NACCHO health news : Making Medicare relevant in the 21st Century: AMA and Catherine King

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AMA President Dr Steve Hambleton (pictured right with NACCHO chair Justin Mohamed at a recent Canberra Event) ,

AHHA Medicare Anniversary Roundtable

Making Medicare Relevant in the 21st Century

I would like to acknowledge the traditional owners of the land on which we meet and pay my respects to their elders past and present.

The future of Medicare

I want to speculate about Medicare’s future today – and the key role of doctors, particularly GPs, in that future.

I will make some suggestions about how Medicare can improve its relevance in a changing environment, and how it can best serve the Australian people by continuing to deliver quality, affordable and accessible health services.

As you know, I am not the only person into Medicare speculation recently.

December and January are traditionally the silly season in the Australian media.

The news is full of sport and celebrations … and stories that are recycled, and stories that normally would not see the light of day.

For health, it has been a very silly season.

We have recently seen many opinions about the health system and health financing

People are speculating about the changes to be made to ensure we have a sustainable health care system.

These opinions became stories that inevitably focused on Medicare – because for most Australians Medicare is the Australian health system.

The most notable proposal was the oft-recycled patient co-payment.

The AMA does not support this concept and we have made our view very well known.

There are better ways.

It is interesting that this speculation has come at a time when a new Lancet Commission, when considering global health up to 2035, has recommend that countries should lower the barriers to early use of health services and increase access to disease prevention and minimise the impact of medical expenses.

While I acknowledge the growth in Medicare expenditure, it is important that any changes do not throw the baby out with the bath water.

Any changes must be in the context of the long term goal to improve population health, which will deliver real cost savings.

In terms of spending on medical services, via the Medicare Benefits Schedule, doctors have done their bit over the past decade on containing costs.

As I have said in other fora, medical services costs are not the problem.

Let’s once again set the record straight.

Here are the facts …

Health expenditure

The proportion of health expenditure on medical services was 18.8 per cent in 2001-02 compared to 18.1 per cent in 2011-12.

The average annual growth in total health expenditure on medical services in the decade to 2011-12 was four per cent, compared to growth in PBS expenditure of 6 per cent and 9.3 per cent for products at the pharmacy.

The growth in average health expenditure by individuals on medical services in the decade to 2011-12 was four per cent, compared to 5.3 per cent for PBS medicines and 7.5 per cent for products at the pharmacy.

The average growth in Medicare benefits paid per service in the decade to 2012-13 was 4.7 per cent, less than the real growth in total health spending of 5.4 per cent in the decade to 2011-12.

It is clear that the MBS – combined with the private health insurers’ schedules – is an effective price dampener for medical services.  At least that is what my members keep telling me!

In terms of access to care – despite the low growth in the Medicare Rebate, today, 81 per cent of GP consultations are bulk billed.

And 89 per cent of privately insured in-hospital medical services are charged according to the patient’s private health insurer’s schedule of medical benefits.

This means that patients had no out-of-pocket cost for their doctor’s fee for 93.5 million GP consultations in 2012-13, and over 26 million privately insured in-hospital services.

When Governments get nervous about spending in health, they have three options: reduce the price they pay; spend more wisely; or collect more revenue.

I think that the recent focus on price, in terms of the Medicare Benefits Schedule, is a bit misdirected.

The focus should be on spending that money wisely.  Today, Minister Dutton is quoted as saying that we need to invest in the areas of greatest benefit.

The medical profession stands ready to do its bit in this regard, too.

Australia must change the way it provides health care, where it provides care, and when it is provided for the major driver of health care costs – non-communicable diseases.

Medicare needs to facilitate this.

With the rapid increase in medical knowledge and the rate of change of best practice care, evaluation and change must be part of the medical practitioner DNA.

In terms of our clinical practice, we are going to have to translate what we know into what we do – and we need the tools to do it.

We will need to do this in a structured way so that we stop doing the things we do that don’t provide real outcomes for the patient.

Our clinical practice must be about doing the right things at the right time in the right part of the health system.

Once people get to hospital, their care becomes very expensive.

Keeping people out of hospital is cheaper and it frees up resources, but it might need an increased investment from Medicare, not a decrease.

That investment must be sufficient to improve the coordination of primary care services.

Population Health in the Community – Medicare Locals

The AMA understands the need for community-based health care organisations to improve the coordination of health care outside of the hospital environment.

Such organisations can help to break down the silos in the non-hospital space, build better links between the hospital sector and community based care, support improved population health, and address gaps in the delivery of primary care services.

The former Government set up 61 Medicare Locals to undertake this role.

Despite now having been in operation for a number of years, few Australians understand what Medicare Locals do.

Many GPs feel disenfranchised by them – and so do almost all community-based medical specialists.

We have welcomed the incoming Government’s review and have made a strong submission, based on frontline medical practitioner input.

We believe the former Government pursued the wrong governance model.

They substituted or downplayed the role of GP leaders in Medicare Locals and in their decision-making structures.

They made the same mistakes that the New Zealand Government made in 2001 when it decided to implement ‘skills based boards’ that excluded GPs.

These boards were initially made up of people who, while experienced in governance, did not understand the complexity of health care delivery.

Clinical leadership was absent in many areas in New Zealand and the models failed to deliver.

The leadership role of GPs has now been restored.

The PHOs in New Zealand are now playing a more meaningful role in support of improved health outcomes for local communities.

In New Zealand, the PHOs are now:

  • supporting GPs to focus on population health;
  • supporting improved quality in general practice by facilitating information sharing among GPs;
  • supporting pro-active management of chronic disease;
  • supporting e-health initiatives;
  • funding specific initiatives to keep people out of hospital; and
  • helping support more sustainable general practice by building improved IT and delivering business support.

These are initiatives that are being built from the ground up and led by GPs, not imposed from the top down.

We are calling on the Abbott Government to overhaul the Medicare Locals model to make them responsive to local health needs and to be fully engaged with GPs, who are the engine room of non-hospital based care.

But enough about Medicare Locals, which have got nothing to do with Medicare.

That is why we have suggested a name change.

Complex and chronic disease

The challenges for primary care are growing with our ageing population.

Complex and chronic disease represents a huge burden to the health system.

It accounts for about 70 per cent of the allocated health expenditure on disease and is estimated to increase significantly in the immediate future.

This is both a threat and an opportunity for the Medicare of tomorrow.

Current Medicare-funded chronic disease management arrangements are limited, can be difficult for patients to access, and involve considerable red tape and bureaucracy.

We need less red tape and more streamlined arrangements allowing GPs to refer patients to appropriate Medicare-funded allied health services.

We need a more structured, pro-active approach to managing patients with complex and chronic disease.

The Department of Veterans Affairs is doing some great work in this area with its Coordinated Veterans Care (CVC) Program.

DVA is supporting GPs to provide comprehensive planned and coordinated care to eligible veterans with the support of a practice nurse or community nurse contracted by the Department.

The CVC program is a proactive interactive approach to the management of high acuity chronic and complex diseases.

It supports GPs to spend more time on these patients on a longitudinal basis.  This is something that Medicare currently works against.

The CVC program recognises the non-face-to-face work required, including regular follow-up to see how patients are going without relying on the patient returning to the surgery.

We need to look at how we can roll out this type of pro-active approach more broadly.

It would allow us to invest in a healthier future with better disease management, and prevention of avoidable costly hospital admissions.

The overall message is that if we as a nation do not wish to spend more on health – and that is the clear message coming from the new Government – than we must spend smarter.

We must invest in the things that work.

We must share the knowledge that our various organisations gather from the coalface of health service delivery.

Above all, we must be spending more time building on the things we agree on – and there are a lot of things that we agree on.

Doctors are ready to be a major part of the solution.

GPs are the foundation of primary care – and they save the health system money.

The GP role in population wellness and, ultimately, cost control must be enhanced by Medicare – not eroded or substituted.

The AMA strongly believes that 2014 and beyond must be the years of the GP who can deliver the right care at the right time to the right person.

Medicare must rise to the challenge.

CATHERINE KING MP SHADOW MINISTER FOR HEALTH

MEMBER FOR BALLARAT

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Introduction

Thank you Alison Verhoeven for that introduction, and thank you for the invitation to make this address today.

May I also acknowledge AMA President Steve Hambleton, Con Costa the President of the Doctors Reform Society, Stephen Duckett from the Grattan Institute, John Glover and all of the other esteemed speakers and guests here with us today.

When Bob Hawke introduced Medicare 30 years ago he warned that without it, two million Australians ‘faced potential financial ruin in the event of major illness’. Today more than 39% of Australia’s population is under 30 – that’s more than eight and a half million Australians who are growing up without knowing what healthcare in Australia looks like without Medicare.

And of the two million Australians who faced potential financial ruin in 1984, it’s worth considering just how many hundreds of thousands of people have had their lives changed thanks to Medicare. It’s quite an achievement, particularly given how hard Labor has had to fight not just to introduce, or reintroduce, the architecture of a universal healthcare system, but to protect it.

That we are celebrating Medicare’s 30th birthday is particularly commendable when a comparison is made of international health systems.  No one health system is perfect, but on this 30th anniversary it is right to be celebrating and reflecting on what is important about our health system.

It’s also important that we focus on what needs to be done to preserve the fundamental principles on which it is based:

  • Universal access
  • Overcoming health inequality
  • Access to new medicines and treatments
  • And prevention.

History

For the millions of Australians who have grown up with Medicare it must be difficult to appreciate how different Australia’s healthcare system was in 1984 compared with the system of universal care we are afforded today.

Of course the Medicare we know is different from the scheme that was originally introduced. Gough Whitlam introduced Medibank in August 1974 only to have Malcolm Fraser and his government overturn it in 1976. The legislation for Medibank had been blocked in the Senate, and was one of the key issues Labor campaigned on during the 1974 election – indeed it was one of the measures on which the Governor-General granted a double dissolution.

At the time, Whitlam argued that the conservatives had:

‘Preserved the inequity, inefficiency and injustice of an antiquated health scheme. They have prevented one million of our fellow-citizens from having any protection against hospital and medical charges.’

Whitlam’s victory in ’74 would prove to be one of the most important steps in achieving a system of universal healthcare but it would not be a decisive one. It took two Labor governments more than two decades to embed what is now Medicare.

When Neal Blewett, the reforming health minister in the Hawke government, introduced the legislation that would re-establish a system of universal care he told the parliament:

“In a society as wealthy as ours there should not be people putting off treatment because they cannot afford the bills. Basic health care should be the right of every Australian.”

It’s a statement that says everything about what Labor stood for 30 years ago and it says everything about what Labor stands for today.

Bulk billing and co-payments

It’s appropriate therefore to focus on some of the achievements of the past two terms in government. When Labor left office bulk billing rates were at more than 80%. This is an achievement I’m very proud of but also something that also causes me deep concern. The increase in bulk billing rates to this historical high did not happen by accident.

The incentives my colleague Tanya Plibersek introduced, and before her Nicola Roxon, for GPs to bulk bill, particularly to bulk bill concessional patients, have made it easier for all Australians to get to see a doctor, but in particular they have benefited those members of the community who most need the assistance Medicare affords. Over the past month we’ve seen the government repeatedly refuse to rule out the introduction of a Medicare co-payment. This would end bulk billing and put considerable pressure on some of the most vulnerable Australians, many of whom already have very low access to GPs.

Labor’s legacy

To strengthen primary care Labor established a network of 61 Medicare Locals servicing every region. Medicare Locals are intended to save money on secondary care and prevent hospital admissions. They are also one of the important ways Labor strengthened Medicare when in government by refocussing on the importance of primary care.

The benefits of the work Medicare Locals are undertaking are already being seen in communities across Australia. Medicare Locals are identifying specific needs for local services and planning for services to address these gaps, such as through the engagement of additional nurses and other allied health professionals at GP clinics, as well as the provision of after-hours GP services.

But most importantly Labor made funding available to ensure these services could be delivered effectively.  Medicare Locals provide the architecture for a stronger reengagement of the Commonwealth in local primary care and planning. Medicare Locals for example are working to increase breastfeeding rates in areas where breastfeeding rates are low; in areas where smoking rates are high there are programs tailored specifically to those communities to reduce smoking rates, as there are programs to reduce rates of type two diabetes in communities that have a significant prevalence of this disease.

Despite the rhetoric of the new government, the vast majority of people employed by Medicare Locals are directly responsible for providing care and improving health services in local regions.

Viability of Medicare

As the demands on the MBS and PBS continue, it’s important to ensure governments get the best value for money on health expenditure and that all Australians continue to get access to the best quality medical care. The sustainability of Medicare is about much more than purely academic arguments.  It’s important that new policies be pragmatic and can actually be implemented by governments. A good example of this is the price disclosure reforms we pursued when in government.

But it’s important to acknowledge too the challenges that had to be met to implement this policy.  I am concerned however that some of the rhetoric of the past few months is more about softening the Australian public and media up for an assault on the universality of Medicare and a further move towards a two tiered health system. Today for example we have seen the Health Minister use a Productivity Commission report as an excuse to talk about cutting ‘waste’ in health.

On its record to date it’s difficult to trust this government, and I fear the Minister is only using this rhetoric as an opportunity to justify cuts to satisfy the Prime Minister’s agenda. Over the next couple of years I am particularly interested in working with you to develop new ways we can ensure greater equity in our health system and make sure the Medicare of the 21st century is something its original architects and the Labor party that introduced it, can be proud of today.

Private Health Insurance

It’s important to acknowledge that the private health insurance industry does play an important role in healthcare in Australia. Labor’s position remains that governments have a responsibility to ensure that the private health insurance industry remains sustainable and that private health insurance is affordable and provides good value. The means testing of the private health insurance rebate that Labor introduced in government meant a number of the health programs and infrastructure projects I’ve already mentioned could be delivered.

Despite the criticism at the time we did not see tens of thousands of Australians giving up their cover as was claimed would occur. On the contrary, the number of people with both general and hospital cover is at the highest rate ever and continues to grow. For the first time ever, 55% of Australians have general cover, with 47% having hospital treatment cover.

The challenge for the government now is to ensure the cost of private health insurance is kept as low as possible and that the system does not undermine Medicare. At the end of last year Minister Dutton announced the largest increase to private health insurance premiums in a decade. In government, we had always taken several months to agree on premium increases, often going back to individual insurers several times to ensure consumers received the smallest increase possible. This was a particularly cynical announcement by this government and one that would be a mistake to repeat.

I want to mention briefly the government’s intention to sell Medibank Private.  Labor has reservations about what the sale of Medibank will do for competition in the sector and what this will mean for consumers. Having a government-owned insurer has had a balancing factor in the sector which would be lost should Medibank be sold.  More concerning again is the new government’s rhetoric about the move of the private health insurance industry into general practice.

I am interested from a policy perspective in good models of care. I am interested in how there can be a stronger role for prevention and more integrated case management, better consumer health literacy, more consumer engagement. There are very good examples across the country, including some of the work private health insurers are doing with their captured population of patients.

But I remain fundamentally concerned as a Labor Shadow Health Minister about health inequality and my very real fear is that there is a genuine danger of a shift toward a two tiered health system.

Conclusion

Today, some 30 years since the introduction of our universal health system – Medicare – debates about its structure, its funding, its principles and its implementation continue. But it is clear that Australians value it and that it is embedded as a fundamental aspect of our society.

I want to wish you well in your deliberations today.

I wish to congratulate the AHHA on pulling together speakers who have been responsible for the establishment, implementation and defence of Medicare.

Labor stands for a system of universal care.

As Neal Blewett told parliament 30 years ago, basic healthcare should be the right of every Australian.

30 years later, it is.

Medicare is a system worth defending and we will do exactly that.


NACCHO political alert: An open letter to the Prime Minister’s Indigenous Advisory Council from a NACCHO member

DON

“I believe passionately in the creation of relevant and workable policies that can bring real change into our communities, policies that have the ability to create better health, education and social outcomes for our people.

I am keenly aware of the many and far-reaching issues surrounding Aboriginal Affairs, as Chief Executive Officer of Awabakal Newcastle Aboriginal Co-Operative, I am faced with these challenges daily.

Don MacAskill  (pictured above in plain shirt with the Deadley Choices mob)

An open letter to the Prime Minister’s Indigenous Advisory Council:

Reasonable questions regarding the Terms of Reference

 To the members of the Prime Minister’s Indigenous Advisory Council, firstly, I thank you for your service and commitment to Aboriginal affairs and issues facing our communities today.

Like many Indigenous people, I was encouraged and hopeful after the announcement of an Indigenous Advisory Council, dedicated to representing the needs and concerns of Aboriginal people across the country. I hope that the Council’s opportunity to work closely with Prime Minister Abbott as he strives to improve the health and welfare of Aboriginal people is maximised, and that you will be courageous in your efforts to ensure he truly is the ‘Prime Minister for Indigenous Affairs’.

While I believe this has the potential to be a worthwhile initiative, I do have a few concerns regarding the transparency of the Council and what the reporting obligations will be to the community. I have listed a few of these concerns below, and look forward to receiving your thoughts on the following.

After some basic research, I have been unable to locate any information detailing the policies and frameworks around the Council. I, and many others in the community, are curious as to how members were elected, and what selection process was undertaken?

Will the frameworks around the Council, for example, code of conduct, reporting responsibilities, minutes of meetings, key performance indicators of both individual and whole of council performance, be made publicly available?

Another area I felt was unclear was relating to the scope of the Council, and the specific impacts it has on policy creation, the assessment of existing policies relating to the Indigenous community, or whether it is simply there to provide advice when requested by the Prime Minister?

Has a strategic plan, complete with objectives and evaluation models, been developed and will this be available for the public? What reports will be made available to the public? As I noted with some concern, stated within the Terms of Reference, ‘the deliberation of the Council will be confidential, but the Council may choose to issue a statement after its meetings.’ There appears to be a worrying lack of transparency, and I have concerns this may undermine the meaningful changes the Council has the opportunity to effect.

I believe passionately in the creation of relevant and workable policies that can bring real change into our communities, policies that have the ability to create better health, education and social outcomes for our people.

I am keenly aware of the many and far-reaching issues surrounding Aboriginal Affairs, as Chief Executive Officer of Awabakal Newcastle Aboriginal Co-Operative, I am faced with these challenges daily. I have been following with some interest, the debate which has been raging within mainstream media regarding the decision making process of not only the Council, but also of Government as a whole.

Pragmatism vs ideology, has dominated the conversation and I believe this is a conversation all Australians need to have.

Our social justice values and the policies and laws that govern wider Australia, are based on several ideologies, mateship, a fair go for all, and taking care of the less fortunate. This is what forms the basis, in my opinion, of what makes us Australian.

The Council itself has been founded on the bipartisan ideology of ‘Closing the Gap’ and all the critical work that needs to be done to achieve this now and into the future.

In order to achieve real outcomes for the Aboriginal community, I believe Ideology should form the basis of every policy developed by those elected to govern, for those they represent. Should it not be the structure, implementation and evaluation of these policies that is pragmatic? Pragmatic solutions solidly rooted in the fundamental ideals we, as a country, support and embody?

I for one do not agree that the decision-making process must be simply ideological, or pragmatic, surely the integration of these concepts has not been eroded from our public consciousness so completely that they are now mutually exclusive.

I do not want to imagine a country, where decisions that impact on our most vulnerable and disenfranchised groups are made purely on economic or political reasons, nor do I want to see policy created based on ideology that has not root in best practice or better outcomes for the community.

I hope through the creation of this Council, you can find a way to engage the broader Aboriginal community and marry these two fundamental concepts in a way that achieves socially just, financially responsible and transparent outcomes for the community.

I look forward to seeing the outcomes you achieve through this Council, on the ground in my community.

Kind regards, Don MacAskill Awabakal Newcastle Aboriginal Co-Operative 0249 408 103

NACCHO news

HAVE You checked out the NACCHO APP HERE ?

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DOWNLOAD links here

The NACCHO App contains a geo locator, which will help you find the nearest Aboriginal Community Controlled Health Organisation in your area and automatically creates a number to call .

2014-01-13 07.27.37

NACCHO Aboriginal health news : How will Assistant Health Minister Fiona Nash fix the regional doctor shortage in 2014 ?

Fiona Nash

“You don’t want to reinvent the wheel, but we also need to look with fresh eyes at why aren’t we getting more allied health professionals and doctors in regional areas, and what can be done better.”

Assistant Health Minister Senator Fiona Nash (BIO and contact details below)

FIXING the broken incentive scheme for doctors to come to regional Australia will be the top priority for Assistant Health Minister Senator Fiona Nash this year.

The Abbott Government’s minister responsible for rural and regional health, Sen Nash said fixing the geographical classification system that governs incentives to encourage doctors to leave the city was the most important issue facing rural health this year.

Exclusive South Burnett Times

The Australian Standard Geographical Classification – Remoteness Area (ASGC-RA) effectively decides whether doctors can access payments from $2500 a year to move to an inner regional area up to $13,000 for working in a very remote area

But long-standing problems have dogged the system since it was introduced in 2001, because it pays the same rates to doctors working in some major regional cities as those in some smaller, more remote towns.

“The previous (Howard) government put in place the incentives program to help ensure doctors move to regional areas, but it actually pays the same incentives for doctors to go to a town of 2000 to those who might move to a major town of 60,000,” Sen Nash said.

“Addressing that and other regional workforce issues and how to improve the incentive scheme is my priority this year.”

While Sen Nash was part of a Senate inquiry last year that closely examined the issue, she said she would not be rushing to meet a deadline this year – instead focussing on “getting it right”.

“What we have after many years of not enough doctors in Australia, is we now have enough, but the problem for rural and regional areas is we have a maldistribution, they largely reside in the cities, but it’s my target that by the end we will be able to say there are better outcomes for rural health,” Sen Nash said.

“You don’t want to reinvent the wheel, but we also need to look with fresh eyes at why aren’t we getting more allied health professionals and doctors in regional areas, and what can be done better.”

Sen Nash said she would also be focused on improving mental health, nutrition and food labelling as chair of the Food Ministers Council.

BIO and contact details Senator the Hon Fiona Nash

Assistant Minister for Health

Minister Nash was first elected to the Senate for the NSW Nationals at the 2004 Federal Election, and was re-elected in 2010.Prior to becoming Assistant Minister for Health, Senator Nash held a range of Parliamentary and Senate Committee positions.

In 2007 she was appointed Party Whip and in 2008, was elected Deputy Leader of the Nationals in the Senate. Also in 2008, Minister Nash was appointed as Shadow Parliamentary Secretary for Water Resources and Conservation, and in 2010 became Shadow Parliamentary Secretary for Regional Education.

In her role as Shadow Parliamentary Secretary for Regional Education, Minister Nash led a successful campaign to make the independent youth allowance criteria fair for thousands of students living in inner regional areas.
In the Senate, Senator Nash chaired the Rural and Regional Affairs and Transport References Senate committee from 2008 – 2010, heading up inquiries on issues such as biosecurity, grains, BSE-affected meat and regional education.

As a resident and representative of regional Australia, Minister Nash has a deep understanding of the challenges faced by people living outside metropolitan Australia.
Minister Nash and her husband, David, have two sons, William and Henry, and operate a mixed farm near Young in south west NSW.

HAVE You checked out the NACCHO APP HERE ?

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DOWNLOAD links here

The NACCHO App contains a geo locator, which will help you find the nearest Aboriginal Community Controlled Health Organisation in your area and automatically creates a number to call .

2014-01-13 07.27.37

NACCHO political health news : Abbott Government cuts to impact on Aboriginal health

Shane

Closing the gap requires a coordinated approach at the state and federal levels as the challenges faced by Aboriginal people are interconnected.You can’t improve overall health outcomes without also looking at the social determinants, things like housing, education and poverty. Similarly, you can’t improve health outcomes while the numbers of Aboriginal people in our jails continues to rise,”

Said NACCHO chair Justin Mohamed .(see press release below) pictured above with Shane Duffy NATSILS

Congress calls upon the Prime Minister to show leadership and understanding of the need for increased capacity in our organisations and communities.  He can demonstrate that by ensuring the National Aboriginal and Torres Strait Islander Legal Services is retained and strengthened,”

Said Co-Chair National Congress Les Malezer.(see press release below)

Overview

Yesterday the Federal Government delivered the Mid Year Economic and Fiscal Outlook 2013-2014.
Here are some things from the report as they relate to Aboriginal Affairs and Aboriginal Health and Health more broadly.
Ceased
-The Indigenous Carbon Farming Fund
-Remote Indigenous Energy Programme
-Aboriginal and Torres Strait Islander Health Programme ($1.0 m in 2013-2014)
-Office of the Coordinator-General for Remote Indigenous Services
-$27m from the Healthier Communities Priority Infrastructure Programme
-$5m Chronic Disease Prevention and Services Improvement Fund
-National Rural and Remote Health Infrastructure Programs – 22.3m
-Public Health Program – $6mil
Established
-$45 mil for Vocation Training and Employment Centres for 5000 Aboriginal job seekers under the Generation One model
-$5 for Empowered Communities based on Jawun Model.
-$1mil for Indigenous Advisory Council (Chaired by Warren Mundine)
-$40mil of redirected funding to re-open Indigenous Employment Programme in remote areas

NACCHO Press release

National Aboriginal Community Controlled Health Organisation (NACCHO) Chair, Justin Mohamed, said cutting legal services made no economic sense when you take into account the wider implications of incarceration on issues such as employment, education and health.

“The fact is people in our jail system often suffer from poor mental and physical health,” Mr Mohamed said.

“Incarceration also can have broader impacts on the health of those left behind – on the imprisoned person’s family and broader community.

“With rates of incarceration of Aboriginal people increasing, we should be doing everything we can to turn around the huge numbers of Aboriginal people in our prisons.

“NACCHO supports the good work of the National Aboriginal and Torres Strait Islander Legal Services and Aboriginal and Torres Strait Islander Legal Services – both who play an important role in keeping our people out of jail.

“They provide education and early intervention support and advice which can mean the difference between a life of incarceration and one that makes a contribution to the community.

“The Federal Government need to rethink their position and recognise how crucial a national voice on Aboriginal legal policy is in reducing the disproportionate numbers of Aboriginal people in the justice system.

“Aboriginal peak bodies understand better than anyone the issues their people face and the factors that contribute to them entering the justice system.

“Taking that voice from the mix to save a few dollars will just hamper future efforts to improve outcomes across a range of factors including health, education and employment.”

Mr Mohamed said closing the gap between Aboriginal and non-Aboriginal people needed an integrated approach.

“Aboriginal people make up more than thirty percent of the prison population, despite being only a fraction of the Australian population.

“Closing the gap requires a coordinated approach at the state and federal levels as the challenges faced by Aboriginal people are interconnected.

“You can’t improve overall health outcomes without also looking at the social determinants, things like housing, education and poverty. Similarly, you can’t improve health outcomes while the numbers of

Aboriginal people in our jails continues to rise,” Mr Mohamed said.

National Congress Condemns Cuts

 
The National Congress of Australia’s First Peoples (Congress) strongly opposes the decision by the Federal Government to cut funding to community controlled Aboriginal and Torres Strait Islander organisations.
The government’s ‘hit or miss’ funding cuts to our organisations, at the beginning of their term and before the completion of their highly-publicised inquiries, endangers the collaborative approach offered by the Prime Minister.
Today’s news that the national body for the Aboriginal and Torres Strait Islander Legal Services is to be defunded is a significant blow and does not reflect an effort to engage in partnership.
Having a national body for the legal services increases the skills, experience and effectiveness of all the Aboriginal and Torres Strait Islander Legal Services, and brings greater efficiency to the expenditure incurred by those legal services.
“Congress calls upon the Prime Minister to show leadership and understanding of the need for increased capacity in our organisations and communities.  He can demonstrate that by ensuring the National Aboriginal and Torres Strait Islander Legal Services is retained and strengthened,” said Co-Chair Les Malezer.
“Our Peoples must be self-determining and will not accept Governments making decisions on funding priorities without us.
“Removing our capacity for policy reform and advocacy to legal assistance programs delivered by Aboriginal, community and legal aid services will affect the most marginalised and vulnerable members of our community.
“Congress supports organisations controlled by Aboriginal and Torres Strait Islander communities to continue representing our interests and to provide expert advice on service delivery,” said Mr Malezer.
Congress recently made a strongly worded submission to the National Commission of Audit which reinforces our fundamental principles of self-determination and community decision making.
“Significant under investment by successive Governments makes our Peoples predicament comparable to some developing countries, “said Co-Chair Kirstie Parker.
“We cannot accept any reduction in Commonwealth spending on housing, remote infrastructure, legal services, community safety, native title, languages and culture, when investment and capacity building is what’s clearly required.
“We will continue to work with the Commission to engage with all of our members.
“Community input and ownership are highlighted as keys to achieve improvements by the Government’s own landmark reports – including the Department of Finance Strategic Review of Indigenous Expenditure (2011) and the Overcoming Indigenous Disadvantage: Key indicators 2011 report,” said Ms Parker.
Contact Congress : Liz Willis 0457 877 408  NACCHO Colin Cowell 0401 331 251
 
 

Government avoids scrutiny by cutting Coordinator-General for Remote Indigenous ServicesGeneral for Remote Indigenous Services.

“This cost cutting measure from the Government is deeply disappointing and will further undermine efforts to deliver on our Closing the Gap commitments,” Senator Rachel Siewert, Australian Greens spokesperson on Aboriginal and Torres Strait Islander Issues.
“The role of Coordinator General is to ‘monitor, assess, advise and drive progress relating to improvements in government service delivery in 29 remote Indigenous communities across Australia’.
Removing this role will directly affect the ability of the Government to monitor and report on the implementation of policies.
“This cut is a comparatively small amount of money that the Government admits will be used to either save money or fund other, unnamed policies.
It isn’t even being reinvested in other programs to help people in remote Australia.
“Decisions such as this make a mockery of Tony Abbott’s comments about being the Prime Minister for Indigenous Affairs, as once again his Government seeks to avoid scrutiny and accountability for its policies,” Senator Siewert concluded.

NACCHO Aboriginal health news: Aboriginal health isn’t all bad news

 

It’s easy to feel disheartened by the bombardment of negative statistics about Indigenous health, but we shouldn’t ignore the many successes, writes Lisa Jackson Pulver in the  ABC online DRUM Photo:  (Dave Hunt, file photo: AAP)

Lisa Jackson Pulver holds the Inaugural Chair of Indigenous Health and is a Professor of Public Health at UNSW. View her full profile here.

The media loves a bad news story – and the response to the latest report on Aboriginal and Torres Strait Islander health is no exception.

The Sydney Morning Herald called the past 10 years a “wasted decade“, highlighting increasing rates of diabetes, kidney disease, asthma and osteoporosis among Indigenous people, along with the 11-year gap in life expectancy between Indigenous and non-Indigenous Australians.

But the largest-ever survey of Aboriginal and Torres Strait Islander health released by the Australian Bureau of Statistics also has some good news to report that was all too easily passed over.

Fewer Indigenous people are taking up smoking, and those who do smoke are giving up the habit. This is despite nicotine being an addictive substance, highly influenced by social norms. For years, smoking rates have been much higher in the Indigenous community than in the non-Indigenous community. But according to the Bureau, the proportion of young Aboriginal and Torres Strait Islander people aged 15 to 17 years who have never smoked has increased from 61 per cent to 77 per cent, with an increase from 34 per cent to 43 per cent for those aged 18 to 24 years.

This result is matched by the non-Indigenous community. It should be applauded and recognised by all Australians: it shows the resilience of our young people who are increasingly saying no to smoking. The choice they are making will mean a decrease in the knock-on effects that chronic smoking brings.

While it must be acknowledged that this is only one indicator of success, it is still a win. So, where are the accolades for all the tobacco control programs, the Aboriginal Health Worker mentors and those with the resolve to never smoke or to stop? Why is this not the story?

Among the findings in the ABS report, Indigenous Australians are reported as being more than three times as likely as non-Indigenous Australians to have diabetes. While this is cause for concern, many of the major health problems for Indigenous communities are not only affected by health spending, but by the wider determinants of health. This means it will take much longer before we see viable gains. So it should come as no surprise that in such a short period, since 2009, the Closing the Gap policy framework and funding did not produce positive health outcomes on all measures. The period surveyed (2012-2013) cannot have benefitted from the new money that flowed as a result of Closing the Gap. It is too early. More importantly, the severe disadvantage many of these data reflect reinforces the argument for concerted action and sustained funding over the longer term.

We must also remember that early prevention and intervention is important, so we need to continue to look for the early and intermediate signs of what will become a long-term improvement in health – which of course includes lower smoking rates, a top risk factor for a wide array of other health conditions. Likewise, we should not simply focus on the current rates of chronic disease, but also the factors that contribute to good health in the future: nutritional status and healthy diets, physical activity, access to antenatal care, not smoking, engagement in family and community activities, housing quality and whether there is overcrowding, employment and cultural and psychological wellbeing – all of which lay the foundations to health.

Aboriginal and Torres Strait Islander health, like everyone’s health, is much more than the absence of disease. It involves physical, social, emotional, cultural, spiritual and ecological wellbeing and fulfilment of potential to contribute to the wellbeing of the whole community. Looking more deeply, we can see the outstanding successes in Aboriginal and Torres Strait Islander primary healthcare services, visual and performing arts, drama, music, tertiary education and sport as examples of early indicators that many people are flourishing.

It is very easy to see only the negative, given the statistics that seem to bombard us. That’s unfortunate because it promotes a sense of hopelessness, when what is needed is energy, positive models of change and positive commitment over the long term. There would be great value in capturing these positive changes, in collecting and amplifying the voices of those young people in particular who have made conscious decisions to live well and let these voices join the growing chorus of role models, exemplars and successful ventures in our communities.

Closing the Gap is a great start – and a much needed catalyst for change – but it is necessary to shift the lens towards the kinds of deeper changes that lead to lifelong health, including not smoking. Instead of focusing on the negatives, why not support those effective, community-driven enterprises and programs already having positive impacts, so that the children of our children will again enjoy the great opportunities that life in this magnificent country has to offer.

Lisa Jackson Pulver holds the Inaugural Chair of Indigenous Health and is a Professor of Public Health at UNSW. View her full profile here.

Topics: indigenous-aboriginal-and-torres-strait-islander, indigenous-policy

NACCHO Aboriginal Health News : Media coverage and download AMA Aboriginal health report 2012-2013

IMG_2368

There are some incredible things happening out there in communities all around Australia. Our Report Card shines a bright light on what needs to be done to improve the health and wellbeing of Aboriginal and Torres Strait Islander children in their important early years of life.

It also brings together some of the great work that is already happening to make a difference

Dr Steve Hambleton (see full launch speech below)

Picture above:  Romlie Mokak CEO  AIDA, Justin Mohamed NACCHO chair, Senator Fiona Nash and AMA CEO Dr Steve Hambleton

WATCH LAUNCH on NACCHOTV and  NITV

(Transcript from World News Australia Radio) Thea Cowie reports

The Aboriginal and Torres Strait Islander health report card highlights the impact early childhood experiences can have on genetic expression

DOWNLOAD THE REPORT HERE

Unfortunately there’s nothing new about inter-generational Indigenous disadvantage.

But Australian Medical Association national president Steve Hambleton says new developments in neuroscience, molecular biology and epigenetics provide a scientific explanation for the cycle of disadvantage.

“Now epigenetics, or the study of the way genes are switched on and off, we can now understand how those early life experiences become hard-wired into the body with lifelong effects on health and wellbeing. Early experiences can influence which of the person’s genes are activated and de-activated and consequently how the brain and body development occurs.”

The AMA report says repetitive stressful experiences early in life can cause changes in the function of genes that influence how well the body copes with adversity throughout life – including the development of emotional control, memory function and cognition.

The report cites research showing more than 20 per cent of Aboriginal and Torres Strait Islander families with children under 16 experience seven or more life stress events in a year.

Chairman of the National Aboriginal Community Controlled Health Organisation, Justin Mohamed, admits it’s daunting to think about the impact early childhood events can have on a genetic level.

“It’s very scary to think that an individual event or a multitude of events, or the environment that you were raised in, can actually switch off your potential of what you could be. And on the other side of the thing I think it’s very encouraging to think that well there might just be some minor adjustments which actually can switch on so you can actually reach your potential.”

Mr Mohamed says in many ways the science backs up what’s long been known.

But he hopes the evidence will help focus efforts and investment on the early years – the years he says really change lives.

“They want evidence, they want to see where they can make the best investment to get the best return. So I think that this report will show that well here’s some evidence. We know that if the right investment is made, the right rollout to frontline services, Aboriginal community controlled health services, that we can have really good turn around with the results.”

The Australian Indigenous Doctors’ Association chief executive officer, Romlie Mokak, says the report also highlights the importance of providing support to mothers- and fathers-to-be.

“Having all of that early education and support is really critical for fundamental things like having access pre-natally. When baby’s born the connect between having all of that clinical support and education, the right nutrition and supportive environments can improve birth weights. And it’s also about making sure that care continues once bub’s born.”

Recommendations from the AMA report include establishing a national plan for expanded maternal and child services including parenting and life skills education, expanding home visit services and building a strong sense of cultural identity and self-worth.

Mr Mokak acknowledges the report is just one of thousands written in an attempt to address Indigenous disadvantage.

But he hopes this one will receive the bipartisan support and funding needed to capitalise on its findings.

“The fact that the president of the AMA, Steve Hambleton, who’s so committed to this agenda, chairs the taskforce that produced the report says something. This is however many thousands of doctors in the country who are saying this is important business for the medical fraternity. The biggest call here I think is for us to think about a future beyond a political cycle. My hope would be that it fits in terms of aligning with government, the Opposition and the Greens and others to say this is an important agenda for us to keep supporting.”

The AMA Indigenous Health Report Card is one of the most significant pieces of work produced by the AMA. It gives us great pride. It matters. It makes a difference.

We have been producing these Report Cards for over a decade now, and each time we focus on a different aspect of Indigenous health – children’s health, primary care, funding, men’s health, or inequity of access.

We come at it from all angles.

We do not pretend to have all the solutions to the many health problems that confront Aboriginal peoples and Torres Strait Islanders. But the AMA recognises and acknowledges the problems and we want to help fix them. Our Report Cards are a catalyst for thinking, and hopefully a catalyst for action.

This year we are focusing on the early years of life. It is the right of every Australian child to have the best start in life – but in Australia today not every child benefits from this right. In their early years, children need to be safe, have adequate opportunities for growth and development, and have access to adequate health, child development, and education services.

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

There have been some improvements in recent years with many Aboriginal and Torres Strait Islander children making a successful transition to healthy adult life.

But there are still far too many who are being raised in community and family environments that are marked by severe early childhood adversity.

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

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

Epigenetics is all about how early life experiences become hard-wired into the body, with life-long effects on health and wellbeing.

Early experiences can influence which of a person’s genes are activated and de-activated and, consequently, how the brain and the body develop.

Building and providing stable and healthy life experiences in the early years can help break the cycle of adversity.

That is our task and our challenge.

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

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

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

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

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

The AMA makes several recommendations in the Report Card, including :

A national plan for expanded comprehensive maternal and child services;

The extension of the Australian Nurse Family Partnership Program of home visiting to more centres;

Support for families at risk with interventions to protect infants and young children from neglect, abuse and family violence;

Efforts to reduce the incarceration of Aboriginal people and Torres Strait Islanders; efforts to improve the access of Aboriginal people and Torres Strait Islanders to the benefits of the economy, especially employment and entrepreneurship;

Efforts to keep children at school;

Building a strong sense of cultural identity and self-worth; improving the living environment with better housing, clean water, sanitation facilities, and conditions that contribute to safe and healthy living; and better data, research and evaluation culturally appropriate measures of early childhood development and wellbeing.

We have also highlighted some examples of programs that are already being successful at improving the early years of Indigenous children.

There is the Darwin Midwifery Group Practice, the Aboriginal Family Birthing Program in South Australia, and the NSW Intensive Family Support Service are just a few.

Our governments – individually and through COAG – must examine these programs, learn from them, and replicate them where possible.

Our governments must also look at the Abecedarian approach to early childhood development.

This involves a suite of high quality teaching and learning strategies to improve later life outcomes for children from at-risk and under-resourced families.

It is being used to great effect at the Central Australian Aboriginal Congress in Alice Springs.

The AMA believes the Abecedarian approach has a strong track record of success and we urge all governments to have a closer look for possible widespread implementation.

There are some incredible things happening out there in communities all around Australia. Our Report Card shines a bright light on what needs to be done to improve the health and wellbeing of Aboriginal and Torres Strait Islander children in their important early years of life.

It also brings together some of the great work that is already happening to make a difference.

Importantly, it defines a challenge for all of us – governments, the medical profession, the r health and education sectors, and the broader community – to give these kids and their families a healthier life.

I now ask the Assistant Minister for Health, Senator Fiona Nash, to say a few words and officially launch our Report Card. Background. Some key factors impacting on Aboriginal and Torres Strait Islander health and wellbeing in the early years:

Pregnancy and Birth

Aboriginal and Torres Strait Islander women have a higher birth rate compared with all women in Australia (2.6 babies compared to 1.9), and are more likely to have children at a younger age: 52 per cent of the Aboriginal women giving birth in 2010 were aged less than 25 years, and 20 per cent were less than 20 years, compared with 16 per cent and 3 per cent, respectively, for the broader community [AIHW, 2012];

Aboriginal women remain twice as likely to die in childbirth as non-Aboriginal mothers, and are significantly more likely to experience pregnancy complications and stressful life events and social problems during pregnancy, such as the death of a family member, housing problems, and family violence [Brown, 2011];around half of Aboriginal and Torres Strait islander mothers who gave birth in 2010 smoked during pregnancy, almost four times the rate of other Australian mothers; and while infant mortality continues to fall, low birth weight appears to be increasing.

Infancy and early years

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

Family Life

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

Aboriginal and Torres Strait Islander children were almost eight times as likely to be the subject of substantiated child abuse and neglect compared with other Australian children [AIHW 2012].

 

Early Childhood Education and Schooling

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

Only modest progress has been made in achieving the Closing the Gap target to halve the gap for Aboriginal and Torres Strait Islander students in NAPLAN reading, writing and numeracy assessment scores by 2018    

 

 

 

 

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

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AMA Indigenous Health Report Card 2012-13

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

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

DOWNLOAD THE AMA 2012-2013 REPORT CARD HERE

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Pregnancy and Birth

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

Infancy and early years

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

Family Life

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

Early Childhood Education and Schooling

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

10 December 2013

CONTACT:        John Flannery                     02 6270 5477 / 0419 494 761

NACCHO Aboriginal health news: Smoking fall a win for Aboriginal health, but many problems remain: ABS report

 Koori Mail Handover

THE gap between the health of Aboriginal and non-Aboriginal Australians is still “significant”, according to NACCHO the peak body on Aboriginal  health.

It also says improving Aboriginal health should be a priority for all state and territory governments.

Report from Patricia Karvelas The Australian

Picture Above :Justin Mohamed Chair of NACCHO recently launching NACCHO Aboriginal Health newspaper ,with Trevor Kapeen Koori Mail

The Australian Bureau of Statistics’ Australian Aboriginal and Torres Strait Islander Health Survey 2012-13, released today, showed some “encouraging” results in reducing smoking rates but other areas needed more focus.

KEY FINDINGS BELOW or

ABS REPORT and more INFO

Justin Mohamed, Chair of the National Aboriginal Community Controlled Health Organisation (NACCHO), said the fact that the National Partnership Agreement (NPA) to Close the Gap had not been renewed by all state and territory governments meant that hundreds of health programs that were improving health outcomes were now at risk.

DOWNLOAD THE NACCHO PRESS RELEASE

“The investment in programs to stop Aboriginal and Torres Strait Islander people from smoking is reaping rewards with smoking rates on the decrease,” Mr Mohamed said.

“It is critical that investment in these programs continues so we maintain the downward trend.

“The fact that two in five Aboriginal people are still daily smokers means we need to keep our focus on the programs that are working such as those run nationally by Aboriginal Community Controlled Health Services.”

Mr Mohamed said another pleasing result was the reduction in the prevalence of ear and hearing problems since 2001.

“However we are still seeing rates of diabetes, asthma and heart and kidney disease are way too high in both remote and urban Aboriginal communities. Obesity rates are 1.5 times non-Aboriginal communities and other areas of concern are alcohol consumption and mental health.”

Mr Mohamed said improving Aboriginal health required long-term commitment and investment, and leadership at the national level.

“There are no quick fixes in Aboriginal health. Todays report shows we are making some headway but achieving generational change means maintaining the momentum,” he said.

“Inaction on the NPA means many of the health programs and services that have contributed to the gains seen in the ABS report will literally have to close their doors within months.”

He said getting the states and territories back on board with a new agreement must now be a priority for the new Coalition government.

“Aboriginal community controlled health services are making a difference in their communities and they need to see continued support from all levels of government.”

KEY FINDINGS

General health

  • In 2012–13, around two in five (39.2%) Aboriginal and Torres Strait Islander people aged 15 years and over considered themselves to be in very good or excellent health, while 7.2% rated their health as poor.
  • Based on age standardised proportions, Aboriginal and Torres Strait Islander people aged 15 years and over were around half as likely as non-Indigenous people to have reported excellent or very good health (rate ratio of 0.6).


Long-term health conditions

Asthma

  • In 2012–13, one in six (17.5%) Aboriginal and Torres Strait Islander people had asthma.
  • Aboriginal and Torres Strait Islander people in non-remote areas were twice as likely as those in remote areas to have asthma (19.6% compared with 9.9%).
  • Based on age standardised proportions, Aboriginal and Torres Strait Islander people were twice as likely as non-Indigenous people to have asthma (rate ratio of 1.9) (Endnote 1).

Ear diseases and hearing loss

  • In 2012–13, around one in eight (12.3%) Aboriginal and Torres Strait Islander people reported diseases of the ear and/or hearing problems.
  • Based on age standardised proportions, Aboriginal and Torres Strait Islander people were more likely than non-Indigenous people to have diseases of the ear and/or hearing problems (rate ratio of 1.3) (Endnote 1).

Heart and circulatory diseases

  • In 2012–13, around one in eight (12.0%) Aboriginal and Torres Strait Islander people had heart disease.
  • Aboriginal and Torres Strait Islander rates for heart disease were significantly higher than the comparable rates for non-Indigenous people in all age groups from 15–54 years.
  • Based on age standardised proportions, Aboriginal and Torres Strait Islander people were more likely than non-Indigenous people to have asthma (rate ratio of 1.2) (Endnote 1).

Diabetes/high sugar levels

  • In 2012–13, around one in twelve (8.2%) Aboriginal and Torres Strait Islander people had diabetes mellitus and/or high sugar levels in their blood or urine.
  • Aboriginal and Torres Strait Islander rates for diabetes/high sugar levels were between three and five times as high as the comparable rates for non-Indigenous people in all age groups from 25 years and over.
  • Based on age standardised proportions, Aboriginal and Torres Strait Islander people were three times as likely as non-Indigenous people to have diabetes/high sugar levels (rate ratio of 3.3) (Endnote 1).


Health risk factors

Tobacco smoking

  • ln 2012–13, two in five (41.0%) Aboriginal and Torres Strait Islander people aged 15 years and over smoked on a daily basis.
  • Rates of daily smoking for Aboriginal and Torres Strait Islander people have come down from 50.9% in 2002 and 44.6% in 2008
  • In 2012–13, current daily smoking was still more prevalent among Aboriginal and Torres Strait Islander people than non-Indigenous people in every age group
  • Based on age standardised proportions, the gap between the daily smoking rate in the Aboriginal and Torres Strait Islander population and non-Indigenous population was 27 percentage points in 2001 and was 25 percentage points in 2012–13 (Endnote 1).

Alcohol consumption

  • In 2012–13, around one in six (18.0%) Aboriginal and Torres Strait Islander people aged 15 years and over had consumed more than two standard drinks per day on average, exceeding the lifetime risk guidelines.
  • Based on age standardised proportions, Aboriginal and Torres Strait Islander people aged 15 years and over and non-Indigenous people were exceeding the lifetime risk guidelines at similar rates (rate ratio of 1.0).
  • In 2012–13, just over half (53.6%) Aboriginal and Torres Strait Islander people aged 15 years and over had consumed more than four standard drinks on a single occasion in the past year, exceeding the threshold for single occasion risk.
  • Aboriginal and Torres Strait Islander women aged 35 years and over were significantly more likely than non-Indigenous women in this age group to have exceeded the threshold for single occasion risk
  • Based on age standardised proportions, Aboriginal and Torres Strait Islander people aged 15 years and over were more likely than non-Indigenous people to have exceeded the single occasion risk guidelines (rate ratio of 1.1)(Endnote 1).

Illicit substance use

  • In 2012–13, just over one in five (21.7%) Aboriginal and Torres Strait Islander people aged 15 years and over said that they had used an illicit substance in the previous year.
  • Marijuana was the most commonly reported illicit drug, having been used by one in six (18%) Aboriginal and Torres Strait Islander people aged 15 years and over in the previous year.

Overweight and obesity

  • In 2012–13, almost one-third (30.4%) of Aboriginal and Torres Strait Islander children aged 2–14 years were overweight or obese according to their BMI
  • In 2012–13, two-thirds (65.6%) Aboriginal and Torres Strait Islander people aged 15 years and over were overweight or obese (28.6% and 37.0% respectively), according to their BMI.
  • Obesity rates for Aboriginal and Torres Strait Islander females and males were significantlyhigher than the comparable rates for non-Indigenous people in almost every age group.

Exercise levels – non-remote areas only

  • In 2012–13, three in five (62%) Aboriginal and Torres Strait Islander people aged 18 years and over were physically inactive and one in ten (10%) had exercise at high intensity.
  • Based on age standardised proportions, Aboriginal and Torres Strait Islander adults in non-remote areas were more likely than non-Indigenous people to have been sedentary or exercising at low intensity (rate ratio of 1.1) and were only half as likely to have been exercising at high intensity (rate ratio of 0.6) (Endnote 1).
  • In 2012–13, just under half (46%) of Aboriginal and Torres Strait Islander adults in non-remote areas had met the National Physical Activity (NPA) Guidelines target of 30 minutes of moderate intensity physical activity on most days (or a total of 150 minutes per week).
  • Based on age standardised proportions, Aboriginal and Torres Strait Islander adults in non-remote areas were less likely than non-Indigenous people to have met the NPA targets of 150 minutes of moderate intensity exercise per week or 150 minutes and 5 sessions per week (rate ratio of 0.8 for both) (Endnote 1).


Physical measurements

Waist circumference

  • In 2012–13, 60.4% of Aboriginal and Torres Strait Islander men aged 18 years and over had a waist circumference that put them at an increased risk of developing chronic diseases, while 81.4% of women had an increased level of risk.
  • On average, Aboriginal and Torres Strait Islander men aged 18 years and over had a waist measurement of 99.7 cm, while women had a waist measurement of 97.4 cm.

Blood pressure

  • In 2012–13, one in five (20.3%) Aboriginal and Torres Strait islander adults had measured high blood pressure (systolic or diastolic blood pressure equal to or greater than 140/90 mmHg).
  • Based on age standardised proportions, Aboriginal and Torres Strait Islander adults were more likely than non-Indigenous people to have high blood pressure (rate ratio of 1.2) (Endnote 1).

Health-related actions

Consultations with health professionals

In 2012–13, in the Aboriginal and Torres Strait Islander population

  • just over one in five (21.9%) people had consulted a GP or specialist in the last two weeks
  • one in five (18.5%) people had visited a health professional (other than a doctor) in the last two weeks
  • one in twenty (4.8%) people aged two years and over had visited a dental professional in the last two weeks.
  • Between 2001 and 2012–13, use of health professionals (other than GP/specialist) increased significantly from 16.3% to 18.5%.
  • Between 2001 and 2012–13, consultation rates for GP/specialist and dental professionals have remained largely unchanged.

Hospital visits and admissions

In 2012–13, in the Aboriginal and Torres Strait Islander population

  • around one in sixteen (6.0%) people had visited the casualty/outpatients/day clinic in the last two weeks
  • around one in six (18.0%) people had been admitted to a hospital in the previous year.

ENDNOTE

1. Difference between the age standardised proportion for Aboriginal and Torres Strait Islander people and non-Indigenous people is statistically significant

NACCHO chair launches Australia’s first Aboriginal Health Newspaper at AGM

Koori Mail Handover

Picture Above: Board Director of the Koori Mail Trevor Kapeen presents the first copy of Australia’s first Aboriginal Health Newspaper to Chair of NACCHO Justin Mohamed on the opening day of the NACCHO AGM in Perth.

Working with Aboriginal community controlled and award-winning national newspaper the Koori Mail, NACCHO aims thru NACCHO Health News to bring relevant information on health services, policy and programs to NACCHO members and key industry stakeholders at a grassroots level.

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NACCHO will leverage the brand, coverage and award-winning production skills of the Koori Mail to produce a 20-28 page three times a year, distributed as a ‘lift-out’ in the 14,000 Koori Mail circulation, as well as an extra 5000 copies to be sent directly to NACCHO member organisations across Australia.

“We have learned that most of the communication around these important Aboriginal health areas tend to float around the top echelons of the government and non-government sectors,” said NACCHO chairman Justin Mohamed.

“Our intention is to broaden the reach of this information, landing in the waiting rooms  and tea rooms of community health clinics, community centres, program offices and other places accessed daily by primary health care workers and our clients .

“While NACCHO’s website and annual report have been valued sources of information for national and local Aboriginal  health care issues for many years, the launch of NACCHO Health News creates a fresh, vitalised platform that will inevitably reach audiences beyond the boardrooms,” Mr. Mohamed said

“This is a tremendous leap for the dissemination of health information across our Aboriginal  population,” Mr Mohamed noted. “Never before has such valuable and relevant health information become so accessible to this sector. If you have a message or job opportunity you want to get into the Aboriginal primary health care sector, NACCHO Health News is your ideal media.”

The first edition of NACCHO Health News hit the presses on November 17 and was promoted heavily via various media channels and social media outlets.

To book an advertisement and/or have your article considered for publication in the April 2014 edition , please contact the NACCHO media team on 02 6246 9309 or email media@naccho.org.au.

NACCHO AGM Perth 2013 health news: Aboriginal life expectancy increases to Close the Gap

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Life expectancy for Aboriginal and Torres Strait Islander men increased by around one and a half years over the last five years, compared to about one year for non-Indigenous men. Life expectancy for Aboriginal and Torres Strait Islander women increased by about half a year over the period, roughly the same increase as non-Indigenous women.

Life expectancy at birth for Aboriginal and Torres Strait Islanders in 2010-2012 was 69.1 years for men and 73.7 years for women, according to figures released November 15 by the Australian Bureau of Statistics (ABS).

Download ABS life tables report 2013

Download ABS life expectancy FACT SHEET 2013

DOWNLOAD THE DATA in Xcel

healthy-futures-great

Justin Mohamed Chair of NACCHO is reporting to the NACCHO AGM in Perth this week that the NACCHO recently  commissioned Healthy for Life report from the Australian Institute of Health and Welfare  gave a great overview of the success of ACCHOs and delivered the evidence of just how big a contribution NACCHO ‘s 150 members are making to improve health outcomes for Aboriginal people.

Follow the NACCHO chair Justin Mohamed in Perth this week on TWITTER #NACCHOAGM13

DOWNLOAD THE AIHW NACCHO Healthy for LIFE Report Card

“The comprehensive report showed that Aboriginal Community Controlled services provided culturally appropriate primary health care to over 310,000 Aboriginal people each year, around half the Aboriginal and Torres Strait Islander population, and we are credited with three quarters of the health gains made against the Close the Gap targets.” Mr Mohamed said.

ABS Director of Demography, Bjorn Jarvis, said “Life expectancy for Aboriginal and Torres Strait Islander men increased by around one and a half years over the last five years, compared to about one year for non-Indigenous men. Life expectancy for Aboriginal and Torres Strait Islander women increased by about half a year over the period, roughly the same increase as non-Indigenous women,”

“The figures show that the gap in life expectancy of Aboriginal and Torres Strait Islander people compared to non-Indigenous people has narrowed,  but only slightly,” said Mr Jarvis.

The new figures for 2010-2012 show that life expectancy of Aboriginal and Torres Strait Islander men is estimated to be 10.6 years lower than non-Indigenous men, while life expectancy of Aboriginal and Torres Strait Islander women is 9.5 years lower than non-Indigenous women. The gap has reduced by 0.8 years for men and 0.1 years for women over the period.

Response from the Close the Gap  Campaign

Life expectancy for Aboriginal and Torres Strait Islander Peoples still lags behind that of non-Indigenous Australians, according to Australian Bureau of Statistics (ABS) data released today.

Close the Gap campaign co-chair, Mick Gooda, said the small improvement disclosed in the data covers a five-year period during which Closing the Gap policies were implemented.

“The ABS data shows a small but very welcome improvement in Aboriginal and Torre Strait Islander life expectancy. However, a significant gap remains,” Mr Gooda said.

Mr Gooda, who is also the Aboriginal and Torres Strait Islander Social Justice Commissioner, said Aboriginal and Torres Strait Islander Peoples don’t want to the health of Australia’s First Peoples to continue to lag behind the broader community.

“When we started the Close the Gap campaign we knew this was a generational effort. We knew that reducing the life expectancy gap was achievable but would take a concerted effort. That’s why we set the 2030 target and are working with the Government and the Opposition to ensure health equality for all Australians.”

Kirstie Parker, co-chair of the Close the Gap campaign and of the National Congress of Australia’s First Peoples, acknowledged the strong support for closing the gap from all political parties and from the wider Australian community.

“It’s heartening to see Government, Opposition and Greens support for the Close the Gap campaign, and almost 200,000 Australians have pledged their support.  Closing the gap is a national priority and an area of bipartisan support that the Government can build on,” Ms Parker said.

In August, the Close the Gap campaign articulated a platform for the first 100 days of the new Government. With that anniversary fast-approaching, Ms Parker said Close the Gap will work with Government so that it:

  • reports back to Parliament on the first parliamentary day of each year;
  • forges an agreement through COAG for a new National Partnership Agreement on Closing the Gap in Health Outcomes; and
  • establishes a clear process to implement the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.