Strait Islander Health Workers Association

 National Rural Health Alliance

 National Rural Health Student Network Executive Committee

 Rural Doctors Association of Australia

 Rural Faculty of the Royal Australian College of General Practitioners

 Rural Health Workforce Australia

 Services for Australian and Rural and Remote Allied Health

I’d also like to take this opportunity to thank the Health Workforce Division within my Department who have assisted in developing this important initiative of our Government.

In addition to establishing the role of the Commissioner, this Bill also contains two other amendments to the Health Insurance Act 1973.

It will repeal section 3GC of the Act, to abolish the Medical Training Review Panel. In October 2014, members of the Medical Training Review Panel identified an overlap between their functions and those of the National Medical Training Advisory Network.

Part of the advisory network’s functions is to provide advice on medical workforce planning and medical training plans to inform government, employers and educators.

Given this focus, it was agreed that the advisory network could pick up the panel’s annual reporting obligations on medical education and training, and that the panel’s role would cease. This measure will simplify legislation in the Health portfolio.

The other amendment will be the repeal of section 19AD of the Act. This will not affect any medical practitioner subject to the legislation, and will not affect the operation of any current workforce or training programs.

It will remove a burdensome and ineffective process which required a review every five years of the operation of the Medicare provider number legislation, subsections 19AA, 3GA and 3GC of the Health Insurance Act 1973.

Previous reviews have not resulted in operational improvements to the legislation. Furthermore, recent developments in systems supporting Medicare provider number legislation and processes are not captured by Section 19AD. Repealing this ineffectual measure in the Act is a necessary measure.

To sum up, this Bill is an important step forward for regional, rural and remote health in Australia.

This Coalition Government recognises the value of our rural communities and the special place they hold within the fabric of this country.

People living in these communities make an enormous contribution to our national economy, and to the culture and character of Australia. Access to a quality standard of health care is what they deserve and are entitled to expect. The key is to recruit and retain more doctors and health professionals outside of the major cities, and that will be the focus of the National Rural Health Commissioner.

With the appropriate training opportunities, recruitment, remuneration and ongoing support, the Government is confident that more people will be encouraged to pursue a rewarding career in rural health.

Regional, rural and remote health is built on the commitment, the expertise and the courage of its workforce. We have some of the most resilient and passionate people working in this sector. The formation of the Commissioner will help to provide the rural health workforce with the support it needs to carry out its vitally important work.

Finally, I, together with the Commissioner will champion the incredible and rewarding opportunities of a career in rural medicine. We will do our best to hear you, to listen to you, and to make the necessary steps for our health system to work better for you.

Our Coalition Government looks forward to working closely with the National Rural Health Commissioner to ensure we can improve access to health services for all the men and women who call regional, rural and remote Australia home.

I commend this Bill to the House.

 

NACCHO Aboriginal Health Debate : # A sugary drinks tax could recoup some of the costs of #obesity while preventing it

bjoyce

Personal responsibility, not the Australian Tax Office, should determine how much sugar Australians consume, says Barnaby Joyce. Often as not, Barnaby’s recovery program involves half a packet of Marlboros, which he calls bungers.

Barnaby was much agitated on Wednesday about the suggestion by the Grattan Institute that a tax on high-sugar fizzy drinks might go some way towards alleviating Australia’s obesity problem.

“This is one of the suggestions where right at the start we always thought was just bonkers mad,” he declared, adding his party would not be supporting a sugar tax.

This shouldn’t knock you cold with surprise. Barnaby is the leader of the Nationals. Name a sugar-growing area and you’ll find a Nationals or a Liberal National Party member at the local school fete knocking back a mug of raw sugar-cane juice and proclaiming it God’s food.

But Barnaby wasn’t simply stopping at political solidarity with his northern MPs.

He had some Barnaby-advice on how you might lose weight without taxing sugar.

“People are sitting on their backside too much, and eating too much food and not just soft drinks, eating too many chips and other food,” he lectured.

“Well, so the issue is take the responsibility upon yourself. The Australian Taxation Office is not going to save your health, right. Do not go to the ATO as opposed to go to your doctor or put on a pair of sandshoes and walk around the block and…go for a run.

The ATO is not a better solution than jumping in the pool and going for a swim.

The ATO is not a better solution than reducing your portion size.

“So get yourself a robust chair and a heavy table and halfway through the meal, put both hands on the table and just push back. That will help you lose weight.”

Barnaby Joyce, living miracle, offers a health plan : Pictured above David Gillespie Assistant Minister for Rural Health and Member for Lyne

Note 1: The Federal electorates of Lyne which takes in Taree and Port Macquarie has been identified at the Number One stroke ‘hotspot’ in Australia.Refer

Note 2 : The Minister is not to be confused with David Gillespie Author of How Much Sugar and Sweet Poison : Why Sugar makes us fat .

xsweet-poison_jpg_pagespeed_ic_k1m_7kl1yc

In the wake of the progress report on Closing the Gap, the Indigenous Affairs Minister Nigel Scullion has declared sugary soft drinks are “killing the population” in remote Indigenous communities.

Key points:

  • Closing the Gap report found worst health outcomes found in remote communities
  • One remote community store drawing half of total profits from soft drink sales, Senator Scullion says
  • Senator Scullion says he thinks attitudes to soft drink are changing

According to evidence provided to Senate estimates today, at least 1.1 million litres of so-called “full sugar” soft drink was sold in remote community stores last financial year.

NACCHO Health News Alert : Scullion says sugary soft drinks ‘killing the population’ in remote Aboriginal communities

ob

Grattan Institute report

 ” Obesity is a major public health problem  In Australia more than one in four adults are now classified as obese, up from one in ten in the early 1980s.

And about 7% of children are obese, up from less than 2% in the 1980s.

The sugary drinks tax  revenue could be spent on obesity programs that benefit the disadvantaged, reducing the regressivity of the tax.

While the beverage and sugar industries are strongly opposed to any tax on sugar, their concerns are overblown.

A sugar-sweetened beverages tax will reduce domestic demand for Australian sugar by around 50,000 tonnes, which is only about 1% of all the sugar produced in Australia. And while there may be some transition costs, this sugar could instead be sold overseas (as 80% of Australia’s sugar production already is).

A tax on sugary drinks is a public health reform whose time has come.

The Conversation

A sugary drinks tax could recoup some of the costs of obesity while preventing it

In our new Grattan Institute report, A sugary drinks tax: recovering the community costs of obesity, we estimate community or “third party” costs of obesity were about A$5.3 billion in 2014/15.

Obesity not only affects an individual’s health and wellbeing, it imposes enormous costs on the community, through higher taxes to fund extra government spending on health and welfare and from forgone tax revenue because obese people are more likely to be unemployed.

In our new , A sugary drinks tax: recovering the community costs of obesity, we estimate community or “third party” costs of obesity were about A$5.3 billion in 2014/15.

We propose the government put a tax on sugar-sweetened beverages to recoup some of the third-party costs of obesity and reduce obesity rates. Such a tax would ensure the producers and consumers of those drinks start paying closer to the full costs of this consumption – including costs that to date have been passed on to other taxpayers. There is the added benefit of raising revenue that could be spent on obesity-prevention programs.

The scope of our proposed tax is on non-alcoholic, water-based beverages with added sugar. This includes soft drinks, flavoured mineral waters, fruit drinks, energy drinks, flavoured waters and iced teas.

While a sugary drinks tax is not a “silver bullet” solution to the obesity epidemic (that requires numerous policies and behaviour changes at an individual and population-wide level), it would help.

Why focus on sugary drinks?

Sugar-sweetened beverages are high in sugar and most contain no valuable nutrients, unlike some other processed foods such as chocolate. Most Australians, especially younger people, consume too much sugar already.

People often drink excessive amounts of sugary drinks because the body does not send appropriate “full” signals from calories consumed in liquid form. Sugar-sweetened beverages can induce hunger, and soft drink consumption at a young age can create a life-long preference for sweet foods and drinks.

We estimate, based on US evidence, about 10% of Australia’s obesity problem is due to these sugar-filled drinks.

Many countries have implemented or announced the introduction of a sugar-sweetened beverages tax including the United Kingdom, France, South Africa and parts of the United States. The overseas experience is tax reduces consumption of sugary drinks, with people mainly switching to water or diet/low-sugar alternatives.

There is strong public support in Australia for a sugar-sweetened beverages tax if the funds raised are put towards obesity prevention programs, such as making healthier food cheaper. Public health authorities, including the World Health Organisation and the Australian Medical Association, as well as advocates such as the Obesity Policy Coalition, support the introduction of a sugar-sweetened beverages tax.

What the tax would look like

We advocate taxing the sugar contained within sugar-sweetened beverages, rather than levying a tax based on the price of these drinks, because: a sugar content tax encourages manufacturers to reduce the sugar content of their drinks, it encourages consumers to buy drinks with less sugar, each gram of sugar is taxed consistently, and it deters bulk buying.

The tax should be levied on manufacturers or importers of sugar-sweetened beverages, and overseas evidence suggests it will be passed on in full to consumers.

We estimate a tax of A$0.40 per 100 grams of sugar in sugary drinks, about A$0.80 for a two-litre bottle of soft drink, will raise about A$400-$500 million per year. This will reduce consumption of sugar-sweetened beverages by about 15%, or about 10 litres per person on average. Recent Australian modelling suggests a tax could reduce obesity prevalence by about 2%.


Author provided/The Conversation, CC BY-ND

Low-income earners consume more sugar-sweetened beverages than the rest of the population, so they will on average pay slightly more tax. But the tax burden per person is small – and consumers can also easily avoid the tax by switching to drinks such as water or artificially sweetened beverages.

People on low incomes are generally more responsive to price rises and are therefore more likely to switch to non-taxed (and healthier) beverages, so the tax may be less regressive than predicted. Although a sugar-sweetened beverages tax may be regressive in monetary terms, the greatest health benefits will flow through to low-income people due to their greater reduction in consumption and higher current rates of obesity.

The revenue could also be spent on obesity programs that benefit the disadvantaged, reducing the regressivity of the tax.

While the beverage and sugar industries are strongly opposed to any tax on sugar, their concerns are overblown. Most of the artificially sweetened drinks and waters, which will not be subject to the tax, are owned by the major beverage companies.

A sugar-sweetened beverages tax will reduce domestic demand for Australian sugar by around 50,000 tonnes, which is only about 1% of all the sugar produced in Australia. And while there may be some transition costs, this sugar could instead be sold overseas (as 80% of Australia’s sugar production already is).

A tax on sugary drinks is a public health reform whose time has come.

NACCHO Aboriginal Health Funding alert : $13.1m infrastructure grants for existing regional, rural and remote general practices.

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 ” Grants may be used for a range of infrastructure projects, including construction, fit-out and/or renovation of an existing general practice building, supply and installation of information and communication technology equipment or medical equipment.

Grants of up to $300,000 will be provided to successful applicants in 2017. All successful applicants will be required to match the Commonwealth funding contribution.”

Assistant Minister for Rural Health Dr David Gillespie

“Improved training facilities, such as communication technology, will also ensure that rural doctors can increase their own training opportunities, so they can continue to keep their skills current and maintain their practice at the high level that they strive for and that rural communities deserve.”

Dr Ewen McPhee, President of the Rural Doctors Association of Australia (RDAA) see full press release below

The Australian Government has committed $13.1 million in funding under the Rural General Practice Grants Program (the Program) for grants up to $300,000 each to deliver improved health services through additional infrastructure, increased levels of teaching and training for health practitioners, and more opportunities to deliver ‘healthy living’ education to local communities.

The Program will provide an opportunity for general practices within Modified Monash Classification 2-7 to deliver increased health services in rural and regional communities.

The Program commences with a call for Expressions of Interest (EOI), in which suitable organisations will be identified and subsequently invited to submit a full application.

Project Officer Details Name: Health State Network
Ph: 02 6289 5600 E-mail: Grant.ATM@health.gov.au
Closing date 2:00 pm AEDST on 13 December 2016

Submit your detail here

Teaching, training and retaining the next generation of health workers in rural, regional and remote Australia is a priority for the Coalition Government.

Assistant Minister for Rural Health Dr David Gillespie said the Coalition Government has moved to streamline the former Rural and Regional Teaching Infrastructure Grants program to better respond to the needs of rural communities and support the work of rural general practices.

“A more streamlined and simplified two-step application process is now open through the new Rural General Practice Grants (RGPG) program,” Dr Gillespie said.

“General practice in rural Australia faces unique challenges in healthcare including the ability to attract and retain a health workforce.

“The RGPG program will enable existing health facilities to provide teaching and training opportunities for a range of health professionals within the practice and for practitioners to develop experience in training and supervising healthcare workers.

“I believe that strong, accessible primary care in regional Australia helps alleviate pressure on the public hospital system and at the same time it also provides opportunities for earlier intervention and better patient outcomes.”

“Our Government wants Australians, no matter where they live, to have access to quality health services,” Dr Gillespie said.

“I also want our health professionals who live and work in rural, regional and remote Australia to have access to teaching and training opportunities so they remain in general practice and in the communities that need them the most.”

Grant documentation will be available from the Department of Health’s Tenders and Grants page at www.health.gov.au/tenders.

Rural doctors congratulate government on new grants program

Australian rural doctors are today welcoming the announcement of a streamlined Rural General Practice Grants (RGPG) program, just announced by Dr David Gillespie, Assistant Minister for Rural Health.

Dr Ewen McPhee, President of the Rural Doctors Association of Australia (RDAA), said that the announcement was a reflection of the importance the Coalition Government places on rural and remote health care.

“We are extremely pleased that Minister Gillespie has been so proactive in his Rural Health portfolio, and he has shown a great understanding of the need for increased training facilities to enable the education of the next generation of rural doctors,” Dr McPhee said.

“The RGPG will allow more of our highly skilled doctors in rural areas to improve their training capacity, allowing them to take on more young doctors in training and ensure they have access to quality educational opportunities in rural areas.

“Research shows us that young doctors who undertake training in rural areas, and have a good experience in their placement, are more likely to choose rural medicine as a career.

“Grants enabling doctors to improve and expand their training facilities will play a key role in the recruitment and retention of the rural doctor workforce of the future,” Dr McPhee said.

While infrastructure grants have been available for rural practices for some time, the application process was onerous, complicated and time consuming, putting it out of the reach of many small practices who did not have the time or expertise to successfully apply.

Grants can be used for a range of projects, including construction, fit-out and/or renovation of an existing general practice building, supply and installation of information and communication technology equipment or medical equipment.

“Simplifying and streamlining the process will ensure that these smaller clinics will no longer be disadvantaged by the system,” Dr McPhee said.

Many doctors enjoy the opportunity to engage with young doctors and be a part of their training journey. We look forward to more of our colleagues being able to participate in this way thanks to the Coalition’s commitment to rural health.

“Improved training facilities, such as communication technology, will also ensure that rural doctors can increase their own training opportunities, so they can continue to keep their skills current and maintain their practice at the high level that they strive for and that rural communities deserve.

“We thank Minister Gillespie for his recognition of the importance of this area.”

The third Rural Health Stakeholder Roundtable was held at Parliament House in Canberra on the 16 November 2016.

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Twenty years ago one of Australia’s greatest health challenges was a lack of doctors coming through the system.

Today, that challenge has been overcome with latest research predicting a surplus of 7000 doctors by 2030,” the Federal Minister for Rural Health, Dr David Gillespie, said today.

“The new challenge is no longer the number of doctors in our nation’s health workforce, but where they are distributed.

“This issue, along with the need for greater numbers of allied health professionals in the bush, are among the major topics to be discussed at the third Rural Health Stakeholder Roundtable at Parliament House in Canberra today,” Dr Gillespie said.

“The Roundtable was attended by an impressive representation of rural health stakeholders, from rural doctors associations, medical educators, rural health consumer and advocacy groups, Aboriginal medical services, rural and remote allied health organisations and health workforce professionals.

“We have an outstanding health workforce in the regional, rural and remote areas of this country and today’s roundtable is designed to get all the key players together with government to work out the very best strategies to support them and the work they do for our more isolated communities.”

Minister Gillespie said the Coalition Government is investing record funding in health as part of its commitment to strengthen the regional, rural and remote health system so that Australians living in these areas have access to the best care available.

“Our Government is working in partnership with these people to deliver health care to rural and remote communities through a broad range of initiatives as part of our record funding investment in the health portfolio.”

The Roundtable will discuss today the establishment of the National Rural Health Commissioner (the Commissioner), a new role to champion the cause of rural practice.

The Commissioner will work with rural, regional and remote communities, the health sector, universities, specialist training colleges and across all levels of Government to improve rural health policies.

Another priority item on the agenda is the development of the National Rural Generalist Pathway. This will improve access to training for doctors in rural, regional and remote Australia, and recognise the unique combination of skills required for the role of a rural generalist.

“General practitioners with advanced skills in areas such as general surgery, obstetrics, anaesthetics and mental health are commonly required in the bush also,” Dr Gillespie said.

“We want to make sure these skills are encouraged, developed and properly remunerated.”

Minister Gillespie said the Coalition Government had increased its investment in education and training initiatives both in medical and allied health professions to create a longer term ‘pipelines’ of boosting the rural health workforce.

“The new multidisciplinary training pipeline incorporating the Rural Clinical Schools and University Departments of Rural Health across regional Australia will be a critical component as we boost the capacity of training through our investment in Regional Training Hubs to bring more doctors and allied health professionals to the bush,” he said.

In response to recommendations put forward to the Rural Classification Technical Working Group, an independent group that has assisted the Government to implement the new geographical classification system, I announce today that more support will be provided to medical practitioners working in Cloncurry, Queensland and Roebourne, Western Australia.

“I am pleased to also announce an additional workforce support in the form of a rural loading will be applied to all doctors working in these two towns from 1 January 2017,”  Minister Gillespie said.

“The additional loading will be up to $25,000 per annum through the General Practice Rural Incentives Program and will recognise exceptional circumstances faced in attracting and retaining a workforce in these locations.

“The Coalition Government’s broader health reforms will have direct benefits for regional, rural and remote health, with the patient at the centre of care. Localised, integrated, community-driven health care is the order of the day,” Dr Gillespie said.

“The Rural Health Stakeholder Roundtable is a central part of informing policy reform in rural Australia and I am looking forward to fruitful discussions with participants today.”

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