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.

NACCHO health conference alert: Health Workforce National Conference to discuss Close the Gap initiatives and supporting workforce

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National initiatives to close the gap in Aboriginal and Torres Strait Islander life expectancy and to build the supporting health workforce will be discussed and debated at Health Workforce Australia’s (HWA) 2013 national conference in November.

Information and registrations here

The life expectancy of Aboriginal and Torres Strait Islander people is more than 10 years less than other Australians. In 2008, the Council of Australian Governments (COAG) agreed to close the gap in life expectancy within a generation by 2031.

This commitment affects all health professionals and the way care is provided.


Greg Craven, Deputy Chair of the COAG Reform Council and Adrian Carson (pictured above ), Chief Executive Officer of the Institute for Urban Indigenous Health, will take part in a panel discussion at HWA’s conference, Skilled and Flexible – The health workforce for Australia’s future.

The session will feature a discussion on the progress made to improve health outcomes to close this gap and how Australia is tracking against its commitment. Mr Craven will also focus on flexible service delivery and funding.

“Any effort to close the gap must acknowledge that Aboriginal and Torres Strait Islander Health Workers make an invaluable contribution,” HWA Acting Chief Executive Ian Crettenden said.

“They are often the first point of contact because Aboriginal and Torres Strait Islander people find it easier to access healthcare services from someone who they can relate to, who understands them and their culture.”

Janine Headshot

Romlie Mokak, Chief Executive of the Australian Indigenous Doctor’s Association, and Janine Milera (pictured above) , Chief Executive of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, will reveal initiatives underway to help increase the numbers of Aboriginal and Torres Strait Islander health professionals in the Australian health workforce.

Murra Mullangari – Pathways Alive and Well is a national Aboriginal and Torres Strait Islander health careers development program, established by the Australian Indigenous Doctors’ Association to encourage Indigenous senior secondary school students to remain in school and pursue health careers.

Ms Milera will describe initiatives to overcome the challenge of many Aboriginal and Torres Strait Islander people being uncomfortable using mainstream healthcare services.

More than 50 local and international speakers will explore the latest ideas on leadership, innovation and workforce reform at the event at the Adelaide Convention Centre from 18 to 20 November.

Registrations are now open for this year’s conference.

Concession tickets cost $350 and full price tickets are $600.

To attend the conference and find out more visit

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NACCHO press release :Download the Closing the Gap progress report: small steps make ongoing commitment vital

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Closing the Gap on track: but more to be done

The National Community Controlled Health Organisation (NACCHO) today welcomed the Closing the Gap Progress Report findings as confirmation that the program is working, but that there is still more to be done to ensure that the gap between Aboriginal and Torres Strait Islanders and other Australians does not widen.

DOWNLOAD the COAG reform Council report here

 Included below Close the Gap and AAP news press release

Download NACCHO Media Release here

NACCHO Chair, Justin Mohamed (pictured above) , said that it was imperative to continue the good progress made in halving the gap in child death rates, improving early childhood education and year 12 or equivalent attainment.


“The Close The Gap programs are working towards achieving their goal, and improving the health and life expectancy of Aboriginal Australians,” said Mr Mohamed.

“The 150 Aboriginal community controlled health organisations (ACCHOs) that NACCHO represents continue to work to improve Aboriginal health and wellbeing across the board at a local community level, providing over 75 per cent of the work on-the-ground to Close The Gap.

“While we have seen vast improvement in child death rates, more must be done to address the overall mortality rates.

“The death rates of Aboriginal Australians have seen little change. The main cause of deaths for Aboriginal Australians is circulatory disease – attributed to the high level of tobacco usage, poor diet, physical inactivity and hypertension.

“It’s imperative that Close The Gap gets long term investment from governments, rather than just three or four year funding phases, to ensure that they have resources to deliver these vital services.

“The National Partnership Agreement hangs in the balance – which means some of these programs are on a precipice – whilst the Federal Government has renewed its commitment, States and Territories are lagging behind.

“We need Aboriginal health and Close The Gap to be a priority for all governments that goes beyond party politics. These programs which have taken a foothold must be allowed to continue to grow and build momentum so that Close The Gap can continue to improve Aboriginal peoples’ health and chances in life.

“Aboriginal ill-health and mortality rates present a grim picture – one that is out of step comparative to other Australians.

“Close The Gap is about improving outcomes for Aboriginal people, but unless these vital programs get ongoing funding, our chance at increasing life expectancy and health for Aboriginal people narrows.

“Aboriginal comprehensive primary health care provided by Aboriginal communities is the key to making a difference to Aboriginal health outcomes,” said Mr Mohamed.

Closing the Gap progress report: small steps make ongoing commitment vital

Australia is on track to halve the gap in child death rates between Aboriginal and Torres Strait Islander people and other Australians but a much greater effort is needed to achieve equality in life expectancy by 2030, an independent report has found.

Close the Gap campaign co-chairs Mick Gooda and Jody Broun welcome the positive results in relation to lowering the child mortality gap

Mr Gooda said addressing child mortality is critical in efforts to close the gap and will help drive improvements in life expectancy for Aboriginal and Torres Strait Islander people.

However, Mr Gooda said more needs to be done because Aboriginal and Torres Strait Islander people are still dying at nearly twice the rate of other Australians.

“The reduction in the death rate for Aboriginal and Torres Strait Islander children is a real step forward, but there is long way to go to improve child health outcomes more broadly.

“The good news is that 91% of Aboriginal and Torres Strait Islander children in remote communities are enrolled in a preschool program and the new attendance target is welcomed.

“We believe the improvements outlined in this report point to what’s possible when we have co-ordinated and long term action from all governments,” Mr Gooda said.

The findings, released today, are part of a report prepared for the Council of Australian Governments (COAG) on behalf of the COAG Reform Council. The report assesses the progress of Australian governments against the Closing the Gap targets on education, employment and health.

Ms Broun said it is essential that all governments recommit to the National Partnership Agreement (NPA) on Closing the Gap in Indigenous Health Outcomes as a matter of urgency.

“We call on all Australian Governments to put greater effort into closing the life expectancy gap by 2030,” said Ms Broun.

“So far, the Federal and Victorian governments have renewed their funding commitment to the NPA. We urge all other Australian governments to commit to the future health of our people through a renewed NPA.

“In this federal election year, it’s important to remember that the Closing the Gap agenda is a truly multi-partisan national project which must be backed by multi-decade commitments spanning policy cycles, funding agreements and governments”, she said.

National AAP news coverage

MORE action is needed to close the life expectancy gap between indigenous and non-indigenous Australians to meet the 2031 target, a national report warns.

The life expectancy gap is 11.5 years for men and 9.7 years for women.

In 2008, federal, state and territory governments agreed on six targets to tackle indigenous disadvantage in life expectancy, health, education and employment.

Only the Northern Territory is on track to close the life expectancy gap, according to the Council of Australian Governments (COAG) Reform Council report released on Wednesday.

Heart attacks and strokes were the most common cause of Aboriginal deaths.

Death rates had declined in Queensland, but not at the needed pace, while NSW and South Australia were not on track to achieve the target, the COAG report said.

Western Australia’s indigenous death rates had also dipped, but the state had not set a target.

 The report noted progress in reducing the death rates of Aboriginal children aged under five.

But it found half of indigenous mothers were still smoking during pregnancy.

Literacy and numeracy skills of indigenous children were also lagging behind, the report said.

On efforts to increase indigenous employment, it said only NSW had seen some improvement.

The early childhood education target to improve access to preschool for all indigenous four-year-olds in remote communities is expected to be achieved this year.

The federal government accepted the COAG report’s recommendation to set a new target to boost attendance levels in preschool programs.

Year 12 completion rates for indigenous children had improved, and WA, SA, NT and ACT were on track to meet the 2020 target, the report said.

National Congress of Australia’s First People spokesman Les Malezer said the small improvements in the report were welcome, but it also came as a warning that more work was needed.

He reiterated a call for a justice target, to reduce the high representation of Aboriginal people in Australian j


NACCHO News alert:Renewed funding $777 m to support Close the Gap efforts welcomed by RACGP


The Royal Australian College of General Practitioners (RACGP) welcomes news of the Australian Government’s recent commitment of $777 million  to fund its share of a renewed National Partnership Agreement on Closing the Gap in Aboriginal and Torres Strait Islander health outcomes until June 2016.

SEE NACCHO Press release

The announced funding will significantly further efforts to close the gap on Indigenous health disadvantage, however the College notes that funding commitments are now required from all states and territories in order to ensure vital programs and services are not at risk from 30 June 2013.

Dr Liz Marles, RACGP President said, “whether it is today or in the coming weeks, the nation’s eyes will be on COAG in hope that leaders from each of the states and territories will follow suit of the Federal Government by recommitting to new funding that will ensure long-term Close the Gap initiatives can be fulfilled.”

“The RACGP is proud to support efforts to tackle health disparities between Indigenous and non-Indigenous Australians and acknowledges the daily work of many of its members to improve health outcomes for their Aboriginal and Torres Strait Islander patients,” said Dr Liz Marles.

Associate Professor Brad Murphy, Chair of the RACGP National Faculty of Aboriginal and Torres Strait Islander Health said, “Sustained commitment of funding and resources by all levels of government is cornerstone to the ongoing success of these efforts to Close the Gap in healthcare inequality for our Nation’s Indigenous population.

“If we are able to continue this focused response to the health needs of our Aboriginal and Torres Strait Islander patients the resulting opportunities within the general practice setting will result in better resourced general practice teams and ultimately better healthcare for all Australians,” A/Prof Murphy said.

There are a number of initiatives GPs and general practice teams can implement to further efforts to close the gap:

  • Register for the practice incentives program (PIP) Indigenous Health Incentive
  •  Enable all members of the practice team to participate in locally relevant cultural awareness training
  • Create systems to identify  Aboriginal and Torres Strait Islander patients
  • Register eligible patients for the PBS Closing the Gap Co-Payment  enabling them to access their medications at reduced cost
  • Perform an Aboriginal and Torres Strait Islander Health Assessment
  • Use appropriate Medicare access program for Allied Health, Practice Nurses and Aboriginal Health Workers

As part of the RACGP Standards for general practices (4th edition) general practice teams need to demonstrate they routinely record the Aboriginal and Torres Strait Islander status in active patient health records. “Without practice awareness, a patient who identifies as Aboriginal or Torres Strait Islander would not benefit from measures available under the Practice Incentives Program Indigenous Health Incentive (PIP IHI) and the Pharmaceutical Benefits Scheme (PBS) co-payment measure,” Dr Marles said.

“The RACGP continues its commitment to raising general practitioners’ awareness of Aboriginal and Torres Strait Islander health needs and their cultural context, and to advocating for culturally appropriate health delivery systems which improve health outcomes.”

“It is now time for Australia’s states and territories to recommit to a renewed agreement to continue long-term funding for the COAG National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes,” Dr Marles said.

NACCHO press release:Julia Gillard to announce that the federal contribution for a renewed Aboriginal health deal will be $777 million until June 2016

Closing the gap now in the hands of state and territory governments

 See Page 5 todays April 18 The Australian for the CTG/NACCHO campaign half page ad

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The National Community Controlled Health Organisation (NACCHO) today welcomed the Gillard Government’s commitment to the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes and called on state and territory leaders to urgently do the same.

According to AAP reports this morning Prime Minister Julia Gillard will announce  that the federal contribution for a renewed deal will be $777 million until June 2016.

Ms Gillard will ask the states and territory government to chip in the remainder, although the issue will not be on the agenda of the Council of Australian Governments (COAG) meeting on Friday.

“As a result of our investments in indigenous health, we are seeing improvements,” Ms Gillard said in a statement.

“We know there is more to be done.”

The original national partnership deal struck in 2008 was worth $1.58 billion over four years and the federal contribution was $805.5 million.

Ms Gillard said the renewed federal contribution would be an increase over previous per annum expenditure.

Following former prime minister Kevin Rudd’s apology to the stolen generations in 2008, federal, state and territory governments agreed on six ambitious Close the Gap targets to tackle indigenous disadvantage.

 NACCHO Chair, Justin Mohamed said the National Partnership Agreement was due to expire at the end of June, putting critical Aboriginal health programs at risk.

 “Improving the appalling state of Aboriginal health must be a priority for all levels of government and Aboriginal people will be relieved to finally have a commitment from the Gillard Government today.

 “The pressure is now squarely on the states and territories as signatories of the 2008 Close the Gap Statement of Intent in which they committed to work together to close the disgraceful seventeen year gap in life expectancy between Aboriginal and non-Aboriginal Australians by 2030.

 “The states and territories need to uphold their commitment to this important goal and sign up to continue the National Partnership Agreement which is due to expire in less than two months.”

Mr Mohamed said it was imperative the Agreement was given priority at the COAG meeting tomorrow.

 “Improving Aboriginal health is not a quick fix – it requires a long-term commitment above party politics.

 “This is not just a matter for the Federal Government. It has been proven that only by all levels of government working together will we see improvements in Aboriginal health.

 “There have been five years of good work on Closing the Gap programs and must maintain the momentum.

 “We must maintain our commitment and build on the inroads the 150 Aboriginal community controlled health organisations (ACCHOs) are making in their communities.

 “Aboriginal comprehensive primary health care provided by Aboriginal communities is the key to making a difference to Aboriginal health outcomes.”

 Mr Mohamed said the Federal Government’s ongoing commitment to Aboriginal health in a challenging fiscal environment was a testament to many in the sector who had worked tirelessly to keep Aboriginal health on the national agenda.

 Press release from the CTG campaign group

Aboriginal and Torres Strait Islander health must be placed on the agenda for this Friday’s COAG meeting if there is to be any hope of closing the life expectancy gap by 2030, the Close the Gap Campaign said today.

 “Five years ago all sides of politics agreed to do something about the national disgrace that sees Aboriginal and Torres Strait Islander people die more than 10 years younger than the broader Australian community,” Campaign Co- Chair Mick Gooda said.

 “While the 2008 COAG meeting saw federal, state and territory governments commit to long term funding for services and programs though the National Partnership Agreement, Aboriginal and Torres Strait Islander health is absent from this Friday’s COAG meeting agenda.

 “We know that the policies and programs resulting from these 2008 COAG commitments are starting to bear fruit and make a real difference on the ground, for example, mortality rates for under five year old Aboriginal and Torres Strait Islander children are falling,” he said.

 “But the life expectancy gap remains just as unacceptable today as it was back then and I know that most of those attending COAG this Friday agree with me,” Mr Gooda said.

 The National Partnership Agreement which has driven efforts to close the gap in Aboriginal and Torres Strait Islander health outcomes is set to expire at the end of June 2013. Despite Federal Government indications that it will continue funding its share of the Agreement, State and Territory governments have not yet signed up to the Agreement  leaving some services and programs in real doubt as to whether they can continue to provide badly needed services beyond 30 June.

 Campaign Co Chair Jody Broun said governments of all persuasions owed it to the rest of the country to maintain their efforts to close the life expectancy gap by 2030.

 “There’s no doubt that nothing short of ongoing funding and commitment to working with Aboriginal and Torres Strait Islander peoples from all levels of government is what’s needed to keep on track,” Ms Broun said.

 “State, territory and federal governments need to continue working together to fund more services and programs that make a real difference to health outcomes for Aboriginal and Torres Strait Islander peoples.

 “We have to maintain our efforts to improve access to critical chronic disease services and to deliver anti-smoking measures, more affordable medicines and healthy lifestyle programs. We need to support and build capacity in our Aboriginal Community Controlled Health Services and we need to build on the inroads already made by our child and maternal health services,” she said.

 “We need more Aboriginal health workers, allied health professionals, doctors, nurses and health promotion workers.

 “A recommitment from state, territory and federal governments at this Friday’s COAG meeting is needed to quite literally save lives.”

 Who is the CLOSE the Gap campaign mob

 Australia’s peak Aboriginal and Torres Strait Islander and non-Indigenous health bodies, health professional bodies and human rights organisations operate the Close the Gap Campaign.

 The Campaign’s goal is to raise the health and life expectancy of Aboriginal and Torres Strait Islander peoples to that of the non-Indigenous population within a generation : to close the gap by 2030.

 It aims to do this through the implementation of a human rights based approach set out in the Aboriginal and Torres Strait Islander Social Justice Commissioner’s Social Justice Report 2005.

 The Campaign’s Steering Committee first met in March 2006. Our patrons, Catherine Freeman OAM and Ian Thorpe OAM launched the campaign in April 2007. To date 176,000 Australians have formally pledged their support. In August 2010 and 2011, the National Rugby League dedicated an annual round of matches as a Close the Gap round, reaching around 3 million Australians per round. 840 community events involving 130,000 Australians were held on National Close the Gap Day in 2011.

How can you ask your state Premier or territory Chief Minister to support Close the Gap?

All Australian governments have committed to Close the Gap through the COAG process and the National Indigenous Reform Agreement.
The development of the Closing the Gap policy platform to back up this commitment set the foundations to meet this generational target.Ask your State Premier or Chief Minister to publicly commit to renewing investment in Aboriginal and Torres Strait Islander health equality.

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 AMA COAG Must make ‘Closing the Gap’ a National Priority

AMA President, Dr Steve Hambleton, said today that it would be a disgrace if the long-term health needs of Aboriginal people and Torres Strait Islanders were not discussed at this Friday’s Council of Australian Governments (COAG) meeting in Canberra.

Dr Hambleton said it would be irresponsible if Australia’s political leaders came away from the meeting without an agreement to continue long-term funding for the COAG National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes.

“Closing the gap and achieving health equality between Aboriginal people and Torres Strait Islanders and other Australians must be a priority for all our governments,” Dr Hambleton said.

“It is a worthy goal that requires long-term funding and genuine political commitment.

“It requires action, not just words.

“Five years ago, our governments signed up in good faith to the National Partnership Agreement, and it has delivered some positive health outcomes.

“Now is not the time to be complacent – we must build on these good results.

“The current Agreement expires in a matter of months.

“We are calling on COAG leaders to this Friday agree to the long-term continuation of the National Partnership Agreement with at least the same level of funding for another five years initially.

“This would send a very strong message to the community that our governments are serious about closing the gap,” Dr Hambleton said.

Since 2008, the Agreement has achieved a number of successes in improving Indigenous health and wellbeing, including:

  • being on track to halve the mortality rates for children under five;
  • significantly increasing Aboriginal and Torres Strait Islander peoples’ access to health services for chronic disease – which underlies much of the gap in health outcomes;
  • having work underway in partnership with Aboriginal and Torres Strait Islander peoples to develop a long term health plan; and
  • meeting the target for early childhood education access in remote communities.

NACCHO’s 150+ members achieve great results in Federal health performance report

Health Perform

Aboriginal and Torres Strait Islander Health Performance Framework (HPF)

Download a copy of report here

Examples of our achievements

  • 2/3 of all performance based outcomes where from the Aboriginal Community Controlled Health Sector
  • 96% increase in episodes (1.22 mil – 2.5 mil) of care being delivered by the Aboriginal Community Controlled Health Sector
  • 150,000 eligible Aboriginal and Torres Strait Islander patients have benefited from the CTG Pharmaceutical Benefits Scheme (PBS Co-pay)
  • Compared Immunisation coverage rate for 2yr old children are nearly at the same level to wider Australia Immunisation (Aboriginal children 92.3% compared to 92.6% of other children)

Executive summary

This is the fourth report against the Aboriginal and Torres Strait Islander Health Performance Framework (HPF) and the first report based on the revisions to the framework endorsed by the Australian Health Minister’s Advisory Council (AHMAC) in 2011

The HPF was designed to measure the impact of the National Strategic Framework for Aboriginal and Torres Strait Islander Health (NSFATSIH) AND WILL BE AN IMPORTANT TOOL FOR DEVELOPING THE NEW National Aboriginal and Torres Strait Islander Health Plan(NATSIHP)

See NACCHO recent 2013 submission to NATSIHP

The HPF monitors progress in Aboriginal and Torres Strait Islander health outcomes, health system performance and the broader determinants of health. The health of Aboriginal and Torres Strait Islander peoples is improving for a number of measures, although there remain many areas where further concerted effort will be needed to achieve improvements in health outcomes.

Data quality limitations hamper our ability to monitor Indigenous health and the performance of the health system (see technical Appendix).

Initiatives to improve data quality have been introduced in recent years and are yielding results. However, caution is still required in interpreting these findings. Note : this report includes revised mortality data for the period 2007,2008 and 2009 due to revisions in the WA mortality data for this period.

Council of Australian Governments (COAG)


In December 2007, COAG agreed to a partnership between all levels of government to work with Aboriginal and Torres Strait Islander peoples to close the gap in Aboriginal and Torres Strait Islander disadvantage.

During 2008 and 2009 new National Partnership Agreements were developed covering areas such as Indigenous early childhood, health, education and employment. The information in this report mainly relates to the period leading up to these agreements and for many of these initiatives it is still too early for the health outcome data to reflect the impact of this work.

Since the introduction of the Aboriginal and Torres Strait Islander Health Performance Framework (HPF) there has been a significant increase in health assessments and chronic disease management items claimed through Medicare.

Given that two thirds of the current gap in health outcomes is due to chronic disease, these improvements in the detection and management of chronic disease are important.

COAG set six targets in 2008 including :

Closing the life expectancy gap within a generation

  • The gap in life expectancy at birth between Aboriginal and Torres Strait Islander peoples and other Australians for 2005-07 was estimated at 11.5 years for males and 9.7 years for females.
  • In the absence of new data on life expectancy (due to be released in late 2013), mortality rates provide an indication of progress. The graph below shows mortality rates from 1998 to 2010 and an indicative trajectory of mortality rates required to reach the target by 2031. This graph shows there has been a significant decline in Indigenous mortality rates in the last decade, however Indigenous rates are currently twice the non-Indigenous rate and this decline would need to accelerate to reach the target.

Halving the gap in mortality rates for Indigenous children under five within a decade

  • In 2008, the Aboriginal and Torres Strait Islander child mortality rate was 213 per 100,000 compared to 101 per 100,000 for non-Indigenous children. This makes the baseline gap 112 per 100,000. Note : the 2008 baseline has been revised since the last report due to revisions in the WA mortality data.
  • The graph below shows child mortality rates from 1998 to 2010 and indicative trajectories required to meet the target by 2018. The 2009 and 2010 rates are within the range required to meet the target.

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NACCHO affiliate news alert:Plea for Aboriginal health funds


WA’s peak Aboriginal health group says almost 100 services and more than 300 jobs are under threat because the State Government is dragging its feet to sign up to a new $150 million funding agreement.

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Cathy O’Leary, Medical Editor, The West Australian

The Aboriginal Health Council of WA, which oversees the Aboriginal Medical Service, wants the Government to commit in writing to the next four-year Council of Australian Governments funding agreement for Closing the Gap in Aboriginal Health Outcomes before it goes into caretaker mode.

Chairwoman Vicki O’Donnell said the current funding ended in June, and the May Budget was too late to find out how much would be provided in the future, particularly for staff who did not know if there would be cutbacks and whether they would still have a job.

Health Minister Kim Hames said the Liberal-Nationals Government had given $117.4 million in 2009 towards closing the gap in Aboriginal health. Dr Hames said future funding for the program would be considered as part of the Budget process.

“The significant improvements we’ve made to date to the health outcomes of Aboriginal people in WA now face an uncertain future due to the lack of clarity over the program’s ongoing funding,” Mrs O’Donnell said.

“Since the four-year COAG funding agreement commenced, we have seen healthcare services delivered to both Aboriginal and non-Aboriginal people in rural, remote and metropolitan regions we’ve never been able to reach before.”

Mrs O’Donnell said the national partnership agreement had helped set up and expand 98 Statewide services, including 23 programs addressing chronic disease and specialist mental health services.

“Without the Government’s continued support and its investment in the health … of Aboriginal people in this State, 98 critical health services will cease and over 300 jobs will be lost in the workforce, 70 per cent of which are held by Aboriginal people,” she said.

“Not having made a commitment at this late stage to continuing this approach and renewing the COAG funding agreement is bordering on recklessness. The situation is critical.”