NACCHO NEWS ALERT: COAG Health Ministers Council Communique acknowledge the importance #ACCHO’s advancing Aboriginal health

 

  Included in this NACCHO Aboriginal Health News Alert

  1. All issues 11 included in  Communique highlighting ACCHO health
  2. Health Ministers approve Australia’s National Digital Health Strategy
  3. Transcript Health Minister Hunt Press Conference

” The Federal Minister for Indigenous Health, Ken Wyatt, attended the COAG Health Council discussed the Commonwealth’s current work on Indigenous health priorities.

In particular this included the development of the 2018 iteration of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 that will incorporate strategies and actions to address the social determinants and cultural determinants of health.

Ministers also considered progress on other key Indigenous health issues including building workforce capability, cultural safety and environmental health, where jurisdictions can work together more closely with the Commonwealth to improve outcomes for Aboriginal and Torres Strait Islander peoples.

Ministers acknowledged the importance of collaboration and the need to coordinate activities across governments to support a culturally safe and comprehensive health system.

Ministers also acknowledge the importance of community controlled organisations in advancing Aboriginal and Torres Strait Islander health. ”

1.Development of the next iteration of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 COAG Health Council 

Read over 50 NACCHO NATSIHP Articles published over past 50 years

INTRODUCTION

The federal, state and territory Health Ministers met in Brisbane on August 4 at the COAG Health Council to discuss a range of national health issues.

The meeting was chaired by the Victorian Minister for Health, the Hon Jill Hennessy MP.

Health Ministers welcomed the New South Wales Minister for Mental Health, the Hon Tanya Davies MP, the Victorian Minister for Mental Health, the Hon Martin Foley MP, the ACT Minister for Mental Health Mr Shane Rattenbury and the Minister for Aged Care and Minister for Indigenous Health, the Hon Ken Wyatt AM, MP who participated in a joint discussion with Health Ministers about mental health issues.

Major items discussed by Health Ministers today included:

2.Andrew Forrest and the Eliminate Cancer Initiative

Mr Andrew Forrest joined the meeting to address Health Ministers in his capacity as Chairman of the Minderoo Foundation to discuss the Eliminate Cancer Initiative. The Minderoo Foundation is one of Autralia’s largest and most active philanthropic groups. It has established the Eliminate Cancer Initiatve (the Initiative), a global initiative dedicated to making cancer non-lethal with some of the world’s leading global medicine and anti-cancer leaders.

The Initiative is a united effort to convert cancer into a non-lethal disease through global collaboration of scientific, medical and academic institutes, commercially sustained through the support of the philanthropic, business and government sectors worldwide.

Australia has a critical role to play in this highly ambitious and thoroughly worthwhile goal.

3.Family violence and primary care

Today, Health Ministers discussed the significant health impacts on those people experiencing family violence.

Health Ministers acknowledged that health-care providers, particularly those in a primary care setting, are in a unique position to create a safe and confidential environment to enable the disclosure of violence, while offering appropriate support and referrals to other practitioners and services.

Recognising the importance of national leadership in this area, Ministers agreed to develop a plan to address barriers to primary care practitioners identifying and responding to patients experiencing family violence.

Ministers also agreed to work with the Royal Australian College of General Practitioners to develop and implement a national training package.

Further advice will be sought from Primary Health Networks on existing family violence services, including Commonwealth, State and NGO service providers in their regions, with a view to developing an improved whole-of-system responses to the complex needs of clients who disclose family violence

4.Fifth National Mental Health and Suicide Prevention Plan

Health Ministers endorsed the Fifth National Mental Health and Suicide Prevention Plan 2017-2022 and its Implementation Plan.

The Fifth Plan is focused on improvements across eight targeted priority areas:

1. Achieving integrated regional planning and service delivery

2. Effective suicide prevention

3. Coordinated treatment and supports for people with severe and complex mental illness

4. Improving Aboriginal and Torres Strait Islander mental health and suicide prevention

5. Improving the physical health of people living with mental illness and reducing early mortality

6. Reducing stigma and discrimination

7. Making safety and quality central to mental health service delivery

8. Ensuring that the enablers of effective system performance and system improvement are in place

The Fifth Plan also responds to calls for a national approach to address suicide prevention and will be used to guide other sectors and to support health agencies to interact with other portfolios to drive action in this priority area.

Ongoing collaboration and engagement across the sector and with consumers and carers is required to successfully implement the Fifth Plan and achieve meaningful reform to improve the lives of people living with mental illness including the needs of children and young people.

Health Ministers also agreed that mental health workforce issues would be considered by the Australian Health Ministers’ Advisory Council.

5.The National Psychosocial Supports Program

Health Ministers agreed to establish a time-limited working group to progress the Commonwealth’s National Psychosocial Supports program. This will have the objective of developing bilateral agreements to support access to essential psychosocial supports for persons with severe mental illness resulting in psychosocial disability who are not eligible for the NDIS.

Those bilateral agreements will take into account existing funding being allocated for this purpose by states and territories.

6.Strengthened penalties and prohibition orders under the Health Practitioner Regulation National Law

Health Ministers agreed to proceed with amendments to the Health Practitioner Regulation National Law (the National Law) to strengthen penalties for offences committed by people who hold themselves out to be a registered health practitioner, including those who use reserved professional titles or carry out restricted practices when not registered.

Ministers also agreed to proceed with an amendment to introduce a custodial sentence with a maximum term of up to three years for these offences.

These important reforms will be fast tracked to strengthen public protection under the National Law. Preparation will now commence on a draft amendment bill to be brought forward to Ministers for approval, with a view to this being introduced to the Queensland Parliament in 2018. The Western Australian Parliament is also expected to consider legislative changes to the Western Australian National Law.

7.Amendment to mandatory reporting provisions for treating health practitioner

Health Ministers agree that protecting the public from harm is of paramount importance as is supporting practitioners to seek health and in particular mental health treatment as soon as possible.

Health Ministers agreed that doctors should be able to seek treatment for health issues with confidentiality whilst also preserving the requirement for patient safety.

A nationally consistent approach to mandatory reporting provisions will provide confidence to health practitioners that they can feel able to seek treatment for their own health conditions anywhere in Australia.

Agree for AHMAC to recommend a nationally consistent approach to mandatory reporting, following discussion paper and consultation with consumer and practitioner groups, with a proposal to be considered by COAG Health Council at their November 2017 meeting, to allow the amendment to be progressed as part of Tranche 1A package of amendments and related guidelines.

8.National Digital Health Strategy and Australian Digital Health Agency Forward Work Plan 2018–2022

Health Ministers approved the National Digital Health Strategy and the Australian Digital Health Agency Work Plan for 2018-2022.

Download Strategy and work plan here  

The Strategy has identified the priority areas that form the basis of Australia’s vision for digital health.

This Strategy will build on Australia’s existing leadership in digital health care and support consumers and clinicians to put the consumer at the centre of their health care and provide choice, control and transparency.

Expanding the public reporting of patient safety and quality measures

Health Ministers supported Queensland and other interested jurisdictions to collaboratively identify options in relation to aligning patient safety and quality reporting standards across public and private hospitals nationally.

Ministers agreed that the Australian Commission on Safety and Quality in Health Care (ACSQHC) would undertake work with other interested jurisdictions to identify options in relation to aligning public reporting standards of quality healthcare and patient safety across public and private hospitals nationally.

The work be incorporated into the national work being progressed on Australia’s health system performance information and reporting frameworks.

 

9.National human biomonitoring program

Health Ministers noted that human biomonitoring data can play a key role in identifying chemicals which potentially cause adverse health effects and action that may need to be taken to protect public health.

Health Ministers agreed that a National Human Biomonitoring Program could be beneficial in assisting with the understanding of chemical exposures in the Australian population.

Accordingly, Ministers agreed that the Australian Health Ministers’ Advisory Council will explore this matter in more detail by undertaking a feasibility assessment of a National Human Biomonitoring Program.

Clarification of roles, responsibilities and relationships for national bodies established under the National Health Reform Agreement

States and territories expressed significant concern that the proposed Direction to IHPA will result in the Commonwealth retrospectively not funding activity that has been already delivered by states and territories but not yet funded by the Commonwealth.

States and territories were concerned that this could reduce services to patients going forward as anticipated funding from the Commonwealth will be less than currently expected.

The Commonwealth does not agree with the concerns of the states and territories and will seek independent advice from the Independent Hospital Pricing Authority (IHPA) to ensure hospital service activity for 2015-2016 has been calculated correctly. The Commonwealth committed to work constructively and cooperatively with all jurisdictions to better understand the drivers of increased hospital services in funding agreements.

10.Legitimate and unavoidable costs of providing public hospital services in Western Australia

Health Ministers discussed a paper by Western Australia on legitimate and unavoidable costs of providing public hospital services in Western Australia, particularly in regional and remote areas, and recognised that those matters create a cumulative disadvantage to that state. Health Ministers acknowledged that Western Australia will continue to work with the Commonwealth Government and the Independent Hospital Pricing Authority to resolve those matters.

11.Vaccination

Health Ministers unanimously confirmed the importance of vaccination and rejected campaigns against vaccination.

All Health Ministers expressed their acknowledgement of the outgoing Chair, the Hon Ms Jill Hennessy and welcomed the incoming Chair Ms Meegan Fitzharris MLA from the Australian Capital Territory.

Health Ministers approve Australia’s National Digital Health Strategy

Digital information is the bedrock of high quality healthcare.

The benefits for patients are signicant and compelling: hospital admissions avoided, fewer adverse drug events, reduced duplication of tests, better coordination of care for people with chronic and complex conditions, and better informed treatment decisions. Digital health can help save and improve lives.

To support the uptake of digital health services, the Council of Australian Governments (COAG) Health Council today approved Australia’s National Digital Health Strategy (2018-2022).

Download Strategy and work plan here  

In a communique issued after their council meeting in Brisbane August 4 , the Health Ministers noted:

“The Strategy has identified the priority areas that form the basis of Australia’s vision for digital health. It will build on Australia’s existing leadership in digital health care and support consumers and clinicians to put the consumer at the centre of their health care and provide choice, control, and transparency.”

Australian Digital Health Agency (ADHA) CEO Tim Kelsey welcomed COAG approval for the new Strategy.

“Australians are right to be proud of their health services – they are among the best, most accessible, and efficient in the world.

Today we face new health challenges and rapidly rising demand for services. It is imperative that we work together to harness the power of technology and foster innovation to support high quality, sustainable health and care for all, today and into the future,” he said.

The Strategy – Safe, seamless, and secure: evolving health and care to meet the needs of modern Australia – identifies seven key priorities for digital health in Australia including delivery of a My Health Record for every Australian by 2018 – unless they choose not to have one.

More than 5 million Australians already have a My Health Record, which provides potentially lifesaving access to clinical reports of medications, allergies, laboratory tests, and chronic conditions. Patients and consumers can access their My Health Record at any time online or on their mobile phone.

The Strategy will also enable paper-free secure messaging for all clinicians and will set new standards to allow real-time sharing of patient information between hospitals and other care professionals.

Australian Medical Association (AMA) President Dr Michael Gannon has welcomed the Strategy’s focus on safe and secure exchange of clinical information, as it will empower doctors to deliver improved patient care.

“Doctors need access to secure digital records. Having to wade through paperwork and chase individuals and organisations for information is

archaic. The AMA has worked closely with the ADHA on the development of the new strategy and looks forward to close collaboration on its implementation,” Dr Gannon said.

Royal Australian College of General Practitioners (RACGP) President Dr Bastian Seidel said that the RACGP is working closely and collaboratively with the ADHA and other stakeholders to ensure that patients, GPs, and other health professionals have access to the best possible data.

“The Strategy will help facilitate the sharing of high-quality commonly understood information which can be used with confidence by GPs and other health professionals. It will also help ensure this patient information remains confidential and secure and is available whenever and wherever it is needed,” Dr Seidel said.

Pharmacy Guild of Australia National President George Tambassis said that technology would increasingly play an important role in supporting sustainable healthcare delivery.

“The Guild is committed to helping build the digital health capabilities of community pharmacies and advance the efficiency, quality, and delivery of healthcare to improve health outcomes for all Australians.

“We are working with the ADHA to ensure that community pharmacy dispensing and medicine-related services are fully integrated into the My Health Record – and are committed to supporting implementation of the National Digital Health Strategy as a whole,” George Tambassis said.

Pharmaceutical Society of Australia (PSA) President Dr Shane Jackson said that the Strategy would support more effective medicationmanagement, which would improve outcomes for patients and improve the efficiency of health services.

“There is significant potential for pharmacists to use digital health records as a tool to communicate with other health professionals, particularly during transitions of care,” Dr Jackson said.

The Strategy will prioritise development of new digital services to support newborn children, the elderly, and people living with chronic disease. It will also support wider use of telehealth to improve access to services, especially in remote and rural Australia and set standards for better information sharing in medical emergencies – between the ambulance, the hospital, and the GP.

Consumers Health Forum (CHF) Leanne Wells CEO said that the Strategy recognises the importance of empowering Australians to be makers and shapers of the health system rather than just the users and choosers.

“We know that when consumers are activated and supported to better self-manage and coordinate their health and care, we get better patient experience, quality care, and better health outcomes.

“Digital health developments, including My Health Record, are ways in which we can support that to happen. It’s why patients should also be encouraged to take greater control of their health information,” Leanne Wells said.

Medical Software Industry Association (MSIA) President Emma Hossack said that the Strategy distils seven key themes that set expectations at a national level.“The strategy recognises the vital role industry plays in providing the smarts and innovation on top of government infrastructure.

This means improved outcomes, research, and productivity. Industry is excited to work with the ADHA to develop the detailed actions to achieve the vision which could lead to Australia benefitting from one of the strongest health software industries in the world,” Emma Hossack said.

Health Informatics Society of Australia (HISA) CEO Dr Louise Schaper welcomed the Strategy’s focus on workforce development.

“If our complex health system is to realise the benefits from information and technology, and become more sustainable, we need clinical leaders with a sound understanding of digital health,” Dr Schaper said.

The Strategy was developed by all the governments of Australia in close partnership with patients, carers and the clinical professionals who serve them – together with leaders in industry and science.

The Strategy draws on evidence of clinical and economic benefit from many sources within Australia and overseas, and emphasises the priority of patient confidentiality as new digital services are implemented.

The ADHA has established a Cyber Security Centre to ensure Australian healthcare is at the cutting edge of international data security.

The ADHA, which has responsibility for co-ordinating implementation of the Strategy, will now be consulting with partners across the community to develop a Framework for Action. The framework will be published later this year and will detail implementation plans for the Strategy.

The National Digital Health Strategy Safe, seamless and secure: evolving health and care to meet the needs of modern Australia is available on

https://www.digitalhealth.gov.au/australias-national-digital-health-strategy (https://www.digitalhealth.gov.au/australias-national-digital-health-strategy)

Greg Hunt Press Conference

Topics: COAG Health Council outcomes; The Fifth National Mental Health and Suicide Prevention Plan; support for doctors and nurses mental health; hospital funding; same-sex marriage

GREG HUNT:
Today was a huge breakthrough in terms of mental health. The Fifth National Mental Health Plan was approved by the states.

What this is about is enormous progress on suicide prevention. It has actually become the Fifth National Mental Health and Suicide Prevention Plan, so a real focus on suicide prevention.

In particular, the focus on what happens when people are discharged from hospital, the group in Australia that are most likely to take their own lives.

We actually know not just the group, but the very individuals who are most at risk. That’s an enormous step.

The second thing here is, as part of that plan, a focus on eating disorders, and it is a still-hidden issue. In 2017, the hidden issue of eating disorders, of anorexia and bulimia, and the prevalence and the danger of it is still dramatically understated in Australia.

The reality is that this is a silent killer and particularly women can be caught up for years and years, and so there’s a mutual determination, a universal determination to progress on eating disorders, and that will now be a central part of the Fifth National Mental Health and Suicide Prevention Plan.

And also, as part of that, we’ve included, at the Commonwealth’s request today, a real focus on early intervention services for young people under 16. Pat McGorry has referred to it as CATs for Kids, meaning Crisis Assessment Teams, and the opportunity.

And this is a really important step because, for many families, when they have a crisis, there’s nowhere to turn. This is a way through. So those are all enormous steps forward.

The other mental health area where we’ve made big, big progress is on allowing doctors to seek routine mental health treatment.

There’s an agreement by all of the states and territories to work with the Commonwealth on giving doctors a pathway so as they can seek routine mental health treatment without being reported to the professional bodies.

JOURNALIST:
What has led to the increased focus on eating disorders? Has there been an uptick in the number of suicides resulting from that, or has there been an uptick in the number of cases?

GREG HUNT:
No, this has been silently moving along. It’s a personal focus. There are those that I have known, and then when we looked the numbers shortly after coming in, and dealt with organisations such as the Butterfly Foundation, they explained that it’s been a high level issue with the worst rate of loss of life amongst any mental health condition.

And so that’s a combination both of suicide, but also of loss of life due to physical collapse. And so it’s what I would regard as a personal priority from my own experience with others, but then the advocacy of groups like Butterfly Foundation has finally landed. It should’ve happened earlier, but it’s happening on our watch now.

JOURNALIST:
That would be my next question, is that I’m sure advocacy groups will say this is great that it’s happened, but it’s taken the Government so long. Why is it that you’re focussing on it now as opposed to…?

GREG HUNT:
I guess, I’ve only just become Minister. So from day one, this is one of the things I’ve wanted to do, and I’m really, personally, deeply pleased that we’ve made this enormous progress.

So I would say this, I can’t speak for the past, it is overdue, but on our watch collectively we’ve taken a huge step forward today.

Then the last thing is I’ve seen some reports that Queensland and Victoria may have been upset that some of their statistical anomalies were referred to what’s called IHPA (Independent Hospital Pricing Authority).

The reason why is that some of their figures simply didn’t pass the pub test.

The independent authority will assess them, but when you have 4000 per cent growth in one year in some services, 3300 per cent growth in some years in other services, then it would be negligent and irresponsible not to review them.

It may be the case that there was a more than 40-fold increase in some services, but the only sensible thing for the Commonwealth to do is to review it.

But our funding goes up each year every year at a faster rate than the states’ funding, and it’s gone up by $7.7 billion dollars since the current health agreement with the states was struck.

JOURNALIST:
Is that, sorry, relating to private health insurance, or is that something separate?

GREG HUNT:
No, that’s just in relation to, a couple of the states lodged claims for massive growth in individual items.

JOURNALIST:
Thank you. So was there a directive given today regarding private health policies to the states? Was that something that was discussed or something that …?

GREG HUNT:
Our paper was noted, and the states will respond. So we’ve invited the states to respond, they’ll respond individually.

JOURNALIST:
And regarding that mental health plan, besides their new focus on eating disorders, how is it different from previous mental health plans?

GREG HUNT:
So, a much greater focus on suicide prevention, a much greater focus on eating disorders, and a much greater focus on care for young children under 16.

JOURNALIST:
Is that something that you can give more specific details about? You’re saying there’s a much greater focus, but is there any specific information about what that would mean?

GREG HUNT:
As part of the good faith, the Commonwealth, I’ve written to the head of what’s called the Medical Benefits Schedule Review, so the Medicare item review, Professor Bruce Robinson and asked him and their team to consider, for the first time, specific additional treatment, an additional treatment item and what would be appropriate for eating disorders.

Closing the gap: who knows?

 John BrumbyThe National Aboriginal Community Controlled Health Organisation (NACCHO) has expressed grave concerns that the COAG Reform Council responsible for monitoring progress towards close the gap targets will close next week on 30 June.

At the 2014 NACCHO Health Summit in Melbourne today, Chairman of the COAG Reform Council, John Brumby, presented the findings of the Council’s final work on Aboriginal and Torres Strait Islander health monitoring, Healthcare in Australia 2012-13: Comparing outcomes by Indigenous status.

NACCHO chairperson Justin Mohamed thanked John Brumby and his Council staff for their efforts to ensure government policy to close the gap was translated into on-ground improvements for Australia’s First Peoples and their communities.

“It was six years ago that Australian governments took on the significant challenge of closing the gap on Aboriginal and Torres Strait Islander disadvantage in health, education, employment and other social areas,” Mr Mohamed said.”

“In that time Mr Brumby and his team have monitored progress on closing the gap, and reported publicly and free of political influence.”

“Today’s report confirms that for all the significant achievement made, including a decrease in the Aboriginal infant mortality rate by 35%, there remains work to be done to improve outcomes in other areas.”

“We are really worried that the millions of dollars being cut from across Aboriginal affairs at the Federal level, plus the introduction of new arrangements in accessing primary health care and changes to unemployment benefits, could potentially push the closing the gap targets even further from reach.”

“It’s now been more than a year since the National Partnership Agreement has lapsed and we still don‚t have any clear advice on how states, territories and the commonwealth plan to coordinate addressing the closing the gap targets.”

“Now there will be no independent umpire able to evaluate progress  ‘or lack of it’ and hold state and territory governments and the Federal Government accountable.”

“The Federal Government must urgently outline how it plans on keeping this priority area of health and social reform on track during the long-term commitment needed to close the gap”, Mr Mohamed said.

Read full report here

Aboriginal controlled health services can close the gap in employment

nac-31-35-b-logo

Investing in Aboriginal Community Controlled Health Services will help address the increasing gap in employment outcomes between Aboriginal and non-Aboriginal people as revealed in the new report released by the COAG Reform Council.

DOWNLOAD FULL REPORT HERE

Justin Mohamed, Chairperson of the National Aboriginal Community Controlled Health Organisation (NACCHO) said the COAG Reform Council report showed encouraging gains are being made in areas such as life expectancy, child mortality and immunisation, but unemployment and obesity rates needed greater attention.

“This is yet another report to add to the many before it which demonstrate that massive inequalities still exist between Aboriginal and non-Aboriginal people,” Mr Mohamed said.

“The take home message is that we can’t shift focus or we risk reversing the gains we have made. There is still a long way to go before Aboriginal people can expect the same levels of health, employment and education as other Australians.

“It’s pleasing to see Aboriginal child mortality rates are decreasing but Aboriginal kids are still twice as likely to die before they are five than non-Aboriginal children. As adults we still have a life expectancy more than ten years less than non-Aboriginal people.

“That’s why we need to keep up the investment in programs and services that are making a difference.

“Aboriginal Community Controlled Health Services are making huge contributions towards closing the gap across a range of indicators and demand for our services is growing.

“In addition to these significant health gains, our 150 health services employ more than 3,200 Aboriginal people – one of the largest employers of Aboriginal people in the country.

“Governments at all levels need to look to supporting and expanding the Aboriginal Community Controlled Health sector if they are committed to improving the health and employment outcomes of Aboriginal and Torres Strait Islander people.”

Mr Mohamed said NACCHO has concerns that we still do not have any concrete commitment of the future of the Close the Gap “National Partnership Agreement” or an alternative structure. This concern is further heightened by the fact that the COAG Reform Council will be abolished come 30 June.

“We are extremely concerned that the millions of dollars being cut from across Aboriginal affairs at the Federal level, plus the introduction of new arrangements in accessing primary health care and changes to unemployment benefits, could potentially push the closing the gap targets even further from reach.

“Yet at the state and territory level we also see apparent indifference to the challenges at hand.

“It’s now been more than twelve months since the National Partnership Agreement has lapsed and we still don’t have any clear advice how states, territories and the commonwealth plan to coordinate addressing the closing the gap targets. The Nation needs a long term agreement that has full support and buy in from all levels of Government.

“NACCHO also questions what replacement reporting mechanisms will be put in place to continue this specific, detailed state and territory reporting given the abolishment of the COAG Reform Council next month. These reports provide a level of accountability to the actions of the different levels of government which needs to be retained. ”

Media contact: Olivia Greentree 0439 411 774

 

NACCHO Aboriginal Health News: How and when will the Abbott Government CLOSE THE GAP?

Abbott and the Mandine

Two months have passed since Tony Abbott became Prime Minister, promising to be a prime minister for indigenous affairs.

He brought the portfolio into his own department. But nothing much has happened as a consequence out in the suburbs, or the towns or the settlements where Aboriginal Australians actually live. It’s now getting to the stage where one might expect to see signs of a government, and a commitment, in action.

From Jack Waterford Canberra Times And we thank Jack for his article

Here’s a few notes from near HQ.

Hundreds of Commonwealth public servants are now inside the Prime Minister and Cabinet portfolio, if not its offices. Not all are from the old FaHCSIA department, which once led the national efforts to reduce Aboriginal disadvantage. Others have come from Education, from Science, and from the miscellaneous units once created in many different agencies to connect the hopes and aspirations for Aborigines with more general parts of national endeavour. Health retains its indigenous health units.

But one will search in vain for any evidence or proof of this transition, indication of the new order or battle, or for signs, beyond broad election policy statements, describing new priorities, programs and activities. Indigenous responsibilities are yet to be reflected on the PM&C website, and the order of battle – who, for example, is responsible to whom, and for what, has yet to be published, certainly to outsiders.

No doubt it has been business as usual, in Canberra, regional offices, or even at the front line. But one thing missing is a steady stream of press statements issued locally, regionally or centrally, announcing actions, reactions, progress or setbacks. There has been an absolute reduction in the number of self-serving statements praising the courage, wisdom, vision and personal generosity of the former minister, Jennie Macklin, but there has not been a commensurate increase in statements associating the new minister, Nigel Scullion, with everything desirable and good.

Most Aboriginal organisations are treating the hiatus much as Russians treat winter at times of invasion. They are waiting to see what the enemy wants and does. Even many of the cynical believe that Abbott is fair dinkum in wanting to achieve change, though they have little idea of what it is he actually wants or plans, or how it will change their lives. For most, if experience is any guide, life will go on, though the quality and quantity of people bossing them around, to no effect, may change.

Abbott plans, apparently, to listen respectfully to ideas from people such as Nyunggai Warren Mundine, chairman of the new Prime Minister’s Indigenous Advisory Council, Noel Pearson, and, probably, Dr Peter Shergold, a former PM&C chief who was once the head of the Aboriginal and Torres Strait Islander Commission, when it was the primary government executive body in indigenous affairs .No doubt this advice will be important in shaping policy. But it is not clear how much it will shape day-to-day decision making, nor does it tell us much about who will be making the decisions.

The council is to meet three times a year with Abbott and senior ministers. Mundine will meet Abbott and Scullion once a month. The council ”will include indigenous and non-indigenous Australians with a broad range of skills, including experience in the public sector, business acumen, and a strong understanding of indigenous culture”; it will be, in short, just the sort of important sounding, but actually powerless body that the government spent much of the past week axing as surplus to requirements.

One of the potential problems of the advisory council was highlighted in a perhaps unintentionally ironic, but not inaccurate, summary of an article by Mundine in the Financial Review this week. This read: ”Policy in the past 40 years has not altered the appalling position of indigenous people. That is why we need an advisory council.”

Gosh, why didn’t anyone think of that before?

Perhaps adding to the (or my) depression was an advertisement from the Menzies School of Health Research for a co-ordinator for its indigenous youth life skills development project. This $70,000 position, based in Darwin to work in the Top End, is to devise an anti-suicide program.

”The indigenous youth life skills development project is a multi-disciplinary intervention study aimed at building an evidence-based suicide prevention program for indigenous youth in remote settings. The project involves the design, pilot and evaluation of a skills-based suicide prevention intervention designed to build strength and resilience amongst indigenous school-aged youth. The project will involve a range of stakeholders in the East Arnhem region to ensure a culturally appropriate, strategic and coordinated approach.

”The project coordinator will support the design, implementation and evaluation of the indigenous youth life skills development project in the East Arnhem region including facilitating and coordinating stakeholder and community consultations, facilitating youth engagement with the program and assisting with the collection of evaluation data in a timely manner.”

One could quote more of the essentially meaningless abstract nouns and other verbiage describing a job for which indigenous people ”are strongly encouraged to apply”. Provided, that is, they have a ”willingness and ability to undertake air travel by light aircraft and use available accommodation in remote communities for several nights per week” and ”an understanding and awareness of relevant workplace health and safety as well as equal opportunity principles and legislation along with a commitment to maintaining a healthy and safe workplace for all Menzies staff, students, volunteers and visitors.”

Heaven knows the suicide problem is bad enough, and the need to do something important. But why wouldn’t any observer recognise immediately that people who see the problem in terms of such agglomerations of abstract nouns are hardly likely to have the insights to do much about it? Indeed, it is in part such a bureaucratic and logorrheic approach to social problems that is making so many despair.

Meanwhile, Abbott might be confirmed in thinking a radical break with the past is needed by the pathetic scorecard accorded to Council of Australian Governments’ ”initiatives” on almost everything, but certainly closing the gap on indigenous disadvantage.

The COAG Reform Council reported during the week that while there were odd signs of progress, it was clear the rate of improvement had slowed over the past five years or so (should one say the period of the Rudd and Gillard governments?). In some areas, things went backwards; in others it was impossible to say whether there had been any change.

The comparisons, and the statistics, were coming primarily from economists and accountants, rather than people able to properly compare slices of life. Even with imagined randomness, and purportedly objective measures (say percentages of children passing a reading exam, or the number of people waiting too long to see a doctor), the results, though interesting and perhaps indicative, were hardly ever likely to be significant in any statistical sense. That the council supposed they were illustrates one of its problems.

Thus the indigenous child death rate fell from 212 per 100,000 in 2008 to 196 per 100,000 in 2012, and this was ticked as evidence of ”good progress”. I very much doubt that it is of even slight statistical significance.

The disappointing or indifferent results from Commonwealth-state initiatives were to be found in the general areas of health and hospitals, schools (including preschools, reading and numeracy) and indigenous affairs.

Perhaps it is all the fault of an incompetent (whether or not well-meaning) Labor government. But it was just this Labor government that brought great energy, zeal and extra resources into precisely these fields, compared with before. Commonwealth spending in indigenous affairs may have increased by 50 per cent. More and, supposedly, more focused, spending on health and education were supposedly big positives of the Labor era. So positive that Abbott decided, late in the election campaign, to ”adopt” Labor policies.

So all that extra money, and all of the earnest and sometimes sanctimonious talk, made hardly any difference? Even if it sometimes did, if not by much, it was quite plain to the COAG Reform Council that the marginal benefits of all of this extra activity and spending were very low.

When politicians and bureaucrats face this fact – and there is no evidence they have done so yet – there are usually three possible responses. One is to recognise that there is something wrong with the policies, and to change course. Another is to ignore the evidence, and to carry on regardless, wasting more and more money, until it all runs out. Another is to redouble efforts and do and spend more, convinced that the plan will work, must work, or is not working only because of some managerial or ideological obstructionism. This is the ”policy is right in theory, so it must work in practice” approach.

This is pretty much the story of Aboriginal affairs, considered from Canberra as a harmless activity or game for ineffectual but zealous bureaucrats. (Considered in the field, by ”clients”, it’s a different, tragic matter, if with surprisingly little relationship to the prattle, the buzz, the memos, or even the relentless search for usable ”good news stories” by inspectors-general for indigenous affairs.)

Ten years from now, indeed, hardly anyone in Aboriginal affairs will even remember that there was a Labor government, although they may regard Kevin Rudd with vague affection for saying sorry. The lamentable Macklin era will have become assimilated into stories of the John Howard-Malcolm Brough intervention. This saw the re-bureaucratisation of the field, the hollowing out of Aboriginal organisations and politics, the abandonment of ”consultation” and the advent of a command ”engagement” economy, and the blaming of most personal and community ”dysfunction” on the victims or their parents. Australian taxpayers invested an extra $7 billion in trying to make a difference, with ever diminishing returns, if any.

Abbott, and those to whom he pays the most respectful attention, will insist that they will be different with a switch away from welfarist policies, ”sit-down” money and cultures of dependency. They will reward initiative, promote enterprise, education, employment and involvement with the wider economy. Yet they do not admit that a good deal of the ineffectual bossiness and reorientation of the past seven years has also been about the same thing. Noel Pearson, to use just one example, has consistently received handsome funding and encouragement from Canberra. One can, perhaps, learn lessons from the experiences of people in his area. But if they were capable of delivering salvation – as Abbott sometimes seems to urge – one ought to have, by now, seen some signs.