NACCHO No smokes health news :Fresh resources give health workers the edge to tackle Indigenous smoking

 Smoke

A suite of new No Smokes Health Worker Guides  was  launched on World No Tobacco Day (Friday, 31 May) providing a culturally relevant toolbox for health workers, including Aboriginal tobacco workers, to tackle Indigenous smoking rates.

For your convenience see quick links  below to NACCHO resources

No Smokes project leader, Associate Professor Sheree Cairney said that with Indigenous Australians smoking at more than twice the rate of their non-Indigenous counterparts, World No Tobacco Day reminds us why tackling smoking in these communities is a priority.

“We created the No Smokes Health Worker Guides to support health care workers and health educators to assess where their client is at in their ‘quit journey’, and then direct them to the No Smokes tools appropriate to that stage,” she said.

 The guides use interactive and visual online resources from the No Smokes website in combination with the latest knowledge and best practice about quitting and the harmful effects of tobacco.

The launch of the No Smokes Health Worker Guides coincides with the one year anniversary of the overarching resources NoSmokes.com.au, a multimedia anti-smoking project that uses humour, music and highly visual mediums to appeal to young Aboriginal and Torres Strait Islanders. NoSmokes.com.au is a project of the Menzies School of Health Research and funded by the Department of Ageing.

“The No Smokes website has had almost 50,000 page views in its first year, using social media, video stories and interactive games to engage its target audience, and the health worker guides add a new dimension,” Assoc Professor Cairney said.

“The No Smokes Health Worker Guides were written by drug and alcohol addiction workers who specialise in Indigenous health settings, and are built to work within standard models of practice – the stages of change model, recovery-oriented practice, and the 5 A’s

The No Smokes Health Worker Guides are available as free PDF downloads from www.nosmokes.com.au/healthworkers and seamlessly with a range of online videos, fact sheets and downloadable music and interactive games.

The following guides are also available at NACCHO

Guide for Health Workers – Introduction

Guide for Health Workers – Not Thinking about Quitting

Guide for Health Workers – Planning to Quit

Guide for Health Workers – Quit and Staying Quit

Guide for Health Workers – Relapse

Guide for Health Workers – Thinking about Quitting

 No Smokes is also holding a Facebook competition for World No Tobacco Day, giving away dozens of exclusive No Smokes t-shirts and baseball caps. Competition details are at:

 Full media release available from Menzies website: 

Lanie Harris

No Smokes team

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

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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.

DOWNLOAD THE CLOSING THE GAP ON INDIGENOUS DISADVANTAGE:

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

Russell, Lesley
Menzies Centre for Health Policy

ABSTRACT and LINK

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

DOWNLOAD THE CLOSING THE GAP ON INDIGENOUS DISADVANTAGE:

NACCHO Medicare Locals news:Coalition to conduct formal review of Medicare Locals if elected

Question Time in the House of Representatives

Speaking at the Australian Medical Association (AMA) conference in Sydney on Friday, opposition health spokesman Peter Dutton said questions remained over the role of Medicare locals, the 61 organisations set up by Labor to co-ordinate primary care.

“Some Medicare locals appear to be doing a good job,” Mr Dutton said.

“But in some cases, health professionals have expressed their frustration, or indeed indifference, to their existence.”

Read NACCHO previous coverage of Medicare Locals

Medicare Locals and the Aboriginal Community Controlled Health Sector: Where are we? Where are we going?

Response from AML Alliance CEO Claire Austin is in the comments below

Mr Dutton has previously criticised Medicare Local, labelling it a bureaucracy that has not improved health services.

On Friday, he said he was concerned Medicare Local could act as a commonwealth-subsidised competitor that disrupted other health services, rather than raising the level of care.

“Contracts have been signed secretly, and the government refuses to provide any further detail about 3000 people now employed across the Medicare Local network,” Mr Dutton said.

He said the coalition would consult experts including general practitioners and clinicians in its review.

The Australian Healthcare and Hospitals Association (AHHA) called on the coalition to reveal its plans for Medicare Local ahead of September’s election.

“Deferring decisions until after the election leaves patients, families, communities and health service providers in limbo,” AHHA chief Prue Power said.

“The health sector is a complicated system and changes in one area can have significant implications for the rest of the system.

“The coalition need to be upfront about their plans for Medicare locals and for primary health care more broadly.

“Health and access to health care services are important issues for all Australians and they have a right to know what is planned before the election so they can make an informed decision on election day.”

AML Alliance, the peak body for Medicare Local, said it would welcome the opportunity to outline to the coalition how Australia’s primary health care system was improving.

“We have a wealth of data available to inform the opposition about the Medicare Local sector and I look forward to the opposition actively seeking this information from us,” AML Alliance chief executive Claire Austin said in a statement.

“Medicare Locals are … ensuring better management of chronic diseases such as diabetes, heart disease, smoking cessation programs and asthma, for example.”

Ms Austin said AML Alliance would treat a review as an opportunity “to fill in the information gaps the coalition seems to have about Medicare locals”.

Read more:

NACCHO health alert:Community solutions must be centre of strategy to address terrible Aboriginal suicide rates

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A Federal Government strategy to address high suicide rates among Aboriginal people, particularly the younger generations, is a welcome step towards addressing the crisis in our communities, the National Aboriginal Community Controlled Health Organisation (NACCHO) said today.

READ previous NACCHO articles on suicide prevention here

 Federal Mental Health Minister Mark Butler today revealed the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy which aims to address Aboriginal suicide rates – which are as high as one a month is some remote Aboriginal communities.

 NACCHO Chair Justin Mohamed said the Federal Government’s focus on the issue, particularly the emphasis on local solutions and capacity building, is welcomed, however he said the detail of the plan still needs careful examination.

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

 “This is a crisis affecting our young people. It’s critical real action is taken to urgently to address the issue and it’s heartening to see the Federal Government taking steps to do that.”

 However Mr Mohamed said that for any strategy to be effective, local, community-led healthcare needed to be at its core.

 “Historically, Aboriginal people have not had great experiences with the mental health system, so breaking down the barriers and building trust is going to be key and having Aboriginal people involved in the delivery of services is critical.

 “Aboriginal Community Controlled Health Organisations are already having the biggest impacts on holistic improvements in Aboriginal health, including mental health. We are already a trusted source of primary health care within our communities, so its important those centres play a pivotal role in any strategy.

 “The Aboriginal Community Controlled Health Sector has always recommended that services be funded to offer an integrated social and emotional wellbeing program with Aboriginal family support workers, alcohol and substance abuse workers, social workers and psychologists available.

 “Up to 15 per cent of the 10-year life expectancy gap between Aboriginal and non-Aboriginal Australians has been put down to mental health conditions. We look forward to working with the government to map out the best possible approach to addressing this crisis in our community.

 Media contact: Colin Cowell 0401 331 251, 

NACCHO condemns Aboriginal flag “skins for smokes” that covers up health warnings

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NACCHO condems the use of “skins for smokes”  that uses cultural content and copyright imagery on cigarette packets to  negate health promotion efforts, such as Australia’s recent introduction of plain packaging laws and calls on the Federal Government to ban the sale under that legistlation

Authors: Karen McPhail-Bell, Chelsea Bond & Michelle Redman-MacLaren (see details Blow)

For just $5.29 Australians can now purchase “Skins” from local, independent grocers to cover their cigarette packet with the Aboriginal or Torres Strait Islander flag.

We argue that this use of cultural content and copyright[1] imagery on cigarette packets negates health promotion efforts, such as Australia’s recent introduction of plain packaging laws and the subsequent dismissal of a legal challenge from the tobacco industry.

Aboriginal and Torres Strait Islander people smoke over twice the rate of non-Indigenous Australians (ABS 2010). Health promotion practitioners working to reduce these smoking rates face the challenge of the broader historical and cultural context of smoking behaviour.

In response, health promotion efforts have endeavoured to shift, displace and resist the notion that unhealthy behaviours, such as smoking, are inherently part of Aboriginal and Torres Strait Islander culture.

Some examples of this approach include Queensland Health’s Smoke-free Support Program (Smoking: It could cost us our culture), the Institute for Urban Indigenous Health’s Deadly Choices campaign and other initiatives beyond Queensland (for example, Adams et al 2010; Basinkski and Parkinson 2001).

Brady (2002) has noted how throughout colonial contact, Europeans have exploited Aboriginal addiction to nicotine and therefore as health practitioners, we are concerned about what may be the continued exploitation of Aboriginal and Torres Strait Islander people for economic gain.

We also note that Skins are available with the Australian flag and are concerned that more broadly, cultural and national pride is being manipulated by these companies. In other words, the sale of products that appropriate cultural content and copyright imagery for the purpose of enhancing the appeal of cigarettes is cause for alarm for us.

As a practice, health promotion endeavours to secure equal opportunity and resources to enable people to achieve their full potential in life. Thus, we raise this issue for your awareness and welcome your analysis, comments and suggestions for action. We are also working on possible responses with advocacy organisations.

Acknowledgement: The authors would like to acknowledge the contributions of Arika Errington (NACCHO) to this article.

References:

Adams K, Liebzeit A, Jakobi M. (2010). “How’s your sugar?: A deadly website for you, your family and your community.” Aboriginal and Islander Health Worker Journal, Aug;34(5):2.

Australian Bureau of Statistics (2010). “The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples, October 2010.” Journal ABS Cat No 4704.0(Issue) http://abs.gov.au/ausstats/abs@.nsf/mf/4704.0/

Basinski D, Parkinson D. (2001). “’We saw we could do it ourselves’: Koorie Cultural Regeneration Project.” Australian Journal of Primary Health;7(1):111-5.

Brady, M. (2002) “Health inequalities: Historical and cultural roots of tobacco use among Aboriginal and Torres Strait Islander people” Australian and New Zealand Journal of Public Health 26(2): 120-124

[1] We note that both the Aboriginal and Torres Strait Islander flags are copyrighted materials and therefore must be reproduced in accordance the provisions of the Copyright Act 1968 or with the permission of the artists, respectively Harold Thomas and the Island Coordinating Council.


[i] School of Social Work and Public Health, Queensland University of Technology; ? k.mcphail-bell@qut.edu.au

[ii] Aboriginal and Torres Strait Islander Unit, University of Queensland; c.bond3@uq.edu.au

[iii] School of Medicine and Dentistry, James Cook University; michelle.maclaren@jcu.edu.au

NACCHO 2013 Election political alert:What are all the political parties promising Aboriginal Australia?

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If there’s one issue that marks Australia out as an international pariah, it’s extreme Aboriginal disadvantage.

While the mining boom burbles along as a boy wonder of the global market, images of Third World-style conditions in bush camps continue to put a lie to the “lucky country” narrative.

The indigenous population lags behind on nearly every major social indicator.

Crikey is rolling out its exclusive PromiseWatch series in conjunction with the Centre for Policy Development.

Today, Aboriginal affairs and “closing the gap”

Reproduced from CRIKEY

NOTE the spelling of indigenous is Crikey not NACCHO

Making up 2.5% of the Australian population, indigenous people are vastly over-represented when it comes to poverty, life expectancy, health problems, disability, psychological distress and unemployment, according to the ABS.

There is just one indigenous MP, Ken Wyatt, currently serving in the House of Representatives and only three Aborigines have ever been elected to federal parliament.

The current government has committed itself to Closing the Gap, a national intergovernmental program meant to address the disadvantages that indigenous Australians face. Under this program, the state and federal administrations aim to:

  • close the gap in life expectancy (the gap between indigenous and non-indigenous life expectancy is 11.5 years in males and 9.7      years for females)
  • halve the gap in mortality rates for indigenous children under five by 2018
  • ensure  access to early childhood education for all indigenous four year olds in  remote communities by 2013
  • halve the gap in reading, writing and numeracy achievements for children by 2018
  • halve the gap for indigenous students in Year 12 (or equivalent) attainment  rates by 2020
  • halve the gap in employment outcomes between indigenous and other Australians by      2018

The government has sought to directly intervene in the most disadvantaged indigenous communities in the NT, reshaping the policies of John Howard and Mal Brough’s NT intervention through the Stronger Futures in the Northern Territory bills.

The legislation seeks to address alcohol abuse, land reform and food security. Under the oversight of the federal government, penalties for alcohol possession on Aboriginal land will be increased, failure for children to attend school will be discouraged through a decrease in welfare payments, X-rated material will be banned in certain areas and customary law considerations can be excluded in sentencing and bail decisions.

So what have the major parties promised on indigenous affairs?

Labor:

Labor reiterated its support for the Closing the Gap program in its 2011 national platform, and says it recognises the disadvantage that Aboriginals and Torres Strait Islanders face in their daily lives. Areas selected for specific attention include literacy, numeracy, employment, infant mortality, life expectancy and education. Labor aims to close the gap by:

  • overcoming decades of under-investment in services and infrastructure
  • establishing clear expectations for governments, and holding all governments to account  for their progress
  • supporting personal responsibility as the foundation for healthy, strong families and  communities
  • building strong, respectful and robust relationships between indigenous and  non-indigenous Australians, so that we can work in partnership

The platform commits the party to investment in healthcare for Aboriginals and Torres Strait Islanders of every age, along with better access to education, employment and housing.

Labor is in favour of the official acknowledgement of indigenous people in the constitution. It has passed a bipartisan Act of Recognition through Parliament committing to some change, however no referendum will be held on the issue until community support reaches an adequate level.

The ALP has preselected former sprinter Nova Peris for a winnable NT Senate slot, a move Julia Gillard says was explicitly designed to increase the party’s paucity of indigenous representation.

The Coalition:

Under its 2010 election policy, the Coalition outlined nine key areas. In March, Opposition Leader Tony Abbott pledged that he would put indigenous affairs at the centre of government by establishing a “Prime Minister of Aboriginal Affairs”.

The Indigenous Affairs portfolio would be relocated to the Department of Prime Minister and Cabinet. In its “Our Plan” policy precis released in January, the Coalition said it would “encourage indigenous Australians to get ahead” by:

  • working  with indigenous communities to bring in a new suite of purposeful and innovative strategies
  • eliminating red tape and streamline programmes to move away from the complex web of overlapping initiatives
  • directing funding away from bureaucracies and overlapping and competing programmes towards local communities and real action
  • working with families to ensure all indigenous children attend school every day
  • supporting the Australian Employment Covenant and its many supporting employers to  create more opportunities for indigenous Australians to get ahead and actively engage more indigenous Australians in real jobs
  • providing $10 million to fund four trial sites to train 1000 indigenous people for  guaranteed jobs, working with the Australian Employment Covenant and Generation One
  • ending training for training’s sake and implement employment or work for the dole programmes
  • Tony Abbott continuing to spend a week a year in a remote community, to gain a better understanding of people’s needs

The party has also said it would retain former ALP national secretary Tim Gartrell as head of the group campaigning for constitutional recognition. And Abbott said last year he wants “authentic” Aborigines in parliament to join Wyatt.

The Greens:

The Greens’ indigenous affairs policies emphasise the respect and deference owed to the First Australians. Like Labor and the Coalition, the party seeks to obtain constitutional recognition of the role of Aboriginal and Torres Strait Islander peoples in pre-1788 Australia. Furthermore, it aims to provide equal access to services such as health, education, training, housing, community infrastructure, employment support, and policing. Under their watch, the Greens will:

  • provide protection and respect for indigenous cultural rights
  • prioritise programmes to improve indigenous health
  • establish community initiatives to address issues of family violence, alcohol and  substance abuse
  • incorporate  indigenous culture and language into the education system
  • repeal the Stronger Futures legislation
  • establish  effective heritage protection laws and protection bodies
  • ensure food security for indigenous populations in regional and remote areas.

NACCHO dental health news:NACCHO wants fluoride added to the water supplies of all Aboriginal communities.

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NACCHO- the National Authority for comprehensive Aboriginal Primary Health  wants fluoride added to the water supplies of all Aboriginal communities.

 The National Aboriginal Community Controlled Health Organisation (NACCHO) CEO Lisa Briggs  gave evidence to a House of Representatives inquiry hearing into adult dental services today.
 

Download the NACCHO submission

In its submission NACCHO called on the federal government to provide money to Aboriginal-controlled health organisations so they could provide dental services.

Aboriginal people were more likely than non-indigenous Australians to have lost all their teeth, it said.

The organisation urged state and territory government to fluoridate all town, city and Aboriginal community water supplies.

As well more work was needed to attract dental workers to remote Aboriginal communities.

“There are concerns among dental health professionals that positions in Aboriginal communities are not seen as part of the usual career ladder,” NACCHO said.

Exposure to Aboriginal controlled health organisations during training would help attract more young dentists.

Proper funding would allow organisations to offer competitive remuneration packages that would encourage dentists to remote and rural areas

RECOMMENDATIONS

NACCHO recommends that the NPA for adult public dental services:

1. Provide culturally appropriate oral health services to all Aboriginal and Torres Strait Islander people;

2. Increase the oral health workforce available to improve the oral health of Aboriginal and Torres Strait Islander people;

3. Increase oral health promotion activity with the aim of improving health outcomes for Aboriginal and Torres Strait Islander people;

4. Improve the collection, quality and dissemination of oral health information about Aboriginal and Torres Strait Islander people; and

5. Foster the integration of oral health within health systems and services, particularly with respect to primary health care and Aboriginal and Torres Strait Islander people.

In addition, NACCHO asserts that:

 1) Oral Health is a priority health issue for Aboriginal peoples.

2) Oral health is a core part of the holistic health that Aboriginal Community Controlled Health Services aim to provide.

3) Aboriginal Community Controlled Health Services should provide primary oral health care services including emergency and preventative oral health care and oral health promotion.

4) Australia’s National Partnership Agreement to come into effect June 2014 should be fully funded and implemented, in particular in relation to measures for Aboriginal and Torres Strait Islander Peoples in particular.

5) The Patient-assisted Transport Scheme (PATS) must be extended to dental patients.

6) Dental services should be subsidised to all needy Aboriginal and Torres Strait Islander patients to reduce or eliminate cost as a barrier to accessing services..

7) Aboriginal and Torres Strait Islanders in correctional facilities should have access to culturally appropriate oral health programs.

8) All oral health workers must receive cultural awareness training either as part of their initial training or through on-going professional development. This will increase the level of culturally accessible oral health services.

9) There should be support for more Aboriginal and Torres Strait Islander individuals to be trained in all the oral health profession: dentists, dental hygienists, dental therapists, etc.

10) The Australian Dental Council (ADC) should include performance indicators for training schools for recruitment and retention of Aboriginal and Torres Strait Islander trainees and have a target of 2.4% of each profession being Aboriginal and/or Torres Strait Islander individuals.

11) Oral health should be included in the core training of all health workers including Aboriginal Health Workers.

12) Fluoridation of drinking water supplies is an effective strategy to reduce oral health problems.

13) Culturally appropriate Oral Health promotion materials need to be developed, tested for impact, and widely disseminated if effective.

14) Improved and regular collection of data on Aboriginal oral health status and use of services is needed to allow monitoring of the impact of interventions and assessment of achievement of oral health goals and targets.

NACCHO will:

15) Work with all Australian governments to develop oral health service provision at all its member health services.

16) Work with stakeholders to develop cultural awareness training for all oral health workers.

17) Campaign in support of fluoridation of city, town and community water supplies.

18) Improve the level of useful Aboriginal oral health data initially by influencing the capacity for the sector to collect national data collection in those Aboriginal Community Controlled Services with an existing oral health service – e.g periodontal and dental caries status, oral hygiene knowledge and periodontal disease links with Diabetes etc.

19) Support research to collect information on the areas of individual oral health behaviours, knowledge and barriers in regards to oral health including the availability and affordability of oral hygiene items.

 NACCHO calls upon the Federal Government, in collaboration with state and territory governments and NACCHO, to:

20) Fully fund and implement the 2014 National Partnership Agreement

21) Set and monitor goals and time specific targets in relation to meeting a range of oral health outcomes such as caries rates, periodontal disease rates and tooth extraction rates.

22) Formally recognise oral health as a key part of Aboriginal holistic health care to be provided by ACCHSs.

23) Allocate resources specifically for oral health services for Aboriginal peoples.

24) Increase oral health promotion activities in ACCHSs. This would require both increased financing for the development and testing of suitable materials, service provision and training of the AHW workforce.

25) Provide subsidised tooth brushes, tooth paste and floss to all remote communities in the first place and extend this as necessary to other communities where data collection indicates there is an access issue for these items.

NACCHO calls upon state and territory governments to:

26) Fluoridate all town, city and Aboriginal community water supplies that do not naturally contain a level of fluoride sufficient to prevent dental caries and immediately fluoridisation where this has ceased.

We welcome feedback on this recommendations

NACCHO political alert: Health policy debate Q and A tonight:Have you submitted a question from your mob yet?

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Health policy is up for debate tonite at 9.30 am (Monday April 22 ) on ABC TV’s Q and A program, featuring Federal Health Minister Tanya Plibersek and the Opposition’s health spokesman Peter Dutton

You can lodge your questions here

ASK A QUESTION ONLINE

VIEW 200 Approved QUESTIONS ASKED SO FAR

Or follow some the commentary on CROAKEY

Some of the comments from our ACCHO’s include

Selwyn Button, CEO, Queensland Aboriginal and Islander Health Council
Self-determination and self-responsibility – in recent weeks much has been spoken about the notion of practical reconciliation from the opposition, whilst there is still some talk of self-determination being critically important to improve outcomes for Indigenous Australians.

Conceptually both these discussions a sound in there logic and proposed approach, although still do not go to the heart of real self-determination of ensuring that not only are Indigenous people provided with access to required services, resources and involvement in decision-making about how this happens, but going a step further to give overall autonomy and responsibility for policy, planning, program development, delivery and outcomes to Indigenous people.

This can and should happen particularly in places where there is demonstrated capacity and willingness to take on this challenge and risk associated, although governments are risk averse in nature and generally shy away from this next step.

If Indigenous communities and organisations can demonstrate willingness, understanding, organisational maturity and capacity, perhaps we should take the risk together in order to support improved outcomes. This work is not ground breaking as it has already happened in Canada and NZ with significant results and could provide a template for greater autonomy in delivering services to Indigenous people by Indigenous organisations in or own country. Working alongside this notion is also the importance of Indigenous communities and organisations willing to accept the challenge and demonstrate capacity and leadership in this space for governments to want to take risks. This also would mean that not only are Indigenous communities and organisations willing to accept the challenge, we must also be willing to accept and embrace our failures if it doesn’t work.

Dr Tim Senior, a Croakey contributor and a GP working in an Aboriginal health service in Sydney, has a long list of questions, including:

  • What do you see as the future for Medicare Locals?
  • There is clear evidence that inequalities are a cause of ill health for everyone. How will your government tackle this?
  • Wherever we look, we see that those who need health care the most get the least. This is true in rural and remote Australia, and true in pockets of our cities. How will you address this?
  • How do you plan to increase the capacity of the workforce to manage increasing numbers of people with complex and chronic care needs?
  • How do you plan to incorporate training of health professionals in health services that are already stretched?
  • How do you see the use of e-health and telehealth initiatives in the future? What impact will your National Broadband Network policies have on this?
  • Given that the evidence shows improved health comes from primary care, rather than hospital care, what are your plans to fund high quality primary care?
  • How will you improve the integration of primary and secondary care? What are your plans for improving access to dental care?
  • Do you have any changes planned for the way Medicare funds health services?

NACCHO press release:Julia Gillard to announce that the federal contribution for a renewed Aboriginal health deal will be $777 million until June 2016

Closing the gap now in the hands of state and territory governments

 See Page 5 todays April 18 The Australian for the CTG/NACCHO campaign half page ad

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The National Community Controlled Health Organisation (NACCHO) today welcomed the Gillard Government’s commitment to the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes and called on state and territory leaders to urgently do the same.

According to AAP reports this morning Prime Minister Julia Gillard will announce  that the federal contribution for a renewed deal will be $777 million until June 2016.

Ms Gillard will ask the states and territory government to chip in the remainder, although the issue will not be on the agenda of the Council of Australian Governments (COAG) meeting on Friday.

“As a result of our investments in indigenous health, we are seeing improvements,” Ms Gillard said in a statement.

“We know there is more to be done.”

The original national partnership deal struck in 2008 was worth $1.58 billion over four years and the federal contribution was $805.5 million.

Ms Gillard said the renewed federal contribution would be an increase over previous per annum expenditure.

Following former prime minister Kevin Rudd’s apology to the stolen generations in 2008, federal, state and territory governments agreed on six ambitious Close the Gap targets to tackle indigenous disadvantage.

 NACCHO Chair, Justin Mohamed said the National Partnership Agreement was due to expire at the end of June, putting critical Aboriginal health programs at risk.

 “Improving the appalling state of Aboriginal health must be a priority for all levels of government and Aboriginal people will be relieved to finally have a commitment from the Gillard Government today.

 “The pressure is now squarely on the states and territories as signatories of the 2008 Close the Gap Statement of Intent in which they committed to work together to close the disgraceful seventeen year gap in life expectancy between Aboriginal and non-Aboriginal Australians by 2030.

 “The states and territories need to uphold their commitment to this important goal and sign up to continue the National Partnership Agreement which is due to expire in less than two months.”

Mr Mohamed said it was imperative the Agreement was given priority at the COAG meeting tomorrow.

 “Improving Aboriginal health is not a quick fix – it requires a long-term commitment above party politics.

 “This is not just a matter for the Federal Government. It has been proven that only by all levels of government working together will we see improvements in Aboriginal health.

 “There have been five years of good work on Closing the Gap programs and must maintain the momentum.

 “We must maintain our commitment and build on the inroads the 150 Aboriginal community controlled health organisations (ACCHOs) are making in their communities.

 “Aboriginal comprehensive primary health care provided by Aboriginal communities is the key to making a difference to Aboriginal health outcomes.”

 Mr Mohamed said the Federal Government’s ongoing commitment to Aboriginal health in a challenging fiscal environment was a testament to many in the sector who had worked tirelessly to keep Aboriginal health on the national agenda.

 Press release from the CTG campaign group

Aboriginal and Torres Strait Islander health must be placed on the agenda for this Friday’s COAG meeting if there is to be any hope of closing the life expectancy gap by 2030, the Close the Gap Campaign said today.

 “Five years ago all sides of politics agreed to do something about the national disgrace that sees Aboriginal and Torres Strait Islander people die more than 10 years younger than the broader Australian community,” Campaign Co- Chair Mick Gooda said.

 “While the 2008 COAG meeting saw federal, state and territory governments commit to long term funding for services and programs though the National Partnership Agreement, Aboriginal and Torres Strait Islander health is absent from this Friday’s COAG meeting agenda.

 “We know that the policies and programs resulting from these 2008 COAG commitments are starting to bear fruit and make a real difference on the ground, for example, mortality rates for under five year old Aboriginal and Torres Strait Islander children are falling,” he said.

 “But the life expectancy gap remains just as unacceptable today as it was back then and I know that most of those attending COAG this Friday agree with me,” Mr Gooda said.

 The National Partnership Agreement which has driven efforts to close the gap in Aboriginal and Torres Strait Islander health outcomes is set to expire at the end of June 2013. Despite Federal Government indications that it will continue funding its share of the Agreement, State and Territory governments have not yet signed up to the Agreement  leaving some services and programs in real doubt as to whether they can continue to provide badly needed services beyond 30 June.

 Campaign Co Chair Jody Broun said governments of all persuasions owed it to the rest of the country to maintain their efforts to close the life expectancy gap by 2030.

 “There’s no doubt that nothing short of ongoing funding and commitment to working with Aboriginal and Torres Strait Islander peoples from all levels of government is what’s needed to keep on track,” Ms Broun said.

 “State, territory and federal governments need to continue working together to fund more services and programs that make a real difference to health outcomes for Aboriginal and Torres Strait Islander peoples.

 “We have to maintain our efforts to improve access to critical chronic disease services and to deliver anti-smoking measures, more affordable medicines and healthy lifestyle programs. We need to support and build capacity in our Aboriginal Community Controlled Health Services and we need to build on the inroads already made by our child and maternal health services,” she said.

 “We need more Aboriginal health workers, allied health professionals, doctors, nurses and health promotion workers.

 “A recommitment from state, territory and federal governments at this Friday’s COAG meeting is needed to quite literally save lives.”

 Who is the CLOSE the Gap campaign mob

 Australia’s peak Aboriginal and Torres Strait Islander and non-Indigenous health bodies, health professional bodies and human rights organisations operate the Close the Gap Campaign.

 The Campaign’s goal is to raise the health and life expectancy of Aboriginal and Torres Strait Islander peoples to that of the non-Indigenous population within a generation : to close the gap by 2030.

 It aims to do this through the implementation of a human rights based approach set out in the Aboriginal and Torres Strait Islander Social Justice Commissioner’s Social Justice Report 2005.

 The Campaign’s Steering Committee first met in March 2006. Our patrons, Catherine Freeman OAM and Ian Thorpe OAM launched the campaign in April 2007. To date 176,000 Australians have formally pledged their support. In August 2010 and 2011, the National Rugby League dedicated an annual round of matches as a Close the Gap round, reaching around 3 million Australians per round. 840 community events involving 130,000 Australians were held on National Close the Gap Day in 2011.

How can you ask your state Premier or territory Chief Minister to support Close the Gap?

All Australian governments have committed to Close the Gap through the COAG process and the National Indigenous Reform Agreement.
 
The development of the Closing the Gap policy platform to back up this commitment set the foundations to meet this generational target.Ask your State Premier or Chief Minister to publicly commit to renewing investment in Aboriginal and Torres Strait Islander health equality.
 

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 AMA COAG Must make ‘Closing the Gap’ a National Priority

AMA President, Dr Steve Hambleton, said today that it would be a disgrace if the long-term health needs of Aboriginal people and Torres Strait Islanders were not discussed at this Friday’s Council of Australian Governments (COAG) meeting in Canberra.

Dr Hambleton said it would be irresponsible if Australia’s political leaders came away from the meeting without an agreement to continue long-term funding for the COAG National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes.

“Closing the gap and achieving health equality between Aboriginal people and Torres Strait Islanders and other Australians must be a priority for all our governments,” Dr Hambleton said.

“It is a worthy goal that requires long-term funding and genuine political commitment.

“It requires action, not just words.

“Five years ago, our governments signed up in good faith to the National Partnership Agreement, and it has delivered some positive health outcomes.

“Now is not the time to be complacent – we must build on these good results.

“The current Agreement expires in a matter of months.

“We are calling on COAG leaders to this Friday agree to the long-term continuation of the National Partnership Agreement with at least the same level of funding for another five years initially.

“This would send a very strong message to the community that our governments are serious about closing the gap,” Dr Hambleton said.

Since 2008, the Agreement has achieved a number of successes in improving Indigenous health and wellbeing, including:

  • being on track to halve the mortality rates for children under five;
  • significantly increasing Aboriginal and Torres Strait Islander peoples’ access to health services for chronic disease – which underlies much of the gap in health outcomes;
  • having work underway in partnership with Aboriginal and Torres Strait Islander peoples to develop a long term health plan; and
  • meeting the target for early childhood education access in remote communities.

NACCHO health news:Roundtable asks ‘how can we do implementation better in Aboriginal and Torres Strait Islander health care’?

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Mick

Aboriginal and Torres Strait Islander Social Justice Commissioner Mick Gooda facilitated the roundtable, which brought together almost 40 international and national stakeholders

Leading implementation experts, researchers, policy makers, and on-the-ground implementers of health innovations came together at a national roundtable in Brisbane on 22 March 2013 to focus on the implementation of new programs and practices in Aboriginal and Torres Strait Islander health care.

Implementation is the process of getting a ‘new better way’ of doing something into routine use. Effective implementation enables a person or organisation to take up a ‘new better way’ of doing things by making the process as efficient and painless as possible, while achieving the best possible outcome. Good implementation can also help avoid wasting time and resources or ‘reinventing the wheel’, and help Close the Gap more quickly.

To help build an evidence base about effective implementation, the Lowitja Institute commissioned the Menzies School of Health Research to carry out a research project, Implementation of Innovations in Aboriginal and Torres Strait Islander Health Care.

So far, the project has included a review of the academic literature on implementation in health care generally, and how that literature might be relevant in Aboriginal and Torres Strait Islander health contexts.

Last week’s roundtable extended that work by getting input from practitioners, policy makers and program managers.

Aboriginal and Torres Strait Islander Social Justice Commissioner Mick Gooda facilitated the roundtable, which brought together almost 40 international and national stakeholders who were eager to share their knowledge of what is going well in the implementation of Aboriginal and Torres Strait Islander health care, and what could be done better.

Highlights of the roundtable included:

  • Allison Nelson’s description of the work of the Institute of Urban Indigenous Health (IUIH) in Brisbane, which acts as an intermediary organisation supporting the implementation of new programs and even new health centres.
  • Jenk Akyalcin’s presentation about the Victorian Health Department’s actively facilitation of the implementation of a statewide program, Primary Care Partnerships.
  • Two presentations from leading international implementation expert John Øvretveit on strategies for improving implementation and systems to support implementation

Priorities for further research and action were identified, including the importance of:

  • Recognising different viewpoints and forms of evidence and knowledge in selecting and implementing ‘new better ways of doing things’
  • Taking a collaborative approach to planning and doing implementation
  • Learning from each other and supporting innovation exchange
  • Building enabling systems and the capacity of organisations to implement change
  • Communicating change with a clear program logic of what is being done and why
  • Understanding what the local context means for the process of innovation
  • Applying and upholding basic principles of social justice

In wrapping up the roundtable, Mick Gooda said: ‘We asked the question ‘Can we do implementation better?’ I think what we’ve heard today is that we don’t have a choice – we have to do implementation better. And that we can do it.’

Roundtable participants will work further with the Implementation of Innovations research team to refine the roundtable outcomes and integrate them with the existing evidence about implementation. A full report on the roundtable will be made available to all participants.

Project leader

Dr Kate Siburn

Project Manager

Jenny Brands

Contact details

E: jenny.brands@menzies.edu.au; M: 0409 284066

Administering organisations

Menzies School of Health Research

CRCATSIH program

Program 1: Healthy Start, Healthy Life

 
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