NACCHO Congratulates #Lowitja @LowitjaInstitut 20 years of making a difference in Aboriginal health and wellbeing

 “It has been 20 years since I was asked to be the inaugural Chairperson of the Cooperative Research Centre for Aboriginal and Tropical Health.

One of my fundamental objectives as a Chairperson was to work towards reconciliation between Aboriginal and Torres Strait Islander and Western perspectives of health and wellbeing and encourage a different way of doing research.

That meant bringing the academics and the researchers together with those who are qualified to know what’s needed on the ground. I wanted practical people to investigate the changes that need to be made in Aboriginal and Torres Strait Islander communities to bring about the change we all want to see for our peoples.

I told them that I wanted them to be a courageous organisation committed to social justice and equity for Aboriginal and Torres Strait Islander people, to match words to action, to achieve real, tangible outcomes. “

Dr Lowitja O’Donoghue AC CBE DSG august 2017

 “When these ( ACCHO ) services are set up, it was very clear that the mainstream system was failing us.

So we decided we had to set up our own services… those original AMSs, Redfern and Congress and all the others that followed… were… hotbeds of political activism as well.

We were flexing our muscles in terms of, not only self-management, but self-determination.”

Pat Anderson Lowitja Chair and former NACCHO Chair Interview , 14 November 2014)

 ” Honoured to be marking 20 years of the two decades of Aboriginal-led excellence in research and making a difference.”

The Hon Ken Wyatt Minister for Indigenous Health launching the report  

Paul House welcomes the audience above to country at launch of report Changing the Narrative in ATSI Health Research. Improving our wellbeing

In 2017 Lowitja is celebrating 20 years of Aboriginal and Torres Strait Islander led and focused health research – recognising the journey of the Lowitja Institute and the four associated Cooperative Research Centres (CRCs).

To mark this anniversary they released at Parliament House in Canberra on Wednesday 9 August 2017 a publication titled

 

Changing the Narrative in Aboriginal and Torres Strait Islander Health Research


Four Cooperative Research Centres and the Lowitja Institute: The story so far

Download a copy here  LOWITJA Changing-the-narrative

Changing the Narrative outlines the journey and the successes of the Institute and the CRCs, and showcases how their cumulative efforts have pioneered a new way of conducting  health research in Aboriginal and Torres Strait Islander communities.

It maps the evolution of a new, collaborative and culturally appropriate way of carrying out health research.

It’s an approach driven by Aboriginal and Torres Strait Islander priorities – an approach developed by the CRCs, and embodied in the Institute.

Each of the CRCs and the Institute has progressed the work to develop health research expertise and processes to achieve lasting reform. Efforts are based on key principles of Aboriginal and Torres Strait Islander control of the research agenda, a broader understanding of health that incorporates wellbeing, and the need for research to have a clear and positive impact.

The Lowitja Institute commissioned the Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS) to write a brief history of our organisation – including audiovisual recordings that highlight the vision of influential individuals.

In addition, the writing, editorial and production work of the Lowitja Institute team have created the hard copy Changing the Narrative publication, and a companion e-book which will be available soon.

Extracts from Report ( for references see report )

Background Aboriginal Community Controlled Health

While this sense of outrage at inequality was being expressed at the universities and in the big cities, little change was occurring in the rural and remote areas of Australia where services for Aboriginal and Torres Strait Islander people were limited.

Those that did exist were segregated and hidden in Aboriginal and Torres Strait Islander welfare departments, missions, reserves and pastoral stations.

In the 1970s, however, there was a significant increase in Aboriginal and Torres Strait Islander health research.11 The results of much of this research confirmed that Aboriginal and Torres Strait Islander life expectancy was lower, and morbidity higher, than for other Australians. In the Northern Territory, these statistics were worse than they had been for non-Indigenous Australians at the turn of the twentieth century.12 Other indicators – such as living conditions, maternal and infant health and chronic disease – highlighted a huge gap in health outcomes between Aboriginal and Torres Strait Islander and non-Indigenous Australians.

This crucial time of activism followed the 1967 referendum to allow amendments to the Australian Constitution that would give the Commonwealth Government the right to make laws affecting Aboriginal affairs and to include Aboriginal peoples in the national Census.13 It was a movement that was ‘most symbolically expressed through the land rights campaigns, but first gained concrete organisational form through the establishment of the Aboriginal legal aid and health services’.14

Change would not happen until the 1970s. The first Aboriginal Community Controlled Health Service (ACCHS) was established in Sydney’s Redfern in 1971, with the Victorian Aboriginal Health Service in Melbourne’s Fitzroy and the Central Australian Aboriginal Congress (CAAC) in Alice Springs two years later.15 The CAAC prides itself today as ‘the voice of Aboriginal health’, from its beginnings in the early 1970s and on its foundation objective that ‘Aboriginal health must be in Aboriginal hands’.16

However, it was not until 1991 that Darwin’s Danila Dilba Biluru Butji Binnilutlum17 and smaller services like18 Miwatj in East Arnhem Land the following year.19 A noticeable exception was Utopia’s Urapuntja Health Service, which opened in 1977.20

When these services are set up, it was very clear that the mainstream system was failing us. So we decided we had to set up our own services… those original AMSs, Redfern and Congress and all the others that followed… were… hotbeds of political activism as well. We were flexing our muscles in terms of, not only self-management, but self-determination. (Pat Anderson Interview 3, 14 November 2014)

Pat Anderson drew attention to the sense of ‘struggle’ against inefficient government control and past polices and the desperately poor health situation for Aboriginal and Torres Strait Islander peoples that framed their thinking in setting up these Northern Territory community controlled health services.

There was a whole range of Aboriginal national bodies that was set up around that time, but in particular with the health services, that was a very conscious decision to be able to be part of the struggle. We used to sign letters in those days, ‘Yours in the Struggle’, with a capital ‘S’. (Pat Anderson Interview 1, 23 October 2014)

The independence of the ACCHSs was enabled by a wide range of people from within the medical profession in Alice Springs and Darwin:

… When we decided that we were going to set up our own organisation, not a government initiative, doctors and nurses and a whole lot of people, as well as Aboriginal people… worked for nothing in those days. They would donate some of their time. The doctors, for instance, when they finished their shifts, they would come to the AMS and they did that for quite a while… NACCHO remains because it came out of the Aboriginal and Torres Strait Islander local communities. (Pat Anderson interview 3, 14 November 2014)

Aboriginal Health Strategy

The other thread that provides crucial background to the establishment of the CRCATH and changes to the Aboriginal and Torres Strait Islander health research landscape that began to emerge at this time was the 1989 National Aboriginal Health Strategy (NAHS).21

It aimed at developing mechanisms to achieve improvements in Aboriginal and Torres Strait Islander health; in particular it focused on taking into account ‘specific health issues, health service provisions, Aboriginal and Torres Strait Islander participation, research and data collection and ongoing monitoring’. It also aimed at maximising the involvement of Aboriginal and Torres Strait Islander people in their own health care.22

A Working Party was established in 1987, which included stakeholders from across a number of sectors involved in Aboriginal and Torres Strait Islander health, including government, communities and the Aboriginal controlled health sector. Its Chairperson was Dr Naomi Mayers, Director of the Redfern Aboriginal Medical Service. Other members of the group included Associate Professor Ted Wilkes and Professor Shane Houston, both of whom would go on to serve on the Board of the CRCAH. The Working Party carried out consultations with interested parties from across all Australian jurisdictions and received approximately 120 submissions for its consideration.23

The Working Party’s report highlighted many of the Aboriginal and Torres Strait Islander community’s concerns regarding the nature of health research. It noted that research was too often imposed on communities, with the communities having little control or redress, and seldom of actual benefit to them. The report also acknowledged that the pervasive nature of the existing Western-centric approach to research needed to be questioned and re-examined.24 The Working Party called for reform of the research processes in Aboriginal and Torres Strait Islander health and, in particular, for more involvement by Aboriginal and Torres Strait Islander people:

… The community should be involved in framing the questions so that the research is relevant to their needs. The Aboriginal community must actively participate in the research process, be kept fully informed, and have some say in how research findings are publicised and used. Only when research projects are subject to Aboriginal community influence, will they be both relevant and of benefit to the community.25

Shane Houston described the Working Party as ‘visionary’ to ‘embrace this notion that good data and good research could be the bedrock or the springboard on which we built really quite an innovative model and approach to Aboriginal health and research’. This was in spite of the fact that, up to that point, ‘appalling relationships [existed] between Aboriginal communities and researchers’ resulting from ‘countless examples’ of research failing to engage in ethical and effective ways with Aboriginal and Torres Strait Islander communities (Shane Houston interview, 1 December 2014).

Shane Houston was critical of what he saw as the dilution of the recommendations of the Working Party in the final report.26 Nevertheless, he later also recognised that it helped reshape the discussions around some of the most important issues regarding Aboriginal and Torres Strait Islander health and continued to be influential 25 years later. He pointed out that the NAHS was a breakthrough for policymakers and for Aboriginal and Torres Strait Islander community controlled health services, as it carried the debates beyond blaming researchers for their self-interest, and grasped the idea of influencing good and ethical research to create better data.

The report talked about intersectoral collaboration before people were talking in this country about the social determinants of health. It argued the case that housing affected health, that education affected health, that education affected housing. And it did so in a really coherent [way] that both government and communities agreed with. It argued for a reform to the style of service delivery in communities. It argued for more collaborative planning – ongoing planning, joint planning by state, territory and Aboriginal communities in the Aboriginal health arena…

And I think, looking back on it, it was one of those key turning points in the Aboriginal health movement across the country that just flipped the debate, that created a new way of talking about, a new way of engaging [with] and a new way of solving the challenges that we confronted. It was never going to be a panacea that would solve every problem. But it gave us the experience and the tools to approach problems in a new way. (Shane Houston Interview, 1 December 2016 )

Aboriginal Health ” managing two worlds ” : How Katherine Hospital, once Australia’s worst for Indigenous health, became one of the best

 

” Katherine Hospital in the Northern Territory has gone from one of the worst facilities in the country when it comes to Indigenous health care to one of the best.

Their secret: engaging with Indigenous patients and supporting doctors.”

Dr Quilty his high level of specialist training has meant that patients who would have had to be evacuated to Royal Darwin Hospital can now receive treatment in Katherine. Full Story below

Photo above : Gaye is a 50 year-old cancer patient from Mataranka in the NT. Supplied: Simon Quilty

NACCHO support INFO

Aboriginal Patient Journey Mapping Tools Project:

Communicating complexity

The Managing Two Worlds Together project aims to add to existing knowledge of what works well and what needs improvement in the system of care for Aboriginal patients from rural and remote areas of South Australia (and parts of the Northern Territory). It explores their complex patient journey.

The relationship between patients and health care providers is the foundation of care and requires communication across cultures, geography and life experiences. As a staff member in one rural Aboriginal Community Controlled Health Service put it: ‘It’s like managing two worlds together, it doesn’t always work’.

Download Stage 3 Study Managing Two World Study Report

NACCHO Aboriginal Health News Alert :

Do we need to close the gap on Aboriginal hospital experiences ?

How Katherine Hospital, once Australia’s worst for Indigenous health, became one of the best

As published ABC NEWS  By Hagar Cohen for Background Briefing

When physician Simon Quilty arrived at the hospital, it was going through a major crisis.

“What had happened in 2010 is that the hospital found itself in a situation where things were falling apart,” he says.

A number of doctors complained to the NT Medical Board about a lack of supervision and the impractical workload. The hospital was on the verge of shutting down.

More than one in four Indigenous patients left Katherine Hospital before completing treatment, often without informing staff, the worst rate in the nation. These “take own leave” cases are complex, but one factor is Indigenous patients’ perception of inadequate treatment.

It’s an issue plaguing the health system nationally: a 2014 Federal Health Department report found that racism contributes to the low rates of access to health services by Aboriginal people.

Similarly, the number of patients who “discharge against medical advice” is recorded and recognised by health departments as a key indicator for the quality of Aboriginal healthcare.

In the NT, 11 per cent of all Indigenous patients discharge themselves against medical advice.

“These people have very complex illnesses,” says Dr Quilty. “Many of them are highly likely, if not treated well, to resolve in significant injury or death. Hospitals in remote locations really need high expertise to deal with the very sick patients that turn up here.

“Thirteen and 15-year-olds are developing type 2 diabetes, they’ve got kidney impairment by the time they’re 22 and they’re on dialysis in their early 30s. It’s a bit terrifying really.”

Back from the brink

The NT Department of Health conducted an investigation into the staffing crisis at the Katherine Hospital. Its findings weren’t released publicly.

Background Briefing can reveal that the final report concluded that there were “significant deficiencies in nearly all the essential dimensions of safe clinical service provision”, adding that the “root cause is that the medical service model is unsustainable and becomes more unsustainable with each passing year”.

Six years ago, a new general manager and a group of new doctors arrived with an ambition to turn things around.

Katherine Hospital

They’ve brought highly trained specialist doctors who are invested in the community, interpreters are used regularly and families of Indigenous patients are consulted on complex treatment plans.

In the past, interpreters were available but rarely used. Families weren’t a part of the consultation process. Many of the doctors were junior, and staff turnover was high.

The new management has made huge inroads in the way the hospital cares for Aboriginal patients.

This year, only 4 per cent of the Indigenous patients “took own leave”, making Katherine one of the best performing hospitals in the nation when it comes to caring for Aboriginal patients.

Systematic use of interpreters

In 2006, when respected Indigenous lawman Peter Limbunya, from the remote community of Kalkarindji, stayed in the hospital for 10 days, he did not have access to an interpreter, despite not speaking English.

At the end of his treatment, Mr Limbunya, who was part of the legendary Wave Hill walk off in the 60s, was flown to a remote airstrip 5 kilometres away from his community.

His family wasn’t told he’d be back that day and nobody was there to meet him. He died of dehydration.

During the inquest into his death, the coroner found that interpreters were not in use at the hospital.

His cousin, lifetime activist and advocate for Aboriginal people Josie Crawshaw, remains outraged. She says her uncle would have known “absolutely nothing” about his treatment and what was going on.

But things have come along way since then. The hospital’s Aboriginal liaison officer, Theresa Haidle, says improving the way doctors communicate is the key to developing Indigenous patients’ trust in their treatment plans.

Regular use of interpreters has been an essential part of Ms Haidle’s work. She says they’ve been key in making sure patients understand their illnesses and treatment options.

“English isn’t their first language. It may not even be their second or third either. If there’s any doubt, we get interpreters in, or even on the phone.”

The systematic use of interpreters is a big change at Katherine Hospital.

Ms Haidle says the hospital has a lot further to go when it comes to providing a culturally safe environment, but overall, the relationship with the Aboriginal community is getting better all the time.

“It’s like a big learning process for everybody,” she says.

“We have to break it down as simple as we can,” she says. “There’s not an Aboriginal word that means cancer, so how do you explain those things?

“I remember one day a lady had this fungus, and there’s no words for those things on women’s bodies, or inside. So I heard the interpreter telling her: ‘You know, like mushrooms growing?’ They got her to stay and get it treated.”

Changing doctors’ attitudes

Pip Tallis, who is training to be a physician at Katherine Hospital, has worked in hospitals in Alice Springs and Darwin, where she says many of her Indigenous patients left before their treatment was complete.

“I found it really hard to understand why,” she says.

“It was frustrating as a doctor, and there was a lot of frustration among the staff and no-one really took the time to understand why people were taking their own leave, or really did anything to change it.

“I think, there was a bit of hands up in the air. ‘Whatever, what can we do about it? It’s their problem.'”

The NT town of Katherine, seen from the air

Dr Tallis says that her perspective has changed since coming to work at Katherine Hospital.

“I’ve spent six months working with the team here and observing how they engage with the patients, and I think that they do significant things to result in people not taking their own leave,” she says.

“Previously I was very inflexible. Now I spend a lot more time appreciating why people take their own leave.

“I’m also picking up the subtle signs on a patient who’s starting to not engage. I’ll sit down with them and explore their issues. And if they say they want to just go for a walk, you just say, ‘Would you like to take some medicine with you just in case you don’t come back?'”

Care plans to lower ‘take own leave’ rates

The introduction of weekly meetings to go over care plans for the Indigenous patients means everyone in the hospital can keep up with what’s happening with individual patients

These meetings are attended by social workers, doctors, nurses and admin staff.

At one such meeting, Dr Tallis mentions Jason, a 30-year-old patient from the remote community of Ngukurr, 330 kilometres south-east of Katherine.

Jason has tuberculosis, and has left the hospital during treatment once before. His family has convinced him to return. Dr Tallis explains at the meeting that Jason doesn’t like the hospital food, and that special food is being provided for him.

“We tried really hard to engage him,” she says. “We even got bacon and eggs for him in the mornings so he doesn’t complain about porridge, he’s got a DVD player, USB drive, he got pizza the other day. So we tried really hard to make it possible.”

But there’s still a cultural divide. At the end of the meeting, Jason explains to another doctor that he thinks “white fella” medicine is too slow.

“I want to go back to bush medicine,” he says. “It’s better and works fast because we learned it from old people.”

More support for staff

The hospital’s general manager, Angela Brannelly, says the 2010 investigation into the staffing crisis recommended major changes to the way the hospital operates, its level of staffing and supervision.

She says supporting the medical staff was one of her first priorities.

“We took it very seriously and made some really serious changes to the way that the medical team was supported here. It was around ensuring that someone’s got their back,” she says.

Dr Quilty, who joined the hospital in 2012, was the first physician to have ever been employed at the hospital. Last year he won the Royal Australian College of Physicians’ medal for clinical service in rural and remote areas.

A dark-skinned doll

His high level of specialist training has meant that patients who would have had to be evacuated to Royal Darwin Hospital can now receive treatment in Katherine. Since 2012, there has been a decrease of 43 per cent in the number of total aeromedical evacuations to Darwin.

Many Indigenous patients who live in remote communities don’t like going to Darwin to receive medical treatment because it’s far from family and the hospital is bigger and less personal.

Gaye, 50, a cancer patient who was transferred to Darwin for chemotherapy says she felt lonely in Darwin. “In Darwin I was always sad and crying a lot,” she says.

No-one in Darwin had realised that Gaye was deaf, which made communication with medical staff virtually impossible. In Katherine her deafness was recognised by the nurses and she was given a hearing aid, which she says made a huge difference to her mental health.

Katherine Hospital now employs two full-time physicians.

Still no Aboriginal doctors

Katherine Hospital employs 24 doctors but none of them are Indigenous.

Ms Brannelly admits the hospital hasn’t done enough to attract Aboriginal doctors.

“That’s good advice for us, and it’s probably where we need to go in that space around seeking out Aboriginal medical officers to come and work for us,” she says.

“I think we have some work to do there, absolutely.”

NACCHO Research Opportunity Alert : Career pathways for Aboriginal and Torres Strait Islander health professionals

Research

“The Lowitja Institute is seeking suitably qualified researchers to undertake a research project under the Institute’s Health Workforce to Address Aboriginal and Torres Strait Islander Health Program”

Career pathways for Aboriginal and Torres Strait Islander health professionals

Project No. 16-HWF-10 Applications close 16 September 2016

The Lowitja Institute is seeking suitably qualified researchers to undertake a research project under the Institute’s Health Workforce to Address Aboriginal and Torres Strait Islander Health Program. Interested parties are invited to consider the project as defined below, and respond to the call for applications.

Responses may include proposed variations to the scope and objectives, argued on the basis of evidence and expert knowledge.

Research aim

To provide insight and guidance to enhance the capacity of the health system to retain and support the development and careers of Aboriginal and Torres Strait Islander people in the health workforce.

Objective

To contribute to the growth, retention and career development of the Aboriginal and Torres Strait Islander health professional workforce.

Please note that applications may only be submitted by Lowitja Institute CRC Participant Organisations. While other institutions may partner in the research team, if successful, the Research Activity Funding must be administered by a Participant Organisation (the Administering Institution).

Application information

Apply

Other Lowitja Institute CRC research projects

NACCHO Aboriginal Health News : National Award in Indigenous Health Ethics goes to SA

photo

Research into health and wellbeing needs to be driven by and involve Aboriginal and Torres Strait Islander people, and provide a tangible benefit back to community and to develop an understanding of Aboriginal and Torres Strait Islander resilience, diversity and community needs.”

Dr Rosie King from the Aboriginal Health Council of South Australia

A project from South Australia has recently been recognised for forging ties between Indigenous and medical research communities for better health outcomes in Aboriginal Australians.

A National Award in Indigenous Health Ethics was presented to the joint project between the Aboriginal Health Council of South Australia and the Wardliparingga Aboriginal Research Unit within the South Australian Health and Medical Research Institute (SAHMRI).

The winning project is entitled “Next Steps for Aboriginal Health Research: How research can improve the health and wellbeing of Aboriginal people in South Australia.”

The tarrn doon nonin award – meaning ‘trust’ in the Woiwurrung language of central Victoria – comes from the Lowitja Institute, Australia’s National Institute for Aboriginal and Torres Straight Islander Health Research. The award recognizes excellence in Aboriginal and Torres Strait Islander health research ethics, and provides $10 000 towards project research funds.

“Research into health and wellbeing needs to be driven by and involve Aboriginal and Torres Strait Islander people.”

Dr Rosie King from the Aboriginal Health Council of South Australia said the philosophy underpinning the project was founded quite simply on asking the South Australian Aboriginal community what they thought research should focus on.

“People told us they want research to focus on their everyday health and wellbeing needs, but importantly they also want approaches that respect and engage with a view of life that is holistic and interconnected with cultural, spiritual, social and physical needs across the lifespan,” she said.

“Research into health and wellbeing needs to be driven by and involve Aboriginal and Torres Strait Islander people, and provide a tangible benefit back to community and to develop an understanding of Aboriginal and Torres Strait Islander resilience, diversity and community needs.”

The winning project was informed by an historic accord for negotiated health outcomes between Indigenous South Australians and medical health researchers, launched at SAHMRI in 2014.

SAHMRI also recently published details of its exemplar Closing the Gap health project ESSENCE to address cardiovascular health in Indigenous Australians based on a foundation of evidence and standards for equitable care.

Kim Morey, the manager for Knowledge Transition and Exchange in SAHMRI’s Aboriginal Research Unit, said that SAHMRI was thrilled to be recognised for the project.

“SAHMRI was most excited about this first partnership with ACHSA on the Next Steps project because it developed Aboriginal Community driven research priorities. SAHMRI welcomes recognition for Next Steps project, which refocuses the research agenda so that those issues most important to South Australian Aboriginal Communities begin to receive the attention that they deserve. Moreover, the majority of the researchers on the Next Steps team are Aboriginal.”

The online resource EthicsHub was also launched at the Indigenous Health Ethics award ceremony. This initiative will support individuals and organisations working or participating in Aboriginal and Torres Strait Islander health research.

Aboriginal and Torres Strait Islander leaders call for scrapping of co-payments

PrintAboriginal and Torres Strait Islander Health Leaders from across Australia met in Canberra today for crisis talks regarding the implications of the Commonwealth Budget.

“The Aboriginal community sector will not agree to turn our backs on the most disadvantaged and disempowered,” said Julie Tongs, CEO of Winnunga Nimmityjah Aboriginal Health Service.”

“A coalition of Aboriginal and Torres Strait Islander organisations calls on the Australian Government to recognise that a co-payment is against the principles of health equity outlined in the Statement of Intent to Close the Gap in Indigenous Health Outcomes.”

“The suggested co-payments run counter to the findings of the World Health Organisation’s Commission on the Social Determinants of Health. Australia’s health policies and funding should reflect those findings.”

“Introducing co-payments will not serve to close the gap in health outcomes; it will only widen the gap between our people and the rest of the community,’ said Ms Tongs.

We reject the introduction of co-payments because they will increase inequality.

· Aboriginal and Torres Strait Islander people already experience considerable health disadvantage

· for every dollar spent on non-Indigenous Australians now, only 60 cents is spent on Aboriginal and Torres Strait Islander people

· international evidence confirms the most efficient way to contain health care costs is a robust universal primary health care system

· the sustainability of Australia’s robust not for profit health sector, which currently supports the most vulnerable in our community, is threatened by this move.

Aboriginal Community Controlled Health Services and Aboriginal Medical Services:

· are the regular source of care for persons without social capital

· are an embodiment of Aboriginal and Torres Strait Islander self-determination

· represent a sound investment in not only health outcomes, but economic participation, employment and education for Aboriginal and Torres Strait Islander people; the health industry is the single largest employer of Indigenous Australians.

“We are calling for an immediate scrapping of the MBS and PBS co-payments scheme.

“The Aboriginal and Torres Strait Islander Health sector will not agree to turn our backs on the needy, disadvantaged and desperate.

“We welcome the opportunity to have further constructive conversations with government. We call on our partners, colleagues and all concerned Australians to stand with us at this critical time,” concluded Ms Tongs.

Contact: Julie Tongs, CEO Winnunga Nimmityjah Aboriginal Health Service Inc – 0418 206 156

 

 

The following agencies were represented at today’s meeting: VACCHO, AMSANT, Lowitja Institute, NACCHO, Winnunga Nimmityjah Aboriginal Health Service, NATSIHWA, AIDA, National Congress of Australia’s First Peoples, QAIHC and AHCSA. Also in attendance Public Health Association of Australia.

NACCHO Close the Gap Day : Warren Mundine: “The Future of Aboriginal Health” Address To Lowitja Institute

Lowitja

“Decades of Indigenous controlled health service delivery have seen the Aboriginal community controlled health sector become a leading provider of primary health care services and a significant employer of Aboriginal and Torres Strait Islander peoples.

This sector has mature organisations with a depth of expertise and capabilities, particularly in remote and regional areas, surpassing the level of mainstream health services in some areas.

I see no reason why organisations in these positions should not be able to leverage their capabilities and positioning to provide health services more broadly, thereby expanding their ability to generate extra income and funding. Opening the door to entrepreneurship, independence and self-sufficiency could present great opportunities.”

Opening Address by Nyunggai Warren Mundine:

“The Future of Aboriginal & Torres Strait Islander Health”

Pictured above with  Lowitja O’Donoghue

Thank you Aunty Di Kerr for the Welcome to Country on behalf of the Wurundjeri Nation.

I too would like to acknowledge and pay respect to the traditional owners of the land on which we meet and also to acknowledge and pay respect to my own Bundjalung, Gumbaynggirr, Yuin and Irish ancestors.

I wish also to thank you the Lowitja Institute for inviting me to give the Keynote Address at this Congress and to Lowitja O’Donoghue for her introduction.

And thank you Deborah Cheetham and the Indigenous Dance Troupe, Koori Youth Will Shake Spear, for your terrific performances.

I also acknowledge the Deputy Chair of the Prime Minister’s Indigenous Advisory Council, Professor Ngiare Brown.

I am honoured to be here today addressing you.

The Future of Aboriginal & Torres Strait Islander Health? The short answer is the Prime Minister’s Indigenous Advisory Council sees a healthy and prosperous future for Aboriginal & Torres Strait Islander health. I see great leadership, innovation and vision when I look at the community controlled Aboriginal & Torres Strait Islander Medical Services and their national advocacy organisation, the National Aboriginal Community Controlled Health Organisation, and the Australian Indigenous Doctors’ Association.

As people would appreciate, after reviewing the recent “Closing the Gap” report there is much more work to be done.

To get an understanding of the Council and the work of the Council I’ll give a brief outline.

The Prime Minister’s Indigenous Advisory Council was created to provide advice to the Federal Government on Aboriginal & Torres Strait Islander Affairs, with a focus on practical changes to improve the lives of Aboriginal and Torres Strait Islander people.

The Council provides ongoing advice to the Government on emerging policy and implementation issues related to Aboriginal & Torres Strait Islander Affairs covering, but not limited to:

  • improving school attendance and educational attainment
  • creating lasting employment opportunities in the real economy
  • reviewing land ownership and other drivers of economic development
  • preserving Aboriginal and Torres Strait Islander cultures
  • building reconciliation and creating a new partnership between black and white Australians
  • empowering Aboriginal and Torres Strait Islander communities, including through more flexible and outcome-focussed programme design and delivery
  • building the capacity of communities, service providers and governments
  • promoting better evaluation to inform government decision-making
  • supporting greater shared responsibility and reducing dependence on government within Aboriginal and Torres Strait Islander communities
  • achieving constitutional recognition of Aboriginal and Torres Strait Islander people.

The Council also has another role of being the Deregulation Committee for Prime Minister and Cabinet as part of the review by Parliamentary Secretary to the Prime Minister, Josh Frydenberg into deregulation including cutting red tape and addressing the overburden of compliance costs.

The Council is supported by a Secretariat based within Prime Minister and Cabinet.

The Chair meets at least monthly with the PM, currently I have weekly conversations with the Prime Minister, the Minister for Indigenous Affairs and other Ministers. The Council meets 4 to 6 times a year. Our 3rd meeting is being held in Sydney on the 2nd April.

As you can see, the Council has a broad Terms of Reference and is an independent body that gives advice. That means we give advice whether the Government agrees or not. A good example of this is the Anti-Discrimination Act Section 18C debate. Council members didn’t agree with the policy taken to the last election by the Coalition and we gave advice to the Prime Minister of our views not to repeal Section 18C. The Government and the general public are very aware of the Council’s view on this matter.

The Council is the Prime Minister’s advisory group not an elected representative body. It is an advisory group like the Commission of Audit, the Gonski Education Review, the Henry Tax Review, the Banking Inquiry Review and many such other bodies. So, when people say we are not an elected body, we don’t represent Aboriginal and Torres Strait Islander people – I say “correct”. We are a group of people who bring a range of expertise, skills and experiences together to advise the Prime Minister and Government. Council meetings are full of robust and frank discussion and new ways of thinking and that is reflected in the advice we give to the Prime Minister.

The Prime Minister wants the Council to focus primarily on the three areas of Jobs, Education and One rule for all. The third area is essentially around upholding community standards and the rule of law in all communities. My term for this is “social stability”.

Broadly, the Council operates within a reform agenda based with an economic and commerce focus. We want to see a focus on outcomes and on the experience of the people who receiving or relying on services; we look for innovative and entrepreneurial approaches; we want service delivery that is integrated and eliminates duplication; we expect service deliverers – including States and Territories – to be accountable and we will hold them to their accountabilities; we want to see less red tape more Bang for the Buck and efficiencies in cost and delivery; we also want to see investment in Indigenous communities. Above all, we want to see simple and practical approaches that really deliver.

That is the lens through which all or our deliberations and recommendations are made and it is the lens through which I will talk about the future of Indigenous Health this morning.

*              *              *

In preparing this speech I received a detailed briefing with pages and pages of statistics on Indigenous health and health risk factors. And these were just a sample. I am all too familiar with the data which paints a dire picture of Indigenous health and wellbeing in Australia.

Of course, for Aboriginal and Torres Strait Islander people it’s not just about statistics; it’s about our family, friends and communities; it’s about our parents and our children and our own selves. It’s my sister who died at aged 50 from heart disease. It’s the man who was stabbed in front of me enraged with alcohol and drugs Musgrave Park when I was a youth. It’s the regular emails I receive letting me know about “sorry business”. It’s the fact that almost every Indigenous person I know over the age of 40 has Type 2 diabetes. It’s my own brush with death in 2012 from cardio-vascular disease.

Indigenous people live these statistics every day and we experience the real impact – not just on individuals and their specific health problems – but also on our communities and families who are being hollowed out by things like low life expectancy, chronic and communicable diseases, and mental health problems, alcohol related disease and assaults, Foetal Alcohol Spectrum Disorder, suicide and child mortality. These problems have an ongoing social, cultural and psychological impact on communities and families.

When it comes to Indigenous health policy and health services, the greatest challenge is bureaucracy, waste and red tape.

Health is one of the most governed of all the public services. Constitutionally, health services are provided by the States. However, the Federal government has considerable influence and control because it provides substantial funding.

Indigenous health policy and the delivery of health services to Indigenous people involves multiple administrators and decision makers at multiple levels. There are at least two portfolios – health and Indigenous affairs – in the Commonwealth and in each State and often other relevant portfolios such as community services and human services. Each portfolio has a Minister and a department and often Assistant Ministers or Parliamentary Secretaries as well.  All of this is before you get to the front line health services, such as State operated hospitals and other medical services and specialised Indigenous health services such as Aboriginal community controlled health services, each of which has their own administrative staff and obligations.

The previous Federal government also had a Minister for Indigenous Health. Prime Minister Abbott chose not to continue with this portfolio and these responsibilities have been rolled into the Department of Health and the Department of the Prime Minister and Cabinet which is responsible for Indigenous affairs.

Some people criticised this, arguing that not having a dedicated Indigenous health portfolio would set back Indigenous health policy and delivery. I disagree. One of the reasons we are spending billions on Indigenous people and not achieving material improvements in closing the gap is because the funding is poorly targeted and wasted on red tape and bureaucracy. The most recent Productivity Commission indicates that the majority of funding allotted specifically to Indigenous Australians is spent on bureaucrats, advisers, contractors and the like, many of whom are non-Indigenous. Shortly after the last election Minister Scullion and I did a preliminary review of the spending figures and we estimated that at least a third of Government funding for Indigenous programs doesn’t even make it past the front doors of office buildings in Canberra and other cities.

Every additional Minister and department or other entity involved in Indigenous health results in additional reporting, handoffs and intra-government dealings. The different groups have to consult and report to each other and handle demarcation issues and duplication. Inevitably this means funding must be being consumed by bureaucratic process.

I recently saw a rerun of an episode of Yes Minister called “The Economy Drive”. In it, Sir Humphrey, Permanent Secretary of the fictional Department of Administrative Affairs, must deal with Minister Hackett wanting to eliminate waste and improve efficiency. Explaining to the more junior public servant, Bernard Woolley, why this is a bad thing, Sir Humphrey explains:

“There has to be some way to measure success in the Civil Service. British Leyland can measure success by the size of their profits, or rather they measure their failure by the size of their losses. We don’t make profits or losses so we have to measure our success by the size of our staff and our budget. By definition, Bernard, a big department is more successful than a small one.”

Even though it is fiction and satire, the scary thing about Yes Minister is that people who have worked in Government very much relate to it.

Whenever funding cuts to Indigenous services or programs are made, the vocal protest and criticism simply assumes that defunding will undoubtedly lead to bad outcomes for Indigenous people. In doing so they are measuring success by the size of budgets and staffing. But if funding to date has not had a material positive impact on Closing the Gap statistics, we can’t simply assume that a funding cut will have an adverse impact. It depends whether what is being cut is actually contributing to improvements or if it is wasted spend. Knee-jerk reactions of outrage without regard to the actual outcomes (if any) the defunded services have achieved, ultimately weaken the voice of criticism.

To me it is a very simple proposition. The success of government service delivery in Indigenous health should be measured by the outcomes achieved.

It’s not about the volume of services or who provides them or how much the Government is spending or how many people are involved or how much activity occurring on a day to day basis. It’s not about the size of the department or how many departments there are or whether we have a dedicated Minister for Indigenous Health. It’s about the outcomes and results achieved for Indigenous people.

We need to get bang for our buck. I do not want to see a single cent of funding wasted on administration, bureaucracy, reporting or other red tape that isn’t contributing to outcomes. Every cent wasted is a cent denied to Indigenous people and not being used to close the gap.

In this country we pride ourselves on our universal health system – a system where everyone gets access to top rate medical treatment in public hospitals with delivery prioritised based on health needs, not on ability to pay or other factors. No one wants to see a two-tiered health system, one for Indigenous people and one for non-Indigenous people. Our health system should deliver the world class medical services to everyone and Indigenous people should benefit from that as much as everyone else. The purpose of special Indigenous health services and policy is to close the health gaps between Indigenous and non-Indigenous people.

In the current Federal ministerial structure we have one Health Minister who is responsible for the funding and funding arrangements for health for everyone.

The job of the Department of Prime Minister & Cabinet (which houses the Indigenous Affairs portfolio) is to focus on what is needed in addition to the mainstream health system to close the gap between Indigenous and non-Indigenous health. This may involve funding additional health services or bodies. It also involves looking at the totality of different services and resources that are targeted towards, or that impact, Indigenous health – including housing, sanitation – and holding States, Territories and other bodies to account to deliver real outcomes.

Groups like the National Aboriginal Community Controlled Health Organisation are critical to delivering health services that cater to the additional needs of Indigenous people and communities to close the gap and recognise the importance of having Indigenous involvement in health policy and service delivery. The Indigenous Advisory Council’s Deputy Chair, Professor Ngiare Brown, who is a doctor, is an Executive Research Manager at NACCHO.

Decades of Indigenous controlled health service delivery have seen the Aboriginal community controlled health sector become a leading provider of primary health care services and a significant employer of Aboriginal and Torres Strait Islander peoples. This sector has mature organisations with a depth of expertise and capabilities, particularly in remote and regional areas, surpassing the level of mainstream health services in some areas. I see no reason why organisations in these positions should not be able to leverage their capabilities and positioning to provide health services more broadly, thereby expanding their ability to generate extra income and funding. Opening the door to entrepreneurship, independence and self-sufficiency could present great opportunities.

*              *              *

At one level, it is very easy to become overwhelmed by Indigenous health statistics, not only the data itself but also the immensely complex interconnectedness of health problems, health risk factors and social issues.

At another level, Indigenous health problems are not complex to understand at all. If you step back from the tangled web of data and statistics, what you are really looking at is poverty.

Across the world, the conditions under which people are born, grow up, live, work and age shape their health.  As the World Health Organisation points out: ‘the poorest of the poor have the worst health’. Most Indigenous people of my generation, and many of those in the generations after that, grew up in poverty or not far above it. Poverty is both a cause and a consequence of poor health.

It is estimated that socioeconomic disadvantage – in things like education, employment and income – account for one-third to one-half of the health gap between Indigenous and non-Indigenous Australians.

If we only achieved two things – eliminating poverty and eliminating smoking – we would close the gap in Indigenous health for good.

It is very important to remember this as we talk about Indigenous health service provision and health policy. Both are vitally important. But even the best policy and the best service provision will not close the gap if Indigenous people continue to live in poverty, or indeed if we make choices, like the choice to smoke, which damage our health.

The solution to poverty is not a mystery. Poverty is solved by economic development and commerce. Between 1990 and 2010 the number of people living in extreme poverty globally halved. That’s one billion people lifted out of poverty in just 2 decades. Two-thirds of poverty reduction comes from economic growth. The most astonishing example is China. Since it began economic reform 30 years ago its extreme-poverty rate fell from 84% to 10%.

For economic development we need our people to be educated and get into jobs and we need social stability in our communities or people will never invest in them.

So – the reason why I talk so much about economic and commercial development, about getting kids to school, about getting Indigenous people into real jobs and about safe communities, is because these are the key to eliminating poverty and therefore they are key to closing the gap in health. And therefore they are priority areas for the Prime Minister’s Indigenous Advisory Council and for the future of Indigenous Health.

Nyunggai Warren Mundine is Executive Chairman of the Australian Indigenous Chamber of Commerce

You can hear more about Aboriginal health and Close the Gap at the NACCHO SUMMIT

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

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

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

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

REGISTRATIONS NOW OPEN

SUMMIT WEBSITE FOR MORE INFO

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NACCHO Croakey health: Major conferences put the spotlight on improving Indigenous health and healthcare

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One of the strongest messages emerging in the program’s surveys of community and health centres is that they really believe that CQI “can make a difference”.

I believe Indigenous primary health services are leading the way in CQI, in part  because they’re used to being accountable, but also because specific features of CQI suit them well.

Doctors and nursing staff in Aboriginal community controlled organisations tend to have a more public health and population health orientation and to be part of a larger network,

One21seventy and National Centre scientific director Ross Bailie says he has seen growing enthusiasm in Indigenous primary health for CQI over the past decade, as more services and staff accept that “it’s not about policing or blaming”.

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Major conferences put the spotlight on improving Indigenous health and healthcare

by Melissa Sweet

The role of Continuous Quality Improvement (CQI) in improving Aboriginal and Torres Strait Islander primary healthcare will be under the spotlight at a Lowitja Institute conference in Melbourne this week.

Journalist Marie McInerney is covering the conference for the Croakey Conference Reporting Service and in the preview below examines the cultural shift that has occurred around CQI, and details the findings of a new report investigating the factors that help and hinder CQI uptake.

Later in the week, she will report from Congress Lowitja 2014.

***

Making a real difference for health and healthcare

Marie McInerney writes:

What has driven a cultural shift towards continuous quality improvement (CQI) initiatives in Aboriginal and Torres Strait Islander primary health, and when and where do they work best?

The 2nd National Conference on Continuous Quality Improvement (CQI) in Aboriginal and Torres Strait Islander Primary Health will this week present CQI approaches and experiences from a diverse range of Indigenous primary health services across Australia to take stock of successes and setbacks and examine what’s needed next.

The discussions follow a recent national appraisal by the University of New South Wales’ Research Centre for Primary Health Care and Equity that showed that a specialist CQI workforce is developing across the Indigenous health sector. It found that while CQI has not been universally adopted as core business, there was “widespread interest and initial take-up” across the sector.

Much of this has come through the work of the One21seventy National Centre for Quality Improvement in Indigenous Primary Health, set up by the Menzies School of Health Research and the Lowitja Institute, which is hosting the conference. It defines CQI as: “a system of regular reflection and refinement to improve processes and outcomes that will provide quality health care.”

One21seventy and National Centre scientific director Ross Bailie says he has seen growing enthusiasm in Indigenous primary health for CQI over the past decade, as more services and staff accept that “it’s not about policing or blaming”.

One of the strongest messages emerging in the program’s surveys of community and health centres is that they really believe that CQI “can make a difference”.

Bailie also believes Indigenous primary health services are leading the way in CQI, in part  because they’re used to being accountable, but also because specific features of CQI suit them well.

“Doctors and nursing staff in Aboriginal community controlled organisations tend to have a more public health and population health orientation and to be part of a larger network,” he said.

“We are seeing greater success with CQI when it’s being done at an integrated level or where we can get systematic data showing practice performance against best practice guidelines – data which we struggle to get more generally in (mainstream) general practice,” he said.

One21seventy is also an important factor, growing out the pioneering Audit and Best Practice in Chronic Disease (ABCD) research project, also steered by Bailie, which ran from 2002-2009 and showed CQI could improve Indigenous health.

It’s credited, for example, with significant improvements in the quality of care and outcomes for diabetes (such as lifting rates of HbA1c testing once every six months from 41 to 74 per cent and the delivery of diabetes guideline scheduled services from 31 to 54 per cent).

ABCD also influenced the Healthy for Life program that collects data from about 100 Indigenous primary health care sites across Australia on essential health indicators and others relating to organisational structure and care provision.

One21seventy was named for its mission to “increase life expectancy for Indigenous people beyond One in infancy, beyond 21 in children and young adults and beyond seventy in the lifespan”.

It has developed a range of clinical audit tools to measure the delivery of best practice service for chronic health conditions and maternal and child health care by more than 200 Indigenous primary healthcare services (see image below – and see the tool in action here).

One21seventy will launch a new tool at the conference for improving youth health, and a set of online modules so that health service staff around the country can access training when they want it – another effort, it says, “to overcome the tyranny of distance and cost of workforce development across the Indigenous primary health care sector”.

Making CQI “everyone’s business”

Lowitja Institute CEO Lyn Brodie said integrating CQI into the operations of primary health care providers delivers substantial benefits for Aboriginal and Torres Strait Islander people. They include:

  • better quality of clinical treatment and care to patients with specific diagnoses
  • quality of health promotion programs (for example, smoking cessation and physical activity programs)
  • quality of community-based care, such as to new parents by Aboriginal health workers
  • capacity and/or readiness of services and systems to meet pre-determined goals (including Key Performance Indicators (KPIs).

“Our goal is to make CQI everyone’s business,” she said. To that end, the Lowitja Institute commissioned the University of NSW national appraisal to look at what influences the take up of CQI initiatives in Aboriginal and Torres Strait Islander primary health services.

The appraisal found uptake was assisted by:

  • leadership, including the commitment of senior management, appointment of dedicated CQUI staff who can then act as CQI champions
  • strong partnerships between CQI system providers and Aboriginal community controlled health service managers, health workers and communities
  • ready availability of standards and tools to use in auditing and assessing local performance
  • access to national and state/territory networks of CQI practitioners and researchers.

The barriers to uptake included:

  • difficulty in recruiting and retaining a skilled workforce (particularly in rural and remote areas), compounded by insecure funding for CQI positions
  • confusion among service managers and health workers/clinicians about CQI and lack of clear understanding about the capacity required by services to conduct CQI
  • scepticism or ambivalence about the purposes and benefits of CQI.

Similar issues and insights were identified in the June 2013 evaluation by Allen & Clarke of the Northern Territory CQI Investment Strategy being developed and implemented in the NT Aboriginal primary health care sector.

The next step, Bailie says, is to develop and apply a CQI focus not just to the local health centre level but “across the whole system and at different levels of the system”.

“The focus up to now has been very much supporting local primary health care centres to use that information for their own purposes,” he said. “We’re now aggregating that data and analysing it at a state and national and territory level, to identify at a system level what is working well, what are the major barriers to improvement, and what we can do about it.”

The Federal Department of Health looks interested. It’s currently calling for tenders for a summary and analysis of CQI activity on Aboriginal and Torres Strait Islander primary health care, looking to identify “systemic enablers, barriers and linkages relevant to the development of a national continuous quality improvement framework that may be used to support improved capacity.”

The two day conference will:

  • discuss challenges and strategies around embedding CQI daily within the workplace
  • hear successful CQI stories and learn from their journeys
  • highlight how CQI contributes to better health outcomes for Aboriginal and Torres Strait Islander peoples and communities
  • harvest best CQI practices, locally, nationally and internationally, from within the primary health care landscape.

Speakers will include:

  • Selwyn Button, CEO of the Queensland Aboriginal and Islander Health Council
  • Associate Professor Gail Garvey, program leader of the Healthy Start, Healthy Life program
  • Dr Mark Wenitong, senior medical advisor at Apunipima Cape York Health Council
  • Lisa Briggs, CEO of National Aboriginal Community Controlled Health Organisations (NACCHO).

You can hear more about Aboriginal health and CQI at the NACCHO SUMMIT

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

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

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

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

SUMMIT WEBSITE FOR MORE INFO

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

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Why you should be considering

The 2014 NACCHO Healthy Futures Summit

for sponsorship and exhibition opportunities

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

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

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

What you will achieve by sponsoring and exhibiting?

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

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

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

NACCHO 2014 SUMMIT Objectives

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NETWORK with the movers and shakers of the Aboriginal health sector

LEARN about the latest research and developments in Aboriginal health

SHARE experiences and ideas with forward thinkers

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

OPPORTUNITIES INCLUDE

To obtain a copy of the NACCHO SUMMIT 2014 SPONSORS PROSPECTUS call NACCHO now or complete enquiry form here – See more at: http://www.naccho.org.au/events/summit-sponsors-exhibition

PLATINUM EAGLE

Only ONE available (Price on application)

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

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

GOLD KANGAROO

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

TRADE EXHIBITION BOOTH

$ 3,520 Inc. GST

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

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

  SILVER PLATYPUS and BANDICOOT on PASSPORTS Only TWO Available

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

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

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

Only ONE Available

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

Only One Available

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

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

. FULL PAGE ADVERTISEMENT                   $ 700 + GST

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

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

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

Josh Quarmby NACCHO SUMMIT TEAM Partnership:

Contact: 02 6246 9345

or email

Or for more information complete the enquiry form HERE

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

Rasism

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

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

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

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

Romlie Mokak CEO Australian Indigenous Doctors Association

JUST ADDED 3 March VACCHO POSITION PAPER Health and Racism

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

Could that in part be due to racism?

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

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

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

How racism affects health

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

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

HOW DO WE BUILD A HEALTH SYSTEM THAT IS NOT

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

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

Could that in part be due to racism?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Racism a driver of Aboriginal ill health

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Call for incoming government to commit to Close the Gap

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

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

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

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

DOWLOAD THE 16 Page BUILDING ON CLOSE THE GAP document here

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

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

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

Team NACCHO

TEAM NACCHO at the NATIONAL PRESS CLUB Health Debate

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

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

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

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

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

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

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

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

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

Media contact: Gary Highland. Mobile: 0418 476 940

DOWLOAD THE 16 Page BUILDING ON CLOSE THE GAP document here