INDIGENOUS Health Minister Warren Snowdon pictured above with NACCHO CEO Lisa Briggs and NACCHO Deputy chair Matthew Cooke launching HEALTHY FUTURES at Parliament House Canberra 19 June 2013
INDIGENOUS Health Minister Warren Snowdon has warned that the nation’s commitment to close the health gap between black and white Australia is being put at risk by state and territory governments failing to sign on six days before it starts.
Only the Victorian government has put its investment on the table and The Australian can reveal it will offer $61.7 million over four years as part of its ongoing commitment to the life of the next three-year National Partnership Agreement on Closing the Gap.
Western Australia has announced $31m to extend funding for 12 months only – an interim measure because of pressure from local Aboriginal health organisations concerned about uncertainty over funding translating to job losses.
The Gillard government has revealed it will spend more than $700m over three years on a new partnership agreement but no states or territories have signed on.
Mr Snowdon wrote to them several weeks ago urging them to reaffirm their support for tackling Aboriginal and Torres Strait Islander disadvantage by signing up.
The National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes, first signed in 2008 between the commonwealth and all states and territories, invested $1.57 billion over four years. But the NPA expires on June 30 and negotiations to re-sign have still not been resolved days before the new partnership is supposed to begin.
Mr Snowdon told The Australian the delay was deeply concerning. “We can’t afford to delay renewing this agreement with the states and territories,” he said.
“We have seen some steady improvements in a number of areas, like reducing child mortality rates and reducing the occurrence of the blindness causing eye disease trachoma.
“We will only continue seeing health outcomes improve if we work together with good programs on the ground that are backed up by solid investment across the board.
“I am especially concerned by the NT government, which has been silent on its future investment. The Northern Territory CLP government has already imposed cuts to the community controlled sector. The Territory’s most recent budget identifies that their investment in primary healthcare is insufficient to meet projected population growth.”
The federal government will continue programs funded through the NPA and expects the states and territories to do the same while negotiations continue.
WA Health Minister Kim Hames said the Closing the Gap funding had created 98 new programs and 317 jobs across government, non-government and the Aboriginal community to deliver vital services. “Closing the Gap aims to improve the life expectancy of Aboriginal West Australians and, while much has been achieved so far, there is still much more work to be done,” Dr Hames said. “The $31m the WA government has committed to today is for 2013-14 and will enable us to continue to deliver these critical services over the next year, which gives job security to those workers engaged in the delivery of these services.”
Dr Hames said the allocation of $31m demonstrates “our very strong commitment to the Closing the Gap program” and improving indigenous health.
“While it is very likely we will sign a new agreement, it is not possible to commit to this at this stage, given we have not yet seen a final proposed agreement.”
“The West Australian Government must be recognised for committing to the National Partnership Agreement as many states are yet to even do that despite it running out on June 30. It is also pleasing to see them commit to measures to improve Aboriginal mental health,” .
The $31million announced by the West Australian Government to Close the Gap will assist Aboriginal health services and other stakeholders in the delivery of comprehensive primary health to maintain the delivery of services for a further twelve months with the hope that a further three years of funding be committed to in the new year.
The National Aboriginal Community Controlled Health Organisation (NACCHO) Chair, Justin Mohamed, said Aboriginal health outcomes were too important to be put at risk and other states and territories also need to urgently commit to their fair share.
“The West Australian Government must be recognised for committing to the National Partnership Agreement as many states are yet to even do that despite it running out on June 30. It is also pleasing to see them commit to measures to improve Aboriginal mental health,” Mr Mohamed said.
“It is well recognised that closing the gap on Aboriginal health – where life expectancy can be a shocking ten to seventeen years gap between Aboriginal and non-Aboriginal Australians – will take a generational commitment.
“In 2008 all state and territory governments signed up to the National Partnership Agreement and committed for four years to concentrate on improving chronic disease and other health issues in Aboriginal communities.
“This commitment has started to see some positive results – child mortality rates in particular are dropping.
“This is very encouraging and shows that the programs are seeing real results on the ground.
“There needs to now be an ongoing, long-term approach that guarantees certainty to Aboriginal health services across Australia so they can continue to deliver what is needed to make a difference in their communities.”
The Aboriginal Health Council of Western Australia (AHCWA) today also commended the establishment of the committee comprised of several Cabinet members which will analyse the WA close the gap program and ensure its key objectives are being met.
“We are pleased that some funding commitment has been delivered and welcome the evaluation across all government departments around where money is being spent across Western Australia,” Vicki O’Donnell, Chair, AHCWA said.
“In the past four years the National Partnerships Agreement funding has created more than 300 jobs and delivered dozens of services to Indigenous Australians and helped in remote areas which didn’t have access to health services. It is important this good work continues.”
Media contact: Colin Cowell 0401 331 251, Olivia Greentree 0439 411 774
The Australian Government has announced $777 million to fund its share of a renewed National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes for a further three years to 30 June 2016.
This funding will ensure indigenous Australians continue to benefit from improved health services and support our commitment to close the gap on indigenous disadvantage.
In particular, our health funding will help us achieve our commitment to close the gap in life expectancy between indigenous and non-indigenous Australians within a generation, and to halve the gap in mortality rates for indigenous children under five within a decade.
The Australian Government will ask the States and Territories to also continue their investment to renew the National Partnership Agreement.
Under the current National Partnership Agreement, due to expire on 30 June 2013, governments provided $1.58 billion over four years to improve access to health services for indigenous families and communities.
The Australian Government provided $805.5 million over four years for this initial agreement.
Our renewed funding of $777 million over three years is an increase over previous per annum expenditure.
The Australian Government will continue to work with indigenous people and health services as we implement the renewed agreement.
As a result of our investments in indigenous health, we are seeing improvements.
This year’s Closing the Gap report showed that local health services were helping to lead a comprehensive approach to chronic disease management, encouraging people to undergo health checks and follow ups.
In 2011-12, 65,501 health assessments were provided to Aboriginal and Torres Strait Islander people aged 15 and over, a 34 per cent increase from 2010-11.
There are also more primary care workers in indigenous and mainstream health services to help meet the increase the uptake of health services by indigenous people.
While this work is encouraging we know there is more to be done.
We need sustained investment and effort to continue the momentum and ensure continued progress.
The renewed NPA will complement the proposed National Aboriginal and Torres Strait Islander Health Plan which has been the subject of extensive stakeholder consultations over the last several months.
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
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 GapStatement 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.
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.
The ability to improve shocking Aboriginal life expectancy rates is at risk while COAG delays discussions on the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes, said the peak Aboriginal health organisation today.
Justin Mohamed, Chair of the National Aboriginal Community Controlled Health Organisation (NACCHO) the national authority in comprehensive health care, said COAG must include the Agreement on the agenda for Friday’s meeting.
Please note :How can you ask your state Premier or territory Chief Minister to support Close the Gap SEE LINK BELOW
“To close the gap in life expectancy of 17 years was the core commitment of the Australian Government and Opposition in the Close the GapStatement of Intent.” Mr Mohamed said.
“Five years ago all state and territory governments also signed up to the Close the Gap statement of intent which would see this appalling statistic reduced by 2030
“Since then we have made some advances and invested in Aboriginal community controlled health services (ACCHO,s)which is starting to have an impact.
“But we can’t stop now. Aboriginal health is not a quick fix – it requires a long-term commitment by all levels of government.
“We must continue to build on the great work being done by the 150 Aboriginal community controlled health services around the country that are making inroads in our communities and making a real difference to their health.
“ACCHO’s are best placed to provide culturally appropriate primary health care and need support to continue and expand their service delivery.
“COAG must make the National Partnership Agreement a priority at Friday’s meeting”
Mr Mohamed said many quality and effective programs were at risk if COAG delayed any longer.
“It is unacceptable that Aboriginal people who rely on health programs funded through the agreement don’t know if they will still be there come July,” Mr Mohammed said.
NACCHO is calling on COAG to show continued commitment to the Close the GAP agreement
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.
The commitment to close the life expectancy gap between Indigenous and non-Indigenous people by 2030 was a watershed moment for the nation.
All Australian governments have committed to this important national priority 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. Thank you for your government’s commitment to this national priority.
More than 185,000 Australians, have signed the close the gap pledge and last year alone more than 130,000 Australians attended 850 events on National Close the Gap Day. In a country as wealthy as Australia, it is unacceptable that a baby born to an Indigenous mother can expect to live between 10 and 17 years less than a baby born to a non-Indigenous mother, or die before the age of four at between two and three times the rate of non-Indigenous children.
That is why I believe that now is the time to build on the foundations in place and continue the necessary investment to close the gap.
I therefore ask that you publicly commit to renewing investment in Aboriginal and Torres Strait Islander health equality through:
– Committing to invest in the renewal of the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes which expires on June 30, with your state funding maintained at least at the level allocated to the current Agreement
– Committing to invest in the delivery of the National Aboriginal and Torres Strait Islander Health Plan due for completion later this year
This year the number of National Close the Gap Day (March 21st) events has again grown to over 900 right around Australia; these events show continuing and growing support for the goal of closing the life expectancy gap by 2030. The message at these events was that it is critical to continue to invest in closing the gap programs.
I trust that you and your government will continue to play your part in this national effort and look forward to your response to my letter.
NACCHO thanks the House of Representatives Standing Committee on Health and Ageing, chaired by Ms Jill Hall MP, for the opportunity to make a submission into the Inquiry into Adult Dental Services in Australia and to inform the development of the National Partnership Agreement (NPA) for adult public dental services.
This submission is intended to provide a succinct comment to the House Standing Committee on Health and Ageing – inquiry into Adult Dental Services in Australia, providing detail on NACCHO’s policy position on Oral Health. It argues for the inclusion of dental checks, basic dental treatment, emergency treatment and oral hygiene/prevention as part of the core primary health care services to be provided by all Aboriginal Community Controlled Health Services (ACCHSs) as the preferred provider.
NACCHO Position
NACCHO asserts that in order to improve the overall health and well-being of Aboriginal and Torres Strait Islander individuals, and thus the community, oral health must be improved and to achieve this all ACCHSs must be funded to provide oral primary health care services.
Since the announcement of the Dental Health Reform Package, also on 29 August 2012, we have been attempting to identify where Aboriginal and Torres Strait Islander people are prioritised in the new policy or in the transition arrangements. From reviewing papers released to date, the new reform package proposes to target disadvantage children and adults on the public waiting list through National Partnership Agreements to be negotiated with the States and Territories, but there is currently no information on specific measures to ensure access for Aboriginal and Torres Strait Islander people. i
More worrying is the gap in time between the closure of the CDDS (8 September 2012 for new patients and 30 November 2012 for all treatments) and the proposed 2014 start date for the new reform package. Transition arrangements accessible for Aboriginal and Torres Strait Islander people as described to us, include continued access the existing Medicare Teen Dental Scheme and a component of the $345 million yet to be finalised arrangement with the States and Territories to address adult waiting lists for 2012-2013. We wish to ensure that the transition arrangements have targets to meet the needs of Aboriginal and Torres Strait Islander people.
The National Oral Health Plan: 2004-2013 clearly prioritises access to dental care for specific groups at risk, one of these being Aboriginal and Torres Strait Islander people.
Some evidence of this prioritisation slowly taking traction was seen recently in the Productivity Commission’s 2012 Indigenous Expenditure Report; where $28.6 million was expended by all levels of government in 2010 – 2011 for dental services for Aboriginal and Torres Strait Islanders, which was a very welcome start.
NACCHO re-endorses the recommendations in Australia’s National Oral Health Plan 2004-2013 endorsed by AHMAC in July 2004.
PRINCIPLES INFORMING the new National Partnership Agreement
The following principles should underpin process and outcome of the National Partnership Agreement on adult dental health services:
Cultural respect;
A holistic approach;
Health sector responsibility;
Community control of primary health care services;
Working together;
Localised decision-making;
Promoting good health;
Building the capacity of health services and communities; and
Accountability for health outcomes.
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 links with Diabetes
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
