NACCHO political alert: Complacent parties taking eye off the ball in Aboriginal health

Question Time in the House of Representatives

This time next week Tony Abbott could be the PM and Peter Dutton Health Minister but:

Closing the health gap between Indigenous and non-Indigenous Australians should be one of the highest priorities for government. Yet Indigenous health has barely been mentioned by either major party during this campaign.


NACCHO chairman Justin Mohamed says the only thing missing is political attention, with indigenous health hardly mentioned so far in the federal election campaign. At the National Press Club Health debate last week Peter Dutton announced that Tony Abbott would be making an announcement before Saturday about Aboriginal health but so far nothing.

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

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

Press release from Australian Healthcare Reform Alliance (AHCRA).

Health care is one of the most important issues to voters at this election but the policies of both major parties fail to deliver on key measures, according to the Australian Healthcare Reform Alliance (AHCRA). “Whilst there are some valuable initiatives from both sides, they fail to add up to a genuine effort to address the scale of the current health system problems.

There is insufficient action to address serious inequities in health and health care or longer term problems – they have taken their eye of the ball,” said Tony McBride, AHCRA chair.

“Closing the health gap between Indigenous and non-Indigenous Australians should be one of the highest priorities for government. Yet Indigenous health has barely been mentioned by either major party during this campaign.

“The current Labor Government has introduced some promising reforms, such as Medicare Locals and national funding of children’s dental services and more public adult services, a move that will address inequities. AHCRA therefore welcomes the Coalition’s broad support for these positive reforms, but is very concerned that there are too few details of how they will be progressed if they win power.

“Another major threat to our health system is the increasingly high co-payments faced by people when accessing care. Unless co-payments are addressed, they will continue to be a severe barrier that undermines the equity and universality of health programs such as Medicare and reverses any gains made by the reform process.

“Most importantly, neither major party has their eyes on the future and on how the looming health funding crisis in the next decade can be avoided as health care costs escalate. Neither party has a robust plan to keep people well and out of hospital by supporting prevention, by seriously addressing the social determinants of health that cause so much ill-health or by effectively managing chronic disease in the community. Without such action, the pressure on hospitals will simply grow to unaffordable levels and society as a whole and health care will become increasingly inequitable.

AHCRA welcomes Labor’s commitments to mental health, medical research, and better stroke care. But overall its initiatives and vision are far too modest.

AHCRA welcomes the Coalition’s significant investment in support for general practice teaching and the 500 additional nursing and allied health scholarships for students and health professionals in areas of need. AHCRA also supports the Coalition’s more detailed plans for mental health research and other initiatives to improve care, especially for young people. However it is concerned about the

Coalition’s plans to hand back hospitals to local rather than regional boards which will not serve consumers’ needs for a highly integrated system unless there is a universal commitment to consumer-centred care. Additionally the plan to restore the private health insurance rebate to the wealthiest Australians makes no financial or health policy sense given the take up of private health insurance has actually increased since the rebate was cut.

AHCRA strongly supports the Greens’ universal dental plan but disappointingly even they do not place health among their top ten policies.

Mr McBride called on both major parties to “address the holes in your health policies before the 7th September and commit to building on the early gains of the reform agenda. Deliver a world class health system for Australia’s future that is effective and financially sustainable by addressing equity and focussing much more on prevention and primary health care” he concluded.


Tony McBride, Chair, 0407 531 468;

Bruce Simmons

NACCHO Closing the Gap report: Analysis of provisions in the 2013-14 budget of the Indigenous Chronic Disease Package


Total government expenditure on Indigenous health has risen significantly since the commencement of the National Partnership Agreement (NPA) on Closing the Gap in Indigenous Health Outcomes in 2009-10 and now represents about 5.1% of total government health expenditure.


An analysis of provisions in the 2013‐14 Budget and implementation of the Indigenous Chronic Disease Package

Russell, Lesley
Menzies Centre for Health Policy


This paper presents the author’s analysis of the Indigenous provisions in the Australian Government’s 2013-14 Budget in the context of current and past strategies, policies, programs and funding support. It also looks at the implementation and impact of the Commonwealth’s Indigenous Chronic Disease Package. This work has been done using only materials and data that are publicly available. The opinions expressed are solely those of the author who takes responsibility for them and for any inadvertent errors. This work does not represent the official views of the Menzies Centre for Health Policy, the Australian Primary Health Care Research Institute (APHCRI) or the Commonwealth Department of Health and Ageing which funds APHCRI.

Report summary

This amounted to $4.7 billion in 2010-11; of this, the Commonwealth provided about one-third ($1.6 billion).

However while there is a significant effort underway to close the gap in Indigenous disadvantage and life expectancy, in most areas this effort has yet to show real returns on the investments. The disadvantages that have built up over more than 200 years will not disappear overnight, and sustained and concerted efforts are needed to redress them.

Chronicdiseases, which account for a major part of the life expectancy gap, take time to develop, and equally, it will take time to halt their progress and even longer to prevent their advent in the first place. Programs will need to be sustained over decades if they are to have an impact on improving health outcomes.

On this basis, it is worrying to see that continued funding for the NPA on Closing the Gap in Indigenous Health Outcomes, as announced in April, will be less over each of the next three years than in 2012-13.

At the same time, the Budget Papers show that expenses in the Aboriginal and Torres Strait Islander health sub-function will decline by 2.7% in real terms.

This comes as states such as Queensland and New South Wales have made damaging cuts to health services and Closing the Gap programs.

Education is a significant determinant of health status so it is also concerning to see a reduced level of funding provided for Indigenous education over the next six years, especiallywhen efforts to close the gap in education for indigenous students have stalled. These cuts inhealth and educations commitments cannot be justified by saying that Indigenous Australianscan access mainstream programs. In many cases these are absent, inappropriate, or perceived as culturally insensitive, despite recent efforts to improve these deficits.

It is a strength of the COAG commitment to close the gap on Indigenous disadvantage that it recognises that a whole-of-government approach is needed to deliver improvements in the lives of Indigenous Australians.

However tackling disadvantage is about more than building houses, providing job training, implementing welfare reform, community policing andincreasing access to health services; it requires that governments recognise and respect the complex social and cultural relationships that underlie the housing, economic, health and societal issues present in many Aboriginal


Dear Prime Minister:Time for the health vision to be a reality :Todays Closing the Gap speech

Close The gap

“While all parties have voiced support for health equality, now is the time to  demonstrate how promises will be turned into programs with accountable  results.”

Source Canberra times 6 February

The Prime Minister will deliver her report to Parliament on Wednesday on  progress towards closing the gap.

The speeches from Julia Gillard  and Opposition Leader Tony Abbott offer an  unparalleled opportunity for all political parties to restate their commitment  to Aboriginal and Torres Strait Islander health equality.

In this election year, it is vital that all sides of politics at all levels  strengthen their commitments to closing the gap by 2030. Long-term commitments  to programs and services will provide surety and results that are literally a  matter of life and death for our peoples.

While all parties have voiced support for health equality, now is the time to  demonstrate how promises will be turned into programs with accountable  results.

  </iframWhy is commitment needed? Isn’t enough being done for first Australians? The  efforts by government, non-government organisations, communities and individuals  are to address simple facts such as babies born to Aboriginal mothers die at  around twice the rate of other babies, and then children survive to experience  higher rates of preventable illness such as heart disease, kidney disease and  diabetes.

Now that the election has been set, and with the budget on the horizon, this  fiscal commitment will most likely be announced in due course. These are nervous  times because without this commitment by both sides, the prospect of closing the  gap within a generation will be lost.

The health of Aboriginal and Torres Strait Islander Australians cannot fall  victim to budget cuts or be propped up on short-term drip funding. All parties  must support multi-decade commitments that will span policy cycles, funding  agreements and governments.

Firstly, and perhaps most importantly, is a re-commitment to a National  Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. The  current agreement expires in a few months.

This is the key funding that underpins all of the Aboriginal and Torres  Strait Islander health programs and services provided by government, as well as  by the Aboriginal community-controlled health organisations.

Secondly, the National Aboriginal and Torres Strait Islander Health Plan is  due midyear. It is already off to a good start and will serve as a partnership  between the government, our community and peak health bodies. The nation expects  commitments to be maintained and crucial investment to continue, until we close  the gap.

The government’s report will highlight some promising signs of health  improvements. Those improvements are the core focus of our Close the Gap  Campaign – a collaboration of health and human rights bodies. The campaign also  publishes our ”shadow report” on  the government’s progress.

Under-five mortality rates for first Australians are falling, and child  health is improving – and a healthier child population means a healthier adult  population.

Aboriginal and Torres Strait Islander peoples are also embracing increased  personal control of our health, with the successful rollout of Tackling Smoking  Initiatives and Chronic Disease Packages, along with increases in health  checks.

Similar programs focused on improving diet and raising awareness about  chronic disease will also take time and involve generational behaviour change.  While these programs must be given the chance to succeed, there is no room for  complacency.

We know that change can and does happen where collaboration between the  community-controlled health sector and the government exists – where there’s  genuine partnership.

There is an undeniable groundswell of good will from Australians, with more  than 185,000 people supporting the Close the Gap campaign.

Tens of thousands of people are expected to take part in National Close the  Gap Day events on March 21. As the day gets bigger each year, it provides hope  that as a nation, we want to address this historical indictment.

This year is a critical juncture if we are to close the gap, and although  there are many challenges and a long way to go, the finish line is within sight  of a generation.

This is the year to hold to the vision of what can be achieved. Time to allow  ourselves to be a nation inspired by it – Aboriginal and Torres Strait Islander  health equality within our lifetimes, within our generation.

We look to the nation’s leaders to take the steps needed to realise this  vision. It is also time to ask ourselves, what can I do to help close the gap by  2030?

Jody  Broun and Mick Gooda are

co-chairs of the Close the Gap Campaign

The NACCHO chair Justin Mohamed is the Co Chair with Jody Broun on the National Health Leadership Forum