NACCHO political alert: Commission of Audit: Aboriginal health would suffer


Aboriginal and Torres Strait Islander people should be exempt from any health co-payments to prevent any backward steps in Aboriginal health, said the National Aboriginal Community Controlled Health Organisation (NACCHO) today.

NACCHO Chair Justin Mohamed said the introduction of co-payments for basic health care such as GP visits and medicines, as recommended by the Commission of Audit, would increase barriers for many Aboriginal people to look after their own health.

“Improving Aboriginal and Torres Strait Islander health remains one of Australia’s biggest challenges,” Mr Mohamed said.

“Increasing barriers to Aboriginal and Torres Strait Islander people seeking appropriate health care will only increase this challenge.

“We need initiatives that will encourage Aboriginal people to seek medical attention and seek it early, not make it even harder for them to get the care they need.”

Mr Mohamed said Aboriginal and Torres Strait Islanders often had a range of complex health issues so even a low co-payment charge could make health care unaffordable for many.

“For people who only visit their GP once a year a small co-payment is likely to be manageable,” Mr Mohamed said.

“However for Aboriginal and Torres Strait Islander people with more complex health needs even a $5 charge for each visit would add up very quickly.

“A large Aboriginal family could be out of pocket hundreds of dollars after just a few GP visits.

“This would put basic health care out of reach and be detrimental to the health of many Aboriginal people.

“I urge the government to carefully consider the implications before implementing this recommendation and to ensure any decision is not going to mean a backward step for the health of Aboriginal people.”

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

NACCHO0032 Press Club Brochure Concept2__190314_Page_1

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)


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.


NACCHO 2014 Summit news: Partnership opportunities to sponsor NACCHO SUMMIT open today


Why you should be considering

The 2014 NACCHO Healthy Futures Summit

for sponsorship and exhibition opportunities

The NACCHO 2014 Summit in June at the Melbourne Convention Centre offers an unparalleled opportunity for you to build relationships with NACCHO, our affiliates, stakeholders, government and our 150 Aboriginal community controlled health organisations that are committed to improving Aboriginal health and Closing the Gap by 2030.

The theme this year is:
“Investing in Aboriginal community controlled health makes economic sense.” After reading this newsletter and obtaining our Summit Partnership and Exhibition Opportunities prospectus, we think you will agree that a sponsorship investment in the NACCHO 2014 Health Summit “makes economic sense”.

Delegates at the Summit will be looking for partnerships, products and services that will help them improve delivery of comprehensive primary health care for their patients and communities and the overall cost efficiency of their service finance and administrative delivery.
Become a sponsor and take advantage of the many excellent sponsorship and exhibition opportunities that are available to promote your organisation at Australia’s most prestigious and well-attended Aboriginal health conference.

What you will achieve by sponsoring and exhibiting?

Achieve profile and brand enhancement through your association with, and support for Australia’s national authority in comprehensive Aboriginal primary health care.

Your involvement in, and contribution to the NACCHO 2014 Summit will help you meet your business objectives:

  • Network and exchange knowledge to better identify community wants and needs
  • Identify prospective health sector supply and partnership opportunities
  • Promote how your product or service will enhance the delivery of a sustainable Australian Aboriginal health sector
  • Support Australia’s Aboriginal health capabilities by providing insightful, relevant and practical information to your clientele about your brand values and attributes
  • Build community relationships and increase your company networks within the Australian Aboriginal health sector
  • Increase sales through direct promotion of your business
  • Promote your staff, products and services among the Aboriginal  health businesses and service industries

NACCHO 2014 SUMMIT Objectives

NETWORK with the movers and shakers of the Aboriginal health sector

LEARN about the latest research and developments in Aboriginal health

SHARE experiences and ideas with forward thinkers

MEET with clinicians, researchers, industry innovators and others who share the desire to deliver better health to all
BENEFITS OF PARTNERSHIP NACCHO Member Services and state territory Affiliates will be attending the Summit so this is a perfect opportunity to interact with delegates first hand.
It is a unique opportunity for government, non-government organisations, and private industry to promote their products and services to NACCHO member services from all over Australia.


To obtain a copy of the NACCHO SUMMIT 2014 SPONSORS PROSPECTUS call NACCHO now or complete enquiry form here – See more at:


Only ONE available (Price on application)

This is the premier opportunity for your organisation to become the major sponsor of the National Aboriginal Community Controlled Health Organisation’s (NACCHO) 2014 Healthy Futures Summit. Your organisation will have an exclusive profile for the period leading up to the Summit and at the event, with your organisation’s logo displayed in conjunction with the Summit logo.

  • One complimentary exhibition stand (3m x 3m) in your preferred position from the spaces available.
  • The chance to prominently display your corporate banner (to be provided by your organisation) in the main plenary room during the Summit.
  • Your organization’s name/logo will be displayed in conjunction with the Summit logo in a prominent position at the Summit to ensure maximum exposure.
  • As well as the following acknowledgement; “The NACCHO2014 Healthy Futures Summit  is proudly supported by our Platinum Sponsor (your Company Name/logo Displayed Here)”.
  • Acknowledgement as Platinum Sponsor in publicity associated with the Summit marketing.
  • Your organisations logo will be prominently featured on a range of print materials (excluding pads, pens, name badges, lanyards and satchels).
  • Acknowledgement as the Platinum Sponsor of the Summit on the website with a short organisational profile and a link to your organization’s website.
  • Your logo will be displayed on the cover of the Summit program as the principle sponsor of the summit.
  • Your logo will be displayed on the Summit name badges as the principle sponsor of the summit.
  • An opportunity to address the Summit in plenary sessions.
  • The opportunity to include a suitable promotional item or a piece of literature (one flyer or brochure) in the Summit satchel.
  • Your organisation will receive two complimentary satchels with all the Summit information and materials.
  • Three complimentary full  Summit delegate registrations,
  • You will also receive an additional two complimentary to the Welcome Event and Dinner with a reserved table.
  • Your organisation will have access to SUMMIT delegate information


Only ONE available (price on application) This is an opportunity for your organisation to become the Gold Sponsor of the NACCHO’s 2013 Summit. Your organisation will have a high exposure for the period leading up to the event, with your organisation’s name and logo displayed in conjunction with the Summit logo.


$ 3,520 Inc. GST

You will have the opportunity to offer your products and services to the entire delegation as well as all of the summit break hospitality will be held in the exhibition area. Delegates will also be encouraged to visit all stands if the Expo passport sponsorship is taken up.

SPACES ARE LIMITED AND SELL FAST (as at 9 March only 24 left)


This is an opportunity not to be missed, become one of two Silver Platypus and Bandicoot Passport Sponsors of the NACCHO2014 Healthy Futures Summit. Each delegate will be given your passport at the beginning of the Summit and, if they visit of the booths and have their passport stamped they are eligible to win one of several major prizes drawn at the end of the Summit.

Only Three Available Become the Morning & Afternoon Break Sponsor for a day at the NACCHO 2014 Summit

Only THREE Available Become the Lunch Sponsor of the NACCHO 2014 Summit for a day.

Only ONE Available

Get your business logo mobile, as this sponsorship option allows your organisation to become the Satchel Sponsor. These quality satchels will be handed to all delegates and exhibitors at the Summit.

Only One Available

Take a firm grasp of this marketing opportunity. Become the pads & pens Sponsor at the NACCHO 2014 Summit.
ADVERTISING in Summit handbook

For an additional cost you can have an advertisement printed in the Summit Handbook

. FULL PAGE ADVERTISEMENT                   $ 700 + GST

HALF PAGE ADVERTISEMENT                   $ 500 + GST (must be landscape)

QUARTER PAGE ADVERTISEMENT           $ 400 + GST (must be portrait)

All advertisements will be printed in colour and must be according to your specifications.
For further information and pricing contact:

Josh Quarmby NACCHO SUMMIT TEAM Partnership:

Contact: 02 6246 9345

or email

Or for more information complete the enquiry form HERE

NACCHO Aboriginal Health : Senator Nova Peris pushes campaign on alcohol-related domestic violence

2014-03-04 10.52.05

Senator Peris said in the Northern Territory an indigenous woman is 80 times more likely to be hospitalised for assault than other Territorians.

“I shudder inside whenever I quote that fact because it makes me picture the battered and bloodied women we see far too often in our hospitals.

“Every single night our emergency departments in the Northern Territory overflow with women who have been bashed.”

Picture above :Senator Nova Peris along with Opposition colleagues  addressing the NACCHO board at Parliament House Canberra this week

LABOR’S first indigenous MP Nova Peris has challenged the Australian Medical Association to advocate for more action in tackling alcohol-related domestic violence.

In a powerful speech, Senator Peris said alcohol-related domestic violence was on the rise and ruining the lives of Aboriginal women.

She told the launch of the AMA’s national women’s health policy that the AMA must use its high standing in the community to “advocate for more action in tackling alcohol-related domestic violence”.

Report from PATRICIA KARVELAS   The Australian

SEE AMA Position Statement on Women’s Health below

“Today I call on the AMA to formally adopt a policy position that supports the principle that people who have committed alcohol-related domestic violence be banned from purchasing alcohol at the point of sale.

“The technology to implement point-of-sale bans exists; it is cost effective and has been proven to work.”

Senator Peris said in the Northern Territory an indigenous woman is 80 times more likely to be hospitalised for assault than other Territorians.

“I shudder inside whenever I quote that fact because it makes me picture the battered and bloodied women we see far too often in our hospitals.

“Every single night our emergency departments in the Northern Territory overflow with women who have been bashed.”

In 2013, domestic violence assaults increased in the Northern Territory by 22 per cent, she said.

She criticised the incoming NT government’s August 2012 decision to scrapped the banned drinker register.

“For those of you who may not be familiar with the banned drinker register, or BDR as it is also known, it was an electronic identification system which was rolled out across the Northern Territory.

“This system prevented anyone with court-ordered bans from purchasing takeaway alcohol — including people with a history of domestic violence.

“Around twenty-five hundred people were on the banned drinker register when it was scrapped. “Domestic violence perpetrators were again free to buy as much alcohol as they liked. As predicted by police, lawyers and doctors, domestic violence rates soared.”

Senator Peris said she had met with doctors, nurses and staff from the emergency department in Alice Springs and they confirmed these statistics represent the true predicament they faced every day.

“Every night the place is awash with the victims of alcohol fuelled violence, with the vast majority of victims being women.”

She said the Northern Territory faces enormous issues with foetal alcohol spectrum disorder.

“We have such high rates of sexually transmitted infections, especially and tragically, with children.

“Rates of smoking are far too high, and diets are poor and heart disease is widespread.”

Senator Peris’s speech was well received by the AMA, which committed to taking on her challenge.


AMA Position Statement on Women’s Health 2014

The AMA today released the updated AMA Position Statement on Women’s Health.

The Position Statement was launched at Parliament House in Canberra by the Minister Assisting the Prime Minister for Women, Senator Michaelia Cash, Senator for the Northern Territory, Nova Peris, and AMA President, Dr Steve Hambleton.

Dr Hambleton said that all women have the right to the highest attainable standard of physical and mental health.

“The AMA has always placed a high priority on women’s health, and this is reflected in the breadth and diversity of our Position Statement,” Dr Hambleton said.

“We examine biological, social and cultural factors, along with socioeconomic circumstances and other determinants of health, exposure to health risks, access to health information and health services, and health outcomes.

“And we shine a light on contemporary and controversial issues in women’s health.

“There is a focus on violence against women, including through domestic and family violence and sexual assault.

“These are significant public health issues that have serious and long-lasting detrimental consequences for women’s health.

“It is estimated that more than half of Australian women have experienced some form of physical or sexual violence in their lifetimes.

“The AMA wants all Australian governments to work together on a coordinated, effective, and appropriately resourced national approach to prevent violence against women.

“We need a system that provides accessible health service pathways and support for women and their families who become victims of violence.

“It is vital that the National Plan to Reduce Violence against Women and their Children is implemented and adequately funded.”

Dr Hambleton said the updated AMA Position Statement also highlights areas of women’s health that are seriously under-addressed.

“This includes improving the health outcomes for disadvantaged groups of women, including Aboriginal and Torres Strait Islander women, rural women, single mothers, and women from refugee and culturally and linguistically diverse backgrounds,” Dr Hambleton said.

“We also highlight the unique health issues experienced by lesbian and bisexual women in the community.”

Dr Hambleton said that the AMA recognises the important work of Australian governments over many years to raise the national importance of women’s health, including the National Women’s Health Policy.

“There has been ground-breaking policy in recent decades, but much more needs to be done if we are to achieve high quality equitable health care that serves the diverse needs of Australian women,” Dr Hambleton said.

“Although women as a group have a higher life expectancy than men, they experience a higher burden of chronic disease and tend to live more years with a disability.

“Because they tend to live longer than men, women represent a growing proportion of older people, and the corresponding growth in chronic disease and disability has implications for health policy planning and service demand.”

The Position Statement contains AMA recommendations about the need to factor in gender considerations and the needs of women across a range of areas in health, including:

  •  health promotion, disease prevention and early intervention;
  •  sexual and reproductive health;
  •  chronic disease management and the ageing process;
  •  mental health and suicide;
  •  inequities between different sub-populations of Australian women, and their different needs;
  •  health services and workforce; and
  •  health research, data collection and program evaluation.


  • cardiovascular disease – including heart attack, stroke, and other heart and blood vessel diseases – is the leading cause of death in women;
  •  for women under 34 years of age, suicide is the leading cause of death; and
  • in general, women report more episodes of ill health, consult medical practitioners and other health professionals more frequently, and take medication more often than men.

The AMA Position Statement on Women’s Health 2014 is at

NT alcohol crackdown makes gains, but questions over mandatory rehabilitation remain

By Michael Coggan NT ABC

It appears that stationing police officers outside bottle shops in regional towns in the Northern Territory has had a significant impact on alcohol consumption.

The latest figures show consumption has dropped to the lowest level on record, but the statistics do not include the impact of the mandatory rehabilitation policy or punitive protection orders.

The ABC has investigated the situation as a new federal parliamentary inquiry is promising to test the evidence.

On a weeknight in Darwin’s city centre, locals and tourists mingle at Monsoons, one of the pub precinct’s busy watering holes.

Less than a block away, six women have found their own drinking place under the entrance of an office building, sheltered from monsoonal rain.

Most of them are visiting from Indigenous communities on Groote Eylandt in the Gulf of Carpentaria. They’re “long-grassing” – living rough on the city streets.

Northern Territory Labor Senator Nova Peris is here to talk to them.

One of the women, from the Torres Strait Islands, tells the Senator how she is trying to get through a catering course while struggling with homelessness and alcoholism.

“I am doing it. I’m trying to get up and I’m finding it hard,” she said.

In an interview after talking to the “long-grassers”, Senator Peris emphasised how homelessness makes alcohol abuse among Aboriginal people more obvious than alcohol use in the non-Indigenous community in Darwin.

“Those ladies, they weren’t from Darwin, they were from communities that came in, so they’re homeless and they drink when they come into town and it’s easy to get alcohol [in town].”

Senator Peris also blames alcohol abuse for much of the poor health in Aboriginal communities.

“When you look at alcohol-related violence, when you look at foetal alcohol syndrome, when you look at all the chronic diseases, it goes back to the one thing and it’s commonly known as the ‘white man’s poison’,” she said.

Alcohol-related hospital admissions increase, senator says

The Northern Territory has long grappled with the highest levels of alcohol abuse in the country, but figures released recently by the Northern Territory Government show the estimated per capita consumption of pure alcohol dropped below 13 litres last financial year for the first time since records started in the 1990s.

Territory Country Liberals Chief Minister Adam Giles believes a more targeted response by police has made a difference.

But Senator Peris says data released last week tells a different story.

Senator Peris has quoted figures showing an 80 per cent increase in alcohol-related hospital admissions over the past 14 months as evidence that the previous Labor government’s banned drinker register was working.

The Territory Government scrapped the BDR when it won power in September 2012.

Alice Springs-based associate professor John Boffa from the Peoples Alcohol Action Coalition wants to see the consumption figures verified.

“If it’s true, it’s very welcome news and it would reflect the success of the police presence on all of the takeaway outlets across the territory,” he said.

Parties, police association at odds

In regional towns where alcohol-fuelled violence is high, police have been stationed outside bottle shops to check identification.

Anyone living in one of the many Aboriginal communities or town camps where drinking is banned faces the prospect of having their takeaway alcohol seized and tipped out.

Northern Territory Police Association president Vince Kelly believes police resources are being concentrated on doing the alcohol industry’s work.

Mr Kelly has also questioned the will of the two major political parties to introduce long-term alcohol supply reduction measures since it was revealed that the Australian Hotels Association made $150,000 donations in the lead-up to the last Territory election.

“No-one I know gives away $150,000 to someone and doesn’t expect something back in return,” he said.

But Mr Giles dismisses Mr Kelly’s view.

“I don’t respond to any comment by Vince Kelly from the Police Association, I think that he plays politics rather than trying to provide a positive outcome to change people’s lives in the territory,” he said.

Giles stands by alcohol rehab program

The Federal Indigenous Affairs Minister has asked a parliamentary committee to investigate the harmful use of alcohol in Indigenous communities across the country.

The committee is expected to examine the application of new policies in the Territory, including mandatory alcohol treatment that was introduced in July 2013.

People taken into police protective custody more than three times in two months can be ordered to go through a mandatory three-month alcohol rehabilitation program.

The figures showing a drop in consumption pre-date the introduction of mandatory rehabilitation but Mr Giles believes the policy is making a difference.

So far there is not enough evidence to convince Professor Boffa that mandatory treatment is making any difference.

“We just don’t have publically available data on the numbers of people who have completed treatment, [or] how long people who have completed treatment have remained off alcohol,” he said.

One of the women from Groote Eylandt explained how she had been locked up to go through the mandatory treatment program but was now back on the grog.

“I was there for three months and we didn’t like it,” he said.

The Chief Minister’s political stablemate, Indigenous Affairs Minister Nigel Scullion, has commended the Territory Government for using a mix of police intervention and mandatory rehabilitation, but says jail is not the solution.

“We can’t keep treating people who are sick as criminals. However annoying they might be, people who are alcoholics are ill,” he said.

Alcohol Protection Orders seen to criminalise alcoholism

Police were given the power to issue Alcohol Protection Orders to anyone arrested for an alcohol-related offence, attracting a jail sentence of six months or more.

Aboriginal legal aid services have criticised the orders for criminalising alcoholism.

Priscilla Collins from the North Australian Aboriginal Justice Agency says the orders are predominantly being handed out to Aboriginal people, threatening jail time if they are breached.

“Alcohol protection orders are really being issued out like lolly paper out on the streets. You can be issued one just for drinking on the street, for drink driving. We’ve already had 500 handed out this year,” she said.

Mr Kelly has welcomed the introduction of APOs as a useful tool but has questioned what they will achieve.

“The community and the Government and everybody else needs to ask itself what the end game is,” he said.

“Are we going to end up with even fuller jails? No matter what legislation we introduce we’re not going to arrest our way out of alcohol abuse and Aboriginal disadvantage in the Northern Territory.”

Do you know more? Email




You can hear more about Aboriginal women’s health  at the NACCHO SUMMIT


The importance of our NACCHO member Aboriginal community controlled health services (ACCHS) is not fully recognised by governments.

The economic benefits of ACCHS has not been recognised at all.

We provide employment, income and a range of broader community benefits that mainstream health services and mainstream labour markets do not. ACCHS need more financial support from government, to provide not only quality health and wellbeing services to communities, but jobs, income and broader community economic benefits.

A good way of demonstrating how economically valuable ACCHS are is to showcase our success at a national summit.




NACCHO Aboriginal Health :The high cost of healthy eating in remote communities


I feel strongly that we should as a nation have some kind of way of giving people in remote parts ccess to fresh food at capital city supermarket prices. It wouldn’t cost us much in relative terms,”

“We give a huge diesel fuel rebate to mining companies and yet we don’t invest in the health of people, particularly children.”

She advocates a junk food tax to reduce the cost of fresh food and encouraging more locally produced food

University of SA Professor Kerin O’Dea

The Ngaanyatjarra Health Service (NACCHO member) provides health care to 2300 people living in a dozen communities across the Great Victorian and Gibson Deserts of central WA.

Chief executive Brett Cowling said the burden of chronic disease was “huge” and still growing in many remote areas.

But he said the problem was being tackled, and in some cases reversed, by the communities themselves

PICTURE ABOVE : Foodbank WA runs breakfast programs in more than 400 schools across the state, providing shelf-stable food and working with communities to make positive health behaviour changes.

WOULD you pay about $9 for six mushrooms  at your  supermarket in Perth? Or a similar amount for a piece of broccoli?

Probably not – but this is what people living in some of the most remote parts of WA are being asked to fork out for fresh produce.

The cost of fruit and vegetables in some of the state’s indigenous communities can be as much as three to four times that of supermarkets in Perth.

It is a cited as one of the reasons for the high rate of chronic health problems, including obesity, diabetes and renal failure, in Aboriginal communities.

As Published NEWS LTD


Aboriginal people and diabetes

– Aboriginal and Torres Strait Islander Australians have the fourth highest rate of type 2 diabetes in the world.

– It is estimated 10-30 per cent of Indigenous Australians may have the condition, but many are undiagnosed.

– Rates are between three and five times higher compared to non-Indigenous people in all age groups over 25 years.

– 39 per cent of the Aboriginal population over the age of 55 has diabetes.

– Deaths from diabetes were seven times more common for Indigenous people than for non-Indigenous people between 2006 and 2010.

– Hospitalisations for kidney complications among Indigenous people are 29 times higher than for other Australians.

Source: Diabetes WA

University of South Australia researcher Kerin O’Dea wants nutritious food to be subsidised and for doctors in remote areas to prescribe food like medicines.

University of SA Professor Kerin O'Dea.

University of SA Professor Kerin O’Dea. Source: News Limited

“I feel strongly that we should as a nation have some kind of way of giving people in remote parts ccess to fresh food at capital city supermarket prices. It wouldn’t cost us much in relative terms,” she said.

“We give a huge diesel fuel rebate to mining companies and yet we don’t invest in the health of people, particularly children.”

She advocates a junk food tax to reduce the cost of fresh food and encouraging more locally produced food.

The idea of subsidising fresh fruit and vegetables was supported by Winthrop Professor Jill Milroy of the Poche Centre for indigenous Health at the University of Western Australia.

“Getting good, healthy food is really important and it needs to be addressed. It probably has to be subsidies because there is a lot of cost factors in getting food up there,” she said.

Department of Health nutrition policy adviser Dr Christina Pollard said the cost of healthy food was up to 29 per cent higher in rural areas compared to capital cities.

Welfare recipients also need to spend 50 per cent of their disposable income to achieve a healthy diet compared with 15 per cent nationally, the author of the Department’s Food Access and Cost Survey said.

“To get the food there, to keep it fresh and of good quality costs a lot more,” the adjunct researcher at Curtin University said.

“Food in general is more expensive, but healthy food is disproportionately expensive, particularly things like fruit and vegetables which need to be transported under refrigeration and don’t have a long shelf life.”

The Ngaanyatjarra Health Service provides health care to 2300 people living in a dozen communities across the Great Victorian and Gibson Deserts of central WA.

Chief executive Brett Cowling said the burden of chronic disease was “huge” and still growing in many remote areas.

But he said the problem was being tackled, and in some cases reversed, by the communities themselves.

At community-owned stores the price of fresh food is being kept low by not applying transport costs and in some areas full-strength soft drinks have been pulled from the shelves.

“Subsidies are  being discussed, and are an option, but I have seen the same results through good community governance and where the community have worked towards that outcome themselves,” he said.

“That always has to be best possible solution.”

Outback Stores was established six years ago to ensure food security in remote communities and today manages 10 community-owned shops in Western Australia.

Chief executive Steve Moore said by keeping the cost of fresh food low consumption of fruit and vegetables was up 13 per cent compared to last year.

The sale of water bottles has also more than doubled since the firm did a deal with Coca-Cola Amatil to sell 600ml bottles of its Mount Franklin water for $1.

“I don’t believe a subsidy or a tax will solve the problem,” he said. “We are making ground, but it’s small steps. It’s time and education  that  will make the difference.

“People are more aware of what they should and shouldn’t consume. Restricting products has never worked because people will just travel to get it.”

Foodbank WA runs breakfast programs in more than 400 schools across the state, providing shelf-stable food and working with communities to make positive health behaviour changes.

As well as getting around the high costs by supplying frozen and tinned produce, Foodbank encourages residents of remote communities to use bushtucker.

“Traditional methods are important and it’s important culturally to keep those going,” Stephanie Godrich, Foodbank WA regional strategy co-ordinator, said.

“We need to acknowledge that Aboriginal people have a lot to offer us.”


What is in a 600ml bottle of cola?

65.4 grams of sugar – The equivilant of 16 teaspoons

1044 kilojoules (100 per cent of energy comes from sugar)

How much sugar is in your favourite drink?

600ml Cola

– 16 teaspoons of sugar

600ml Iced Coffee Chill

– 14 teaspoons of sugar

600ml Orange juice

– 16 teaspoons of sugar

600ml Choc Chill

– 13 teaspoons of sugar

600ml Powerade

– 11 teaspoons of sugar

375ml Cola

– 10 teaspoons of sugar

350ml Apple juice

– Nine teaspoons of sugar

375ml Lemonade

– Eight teaspoons of sugar

500ml Lemon Ice Tea

– Eight teaspoons of sugar

250ml Red Bull

– Seven teaspoons of sugar

300ml V8 Juice

– Six teaspoons of sugar

500ml Vitamin Water

– Five teaspoons of sugar

300ml fresh cow’s milk

– Four teaspoons of sugar



NACCHO health political alert : Minister Dutton tells NACCHO board he awaits audit to decide the future of the health system.


Health Minister Peter Dutton and Indigenous Health Minister Senator Fiona Nash  (pictured above meeting with the NACCHO Board at Parliament House  Canberra yesterday) told the NACCHO board they are awaiting the findings of the budget Commission of Audit, along with reviews of Medicare Locals and electronic health records, to decide the future of the health system.

Mr Dutton declared the system to be “riddled with inefficiency and waste” and foreshadowed changes to Medicare, with private health insurers likely to play a greater role and wealthy Australians asked to pay more for their care.

NACCHO will be reporting further outcomes from this meeting in the next 24 hours

Meanwhile in the Australian it is reported Treasury officials are working on a formula to determine whether health spending is sustainable

Tackling avoidable cost has to be at the heart of how the hospital system works : Sean Parnell From: The Australian

PUBLIC hospitals are wasting up to $1 billion a year and should be held to account for inefficient and substandard medical care, the Grattan Institute has warned.

In a report released last night, the think tank headed by long-time reform advocate Stephen Duckett has called for activity-based funding to be accompanied by measures that would reduce costs and rein in health inflation.

The institute’s report calls for states to exclude abnormally high costs from activity-based funding calculations to ensure the new average prices “drive hospital costs down towards achievable benchmarks”.

“But the reform won’t work on its own, the report concludes. “Tackling avoidable cost has to be at the heart of how the whole system works.

“Hospitals need data showing how much of their spending is avoidable and where that spending is concentrated.”

Last year, health fund Bupa and private hospital operator Healthscope entered into an Australian-first, quality-based funding system.

Under the arrangements Healthscope forgoes payment from the insurer if it makes a serious mistake treating any of its 3.5 million members, with reward payments likely to be considered in future for above-standard care.

Mr Dutton at the time welcomed the arrangements and said he expected providers to be more transparent and release data on avoidable costs.

“If we can bring that pressure to bear on both the public and private systems, we will end up with better health outcomes,” he said last October.

Mr Dutton has not taken the issue further and the so-called “budget emergency” has put any intergovernmental health reform talks on hold.

Treasury officials are working on a formula to determine whether health spending is sustainable.

NACCHO Chair JUSTIN MOHAMED will be telling the  Coalition Government at the NACCHO SUMMT  Investing in Aboriginal Community Controlled Health makes economic sense


The importance of our NACCHO member Aboriginal community controlled health services (ACCHS) is not fully recognised by governments.

The economic benefits of ACCHS has not been recognised at all.

We provide employment, income and a range of broader community benefits that mainstream health services and mainstream labour markets do not. ACCHS need more financial support from government, to provide not only quality health and wellbeing services to communities, but jobs, income and broader community economic benefits.

A good way of demonstrating how economically valuable ACCHS are is to showcase our success at a national summit.



NACCHO Aboriginal health and racism : What are the impacts of racism on Aboriginal health ?


“On an individual level, exposure to racism is associated with psychological distress, depression, poor quality of life, and substance misuse, all of which contribute significantly to the overall ill-health experienced by Aboriginal and Torres Strait Islander people.

Prolonged experience of stress can also have physical health effects, such as on the immune, endocrine and cardiovascular systems.”

Pat Anderson is chairwoman of the Lowitja Institute, Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research (and a former chair of NACCHO) see her opinion article below

“If you (Indigenous patient) go to a health service and you’re made to feel unwelcome, or uncomfortable or not deserving or prejudged and there are lots of scenarios of Aboriginal people being considered to be perhaps being seriously intoxicated when in fact they’ve been seriously ill.”

Romlie Mokak CEO Australian Indigenous Doctors Association


Read over 100 Aboriginal Health and Racism articles pubished over past 6 years by NACCHO 


images IOce

It’s well known that Indigenous Australians have much lower life expectancy than other Australians, and have disproportionately high rates of diseases and other health problems.

Could that in part be due to racism?

Would cultural awareness training for health professionals would reduce the incidence of racism ?

Should governments acknowledge and address the impact of factors such as racism on health outcomes?

These are some of the question being asked in the health and community sectors, amid reports of a rise in racist incidents.

How racism affects health

The impact of racism on the health of Aboriginal and Torres Strait Islander people can be seen in:

  •   inequitable and reduced access to the resources required for health (employment, education, housing, medical care, etc)
  •   inequitable exposure to risk factors associated with ill-health (junk food, toxic substances, dangerous goods)
  •   stress and negative emotional/cognitive reactions which have negative impacts on mental health as well as affecting the immune, endocrine, cardiovascular and other physiological systems
  •  engagement in unhealthy activities (smoking, alcohol and drug use)
  •  disengagement from healthy activities (sleep, exercise, taking medications)
  •  physical injury via racially motivated assault


World news radio Santilla Chingaipe recently interviewed a number of health organisations

It’s well known that Indigenous Australians have much lower life expectancy than other Australians, and have disproportionately high rates of diseases and other health problems.

Could that in part be due to racism?

The Social Determinants of Health Alliance is a group of Australian health, social services and public policy organisations.

It lobbies for action to reduce inequalities in the outcomes from health service delivery.

Chair of the Alliance, Martin Laverty, has no doubt racism sometimes comes into play when Indigenous Australians seek medical attention.

“When an Indigenous person is admitted to hospital, they face twice the risk of death through a coronary event than a non-Indigenous person and concerningly, Indigenous people when having a coronary event in hospital are 40 percent less likely to receive a stent* or a coronary angiplasty. The reason for this is that good intentions, institutional racism is resulting in Indigenous people not always receiving the care that they need from Australia’s hospital system.”

Romlie Mokak is the chief executive of the Australian Indigenous Doctors’ Association.

Mr Mokak says the burden of ill health is already greater amongst Indigenous people – but this isn’t recognised when they go to access health services.

“Whereas Aboriginal people may present to hospitals often later and sicker, the sort of treatment they might get once in hospital, is not necessarily reflect that higher level of ill health. We’ve got to ask some questions there and why is it that the sickest people are not necessary getting the equitable access to healthcare.”

Mr Mokak says many Indigenous people are victims of prejudice when seeking medical services.

“If you (Indigenous patient) go to a health service and you’re made to feel unwelcome, or uncomfortable or not deserving or prejudged and there are lots of scenarios of Aboriginal people being considered to be perhaps being seriously intoxicated when in fact they’ve been seriously ill.”

But Romlie Mokak from the Australian Indigenous Doctors Association says the onus shouldn’t be on the federal government alone to improve the situation.

He suggests cultural awareness training for health professionals would reduce the incidence of racism.

“Not only is it at the point of the practitioner, but it’s the point of the institution that Aboriginal people must feel that they are in a safe environment. In order to do this, it’s not simply that Aboriginal people should feel resilient and be able to survive these wider systems, but those services really need to have staff that have a strong understanding of Aboriginal people’s culture, history, lived experience and the sorts of health concerns they might have and ways of working competently with Aboriginal people.”

Martin Laverty says at a recent conference, data was presented suggesting an increase in the number of Australians experiencing racism.

And he says one of the results is an increase in psychological illnesses.

“We saw evidence that said about 10 percent of the Australian population in 2004 was reporting regular occurences of individual acts of racism and that that has now double to being close to 20 percent of the Australian population reporting regular occurences of racism. We then saw evidence that the consequences of this are increased psychological illnesses. Psychological illnesses tied directly to a person’s exposure to racism and discrimination and that this is having direct cost impacts of the Australian mental health and broader acute health system.”

Mr Laverty says it’s time governments acknowledged and addressed the impact of factors such as racism on health outcomes.

He says a good start would be to implement the findings of a Senate inquiry into the social determinants of health, released last year.

“In the country of the fair go, we should be seeing Australian governments, Australian communities acting and indentifying these triggers of racism that are causing ill health and recognising that this is not just something the health system that needs to respond to, but the Australian government can respond by implementing the Senate inquiry of March 2013 that outlines the set of steps that can be taken to overcome these detriments of poor social determinants of health.”

Racism a driver of Aboriginal ill health


On an individual level, exposure to racism is associated with psychological distress, depression, poor quality of life, and substance misuse, all of which contribute significantly to the overall ill-health experienced by Aboriginal and Torres Strait Islander people. Prolonged experience of stress can also have physical health effects, such as on the immune, endocrine and cardiovascular systems.

Pat Anderson is chairwoman of the Lowitja Institute, Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research (and a former chair of NACCHO)

As published in The Australian OPINION originally published in NACCHO July 2013

 In July 2013, the former federal government launched its new National Aboriginal and Torres Strait Islander Health Plan.

As with all such plans, much depends on how it is implemented. With the details of how it is to be turned into meaningful action yet to be worked out, many Aboriginal and Torres Strait Islander people, communities and organisations and others will be reserving their judgment.

Nevertheless, there is one area in which this plan breaks new ground, and that is its identification of racism as a key driver of ill-health.

This may be surprising to many Australians. The common perception seems to be that racism directed towards Aboriginal and Torres Strait Islander people is regrettable, but that such incidents are isolated, trivial and essentially harmless.

Such views were commonly expressed, for example, following the racial abuse of Sydney Swans footballer Adam Goodes earlier this year.

However, the new health plan has got it right on this point, and it is worth looking in more detail at how and why.

So how common are racist behaviours, including speech, directed at Aboriginal and Torres Strait Islander people?

A key study in Victoria in 2010-11, funded by the Lowitja Institute, documented very high levels of racism experienced by Aboriginal Victorians.

It found that of the 755 Aboriginal Victorians surveyed, almost all (97 per cent) reported experiencing racism in the previous year. This included a range of behaviours from being called racist names, teased or hearing jokes or comments that stereotyped Aboriginal people (92 per cent); being sworn at, verbally abused or subjected to offensive gestures because of their race (84 per cent); being spat at, hit or threatened because of their race (67 per cent); to having their property vandalised because of race (54 per cent).

Significantly, more than 70 per cent of those surveyed experienced eight or more such incidents in the previous 12 months.

Other studies have found high levels of exposure to racist behaviours and language.

Such statistics describe the reality of the lived experience of Aboriginal and Torres Strait Islander people. Most Australians would no doubt agree this level of racist abuse and violence is unwarranted and objectionable. It infringes upon our rights – not just our rights as indigenous people but also our legal rights as Australian citizens.

But is it actually harmful? Is it a health issue? Studies in Australia echo findings from around the world that show the experience of racism is significantly related to poor physical and mental health.

There are several ways in which racism has a negative effect on Aboriginal and Torres Strait Islander people’s health.

First, on an individual level, exposure to racism is associated with psychological distress, depression, poor quality of life, and substance misuse, all of which contribute significantly to the overall ill-health experienced by Aboriginal and Torres Strait Islander people. Prolonged experience of stress can also have physical health effects, such as on the immune, endocrine and cardiovascular systems.

Second, Aboriginal and Torres Strait Islander people may be reluctant to seek much-needed health, housing, welfare or other services from providers they perceive to be unwelcoming or who they feel may hold negative stereotypes about them.

Last, there is a growing body of evidence that the health system itself does not provide the same level of care to indigenous people as to other Australians. This systemic racism is not necessarily the result of individual ill-will by health practitioners, but a reflection of inappropriate assumptions made about the health or behaviour of people belonging to a particular group.

What the research tells us, then, is that racism is not rare and it is not harmless: it is a deeply embedded pattern of events and behaviours that significantly contribute to the ill-health suffered by all Aboriginal and Torres Strait Islander Australians.

Tackling these issues is not easy. The first step is for governments to understand racism does have an impact on our health and to take action accordingly. Tackling racism provides governments with an opportunity to make better progress on their commitments to Close the Gap, as the campaign is known, in Aboriginal and Torres Strait Islander health. The new plan has begun this process, but it needs to be backed up with evidence-based action.

Second, as a nation we need to open up the debate about racism and its effects.

The recognition of Aboriginal and Torres Strait Islander peoples in the Constitution is important for many reasons, not least because it could lead to improved stewardship and governance for Aboriginal and Torres Strait Islander health (as explored in a recent Lowitja Institute paper, “Legally Invisible”).

However, the process around constitutional recognition provides us with an opportunity to have this difficult but necessary conversation about racism and the relationship between Australia’s First Peoples and those who have arrived in this country more recently. Needless to say, this conversation needs to be conducted respectfully, in a way that is based on the evidence and on respect for the diverse experiences of all Australians.

Last, we need to educate all Australians, especially young people, that discriminatory remarks, however casual or apparently light-hearted or off-the-cuff, have implications for other people’s health.

Whatever approaches we adopt, they must be based on the recognition that people cannot thrive if they are not connected.

Aboriginal and Torres Strait Islander people need to be connected with their own families, communities and cultures. We must also feel connected to the rest of society. Racism cuts that connection.

At the same time, racism cuts off all Australians from the unique insights and experiences that we, the nation’s First Peoples, have to offer.

Seen this way, recognising and tackling racism is about creating a healthier, happier and better nation in which all can thrive.

Pat Anderson is chairwoman of the Lowitja Institute, Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research.

NACCHO political alert : Health Minister Dutton signals major overhaul of health :Full transcript 7:30 report

Question Time in the House of Representatives

“Well I’m saying when you look at the fact that over the course of the next four years the funding is projected to go up in public hospitals by 50 per cent.

If you look at over the course of the last 10 years where payments have gone up under Medicare Benefits Schedule where we pay the doctors and pay for pathology and diagnostic tests and whatnot, it was $8 billion a year 10 years ago; it’s $18 billion a year today.”

Minister for Health Peter Dutton  Speaking on ABC 7:30 report , read full transcript below


According to reports in the Guardian the federal health minister, Peter Dutton, has signalled dramatic changes to Medicare to address “staggering” increases in health spending, confirming the Abbott government would consider a new fee for visits to the doctor.

Laying the groundwork for politically sensitive reforms, Dutton said he wanted to “start a national conversation about modernising and strengthening Medicare”. He said the health system was “riddled with inefficiency and waste” and warned that doing nothing to address the long-term budget burden was not an option.

In a speech in Brisbane on Wednesday, the minister flagged a greater role for the private sector and private insurers in primary care as the government wanted to “grow the opportunity for those Australians who can afford to do so to contribute to their own healthcare costs”.

But Labor seized on his comments of evidence that the government planned “to destroy universal healthcare in Australia” by making people pay more to access services.

The shadow health minister, Catherine King, said Dutton’s claims about rising health costs were “hysterical” as Australia spent 9.1% of its gross domestic product on health compared with 17% by the United States.

Dutton followed up his speech with an interview on the ABC’s 7.30 program in which he said the country should debate how governments and consumers paid for health services. He said the discussion should include payment models for people who had “a means to contribute to their own healthcare”.

A discussion about who pays for our health system and how is what Federal Health Minister Peter Dutton has flagged, suggesting those with a mean to contribute may have to pay more.


SARAH FERGUSON, PRESENTER: Federal Health Minister Peter Dutton today called for a fearless, far-reaching debate about Australia’s health system, saying that current spending is unsustainable. He’s now flagging major changes to health services, with Australians who can afford it paying more for healthcare and medicines.

The minister has revealed he’s looking at a potential Medicare co-payment, which some argue could mean the end of universal healthcare. It comes after a controversial week in the Health portfolio, with junior Health Minister Fiona Nash accused of doing the bidding of the junk food industry, pulling down a healthy consumers’ website years in preparation. Peter Dutton joined me earlier from Brisbane.

Peter Dutton, thank you very much for joining us.

PETER DUTTON, HEALTH MINISTER: Pleasure. Thank you, Sarah.

SARAH FERGUSON: You said in your speech today that in the past 10 years the cost of Medicare has increased by 120 per cent, the Pharmaceutical Benefits Scheme by 90 per cent, hospital care by 80 per cent. You say that’s not sustainable and something must be done. What exactly is it that you are planning to do?

PETER DUTTON: Well the first thing that we have to do is have a conversation with the Australian people to say that we want to strengthen and modernise Medicare. It’s a system that, obviously, all Australians, including myself, hold near and dear. But it’s a system that was set up in the 1980s and we have to accept the changing and ageing demographic of our society, we have one of the highest obesity rates in the world, we have cancers that if early detection takes place, we can help those people if we have better connections between people and their GPs – all of those things are great, but they have to be paid for. So we have to look at where it is we’re spending money at the moment, whether or not that’s the most efficient way to spend the money so that we can strengthen and sustain our system into the future.

SARAH FERGUSON: Now, does that include increasing the costs of healthcare for those who can afford to pay more?

PETER DUTTON: Well I think it does and at the moment government pays about 70 per cent of that which we spend on health each year, and I know these figures sort of gloss – are glossed over or go over people’s heads, but $140 billion at the moment we’re spending each year on health that we raise about $10 billion a year out of the Medicare levy. There is enormous amounts of money to be spent. There are lots of technologies coming through, and as a First World country, we want to adopt those early and we have to have a conversation about how we pay for those and those that have a capacity to pay in many cases are already paying within the system, but we have to have a discussion about how it is that payment model works going forward.

SARAH FERGUSON: Individuals are already contributing about 18 per cent of the cost of their own health care. Are you saying those payments are going to have to go up?

PETER DUTTON: Well I’m saying when you look at the fact that over the course of the next four years the funding is projected to go up in public hospitals by 50 per cent. If you look at over the course of the last 10 years where payments have gone up under Medicare Benefits Schedule where we pay the doctors and pay for pathology and diagnostic tests and whatnot, it was $8 billion a year 10 years ago; it’s $18 billion a year today. We have to look at the next 10 years where we we’re going to have millions of people who will go onto the age group of over 65. I want to make sure that we can provide for those and we do have to have a national discussion about who pays for what and how the Government pays going forward and how consumers pay for those health services.

SARAH FERGUSON: Specifically, for example, are you in favour of introducing a Medicare copayment. A figure of $6 a visit has been touted already?

PETER DUTTON: Well there are suggestions that have been made both in favour and against this particular proposal, but it’s one aspect that the Government will need to consider. The Commission of Audit obviously …

SARAH FERGUSON: And what’s your own view – what’s your own view on that? Excuse me.

PETER DUTTON: Well my own view is that people at the moment pay a co-contribution through when they buy their medicines, regardless of their income. People pay as little as $6 for a $17,000 prescription, a single prescription. People pay a copayment at the moment for their private health insurance. 11 million Australians have private health insurance. Many Australians already pay a copayment when they go to see the doctor. Now, the issue is how you guarantee access, particularly for those who are without means, and how you don’t deter people from going to see a doctor if there is some sort of a payment mechanism in place.

SARAH FERGUSON: You also raise the issue today of the ageing population. Is your government going to be forced to make older people who have more resources pay more for their healthcare?

PETER DUTTON: Well, I don’t want to single anybody out, but what I would say is that as a general principle, in a society where we have an ageing of our population, regardless of people’s age, if they have a means to contribute to their own health care, we should be embarking on a discussion about how that payment model will work.

SARAH FERGUSON: And is that going to require a new form of means testing to make that possible?

PETER DUTTON: Well, not necessarily, and again, this is the recommendations that we’ll wait to see from the Commission of Audit. I want to make sure that, for argument’s sake, we have a discussion about you or me on reasonable incomes whether we should expect to pay nothing when we go to see the doctor, when we go to have a blood test, should we expect to pay nothing as a co-contribution and other taxpayers to pick up that bill. I think these are all reasonable discussions for our population to have.

SARAH FERGUSON: Now, you set out as the key rationale for your speech today the dramatically rising rates of obesity and diabetes in society, yet your own junior minister, Fiona Nash, shut down a website which was designed to help prevent those scourges. Was that a mistake?

PETER DUTTON: It wasn’t a mistake. The Government obviously has a number of people who were advising us in these particular areas. The issue that you speak of is a reasonable discussion to take place. But to put this issue into perspective, there was a system that was proposed in relation to a star rating that people could assess whether or not they purchased particular foods based on that system or that star rating system. The system hasn’t started, and as I understand the minister’s position, she said that the website shouldn’t proceed until there had been a rolling out of this system or a better understanding …

SARAH FERGUSON: But that wasn’t the view of those people who had been involved in putting that website together; they said it was ready to go.

PETER DUTTON: Well again, I mean, you’ve got Labor premiers sitting around the table in South Australia and Tasmania, two of the worst-performing health systems in the country. I don’t place much credibility in what might have been leaked by Labor ministers out of that meeting. I find Fiona Nash not only to be an effective minister, but a very decent person. I think she’s served her constituency well.

SARAH FERGUSON: That’s not actually the question here. Excuse me, minister, …

PETER DUTTON: Well it goes to credibility and the credibility that I place in this debate is with Senator Nash and I think she has done the right thing here. We’ll have a proper discussion about what we should do in terms of food labelling and the rest of it, but we aren’t going to be cajoled or bullied by people like SA or Tasmania or indeed the ACT, who have very poor performing health systems.

SARAH FERGUSON: Forgive me for interrupting. It doesn’t just go to the credibility of the minister. I’m asking you for your opinion. These are exactly the tools that public health experts say the public needs to fight diabetes and obesity. Do you still maintain that website should be taken down?

PETER DUTTON: If the system hasn’t started, I don’t see an argument for the website being up in place and that’s the decision rightly that the minister took.

SARAH FERGUSON: Did you know that her chief-of-staff was a lobbyist for the food and soft drink industry?

PETER DUTTON: Well, again, Sarah, these are matters that have been trawled over.

SARAH FERGUSON: What’s the answer to the question, if you would?

PETER DUTTON: Well I knew of course, as everybody else did, Mr Furnival’s history, but today is our opportunity to talk about ways in which we can strengthen Medicare going forward and that’s the speech I gave today and I think that’s the discussion the public wants to hear about, about how can we provide …

SARAH FERGUSON: Except that you’re – minister, if I may say, you’re the person that raised the issue of obesity and diabetes, that wasn’t me.


SARAH FERGUSON: You made that the centrepiece of your speech, the opening lines in fact.


SARAH FERGUSON: You’re saying you knew that Mr Furnival was a lobbyist for the food and drink industry. Doesn’t that mean there was a clear conflict of interest between his past and the actions of your minister?

PETER DUTTON: No, the appropriate, the appropriate – as I’m advised, the appropriate declarations were made and signed, and as I say, Mr Furnival now has moved on. Our discussion today was about the fact that we have one of the highest obesity rates in the world. About two in three Australians have – are either overweight or obese. We now have about 2,200 young children and youngsters who are identified as having Type 2 diabetes. That’s what I was speaking about today and frankly I think that’s a much more substantive discussion to have with the public and if we do that then we can talk about the ways that we can make our system sustainable going forwards.

SARAH FERGUSON: Thank you very much indeed for joining us, Mr Dutton.

PETER DUTTON: My pleasure. Thank you.

Please Take

NACCHO needs to improve how we  connect, inform and engage into the Ifuture.


NACCHO weekly health news wrap :Health Minister Peter Dutton backs less bureaucrats, more frontline GPs


LABOR’S “dud’’ Medicare Locals will be rebadged and redesigned after GPs complained that the $1.8 billion bureaucracy is failing to deliver real services to patients.

See previous NACCHO reports here

NACCHO Aboriginal healthly debate: Medicare Locals (MLs) their future is unclear ?

Also below Croakey Health WRAP

Senior government sources have revealed that a review into the system has confirmed some sites underperforming. Staff working at Medicare Locals also hate the name, complaining patients think they can claim Medicare refund there or actually see a doctor.


But the review has come with a hefty $550,000 price tag according to tender documents obtained by the Sunday Telegraph. Despite the contract running for just three months, it comes with a $550,000 contract for accounting services awarded to Deloitte.

Medicare Locals were established by the Rudd-Gillard government and were designed to better integrate GP and primate health care services. Unlike GP superclinics, they are not a shopfront with doctors.

Doctors have also labelled the program a dud, with the Australian Medical Association releasing a survey stating that 75 per cent of GPs believed the program had “not resulted in any improvement in access to, or deliver of primary healthcare, and should be scrapped.”

Health Minister Peter Dutton confirmed he would announce changes to Medicare locals when he had considered the findings of the review.

“Labor wasted billions in health and we have to get the system back on track so we can pay for cancer drugs, the ageing population and the massive onset of dementia and obesity,’’ he said.

But Labor health spokeswoman Catherine King said any moves to scrap Medicare locals, reduce funding or close some down would represent a broken election promise.

“Any cut to Medicare Locals would be a clear broken promise by the Prime Minister.

Medicare Locals are transforming the way primary care is delivered across Australia and making it easier for all Australians to get to doctors, psychologists, nurses and other allied health professionals,’’ she said.

During the election, the Prime Minister announced he would review Medicare locals if elected, admitting he cannot guarantee they will stay “exactly the same.”

“I don’t guarantee they’re all going to stay exactly the same. Our focus is on trying to move the money from the back office to frontline services,’’ he said.

“Now, can I say that absolutely no Medicare Local will close? I can’t say that.”

But a week later, during a leaders’ debate on August 27, Mr Abbott also pledged: “we are not shutting any Medicare Locals.”


By Melissa Davey

Welcome back to the fortnightly Health Wrap, and the first for 2014.  We hope your start to the year has been a healthy one. There have been some hot health topics in the headlines for the past couple of weeks, and they have particularly focussed on alcohol and cancer.

World Cancer Day reveals some sombre projections

A cancer tidal-wave is on the horizon, the BBC reports, leaving World Health Organisation (WHO) scientists warning that that much tougher restriction on alcohol and sugar intake is needed. The BBC also reports the World Cancer Fund as saying that the public still has a huge level of naivety about the importance of diet and alcohol intake in cancer prevention.

Alcohol is an attributable factor in nearly 2000 new cancer diagnoses a year in Scotland, with an increased risk of developing breast, head, neck, oesophagus, bowel and liver cancers, the Herald Scotland reports. The article says that even drinking alcohol within sensible limits may lead to an increase in cancer risk.

The success of the program has prompted some Australian health experts to call for cigarette-style warning labels to be placed on alcohol packaging warning of cancer and other risks, reports.

World Cancer Day on February 4 coincided with the release of the WHO’s World Cancer Report, which found cancer had surpassed heart disease as the biggest killer in Australia. In 2011 there were 7.87 million cancer deaths compared to 7.02 million from heart disease (stroke deaths were considered separately), the report found.

Also concerning was the release of Cancer Council NSW data  that revealed NSW men over 50 are three times as likely to die from melanoma as women the same age, partly because more than half of men in that age bracket are not aware of the high risk associated with skin cancer.

Meanwhile the New York Times asks if we are giving ourselves cancer, in this piece examining the link between radiation – particularly from CT scans– and the disease.

Finally, The European Cancer Patient’s Bill of Rights was unveiled this week to address the differences in care received by cancer patients across Europe. Some 1000 medical organisations and cancer groups from 17 European countries collaborated to produce the Bill.


A mixed response to alcohol law reforms

The NSW government has revealed its latest plan to curb alcohol-related violence which will see an eight-year minimum sentence for alcohol or drug-fuelled assaults that result in death, while bottle shops will close at 10pm across the state and licensed premises in the centre of Sydney won’t be allowed to let new patrons in after 1.30am. The laws have civil liberties groups up-in-arms, the ABC’s PM reports.

But NSW Opposition leader John Robertson believes the plans don’t go far enough, telling SBS that the announcement is rife with loopholes. “We have lock-outs with loopholes where small bars will be exempt from lock-outs,” Mr Robertson said to SBS. “Backpacker bars will be exempt from lock-outs and hotels with bars will also be exempt from lock-outs.”

The family of alcohol-related violence victim Thomas Kelly, the teenager who died in 2012 after being punched once in the head, spoke to the media following the reform announcements, describing them as “bittersweet” but “amazing”.

However, the SBS reports legal experts have raised concerns about plans that have been rushed through the State Parliament, fearing they will result in a large increase in the number of Indigenous people jailed. Fines for some drunken violence offences will result in people who are unable to pay being jailed, they report.

While the Australian Medical Association (AMA) welcomed the proposed measures, they also say measures should be tougher. The AMA called on the federal government to convene a national summit bringing together government, councils, police, health experts, teachers, victims and industry to come up with solutions to the alcohol misuse epidemic.

Finally, Croakey reports that The Alcohol and other Drugs Council of Australia – the national peak body for the alcohol and other drugs sector for nearly 50 years – has put in a heartfelt request to present to the Abbott Government’s National Commission of Audit on the impact of its unexpected defunding last November.


Vaccines, fluoride and vitamins – pushing for best practice

Prominent public health expert and anti-pseudoscience campaigner Dr Ken Harvey quit his job as an adjunct professor with Victoria’s La Trobe University after the University struck a $15 million, six-year deal with vitamins manufacturer Swisse.

The ABC reports the University described the memorandum of understanding with Swisse as an important step towards establishing a complementary medicine centre, which Dr Harvey described as a conflict of interest.

Dr Harvey’s move has been supported by Friends of Science and Medicine, an association that lobbies for evidence-based medicine, The Conversation reports. The organisation has called on La Trobe University to abandon the planned research into Swisse supplements.  In his resignation letter, Professor Harvey said he was concerned La Trobe University would be pressured to “produce results that will justify the company’s investment”.

GP and medical writer Dr Justin Coleman has also backed Dr Harvey’s  “brave stance”, writing:

“ I am a senior lecturer at two Australian universities and I would also be very troubled if one of them compromised its independence in this way.”

To vaccines, and The West Australian reports more WA doctors are refusing to endorse parents who object to their children being vaccinated, but who need a letter from their GP to get government benefit payments.

New Federal Human Services Department figures reveal an extra 479 WA children were added to the conscientious objectors’ database last year – a 13% increase on the previous year, the piece says.

Meanwhile, experts fear public confidence in vaccination programs could be undermined after dozens of young children were given a flu vaccine despite it being banned for under five-year-olds. The Therapeutic Goods Administration says across the country, 43 children under the age of five were injected with Fluvax last year, the ABC reports.

This excellent map from Mother Jones reveals the high cost of vaccine hysteria across the world, with measles and mumps making a comeback thanks to anti-vaxxers claiming an autism link – a link that has been utterly and thoroughly debunked thanks to evidence and science.

We’ll let Slate have the final say on anti-vaxx nonsense, in this piece which explores what creationists and anti-vaxxers have in common. “Ignorance is curable by education, but wilfully ignoring the facts can be contagious — and even fatal,” they write.


E-cigarettes – ban or regulate?

In a world where there are one billion smokers and smoking kills almost six million people a year, the regulation of e-cigarettes is a high-stakes debate, writes health journalist Andre Picard for the Globe and Mail.

While research on e-cigarettes and their potential harms and potential benefits is in its infancy, and data on long-term risks and benefits are lacking, he writes that with tobacco causing so many deaths around the world e-cigarettes may be a step in the right direction.

But as this piece for OPB says, a major barrier to policy making on e-cigarettes is the lack of scientific knowledge about the products. A report released this month by the US Surgeon General called for research and regulations on e-cigarettes, as well as other new nicotine-based products being introduced to the market, the piece says.

Meanwhile, tobacco giant Philip Morris has been taken-to-task by the ABC’s Fact Check Unit for saying “the data is clear” that plain packaging has not stopped people smoking. Public health experts and even Philip Morris competitor Imperial Tobacco say it’s too soon to draw conclusions about the long-term impact of plain packaging on smoking, the ABC reports.

Meanwhile,  Dr Melissa Stoneham reports for Croakey on research that investigated smoking cessation apps and whether they adhered to evidence-based practice. The researchers found that of the more than 400 apps available, most were missing basic evidence-based practices, such as referral to a Quit line or providing information on approved medications.


Experts are arguing for a cultural approach to health spending in light of high costs and poor outcomes, this piece for Al Jazeera says. According to the World Health Organization, Australia’s 670,000 Aboriginal and Torres Strait Islander people suffer from diseases found nowhere else in the developed world – such as trachoma, a form of preventable blindness.

Meanwhile the National Aboriginal Community Controlled Health Organisation (NACCHO) reports that during the past three years, Aboriginal and Torres Strait Islander suicides reached nearly 400.

Commenting on the crisis, NACCHO chair Justin Mohamed said: “Aboriginal and Torres Strait Islander people experience suicide at around twice the rate of the rest of the population. Aboriginal teenage men and women are up to 5.9 times more likely to take their own lives than non-Aboriginal people.”

Psychiatrist Professor Alan Rosen writes for Croakey that the impact of sustained heatwaves or drought on Aboriginal communities needs further investigation. He referred to this study; ‘The impact of prolonged drought on the social and emotional well-being of Aboriginal communities in rural New South Wales’, published in the Australian Journal of Rural Health in 2011.

It found drought was affecting Aboriginal wellbeing by damaging traditional culture; skewing the population profile in smaller centres; exacerbating underlying grief and trauma; and undermining livelihoods and participation, amongst other things.


Australians nutritional guidelines need to be tougher

Australian researchers have found controls on food manufacturers are being weakly implemented, as foods continue to contain too many unhealthy ingredients like sugar and fat. Professor Bruce Neal, at The George Institute and The University of Sydney, led a team that evaluated the Federal Government’s Food and Health Dialogue, Health Canal reports. The evaluation was published in the Medical Journal of Australia.

As director of Health Strategies for the Cancer Council NSW, Kathy Chapman, writes in a piece published by Croakey and originally appearing in The Conversation; “most people doing their grocery shopping are blissfully unaware of the industry lobbying and backroom politics that determines what information appears on food labels”.

But attempts to treat obesity are being hampered by flaws in clinical guidelines as well, with the head of clinical obesity research at the Baker IDI Heart and Diabetes Institute, John Dixon, saying Australian obesity guidelines contain inadequate advice on monitoring nutritional deficiencies after bariatric surgery.

National Health and Medical Research Council guidelines released in June last year contained the “potentially dangerous” implication that nutritional problems should only be assessed after symptoms developed, including muscle wastage and bone pain, Professor Dixon tells Fairfax.

However, Australia must be getting at least something right in the war on obesity. New Zealand Prime Minister John Key has announced that Australia‘s obesity prevention program will be adopted there , International Business Times reports. New Zealand Health Minister Tony Ryall visited Victoria and said the children who were part of the obesity prevention program had become more active and lost weight.

Meanwhile, academics and policy experts specialising in medicine and nutrition in the UK have formed a campaign group, Action on Sugar, to convince manufacturers to gradually lower the amount of sugar added to foods – so slowly that it isn’t missed by consumers.

But this piece in New Scientist says using initiatives that have successfully reduced the amount of salt in manufactured foods may not work when it comes to sugar.


Health sector reforms and health policy

In this piece for Croakey, Australian Healthcare and Hospitals Association CEO Alison Verhoeven reports on a round-table meeting held in Canberra to celebrate Medicare’s 30th birthday. She asks whether consumer expectations for access to free public hospital services and bulk-billed consultations with doctors are realistic in a time when healthcare costs are increasing.  Some thoughtful wishes for a 30th birthday makeover for Medicare were also shared in this Croakey piece.

Sydney Morning Herald Economics Editor Ross Gittins writes that while therising cost of healthcare is the greatest reason for increasing in budget deficits, it is rarely made clear that this assumes a limit on the growth in healthcare taxation.

And Drs Gemma Carey from the Centre of Excellence in Intervention and Prevention Science and Pauline McLoughlin from the LightHouse Foundation examine the Victorian Government’s recently launched  ‘Roadmap for Community and Human Services Reform’, lead by Dr Peter Shergold. Their article for Croakey covers some of the challenges for reformers hoping to tackle ‘top-down’ relationships, service silos, overly complex funding arrangements and legacies of mistrust.

The policy head of Research Assets at the Sax Institute*, Bob Wells, says health policy analysts have spent the first weeks of the year vigorously debating ways to rein in Australia’s rising health budget and to make the system more efficient. His  piece for The Conversation examines a couple of the proposals on the table.

Meanwhile Professor Peter Brooks argues in a piece for Croakey that reform of the fee-for-service payment system must be considered as part of a broader discussion about the future sustainability of the health system.

Also for Croakey, a health policy analyst writing anonymously  examines what might be expected from the National Commission of Audit when it comes to health policy. Looking back might help us look to the future, the writer says, speculating about what the Commission might recommend and implement including removing regulatory duplication, and pricing blood products.


Healthy bloggers

The health blog featured in this Health Wrap comes from NPR. Their comprehensive public health blog includes news about health from around the globe including the latest on prevention, disease outbreaks and the world’s response to health crises.


Other Croakey reading you may have missed this fortnight:


Last year, Health Minister Peter Dutton appointed Professor John Horvath, a former Commonwealth chief medical officer to head the review.

The terms of reference include an investigation into whether the program is actually delivering clinical services and whether it has increased the co-ordination of after hours care.

Nearly half of all GPs surveyed by the AMA last year found the bureaucracy employing 3,000 people was “duplicating existing GP services.

“The starting point for the Review is to change the name — ‘Medicare Locals’ means nothing to the people who need access to quality primary health care services in their communities,’’ Australian Medical Association President Steve Hambleton said in a statement.

“It sounds like another layer of bureaucracy. The name should project an active role in looking after people’s health.”


NACCHO Aboriginal health political alert:’PM for Indigenous affairs’ has his task cut out on that front

sunset 2

EARLY life experiences become hard-wired into the body, with lifelong effects on health and wellbeing.”

A very important statement – but not news. Research demonstrating the complex interplay of “givens” (genetics) and early-life “contingent factors” (the environment of pregnancy and early childhood) in determining lifelong risk of ill-health dates back to the middle of the last century.

From diabetes to depression, the intra-uterine and early childhood environments critically influence the quality and length of our lives.

FROM THE AUSTRALIAN Ernest Hunter is a medical practitioner in north Queensland.

Photo courtesy Apunipima Cape York Health Council Photovoice project. Photographer Grace Morris’.

The quote opens the Australian Medical Association’s Aboriginal and Torres Strait Islander Health Report Card 2012-2013, with Steve Hambleton, president of the AMA, commenting in the introduction on “gaps in preventive child health care, the promotion of early childhood development, and the alleviation of key risks for adverse developmental outcomes, especially in remote communities”.

Download report card here

In fact, it can reasonably be argued that developmental adversity is the main contributor to the continuing poor health status of indigenous Australians. That’s the bad news; to the extent that those effects “become hard-wired into the body”, it may not be possible to rectify – at times even to modify – the harms done.

In my role as a psychiatrist and public health physician in Cape York, most of my work is about mitigating the downstream consequences, be it psychosis, depression, interpersonal violence, self-harm, alcohol abuse or chronic disease. There is no shortage of work for clinicians.

While indigenous developmental vulnerability and its effects should be cause for alarm, it is not a reason for fatalism. Indeed, the good news is that the scope for intervention and prevention is enormous and, broadly, we know what needs to be achieved: equity in pregnancy and early childhood health and social outcomes.

Unfortunately, we do not know how to get there – although, clearly, it’s not through business as usual. Even if it is achievable it will take generations for the full effects of healthy pregnancies and early childhoods to be reflected in a reduction in the burden of chronic disease from midlife on, particularly in remote Aboriginal communities.

Imagine if somehow the pregnancies of young indigenous women, right now, were no more likely than non-indigenous pregnancies to be exposed to smoking, alcohol consumption, other drug use, the effects of violence, high levels of maternal stress hormones and inadequate nutrition; if the babies were born to women at no greater risk of prematurity and labour complications, who have had access to the same quality of antenatal and birthing services. Don’t stop – imagine if those babies, now as healthy as their peers across Australia – could spend their infancies in safe, nurturing and stimulating environments in which they were nourished and cherished by their parents, no more likely to be exposed to abuse, neglect or removal from their families; if they did not live in overcrowded houses and were protected from the waves of chaos and stress that wash through homes in remote communities. Imagine.

Even if this miracle did occur, service demands will remain unchanged for a long time as the developmental adversity experienced by older relatives works its effects through the population. Indeed the consequences are evident already among their older siblings, let alone those suffering chronic diseases in middle age.

Educational disadvantage has received a lot of media attention, as has fetal alcohol exposure, both of which predispose affected children to a range of additional risks that will follow them through their lives. Lives that in many cases will be much shorter: the Commission for Children and Young People and the Child Guardian annual report on the deaths of children in Queensland records that between 2004-05 and 2012-13 the suicide rate of indigenous children aged 10 to 17 was more than 5.5 times higher than that of their non-indigenous peers.

The Australian public was given cause for some optimism with the announcement by Tony Abbott prior to the federal election that he intended to be the “prime minister for indigenous affairs” and that he would be “hands on”. Since becoming PM he has appointed, with fanfare, an Indigenous Advisory Council, which first met in December under the leadership of Warren Mundine. Unsurprisingly, this move has been divisive in the wider indigenous population (indeed there is a petition initiated by writer Ken Canning for it to be replaced by an elected body).

Abbott has many other pressing demands; he has alluded also to the sobriquet of “the infrastructure PM” and he could be a contender for the title of “tow/push the boats back PM” too – and much more. But his statements about indigenous affairs were clearly broadcast, and the implication was that he would brook no obstruction to pursuing it as a national – and personal – priority.

So it is surprising to hear rumours, just months after his seemingly heartfelt assurance, that he has reconsidered (or been forced to reconsider) his and the Coalition’s political investment.

While the Indigenous Advisory Council is now at the table and constitutional reform placed back on it, the setting is, so far, pretty humble. The main course may be a way off but the entrees are hardly satisfying.

Following on the heels of the announcement of funding cuts for legal services, Mundine has anticipated that Aboriginal and Torres Strait Islander Australians may have to share the pain of national economic recovery.

In Queensland, of course, they are already sharing it. Among the outcomes of the cuts and divestments since the change of the Queensland government has been a reduction in human resources and institutional capacity in population health and social programs which will have the greatest consequences for those most disadvantaged, the residents of remote Queensland Aboriginal communities.

As they have less visibility and voice, and as the effects will be delayed, it’s a safe political strategy. And, of course, it can always be passed off as a commonwealth responsibility.

Who should pay – commonwealth or state – has been argued ad nauseam. That has been and remains a major obstacle to effective action. But, in terms of responsibility, Abbott made a commitment – to the nation – that he would personally take on the challenge of making a difference for indigenous Australians.

I want to believe that it was sincere and that he understood, in making it, that it will require broad support and long-term effort. Whether he is sufficiently inclusive or overly reliant on particular individuals will be debated and will play out. But if he really is the “PM for indigenous affairs” then he needs to lead and be seen to do so – “hands on”. And he needs to be in there for the long haul.

These two issues, developmental determinants and opportunities, and assertive political leadership, are linked. Sufficient and sustained investment in the former is the surest means to effect significant gains in indigenous health (though perhaps not the most politically visible in the short term) and is dependent on the latter.

In election mode Abbott also frequently commented that “we say what we mean and we do what we say”. Now it’s time for doing.

Ernest Hunter is a medical practitioner in north Queensland.