The Remote Vocational Training Scheme (RVTS) has opened up for a second round of applications for doctors working in Aboriginal Community Controlled Health Services. 5 positions are still available for 2015 and RVTS is very interested in connecting with doctors working in ACCHSs who may be eligible for the program.
Candidates apply online at www.rvts.org.au and applications close on November 7.
The RVTS Extension to ACCHS is supported by the National Aboriginal Community Controlled Health Organisation (NACCHO) and is an Australian Government initiative designed to deliver structured distance education and supervision to doctors already providing medical services within ACCHSs.
Doctors receive GP vocational training over a 3 to 4 year period to obtain fellowship of RACGP and/or ACRRM, while they continue to work in the ACCHS. The training is delivered by distance education and remote supervision, and is specifically tailored to doctors working with indigenous communities. I have attached the applicant guide and brochure, further information can be found at www.rvts.org.au
If you have any questions about the program please contact Veeraja Uppal or Jeanette Mclaren on 02 6057 3400.
A peak Aboriginal health body has told a Senate committee that the proposed GP co-payment and changes to the PBS would discourage Aboriginal and Torres Strait Islander patients seeking preventative health care and impact on efforts to close the gap in Aboriginal life expectancy.
The National Aboriginal Community Controlled Health Organisation (NACCHO) submission to the Senate Select Committee on Health also calls for a recommitment to health promotion and early intervention programs and for a particular focus on Aboriginal and Torres Strait Islander-specific health initiatives.
The NACCHO submission said health policy should recognise Aboriginal people’s increasing preference to use Aboriginal Community Controlled Health Services over mainstream services and ensure funding keeps up with demand and inflation.
“As a nation we must look for ways to improve the health of Aboriginal people and invest in programs and services that are working for Aboriginal people,” Mr Mohamed said.
“We must encourage Aboriginal people to get regular check ups, to see their GP and to participate in initiatives that promote healthy lifestyles.
“The introduction of extra expenses such as GP co-payment and a rise in the cost of PBS medicines will discourage Aboriginal and Torres Strait Islander people to seek preventative health care and impact on their long-term health.
“The additional expenses will also seriously affect the long term sustainability of Aboriginal Community Controlled Health Services, most of who will not pass on the charges to patients.
“For the sake of the health of Aboriginal men, women and children, these proposals must be rejected.”
Mr Mohamed urged the Senate committee to focus on preventative health measures which deliver long-term benefits through improved health and wellbeing and reduce the burden on the healthcare system at the tertiary and acute end of care.
“The NACCHO submission also calls for ongoing culturally-appropriate health programs that are specifically designed and run-by Aboriginal people as we know these have the greatest success,” Mr Mohamed said.
“In particular, Aboriginal and Torres Strait Islander-specific population health initiatives and child and maternal health programs must be maintained to ensure we continue to close the gap on life expectancy and infant mortality.”
Aboriginal health services today called on the Federal Government to consult more widely on the impact of the GP co-payment before it is put to the Senate.
The National Aboriginal Community Controlled Health Organisation (NACCHO) Deputy Chairperson Matthew Cooke said the dealing apparently going on behind closed doors without input from the Aboriginal health sector was cause for concern.
“The fact is, the introduction of a GP co-payment is poor health policy for all Australians,” Mr Cooke said.
“Abolishing free universal health care will introduce a dangerous disincentive for people to seek the medical attention they need until their health conditions are advanced and need more invasive and costly attention.
“When applied to Aboriginal health its impact is likely to be magnified.
“We have made some gains in improving the health of Aboriginal people but we still have a long way to go to close the appalling health gap between Aboriginal and other Australians.
“We need our pregnant women to attend check ups, we need our children to be immunized, we need our young men to have access to mental health services.
“We simply can’t put any barriers in the way of Aboriginal people seeking health care or we risk the gains we are making in Aboriginal health. The GP co-payment is a significant barrier.”
Mr Cooke said speculation about exemptions from the GP co-payment for particular groups would only go part of the way to addressing the issues.
“Although we applaud the AMA’s efforts to work with the Federal Government to resolve the impact of a GP co-payment on vulnerable Australians, an exemption for Aboriginal Medical Services is not the silver bullet.
“The majority of our Services would have waived the co-payment for their patients, which would effectively have meant a cut in their funding, so in this regard it would be of benefit for our Services.”
“However, many Aboriginal people do not have access to Aboriginal Community Controlled Health Services because of where they live.
“There are 150 Aboriginal Community Controlled Health Services across Australia, providing primary health care to over half Australia’s Aboriginal population.
“But we don’t have national coverage so that would leave a lot of Aboriginal people using mainstream services still subject to the GP co-payment.”
Mr Cooke said he was also concerned about the additional pressures on Aboriginal Community Controlled Health Services if the exemption only applied to these Services.
“Demand for our Services is growing at a rate of about six per cent a year. Aboriginal people are already travelling large distances to seek out our Services as they prefer to be treated by someone who understands their culture and community.
“The co-payment exemption is likely to increase demand even further and would be a challenge for our Services to manage within their existing budgets and resources.”
The National Aboriginal Community Controlled Health Organisation (NACCHO) has expressed grave concerns that the COAG Reform Council responsible for monitoring progress towards close the gap targets will close next week on 30 June.
At the 2014 NACCHO Health Summit in Melbourne today, Chairman of the COAG Reform Council, John Brumby, presented the findings of the Council’s final work on Aboriginal and Torres Strait Islander health monitoring, Healthcare in Australia 2012-13: Comparing outcomes by Indigenous status.
NACCHO chairperson Justin Mohamed thanked John Brumby and his Council staff for their efforts to ensure government policy to close the gap was translated into on-ground improvements for Australia’s First Peoples and their communities.
“It was six years ago that Australian governments took on the significant challenge of closing the gap on Aboriginal and Torres Strait Islander disadvantage in health, education, employment and other social areas,” Mr Mohamed said.”
“In that time Mr Brumby and his team have monitored progress on closing the gap, and reported publicly and free of political influence.”
“Today’s report confirms that for all the significant achievement made, including a decrease in the Aboriginal infant mortality rate by 35%, there remains work to be done to improve outcomes in other areas.”
“We are really worried that the millions of dollars being cut from across Aboriginal affairs at the Federal level, plus the introduction of new arrangements in accessing primary health care and changes to unemployment benefits, could potentially push the closing the gap targets even further from reach.”
“It’s now been more than a year since the National Partnership Agreement has lapsed and we still don‚t have any clear advice on how states, territories and the commonwealth plan to coordinate addressing the closing the gap targets.”
“Now there will be no independent umpire able to evaluate progress ‘or lack of it’ and hold state and territory governments and the Federal Government accountable.”
“The Federal Government must urgently outline how it plans on keeping this priority area of health and social reform on track during the long-term commitment needed to close the gap”, Mr Mohamed said.
Successes in improving the health of Aboriginal people, to be showcased over the next three days at an Aboriginal health summit in Melbourne, will highlight the importance of ongoing investment in Aboriginal Community Controlled Health Services and programs.
Justin Mohamed, Chair of the National Aboriginal Community Controlled Health Organisation (NACCHO) said the 2014 NACCHO Health Summit will feature innovative and creative approaches to Aboriginal health, driven by Aboriginal people, which are achieving results.
“The Federal Budget has taken a huge chunk of funding out of Aboriginal health programs,” Mr Mohamed said.
“Given the incredible work being done by our sector to improve the lives of Aboriginal and Torres Strait Islander people, through prevention, early detection and health promotion, it simply doesn’t make economic sense to cut front line Aboriginal health programs.
“We still have a long way to go close the huge gap in life expectancy between Aboriginal and other Australians but we are on the right track to reaching our targets by 2031.
“It’s critical we maintain the momentum and continue to give Aboriginal people control over their own health – funding programs run by Aboriginal people – since that is where we will have the biggest effect.”
Mr Mohamed said some of the examples which will be shared at the 2014 NACCHO Health Summit include:
• The Victorian Aboriginal Health Services Healthy Lifestyles and Tackling Tobacco Team has implemented a range of different health promotion strategies to engage members of the community from children to elders in physical activity, quit and healthy lifestyles programs. Successful initiatives over the last 12 months include: fun runs, yoga, hypnotherapy, social marketing, a comedy show and more recently the VAHS Tram taking the Australian public along for the ride.
• Wuchopperen Health Service ‘Community Controlled Health Services have to prove their value contribution in an increasingly competitive landscape. Wuchopperen has survived three decades of funding uncertainty. Wuchopperen has enacted a multi-faceted strategy to ensure long term sustainability and self-determination – with self-sufficiency a possible endpoint within a decade. Leveraging MBS income streams Wuchopperen has facilitated an increase in staff numbers from 135 to 180 over three years, maintaining a proportion of 80 per cent Aboriginal and Torres Strait Islander Staff. All funds generated have been reinvested into further services to the community, including expanded allied health services and optometric care facilitating on-site eye-testing and dispensing of spectacles.’
• ABS presentation (funded by ABS/ Dept of Health/ National Heart Foundation) ‘The 2012-2013 Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) is the largest and most comprehensive survey of the Aboriginal and Torres Strait Islander community ever undertaken. This survey provides a platform for a range of new research into health determinants and patters, supporting assessment of of progress in closing the gap in health outcomes.’
• Walgett AMS Accreditation Experience, Fifteen Years and Still Going Strong ‘In 1987 the CEO and Board of WAMS became concerned about changes to AMS funding conditions. In order to prepare for the possibility WAMS investigated agencies which accredited health services. In 2013 WAMS gained it’s fifth round of accreditation and in 2014 will work to bring it’s Dental Clinic into the process. Accreditation assists in improving client services and also enables the service to stand as equals with other Health Services and Medicare Locals’.
• John Patterson AMSANT CQI ‘The life expectancy gap between Aboriginal and other Australians in the NT is the widest in the nation, but it is also closing at the fastest rate. NT is the only jurisdiction on track to close the life expectancy gap by 2031. AMSANT believe that the implementation of the CQI programs has been pivotal to improving the Aboriginal PHC contribution to closing the gap.’
Mr Mohamed said “The summit will be the Centre of Excellence in Aboriginal Community Controlled Health and the best demonstration of Aboriginal Health in Aboriginal Hands.”
Media contacts: Olivia Greentree 0439 411 774 / Jane Garcia 0434 489 533
The National Aboriginal Community Controlled Health Organisation has welcomed the Federal Government’s announcement today that an implementation plan for the National Aboriginal and Torres Strait Islander Health Plan will be developed by the end of the year.
NACCHO chairperson Justin Mohamed said the 10-year health plan had been developed with extensive consultation with NACCHO and Aboriginal and Torres Strait islander health stakeholders in urban, regional and remote community settings.
“The National Aboriginal and Torres Strait Islander Health Plan is a great example of a blueprint harnessing the expertise and deep knowledge of Aboriginal people for better health outcomes in their communities,” Mr Mohamed said today.
“I welcome in particular the long-sought acknowledgement that racism continues to have a negative impact on the health and wellbeing of Aboriginal and Torres Strait Islander people.
“Factors such as person’s social and economic position in life, exclusion from participation in society and employment and exposure to stress can all influence their health throughout life.
“The Plan addresses many issues for the delivery of health services and outcomes, but there remains serious concerns about the cuts to Aboriginal health funding and the Medicare co-payment announced in the Federal Budget.
“NACCHO and its member services look forward to working with the Federal Government on the exciting next phase of the Plan – a comprehensive implementation strategy with meaningful targets and adequate resources.
“Aboriginal Community Controlled Health Organisations have a proven track record in providing a range of quality employment and education opportunities for Aboriginal people and boosting local economies.
“We would embrace continued consultation and involvement with on-ground Aboriginal services and communities to increase access to culturally appropriate, community-driven health care,” Mr Mohamed said. Media contact: Jane Garcia 0434 489 533
The harsh tragedy at the centre of indigenous health in Australia is anchored to shortened life expectancy and a greater predisposition to chronic illness for Aboriginal and Torres Strait Islander people than the general population.
For indigenous men, life expectancy is 11.5 years less than someone of non-indigenous background. Women are barely 1.5 years better off, with indigenous women having 10 years less than their non-indigenous counterparts.
“The figures can vary,” said Professor Ngiare Brown, executive director of research at the National Aboriginal Community Controlled Health Organisation. “That’s because there are different methods of calculation. But it’s anywhere between 12 and 15 years and that’s an unacceptable disparity.”
Much of the disparity in life expectancy comes down to chronic disease, much of it preventable, including kidney disease, cardiovascular disease and a rise in some forms of cancer.
For younger Aboriginal and Torres Strait Islander people, there’s also a high preponderance of self harm, suicide and injuries.
“With adolescents and young people, it’s hard for them to develop a social identity, so the levels of suicide and substance abuse are very high. Dealing with that in a social and medical context is very hard,” Professor Brown said.
So if much of the difference in life expectancy comes down to preventable disease, why isn’t more being done about it? According to Joshua Creamer, a barrister and president of the Indigenous Lawyer’s Association Queensland, who has been active in indigenous health, much of the problem comes down to a lack of access to services.
Access to services
“There are many factors,” he said. “But it generally comes down to access to healthcare and health services. People are living in remote communities and there simply isn’t the same level of service that there is for people living in larger population centres.”
Professor Brown concurs. “There are real problems associated with access to health services and the prevention of disease and maintenance of good health,” she said.
There are also intergenerational factors at work, Professor Brown noted. “There is the exposure of parents and grandparents and this continues down through the generations,” she said.
“Mental health, social and emotional and cultural wellbeing are also issues,” she continued. “There are the usual pressures of family and community education and employment. Layer that with complexities [in terms of] exposure to policies, extermination, identity and cultural responsibility and indigenous health becomes a very hard area to deal with.”
Professor Brown and Mr Creamer were concerned about the effect of the recent budget on Aboriginal and Torres Strait Islander populations.
Professor Brown said a completely free system is becoming unsustainable. “It was meant to be a safety net, but people have become accustomed to completely free care,” she said.
Yet on the other hand, she noted, people who can already afford private care will use it in any case. The impact of introducing co-payments and increasing the pension age to 70, will be on people and populations that cannot already afford private primary care.
“It’s going to be a mess,” she stated. “The impact will be more on the people who cannot afford it. There needs to be detailed and careful consideration of intended and unintended consequences of fee for services [if the changes] are going to be a success and not hurt people who cannot already afford healthcare.”
In terms of the budget measures, Brown continued, the impact on indigenous people is twofold. “We are the most disadvantaged population in Australia and secondly, we have the highest burden of morbidity and mortality. Our services rely on MBS and medicare rebates to provide affordable services.
“If you reduce Medicare rebate and charge a fee, for people with multiple visits, chronic disease, children with special needs, the families will not be able to afford it.”
On a positive note, Mr Creamer said under the budget funding for Aboriginal Community Controlled Healthcare will continue and that type of healthcare remains a bright spot when it comes to dealing with the healthcare issues of Aboriginal and Torres Strait Islander people.
Professor Brown said she remains an optimist, despite the harrowing life expectancy and disease statistics. “If it was that bad, I would not continue doing what I do. I remain an optimist because community health centres are locally led responses to local priorities. In the end, however, what we need is collaboration, between policymakers and government to address indigenous health in a more integrated manner.”
Investing in Aboriginal Community Controlled Health Services will help address the increasing gap in employment outcomes between Aboriginal and non-Aboriginal people as revealed in the new report released by the COAG Reform Council.
Justin Mohamed, Chairperson of the National Aboriginal Community Controlled Health Organisation (NACCHO) said the COAG Reform Council report showed encouraging gains are being made in areas such as life expectancy, child mortality and immunisation, but unemployment and obesity rates needed greater attention.
“This is yet another report to add to the many before it which demonstrate that massive inequalities still exist between Aboriginal and non-Aboriginal people,” Mr Mohamed said.
“The take home message is that we can’t shift focus or we risk reversing the gains we have made. There is still a long way to go before Aboriginal people can expect the same levels of health, employment and education as other Australians.
“It’s pleasing to see Aboriginal child mortality rates are decreasing but Aboriginal kids are still twice as likely to die before they are five than non-Aboriginal children. As adults we still have a life expectancy more than ten years less than non-Aboriginal people.
“That’s why we need to keep up the investment in programs and services that are making a difference.
“Aboriginal Community Controlled Health Services are making huge contributions towards closing the gap across a range of indicators and demand for our services is growing.
“In addition to these significant health gains, our 150 health services employ more than 3,200 Aboriginal people – one of the largest employers of Aboriginal people in the country.
“Governments at all levels need to look to supporting and expanding the Aboriginal Community Controlled Health sector if they are committed to improving the health and employment outcomes of Aboriginal and Torres Strait Islander people.”
Mr Mohamed said NACCHO has concerns that we still do not have any concrete commitment of the future of the Close the Gap “National Partnership Agreement” or an alternative structure. This concern is further heightened by the fact that the COAG Reform Council will be abolished come 30 June.
“We are extremely concerned that the millions of dollars being cut from across Aboriginal affairs at the Federal level, plus the introduction of new arrangements in accessing primary health care and changes to unemployment benefits, could potentially push the closing the gap targets even further from reach.
“Yet at the state and territory level we also see apparent indifference to the challenges at hand.
“It’s now been more than twelve months since the National Partnership Agreement has lapsed and we still don’t have any clear advice how states, territories and the commonwealth plan to coordinate addressing the closing the gap targets. The Nation needs a long term agreement that has full support and buy in from all levels of Government.
“NACCHO also questions what replacement reporting mechanisms will be put in place to continue this specific, detailed state and territory reporting given the abolishment of the COAG Reform Council next month. These reports provide a level of accountability to the actions of the different levels of government which needs to be retained. ”