The Implementation Plan outlines the actions to be taken by the Australian Government, the Aboriginal community controlled health sector, and other key stakeholders to give effect to the vision, principles, priorities, and strategies of the National Aboriginal and Torres Strait Islander Health Plan 2013–2023.
The Implementation Plan has set goals to be achieved by 2023 for 20 indicators.
These goals were developed to complement the existing COAG Closing the Gap targets, and focus on prevention and early intervention across the life course.
Of the 15 goals currently able to be assessed, 12 are on track
This indicator reports on the age-standardised proportion of Indigenous women who smoked during pregnancy. The goal for this indicator is 37% by 2023.
Why is it important?
Many lifestyle factors contribute to, and can have adverse effects on, the health and wellbeing of a woman and her baby during pregnancy, birth and beyond. Smoking tobacco increases the risk of complications such as miscarriage, ectopic pregnancy, placental abruption and gestational diabetes and is associated with low birthweight, foetal growth restriction, pre-term birth, congenital anomalies and perinatal death.
What data are available?
Data for this indicator were sourced from the National Perinatal Data Collection (NPDC). Perinatal data are collected for each birth in each state and territory, most commonly by midwives.
What do the data show?
Progress towards the goal is on track, with the age-standardised rate in 2016 (42.8%) similar to the trajectory point required to meet the goal (43.4%).
Based on age-standardised rates, the proportion of Indigenous women smoking during pregnancy decreased between 2009 and 2012 (from 50% to 47%). This proportion was slightly higher in 2013 (48%), but lower again in 2014 and 2015 (both 45%) and lower again in 2016 (43%).
In 2016, 44% of Indigenous women reported smoking during pregnancy.
Based on age-standardised rates, in 2016:
the smoking rate among Indigenous women was highest in Very remote areas (53%) and lowest in Major cities (38%)
Indigenous women were substantially more likely than non-Indigenous women to report smoking during pregnancy—43% compared with 12%.
The National Aboriginal and Torres Strait Island Health Implementation Plan also means much improved management and information processes. A dedicated share of the eHealth budget is required to ensure funds to monitor and support continuity of care and quality improvement across both mainstream and Aboriginal Community Controlled Health Services (ACCHS). Management needs to be reshaped from a blind contract management process to a mutual, shared process between funder and service provider process which will guarantee return on investment.
Ian Ring is a professorial fellow at the Australian Health Services Research Institute at the University of Wollongong.
Aboriginal and Torres Strait Islander Health Plan 2013-2023 looks to the people who have runs on the board, those in the Aboriginal Community Controlled Health sector, to play a key role, and offers further opportunities for our Services to grow and deliver more primary health care to more Aboriginal and Torres Strait Islander people. We congratulate Minister Fiona Nash on seeing this through – a process started by the former government but broadly informed by the Aboriginal health sector”
The launch of the National Aboriginal and Torres Strait Island Health Implementation Plan by Rural Health Minister Fiona Nash on October 22 is another important milestone on the long path towards achieving the goals of Australian governments to Close the Gap in child mortality and life expectancy. It is potentially a game changer and comes at a critical time for Australia’s Indigenous people, following the threats to remote Indigenous communities in WA, cuts to major programs such as those aimed at reducing smoking by Indigenous people, and what is widely seen as a debacle with changes to the Indigenous Advancement Strategy.
It was generally recognised that the national Aboriginal and Torres Strait Island Health Plan launched by former Indigenous health minister Warren Snowdon needed an implementation plan to turn the concepts in that document to services which would actually alter what happens on the ground, and deliver the services which are needed to Close the Gap. Of course the NATSIHIP isn’t really a fully developed implementation plan at this stage, and probably couldn’t be, but it does have the architecture of one, and recognises most of the key elements. Full credit to Minister Nash and to the National Indigenous Health Leadership Forum for reaching this stage.
The NATSIHIP recognises the central importance of culture and racism in shaping Indigenous health and, for the first time, starts to come to grips with the obvious question of what services are need to Close the Gap, what workforce is required and how would they be paid for. Most importantly, it focuses on the need to identify the areas with relatively poor health and not enough services, to make capacity building of services in those areas a priority. Some health gains are possible through improvements to services for people already receiving some kind of service, but much more gain is possible through provision of services to those who aren’t receiving them or aren’t receiving adequate services.
But the real work lies ahead. The key question of identifying a set of services required to Close the Gap remains to be tackled, although fortunately there is some excellent work on this topic in the NT that can be used as a starting point. Once the services are clearly defined, then the workforce requirements and funding strategies can be developed. This does not mean that there is an inbuilt assumption of an unlimited bucket of money to fund services but it does imply shifting the current ad hoc inequitable and inefficient funding mechanisms to a more rational basis and clearly identifying service gaps for government consideration.
So, the first key point is that the NATSIHIP is not a one-off, static, glossy piece of paper. Rather it is an ongoing process whose aim is the continuous improvement of services. The goals are achievable but require high quality services delivered in the right way. That is the job of the NATSIHIP and it is to be achieved, not through words, but with services and actions on a continuing long-term basis, and a small combined Indigenous/government oversight group for that purpose is essential.
What is missing at this stage? Firstly, a process to define the core services and associated workforce and funding strategies. Secondly, “training opportunities” need to become a formal national training plan. Much greater value will be achieved from funds for Indigenous health services if all those involved are actually trained in how best to provide those services. This means training public servants in health planning, health administration and the core elements of Indigenous health, training clinicians in technical and cultural aspects of Indigenous health, and managers and board members of health service organisations. And everyone involved needs to understand, live and breathe Continuous Quality Improvement.
It also means much improved management and information processes. A dedicated share of the eHealth budget is required to ensure funds to monitor and support continuity of care and quality improvement across both mainstream and Aboriginal Community Controlled Health Services (ACCHS). Management needs to be reshaped from a blind contract management process to a mutual, shared process between funder and service provider process which will guarantee return on investment.
And much more work needs to be done to develop a sensible set of targets (badged as “Goals” in the Implementation Plan). The National Indigenous Health Equality Targets developed by a broad range of organisations is a sensible starting point. These targets identified the health issues responsible for the life expectancy and child mortality gaps (chronic disease, low birth weight etc), defined services required for those topics, spelt-out infrastructure requirements (workforce and funding) and the central importance of social determinants.
The targets identified in the NATSIHIP seemed to have been framed to present predictions from current trajectories and rather miss the point. A target is an aspiration, not a prediction and needs to bear a logical relationship with the overall Goal (Close the Gap) and with the level of investment in a given time period. The level of health gain is closely linked to the degree of service enhancement that is possible. For this reason, the critical targets at this stage are those for service provision and can really only be set when the core service requirements are defined.
The success of the NATSIHIP will ultimately turn on all these elements and particularly on building up ACCHS services in areas lacking sufficient services, lifting the standard of mainstream services and formal structures and mechanisms for both types of services to work constructively together in each region of Australia.
There is still a long way to go but everyone involved, including Minister Nash and the Indigenous health leaders should be congratulated for reaching this stage.
Ian Ring is a professorial fellow at the Australian Health Services Research Institute at the University of Wollongong.
The document portrays racism as being institutionalised within health care — rather than being an aberrant behaviour by a minority. Journalism that has learned this lesson might end up with much more powerful and instructive stories.
Lessons from a report on Aboriginal health issues can be transferred to journalism.
The document calls for culturally supportive and culturally safe environments in health care. A large part of the media industry has not grappled with what this might look like in journalism, whether for members of our industry, or for communities and people interacting with us.
The document portrays racism as being institutionalised within health care — rather than being an aberrant behaviour by a minority. Journalism that has learned this lesson might end up with much more powerful and instructive stories. As the ABC presenter Waleed Aly wrote earlier this year, in the wake of yet another publicised incident of abuse, “our real problem is the subterranean racism that goes largely unremarked upon and that we seem unable even to detect”.
Nareen Young, CEO of the Diversity Council of Australia (and a tweeter on these issues), says the media could help by spending less time arguing about what constitutes racism, as this unending debate is exacerbating the hurt. “We need to say that if something hurts someone deeply, it is racist,” she said. The council would like to work with the media to identify areas for improvement.
The plan’s holistic approach to health is something we all could learn from. Indeed, GP Dr Tim Senior has argued for a wider adoption of the Aboriginal definition of health. Much media reporting reinforces a narrow biomedical focus, and neglects the wider determinants of health — like the importance of an equitable education system, an inclusive society and a healthy environment. If journalists incorporated the plan’s broad understanding of health into our work, we might see more useful reporting — whether on health or wider policy issues.
The document stresses the importance of culture, language and cultural identity to the social and emotional wellbeing of Aboriginal and Torres Strait Islander people. Yet so often, media reports portrays culture as a negative. If reporting such concerns, then at the least this broader context needs to be included. Beyond that, how might journalism contribute to wider acknowledgement of culture? Through use of language, for example?
The plan also stresses the importance of acknowledging and understanding the diversity of Aboriginal and Torres Strait Islander peoples. The fact that different people hold different views does not automatically mean conflict and division. Is journalism capable of respect for diversity?
The plan emphasises the importance of strengths-based approaches to Aboriginal health, rather than a focus on the deficit model that is so common amongst both the media and health sectors. Journalism can be overly focused on the deficit model — telling us about problems we often already know about — rather than investigating potential solutions. This is not an argument for “soft” journalism — it is actually easier to describe problems, whether in Aboriginal health, climate change or obesity, than to do the hard yards of solutions-focused journalism.
The plan also underlines the impact of the past upon contemporary health and wellbeing, referring to the legacy of intergenerational trauma. Most of the recent media coverage celebrating the 200th anniversary of European explorers crossing the Blue Mountains did not even canvass the implications for the area’s Aboriginal peoples. Surely this type of coverage — that privileges one historical experience and account over another — exacerbates the intergenerational trauma identified by the new plan.
No doubt some hackles will rise about the idea that we in the media have a responsibility for our work’s impact. But the industry’s engagement with mental health initiatives suggests there is a wider awareness and willingness to evolve our practices.
This piece is written from my perspective as a non-indigenous journalist. I wish I’d had the chance to reflect on these issues earlier in my career. There are many journalists and organisations, particularly in the community sector, whose work reflects the principles underlying the new national health plan.
And the digital era is enabling initiatives like the Cherbourg MoJo project in Queensland which is equipping young people with the skills to tell their community’s stories. You can see this as a digital media project or as a health intervention, given that it aims to improve self-esteem, confidence, literacy, and to “present a less marginalised view of the community”.
So while journalism can learn plenty from the health sector, it works both ways. The Cherbourg project suggests the skills of journalism can be harnessed for improving a community’s wellbeing. Mind you, the ancient art of telling stories was around long before the modern concept of journalism was invented.
*Melissa Sweet is a PhD candidate at Canberra University, and is researching journalism and Aboriginal and Torres Strait Islander health
This week’s Health Wrap has been prepared by Melissa Davey, former SMH journalist, prolific tweeter and keen public health observer who has joined me at the Sax Institute in the new role of Communications Manager.
This expansion of the Croakey Health Wrap team is well timed given the amount of health news being produced and debated. This past fortnight, tobacco was on the agenda, there were some interesting discussions on obesity and the Federal Government unveiled its new vision for Aboriginal health.
Drawing attention to Aboriginal health is difficult when the launch of the National Aboriginal Torres Strait Islander Health Plan falls on the same day of the birth of a new Royal, writes Colin Cowell for Croakey. The plan aims to provide an evidence-based framework to guide policy. Priorities identified include Aboriginal social and emotional wellbeing and the factors influencing it, including drugs and alcohol.
“The plan has also resolved to tackle the difficult and distressing issues of violence, abuse and self-harm,” Cowell writes. “Importantly, in this plan the sector has signalled the need to expand our focus on children’s health to broader issues in child development. There is also much work to do in developing robust research and data systems. The plan has also resolved to tackle the difficult and distressing issues of violence, abuse and self-harm.”
Bridie Jabour for the Guardiandetails how the Federal Government has pushed ahead with the plan despite the June 30 deadline for signing the Closing the Gap agreement on Indigenous health being missed. However, Victoria has since put forward its own funding offer.
A culturally appropriate screening tool that can gauge Indigenous social and emotional wellbeing may be one solution to help determine patients with mental health concerns or who need referring on for evaluation, writes Marnie McKimmie in The West Australian.
And about 120 Aboriginal men came together recently at at Ross River, 100 km east of Alice Springs, to identify ways of better targeting men in remote communities. (The location of the meeting has been corrected from an earlier version of this post). Indigenous health minister, Warren Snowdensaid, “Rather than having Aboriginal and Torres Strait Islander people feel like they are part of the problem, we want to encourage and support Aboriginal men to be a part of the solution”. A national summit on Aboriginal and Torres Strait Islander health was also held in Melbourne.
As NAIDOC week drew to a close, 10 Indigenous Australians were honoured at the NAIDOC award ceremony in Perth. ABC reported the story here.
And in an update on closing the gap in Indigenous health for Croakey, health policy analyst Dr Lesley Russell hopes Prime Minister Kevin Rudd sees formal funding agreements with the states and territories as “part of the unfinished business that must be taken off his desk before the election is called”.
Elizabeth Strakosch is particularly scathing of the lack of progress in Indigenous health from both sides of politics in this piece for The Conversation.
Tobacco reform: evidence takes a back seat
The UK Government’s backflip on plans to introduce plain packaging of tobacco has attracted widespread criticism from public health experts over the past couple of weeks. The Conservative party’s chief strategist, Lynton Crosby, has previously said issues like immigration and the economy should be the focus of government, with health barely rating a mention. His stance is perhaps not surprising, given this New Statesman report that his lobbying company has close links to the tobacco industry. Conservative MP Philip Davies also said introducing plain packaging in the UK would be “gesture politics” with “no basis in evidence”.
Writing for The Conversation, Assistant Professor at the University of Michigan Holly Jarmansays it’s looking like the policy is dead in the water. Her comments were prompted by an announcement from Health Secretary Jeremy Hunt that the UK Government had decided to wait until the impact of plain packaging in Australia could be measured before acting. But Professor Jarman refers to numerous studies that indicate plain packaging is effective. “The evidence base for plain packaging is arguably better than that for many other policies currently being pursued by the government,” she says.
New research published in the online medical journal BMJ Open also concludes plain packaging is associated with lower smoking appeal, more support for the policy and more urgency to quit among adult smokers. It’s the first study to examine the effect of Australia’s plain packaging reforms on the attitudes of smokers. Tobacco control advocate and professor of public health Simon Chapman shares his thoughts on the study for The Conversation.
Meanwhile, a Guardianeditorial sums the UK Government’s public health policy like this: “Squint for long enough at the remains of the coalition’s policies to help Britons live longer, healthier lives, and it might appear that ministers really believe multinational tobacco businesses and FTSE-listed retailers deserve greater protection than parents doing the school run.”
Another blow to the “not enough evidence” argument comes from the World Health Organization, which released a report on the global tobacco epidemic describing bans on tobacco advertising, promotion and sponsorship as one of six measures known to be protective against tobacco’s effects. And packaging is a key platform for that advertising and promotion.
The Telegraph’sTom Chivers, however, is not convinced the freedom of tobacco companies to sell cigarettes in one coloured pack or another is particularly important.
Obesity: a wicked problem
Perhaps some Australians are getting the message to cut back on fast food with this report from Eli Greenblat that McDonald’s sales in Australia are going backwards. However McDonald’s president, Don Thompson, appears to have fudged youth unemployment figures to explain the decline in sales. “Youth unemployment in Australia is about 25.5 per cent,” he is quoted as saying. “So they’re facing something; unemployment for them has risen.” In fact, youth unemployment was at 11.6% as of May.
But even if our taste for some fast foods has dropped it is well known that portion sizes are growing. Senior Lecturer at the University of NSW Lenny Vartanian says people eat large portions even if they are not very hungry or if the food doesn’t taste that good. Writing for The Conversation, he also says education about portion size alone may not be enough to help people to eat more mindfully.
One tactic that definitely doesn’t help people lose weight is weight discrimination, a study published online by PLoS Onehas found. Not only does it lead to poorer mental health outcomes, but discrimination increases risk of obesity rather than motivating people to lose weight, the study found. Cat Pause offers a good analysis of the issues here.
The obesity epidemic here has attracted the attention of the US media. This excellent analysis by The New York times reports the prevalence of obesity is growing faster in Australia than any other industrialised nation. It also gives an overview of the various strategies state and territory governments have tried to tackle the problem. But the report says these campaigns may not be enough, with obesity rates projected to rise across all age groups in Australia for the next decade.
More than 5000 NSW nurses and midwives went on strike this week, saying patient care had been compromised because of a lack of clinical staff to treat them. In the Sydney Morning Herald, Lucy Carroll writes that the NSW Midwives and Nurses Association wants one nurse for every four patients in general medical, surgical and mental health wards. It also wants one nurse for every three patients in general children’s wards and in emergency departments.
The NSW branch of the Australian Medical Association was among those to lend support to the action. In a statement their president, Associate Professor Brian Owler, says nurse-to-patient ratios have provided a sound basis for improving staffing levels in major hospitals and should be extended to hospitals more generally. He says hospitals are often staffed on the basis of historical funding levels rather than patient need, which means western and outer metropolitan Sydney hospitals are understaffed compared to those in the CBD.
And with Health Workforce Australia predicting a shortfall of nearly 110,000 nurses by 2025, University of Sydney vice-chancellor, Dr Michael Spence says the Federal Government’s proposed $2000 cap on self-education tax deductions for the health and medical workforce is a bad move. He’s not alone. The cap has attracted significant attention and a good debate on the issue can be found at The Conversation.
Meanwhile Sean Nicholls writes in the SMH that paramedics are plagued by inappropriate emergency call-outs for “ailments” such as bed-bugs, leech bites, scraped knees and even light bulb changes.
It’s a problem exacerbated by current protocols which require paramedics to take patients to hospital if the patient insists, the NSW Auditor General Peter Acherstraatreports. He found only 65% of ambulance crews handed over patients within 30 minutes of arriving at hospital, well below NSW Health’s target of 90 per cent.
Doctors in Queensland seem to be having an easier time of it, if this report from news.com.au is to be believed, which found senior public hospital doctors are being paid $100,000 to do nothing.
At the federal level, The Drum and Croakey ask: whatever happened to the health debate? In the latter piece, Croakey co-ordinator Melissa Sweet says health policy is unlikely be a vote-swinger come the federal election, despite the AMA doing its bit to drum up interest. It has released its health policy platform – available here. Affordable healthcare and rural and Aboriginal health are key areas on their agenda, news.com.au reports.
Vaccination supporters get vocal
Confirmation that actress and anti-vaxxer Jenny McCarthy will be appointed as a panellist on popular US day-time talk show The View, has Toronto Public Health in Canada up in arms. As Canada.com reports, they have launched a campaign against her hire by the ABC. And National Public Radio in the US aired this podcast called ‘A Dangerous View’ that gives a great overview of the controversy surrounding her hiring.
Back in Australia, anti-vax lobby group the Australian Vaccination Network has been dealt a blow. Medical Observer reports the group had been using comments made by former Greens leader Bob Brown to promote their cause. But in an open letter, Brown says his view has always been that vaccination is in the interests of public health and should be promoted.
NSW Opposition leader John Robertson meanwhile, has accused the State Government of making its new policy on vaccinating mothers against whooping cough confusing. The changes mean NSW Health will no longer provide free whooping cough vaccine to GPs for mothers after they have given birth. Explaining the changes, NSW Health Director of Communicable Diseases Dr Vicky Sheppeard says to be most effective the vaccine needs to be given before the baby is born.“Research by NSW Health and the National Centre for Immunisation Research and Surveillance confirms it’s best to get vaccinated before conception, during the third trimester of pregnancy or failing that, at soon as possible after delivery,” Dr Sheppeard says.
*** Research and pharma
Australians are abusing and becoming dependent on a wider range of opioids, reports Shevonne Hunt for the ABC. Shevonne’s report highlights a presentation at the International Narcotics Research Conference in which Professor Paul Haber showed a continuous rise in the use of oxycodone over the past three years, while fentanyl and buprenorphine use are also rising. “Instead of having an epidemic of one prescription opioid we’re in the midst of an epidemic of three,” he says.
In other research news, the Guardian health editor Sarah Boseley reports alcohol-related deaths of UK women in their 30s and 40s are steadily rising. Late night drinking culture, cheap alcohol and industry marketing and promotion had all played a part, researchers found – these are also issues for Australia, Fairfax reports.
In international research, a study linking the consumption of fatty acids found in fish with increased prostate cancer risk has been widely written about, read and criticised. The Inquisitrexamines the views of some of the critics of the study. David Katz sits more in the middle, writing for the Huffington Post that while the study does not prove that fish oil intake causes prostate cancer, it was not “dismissible rubbish”.
Also on the Huffington Post is this piece from neurologist Aysha Akhtar, who argues animals should not be used in medical research because they are not good ‘models’ of human physiology. “Over one hundred stroke drugs have been found effective in animals in the lab, yet all have failed in humans,’’ she writes. “Over 85 HIV vaccines that worked in non-human primates failed miserably when tried in humans.”
Another controversial topic this fortnight was male fertility, after an analysis from France found the sperm concentration of men had decreased by one third between 1989 and 2005. It led fertility experts attending the European Society of Human Reproduction and Embryology conference to debate whether male fertility is on the decline, The Wall Street Journal reports.
In women’s health, researchers from the University of NSW have found in a major study that women may not need a pap smear every two years. In their review of 20 years’ worth of data from Australia, New Zealand and England, they found women screened every three years had a similar rate of cervical cancer and deaths compared to those screened more regularly, the ABC reports.
Sensitive and confidential medical data belonging to nearly 3000 patients was found on a computer sold by the National Health Service in England through an auction site. The Service was fined 200,000 pounds for the data breach, ehealth Insider reports.
And in Australia, 6Minutes reports e-records are still a long way from benefiting GPs. It comes as the Federal Health Minister Tanya Plibersekannounced $8 million towards developing software to enable pathology and radiology results to be sent to the patient’s personally controlled electronic health record, as well as to their GP.
What doctors won’t do
Only 11% of doctors who responded to a recent Australian Doctor survey said they would want to be kept alive after a major accident. And one third of male GPs would shun PSA screening for prostate cancer. Check out @australiandr who is tweeting results from their survey of GPs about the medical treatments they would never want to undergo themselves.
You can find previous editions of the Health Wrap here.
Twitter shout-outs this week go to: @LRussellWolpe, @lucy_carroll, @australiandr, @cancerNSW, @picardonhealth, @DrHWoo, @SimonChapman6, @curious_scribe, @upulie, @richardhorton1
Melissa Davey is the Sax Institute’s Communications Manager. She was previously a health and medical reporter for the Sydney Morning Herald and the Sun Herald. She is completing her Masters of Public Health at the University of Sydney and has a strong interest in public health messaging and mental health. The Sax Institute is a not-for-profit organisation that drives the use of research evidence in health policy and planning. Twitter: @MelissaLDavey
PLEASE NOTE: NACCHO provides comments from both sides of politics in the interest of our members. It should also be noted that our Chair Justin Mohamed and/or CEO Lisa Briggs/and other NACCHO staff attended every NATSIHP consultation throughout Australia and played a major role in the creation of this document through leadership groups.
The Coalition’s indigenous health spokesman, Andrew Laming, told The Australian it was disappointing indigenous health stakeholders were kept in the dark about the final plan until today, and more worrying that state and territory health ministers did not endorse the plan as was usual.
“The plan is supposed to outline the Australian government’s 10-year strategy to improve indigenous health outcomes, but instead it contains little detail and in fact appears to support the case for business as usual,” Dr Laming said. “The release of the plan appears to be yet another exercise in political spin, lacking any substance, and fails to say how we are going to get there.
“We have returned to the Kevin Rudd era of government by press release and big numbers.
“The plan as released by Labor contains considerably less detail than the previous national strategic framework for Aboriginal and Torres Strait Islander health that it replaces.”
The criticism comes after the government yesterday announced an expansion of the health system to focus on indigenous children and to include broader issues of child development as the central plank of a 10-year Aboriginal health plan.
Indigenous Health Minister Warren Snowdon said the National Aboriginal and Torres Strait Islander Health Plan would be critical in meeting the closing the gap life expectancy target.
“It provides guidance for state and territory governments as to what we see as our priority,” he said yesterday. “It’ll make sure when we sign new partnership agreements with them, the material in this plan is considered.”
Mr Snowdon said about 50 per cent of indigenous people smoked. “Tobacco smoking is directly responsible for about 20 per cent of the burden of disease and 12 per cent of deaths,” he said.
He urged state and territory governments to sign up to the plan and commit funding.
Justin Mohamed, chairman of the National Aboriginal Community Controlled Health Organisation, the national authority for comprehensive Aboriginal primary healthcare, said the plan for the first time incorporated the social determinants of health which the sector had long fought for. “The federal government should be congratulated for delivering this plan, which has been developed with the involvement of Aboriginal people and Aboriginal health authorities,” he said.
“It is also significant that the plan’s vision articulates a health system free of racism and inequality for the first time.”
“The plan accepts the evidence that Aboriginal Community Controlled Health Organisations are central to improving the health of Aboriginal people in their communities and that participation by Aboriginal people in decisions relating to their health must be supported“
The release of the National Aboriginal and Torres Strait Islander Health Plan and its commitment to support the Aboriginal community controlled health model is welcome and needs mutli-partisan support across all governments, state and federal, for effective implementation.
Justin Mohamed, (pictured above) Chair of the National Aboriginal Community Controlled Health Organisation (NACCHO), the national authority in comprehensive Aboriginal primary health care, said the health plan for the first time incorporates the social determinants of health which the sector has long fought for.
“The Federal Government should be congratulated for delivering this plan which has been developed with the involvement of Aboriginal people and Aboriginal health authorities,” Mr Mohamed said.
“The plan accepts the evidence that Aboriginal Community Controlled Health Organisations are central to improving the health of Aboriginal people in their communities and that participation by Aboriginal people in decisions relating to their health must be supported.
“Critically, the plan moves Aboriginal health from being viewed in a clinical and isolated way and instead adopts a more holistic approach – considering social and emotional wellbeing, mental health, the impacts of drug and alcohol and the importance of culture as all part of a broader health picture.
“It is also significant that the plan’s vision articulates a health system free of racism and inequality for the first time.
“As always though the test of the plan will be in the implementation and NACCHO looks forward to being involved in the next steps – setting performance indicators and targets to ensure the vision of the plan can be realised.”
Mr Mohamed said it was essential that the implementation of the health plan be placed above party politics.
“Aboriginal people and organisations like NACCHO have been integral to the development of this plan and have worked hard to ensure the final product can work in our communities.
“I would encourage all sides of politics to view the plan through the prism of what needs to be done to fix the shameful health and life expectancy gap between Aboriginal and non-Aboriginal people and not through the prism of a looming federal election.
“Too much work has been put in by the sector for it to fall at the last hurdle. We must see a multi-partisan approach to implementing the plan.
“State and territory governments are also an integral part of making this plan a reality yet only Victoria has recommitted to the recently expired National Partnership Agreement (NPA) in Indigenous Health Outcomes for a three year period and the WA government for 12 months.
“Critical health programs are at risk unless all state and territory governments urgently sign up to the NPA.”
Media contact: Olivia Greentree 0439 411 774, Colin Cowell 0401 331 251
Projected funding for health programs specifically designed for and targeted at Aborigines and Torres Strait Islanders is estimated to be about $12 billion to 2023-24.
Aboriginal and Torres Strait Islander community-controlled health services will continue to be supported to fulfil their pivotal role in improving Aboriginal and Torres Strait Islander health outcomes.”
A DRAMATIC expansion of the health system to focus on indigenous children’s health and to include broader issues of child development is the central plank of a 10-year Aboriginal health plan to be unveiled today.
The plan, which dictates where state and federal governments should focus their efforts, aims to deliver the policies required to eliminate the indigenous life expectancy gap by 2031.
It commits governments to give more attention to and increase spending on “difficult and distressing issues of violence, abuse and self-harm”.
Indigenous Health Minister Warren Snowdon (pictured below last week opening Male Health Summit) will say today that the health plan places priority on social and emotional wellbeing and the issues that impact on it, including alcohol and other drugs. It also focuses on improving the wellbeing of indigenous people with a disability.
The Rudd government says the 10-year National Aboriginal and Torres Strait Islander Health Plan is “free of racism and inequality” and provides the “necessary platform to realise health equality by 2031”.
“Importantly, in this health plan we signal the need to expand our focus on children’s health to broader issues in child development,” Mr Snowdon will say. “We have much more work to do in developing robust research and data systems. I am also resolved that we will tackle the difficult and distressing issues of violence, abuse and self harm.” The government will commit to “drive health system improvements and maintain a clear priority on primary healthcare system reform”, he will say. “Aboriginal and Torres Strait Islander community-controlled health services will continue to be supported to fulfil their pivotal role in improving Aboriginal and Torres Strait Islander health outcomes.”
The government will report annually to parliament about measures and targets aligned to the new plan.
“The health plan provides a clear focus on strategies to address racism and to empower people to take control of their own health,” Mr Snowdon will say. “While we need to continue to strengthen healthcare we also need to enhance our focus on specialist care and hospital care in the secondary and tertiary systems.”
A series of 17 nationwide consultations was held with Aborigines and Torres Strait Islanders, communities and groups, with more than 140 written submissions and a series of roundtables to gather expertise on a range of issues relevant to Aboriginal and Torres Strait Islander health. Projected funding for health programs specifically designed for and targeted at Aborigines and Torres Strait Islanders is estimated to be about $12 billion to 2023-24.
Mr Snowdon will also use the launch of the health plan to reiterate his call to state and territory governments to publicly commit their contributions to the new National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes.
National Aboriginal and Torres Strait Islander Health Plan
Introduction to the NATSIHP (the Health Plan)
The Australian Government is developing a new National Aboriginal and Torres Strait Islander Health Plan (the Health Plan) in partnership with Aboriginal and Torres Strait Islander people and their representatives. State and territory governments have been invited to participate.
The Health Plan will support the Government’s efforts to close the gap in life expectancy and infant mortality between Aboriginal and Torres Strait Islanders and the broader population. It will recognise that health for Aboriginal and Torres Strait Islander peoples is not just the physical wellbeing of the individual, but also encompasses their social, emotional, spiritual and cultural wellbeing.
To develop a comprehensive plan in partnership, the Australian Government is holding a series of nation-wide community consultations and conducting an online submissions process to capture different views and ideas. To provide context and guidance for the consultations and submissions process, the Department has developed a Discussion Paper which seeks responses to a range of questions to help shape the development of the Health Plan.
By attending a consultation or completing a submission, key stakeholders will play an active role in ensuring the Health Plan identifies the key health issues and necessary priorities to further close the gap in health outcomes for Aboriginal and Torres Strait Islander peoples.
The Department has developed a Discussion Paper to provide context and guidance throughout the consultations and submission process for the National Aboriginal and Torres Strait Islander Health Plan (the Health Plan).
The Discussion Paper outlines the current state of Aboriginal and Torres Strait Islander health and seeks responses to a range of questions related to health system performance and the social determinants of health. The aim of the Discussion Paper is to start a conversation about the development of the Health Plan and important health issues for Aboriginal and Torres Strait Islander peoples.
The wide range of questions asked throughout the Discussion Paper will help capture different views and ideas. Your views on this Discussion Paper and any other feedback will help shape the development of the health plan so your responses are most welcome.
The Australian Government invites you to make a submission on the broad health needs of Aboriginal and Torres Strait Islander peoples. The submission process provides an opportunity for all points of views in the community to be heard and considered throughout the development of the Health Plan.
To have your say in the development of the Health Plan, please read the Discussion Paper and complete a submission. All comments will be considered by the Department and may be published on the website (unless otherwise indicated). The online submission portal will be available from 11 September 2012 to 20 December 2012.
By completing a submission and responding to these questions, you can help to ensure the Health Plan reflects the key health issues and priorities that matter most to Aboriginal and Torres Strait Islander individuals and communities.
The Australian Government is holding a series of nation-wide consultations with Aboriginal and Torres Strait Islander individuals, communities and groups, health/social determinants service providers, and state and territory governments. The consultations will seek feedback from stakeholders to ensure the Health Plan meets the needs of Indigenous Australians of all ages and from different backgrounds and locations.
At the consultations, participants will have the opportunity to provide their views on the health needs of Aboriginal and Torres Strait Islander peoples through group workshops and public forum. The Discussion Paper will provide participants with context and guidance for the consultations and is available online and also in hard-copy at each of the consultations.
By attending a consultation in your state or territory, you can help to ensure the Health Plan reflects the key health issues and priorities that matter most to Aboriginal and Torres Strait Islander individuals and communities.
On 3 November 2011 Ministers Roxon and Snowdon announced the development of the National Aboriginal and Torres Strait Islander Health Plan (the Health Plan). The Health Plan will support the Government’s efforts to close the gap in life expectancy and infant mortality between Aboriginal and Torres Strait Islander peoples and the broader population.
Development of the Health Plan will be led by the Minister for Indigenous Health. A Stakeholder Advisory Group (SAG) has been established to guide development of the Health Plan by bringing together government and organisations with expertise in Indigenous health and broader health issues. The SAG is co-Chaired by David Learmonth, Deputy Secretary, Department of Health and Ageing and Ms Jody Broun, co-Chair of National Congress of Australia’s First People.
The Health Plan will replace the National Strategic Framework for Aboriginal and Torres Strait Islander Health which expires in 2013. The Plan will be developed in partnership with Aboriginal and Torres Strait Islander people.
The success of the Plan depends on the participation of people and organisations in the community. The development process will allow the opportunity for community views to be heard and considered. Individuals, groups and organisations with an interest in Aboriginal and Torres Strait Islander health are invited to participate.
THE HON WARRENSNOWDON MP
Minister for Indigenous Health
Tuesday 11 September 2012
VIEWS SOUGHT ON NATIONAL ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH PLAN
A discussion paper is being released today for input to a new National Aboriginal and Torres Strait Islander Health Plan (NATSIHP).Minister for Indigenous Health, Warren Snowdon, has called for submissions to ensure the health plan reflects the key health issues and priorities that matter most to Aboriginal and Torres Strait Islander individuals and communities.
“A new health plan will guide governments Australia wide over the next decade, in policy making and program design to improve health outcomes for Aboriginal and Torres Strait Islander people,” he said.
“The Australian Government has a long standing commitment to partner with Aboriginal and Torres Strait Islander people to support improvements in health outcomes and other determinants of health. This discussion paper is one way we are engaging.
“Improving the health outcomes of Aboriginal and Torres Strait Islander people is an ongoing challenge for all Australia. A national health plan will set the course for future policy and strengthen the engagement of states and territories,” Mr Snowdon said.
“It will provide a roadmap covering not only health, but also factors which impact health, such as education, employment and early childhood development. The health plan will link with other major health reforms currently under way.”
“By having your say you can help shape the types of health services and how they will be delivered into the future.”
The plan will replace the National Strategic Framework for Aboriginal and Torres Strait Islander Health which expires in 2013.
Consultations begin this month with Aboriginal and Torres Strait Islander young people in Sydney, followed by a further 16 community consultations in urban, regional and remote areas to engage with Aboriginal and Torres Strait Islander people, local health and service providers, and state and territory governments.
The discussion paper, a schedule of consultations and details on attending are above or by phone – (02) 8569 4477.