NACCHO Aboriginal Health News: Trust, integrity and respect confirmed as cornerstones of effective Indigenous engagement

Tony

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.

DOWNLOAD THE REPORT HERE

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).

Canberra, 2 October 2013

Further information: Nigel Harding, AIHW, tel. (02) 6244 1025, mob. 0409 307 671

For media copies of the report: 02 6249 5048/02 6249 5033 or email

NACCHO Aboriginal Health News: Cancer risk greater for Indigenous Australians-AIHW report download

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Indigenous Australians being approximately 50% more likely to die from cancer than non-Indigenous Australians….with lung cancer at the top of the rankings

Aboriginal and Torres Strait Islander people have higher rates of new cancer cases and cancer deaths than non-Indigenous Australians, according to a report released today by the Australian Institute of Health and Welfare (AIHW) and Cancer Australia.

Cancer in Aboriginal and Torres Strait Islander peoples of Australia: an overview is the first comprehensive summary of cancer statistics for Indigenous Australians.

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The report details the leading causes of cancer deaths for both Indigenous and non-Indigenous Australians.

AIHW spokesperson Justin Harvey said Indigenous Australians also had lower survival rates after a cancer diagnosis than non-Indigenous Australians.

‘Aboriginal and Torres Strait Islander peoples diagnosed with cancer between 1999 and 2007 had a 40% chance of surviving for at least 5 years, compared with 52% for non-Indigenous Australians,’ Mr Harvey said.

Cancer Australia CEO Professor Helen Zorbas said the report highlighted the significant impact that cancer had on the Indigenous population.

‘Whilst incidence rates for cancer overall were marginally higher for Indigenous Australians, mortality and survival differences between the two population groups are far more striking with Indigenous Australians being approximately 50% more likely to die from cancer than non-Indigenous Australians,’ Professor Zorbas said.

Mr Harvey said that while lung cancer was at the top of the rankings for both groups, differences emerged after that.

‘After lung cancer, the two most common causes of cancer death among Indigenous Australians are cancer of the liver and breast cancer (in females). For non-Indigenous Australians, the most common causes are lung cancer, followed by bowel and prostate cancer (in males),’ Mr Harvey said.

Professor Zorbas said the report emphasised the important work that needs to be undertaken to address the disparity between Indigenous and non-Indigenous Australians.

‘The findings of this report underscore the continuing action needed in health promotion, research and health service delivery to best meet the cancer prevention and treatment needs of Indigenous Australians,’ Professor Zorbas 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.

Cancer Australia provides national leadership in cancer control to improve outcomes for those affected by cancer their families and carers.

Canberra, 1 October 2013

Further information: AIHW—Mr Justin Harvey, tel. (02) 6249 5057, mob. 0450 677 562

Cancer Australia—Mr Simon Thomas, tel. (02) 9357 9401 or 0438 209 833

For media copies of the report: 02 6249 5048/02 6249 5033 or email Helpdesk-Media@aihw.gov.au

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NACCHO JOB Opportunities:

Are you interested in working in Aboriginal health?

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

Register your current or future interest with our HR TEAM HERE

NACCHO Aboriginal health news alert :Over $140 billion spent on health in 2011–12

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More than $140 billion was spent on health in Australia in 2011-12, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

DOWNLOAD REPORT HERE

The report, Health expenditure Australia 2011-12, shows health spending was estimated to be $140.2 billion in 2011-12-up from $132.6 billion in 2010-11 and from $82.9 billion 10 years earlier in 2001-02 (after adjusting for inflation).

SPEND ON INDIGENOUS HEALTH $4.60 Billion

Almost 70% of total health expenditure during 2011-12 was funded by governments, with the Australian Government contributing 42.4%, and state and territory governments contributing 27.3%. The remaining 30.3% was funded by individuals, private health insurers, and other non-government sources.

As a proportion of Australia’s gross domestic product (GDP), health spending was 9.5% in 2011-12, up from 9.3% in 2010-11 and 8.4% in 2001-02.

‘Over the decade from 2001-02, the ratio of health spending as a proportion of GDP and taxation revenue has risen, particularly following the global financial crisis,’ said AIHW CEO David Kalisch.

Over the decade to 2011-12, the Australian Government ratio of health expenditure to taxation revenue rose by 4.0 percentage points to 26.4%, while the state and territory governments’ ratio rose by 8.1 percentage points to 24.5%.

‘Our analysis of health inflation suggests that in recent years annual price rises in the broader economy have generally been greater than price rises in the health sector’, Mr Kalisch said.

The estimated recurrent expenditure on health per person in 2011-12 was $5,881, a rise from $5,681 per person in 2010-11 and $4,062 in 2001-02 (after adjusting for inflation).

Public hospital spending was the biggest component of health expenditure in 2011-12, accounting for $42.0 billion, or 31.8% of recurrent expenditure. The largest component of the overall rise in health spending was also spending on public hospital services (up by $2.1 billion), making up almost a third of the growth in recurrent health expenditure.

The Australian Government’s share of public hospital funding was 38.2% in 2011-12, down from 39.6% in 2010-11. The state and territory governments’ share of public hospital expenditure was 53.3% in 2011-12, up from 52.0% in 2010-11.

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.

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NACCHO JOB Opportunities:

Are you interested in working in Aboriginal health?

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

Register your current or future interest with our HR TEAM HERE

NACCHO health funding cuts alert: New Health Minister Dutton to cut jobs and research

Tanya Plibersek and Peter Dutton Debate

HEALTH Minister Peter Dutton (pictured above at the National Press Club) will cut the 6,500-strong army of health bureaucrats in federal departments to deliver “less spin doctors and more real doctors” and could cut research funding for two major health agencies – the Australian Institute of Health and Welfare and the year-old National Health Performance Authority .

  • The Coalition will also begin unwinding key “nanny state” agencies such as the Australian National Preventative Health Agency, established to lead the national fight against obesity, alcohol abuse and tobacco use.
  • Two major health agencies – the Australian Institute of Health and Welfare and the year-old National Health Performance Authority – are under review and could have their combined budgets – of around $40 million a year – slashed.
  • Scrapping ANPHA will leave the Government open to criticism that it’s not taking seriously a raft of key health challenges – including the growing obesity challenge and tobacco and alcohol control.
  • But Mr Dutton is determined to slash hundreds of millions of dollars in bureaucratic expenses and is reviewing the ongoing role of the AIHW – which provides a national service on health and welfare statistics.
  • The National Health Performance Authority – established in 2011 to provide uniform statistics on the performance of hospitals and other health facilities – could also be absorbed back into the health department.

Job cuts loom for army of health bureaucrats

Confirming public servants should expect job cuts in the May budget, Mr Dutton said the big rise in health bureaucrats under Labor was “unsustainable”

But families hoping the Abbott government will overturn Labor’s means test for the 30 per cent rebate could be waiting a long time.

Mr Dutton said there was “little chance” of that happening in the May budget as Labor had left “no money in the bank.”

“I want less spin doctors and more real doctors and I want more money spent in operating theatres and not backroom operations,” Mr Dutton said.

“I think some of those jobs will have to go.”

The Abbott government is targeting up to 12,000 public servant jobs across all departments. Mr Dutton would not reveal how many health jobs were in the firing line.

“I’ve just got my eye on next May’s budget. The previous government increased bureaucracy in health by 30 per cent,” he said.

“We have to make sure we are spending money on hip operations, on GPs, on medicines and new cancer drugs and there’s only so much money. We have to make sure we are spending money wisely.

“There’s no money in the bank, that’s what Labor’s left us with. In terms of next May’s budget I think it’s very hard to see how we would be able to achieve the savings to turn back Labor’s attacks on private health insurance.”

The Gillard government introduced a means test for the 30 per cent private health insurance rebate for singles earning over $88,000 and for couples and families earning more than $176,000

Commonwealth agencies to be cut by Abbott Government 

AGENCIES responsible for tackling obesity, capital city planning and security advice on asylum seekers are to be slashed as Tony Abbott takes the axe to Labor’s reform agenda.

Less than a week after taking office, the Coalition Government has scrapped plans to build a multimillion-dollar embassy in Africa, and will also wipe $100 million off research funding.

The Prime Minister has also pulled the pin on a key Kevin Rudd initiative – Community Cabinet – as he instructs his new ministry team to put the broom through the bureaucracy.

Key elements of Labor’s reform agenda are being dismantled.

The Major Cities Unit – which provided advice on developing Australia’s 18 biggest cities – and the Social Inclusion Unit in Mr Abbott’s own Department of Prime Minister & Cabinet will be dismantled.

The Coalition will also begin unwinding key “nanny state” agencies such as the Australian National Preventative Health Agency, established to lead the national fight against obesity, alcohol abuse and tobacco use.

Health Minister Peter Dutton has been critical of ANPHA’s decision to spend $500,000 on a study into a potential “fat tax” despite neither side of politics supporting such a move.

Senior ministers are now searching for big savings from departments with a raft of back office operations and smaller agencies on the chopping block.

“It’s out of control,” one senior minister said, of the rapid growth in Commonwealth agencies.

Even the Australian Institute of Criminology, established by Gough Whitlam in 1973, is under review and could be merged with a major university. in a bid to save millions of taxpayer dollars.

Two major health agencies – the Australian Institute of Health and Welfare and the year-old National Health Performance Authority – are under review and could have their combined budgets – of around $40 million a year – slashed.

One micro agency likely to be scrapped is the Independent Reviewer of Adverse Security Assessments.

It was established in 2012 last year and reviews assessments by ASIO into people in detention.

But with a $1 million a year price tag, the Government will likely scrap the organisation.

The future is also uncertain for key agencies such as the Human Rights Commission.

Some senior Coalition figures are keen to scrap the Commission altogether – but that would provoke a serious political brawl that Mr Abbott is not keen to have.

Attorney-General George Brandis has signalled his intention to challenge what he sees as a Left-controlled human rights agenda, and the role of issue-specific commissioners – such as Disability – could be broadened as part of an overhaul of the HRC.

The future of the national Children’s Commissioner – announced by former PM Julia Gillard in February – is also in doubt. Its role could be radically reshaped to focus on cyber bullying.

Around $100 million will be cut from Australian Research Council grants with the Government determined to wipe out costly academic indulgences., such as a $443,000 study into the “God of Hegel’s Post-Kantian idealism”.

Senior Coalition figures say the Australian Institute of Criminology will be reviewed to see whether it should remain a stand-alone agency.

The Institute produces academic-style research papers and there is a view that its operations should be taken over by a big university, saving taxpayers a considerable sum of money.

Climate Change Minister Greg Hunt has already taken the knife to key agencies, including the Climate Commission.

And another of Kevin Rudd’s pet initiatives, Community Cabinet, will be scrapped with a saving of around $13 million over the four year forward estimates.

Other key Rudd reforms – including the expensive bid for a seat on the United Nations Security Council – are being wound back with a planned new Australian embassy in Senegal to be abandoned.

Scrapping ANPHA will leave the Government open to criticism that it’s not taking seriously a raft of key health challenges – including the growing obesity challenge and tobacco and alcohol control.

But Mr Dutton is determined to slash hundreds of millions of dollars in bureaucratic expenses and is reviewing the ongoing role of the AIHW – which provides a national service on health and welfare statistics.

The National Health Performance Authority – established in 2011 to provide uniform statistics on the performance of hospitals and other health facilities – could also be absorbed back into the health department.

NACCHO health report card news: Aboriginal babies’ health improving, but concerns remain over immunisation

WayneQuilliam

DOWNLOAD THE AIHW and NACCHO REPORT CARD HERE

Stuart Rintoul article The Australian

ABORIGINAL community health services have called for more frontline spending on doctors and health workers as they released a report card showing improvements in infant birthweights, but continuing concerns around child immunisation, coronary heart disease, and type 2 diabetes.

Data derived from 53 Aboriginal health services that participate in the federal government’s Healthy for Life initiative showed that the average birthweight of indigenous babies rose by 66 grams from 2007-08 to 2010-11 and the proportion with normal birthweight increased from 81.5 per cent to 84.2 per cent.

The number of pregnant women recorded as not smoking or consuming alcohol in the third trimester more than doubled and the number recorded as not using illicit drugs almost tripled, although 51.2 per cent of women smoked, 14.8 per cent drank alcohol and 15.9 per cent used illicit drugs.

The findings closely follow the first publicly released Healthy for Life report, in March, which found that the proportion of expectant mothers who smoked, consumed alcohol and used illicit drugs was lower during third trimester antenatal visits (52.4 per cent, 17.9 per cent, 17.2 per cent) than first trimester visits (55.1 per cent, 25.0 per cent, 23.8 per cent).
The report finds that immunisation of Aboriginal children fell between 2007 and 2011 and is an area requiring “improvement”.

In March, the Australian Institute of Health and Welfare found that only 70 per cent of Aboriginal children aged 12-24 months, 68 per cent of children aged 24-36 months and 56 per cent of children aged 60-72 months were fully immunised.

It found that children aged 12-24 months in very remote areas were far more likely (91 per cent) to be immunised than children in major cities (42 per cent). It found that only 26 per cent of Aboriginal children aged 24-36 months in major cities were fully immunised.

The number of indigenous people with type 2 diabetes who had a GP management plan increased between 2007-08 and 2010-11 by about 50 per cent, from 1492 to 2156, while the number who had blood sugar tests rose from 2797 to 3610. The number of clients with coronary heart disease with a management plan rose from 405 to 750.

Lisa Briggs, chief executive of the National Aboriginal Community Controlled Health Organisation, said the report, by the Australian Institute of Health and Welfare, showed the need for a stronger focus on frontline services.

“When you deliver comprehensive care, particularly to the most vulnerable and those who have the highest burden of disease and disadvantage, you get health gains,” she said.

NACCHO chairman Justin Mohamed said the report showed the importance of health services delivered “by Aboriginal people, for Aboriginal people”. He said longer-term data showed a 33 per cent decline in overall mortality and a 62 per cent decline in infant mortality from 1991-2010.

The Healthy for Life program focuses on mothers, babies and children; early detection and management of chronic disease; and long-term health outcomes. Indigenous health spending was $4.5 billion in 2010-11, or 3.7 per cent of total health spending.

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NACCHO health news:Governments failing to close the gap in the indigenous youth justice system

Close The gap

The policy is called ‘closing the gap’ and we’re not moving in the direction we need to.

STATES and territories have not only failed to close the gap in the indigenous youth justice system, but have overseen a widening in the past four years despite efforts to stop young Aborigines being jailed more often than their peers.

Data from various jurisdictions captures youth aged 10 to 17 and reveals Aboriginal and Torres Strait Islander children become part of the justice system earlier, are 16 times as likely to be under community supervision and 25 times as likely to be in detention than non-indigenous young.

But the Australian Institute of Health and Welfare report, Youth Justice in Australia 2011-12, released today, might have been compromised by the refusal of the West Australian Department of Corrective Services to participate and the failure of the Northern Territory’s Department of Correctional Services to find the data.

The jurisdictions have two of the largest indigenous populations, and the institute’s head of child welfare and prisoner health unit, Tim Beard, said the indigenous problem may have been larger had accurate data been obtained. “We’ve had discussions, given the nature of the demographies of these states, that this data would have been useful for an even more complete picture,” he said.

“We have relied on estimates where we can to form a national picture, which shows the supervision rates for indigenous youth have increased slightly, but not to the extent that you’d say the gap has significantly widened.

“But the policy is called ‘closing the gap’ and we’re not moving in the direction we need to.”

In 2011-12 there were 6940 young people under supervision for a crime or alleged crime on an average day in Australia, 13,830 throughout the year.

Although they account for 5 per cent of young Australians, 39 per cent of those under supervision were indigenous. On an average day there were 236 indigenous youth per 10,000 — up from 226 in 2008-09 — under community supervision, compared with 23 per 10,000 across the board. There were 42 indigenous youths under supervision in detention for every 10,000, compared with 1.7 for young Australians. This figure has worsened since a “best” result in 2010-11 where Aboriginal youth were 23 times as likely to be in detention compared with 25 times as likely today than non-indigenous youth.

They spent almost two weeks more in unsentenced detention and two weeks less in sentenced detention — possibly due to time served — but similar time in community-based supervision: 183 days on average.

“These are kids who are in detention with allegations that are basically unproven,” Mr Beard said. “It’s reasonable to assume that may be because of some prejudice against their race, and it may also be due to resourcing issues in remote areas where they are predominantly from.”

Mr Beard said the data indicated youth in detention were more likely to have multiple returns to the system, which could pose problems for the Queensland government, which is considering removing “detention as a last resort” policies.

Queensland Attorney-General Jarrod Bleijie said no decision had been made on the review of the principle. “If the principle was changed, it may allow courts to consider a broader range of options when sentencing young offenders,” he said.