NACCHO #Budget2018 Coverage 4 of 5 : Government Press Releases @GregHuntMP #HealthBudget18 @senbmckenzie #RuralHealthBudget @KenWyattMP #IndigenousHealth @NigelScullion #IndigenousAffairs #Budget2018NACCHO

 

1.Minister Health Greg Hunt

1.1 Guaranteeing essential services – record investment in health

1.2 Guaranteeing Medicare with record funding

1.3 More choices for a longer life

1.4 Providing record access to life-saving and life-improving medicines

1.5 Record Commonwealth funding for public hospitals

1.6 Supporting better mental health for all Australians

1.7 Boosting essential infant and maternal health services

1.8 Promoting a healthy and active Australia

2.Minister Rural Health Bridget McKenzie

2.1 Stronger Rural Health Strategy to deliver high quality care

3.Minister Indigenous Health Ken Wyatt

3.1 Better targeting support to improve Indigenous health

3.2 : Close to Country: $25 million for remote area dialysis

4. Minister Indigenous Affairs Nigel Scullion

4.1: 2018-19 Budget to strengthen economic, employment and health opportunities for First Australians

 “ This Budget confirms the Coalition Government’s continued investment of $5 billion over four years through the Indigenous Advancement Strategy which is making targeted investments in the three priorities fundamental to improving outcomes – getting kids to school, adults to work and making communities safer. Importantly, the number of Indigenous organisations delivering services has drastically increased under the Indigenous Advancement Strategy from 30 to 45 per cent now. “

Post 1 of our NACCHO Posts on #Budget2018 NACCHO

Post 2 will be the NACCHO Chair Press Release

Post 3 will be Health Peak bodies Press Release summary

Post 4 will be Government Press Releases

Post 5 Opposition responses to Budget 2018

ALL NACCHO BUDGET COVERAGE HERE

1.Minister Health Greg Hunt

1.1 Guaranteeing essential services – record investment in health

Download Health Budget HERE  NACCHO Budget INFO

The 2018–19 Budget is guaranteeing the essential health services that Australians rely on, with a $12.4 billion increase in the Health Budget and a $414.5 billion investment in health, aged care and sport.

We will increase:

Medicare funding by $4.8 billion;

public hospital funding by more than $30 billion;

investment in new medicines by $2.4 billion; and

funding for aged care by $5.0 billion.

We will invest in a National Health and Medical Industry Growth Plan of $1.3 billion, including a ground-breaking $500 million Australian Genomics Health Futures Mission.

The Government is also delivering the More Choices for a Longer Life Package to help Australians maximise the opportunities that a longer life brings.

1.2 Guaranteeing Medicare with record funding

The Turnbull Government will continue our absolute rock-solid commitment to Medicare with an additional $4.8 billion investment, building on the Medicare Guarantee Fund we established last year.

For 2017-18, $34.4 billion has been credited to the Fund. A further credit of $35.3 billion will be made to meet the estimated Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) expenditure for 2018-19.

Medicare spending is guaranteed and increasing every year from $24 billion in 2017-18 to $28.8 billion in 2021-22 to support healthcare for every Australian.

Indexation of the Medicare Benefits Schedule, which the Government reintroduced in last year’s Budget will deliver an additional $1.5 billion for Medicare services through to 2021-22.

Following recommendations from the expert MBS Review Taskforce and the independent Medical Services Advisory Committee we will provide new Medicare support for renal dialysis in remote communities, MRI scans for prostate cancer checks, a new cutting edge 3D mammography test for the early detection of breast cancer and new genetic testing for cystic fibrosis.

1.3 More choices for a longer life

The 2018-19 Budget will deliver the More Choices For a Longer Life package which will support older Australians to live longer and be better prepared, healthier, more independent and connected to their communities,

The Package gives older Australians more choices and greater flexibility, including:

An additional 14,000 high-level home care packages so older Australians can stay in their homes longer if they want to;

Allowing pensioners to earn more without reducing their pension;

Greater flexibility to use home equity to increase retirement incomes.

Since the last Budget, the Turnbull Government has delivered an extra 20,000 high-level home care packages, to support people to live at home longer.

We will provide 13,500 new residential aged care places and 775 short-term restorative places to be made available where they are most needed, plus $60 million for capital investment.

We will also invest $40.0 million to support aged care providers in regional, rural and remote Australia for urgent building and maintenance works.

More than $105 million will improve access to culturally safe aged care services in remote Indigenous communities.

The Turnbull Government will establish an Aged Care Quality and Safety Commission to create a tough cop on the beat to ensure older Australians receive the best possible care, with an additional $50 million to assist providers implement the new standards.

MyAged Care will be improved with an investment of $61.7 million to make it easier to use, along with simplifying the forms required to apply for aged care services, and $7.4 million to trial navigators to assist people to choose the aged care services that suit their needs.

We will invest $32.8 million to improve palliative care for older Australians living in residential aged care, filling current gaps in support services, $5.3 million for innovations in managing dementia, and $102.5 million for mental health programs for older Australians.

And people over 65 will be assisted to undertake more physical activity, with locally-based sporting organisations receiving grants totalling $22.9 million to deliver new programs for older Australians.

The Government is helping Australians to work for as long as they want, laying the foundations for a secure retirement. We will provide up to $10,000 in Restart wage subsidies for employing Australians aged 50 and over. The Skills and Training incentive will provide up to $2,000 to fund up-skilling opportunities for mature aged workers.

The 2018-19 Budget delivers measures to boost living standards and expand retirement income options to give retirees confidence in their financial security.

We are increasing the Pension Work Bonus to allow age pensioners to earn an extra $50 per fortnight without reducing their pension. The Pension Loans Scheme will be expanded giving greater flexibility to use home equity to boost retirement incomes, e.g. up to $17,787 a year for a full rate age pensioner (couple).

1.4 Providing record access to life-saving and life-improving medicines

The Turnbull Government will invest $2.4 billion on new medicines to build on our commitment to guarantee those essential services that all Australians rely on. This includes a new $1 billion provision to maintain our commitment to listing all new medicines recommendation by the independent Pharmaceutical Benefits Advisory Committee.

Unlike Labor, we list and will continue to list, every single drug recommended by the medical experts – the Pharmaceutical Benefits Advisory Committee – with approximately $9 billion of investment in new drug listings since coming into government.

In particular, the Government will provide $703.6 million for the listing of Kisqali ® on the PBS to support women with breast cancer. Without subsidy, patients would pay $71,820 per year.

We will also list Spinraza ® on the PBS, a life-changing medicine which treats the devastating illness Spinal Muscular Atrophy. Without subsidy, patients would pay more than $367,850 per year. These new listings mean patients will have access to these medicines paying a maximum of $39.50 per script. Concessional patients, including pensioners, will pay just $6.40.

The Turnbull Government has also signed a landmark agreement with Medicines Australia to improve access to life saving medicines for rare diseases through key reforms to the Life Saving Drugs Program.

1.5 Record Commonwealth funding for public hospitals

The Government will deliver more than $30 billion in additional public hospital funding under a five-year National Health Agreement, with funding increasing for every state and territory, every year.

From 2020-21 to 2024-25, the new agreement will deliver a record $130.2 billion in public hospital funding, with six of Australia’s eight states and territories now covered by this new agreement, including three Labor governments and three Liberal governments.

This represents a more than doubling of public hospital funding under the Coalition Government, rising from $13.3 billion in 2012-13 to $28.7 billion in 2024-25.

1.6 Supporting better mental health for all Australians

The Turnbull Government will deliver an increase of $338.1 million in mental health funding, with a focus on suicide prevention, research and older Australians and advancing the Fifth National Mental Health and Suicide Prevention Plan.

We will expand the beyondblue Way Back Support Service across Australia, which provides outreach, follow-up care and practical support to people discharged from hospital after a suicide attempt. This will see an investment of $37.6 million.

We will provide Lifeline Australia $33.8 million to support its phone counselling services, and SANE Australia will receive $1.2 million for the Better off With You campaign.

The Government will fund a new Million Minds Mission through the Medical Research Future Fund. Over the next 10 years, $125 million will be invested in new research to support an additional million people with mental illness, through new research, diagnosis and treatment.

Men over 85 years of age have the highest risk of suicide for all ages. That’s why the Government will deliver $82.5 million for psychological services in residential aged care, while mental health nurses will help develop and deliver a $20 million program to support older Australians in the community who are isolated and at risk.

The National Mental Health Commission will receive an increase of $12.4 million to oversee mental health reform and take an expanded role under the Fifth National Mental Health and Suicide Prevention Plan. Funding of $4.7 million will support the continued operation of Head to Health, the new digital gateway for mental health services.

We will also fund the Royal Flying Doctor Service for mental health outreach, which will receive $20.4 million to ensure regional and rural Australians get care wherever they are.

1.7 Boosting essential infant and maternal health services

To give Australian children the best possible start in life, we are investing $77.9 million in infant and maternal health and for the first 2,000 days of a child’s life.

This includes $17.5 million for maternal and infant health medical research.

Health professionals will give parents-to-be simple and effective guidance on staying healthy during pregnancy with a $3.0 million program.

The Government will extend the childhood immunisation education campaign, targeting areas with low vaccination rates.

Every mother will be given the opportunity to vaccinate against whooping cough, with $39.5 million to fund the pertussis vaccine to all pregnant women.

To help parents keep track of their children’s health from birth, the Government will introduce a national digital baby book with $5.0 million of funding, replacing state and territory hard copy baby books, and giving children their passport to a lifelong health record.

We will invest $6.2 million to subsidise the cost of more insulin pumps for children with type 1 diabetes.

With injury the leading cause of death of children aged one to 16 years, the Government will fund $0.9 million for the development of a new National Injury Prevention Strategy aimed at reducing childhood injuries. In addition, funding of $1.0 million for the SeeMore Safety Program will support preschool and kindergarten children and their families to reduce the number of preventable childhood injuries.

We will also roll out a new $1 million program to assist GPs to learn more about endometriosis, so they can better diagnose and treat the condition, which can affect around one in ten women and is a key contributor to infertility.

1.8 Promoting a healthy and active Australia

The Turnbull Government will invest $230 million to implement a range of sport and physical activity initiatives that will see more Australians, more active, more often.

This investment builds on our national strengths and will provide more opportunities for Australians to participate in sport and physical activity and promote healthy, active life styles.

The Government will invest $28.9 million in participation grants targeted at less active Australians.

This includes an extension of the Local Sporting Champions grants program which will see more than 3,000 additional young athletes receiving support, including for young athletes in the regions to attend competitions.

The Government will also provide $41.7 million towards extending the popular Sporting Schools Program which provides opportunities for children to participate in sport by reducing the financial burden for parents and building a culture of the enjoyment and benefits of sport for a digitally focused generation.

The Government is acting to reduce drowning at Australia’s beaches, rivers and waterways, as well as improving safety on our snow fields through the Water and Snow Safety Program, with a total investment of $48.5 million.

Participation in sport is vital for the health and wellbeing of all Australians, and is foundational to the Government’s sport plan which will be released later this year.

The Turnbull Government is delivering a strong economy which means we can guarantee the essentials that Australians rely on like Medicare, hospitals, lifesaving medicines and aged care.

2.1 Stronger Rural Health Strategy to deliver high quality care

The Turnbull Government will deliver the most comprehensive rural health package in decades, which will improve access to doctors, nurses and other health care services for all Australians, especially those in the regions.

The Stronger Rural Health Strategy will improve the delivery of healthcare by ensuring we have the right health care professionals located in the regions. It will provide greater opportunities for Australian doctors through better teaching, training, recruitment and retention. The package will see growth in multidisciplinary care and increased access to nursing and allied health services.

This comprehensive strategy has been developed in close consultation with the AMA, RACGP, ACRRM and other rural medical leaders.

In order to support teaching in the regions, we will invest $95.4 million to create the new Murray Darling Medical Schools Network comprising of the University of NSW (Wagga Wagga), University of Sydney (Dubbo), Charles Sturt University/Western Sydney University (Orange), Monash University (Bendigo, Mildura), and University of Melbourne/La Trobe University (Bendigo, Wodonga, Shepparton). The Government will also include Curtin University (for medical training) and La Trobe University (for nursing and allied health training) in the Rural Health Multidisciplinary Training (RHMT) program.

This will be done while retaining the existing number of Commonwealth Supported Places for medical students.

This is a fundamental change in the teaching and supply of rural and regional doctors and will transform rural training schools, enabling students to undertake most of their education and training in rural areas to provide a continuum for doctors to learn, train and work in the regions.

The Stronger Rural Health Strategy will mean more Australian doctors for the regions.

3.1 Better targeting support to improve Indigenous health

The Budget provides ever greater support for our effort to Close the Gap and better targets funding to improve outcomes for Aboriginal and Torres Strait Islander people, with funding for Indigenous Health of $3.9 billion from 2018-19 to 2021-22 and $10 billion over a decade.

In particular, the Turnbull Government will deliver $33.4 million for Aboriginal and Torres Strait Islander health workforce, and provide funding to prevent and treat complex and chronic health conditions including eye disease ($34.3 million), hearing loss ($30.0 million), and crusted scabies ($4.8 million).

3.2 : Close to Country: $25 million for remote area dialysis

The Australian Government is funding a $25 million expansion of remote renal clinics, so more Aboriginal people in Central Australia who suffer from kidney disease can receive dialysis on country or as near to their communities as possible.

Minister for Indigenous Health, Ken Wyatt AM, said the Government was proud to support the highly successful Western Desert Nganampa Walytja Palyantjaku Tjutaku, also known as Purple House, to complete four new clinics and extend a fifth.

“Purple House is making a huge difference to the physical, mental and spiritual health of people across Central Australia, by allowing them to receive care while remaining connected to their land and their people,” Minister Wyatt said.

“This expansion will take the number of remote clinics in the region to 17 and builds on this community driven project’s outstanding record.

“Purple House now provides 70 per cent of Central Australian dialysis services and is not only changing lives, its vast program has saved many lives, because patients don’t have to leave their families and communities for treatment.”

Recent clinical data shows the mortality rate for people on dialysis in Central Australia is now less than half the rate of the rest of the nation.

The funding will allow completion of clinics this year at Utopia, Ampilawatja, Kalkarindji and Ernabella, plus the expansion of the Lajamanu clinic. It will also support the operating costs of another three clinics

The expansion will take the number of remote dialysis machines from 36 to 54 and increase the remote patient group from around 250 to more than 400.

Chronic kidney disease is a significant health challenge among Aboriginal and Torres Strait Islander communities. More than 1,800 First Nations people are currently receiving dialysis, with almost 60 per cent of these starting dialysis before they were 55 years old.

Minister Wyatt said reducing the misery and death caused by kidney disease was a key Turnbull Government priority.

“Following a recent roundtable in Darwin, development of an Aboriginal and Torres Strait Islander renal health road map is underway,” said the Minister.

“Prevention is crucial and it starts during pregnancy, with low birthweight babies born with weaker kidneys.

“Organisations like Purple House are showing the way, through community based, holistic services and strong and effective Aboriginal governance.

“An independent study has shown Purple house delivers remote renal services at a cost comparable to or even lower than the standard Australian hospital dialysis cost.”

Purple House was formed in 2003, following years of work by Aboriginal leaders and supporters that culminated in a million-dollar fundraising auction of local art to establish the project.

The Commonwealth Government has previously provided $17.6 million over four years to Purple House for renal support services in the NT and Western Australia, including $6.45 million to enable the Purple House to build and expand renal infrastructure in Central Australia at six locations in the NT and one in South Australia.

The new funding, under the Government’s Indigenous Australians’ Health Program, will apply for three years from July 2018.

4.1: 2018-19 Budget to strengthen economic, employment and health opportunities for First Australians

 

First Australians right across the nation will benefit from a stronger economy, more jobs and guaranteed essential services through the 2018-19 Federal Budget.

Minister for Indigenous Affairs, Nigel Scullion, said this year’s Budget is delivering for First Australians across the board by investing in health, safety and security through economic and employment opportunities.

“The Coalition Government’s economic plan has already delivered over 400,000 jobs last year – the highest number of any year on record.

“We are delivering tax relief to hard-working Australian families, guaranteeing the essential services in health, education and community safety that all Australians rely upon, returning the Budget to a credible trajectory to surplus, while setting the stage for a return of business confidence and the jobs boom. We are also ensuring that First Australians have their fair share of this economic success.”

The Coalition Government’s cross-portfolio investment in initiatives to improve outcomes for Aboriginal and Torres Strait Islander Australians include:

  • The Community Development Programme (CDP) reforms to ensure remote job seekers are further supported on their pathway to employment. It will now be a simpler, more streamlined program, with less interactions with the national welfare system for remote job seekers. This is being complemented by a government-funded employment program for 6,000 jobs in remote Australia.
  • A new Aboriginal and Torres Strait Islander Land and Sea Future Fund (ATSILSFF) will replace the $2 billion Aboriginal and Torres Strait Islander Land Account (Land Account) leaving the Fund up to $1.5 billion better off, over 20 years, compared to the current investment mandate.
  • $550 million over five years ($110 million per annum) to support remote housing in Aboriginal and Torres Strait Islander communities across the Northern Territory. This funding will be matched by Northern Territory Government contributions. Negotiations remain ongoing with Western Australia, South Australia and Queensland however the Commonwealth remains hopeful of reaching an agreement with these jurisdictions soon.
  • $3.8 billion investment to the Indigenous Australians’ Health Programme (IAHP) from 2018‑19, an increase of over $800 million compared with the previous four years.
  • $38.1 million, over five years, to support Aboriginal and Torres Strait Islander students who need to travel away from home for education, in recognition of the 50th anniversary of ABSTUDY.
  • $105 million for better access to aged care Aboriginal and Torres Strait Islander people.
  • $18.2 million to support domestic violence prevention and protection programs for women and girls including maintaining the current DV alert service and 1800RESPECT trauma counselling service.
  • $34.8 million over four years to support the delivery of dialysis by nurses, including Aboriginal and Torres Strait Islander health workers in remote areas, under a new Medicare Benefits Schedule item.
  • $23.2 million over four years for Healthy Active Beginning Package which includes a policy to reduce the traumatic injury rate among young Indigenous Australians, who are 4.5 times more likely to sustain serious injury than non-Indigenous children.
  • $200 million for a third round of the Building Better Regions Funding to support rural, regional and remote community infrastructure projects.
  • $28.3 million over four years for Remote Airstrip Upgrade works supporting air access to remote towns and Indigenous communities.
  • $2 million over three years to the Australian Institute for Aboriginal and Torres Strait Islander Studies (AIATSIS) for a program of preservation and celebration of Indigenous languages and culture.

This Budget confirms the Coalition Government’s continued investment of $5 billion over four years through the Indigenous Advancement Strategy which is making targeted investments in the three priorities fundamental to improving outcomes – getting kids to school, adults to work and making communities safer. Importantly, the number of Indigenous organisations delivering services has drastically increased under the Indigenous Advancement Strategy from 30 to 45 per cent now.

Minister Scullion said efforts across the government would build on the success of initiatives such as the Indigenous Procurement Policy, which has seen over 1,000 Indigenous businesses win Australian Government contracts worth more than $1 billion since the policy’s inception in July 2015.

The IPP stands in stark contrast to the pathetic $6.2 million to just 30 Indigenous businesses in Labor’s last year in government.

“The Indigenous Grants Policy (IGP) we unveiled in February will see services intended specifically for Aboriginal and Torres Strait Islander communities to be delivered by local Indigenous organisations.

The policy will be trialled later this year for grants administered by the Department of Communications and the Arts, the Department of Social Services and the Department of the Prime Minister and Cabinet.

“The IGP builds on the Coalition’s efforts to deliver more grant funding through the Indigenous Advancement Strategy to Aboriginal and Torres Strait Islander organisations.

We are now delivering 55 per cent of grants through First Australian owned or controlled organisations compared with 35 per cent under Labor.

“To drive greater change and to close the gap, we need to harness greater opportunities for Aboriginal and Torres Strait Islander peoples across all areas of government expenditure and investment and that is precisely what we are doing,” Minister Scullion said.

“Through the Indigenous Business Sector Strategy, the Employment Parity Initiative, the Vocational Training and Employment Centre programme and the Indigenous Rangers Programme we are supporting First Australians realise their economic aspirations.

“Our strategic partnerships with First Nations’ representative bodies like the New South Wales Aboriginal Land Council in Western Sydney to include procurement and employment targets as part of the $5 billion Western Sydney Airport, and with the Northern Land Council on remote housing in the Northern Territory, demonstrates our strong commitment to putting First Australians at the heart of our economic plan for the nation,” Minister Scullion said today.

 

“The IGP builds on the Coalition’s efforts to deliver more grant funding through the Indigenous Advancement Strategy to Aboriginal and Torres Strait Islander organisations. We are now delivering 55 per cent of grants through First Australian owned or controlled organisations compared with 35 per cent under Labor.

“To drive greater change and to close the gap, we need to harness greater opportunities for Aboriginal and Torres Strait Islander peoples across all areas of government expenditure and investment and that is precisely what we are doing,” Minister Scullion said.

“Through the Indigenous Business Sector Strategy, the Employment Parity Initiative, the Vocational Training and Employment Centre programme and the Indigenous Rangers Programme we are supporting First Australians realise their economic aspirations.

“Our strategic partnerships with First Nations’ representative bodies like the New South Wales Aboriginal Land Council in Western Sydney to include procurement and employment targets as part of the $5 billion Western Sydney Airport, and with the Northern Land Council on remote housing in the Northern Territory, demonstrates our strong commitment to putting First Australians at the heart of our economic plan for the nation,” Minister Scullion said today.

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NACCHO Aboriginal Health #HealthBudget18 : Will the #Budget2018NACCHO Improve health outcomes for Indigenous Australians ?

 

” A greater focus on outcomes and transparency of funding will support our ongoing commitment to Closing the Gap in Indigenous health with a total of $10 billion for Indigenous health over the next decade.”

Extract from Health budget papers See Part 2 below Improving health outcomes for Indigenous Australians : download full copy of Health Budget

 ” Funding for a key Aboriginal health program will climb $200 million to nearly $4 billion as the Turnbull government negotiates with the states over other investments.

The government will implement a new primary care funding model for the Indigenous Australians’ Health Program to provide greater transparency of funding and improve health outcomes.

This new transparency initiative would be based on patient numbers, episodes of care and the remote nature of the treatment and be designed to ensure resources are directed to the right areas, minimising waste.

The contribution will total $3.9bn over four years from 2018-19 and the budget papers state that extra funding could also be provided under the Medicare system.”

From the Australian see Part 1 Below

Post 1 of our NACCHO Posts on #Budget2018 NACCHO below

Post 2 will be the NACCHO Chair Press Release and Analysis

Post 3 will be Health Peak bodies press release summary

Post 4 will be Government Press Releases

See our live interviews on NACCHO Facebook

 ” National Congress welcomes the renewal of funding for our health organisations and programs. In particular, we appreciate the recognition of the crucial role which the Aboriginal and Torres Strait Islander workforce plays in delivering positive health outcomes for our peoples.

However, we note that the provision of culturally safe and appropriate healthcare must also be integrated into the mainstream health system.

We also acknowledge the Government’s commitment to provide new funding to aged care, but unless the large gap in life expectancy is resolved, many of our peoples may not enjoy the longevity to benefit from these services.”

National Congress Press Release see Part 3 Below

Part 1 The Australian Continued

Existing eye health initiatives will be bolstered by $34m to provide further health checks and address the issue of vision loss. The government has pledged more than $33m to bolster the Aboriginal and Torres Strait Islander workforce.

Indigenous Affairs Minister Nigel Scullion also earmarked $550m over five years for remote housing in the Northern Territory, with matched funding from the territory government.

“Local Aboriginal decision-making, local Aboriginal employment and local Aboriginal procurement are at the heart of our investment,” he said.

Senator Scullion said the government was in negotiations with the Queensland, South Australian and West Australian governments about future funding.

The budget would support 6000 jobs in remote areas, with so-called tailored support to indigenous jobseekers.

The overhaul of the Community Development Program would start from early next year, cutting income reporting demands to Centrelink.

Senator Scullion said the new system would ensure that all jobseekers — regardless of their location — would face the same compliance framework

Part 2 From Health Budget Papers : Improving health outcomes for Indigenous Australians

 

Download the 472 Page Health budget here

NACCHO Budget INFO

 Funding for the Indigenous Australians’ Health Programme (IHAP) will increase by $200 million to total $3.9 billion over four years from 2018-19.

As part of the Closing the Gap agenda, the Government will implement a new primary care funding model for IHAP to improve outcomes for Aboriginal and Torres Strait Islander peoples.

Greater transparency of funding based on patient numbers, episodes of care and remoteness will assist in ensuring resources are directed to areas of need.

The program will be introduced in consultation with the community and overall funding is retained, while increased opportunities will exist for additional funding under Medicare.

The Government will target specific health conditions that disproportionately affect Aboriginal and Torres Strait Islander peoples, including a focus on avoiding hearing loss and vision impairment.

The Government will allocate approximately $30 million to expand hearing assessments. Aboriginal and Torres Strait Islander children have high rates of otitis media and subsequent hearing loss.

Poor vision is a barrier to education and employment, and impacts mobility, independence and social interaction.

The Government will boost existing eye health initiatives, investing $34.3 million to provide eye health checks and target the major causes of vision loss in Aboriginal and Torres Strait Islander communities.

The detection, treatment and management of crusted scabies in remote Aboriginal and Torres Strait Islander communities in Northern Australia will also be improved through an investment of $4.8 million.

The measure will help eliminate the highly infectious condition, which can lead to acute rheumatic fever, rheumatic heart disease and renal disease.

This initiative builds on a successful pilot in East Arnhem, which achieved a 44 per cent reduction in recurring crusted scabies over four years.

Funding for Aboriginal and Torres Strait Islander Health Professional Organisations will also be boosted, with funding of $33.4 million over four years to enable further increases to the Aboriginal and Torres Strait Islander health workforce.

This will assist with meeting increased demand for services and will also help non-Indigenous Australians develop cultural understanding and capability.

The Government will also expand the National Aboriginal and Torres Strait Islander Flexible Aged Care (NATSIFAC) program to improve access to culturally safe aged care services in remote Indigenous communities.

From 2018-19 to 2021-22, the Government will provide $105 million to better support older Aboriginal and Torres Strait Islander people.

Part 3 National Congress

 

The Government’s priority for First Australians focuses primarily on economic prosperity. While many would welcome this outcome, the Government’s roadmap to accomplishing this prosperity is fanciful, incoherent and sorely lacking in the detail necessary for success.

Although the Government has listened to a few of our concerns regarding the Community Development Program, major issues largely remain unresolved in this budget.

The harsh and discriminatory penalty system is largely intact. In fact, penalties have worryingly been strengthened in cases involving participants who need the greatest amount of support. For this reason alone we renew our call for the CDP to be replaced with a wage-based program which provides meaningful employment and training for our peoples.

We are deeply concerned by the Government’s proposal to withhold income support payments from individuals who default on fines. This is a recipe for ensuring that the poorest and most vulnerable members of our society will remain so, with unpaid fines likely leading to increased rates of incarceration rather than pathways to prosperity. Our peoples cannot achieve economic prosperity if we cannot meet our basic needs.

In claiming that it will provide $550 million in new funding for remote housing in the Northern Territory, the Government has attempted to hide its abandonment of a national housing strategy.

The National Partnership Agreements on Remote Indigenous Housing have expired. Prospects of renewal are slim, particularly if negotiations with state and territory governments are unsuccessful.

If Aboriginal and Torres Strait Islander peoples are forced to live in insecure, overcrowded and unsafe homes, or are homeless, the barriers to economic empowerment are overwhelming.

The Federal Budget fails to address the shameful over-incarceration of Aboriginal and Torres Strait Islander peoples. We make up 3% of Australia’s population, but 27% of its prisoners.

If anything, the Government’s callous disregard for our basic human rights to equality and quality health, education, housing and employment opportunities makes this problem worse.

These factors are also responsible for child removal rates being ten times greater than for non-Indigenous Australians, which threatens to create a new Stolen Generation and perpetuates intergenerational trauma.

Aboriginal and Torres Strait Islander legal services have highlighted gross inadequacies in government funding for civil cases.

As Centrelink breaches, inability to repay fines and housing tenancy disputes become more commonplace due to Budget measures, the demand for legal services will only increase and these inadequacies are likely to become more severe.

Attempts to Close the Gap appear to have stalled, with Minister Scullion making no reference to the program in his media release.

No new funding has been allocated to the strategy, despite a dire need for further community consultation and national co-operation between governments and our organisations.

The Government’s failure to Close the Gap must not be used as an excuse to abandon the targets altogether, lower expectations and wide the life expectancy gaps or shift responsibilities to state and territory governments.

We note in this budget that $50 million has been allocated for the memorialisation of the 250th Anniversary of Captain Cook’s voyage to Australia. Whilst gaining pockets of local support, this appears a controversial investment in the Treasurer’s own electorate.

Our preference would be to redirect these funds into community based Closing the Gap initiatives to address the negative impacts of the European invasion of Australia.

National Congress welcomes the renewal of funding for our health organisations and programs. In particular, we appreciate the recognition of the crucial role which the Aboriginal and Torres Strait Islander workforce plays in delivering positive health outcomes for our peoples.

However, we note that the provision of culturally safe and appropriate healthcare must also be integrated into the mainstream health system.

We also acknowledge the Government’s commitment to provide new funding to aged care, but unless the large gap in life expectancy is resolved, many of our peoples may not enjoy the longevity to benefit from these services.

We reiterate our call for the Government to work collaboratively with us. The need for an independent and well funded national representative body to inform Governments is greater now than ever.

Our organisations are in the best position to provide culturally safe and appropriate services to our peoples. However, we cannot achieve this without adequate resources and support.

On reflection this budget leaves so many of us uncertain of the true value of our extensive consultations with Government over the past year. So little of what we have said, like so little of what we have recommended, has been taken up by this Government in this underwhelming budget.

Our political leaders have seemingly exhibited an attention deficit; one proportional to the surplus evident in their own self-interest.

NACCHO Guide to Aboriginal Health and the #Budget2018NACCHO : What @NACCHOAustralia @AMAPresident @RACP @CroakeyNews and 21 peak health groups would like to see in tonight’s #Healthbudget18 ?

 

We need political will to #CloseTheGap. There are volumes of research, strategies and action plans sitting with governments – but they are not being properly resourced and funded. Make it right in tonight’s Budget “

AMA President, Dr Michael Gannon, said that the culmination of key reviews, under the guidance of Health Minister Greg Hunt, provides the Government with a rare opportunity to embark on a new era of ‘big picture’ health reform – but it will need significant long-term investment.

Also read NACCHO Aboriginal Health @AMAPresident Download AMA Pre-Budget Submission 2018-19 #Indigenous health reform – needs significant long-term investment

 ” The Federal Government must provide long-term funding certainty for the Medical Outreach Indigenous Chronic Disease Program, which is focused on preventing, detecting and managing chronic disease for Aboriginal and Torres Strait Islander people.”

RACP President Dr Catherine Yelland

Download the full submission here or read Aboriginal health extracts below

racp-2018-19-pre-budget-submission

Historical background RACP Associate Professor Noel Hayman

 “I’ve been working in the field of Indigenous health for 20 years now. The major changes, trends that I’ve seen over the years, has been improvements in infant mortality. But the one that contrasts that is the worsening mortality in middle age—we see high rates of mortality in Aboriginal people in their 40s and 50s. And this is due to chronic disease, particularly diabetes, ischaemic heart disease and chronic kidney disease.

Associate Professor Noel Hayman, Clinical Director of the Inala Indigenous Health Service in Brisbane.

He was the first Aboriginal GP in Queensland, and the first Aboriginal and Torres Strait Islander person to become a Fellow of the Australasian Faculty of Public Health Medicine at the RACP.

From Interview June 2016 Listen HERE

RACP Press Release

Doctors are calling for the Federal Government to provide long-term funding to programs that prevent, detect and manage chronic disease for Aboriginal and Torres Strait Islander people.
As detailed in the Royal Australasian College of Physicians’ pre-budget submission, these programs could help ensure better health outcomes and close the gap between Aboriginal and Torres Strait Islander health outcomes and those of the non-Indigenous community.

The RACP recommends that the Australian government :

Aboriginal and Torres Strait Islander Health

• Allocate secure long-term funding to progress the strategies and actions identified in the National Aboriginal and Torres Strait Islander Health Plan (NATSIHP) Implementation Plan.

• Provide secure, long-term funding for the Rural Health Outreach Fund (RHOF) and Medical Outreach Indigenous Chronic Disease Program (MOICDP).

• Build and support the capacity of Aboriginal and Torres Strait Islander health leaders by committing secure long-term funding to the Indigenous National Health Leadership Forum.

• Reinstate funding for a clearinghouse modelled on the previous Closing the Gap clearinghouse, in line with the recommendations of the Fifth National Mental Health and Suicide Prevention Plan. Allocate sufficient funding for the implementation of the Fifth National Aboriginal and Torres Strait Islander Blood-Borne Viruses (BBV) and Sexually Transmissible Infections (STI) Strategy.

• Fund the syphilis outbreak short-term action plan and coordinate this response with long term strategies.

• Allocate long-term funding for primary health care and community- led sexual health programs to embed STI/BBV services as core primary health care (PHC) activity, and to ensure timely and culturally supported access to specialist care when needed, to achieve low rates of STIs and good sexual health care for all Australians.

• Invest in and support a long-term multi-disciplinary sexual health workforce and integrate with PHC to build longstanding trust with communities.

• Allocate funding for STI and HIV point of care testing (POCT) devices, the development of guidelines for POCT devices and Medicare funding for the use of POCT devices.

Extract from Pre budget submission

Aboriginal and Torres Strait Islander Health

Aboriginal and Torres Strait Islander people continue to experience poorer health outcomes than non-Indigenous Australians.

The latest ‘Closing the Gap’ report found that Australia is not on track to close the life expectancy gap by 2031 – with the gap remaining close to ten years for both men and women.

The gap for deaths from cancer between Aboriginal and Torres Strait Islander and non-Indigenous Australians has in fact widened in recent years, with Aboriginal and Torres Strait Islander cancer death rates increasing by 21 percent between 1998 and 2015, while there was a 13 per cent decline for non-Indigenous Australians in the same period8.

To address these inequities and improve access to care, continuing and strengthened focus and appropriate long-term funding is required. It is imperative that there is secure funding for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 (NATSIHP) Implementation Plan.

Funding uncertainty and frequent changes create significant issues that impact the continuity of services to patients and organisations in their ability to retain and build their capacity.

Read in full NACCHO Aboriginal Health and #Sexual Health @TheRACP 2018-19 Pre-#budget submission : Long-term funding needed to improve #Indigenous health

 

”  A December 2017 report from the Australian Institute of Health and Welfare (AIHW) shows that the mortality gaps between Indigenous and non-Indigenous Australians are widening, not narrowing.

Urgent action is needed to reverse these trends to have any prospect of meeting the Council of Australian Governments’ goal to Close the Gap in life expectancy within a generation (by 2031).

The following submission by the National Aboriginal Community Controlled Health Organisation (NACCHO) in relation to the Commonwealth Budget 2018 aims to reverse the widening mortality gaps.

The following policy proposals are divided into four areas below and summarised in the following table:

  1. Proposals that strengthen and expand ACCHOs’ capacity and reach to deliver health services for Indigenous people
  2. Proposals that improve responsiveness of mainstream health services for Indigenous people
  3. Proposals that address specific preventable diseases
  4. Proposals that build in an Indigenous position into policy considerations that impact on health.

NACCHO is committed to working with the Australian Government to further develop the proposals, including associated costings and implementation plans and identifying where current expenditure could be more appropriately targeted ”

Download the full NACCHO submission HERE or part 3 below

NACCHO-Pre-budget-submisson-2018

Connect tonight with NACCHO #Budget2018NACCHO

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Besides our NACCHO live and recorded interviews

What will the 2018 Federal Budget mean for the health sector and consumers?

Consumers Health Forum of Australia Policy Team will be holding a free public webinar next Wednesday 16 May, 12:30pm AEST, to discuss the key health measures in the budget from a consumer perspective.

They will share our position on them, and take participants’ feedback and questions.

To join , register herehttps://chf.org.au/events/budget-2018-consumer-perspective

Part 2 Federal Budget 2018/19 – Preview and review of 21 health sector submissions

What is the number one health issue that the Government should address in tonight’s  Federal Budget?  Jennifer Doggett from Croakey analyses the pre-Budget Submissions from 21 health groups and finds surprising agreement among them on the urgent need for action in one key area.

Read on to find out what this issue is and the six key measures the Government should announce on Tuesday night if it wants to keep the health sector onside.  Check back on Wednesday to see how closely the Federal Government has followed the proposals from health and medical groups in this (possibly) pre-election Budget.

Bookmark this link for our coverage of the Federal Budget, and please use the hashtag #HealthBudget18 to share health-related budget news.

Read and subscribe here

Read full article here

2018/19 Federal Budget priorities

So what do this year’s crop of Pre-Budget submissions tell us about the current priorities of the health sector? After reviewing a slew of health-related pre-Budget submissions it is clear that there is one stand-out issue that has the overwhelming support of the health sector, with virtually every submission supporting action on this issue in some form or other.

That issue is prevention.  The clear message emerging from the submissions was that preventive health is the glaring gap in health policies at the federal level and the most pressing issue that needs to be addressed to improve the health of our community.

Almost every health-related pre-Budget submission included a strong focus on prevention, in particular those from the Public Health Association of Australia (PHAA), the Consumers Health Forum (CHF), the Australian Healthcare and Hospitals Association (AHHA), the Australian Medical Association (AMA), the Complementary Medicines Association (CMA), the Victorian Healthcare Association (VHA) and the Royal Australian College of Physicians (RACP).

The most strongly supported proposal overall was for the establishment of a national preventive health body to oversee and coordinate preventive health policies across all sectors and level of government.

The AMA’s submission reflected the reasons expressed in many submissions for such a national body: Obesity, nutrition, alcohol, tobacco and physical activity are health policy areas desperately in need of funded national strategies and measurable targets. These are best delivered through an independent, dedicated organisation.

Obesity was the most commonly mentioned health issue with a number of groups supporting a sugar tax, junk food advertising restrictions and physical activity programs.

Indigenous health

There was broad agreement across the submissions that we need to do more to close the health and life expectancy gap between Indigenous and non-Indigenous Australians and that supporting Indigenous community-controlled initiatives and services are the best way to achieve this.

Supporting and growing the Indigenous health workforce was a key feature of NACHHO’s submission, along with establishing an Aboriginal and Torres Strait Islander Commonwealth Advisory Group to support consideration, implementation and monitoring of an Indigenous position in efforts to Close the Gap and on jurisdictional agreements that have high impact on Indigenous peoples.

The AHHA and the AMA called for funding to implement the National Aboriginal and Torres Strait Islander Health Plan and the AMA also called for the Government to support the Redfern Statement.

Six key actions

After reviewing these submissions, the message is clear.  If the Government wants to win over the health sector on Tuesday night it needs to do the following:

  1. Establish a National Preventive Health Body (although this could be slightly awkward for the Government, given it abolished a similar body, the Australian National Preventive Health Agency in 2014)
  2. Announce a national obesity strategy
  3. Set up a Productivity Commission review of private health insurance
  4. Increase funding for the community-controlled Indigenous health sector
  5. Increase funding for public dental services
  6. Take action on mental health

Part 3

Widening mortality gaps require urgent action

The life expectancy gap means that Indigenous Australians are not only dying younger than non-Indigenous Australians but also carry a higher burden of disease across their life span, impacting on education and employment opportunities as well as their social and emotional wellbeing.

Preventable admissions and deaths are three times as high in Indigenous people yet use of the main Commonwealth schemes, Medicare Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS) are at best half the needs based requirements.

It is simply impossible to close the mortality gaps under these conditions. No government can have a goal to close life expectancy and child mortality gaps and yet concurrently preside over widening mortality gaps.

Going forward, a radical departure is needed from a business as usual approach.

Funding considerations, fiscal imbalance and underuse of MBS/PBS

The recent Productivity Commission Report found that per capita government spending on Indigenous services was twice as high as for the rest of the population.

The view that enormous amounts of money have been spent on Indigenous Affairs has led many to conclude a different focus is required and that money is not the answer.

Yet, the key question in understanding the relativities of expenditure on Indigenous is equity of total expenditure, both public and private and in relation to need.

In terms of health expenditure, the Commonwealth spends $1.4 for every $1 spent on the rest of the population, notwithstanding that, on the most conservative assumptions, Indigenous people have at least twice the per capita need of the rest of the population because of much higher levels of illness and burden of disease.

This represents a significant market failure. The health system serves the needs of the bulk of the population very well but the health system has failed to meet the needs of the Indigenous population.

A pressing need is to address the shortfall in spending for out of hospital services, for which the Commonwealth is mainly responsible, and which is directly and indirectly responsible for excessive preventable admissions funded by the jurisdictions – and avoidable deaths.

The fiscal imbalance whereby underspending by the Commonwealth leads to large increases in preventable admissions (and deaths) borne by the jurisdictions needs to be rectified.

Ultimately, NACCHO seeks an evidenced based, incremental plan to address gaps, and increased resources and effort to address the Indigenous burden of disease and life expectancy.

The following list of budget proposals reflect the burden of disease, the underfunding throughout the system and the comprehensive effort needed to close the gap and ideally would be considered as a total package.

NACCHO recommends initiatives that impact on the greatest number of Indigenous people and burden of preventable disease and support the sustainability of the Aboriginal Community Controlled Health Organisation (ACCHO) sector – see proposals 1. a) to e) and 3. a) and b) as a priority.

NACCHO is committed to working with the Australian Government on the below proposals and other collaborative initiatives that will help Close the Gap.

National Aboriginal Community Controlled Health Organisation

NACCHO is the national peak body representing 144 ACCHOs across the country on Aboriginal health and wellbeing issues

In 1997, the Federal Government funded NACCHO to establish a Secretariat in Canberra, greatly increasing the capacity of Aboriginal peoples involved in ACCHOs to participate in national health policy development.

Our members provide about three million episodes of care per year for about 350,000 people. In very remote areas, our services provided about one million episodes of care in a twelve-month period.

Collectively, we employ about 6,000 staff (most of whom are Indigenous), which makes us the single largest employer of Indigenous people in the country.

The following proposals are informed by NACCHO’s work with Aboriginal health services, its members, the views of Indigenous leaders expressed through the Redfern Statement and the Close the Gap campaign and its engagement and relationship with other peak health organisations, like the Australian Medical Association (AMA).

Guiding principles

Specialised health services for Indigenous people are essential to closing the gap as it is impossible to apply the same approach that is used in health services for non-Indigenous patients.

Many Indigenous people are uncomfortable seeking medical help at hospitals or general practices and therefore are reluctant to obtain essential care. Access to healthcare is often extremely difficult due to either geographical isolation or lack of transportation.

Many Indigenous people live below the poverty line so that services provided by practices that do not bulk bill are unattainable. Mainstream services struggle to provide appropriate healthcare to Indigenous patients due to significant cultural, geographical and language disparities: ACCHOs attempt to overcome such challenges.

An ACCHO is a primary health care service initiated and operated by the local Aboriginal community to deliver holistic, comprehensive, and culturally appropriate health care to the community which controls it, through a locally elected Board of Management.

They form a critical part of the Indigenous health infrastructure, providing culturally safe care with an emphasis on the importance of a family, community, culture and long-term relationships.

Studies have shown that ACCHOs are 23% better at attracting and retaining Indigenous clients than mainstream providers and at identifying and managing risk of chronic disease.

Indigenous people are more likely to access care if it is through an ACCHO and patients are more likely to follow chronic disease plans, return for follow up appointments and share information about their health and the health of their family.

ACCHOs provide care in context, understanding the environment in which many Indigenous people live and offering true primary health care. More people are also using ACCHOs.

In the 24 months to June 2015, our services increased their primary health care services, with the total number of clients rising by 8%. ACCHOs are also more cost-effective providing greater health benefits per dollar spent; measured at a value of $1.19:$1.

The lifetime health impact of interventions delivered our services is 50% greater than if these same interventions were delivered by mainstream health services, primarily due to improved Indigenous access.

If the gap is to close, the growth and development of ACCHOs across Australia is critical and should be a central component to policy considerations.

Mainstream health services also have a significant role in closing the gap in Indigenous health, providing tertiary care, specialist services and primary care where ACCHOs do not exist.

The Indigenous Australians’ Health Programme accounts for about 13% of government expenditure on Indigenous health.

Given that other programs are responsible for 87% of expenditure on Indigenous health, it reasonable to expect that mainstream services should be held more accountable in closing the gap than they currently are.

Greater effort is required by the mainstream health sector to improve its accessibility and responsiveness to Indigenous people and their health needs, reduce the burden of disease and to better support ACCHOs with medical and technical expertise.

The health system’s response to closing the gap in life expectancy involves a combination of mainstream and Indigenous-specific primary care providers (delivered primarily through ACCHOs) and where both are operating at the highest level to optimise their engagement and involvement with Indigenous people to improve health outcomes.

ACCHO’s provide a benchmark for Indigenous health care practice to the mainstream services, and through NACCHO can provide valuable good practice learnings to drive improved practices.

NACCHO also acknowledges the social determinants of health, including housing, family support, community safety, access to good nutrition, and the key role they play in influencing the life and health outcomes of Indigenous Australians.

Elsewhere NACCHO has and will continue to call on the Australian and state and territory governments to do more in these areas as they are foundational to closing the gap in life expectancy.

Addressing the social determinants of health is also critical to reducing the number of Indigenous incarceration. Comprehensively responding to the Royal Commission into the Protection and Detention of Children in the Northern Territory must be a non-negotiable priority.

Proposals

The following policy proposals are divided into four areas below and summarised in the following table:

  1. Proposals that strengthen and expand ACCHOs’ capacity and reach to deliver health services for Indigenous people
  2. Proposals that improve responsiveness of mainstream health services for Indigenous people
  3. Proposals that address specific preventable diseases
  4. Proposals that build in an Indigenous position into policy considerations that impact on health.

NACCHO is committed to working with the Australian Government to further develop the proposals, including associated costings and implementation plans and identifying where current expenditure could be more appropriately targeted

Continued HERE NACCHO-Pre-budget-submisison-2018

Aboriginal Health Download NACCHO Pre #Budget2018 Submission : Budget proposals to accelerate #ClosingTheGap in #Indigenous life expectancy

 

 ” A December 2017 report from the Australian Institute of Health and Welfare (AIHW) shows that the mortality gaps between Indigenous and non-Indigenous Australians are widening, not narrowing.

Urgent action is needed to reverse these trends to have any prospect of meeting the Council of Australian Governments’ goal to Close the Gap in life expectancy within a generation (by 2031).

The following submission by the National Aboriginal Community Controlled Health Organisation (NACCHO) in relation to the Commonwealth Budget 2018 aims to reverse the widening mortality gaps.”

Download the full NACCHO submission HERE

NACCHO-Pre-budget-submisson-2018

Also read NACCHO Aboriginal Health @AMAPresident Download AMA Pre-Budget Submission 2018-19 #Indigenous health reform – needs significant long-term investment

Widening mortality gaps require urgent action

The life expectancy gap means that Indigenous Australians are not only dying younger than non-Indigenous Australians but also carry a higher burden of disease across their life span, impacting on education and employment opportunities as well as their social and emotional wellbeing.

Preventable admissions and deaths are three times as high in Indigenous people yet use of the main Commonwealth schemes, Medicare Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS) are at best half the needs based requirements.

It is simply impossible to close the mortality gaps under these conditions. No government can have a goal to close life expectancy and child mortality gaps and yet concurrently preside over widening mortality gaps.

Going forward, a radical departure is needed from a business as usual approach.

Funding considerations, fiscal imbalance and underuse of MBS/PBS

The recent Productivity Commission Report found that per capita government spending on Indigenous services was twice as high as for the rest of the population.

The view that enormous amounts of money have been spent on Indigenous Affairs has led many to conclude a different focus is required and that money is not the answer.

Yet, the key question in understanding the relativities of expenditure on Indigenous is equity of total expenditure, both public and private and in relation to need.

In terms of health expenditure, the Commonwealth spends $1.4 for every $1 spent on the rest of the population, notwithstanding that, on the most conservative assumptions, Indigenous people have at least twice the per capita need of the rest of the population because of much higher levels of illness and burden of disease.

This represents a significant market failure. The health system serves the needs of the bulk of the population very well but the health system has failed to meet the needs of the Indigenous population.

A pressing need is to address the shortfall in spending for out of hospital services, for which the Commonwealth is mainly responsible, and which is directly and indirectly responsible for excessive preventable admissions funded by the jurisdictions – and avoidable deaths.

The fiscal imbalance whereby underspending by the Commonwealth leads to large increases in preventable admissions (and deaths) borne by the jurisdictions needs to be rectified.

Ultimately, NACCHO seeks an evidenced based, incremental plan to address gaps, and increased resources and effort to address the Indigenous burden of disease and life expectancy.

The following list of budget proposals reflect the burden of disease, the underfunding throughout the system and the comprehensive effort needed to close the gap and ideally would be considered as a total package.

NACCHO recommends initiatives that impact on the greatest number of Indigenous people and burden of preventable disease and support the sustainability of the Aboriginal Community Controlled Health Organisation (ACCHO) sector – see proposals 1. a) to e) and 3. a) and b) as a priority.

NACCHO is committed to working with the Australian Government on the below proposals and other collaborative initiatives that will help Close the Gap.

National Aboriginal Community Controlled Health Organisation

NACCHO is the national peak body representing 144 ACCHOs across the country on Aboriginal health and wellbeing issues

. In 1997, the Federal Government funded NACCHO to establish a Secretariat in Canberra, greatly increasing the capacity of Aboriginal peoples involved in ACCHOs to participate in national health policy development.

Our members provide about three million episodes of care per year for about 350,000 people. In very remote areas, our services provided about one million episodes of care in a twelve-month period.

Collectively, we employ about 6,000 staff (most of whom are Indigenous), which makes us the single largest employer of Indigenous people in the country.

The following proposals are informed by NACCHO’s work with Aboriginal health services, its members, the views of Indigenous leaders expressed through the Redfern Statement and the Close the Gap campaign and its engagement and relationship with other peak health organisations, like the Australian Medical Association (AMA).

Guiding principles

Specialised health services for Indigenous people are essential to closing the gap as it is impossible to apply the same approach that is used in health services for non-Indigenous patients.

Many Indigenous people are uncomfortable seeking medical help at hospitals or general practices and therefore are reluctant to obtain essential care. Access to healthcare is often extremely difficult due to either geographical isolation or lack of transportation.

Many Indigenous people live below the poverty line so that services provided by practices that do not bulk bill are unattainable. Mainstream services struggle to provide appropriate healthcare to Indigenous patients due to significant cultural, geographical and language disparities: ACCHOs attempt to overcome such challenges.

An ACCHO is a primary health care service initiated and operated by the local Aboriginal community to deliver holistic, comprehensive, and culturally appropriate health care to the community which controls it, through a locally elected Board of Management.

They form a critical part of the Indigenous health infrastructure, providing culturally safe care with an emphasis on the importance of a family, community, culture and long-term relationships.

Studies have shown that ACCHOs are 23% better at attracting and retaining Indigenous clients than mainstream providers and at identifying and managing risk of chronic disease.

Indigenous people are more likely to access care if it is through an ACCHO and patients are more likely to follow chronic disease plans, return for follow up appointments and share information about their health and the health of their family.

ACCHOs provide care in context, understanding the environment in which many Indigenous people live and offering true primary health care. More people are also using ACCHOs.

In the 24 months to June 2015, our services increased their primary health care services, with the total number of clients rising by 8%. ACCHOs are also more cost-effective providing greater health benefits per dollar spent; measured at a value of $1.19:$1.

The lifetime health impact of interventions delivered our services is 50% greater than if these same interventions were delivered by mainstream health services, primarily due to improved Indigenous access.

If the gap is to close, the growth and development of ACCHOs across Australia is critical and should be a central component to policy considerations.

Mainstream health services also have a significant role in closing the gap in Indigenous health, providing tertiary care, specialist services and primary care where ACCHOs do not exist.

The Indigenous Australians’ Health Programme accounts for about 13% of government expenditure on Indigenous health.

Given that other programs are responsible for 87% of expenditure on Indigenous health, it reasonable to expect that mainstream services should be held more accountable in closing the gap than they currently are.

Greater effort is required by the mainstream health sector to improve its accessibility and responsiveness to Indigenous people and their health needs, reduce the burden of disease and to better support ACCHOs with medical and technical expertise.

The health system’s response to closing the gap in life expectancy involves a combination of mainstream and Indigenous-specific primary care providers (delivered primarily through ACCHOs) and where both are operating at the highest level to optimise their engagement and involvement with Indigenous people to improve health outcomes.

ACCHO’s provide a benchmark for Indigenous health care practice to the mainstream services, and through NACCHO can provide valuable good practice learnings to drive improved practices.

NACCHO also acknowledges the social determinants of health, including housing, family support, community safety, access to good nutrition, and the key role they play in influencing the life and health outcomes of Indigenous Australians.

Elsewhere NACCHO has and will continue to call on the Australian and state and territory governments to do more in these areas as they are foundational to closing the gap in life expectancy.

Addressing the social determinants of health is also critical to reducing the number of Indigenous incarceration. Comprehensively responding to the Royal Commission into the Protection and Detention of Children in the Northern Territory must be a non-negotiable priority.

Proposals

The following policy proposals are divided into four areas below and summarised in the following table:

  1. Proposals that strengthen and expand ACCHOs’ capacity and reach to deliver health services for Indigenous people
  2. Proposals that improve responsiveness of mainstream health services for Indigenous people
  3. Proposals that address specific preventable diseases
  4. Proposals that build in an Indigenous position into policy considerations that impact on health.

NACCHO is committed to working with the Australian Government to further develop the proposals, including associated costings and implementation plans and identifying where current expenditure could be more appropriately targeted

Continued HERE NACCHO-Pre-budget-submisison-2018