NACCHO Tackling Indigenous Smoking NEWS : DOH tender for National Best Practice Unit for TIS

Smoking

Tobacco smoking is the most preventable cause of ill health and early death among Aboriginal and Torres Strait Islander people and is responsible for around one in five deaths,”

Through the Council of Australian Governments (COAG), the Australian government has committed to six targets to close the gap in disadvantage between Indigenous and non-Indigenous Australians across health, education and employment.

Two of these targets relate directly to the health portfolio: to close the gap in life expectancy within a generation (by 2031); and to halve the gap in mortality rates for Indigenous children under five within a decade (by 2018).”

SEE NACCHO REPORT HERE

As the federal government seeks to raise the average lifespan of Indigenous individuals closer to levels enjoyed by the rest of the population smoking remains under the gun, blamed for one-fifth of the Indigenous death rate.

A recent Health Department tender seeks to add a national organisation to run a drive against smoking by Aboriginal and Torres St Island individuals, to complement existing anti-tobacco regional programs run under the banner of Tackling Indigenous Smoking.

The organisation or consortium chosen to support the current TIS program will be referred to as the National Best Practice Unit for TIS.

Closing date for applications is September 1, Melbourne-based tenders specialist TenderSearch says. Contract execution is listed for October-November and release of operational guidelines for January-February 2016.

Download the 2 Tender documents here

Health-010-1516 – RFT

Health-010-1516 – DRAFT Contract for Services

The NBPU managing supervisory body will be expected to work mainly with grant recipients funded under the TIS program for regional tobacco control activities, with support and leadership from Professor Tom Calma, the national co-ordinator tackling Indigenous smoking.

The to-do list starts with developing and maintaining operational guidelines for tobacco use reduction among Aboriginal and Torres Strait Islander people. It will provide organisational support to grant recipients responsible for implementing evidence-based approaches to tobacco control.

It will help them develop and implement performance indicators and data collection methods, and

The NBPU will facilitate workforce development for the project, disseminating evidence and information on best practice, building a community of practice, and promoting a culture of evaluation and continuous improvement for the TIS program. There will also be advice and assistance to the department.

“Tobacco smoking is the most preventable cause of ill health and early death among Aboriginal and Torres Strait Islander people and is responsible for around one in five deaths,” the tender document said.

“Through the Council of Australian Governments (COAG), the Australian government has committed to six targets to close the gap in disadvantage between Indigenous and non-Indigenous Australians across health, education and employment.

“Two of these targets relate directly to the health portfolio: to close the gap in life expectancy within a generation (by 2031); and to halve the gap in mortality rates for Indigenous children under five within a decade (by 2018).

“Under the COAG National Healthcare Agreement, Australian governments have committed to halve the daily smoking rate among Aboriginal and Torres Strait Islander adults (18 or older) from 44.8 per cent in 2008 to 22.4 per cent by 2018.

“Work to reduce high rates of smoking has resulted in a reduction of seven percentage points since 2002, accompanied by a significant increase in the proportion of Aboriginal and Torres Strait Islander people who have never smoked.”

Indigenous-specific activities were required because the strong history and impact of mainstream action in Australia had failed to deliver equivalent reductions in smoking rates within the Aboriginal and Torres Strait Islander population, the tender document said.

The Medical Journal of Australia noted recently that the Talking About the Smokes health project from the Menzies School of Health Research indicated that the majority of Aboriginal and/or Torres Strait Islander smokers want to quit.

 

NACCHO Aboriginal Health :Dr Lesley M Russell: Analysis of Indigenous provisions in the 2015-16 Federal Budget

Aboriginal-Mobs

“Despite the need and the promises, Commonwealth funding for Indigenous Affairs as a percentage of both total outlays and GDP is in decline. And it is disconcerting to see Indigenous voices and input into decision-making being side-lined.  Indigenous groups and spokespeople have called the government on the absence of real engagement and consultation – something which has long been recognised as the key to failure or success in Indigenous affairs. “

Dr Lesley M Russell Adj Assoc Professor, Menzies Centre for Health Policy University of Sydney

It is not credible to suggest that one of the wealthiest nations in the world cannot solve a health crisis affecting less than 3 per cent of its citizens. Research suggests that addressing Aboriginal and Torres Strait Islander health inequality will involve no more than a 1 per cent per annum increase in total health expenditure in Australia over the next ten years. If this funding is committed, then the expenditure required is then likely to decline thereafter.”

Tom Calma, in his role as Aboriginal and Torres Strait Islander Social Justice Commissioner and Race Discrimination Commissioner, pointedly stated in 2008:

Notes

This work does not represent the official views of the Menzies Centre for Health Policy or NACCHO

DOWNLOAD THE FULL REPORT HERE

This analysis looks at the Indigenous provisions in the 2015-16 federal Budget. This is done in the light of current and past strategies, policies, programs and funding, and is supported, where this is possible, by data and information drawn from government agencies, reports and published papers.

Similar analyses from previous budgets are available on the University of Sydney e‐scholarship website.[1]

The opinions expressed are solely those of the author who takes responsibility for them and for any inadvertent errors.

Introduction

The 2015-16 Budget from the Abbott Government has no major announcements on Indigenous issues, and they did not rate a mention in the Treasurer’s budget night speech.

However the Budget is far from benign in its support for Indigenous programs and advocacy groups say   it has failed to undo the damage done  and anxiety caused by funding cuts in last year’s Budget.  Many programs and services must continue to operate with uncertain funding into the future and in the absence of clear strategies and policies from the Abbott Government.

This comes on top of the threat of remote community closures in Western Australia, attempts to weaken protection from racial vilification under the Racial Discrimination Act, and concerns about the implementation of and outcomes from the Indigenous Advancement Strategy (IAS) tendering process.  Indigenous organisations are losing out in the competition for funds to deliver Indigenous programs and services and after last year’s Budget cuts, there is no new funding for key representative groups such as the National Congress of Australia’s First Peoples.

Despite the need and the promises, Commonwealth funding for Indigenous Affairs as a percentage of both total outlays and GDP is in decline. And it is disconcerting to see Indigenous voices and input into decision-making being side-lined.  Indigenous groups and spokespeople have called the government on the absence of real engagement and consultation – something which has long been recognised as the key to failure or success in Indigenous affairs.

In March 2015 the Minister for Indigenous Affairs, Nigel Scullion, took delivery of ‘The Empowered Communities Report’, produced of a group of Indigenous leaders from across Australia brought together by the Jawun Indigenous Partnerships Corporation.  The report outlined ways for Indigenous communities and governments to work together to set priorities and streamline services at a regional level, in line with the Government’s approach. The Minister committed that the Government would consider carefully the report’s recommendations and respond ‘in due course’.  That has yet to happen.

What emerges most strikingly from this year’s Budget analysis is that little has been done over the past twelve months to assess the implications of commissioned reports and reviews, to capitalise on the restructure and realignment of Indigenous programs, to develop promised new policies and to roll them out.  All that has been done to date is to shift responsibility for programs to the Department of Prime Minister and Cabinet and to rebrand programs that may or may not be effective. It’s a policy-free zone, where ad hoc decisions are the norm and budgets continue to be constrained in ways that limit the effectiveness and reach of programs and services.

There are a number of examples where program funding has been provided at the expense of other needed programs – taking $11.5 million from Indigenous Safety and Wellbeing programs to reverse funding cuts to the Indigenous Legal Assistance Program is perhaps the most egregious example.

There are also concerns that proposed changes to mainstream programs such as increased co-payments and safety net threshold in health, reduced Commonwealth funding for public hospitals, increased costs for higher education, and changes to the collection of census data will have a disproportionate impact on Indigenous Australians.

Small wonder then that most Closing the Gap targets remain out of reach and the sector is struggling to keep programs functioning and retain staff.

The inequality gap between Indigenous peoples and other Australians remains wide and has not been progressively reduced. With a significant proportion of Indigenous Australians in younger age groups, and without funded commitments to actions now and into the next several decades to improve their socio-economic status, future demands for services will burgeon.

Implementation of the National Aboriginal and Torres Strait Islander Health Plan

The National Aboriginal and Torres Strait Islander Health Plan 2013-2023 was developed to provide an overarching framework which builds links with other major Commonwealth health activities and identifies areas of focus to guide future investment and effort in relation to improving Indigenous health.

On 30 May 2014 the Assistant Minister for Health, Fiona Nash, announced that an Implementation Plan would be developed for this Health Plan.

This was supposed to be available from 1 July 2015 to enable the progressive implementation of the new funding approach for the Indigenous Australian’s Health Program. The new approach will target funds to those regions whose populations experience high health need and population growth. The Budget Papers explicitly mention NACCHO as the nominated community stakeholders along with States/Territories in the development of this mechanism.

At June 2015 Senate Estimates PM&C officials said that the implementation plan was still being developed by DoH in collaboration with the National Health Leadership Forum, AIHW and PM&C. Its release was expected within a ‘short period of time’.

The Close the Gap Campaign Steering Committee believes that the Implementation Plan requires the following essential elements:

  • Set targets to measure progress and outcomes. Target setting is critical to achieving the COAG goals of life expectancy equality and halving the child mortality gap;
  • Develop a model of comprehensive core services across a person’s whole of life including end of life care with a particular focus, but not limited to, maternal and child health, chronic disease, and mental health and social and emotional wellbeing; and which interfaces with other key service sectors including, but not limited to, drug and alcohol, aged care and disability services;
  • Develop workforce, infrastructure, information management and funding strategies based on the core services model;
  • A mapping of regions with relatively poor health outcomes and inadequate services. This will enable the identification of service gaps and the development of capacity building plans, especially for ACCHS, to address these gaps;
  • Identify and eradicate systemic racism within the health system and improve access to and outcomes across primary, secondary and tertiary health care;
  • Ensure that culture is reflected in practical ways throughout Implementation Plan actions as it is central to the health and wellbeing of Aboriginal and Torres Strait Islander people;
  • Include a comprehensive address of the social and cultural determinants of health; and
  • Ensure the development and implementation of the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Wellbeing 2014-2019 as a dedicated mental health plan for Aboriginal and Torres Strait Islander peoples, and in coordination with the implementation of the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy and the National Aboriginal and Torres Strait Islander Drug Strategy.
  • Establish partnership arrangements between the Australian Government and state and territory governments and between ACCHS and mainstream services providers at the regional level for the delivery of appropriate health services.

The Health Portfolio Budget Statement says that in n 2015-16, the Government will implement a National Continuous Quality Improvement Framework for Indigenous primary health care through the expansion of the Healthy for Life activity. This will support the delivery of guideline-based primary health care and support improved health outcomes.

Health

There were no specific Indigenous issues included in the Health budget, and there are questions about the future of some programs.

Aboriginal Community Controlled Health Organisations

The Abbott Government has provided $1.4 billion /3 years ($448 million / per year) for Aboriginal Community Controlled Health Organisations (ACCHOs). This will include a 1.5% CPI increase over the 3 year period. NACCHO and Affiliate funding of $18 million is provided for 18 months and in that time DoH will commence a review of NACCHO’s role and function.[2]

NACCHO Budget Analysis HERE

In addition, NACCHO has secured confirmation of an extension of the exemption from Section 19.2  of the Health Insurance Act 1973 which expires on 30 June 2015, which enables ACCHOs to receive financial benefit from Medicare rebates in addition to Government funding.  This extension will be granted until June 2018.

The freeze on MBS rebate indexation will have a significant financial impact on ACCHOs as will any increase in Medicare and PBS co-payments.

Flexible Funds

In combination the 2014-15 and 2015-16 Budgets will cut $500 million / 4 years from 14 of the 16 DoH flexible funds.  There is still no clarity in relation to how these savings are to be achieved, although the Aboriginal and Torres Strait Islander Chronic Disease Fund will not be cut.  However cuts to other funds such as those that support the provision of essential services in rural, regional and remote Australia, that manage responses to communicable diseases and that deliver delivering substance abuse treatment services will affect  Indigenous Australians.

Aboriginal and Torres Strait Islander Chronic Disease Fund

Within the Health portfolio, the Aboriginal and Torres Strait Islander Chronic Disease Fund supports activities to improve the prevention, detection, and management of chronic disease in Indigenous Australians and to contribute to the target of closing the gap in life expectancy. The Fund consolidates 16 existing programs, including the majority of initiatives under the Indigenous Chronic Disease Package, into a single flexible fund. The three priority areas targeted are:

  • Tackling chronic disease risk factors
  • Primary health care services that can deliver
  • Fixing the gaps and improving the patient journey.

The Fund was established in the 2011 Budget and came into operation on 1 July 2011. The funding is $833.27 million / 4 years (from 1 July 2011 to 30 June 2015). The majority of funding has been directly allocated to organisations to support activities under the Fund’s Indigenous Chronic Disease Package programs.

At June 2015 Senate Estimates it was confirmed that most, but not all, of the activities under this fund were continuing.  Local community campaigns and the chronic disease self-management program were named as two programs that were not continued.

Tackling Indigenous Smoking Program

The 2014-15 Budget cut $130 million / 5 years from the Tackling Indigenous Smoking Program, despite the fact that 44% of Indigenous people smoke.    The program was reviewed in 2014 and the DoH website says that this review will “provide the Government with options to ensure the program is being implemented efficiently and in line with the best available evidence. The outcome of the review will inform new funding arrangements from 1 July 2015.” However there were no announcements in the Budget.

The redesigned program was announced on 29 May 2015, but with no increase in funding It is not clear when or if the review of this program, conducted by the University of Canberra, will be released.

Funding in 2014-15 was $46.4 million; this is reduced to $35.3 million in 2015-16.  Staffing levels have also fallen significantly, from 284 FTEs in May 2014 to 194 FTEs in May 2015. There will be further disruption to this important program as current contracts cease at the end of June 2015 and the 49 organisations that deliver the program must go through the IAS Invitation to Apply Process for further funding.  Transitional funding will be available for the next 6 months.

Australian Nurse Family Partnership Program and New Directions: Mothers and Babies Services

In the 2014-15 Budget there was additional funding for a Better Start to Life will improve early childhood outcomes :

  • $54 million expansion, from 2015-16, of New Directions from 85 to 137 sites (52 additional sites overall) to ensure more Indigenous children are able to access effective child and maternal health programs.
  • $40 million expansion, from 2015-16, of the Australian Nurse Family Partnership Program from 3 to 13 sites (10 additional sites overall) to provide targeted support to high needs Indigenous families in areas of identified need.

In 2015 the Australian Nurse Family Partnership Program will grow from three to five sites and New Directions: Mothers and Babies Services will reach an additional 25 services, bringing the total to 110 services, with an enhanced capacity to identify and manage Fetal Alcohol Spectrum Disorder in affected communities

Prevention – Shingles vaccine

The Budget provides for the listing of Zostavax vaccine for the prevention of shingles to be listed on the National Immunisation Program for 70 year olds from 1 November 2016.  This measure includes a 5-years program to provide a catch-up program for people aged 71-79.

There is concern that the 70-79 year old age cohort largely excludes Indigenous people because of their lower life expectancy.

Pharmaceutical Benefits Scheme

Close the Gap PBS Co-payment

This is an ongoing measure and although it was not mentioned in the Budget, it was stated in Senate Estimates that this would continue as currently.

QUMAX Program

The QUMAX program is a quality use of medicines initiative that aims to improve health outcomes for Indigenous people through a range of services provided by participating ACCHO and community pharmacies in rural and urban Australia. It commenced in 2008 as a two year pilot. It was later approved for a transition year outside the 4th Community Pharmacy Agreement and for a further four years under the  5th Community Pharmacy Agreement.

NACCHO and the Pharmacy Guild of Australia have been negotiating 1 year transition funding of QUMAX to enable development of an Implementation Plan under the 6th Community Pharmacy Agreement.  NACCHO will seek to expand QUMAX from 76 services to 134 services.

Medicare

MBS Practice Incentive Program (PIP) Indigenous Health Incentive

This is an ongoing program (although it may be subject to an indexation freeze).  It is expected to be considered as part of the new MBS Review.

Healthy Kids Check

The Budget cut Medicare funding for the Healthy Kids Check, a consultation with a nurse or GP to assess a child’s health and development before they start school, on the basis that this measure is a duplication with existing State and Territory based programs.  NACCHO states that this change will not impact ACCHOs or Indigenous children as ACCHOs can continue to bill health assessments through a separate item (MBS item 715).

Primary care – PHN Funding

The current transition of Medicare Locals (MLs) to Primary Health Networks (PHNs) is proceeding slowly and many details relating to specific programs remain unknown, perhaps even undecided.

To date, 21 of 61 MLs outsource the provision of services for Indigenous Australians directly to ACCHOs. The provision of these services will now move to a competitive commissioning process, leading to concerns about issues such as cultural safety and sensitivity.

The Minister for Health, Sussan Ley,  has advised NACCHO that funding for Complementary Care and Supplementary Services will transition to the PHNs.

Mental Health

The Budget has nothing that responds to the National Mental Health Commission’s review of programs and services. The report describes Indigenous mental health as ‘dire’. It’s a dominant over-arching theme throughout, and there is a recommendation to make Indigenous mental health a national priority and agree an additional COAG Closing the Gap target for mental health.

Despite this, the Government has delayed any action and has established an Expert Reference Group to develop implementation strategies.  There is no Indigenous representation on the Reference Group.

Substance and alcohol abuse  

Alcohol abuse

Alcohol abuse has been identified as a major public health concern among Indigenous people, with serious physical and social consequences. Indigenous Australians between the ages of 35 and 54 are up to eight times more likely to die than their peers, with alcohol abuse the main culprit and alcohol is associated with 40% of male and 30% of female Indigenous suicides.

Fewer Indigenous people drink alcohol than in the wider community, but those who do drink do so at levels harmful to their health. Culturally appropriate intervention approaches are needed and ‘dry zones’ are only seen as stop gap measures.

Cuts made in Flexible Funds affect drug and alcohol programs. Professor Kate Conigrave reports that there are now only 5 dedicated Indigenous drug and alcohol services nationally.

Ice campaign

This Budget commits $20 million / 2 years for a new stage of the National Drugs Campaign primarily aimed at the use of ice. No consultation has been undertaken in the lead up to the announcement of this health promotion campaign.

It almost certainly will not achieve tangible outcomes for Aboriginal people, despite concerns about a growing ice epidemic in remote Indigenous communities.

Opal fuel

There are 123 petrol stations selling Opal fuel in remote parts of Australia but some retailers in the roll-out zones don’t and there are pockets of sniffing near state borders. In December 2014 it was announced that a bulk storage tank for low-aromatic unleaded fuel (LAF or Opal ) is to be installed in northern Australia as part of the  roll-out of OPAL in the fight to curb the problem of petrol sniffing.

DOWNLOAD THE FULL REPORT HERE

REGISTRATIONS FOR 2015 NACCHO AGM and Members meeting NOW OPEN

AGM

 

Call out for Health Heroes!

healthheroes
The Department of Health are looking for ‘Health Heroes’ and are sending a call out to health professionals and students who would like to come down to the Careers Expos listed below to be a speaker and assist in promoting careers within indigenous health.

If you or know someone who would be interested in attending to be a speaker please contact

Jessica Lowe on 02 8354 0866     E: jessica.lowe@alltheperks.com.au

Further information available at : http://australia.gov.au/healthheroes

 

Dates & Locations

Brisbane, Convention and Exhibition Centre – 23 May between 9 and 3:30pm and 24 May 2014 between 10am and 4pm

Sydney, Moore Park – 29 May – 1 June between 10am and 3pm

Sydney, Olympic Park – 19 – 22 June between 9am and 3pm

Darwin, Convention Centre – 13 and 14 August times TBC

Alice Springs, Convention Centre – 21 and 22 August times TBC

 

Further information available at : http://australia.gov.au/healthheroes

NACCHO at National Press Club April 2 : Investing in Aboriginal community controlled health makes economic $ense

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On 2 April the NACCHO chair Justin Mohamed will be appearing at the National Press Club in Canberra

Watch live on ABC-TV at 12.30 pm (see below)

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New Microsoft Word Document (5)

 

 

“Investing in Aboriginal Community Control makes economic $ense”

The good news is that ACCHS deliver the goods – not only health gains, but also substantial economic gains.

 In all the rhetoric about Closing the Gap, what is missing from the picture is this —  the ACCHS network of clinics, community health centres and health-based co-operatives throughout Australia generates substantial  economic value for Aboriginal people and their  communities. ACCHS are a large-scale employer of Aboriginal people. This provides  real income and economic independence for many people. They contribute enormously to raising the education and skill levels of the Aboriginal workforce.

Investing in ACCHS is a good business proposition. It provides value for money and is highly cost-effective for four main reasons:

ACCHS deliver primary health care that delivers results

 Like your local GP does but more effectively for Aboriginal people because  the ACCHS model combines the best of clinical know-how with culturally enriched local knowledge and wisdom. It takes care of the whole person, not separate body parts. People work as part of a team that includes Aboriginal Health Workers, allied health,  and social and emotional wellbeing counsellors   in the front line. GPs as well, although not always. It runs health promotion and health screening to identify and treat health problems before they get serious. It organises access to medical specialists and hospitals if necessary. The ACCHS model considers individuals and families as part of a community and it responds effectively to community-based needs and issues.

This model of health care works for Aboriginal people. Evidence-based inquiries and reports show that ACCHS outperform mainstream services in terms of treatment and prevention. They reduce the need for highly expensive hospital-based services. And they  save lives.

ACCHS employment boosts Aboriginal education and training levels

 ACCHS employ people with high skill levels. Most have tertiary level qualifications and several have multiple qualifications. This increases the  education and skill base of the Aboriginal workforce.  Organisational  pathways in ACCHS are based on continuing and further education.  The message is that ACCHS have education benefits. A single investment by government in ACCHS  deals effectively with the  two main problems in Aboriginal communities – high unemployment and low levels of education.

BOOKINGS

NACCHO AMA Aboriginal health news : Action needed to give Aboriginal children a healthier start to life ; Download report

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AMA Indigenous Health Report Card 2012-13

“The Healthy Early Years – Getting the Right Start in Life”

The AMA Indigenous Health Report Card 2012-13, The Healthy Early Years – Getting the Right Start in Life, was released today by Assistant Minister for Health, Senator the Hon Fiona Nash, at Parliament House in Canberra.(see Senator Nash Press Release below )

DOWNLOAD THE AMA 2012-2013 REPORT CARD HERE

If you missed the NACCHO AIHW HEALTHY FOR LIFE REPORT CARD Download here

AMA President, Dr Steve Hambleton, said it is the right of every Australian child to have the best start in life but in Australia today not every child benefits from this right.

“In their early years, children need to be safe, have adequate opportunities for growth and development, and have access to adequate health, child development, and education services,” Dr Hambleton said.

“Many of our children are missing out, but none more so than Aboriginal and Torres Strait Islander children.

“There have been some improvements in recent years with many Aboriginal and Torres Strait Islander children making a successful transition to healthy adult life, but there are still far too many who are being raised in community and family environments that are marked by severe early childhood adversity.

“This adversity in early life can affect educational and social functioning in later life, and can increase the risk of chronic illness.

“Without intervention, these problems can be transmitted from one generation to the next – and the cycle continues.

“Good nutrition, responsive care and psychosocial stimulation can have powerful protective benefits to improve longer-term health and wellbeing.

“Strong culture and strong identity are also central to healthy early development.

“The costs to individuals, families, and society of Aboriginal and Torres Strait Islander children failing to reach their developmental potential continue to be substantial.

“Robust and properly targeted and sustained investment in healthy early childhood development is one of the keys to breaking the cycle of ill health and premature death among Aboriginal peoples and Torres Strait Islanders.

“We are seeing improvements through government commitment and cooperation on closing the gap initiatives, but much more action is needed

“It is crucial for the momentum to be sustained by renewing the COAG National Partnership Agreements on Indigenous Health and on Indigenous Early Childhood Development for another five years,” Dr Hambleton said.

The AMA makes several recommendations in the Report Card to improve the health and wellbeing of Aboriginal and Torres Strait Islander children in their early years, including:

a national plan for expanded comprehensive maternal and child services that covers a range of activities including antenatal services, childhood health monitoring and screening, access to specialists, parenting education and life skills, and services that target risk factors such as smoking, substance use, nutrition, and mental health and wellbeing;

  • the extension of the Australian Nurse Family Partnership Program of home visiting to more centres;
  • support for families at risk with interventions to protect infants and young children from neglect, abuse and family violence;
  • efforts to reduce the incarceration of Aboriginal people and Torres Strait Islanders;
  • efforts to improve the access of Aboriginal people and Torres Strait Islanders to the benefits of the economy, especially employment and entrepreneurship;
  • efforts to keep children at school;
  • building a strong sense of cultural identity and self-worth;
  • improving the living environment with better housing, clean water, sanitation facilities, and conditions that contribute to safe and healthy living; and better data, research and

Background – some key factors impacting on Aboriginal and Torres Strait Islander health and wellbeing in the early years:

Pregnancy and Birth

  • Aboriginal and Torres Strait Islander women have a higher birth rate compared with all women in Australia (2.6 babies compared to 1.9), and are more likely to have children at a younger age: 52 per cent of the Aboriginal women giving birth in 2010 were aged less than 25 years, and 20 per cent were less than 20 years, compared with 16 per cent and 3 per cent, respectively, for the broader community [AIHW, 2012];
  • Aboriginal women remain twice as likely to die in childbirth as non-Aboriginal mothers, and are significantly more likely to experience pregnancy complications and stressful life events and social problems during pregnancy, such as the death of a family member, housing problems, and family violence [Brown, 2011];
  • around half of Aboriginal and Torres Strait islander mothers who gave birth in 2010 smoked during pregnancy, almost four times the rate of other Australian mothers; and
  • while infant mortality continues to fall, low birth weight appears to be increasing.

Infancy and early years

  • Aboriginal and Torres Strait Islander children are twice as likely to die before the age of five than other Australian children of that age group. However, the Closing the Gap target to halve this gap in mortality rates by 2018 will be reached if current trends continue;
  • between 2008 and 2010, Aboriginal and Torres Strait Islander children less than five years of age were hospitalised at a rate 1.4 times greater than other children of the same age [AIHW 2013];
  • Aboriginal and Torres Strait Islander children suffer from nutritional anaemia at 30 times the rate of other children [Bar-Zeev, et. al., 2013]; and
  • Aboriginal and Torres Strait Islander children between 2 and 4 years of age are almost twice as likely to be overweight or obese compared with all Australian children in that age range [Webster et. al., 2013].

Family Life

  • More than 20 per cent of Aboriginal and Torres Strait Islander families with children younger than 16 years have experienced seven or more life stress events in a year [Zubrick et al, 2006]. The greater the number of family life stress events experienced in the previous 12 months, the higher the risk of children having clinically significant social and emotional difficulties [FaHCSIA, 2013];
  • for Aboriginal and Torres Strait Islander children, risk factors such as: a close family member having been arrested, or in jail or having problems with the police, being cared for by someone other than their regular carers for more than a week; being scared by other people’s behaviour had the greatest impact on a child’s social and emotional difficulty scores; especially if these factors were sustained over a number of years [FaHCSIA  2013];
  • between 2006 and 2010, the injury death rate for Aboriginal and Torres Strait Islander children was three times higher than that for other children. In 2010–11, the rate of hospitalisation for injuries was almost 90 per cent higher for children from remote and very remote areas than for children in major cities. Overall, hospitalisation due to injury among Aboriginal and Torres Strait Islander children was almost double that of other children, with the greatest disparity relating to assault [AIHW, 2012];
  • Aboriginal and Torres Strait Islander children were almost eight times as likely to be the subject of substantiated child abuse and neglect compared with other Australian children [AIHW 2012].

Early Childhood Education and Schooling

  • Aboriginal and Torres Strait Islander children were almost twice as likely to be developmentally vulnerable than other Australian children, and to require special assistance in making a successful transition into school learning;
  • the Closing the Gap target for all Aboriginal and Torres Strait Islander four-year-olds living in remote communities to have access to 15 hours of early childhood education per week was achieved in 2013;
  • across the country, the proportion of Aboriginal and Torres Strait Islander children achieving the national minimum standards decreases as remoteness increases. For example, in 2012, only 20.3 per cent of Aboriginal and Torres Strait Islander year 5 students in very remote areas achieved national minimum standards in reading, compared with 76 per cent in metropolitan areas;
  • only modest progress has been made in achieving the Closing the Gap target to halve the gap for Aboriginal and Torres Strait Islander students in NAPLAN reading, writing and numeracy assessment scores by 2018.

10 December 2013

CONTACT:        John Flannery                     02 6270 5477 / 0419 494 761

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

Image for newsletters

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.

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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 www.hwa.gov.au/2013conference

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NACCHO member good news : Apunipima Cape York Mossman Gorge PHCC named (AGPAL’s) Rural & Remote General Practice of the Year

Mossman Gorge Primary Health Care Centre (1)

“AGPAL accreditation demonstrates our ability to provide the highest quality care. This award means we are providing the highest quality of care possible in a rural and remote setting.

This award is significant as we were competing against mainstream organisations from across Australia.

To be recognised as the Rural and Remote General Practice of the Year sends a clear message that Aboriginal Health Organisations are providing the best care in the country.’’

Mossman Gorge Primary Health Care Centre – Rural & Remote General Practice of the Year

Mossman Gorge Primary Health Care Centre (PHCC) has been  named Australian General Practice Accreditation Limited’s (AGPAL’s) Rural & Remote General Practice of the Year at a gala event in Sydney on Friday September 27.

AGPAL Rural and Remote Practice of the Year Award

Mossman Gorge PHCC, the only community controlled primary health care centre on Cape York, is run by Apunipima Cape York Health Council which provides culturally appropriate, family centred comprehensive primary health care to 11 Cape York communities.

AGPAL is the leading provider of accreditation and related quality improvement services to general practices. Accreditation is based on standards developed by the Royal Australian College of General Practitioners.

Apunipima Program Manager: Family Health Leeona West says the award was a significant milestone for Apunipima, Mossman Gorge PHCC and most importantly, the people and communities of Cape York.

‘AGPAL accreditation demonstrates our ability to provide the highest quality care. This award means we are providing the highest quality of care possible in a rural and remote setting. This award is significant as we were competing against mainstream organisations from across Australia. To be recognised as the Rural and Remote General Practice of the Year sends a clear message that Aboriginal Health Organisations are providing the best care in the country.’

‘The people of Cape York deserve the very best care. This award recognises that our service is providing it.’

The health picture in Mossman Gorge has changed significantly since Apunipima took over the community’s small Queensland Health clinic in 2009.

‘Back then, the clinic had paper records and doctors who visited the community for four hours a week. Anecdotally, health outcomes were poor with high rates of smoking, drinking and chronic disease,’ Ms West explains.

‘Apunipima took over the clinic in December 2009, rebuilt it to AGPAL standards by June 2010, introduced electronic records and billing and was accredited by AGPAL in January 2011.’

‘We even implemented an Aboriginal patient friendly recall system which was so successful that the Brisbane Aboriginal and Islander Community Health Service copied our system for their clients.’

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NACCHO AMA political alert: Big “bang”gap in health policies to Close the Gap

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“No party has yet produced a comprehensive Indigenous health policy that would provide significant new funding and direction to build on the modest but welcome successes to date of the Closing the Gap strategy.

“The ideal health policy for this election would combine elements of each of the policies on offer from Labor, the Coalition and The Greens – topped with a ‘big bang’ Indigenous health policy and a well-articulated approach to dealing with the growing impact of chronic disease.

AMA President, Dr Steve Hambleton, (picture above left with NACCHO CEO Lisa Briggs, Chair Justin Mohamed and DoHA Department Secretary Jane Halton)

AMA PRESS RELEASE

AMA President, Dr Steve Hambleton, today urged the major parties to plug the gaps in their election health platforms before Saturday’s election.

Dr Hambleton said that there are lots of votes in positive, forward-looking health policies and there is still time for Mr Rudd and Mr Abbott to pitch more comprehensive health policies to the electorate.

“I set a health policy challenge at the National Press Club in July,” Dr Hambleton said.

“We currently have a new set of problems and challenges in meeting the health needs of the Australian community, and they require a new set of solutions – and that is the great task for the major parties.

“Any change must be tested against the reasons we need proper health reform – mainly our increasing burden of chronic disease and our ageing population.

“Proposals should be moving us toward a joined-up, strengthened primary health care system built on team-based solutions.

“The Labor emphasis to date in this campaign has been on hospital infrastructure, while the Coalition is concentrating on primary care, especially general practice.

“The Greens have focused on access to healthcare, public health and environmental health.  They have a policy that supports the AMA proposal for an independent panel to assess the health of asylum seekers.

“No party has yet produced a comprehensive Indigenous health policy that would provide significant new funding and direction to build on the modest but welcome successes to date of the Closing the Gap strategy.

“The ideal health policy for this election would combine elements of each of the policies on offer from Labor, the Coalition and The Greens – topped with a ‘big bang’ Indigenous health policy and a well-articulated approach to dealing with the growing impact of chronic disease.

“We encourage the major parties to commit to practical and affordable policies that would improve public health, help the most vulnerable and disadvantaged in the community, and ensure a strong, highly skilled medical workforce to meet the future health needs of the community.

“The AMA released a Key Health Issues plan in July, which set out achievable policies that would deliver health service improvements at the front line, directly to patients.

“Some elements have been addressed, but many haven’t.

“We remind our political leaders of what they can do to bolster their health credentials in the final days of the campaign.”

Indigenous Health No significant new funding or direction to build on the modest but welcome successes to date of the Closing the Gap strategy.

Scrap the Cap The Government deferred its ill-considered cap on the tax deductibility of self-education expenses, but no party has yet been prepared to dump this policy, which is bad for education, productivity, and the economy, as well as the safety and quality of our health services.

Medical Training The AMA remains committed to working with the next Government to come up with a long-term policy that supports medical education and training.

Despite the major parties announcing additional intern places in the private sector, which were welcomed, no party has tackled the need to better coordinate the medical training pipeline or address the looming shortage of prevocational and specialist training positions as predicted by Health Workforce Australia.

There needs to be a concerted effort through COAG processes to commit to additional prevocational and specialist training places, including in general practice, with funding to match, in order to ensure that Australia can properly address future community health needs

Chronic Disease The major parties need to do more to tackle the impact of chronic disease so that we can keep people well and out of hospital.  Current Medicare arrangements impose too much paperwork on GPs and limit access to services for patients with higher health care needs.

The major parties need to do more to support GPs in caring for these patients by streamlining current Medicare arrangements and by looking to adopt innovative approaches such as the Department of Veterans’ Affairs Coordinated Veterans Care program more broadly.

We note and welcome the proposed Australian Prevention Partnership Centre, launched today by Federal Minister for Health and Minister for Medical Research Tanya Plibersek, to research what works and what doesn’t in helping people make lifestyle changes to prevent chronic disease.

Rural Health Rural health has still missed out on the big funding boost it needs to address rural medical workforce shortages.

The AMA/RDAA Rural Rescue Package outlines the funding required to get more doctors into rural and remote Australia, with the right mix of skills to deliver services to these communities

Healthier Australian Families There has been no specific policy announcement from Labor or the Coalition on significant public health concerns around Better Environmental Health (effects of climate change, better standards for clean air, greater health monitoring of non-conventional gas mining projects), Preventing Harms of Alcohol (curbs on alcohol marketing to young people, minimum pricing for alcohol products), or Asylum Seeker Health (independent panel).

Dementia, Aged Care and Palliative Care We acknowledge and welcome recent policy announcements around palliative care and dementia, but they do not go to the key issue of access to medical care.

The major parties need to ensure that people with dementia, those who require palliative care, and older Australians with complex and multiple conditions can receive appropriate medical care.  The major parties need to do more to ensure the Medicare arrangements are geared to deal with the increasing numbers of these patients and the need to better manage these patients in the community.

Better recognition of and support for the time that doctors spend assessing patients, organising services and providing support to the patient’s family and carers would ensure that quality dementia, palliative and medical care for the elderly is provided inappropriate settings.  This would relieve the counterproductive use of acute services.

Affordable Medical Services Immediately restore indexation of MBS patient rebates.  Reverse the decision to raise the Extended Medicare Safety Net threshold from 2015.  Restore tax deductibility of out-of-pocket medical and health care gaps.

Authority Prescriptions While the major parties mention tackling red tape, no party has committed to reducing the time wasted by doctors having to telephone the Department of Human Services (DHS) to obtain an authority to write prescriptions for certain PBS medicines.  Based on DHS information, up to 25,000 patient consultations are lost while doctors wait for their calls to DHS to be answered.

AMA Key Health Issues for the 2013 Federal Election is available on the AMA website at https://ama.com.au/keyhealthissues

The AMA publication, Alcohol Marketing and Young People, is at https://ama.com.au/alcohol-marketing-and-young-people

NACCHO political news: What are the Aboriginal health priorities for the next Government ?

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Call for incoming government to commit to Close the Gap

A renewed COAG National Partnership Agreement on Closing the Gap and action on the National Aboriginal and Torres Strait Islander Health Plan should be key priorities for the next government, according to an incoming government brief prepared by the Close the Gap Steering Committee.

Picture above Tanya Plibersek and Peter Dutton National Press Club Health Debate 

VIEW VIDEO on current  Peter Dutton Aboriginal Health policy NATIONAL PRESS CLUB HEALTH DEBATE

The briefing paper, to be released today, outlines the key steps needed in the next parliament to ensure progress on closing the life expectancy gap between Aboriginal and Torres Strait Islander and other Australians.

DOWLOAD THE 16 Page BUILDING ON CLOSE THE GAP document here

The paper says that within its first hundred days, a new government should:

  • Reaffirm the commitment for the Prime Minister to annually report at the beginning of Parliament on progress towards closing the gap;
  • Secure a new COAG National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes, with a minimum Commonwealth investment of $777 million over the next three years; and
  • Begin the implementation of the National Aboriginal and Torres Strait Islander Health Plan in partnership with Aboriginal and Torres Strait Islander people and their representatives.

Campaign spokesperson and Chair of National Aboriginal Community Controlled Health Organisation, Justin Mohamed said that closing the gap is literally a life or death issue for Aboriginal and Torres Strait Islander people.

Team NACCHO

TEAM NACCHO at the NATIONAL PRESS CLUB Health Debate

“We’re only at the beginning of the journey to close the gap in life expectancy by 2030.  We can’t turn back now because closing the gap needs long-term commitment and policy continuity. Aboriginal and Torres Strait Islander health in our hands is having an impact and we must keep supporting our people to deliver their own health outcomes,” Mr Mohamed said.

AMA President, Dr Steve Hambleton said that both Kevin Rudd and Tony Abbott have been strong supporters of Close the Gap.

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AMA President, Dr Steve Hambleton with Department of Health Secretary Jane Halton .NACCHO’S Lisa Briggs and Justin Mohamed

He said that Tony Abbott gave the campaign strong encouragement in its early days when he was Health Minister and Kevin Rudd committed to the targets and deadlines we proposed and secured the first National Partnership Agreement through COAG.

“It’s important that momentum towards closing the gap is maintained regardless of who wins the election.  Closing the gap is a generational effort and we are beginning to see signs of progress,” Dr Hambleton said.

Lowitja Institute Chair, Pat Anderson said the Close the Gap Steering Committee welcomed the attention given to Aboriginal and Torres Strait Islander education and employment in the election campaign.

“Along with racism, education and employment are key social determinants of health.  But action on these needs to proceed at the same time as action on health because kids can’t study and parents can’t hold down a job if they have poor health,” Ms Anderson said.

The Close the Gap Campaign was launched by Olympians Catherine Freeman and Ian Thorpe in April 2007. Since then almost 200,000 Australians have signed up to the campaign, which has also received multi party support by all Federal, State and Territory Governments.

 Close the Gap platform : https://www.humanrights.gov.au/close-gap-indigenous-health-campaign

Media contact: Gary Highland. Mobile: 0418 476 940

DOWLOAD THE 16 Page BUILDING ON CLOSE THE GAP document here

NACCHO political alert: NACCHO calls on both parties for greater control of Aboriginal health

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Transcript from World News Australia Radio

Aboriginal community-controlled health organisations have entered the election fray, releasing a major plan they want political parties to commit to.

At a national summit in Adelaide, the organisations challenged both sides of politics to promise to give Aboriginal communities greater control over health programs.

Karen Ashford reports.

Trust us – that’s the message from the leaders of some 150 Aboriginal controlled health agencies, who contend a community-driven approach to Indigenous health can deliver results the mainstream can’t.

Ngiare Brown (pictured above) is research manager for the National Aboriginal Controlled Community Health Organisation, or NACCHO.

She says governments have to be prepared to try something different if Australia’s to make any headway on addressing indigenous health disadvantage.

“I think it was Albert Einstein wasn’t it that said insanity isn’t that when you do the same things over and over and expect a different result?”

NACCHO thinks it would be smarter for Australia to embrace its 40 years of community health provision that it says delivers results – and they’ve produced a ten point plan to take it further.

The plan focuses Indigenous leadership, to drive health reforms and find innovative ways of closing the gaps on Indigenous health between now and 2030.

Ngiare Brown says it’s a much-needed departure from the traditional mainstream model.

“There is an ever changing line up of politicians and bureaucracies and in systems, so we’re having the same sorts of conversations over and over again. So if we’re able to demonstrate and articulate those principals and provide the kind of evidence and structural approach to that change, it should be independent of any change of government, any change in politics, any reform of the system that’s outside of that, because we in fact are one of the most consistent leadership processes and a demonstration of community control that this country has. In fact whilst there’s the revolving door of politics, Aboriginal community control is one of our strongest and most consistent national vehicles for positive change. ”

The NACCHO plan, presented to more than 300 delegates at its inaugural Primary Health Care Summit in Adelaide comes hot on the tail of the Australian Institute of Health and Welfare report card which has given Aboriginal-controlled health organisations a big tick.

The report credited those organisations with making significant improvements in areas like diabetes management, increase child birth weights and better maternal health.

NACCHO chairman Justin Mohamed says the only thing missing is political attention, with indigenous health hardly mentioned so far in the federal election campaign.

“I think to be honest both parties at different times do talk about Aboriginal community control, do talk about Aboriginal health, but I think what we’re seeing in the election process at the moment is that I would like to see more of the parties to let us know what their platform is or what their thoughts are around Aboriginal health, not just health in general.”

Mr Mohamed argues that Aboriginal community-controlled health bodies have proven their expertise and efficiency, and whoever wins government on September 7 must show greater faith in the sector.

“I think that this is a time that things are changing. Our stakeholders and other groups that are working in health are actually saying to government that Aboriginal community controlled health works, you need to give them the keys to the vehicle and let them drive it, and results will show with that. And we’ve seen the results in recent reports that Aboriginal community control delivers results in health.”

A big slice of the conference was devoted to governance.

“You certainly need to be aware of potential risks to your operations” (fade under)

Much of the program was devoted to discussing how community health bodies could make sure they’re accountable.

Ngiare Brown says the sector is tired of paternalism and keen to prove they can be trusted with the purse strings.

“I think we’ve become far more sophisticated. So in the past it has been very much the attitude for example of politicians and departments that they’re doing us a favour by providing us with funds and resources, but we’ll still maintain that control – we are actually able to demonstrate that we’re focused on governance, we’re focused on our internal capacity to be able to lead, to understand business models, to be able to be responsible for funding and other resources, and we demonstrate that at more than 150 services across the country as well as at a national level. ”

Meanwhile, Justin Mohamed won’t say whether he believes Labor or the Coalition is leading in promises on Indigenous health, instead committing to work with whoever wins.

“We need to see results. We aren’t worried about being a political football and thrown around and showcased, or rolled out when it suits – we want to see results, and we just can’t afford to take sides, it’s about we want results and we need to have whoever is in power to give us those results and work with us.”