All Aboriginal and Torres Strait Islander people are eligible for an annual Indigenous-specific health check: item 715 on the Medicare Benefits Schedule (MBS).
See update 22 July For Aboriginal Health Workers
The aim of this MBS health assessment item is to help ensure that Aboriginal and Torres Strait Islander people receive primary health care matched to their needs, by encouraging early detection, diagnosis and intervention for common and treatable conditions that cause morbidity and early mortality.
For the purpose of this item, a person is an Aboriginal or Torres Strait Islander person if they, or their parent or carer, identify them as being of Aboriginal or Torres Strait Islander descent.
The MBS health assessment for Aboriginal and Torres Strait Islander people covers the full age spectrum, and should be used for health assessments for the following age groups:
Aboriginal and Torres Strait Islander children who are less than 15 years old
Aboriginal and Torres Strait Islander adults who are aged fifteen years and over but under the age of 55 years
Aboriginal and Torres Strait Islander older people who are aged 55 years and over
Indigenous specific measures tool 5th release (dynamic data display)
This tool shows numbers and usage rates of the checks at various geographic areas. Charts and tables in the tool can be customised to show different time periods and, where possible, disaggregations by age and sex.
The Australian Institute of Health and Welfare has released a new web product on 21 July, 2016:
Indigenous specific measures tool 5th release (dynamic data display)
1.The Indigenous health check (MBS 715) data tool provides information on use of MBS-rebated health checks for Aboriginal and Torres Strait Islander people displayed using SAS Visual Analytics.
2 The tool shows; numbers and rates of health check uptake at national, jurisdiction, Medicare Local and peer group, and Primary Health Network levels.
3 .This update adds national and jurisdiction data up to December 2015, updated from 30 June 2014.
The health assessment includes an assessment of the patient’s health, including their physical, psychological and social wellbeing. It also assesses what preventive health care, education and other assistance should be offered to the patient to improve their health and wellbeing. It complements existing services already undertaken by a range of health care providers. This health assessment must include:
information collection, including taking a patient history and undertaking examinations and investigations as required;
making an overall assessment of the patient;
recommending appropriate interventions;
providing advice and information to the patient;
keeping a record of the health assessment, and offering the patient a written report about the health assessment, with recommendations about matters covered by the health assessment; and
offering the patient’s carer (if any, and if the medical practitioner considers it appropriate and the patient agrees) a copy of the report or extracts of the report relevant to the carer.
As part of a health assessment, a medical practitioner may develop a simple strategy for the good health of the patient. The strategy should identify any services the patient needs and the actions the patient, or parent or carer, should take. It should be developed in collaboration with the patient, or parent or carer, and documented in the written report on the assessment that is offered to the patient, and/or patient’s carer.
More than half (54%) of all Australians report having at least one long term eye health condition, with nearly half the population wearing glasses or contact lenses, according to data released today by the Australian Institute of Health and Welfare (AIHW).
‘In 2011-12, almost 12 million Australians reported having an eye health condition, with long and short sightedness the most commonly reported conditions, and there’s been an increase in these conditions in recent years,’ said AIHW spokesperson Mardi Ellis.
Between 2001 and 2012, the proportion of the population affected by long sightedness rose from about 22% to 26%, while short sightedness increased from around 21% to 23%.
The likelihood of having a long term eye condition increased with age, with 95% of people aged 55 and over affected by an eye health condition, compared with 11% of those aged 0-14.
‘Eye conditions were more common among females than males, and much more common among Indigenous Australians than nonindigenous Australians,’ Ms Ellis said.
Aboriginal and Torres Strait Islander people experience higher rates of preventable blindness and vision loss than other Australians, and are more than twice as likely as non Indigenous Australians to have complete or partial blindness.
Aboriginal and Torres Strait Islander Australians are almost one and a half times more likely to have cataracts, but despite this, are less likely than other Australians to undergo cataract extraction surgery.
‘Some improvements have been seen, however cataract extraction among Indigenous Australians has increased from 5.6 per 1,000 population in 2010-11 to 7.3 per 1,000 in 2013-14,while the rate for other Australians remained steady,’ Ms Ellis said.
The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.
“What this report highlights is that while there are areas such as infant mortality where we are slowly closing the gap, there are areas where there is a lot of work to do – like mental health and incarceration rates.
“Providing Aboriginal health care for Aboriginal people has also been proven time and time again, to be the health model that makes the biggest gains in closing the gap for Aboriginal and Torres Strait Islander people.
“Such reports as the one released today cause us to renew our call for ensuing Aboriginal health funding is targeted where it will have the most impact for Aboriginal people – in advancing and expanding the Aboriginal Community Controlled Health sector”
Matthew Cooke NACCHO CHAIR:
Pictured above meeting recently with Associate Professor Brian Owler, Federal President of the Australian Medical Association (AMA)
Australia’s peak Aboriginal health body today called for more health funding to be directed to Aboriginal community controlled health services on the back of a new report that shows a widening gap in cancer rates and mental health issues in Aboriginal people compared to other Australians.
National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson, Matthew Cooke said the 2015 report by the Australian Institute of Health and Welfare reflected encouraging gains in some critical health areas but a growing chasm in other areas that needed to be urgently addressed.
Mr Cooke said the 150 Aboriginal Community Controlled Health Services around the country continue to make the biggest inroads to improve Aboriginal health and must be supported and expanded if these statistics are to improve.
“What this report highlights is that while there are areas such as infant mortality where we are slowly closing the gap, there are areas where there is a lot of work to do – like mental health and incarceration rates.
“The report again illustrates just how badly we are failing young Aboriginal people. Aboriginal teenagers, our 15-18year olds are five times more likely to take their own lives than other Australians of the same age.
“This is a truly devastating statistic which has huge impacts throughout Aboriginal communities. There needs to be a concerted effort to improve the mental health and social emotional wellbeing of Aboriginal people, and concrete Closing the Gap targets introduced to reverse these terrible trends and offer hope to Aboriginal young people. “
Mr Cooke said Aboriginal people also still have a life expectancy at least 10 years less than non-Aboriginal people.
“The report shows that 31 per cent of the health gap is due to socio economic factors – such as employment, education and higher than average levels of poverty.
“There is no quick fix for these issues, however as the largest employer of Aboriginal people in many communities, Aboriginal Controlled Community Health Organisations provide an important means of lifting health and wellbeing in their local communities and breaking the cycle of poverty, incarceration poor mental health and social emotional wellbeing.
“Providing Aboriginal health care for Aboriginal people has also been proven time and time again, to be the health model that makes the biggest gains in closing the gap for Aboriginal and Torres Strait Islander people.
“Such reports as the one released today cause us to renew our call for ensuing Aboriginal health funding is targeted where it will have the most impact for Aboriginal people – in advancing and expanding the Aboriginal Community Controlled Health sector,” Mr Cooke said.
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“Aboriginal Community Controlled health services continue to be the best way to provide primary care to Aboriginal people and are making the biggest gains in closing the gap, The report card launched today shows that Aboriginal Community Controlled health services continue to improve in all areas that measure good practise in primary health care.
“This means our services are achieving good health outcomes for the Aboriginal people they serve “
At the launch of the Healthy Futures Report Card today, NACCHO chairperson Matthew Cooke( pictured above)
Aboriginal Community Controlled Health Organisations continue to improve on all key performance indicators that measure good practice in primary health care, said the peak Aboriginal health body today.
At the launch of the Healthy Futures Report Card today, NACCHO chairperson Matthew Cooke said the report showed that Aboriginal Community Controlled Health Services were improving in all 16 key performance indicators.
“Aboriginal people have shown time and time again that they prefer community controlled services because of the unique and culturally appropriate environment they provide. Demand for these services is growing at an extremely high rate of 6 per cent per year.
“This shows that we need to continue to invest in this model for primary health care which is proving to be so effective. We welcome Ministers Ley and Nash’s recent recognition of the important work of community controlled health services by guaranteeing government funding for another three years.
“With this increase in demand we are also experiencing a chronic shortage of health workers in many of our services and long waiting lists for special care so funding certainty for our services is essential.”
However, Mr Cooke said that preventative health programs as well as primary health care are needed to close the gap.
“Chronic disease is way out of proportion for Aboriginal people compared with other Australians.
“We also need preventative programs which address risk factors for chronic disease, such as by reducing smoking rates.
“Many of these core preventative programs fall under the Department of Prime Minister and Cabinet’s Indigenous Advancement Strategy and unfortunately it is not yet clear whether they will be approved.
“We’re urging the Government to urgently provide funding certainty for these essential preventative programs.
The generally poor results of Closing the Gap strategies should signal the need to review how decisions are made and why policy makers fail to adopt and apply their own evidence of “what works”. Part of the answer is that it is processes rather than content that undermine the potential of programs to succeed.
The first step towards success is to close the gap between political and bureaucratic cultures and the community inequities that need to be overcome.
PHOTO: The abundant evidence of what works shows the way to help Indigenous Australians build a better future. If only politicians and bureaucrats would heed the findings. AAP/Dan Peled
The disappointing data that regularly appears in Closing the Gap reports should raise serious questions about policy development and funding processes.
The assumption of media stories and many politicians is that gap closing is a “wicked” problem – that is, it’s too hard because of faults of the Indigenous targets.
It is easier to blame others when good intentions fail, but there is a much more mundane explanation, backed by substantial evidence: poor outcomes could be the result of flaws in how officials devise and deliver programs and funding.
Many programs designed to reduce Indigenous disadvantage fail to meet the federal government’s clear criteria for what works. These criteria come from the Commonwealth’s own major advisers’ analysis of performance and research data.
Multiple agencies monitor the effectiveness of government programs. They include the Australian National Audit Office (ANAO), the Ombudsman, a range of internal evaluation units and the Australian Institute of Health and Welfare (AIHW). The last of these is a particularly significant source of data for the current issue as it runs the official Closing the Gap Clearinghouse.
Reports on programs delivered plus summaries called Key Learnings are based on analysis of multiple publications. These reports clearly extract data on what works and what does not work in general and in particular program areas – for example, early childhood services. Another reputable advisory body, the Productivity Commission, extensively quotes these reports in its series of publications on Overcoming Indigenous Disadvantage.
The AIHW collection and the related papers from 2009 onwards offer a range of painstakingly rigorous findings of what worked and didn’t work. Their brief criteria summaries emphasise the importance of good processes in decision-making.
What works
The Clearinghouse has continued to find that there are high-level principles and practices that underpin successful programs for Indigenous Australians. These include:
flexibility in design and delivery so that local needs and contexts are taken into account;
community involvement and engagement in both the development and delivery of programs;
a focus on building trust and relationships;
a well-trained and well-resourced workforce, with an emphasis on retention of staff;
continuity and coordination of services.
What doesn’t work
“One size fits all” approaches;
lack of collaboration and poor access to services;
external authorities imposing change and reporting requirements;
interventions without local Indigenous community control and culturally appropriate adaptation;
short-term, one-off funding, piecemeal interventions, provision of services in isolation and failure to develop Indigenous capacity to provide services.
We have examined aspects of the Northern Territory Emergency Response (NTER) and its sequel, Stronger Futures. Both interventions have been criticised as procedurally flawed and have not shown many positive findings for very disruptive and costly programs.
We are concerned that, despite the data from AIHW and their use by the Productivity Commission, the service delivery sections of government and their political masters show few signs that many were taking the criteria seriously. If they had, they would have changed their top-down, culturally inappropriate design, delivery and funding processes.
In an effort to publicise these flawed processes and the possible improvements for communities and bureaucrats, and maybe politicians, I am collating a range of quotes from mainly federal agency reports that list the reasons for successes and failures of Indigenous policy programs.
The extracts from about 30 diverse reports on specific programs confirm the repeating problems of flawed processes of design. In particular, there are consistent failures to consult communities before decisions are taken, to engage locally and to make decisions with and not for local groups.
Backing the legitimacy of these generally professional critiques and top-down analyses are similar views recorded by many affected communities. A recent extensive consultative process with NSW Aboriginal communities documented similar complaints of poor processes by funders and service deliverers.
The diverse sources show why too many Indigenous-focused programs regularly failed to deliver needed services effectively. Poor government processes meant the programs were often too badly designed to work.
Tony Abbott’s speech on the sixth Closing the Gap report offered hopeful hints of change, but the prime minister still clings to the punitive elements of a largely failed approach. AAP/Alan Porritt
Until now, politicians have not acknowledged this but maybethe new players will loosen the old bureaucratic and political biases. The following extracts from prime minister Tony Abbott’s speech on the sixth annual Closing the Gap report suggest he may see options for reviewing processes:
Even as things began to change, a generation or two back our tendency was to work “for” Aboriginal people rather than “with” them. We objectified Aboriginal issues rather than personalised them. We saw problems to be solved rather than people to be engaged with…
Every education department knows the attendance rate for every school. The lower the attendance rate, the more likely it is that a school has problems. The lower the attendance rate, the more likely it is that a school is failing its students.
However, a later part of Abbott’s speech signalled that the punitive element – we know better what is good for them – is still there.
One of the worst forms of neglect is failing to give children the education they need for a decent life. That’s why every state and territory has anti-truancy laws. That’s why the former government, to its credit, tried to quarantine welfare payments for families whose children weren’t at school.
The quote shows Abbott fails to understand that most children will go to school if it works for them. Fairfax Media reports of this speech offered the following Indigenous responses: Kirstie Parker, co-chairman of the National Congress of Australia’s First Peoples, said “punitive” measures alone would not lift attendance. She said:
We want to see as much energy and focus on making schools places that our kids want to go and our families trust and genuinely feel a part of.
Indigenous educator Chris Sarra, the principal of Cherbourg school in Queensland, lifted attendance rates from 62% to 94%. He said the underlying causes of truancy usually related to the school rather than the child or their family. Sarra said:
You’ve got to look at why kids have rejected school in the first place.
A recent contribution in The Conversation quoted a similar statement by another new major player, but also expresses doubts that this will happen.
Recently, indigenous affairs minister Nigel Scullion claimed that he will prioritise Indigenous participation in policy making because it improves outcomes and creates better policy. This is sensible, but it subordinates the question of how the government values and interacts with Indigenous people to the question of the best method to reduce disadvantage.
The generally poor results of Closing the Gap strategies should signal the need to review how decisions are made and why policy makers fail to adopt and apply their own evidence of “what works”. Part of the answer is that it is processes rather than content that undermine the potential of programs to succeed.
The first step towards success is to close the gap between political and bureaucratic cultures and the community inequities that need to be overcome.
Relationships built on trust, integrity and respect are crucial for effective engagement with Indigenous communities, according to two papers released today on the Closing the Gap Clearinghouse website.
Engaging with Indigenous Australia—exploring the conditions for effective relationships with Aboriginal and Torres Strait Islander communities reviews the evidence on engagement and outlines the conditions required for effective engagement.
The evidence shows that engaging successfully with Indigenous communities requires:
an appreciation of the historical, social, cultural and political complexity of specific Indigenous contexts
active Indigenous participation from the earliest stage of defining the problem to be solved and defining aspirations, through to implementing the program and evaluating the results
long term relationships of trust, respect and honesty, as well as accessible and ongoing communication and clarity about roles and responsibilities
genuine efforts to share power, including through negotiated agreements
clarity about the purpose of and scale for engagement and appropriate timeframes
attention to strengthening governance and capacity within both the Indigenous community and governments themselves, and good leadership
negotiation of clear and agreed outcomes and indicators of success with monitoring and evaluation processes that meet each parties’ needs.
This paper says evidence shows that effective engagement requires strong and strategic Indigenous and government leadership and adequate governance, and that hurried one-off ‘consultations’ that are organised without Indigenous input do not work.
Fragmented arrangements, where each agency tries to engage with the same Indigenous people and organisations, place unnecessarily heavy burdens on Indigenous people.
These findings are consistent with the findings of the second paper, Engagement with Indigenous communities in key sectors. This paper reviews evidence from studies of Indigenous engagement in early childhood services, environmental and natural resource management activities, and health programs at local, regional, state and national levels.
It outlines the common lessons on different levels of engagement from local engagement through to regional, state-wide and national engagement.
The Closing the Gap Clearinghouse is jointly funded by all Australian governments and provides an online source of information on what works to close the gap in Indigenous disadvantage. It is delivered by the Australian Institute of Health and Welfare (AIHW) and the Australian Institute of Family Studies (AIFS).
