NACCHO political alert :Elite “Empowered Communities” unit to drive Noel Pearson’s national Aboriginal reforms

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SIXTEEN of the most powerful indigenous and business leaders as well as top-ranking bureaucrats have been appointed to oversee a radical plan devised by Noel Pearson to empower Aboriginal communities and ensure that funding delivers real gains on the ground.

From The Australian PATRICIA KARVELAS

Mr Pearson will co-chair the new steering committee with Department of Prime Minister and Cabinet associate secretary Liza Carroll to drive enormous change in the way money for indigenous Australians is spent.

The Cape York leader told The Australian that Tony Abbott had placed a high priority on the Empowered Communities project, and was receiving maximum co-operation from state and territory counterparts.

The first official meeting of the federal government’s Empowered Communities project took place this week.

“The meeting brought together the most senior public servants responsible for indigenous affairs, together with commonwealth government officials and indigenous leaders,” Mr Pearson said. “The fact that the heads of the Premier’s Department in NSW and Queensland were there spoke volumes about the seriousness with which both levels of government are treating the Empowered Communities project.”

Mr Pearson said the involvement of key commonwealth department secretaries, particularly David Tune from Treasury and Finn Pratt from Social Services, meant the “most important players in the public service” were turning their minds to how to develop a better and more productive system for tackling indigenous affairs.

“This will be very hard work and we have bold ambitions, but I am optimistic,” he said.

The project is a joint effort between indigenous leaders from eight regions across Australia, the Australian government and Jawun Indigenous Corporate Partnerships. Several state governments are also participating.

Parliamentary Secretary to the Prime Minister on Indigenous Affairs Alan Tudge said the $5 million investment to fund the detailed design of the project would address key problems that caused waste instead of service delivery.

He said one of the key problems in government interaction with indigenous communities had been the sheer number of programs and agencies that interacted with often very small communities.

Sometimes these programs and agencies were aligned and customised, but frequently they were not.

“For example, the (Australian National Audit Office) reported a community with a population of less than 500 indigenous people receiving over 100 programs, delivered by seven federal government agencies and 11 state government agencies.” Mr Tudge said. “The Empowered Communities model will change the way government and indigenous communities work together.

“It will create a model to achieve greater co-ordination of government policy and it will ensure that government investment is informed by local leaders and targeted to make a genuine and practical difference to the lives of indigenous people.”

Mr Tudge said the project would build on the government’s decision to consolidate indigenous specific programs, bringing them under one government department and ensuring greater policy co-ordination.

He said a stronger local governance structure, led by key indigenous leaders, would be important to delivering better services. “We know local empowerment and locally driven solutions will improve outcomes for indigenous people,” he said. “We need to give indigenous people a greater say and greater responsibility about how best to respond to local issues, and especially to combat welfare dependence.”

The eight regions involved are Cape York, NSW central coast, inner Sydney, Goulburn Murray, East Kimberley, West Kimberley, APY/NPY Lands and northeast Arnhem Land. Marcia Langton of the University of Melbourne is a special adviser to the co chairs.

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NACCHO Aboriginal health news : New report highlights the challenges that remain to significantly improve the lives of Aboriginal people in remote communities

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The Coordinator General, Brian Gleeson, says in the report that while the National Partnership has made a solid start on improving the quality of life for Indigenous people in remote communities, it will take a generation to change,”

The Minister said the report highlights the need for greater government coordination as a critical factor in achieving sustainable results in communities.

Picture above: Minister for Indigenous Affairs, Nigel Scullion visiting a remote community in Central Australia with NT Chief Minister Adam Giles

A new report highlights the challenges that remain to significantly improve the lives of Indigenous people living in remote communities, Minister for Indigenous Affairs, Nigel Scullion, said today.

The eighth report of the Coordinator General for Remote Indigenous Services, released today, details outcomes of the National Partnership Agreement on Remote Service Delivery which aims to improve the delivery of government services to people living in 29 priority communities across Australia.

DOWNLOAD Eighth Report Into Remote Indigenous Service Delivery

“The Coordinator General, Brian Gleeson, says in the report that while the National Partnership has made a solid start on improving the quality of life for Indigenous people in remote communities, it will take a generation to change,” the Minister said.

“That’s why I am determined to ensure that no time is wasted in implementing key measures, such as lifting school attendance.

“Ensuring every child attends school every day and receives an education that meets national standards be a fundamental that is without question, but attendance rates at too many schools in remote Indigenous communities are not good enough.

“This will be a key focus of the Australian Government’s efforts to improve the circumstances of remote Indigenous people to ensure that we build future capability and capacity.”

The Minister said the report highlights the need for greater government coordination as a critical factor in achieving sustainable results in communities.

“That’s exactly why the Government has transferred most Indigenous policy and programmes into the Department of the Prime Minister and Cabinet (PM&C),” Minister Scullion said.

“The significance of this move should not be under-estimated. It puts Indigenous affairs at the centre of decision-making and will simplify programme delivery and cut red tape to ensure funding It has involved moving 1700 employees from eight departments to better coordinate Indigenous programme funding in 2013-14 totalling $2.5 billion.”

Mr Gleeson also says in his report that further attention needs to be paid to three key areas:

  •  Enhancing local governance and local ownership of decision making
  •  Reforming funding arrangements to support decision making at the local level
  •  Introducing simplified and meaningful monitoring and evaluation frameworks that reflect community perceptions of success.

The report also identifies areas where continued momentum can yield significant results, including joint planning and engagement between communities and government; a renewed focus on intergovernmental cooperation to achieve strategic objectives; ongoing government presence in communities; greater shared responsibility for accountability and transparency; and a strengthened independent monitoring and accountability mechanism.

“I thank Mr Gleeson for his report and the important assistance he provides in supporting real change in remote Indigenous communities,” Minister Scullion said.

Media contact: Minister’s Media contact: Russel Guse 0438 685645

CGRIS Contact: Llewella Jago 02 6146 2357

NACCHO AGM News: Prime Minister Tony Abbott sends positive message to open NACCHO AGM in Perth

Question Time in the House of Representatives

“New Government,New Approach” was the theme on the opening day of the  NACCHO AGM and members meeting in Perth this week.

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With Parliament sitting in Canberra messages and video addresses were sent from the Prime Minister (see below), Senator the Hon Fiona Nash Assistant Minister of Health ,Samantha Palmer First Assistant Secretary Indigenous Health Service Delivery Department of Health, Maria Jolly Assistant Secretary Health Policy  and John Shevlin Assistant Secretary Health Programmes DPM and C.

Jeff McMullen ,Justin Mohamed and Fred Chaney moderated a very robust discussion on ” the Future of Aboriginal Affairs and Aboriginal Health”

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I send warm greetings to delegates attending the National Aboriginal Community Controlled Health Organisation Annual General Meeting and Members Meeting in Perth.

Every day the 150 local community health organisations that you represent improve the physical and emotional health of Aboriginal communities across Australia. I honour the work that you do.

It is appropriate that you meet only days after the release of the latest Australian Bureau of Statistics data on indigenous life expectancy. While we can all draw some comfort from the improvements in life expectancy, the roughly 10 year gap between indigenous and non-indigenous life expectancy is still disturbing.

It must be our goal as a nation to eliminate this gap within a generation.

Our health is in many ways a reflection of our communities. That is why we have to ensure that children go to schools, adults go to work and the ordinary rule of the land operates in Aboriginal communities.

We need a new level of engagement at every level of society to ensure that Aboriginal people receive better educational, employment, housing and health outcomes. I have brought indigenous affairs into the Department of Prime Minister and Cabinet to achieve exactly that.

I pay tribute to all of you who are working to provide Indigenous Australians with the local health services they need.

I send my best wishes for a successful meeting.

The Hon Tony Abbott MP

Prime Minister of Australia

19 November

NACCHO Aboriginal health news: Bureaucratic overhaul, meaningful partnership can fix the Aboriginal health gap

Ian Ring

A bureaucratic overhaul and a more meaningful partnership with  Aboriginal people are essential changes according to Ian Ring who is a professorial fellow at the Australian Health Services  Research Institute at the  University of Wollongong.

Opinion article Canberra Times

A recent episode of Q&A echoed traces of the widespread view  that much money has been spent on Aboriginal health and other matters, with  relatively little to show for it – and that the money must have been eaten up by  a bloated bureaucracy, was misdirected, or corruptly or incompetently used.

All of these may be true but only to a very limited extent. The reality is  that, until recently, the federal government, through its own programs, was  spending less per capita on Aboriginal health than it was on the rest of the  population – despite Aboriginal people being at least twice as sick

That changed with the introduction of the National Partnership Agreements  (NPAs) involving the Commonwealth and all state and territory governments, which  injected $1.6 billion into Aboriginal health and $4.6 billion over four years to  2012-13 into health, education, housing, employment and remote services as part  of the Closing the Gap programs. Australia went from having a degree of  international opprobrium because of its  neglect of Aboriginal issues to  becoming internationally competitive in terms of indigenous policy and  funding.

But what results have we seen from this allocation of additional funds? In a  four-year program, the funds start out at low levels in the first year and build  up progressively over the next three. The funds then need to be used to employ  people, who need to be recruited and trained, and then it takes more time for  the programs in which they work to become fully effective.

Taking the  $100 million allocated to smoking, for example, the very earliest  we could hope to see any kind of significant change in smoking would be picked  up by the next smoking surveys, the results of which will be available next  year.

Given the lag between smoking reduction and improvements in smoking-related  diseases, the earliest we could  see measurable changes in heart and lung  mortality may not be until 2020.

The apparent lack of progress from data currently available tells us about  the lack of progress before the additional $1.6 billion hitting the ground and  is just what we would expect to see at this stage rather than indicating  waste  of funds or misallocation of resource.

But was the money optimally allocated? Almost certainly not and for reasons  that are crying out to be dealt with by the Mundine review. The programs funded  by the NPAs all made sense individually but, collectively, they missed the point  and in no sense approximated the comprehensive long-term action plan promised in  the statement of intent. The problem was not in the policy determined by  governments, or in the funding, but in the bureaucratic implementation of those  policies.

The programs were determined by officials in state and territory governments  with insufficient genuine consultation with   the people who run the Aboriginal  community controlled health services (ACCHS).

Nobody seemed to have asked if we want to halve the child mortality gap in 10  years and the life expectancy gap in a generation, what services do we need to  achieve those goals?

And nobody seems to have wondered how it was possible to have healthy mothers  and babies and to get on top of chronic diseases without adequate provision for  mental health services.

The limited evidence available clearly shows that ACCHS  run by and for  Aboriginal people eclipse mainstream general practice in the identification of  risk factors, performance of health checks, care planning and the management of  Aboriginal and Torres Strait Islander patients.

So instead of asking  what services would produce the best return on  investment, the decision seems to have been taken to allocate new funds to  perpetuate current patterns of use between mainstream (GP) and ACCHS.

Too many senior officials still cling to the notion that in Australia’s  cities and towns mainstream services are the answer – in the absence of   evidence that  this is so and in the face of evidence that it isn’t. There is a  real risk that mainstreaming will be seen as some kind of solution, when the  reality is that there needs to be sensible arrangements for mainstream and ACCHS  services to work together, as in the Urban Indigenous Health Institute.

While current levels of indigenous health funding go a long way to redressing  the previous shortfall in health expenditure, estimated by health economists at  about $500 million a year, inequities in  the share of mainstream program  funding received by Aboriginal people is still an issue.

So what does this mean for the Mundine review and the new  government? Three  issues stand out.

First, bureaucratic reform is  essential. That means substantially fewer  public servants but those that remain need to have the requisite skills and  experience. There is broad agreement that the main functions of Aboriginal  health should remain with the Department of Health,  preferably led by an  indigenous official, but a small, high-level group in the Department of the  Prime Minister and Cabinet, to ensure the new Prime Minister’s requirement to  deliver for Aboriginal people, is an essential component of the new  arrangements.

Second, the recently formulated National Aboriginal and Torres Strait  Islander Health Plan isn’t really a plan in any meaningful sense but could  become one if the implementation plan foreshadowed in it is developed in genuine  partnership with Aboriginal people and involves officials with the requisite  skills, experience and training. But that implementation plan needs to also  include mental health and,  this time, to wrestle successfully with  mainstreaming.

Third, and most important, there seems to be an increasing recognition that  non-Aboriginal people really can’t make indigenous people healthy.  It is time  for Aboriginal communities to play a more central role in the design and conduct  of their own services, bearing in mind that  some of the best health services in  Australia are run by the ACCHS sector.

If the Mundine review and the Abbott government can successfully address  these issues,  Australia, in the not too distant future,  could complete the  long transition from international opprobrium to leading the world in indigenous  health.

  • Ian Ring is a professorial fellow at the Australian Health Services  Research Institute at the  University of Wollongong.

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NACCHO political health news: Abbott Government creates new Indigenous Health Service Delivery Division to replace OATSIH.

Question Time in the House of Representatives

“Funding responsibility for most Indigenous health services remains in the Health Department, to be coordinated by a new Indigenous Health Service Delivery Division (which replaces OATSIH).”

As previously noted, in both Croakey and NACCHO Aboriginal Health Alerts there has been a deal of uncertainty about the fate of Indigenous health programs and services administered by the Federal Health Department and the Office of Aboriginal and Torres Strait Islander Health (OATSIH) under the new Federal Government.

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Our thanks to Melissa Sweet (CROAKEY) for providing this Information

While no doubt there are still issues to resolve, at last there is some news – some programs will transfer to the Department of Prime Minister and Cabinet, as outlined below.

But funding responsibility for most Indigenous health services remains in the Health Department, to be coordinated by a new Indigenous Health Service Delivery Division (which replaces OATSIH).

No doubt many will be interested in the prediction that the new arrangements will mean less red tape for service providers.

The departmental statement below has been distributed to the major stakeholders.

“A number of stakeholders have been asking how OATSIH is affected by the Machinery of Government (MoG) changes announced by the Prime Minister recently.

The Prime Minister has indicated that Indigenous affairs will be a significant priority for this Government and has decided to bring together many of the Indigenous policies and programmes under his own Department.

The Health Department has now received clarity on the changes and I am able to confirm that the following programmes or functions will move from Health to the Department of Prime Minister and Cabinet:

  •  A number of strategic policy functions including responsibility for the health performance framework, health expenditure analysis, and life expectancy modelling
  • Bringing them Home and Expanding Link-up programmes
  • Combating petrol sniffing–expanding the supply and uptake of low aromatic fuel         Indigenous Drug and Alcohol treatment services (including staff working on these programmes in State and Territory Offices)
  • Stronger Futures NT Mobile Outreach Service Plus
  • National Sorry Day Committee
  • Indigenous Sport and Active Recreation Programme currently managed by the Sport Branch (previously in the Department of Regional Australia, Local Government and Sport).

The funding responsibility for the majority of Indigenous health services remains in the Health department, to be coordinated by a new Indigenous Health Service Delivery Division (which replaces OATSIH).

This decision recognises the importance of the critical links between Indigenous health programmes and mainstream health structures.

While there are a number of structural changes required as part of the movement of policies and programmes to PM&C, the key priority for Government is to continue to deliver uninterrupted services to Indigenous people. 

It will be business as usual with service providers and funding arrangements during this transition period from both the Health Department and PM&C.

The consolidation of policies and programmes into PM&C will provide significant opportunities, including reducing the red tape burden on service providers.”

Croakey and NACCHO will be interested to hear your response to these changes.

Please leave comments below.

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NACCHO Aboriginal health news alert: Confusion still surrounds future of Aboriginal health in new government structure

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“A spokesman for Prime Minister Tony Abbott told AAP indigenous health would be the responsibility of Indigenous Affairs Minister Nigel Scullion and indigenous health programs would fall under the department of PM&C.”

Lisa Martin AAP News  (full report below) Picture above Senator Nigel Scullion and Warren Mundine at the recent  Garma Festival

Confusion still surrounds the future department /minister responsible for Aboriginal health under the new Abbott government  sworn in yesterday (18 September 2013)

In an interview with NITV the new Minister for Aboriginal Affairs Senator Nigel Scullion responded to NITV concerns about the  Indigenous Health portfolio by confirming that Senator Fiona Nash will be responsible for Aboriginal Health as the new Minister for Rural Health under Peter Dutton the new Minister for Health.

But Senator Scullion told NITV National News he would work closely with Senator Fiona Nash – who has the assistant health portfolio.

There is a minister for rural health, or a deputy minister, an assistant minister for health and that’s Senator Fiona Nash. I’ll work very closely with Senator Nash.. she’s one of my colleagues in the Senate, she’s going to make an excellent minister.

“Clearly in terms of many of the demographics in need of health, in regional and remote areas, certainly in those areas will come under her commute, so it hasn’t been abandoned it’s just simply been placed in another area.

“…We are going to have a very very good focus and a fresh focus on Indigenous health.”

In the interview the Senator praised NACCHO member  Aboriginal community controlled health organisations as “Top of the BOX” second to none as well run organisations not only in the Aboriginal context but in the national context.

VIEW NITV Nigel Scullion Interview here on NACCHO TV

However AAP news service today is reporting (see full report below) that spokesman for Prime Minister Tony Abbott told AAP indigenous health would be the responsibility of Indigenous Affairs Minister Nigel Scullion and indigenous health programs would fall under the department of PM&C.

In an interview with NITV last night the Chair of NACCHO Justin Mohamed welcomed the opportunity to work with all ministers and advisors in the new Abbott government to discuss investment in Healthy futures for generational change.

VIEW NITV interview with Justin Mohamed here on NACCHO TV

An official NACCHO response to the new ABBOTT government’s allocation of Indigenous Health will be available in the next few days when the position becomes clearer.

FULL AAP REPORT

AUSTRALIA’S former indigenous health minister is concerned Prime Minister Tony Abbott has not retained the position in his ministry and warned it may affect progress on closing the gap.

Northern Territory Labor MP Warren Snowdon, who was the first indigenous health minister from 2009 until Labor lost power, is concerned about whether Aboriginal health is actually a priority for the incoming government.

Prime Minister Tony Abbott has flagged he will move indigenous affairs under the umbrella of the Department of Prime Minister and Cabinet (PM&C).

But in administrative arrangements released on Wednesday there is no specific reference to indigenous health in either PM&C, the department of health or ministerial responsibilities.

A spokesman for Prime Minister Tony Abbott told AAP indigenous health would be the responsibility of Indigenous Affairs Minister Nigel Scullion and indigenous health programs would fall under the department of PM&C.

Asked if the absence of a specific minister could negatively impact efforts to achieve the close the gap targets and improve life expectancy, Mr Snowdon told AAP: “I think it is a problem.”

The life expectancy gap between indigenous and non-indigenous Australians is 11.5 years for men and 9.7 years for women.

This year’s report card on it said efforts to close the gap on life expectancy by 2031 were falling behind.

Mr Snowdon, who released Australia’s first national indigenous health plan in July, says he is concerned about the Abbott government’s commitment to it.

The coalition dismissed it as an exercise in political spin and lacking substance when it was released.

Mr Snowdon is also worried about progress on negotiations for a new national partnership agreement between states and territories on indigenous health.

The previous agreement expired in June and had $1.57 billion in combined federal and state funding.

Labor committed $777 million until 2016 in the May budget towards the national partnership agreement, but so far only Victoria has offered money.