NACCHO National News: Indigenous issues address by Minister Nigel Scullion to Nationals Federal Council

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“This is a mighty dream, full of risks, but we should never allow our expectations to lower because that would create two Australia’s – one with high expectations for a child’s future and another with low expectations.

That inequity is wrong. Indigenous Australians should have the same expectations that non-indigenous Australians have: a proper education for their children, a decent job and safety in their home and community.

Everything flows from meeting these three objectives.”

THE NATIONALS’ FEDERAL COUNCIL CANBERRA 30TH AUGUST 2014

ADDRESS BY THE MINISTER FOR INDIGENOUS AFFAIRS

THE NATIONALS’ SENATE LEADER SENATOR THE HON NIGEL SCULLION

I begin by acknowledging the traditional owners of the land on which we meet.

Today I will make a few remarks on the state of the Senate and the contributions of my Senate colleagues. Then I will take you on the journey that is Indigenous policy and pay a visit to constitutional recognition

For Senate text see LINK

Indigenous Affairs

I would now like to take you on a journey into Indigenous affairs. This is important because so much is happening – and the Nationals have always taken a keen interest in Indigenous affairs because they share many of the rural and remote challenges and opportunities.

Like a few in this room I’m sure, I didn’t really think that the Apology we made in 2008 would matter.

I couldn’t see the apology helping at all to close the vast gap on vital issues such as Indigenous life expectancy, remote children’s education, housing, decent work for adults and community safety.
All the symbolic trumpeting was wonderful, but I could not see what difference it could make.

How wrong I was.

The changes to the way Aboriginal people as individuals and as communities saw themselves after that apology were extraordinary. Clearly, those who would diminish the importance of symbolism as something that doesn’t have a role to play in practical outcomes are quite wrong.

Symbolic change must happen if practical changes are to succeed.

They go hand in hand. The government’s response to the Forrest Report will give us the practical policy future while constitutional recognition of our Indigenous peoples will give the matching symbolic change. They are twin engines in a plane that we must bring in to land together.

The case for recognition is very clear. Imagine there is a race and the winner is never acknowledged as having crossed the line first. In fact the second place getter gets all the accolades. The winner doesn’t even get to stand on the podium. That is quite wrong, obviously. And it is quite wrong for our Indigenous peoples to be left off the constitutional podium as well.

We started on the first day we were elected to change the future of Indigenous Affairs in the biggest shake-up of the bureaucracy in decades. One of the first acts of the new government was to bring the administration of more than 150 Indigenous programs and services from eight different government departments into the department of the Prime Minister and Cabinet.

The Prime Minister effectively became the overall Minister for Indigenous Affairs, as well as having me as a Cabinet Minister dedicated to Indigenous Affairs and a Parliamentary Secretary. As for Labor, they gave the shadow portfolio to Shayne Neumann. The Member for Ipswich also has to shadow the large portfolio of Ageing. Following criticism of Neumann by aboriginal elders, the editor in chief of The Australian described Shayne Neumann as having “no idea what he is talking about”. The picture is of a Shadow Minister who is not across his brief and has lost both the support of elders, communities and the national media.

We faced dealing with 150 different programs and services. We inherited a structural mess. A former community organisation in Yuendumu had 34 separate funding agreements requiring a report on average once a week. There has been far too much waste for far too long in Indigenous Affairs.

Billions have been spent on housing under Labor but overcrowding remains chronic.

We turned those 150 lines of funding into five streamlined areas with total funding of $4.8 billion and named it the Indigenous Advancement Strategy.

The five areas are 1) jobs, land and economy; 2) children and schooling; 3) safety and wellbeing; 4) culture and capability; and 5) remote Australia strategies.

From this we distilled the essence of Coalition action, our mantra, which is: to get children into school – which is our number one priority, adults into work and the creation of safe communities.

They are the core of everything. We are already implementing the $46.5 million Remote School Attendance Strategy across 73 schools in 69 communities. Over 500 local indigenous jobs are also created in terms of School Attendance Supervisors and Officers. A key part of the Forrest Review is effectively already at work via our $45 million Vocational Training and Employment Centres (or VTECs) training for jobs model. These VTECs have guaranteed jobs for the people who undergo the right training. So it’s goodbye to training or training’s sake which has been the problem in many communities. Now we’ve linked up employers, trainers and Indigenous job seekers in a demand driven model. 4,074 jobs have already been created this way with another thousand expected by the end of the year. Indigenous people are entering the workforce in a range of industries – hospitality, tourism, construction, mining and transport.

Safer communities are essential for Indigenous families to be happy and healthy. We will continue to support the efforts of Indigenous communities to combat alcohol fuelled violence so all community members, particularly women, children and the elderly can live peacefully and safely. The government is helping end petrol sniffing by expanding the roll out of low aromatic fuel across Northern Australia and building storage tanks in Darwin. The government is also investing $54.1 million in police infrastructure so there is a 24 hours police presence for the first time in some remote communities. There is also $2.5 million for Community Engagement Police Officers and $3.8 million towards the ongoing Northern Territory’s Child Abuse Taskforce.

Already we are seeing these practical measures make significant inroads. But it’s a long and winding road, this highway to better lives for Indigenous peoples. Many have tried and failed despite major investments. The only way to succeed is to involve the Indigenous people at the decision making level. The Government committed to provide $5 million to support a nine month design phase of the Empowered Communities initiative. Indigenous leaders report encouraging outcomes, particularly in relation to community acceptance of the need to take increased responsibility in key areas such as school attendance and employment. Significant consultation with Indigenous groups across all eight Empowered Communities regions has been occurring.  I look forward to receiving the final Empowered Communities proposal from the Indigenous leaders later this year.

Unless Indigenous people own the reforms nothing will change. Engaging Indigenous people in delivering solutions and services is critical to empowering communities and doing business in the new way. So it’s a mindset thing on both sides. And they don’t happen overnight. But I believe that we have started well. We have a Prime Minister who believes passionately in improving the lives of Indigenous people on a practical level – children to school, guaranteed jobs for adults after training and communities where families have decent housing and the option to buy their own home, where substance abuse and domestic violence have disappeared.

This is a mighty dream, full of risks, but we should never allow our expectations to lower because that would create two Australia’s – one with high expectations for a child’s future and another with low expectations. That inequity is wrong. Indigenous Australians should have the same expectations that non-indigenous Australians have: a proper education for their children, a decent job and safety in their home and community. Everything flows from meeting these three objectives.

As The Nationals look to private enterprise as the solution to a healthy economy, so too is it the solution to Indigenous employment. Corporate Australia is offering many opportunities for Indigenous employment. The first example is that of Andrew Forrest who has just completed a report for the government on employment and training. Before this he established the Australian Employment Covenant that attracted over 60,000 job pledges from 338 employers. Over 15,000 of these jobs have been filled. A real breakthrough in pioneering a demand-driven approach where the employer provides the job and the job seeker is trained to do it. The Business Council of Australia membership placed 3,500 Indigenous people in jobs and traineeships in a year. Some of Australia’s best known companies are also engaged in providing real jobs and training, such as Woolworths, Coles, the Commonwealth Bank, Transfield and the CopperChem mine in Cloncurry. Then there are the business opportunities being built up by local Indigenous people. I tell you this because it’s important to get the message out that there are positive stories happening and lessons being learnt on how to make real jobs which is the ultimate solution to welfare dependency.

I’ve outlined what I believe to be a realistic way through the years of mismanagement and waste in Indigenous affairs. The key is relationships with people at the grass roots. The Nationals have always been good at that and naturally understand it because they too have experience in being a long way from decision makers. The Nationals’ seats are generally the poorest seats and contain significant numbers of Indigenous people. If we can stand up and say ‘Yes’ to constitutional recognition then we are saying ‘yes’ to recognising people who we’ve grown up with or worked beside or gone to school with.

Aboriginal and Torres Strait Islander peoples are the first inhabitants of this country, and recognising them in our Constitution presents an historic opportunity to acknowledge their unique culture and history, and their enormous contribution to this nation.

The vote of conservatives is of vital importance in the debate on constitutional recognition. It will only succeed with bipartisanship.

Our own former Nationals’ Party Leader John Anderson has been recruited to head a panel to conduct a review into public support for Indigenous constitutional recognition.

The review panel will work with the Joint Select Committee on Constitutional Recognition of Aboriginal and Torres Strait Islander Peoples to progress the government’s commitment towards a successful referendum.

The joint select committee, chaired by Ken Wyatt, the first Indigenous member of the House of Representatives, was formed to work towards a parliamentary and community consensus on referendum proposals, and report on how to achieve a successful referendum.

The review panel is required to provide a report to me by September 28.  When the time is right and informed by these two reports, the government will release a draft amendment. We must get it right because if the referendum fails, it would be a body blow to our fellow Indigenous Australians. Indeed, the whole nation would falter, would be diminished.

When you leave this Council, I would like you to ask yourself this question:- Is it honourable to support Indigenous recognition in Australia’s founding document? If it is, (and I strongly believe it is), then I will do everything possible to see that it succeeds in my local community.

It will quite literally take a ‘National’ sense of honour to see this through.

If we get this right as a nation, we will be able to work together to write a new story for all of us.

Thank you.

NACCHO Aboriginal health news: Action plan to increase the number of Aboriginal Health Practitioners

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Pictured above AMSANT CEO John Paterson along with Aboriginal Medical Services Alliance NT chair Marion Scrymgour  and Central Australian Aboriginal Congress CEO Donna Ah Chee who will sit on the Back on Track taskforce

Minister for Health Robyn Lambley has today announced the Back On Track taskforce that will lead an action plan to increase the number of Aboriginal Health Practitioners in the Northern Territory.

“It was wonderful to see that the Country Liberals Government’s Aboriginal Health Practitioners Back on Track plan received support from all sides of politics in Parliament today,” Mrs Lambley said.

“In July I announced that we would boost the number of Aboriginal Health Practitioners across the Territory by 10 per cent a year.

“We are also committed to working with five key communities including Wadeye and Papunya to reach specific targets of Aboriginal Health Practitioners working in health clinics

“Today I am pleased to announce that I have so far asked Aboriginal Medical Services Alliance NT chair Marion Scrymgour, AMSANT CEO John Paterson and Central Australian Aboriginal Congress CEO Donna Ah Chee to sit on the Back on Track taskforce.

“I will chair the Taskforce and together we will concentrate on reaching these targets.

“We will work closely with community leaders, health managers and current Aboriginal Health Practitioners.

“I am committed to ensuring that representatives from the Department of Health visit communities that have been left without an Aboriginal Health Practitioner for years, to work with the community to encourage people to train as Aboriginal Health Practitioners.

“We need to know the barriers to successful outcomes. We need to find ways through those barriers, because as far as I am concerned, the result is too important to too many Territorians and their communities.

“We cannot afford to let this fall by the wayside and fail our remote areas as the previous Labor Government did, if we are to see real progress in Indigenous health outcomes and economic opportunity in our remote communities.

“Encouraging more Aboriginal Health Practitioners into health clinics across all areas of remote Australia is an important national health issue for Indigenous people.

“I’m looking forward to standing up in Parliament next year and reporting to the Assembly that we are well and truly back on track in the Territory.”

 

 

NACCHO political alert: Commission of Audit: Aboriginal health would suffer

Peter

Aboriginal and Torres Strait Islander people should be exempt from any health co-payments to prevent any backward steps in Aboriginal health, said the National Aboriginal Community Controlled Health Organisation (NACCHO) today.

NACCHO Chair Justin Mohamed said the introduction of co-payments for basic health care such as GP visits and medicines, as recommended by the Commission of Audit, would increase barriers for many Aboriginal people to look after their own health.

“Improving Aboriginal and Torres Strait Islander health remains one of Australia’s biggest challenges,” Mr Mohamed said.

“Increasing barriers to Aboriginal and Torres Strait Islander people seeking appropriate health care will only increase this challenge.

“We need initiatives that will encourage Aboriginal people to seek medical attention and seek it early, not make it even harder for them to get the care they need.”

Mr Mohamed said Aboriginal and Torres Strait Islanders often had a range of complex health issues so even a low co-payment charge could make health care unaffordable for many.

“For people who only visit their GP once a year a small co-payment is likely to be manageable,” Mr Mohamed said.

“However for Aboriginal and Torres Strait Islander people with more complex health needs even a $5 charge for each visit would add up very quickly.

“A large Aboriginal family could be out of pocket hundreds of dollars after just a few GP visits.

“This would put basic health care out of reach and be detrimental to the health of many Aboriginal people.

“I urge the government to carefully consider the implications before implementing this recommendation and to ensure any decision is not going to mean a backward step for the health of Aboriginal people.”

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

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

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

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

Opening Address by Nyunggai Warren Mundine:

“The Future of Aboriginal & Torres Strait Islander Health”

Pictured above with  Lowitja O’Donoghue

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

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

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

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

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

I am honoured to be here today addressing you.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

*              *              *

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

*              *              *

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

REGISTRATIONS NOW OPEN

SUMMIT WEBSITE FOR MORE INFO

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NACCHO Close the Gap Day : Will Government funding of $800 M be enough to Close the Aboriginal health Gap ?

Peter

Updated at 7.00 Pm 18 March 2014 the above heading should read

Will Government funding of $1.3 billion  be enough to Close the Aboriginal health Gap ?

See Official Press Release below after the SBS interview

The government is responding to the call to Close the Gap with around $800 million in grant funding to organisations for Indigenous specific primary health and allied health care, the majority of which are Aboriginal and Torres Strait Islander Community Controlled Health Organisations (ACCHOs).

ACCHOs deliver culturally appropriate and sustainable primary health care services to Aboriginal and Torres Strait Islander communities.

Many communities have different cultures and histories so different needs may need to be addressed by locally developed, specific strategies,” .

Says Assistant Minister for Health Senator Fiona Nash  talking with SBS this week (refer official press release below for funding details)

This is Justin Mohamed statement about the need to Close the Gap

Unless the critical social issues of housing, education and self-determination that contributed to Aboriginal and Torres Strait Islander health inequality were adequately addressed, along with health funding, then it could take many generations to Close the Gap.

“In many rural, remote and urban areas we have many generations of a family living under one roof with high unemployment ,low income, no food in the fridge and the kids unable to attend school or do their homework because of the overcrowded living conditions.

The Aboriginal community controlled health services operate on multiple levels, and contribute significantly not just to cutting edge primary health care services, but to addressing some of the key social determinants as well, such as meaningful, employment, training, and leadership development.

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

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

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

Justin Mohamed NACCHO chair will be speaking at the National Press Club 2 April

“Investing in Aboriginal Community Controlled Health makes economic sense

PRESS CLUB BOOKINGS

For a country rich in resources and opportunity, the Indigenous people of Australia do not share the same fortune when it comes to health.

Aboriginal and Torres Strait Islanders can expect to live 10-17 years less than non-Indigenous Australians. The babies of Aboriginal mothers are twice as likely to die as other Australian babies, and in general Indigenous Australians experience higher rates of preventable illness such as heart disease and diabetes.

These are startling statistics from a country that enjoys the privilege of having one of the highest life expectancies in the world. For a country rich in resources and opportunity, the Indigenous people of Australia do not share the same fortune when it comes to health.

The reasons for the gap in Indigenous health are complex. Decades of discrimination, inaccessible health services, a misrepresentation of Indigenous Australians working in the health industry and failure to address root causes such as substandard education, housing and infrastructure all contribute.

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Oxfam’s National Close the Gap day is March 20, a day designed to create awareness, spark conversation and remind politicians on the inequality of health care that exists in our own country.

Close the GAP WEBSITE for events

Last year 145,000 people registered to support the campaign by holding a small event, like a morning tea, to discuss Indigenous health with family, friends and colleagues.

Oxfam Australia’s Indigenous Rights Policy Advisor Andrew Meehan says support of the campaign has helped put Indigenous health back on the agenda with government officials. “Registered events this year have now hit a record of 1060, showing an undeniable groundswell of support from everyday Australians expecting governments to keep their promise to invest in Indigenous health. It’s clear Australians care about this issue and expect our leaders to act,” Meehan said.

In 2008 The Council of Australian Government set a series of goals to decrease the general gap between Indigenous and non-Indigenous Australians. Earlier this year the progress of these goals were reviewed. In the areas of health, the goal of closing the life expectancy gap by 2031 has seen little improvement. Only the Northern Territory looks set to achieve this goal. More optimistic though is the goal of halving the gap in Indigenous mortality rates in children under five. If the current rate of improvement continues this goal is set to be achieved by 2018.

A number of aid organisations and humanitarian groups are working tirelessly to do their bit to close the gap, One Disease at a Time is a not for profit organisation with the vision to systematically target and eliminate one disease at a time. Currently in its sights is scabies, a highly contagious skin disease which affects seven out of ten children Indigenous children before their first birthday. Left untreated, scabies can lead to chronic disease and even death.

It can be disfiguring, children are forced to miss school and employment and personal relationships can be impacted. “Recognising the importance in giving kids the best start in life, one of our core program goals is to reduce scabies rates in children under five years old. Among children living in households with crusted scabies, we have seen an 88 per cent reduction in their time spent in hospital for scabies,” says founder of One Disease at a Time Dr Sam Prince.

One Disease at a Time work closely within communities to achieve their goals, something Meehan says is a critical element in closing the gap. “We’re pushing the government to invest in community controlled health. These are the people better placed to identify the services that are actually required. Focusing on this area is also an investment in jobs, giving these people an opportunity into a health career path,” he says.

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The PM Tony Abbott recently released at the Closing the Gap Report in Canberra with Tom Calma and Justin Mohamed above

DOWNLOAD PM 2014  REPORT

DOWNLOAD THE CLOSE THE GAP CAMPAIGN REPORT

Assistant Minister for Health Senator Fiona Nash says the government is responding to the call with around $800 million in grant funding to organisations for Indigenous specific primary health and allied health care, the majority of which are Aboriginal and Torres Strait Islander Community Controlled Health Organisations (ACCHOs). “ACCHOs deliver culturally appropriate and sustainable primary health care services to Aboriginal and Torres Strait Islander communities.  Many communities have different cultures and histories so different needs may need to be addressed by locally developed, specific strategies,” she says.

Further to this, a $1.3 billion dollar investment in 2013-14 has been pledged for health projects including child and maternal health and the management of chronic diseases with specific focus on reducing the factors that create risk for disease including smoking and diet.

Dr Prince believes the secret to success in closing the gap is sharing stories of hope. “These will serve to ignite change in Indigenous communities, amongst the next generation of medical practitioners, and Australians as a whole.”

OFFICIAL PRESS RELEASE From Senator Nash’s Office

What current government initiatives are in place to tackle the gap in Indigenous health care?

As most parents will know, healthy children are happier and more responsive, both at home and at school.
We are committed to getting kids into school, adults into work and ensuring the ordinary rule of law applies in communities.
This is important and cannot be achieved without a continued focus on good health.
In order to contribute to closing the gap in health outcomes the Government is providing around $1.3b in 2013-14 for Aboriginal and Torres Strait Islander healthactivities including:
·   child and maternal health services to give children a great start to their life, education and employment opportunities;
·   effective approaches to preventing and managing chronic disease especially in relation to reducing the factors that create risk for disease including smoking, healthy food and lifestyle;
·    ensuring a well-functioning and culturally appropriate health system and specific strategies and approaches to combat areas of concern such as trachoma, STIs, eye health and ear health.
The Government will provide around $800m in grant funding to organisations for Indigenous specific primary health and allied health care, the majority of which are Aboriginal and Torres Strait Islander Community Controlled Health Organisations (ACCHOs).
ACCHOs deliver culturally appropriate and sustainable primary health care services to Aboriginal and Torres Strait Islander communities.  Many communities have different cultures and histories so different needs may need to be addressed by locally developed, specific strategies.
The Government is working with Aboriginal and Torres Strait Islander people and organisations, and with state and territory governments, to implement programmes to reduce the disparities in life expectancy and health outcomes between Aboriginal and Torres Strait Islanders and non-Indigenous Australians.
We are seeking change – improved access and outcomes across the breadth and depth of the health sector.

ON CLOSE THE GAP DAY March 20 show your support

by changing your Facebook or Twitter profile to CLOSE THE GAP

CTG

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

summit-2014-banner

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

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

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

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

SUMMIT WEBSITE FOR MORE INFO

NACCHO Aboriginal health, Bolt and racism: Aboriginal Coalition MP Ken Wyatt breaks ranks on race law moves

KW

Indigenous Coalition MP Ken Wyatt has spoken out against the repeal of legislation making it unlawful to offend, insult, humiliate or intimidate on the grounds of race or ethnicity.

Mr Wyatt told Fairfax Media he feared that repealing section 18c of the Racial Discrimination Act would either disempower the vulnerable or result in a hardening of intolerant attitudes.

Aboriginal Coalition MP Ken Wyatt

So it feels I’ve lost, and not just this argument. I feel now the pressure to stop resisting the Government’s plan to change the Constitution to recognise Aborigines as the first people here — a dangerous change, which divides us according to the “race” of some of our ancestors.

My wife now wants me to play safe and stop fighting this new racism, and this time I’m listening. This time I was so bruised by Q & A that I didn’t go into work on Tuesday. I couldn’t stand any sympathy — which you get only when you’re meant to feel hurt.

Andrew Bolt Herald Sun (full response blog below )

Bolt was found to have contravened Section 18C of the Racial Discrimination Act. Nine aboriginal applicants brought a class-action against Bolt and the Herald and Weekly Times claiming Bolt wrote they sought professional advantage from the colour of their skin.

Aboriginal Coalition MP Ken Wyatt breaks ranks on race law moves

”Australia has come a long way in the last 30 or 40 years and what I wouldn’t like to see is a regression that allows those who have bigoted viewpoints to vilify any group of people at all,” he said.

”For me, it is about not disabling a mechanism that makes people think carefully about the vilification of anyone or any group because they know there is a deterrent,” he said.

Rasism

His remarks came as Attorney-General George Brandis described the existing law as ”extremely invasive” and reaffirmed the government’s intention to ”do away” with it.

Tony Abbott vowed  in August 2012 to ”repeal section 18C in its current form” on the basis that freedom of speech should not be restrained ”just to prevent hurt feelings”. Ethnic, religious and indigenous groups have urged the government to think again, raising expectations that the words ”offend”, ”insult” and possibly ”humiliate” will be taken out of the section.

Mr Wyatt said his attitude was shaped by his 10 years’ experience in Western Australia’s equal opportunity tribunal and witnessing how ”racial vilification has significant impacts on people in ways we don’t fully appreciate”.

”I support the whole concept of free speech, but I think there are boundaries that you have to draw and this is one of them.”

He believed that section 18c encouraged mediation and parties coming together to resolve conflicts and that its repeal would result in disempowerment of vilified groups or ”greater use of litigation, which doesn’t resolve the issue at all”.

Senator Brandis has been meeting interested groups,  focusing on how to strike the balance between free speech and protection from vilification. ”The government comes down on the side of those who want to see maximum freedom of speech,” he told ABC radio on Friday.

”And, by freedom of speech, I mean people’s freedom to hold opinions and express those opinions without some bureaucrat or official or human rights body or judge telling them what they are allowed, and what they are not allowed, to say.”

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STRANGE, after all I’ve been through, but Monday on the ABC may have been finally too much for me.

ANDREW BOLT BLOG

You see, I was denounced on Q & A — on national television — as a racist. I watched in horror as Aboriginal academic Marcia Langton falsely accused me of subjecting one of her colleagues — “very fair-skinned, like my children” — to “foul abuse … simply racial abuse”.

WILL THE ABC APOLOGISE? Blog with Andrew Bolt               

Langton falsely claimed I was a “fool” who believed in “race theories” and had “argued that (her colleague) had no right to claim that she was Aboriginal”. I had so hurt this woman she “withdrew from public life” and had given up working with students (something seemingly contradicted by the CV on her website).

FULL TRANSCRIPT: Marcia Langton’s apology               

And when Attorney-General George Brandis hotly insisted I was not racist, the ABC audience laughed in derision. Not one other panellist protested against this lynching. In fact, host Tony Jones asked Brandis to defend “those sort of facts” and Channel 9 host Lisa Wilkinson accused me of “bullying”. And all panellists agreed Brandis should drop the government’s plan to loosen the Racial Discrimination Act’s restrictions on free speech, which the RDA used to ban two of my articles. Can the Abbott Government resist the pressure from ethnic and religious groups to back off?

So it feels I’ve lost, and not just this argument. I feel now the pressure to stop resisting the Government’s plan to change the Constitution to recognise Aborigines as the first people here — a dangerous change, which divides us according to the “race” of some of our ancestors.

My wife now wants me to play safe and stop fighting this new racism, and this time I’m listening. This time I was so bruised by Q & A that I didn’t go into work on Tuesday. I couldn’t stand any sympathy — which you get only when you’re meant to feel hurt.

It was scarifying, even worse than when a Jewish human rights lawyer told a Jewish Federal Court judge that my kind of thinking was “exactly the kind of thing that led to the Nuremberg race laws” and the Holocaust — a ghastly smear published in most leading newspapers. That time, at least, half a dozen Jewish and Israeli community leaders and officials, who knew my strong support for their community, privately assured me such comments were outrageous and the attempt by a group of Aboriginal academics, artists and activists to silence me wrong.

True, none said so publicly for the next two years for fear of discrediting the RDA, which they hope protects them, yet it was some consolation.

But this?

How could I have failed so completely to convince so many people that I am actually fighting exactly what I’m accused of?

The country’s most notorious racist today is someone whose most infamous article, now banned by the Federal Court for the offence it gave “fair-skinned Aborigines”, actually argued against divisions of “race” and the fashionable insistence on racial “identity”.

It ended with a paragraph the court does not let me repeat, but which I will paraphrase as precisely as my lawyer allows: Let us go beyond racial pride. Let us go beyond black and white. Let us be proud only of being human beings set on this country together, determined to find what unites us and not to invent racist excuses to divide.

Yet I am not asking for your sympathy. My critics will say I’m getting no more than what I gave out — except, of course, this is more vile and there’s no law against abusing me, or none I’d use.

No, what’s made me saddest is the fear I’m losing and our country will be muzzled and divided on the bloody lines of race.

I worry, for instance, for the kind of person who turned up in the Q & A audience on Monday and still dared ask why so much land was being returned to Aborigines when “really we’re all here, we’re all Australians”.

He was shown the lash just used to beat me. He was corrected (rightly) for overstating the effect of land rights laws but reprimanded (wrongly) for allegedly ignoring Aboriginal disadvantage, as if he were some, you know, racist.

No panellist addressed his deepest concern, that we are indeed all in this together, yet find ourselves being formally divided by race and by people only too keen to play the race card against those who object.

Langton is an exemplar of those who use the cry of “racist” not to protect people from abuse but ideas from challenge. She’s accused even feminist Germaine Greer of a “racist attack” for criticising Langton’s support for federal intervention in Aboriginal communities.

She accused warming alarmist Tim Flannery of making a “racist assumption” in arguing wilderness was “not always safe” under Aboriginal ownership and when Labor lawyer Josh Bornstein protested, she slimed him as a racist, too: “Doodums. Did the nig nog speak back?”

And three years ago Langton wrote an article in The Age falsely claiming I believed in a “master race” and “racial hygiene” — like the Nazis.

It was a public vilification for which she privately apologised two years ago, but never publicly.

Instead, she now accuses me of this “foul abuse” of her colleague, Dr Misty Jenkins, in a column six years ago.

HER allegations are utterly false. My column, written before my now-banned articles, was on the groupthink Leftism at Melbourne University, of which I gave many examples.

I wrote: “Read the latest issue of … the university’s alumni magazine … The cover story argues that the mainly black murderers (in the Deep South) … are victims … Page two promotes Kevin Rudd’s apology … Page three announces that Davis has picked … global warming alarmist Ross Garnaut, as one of his Vice-Chancellor’s Fellows.

“Page four has a feature on Dr Misty Jenkins, a blonde and pale science PhD who calls herself Aboriginal and enthuses: ‘I was able to watch the coverage of Kevin Rudd’s (sorry) speech with tears rolling down my cheeks … Recognition of the atrocities caused by Australian government policies was well overdue’ …

“Pages six and seven boast that the university hosted Rudd’s ‘first major policy conference’ … You get the message.”

Where’s the “foul abuse”, Marcia? Where have I “argued that [Jenkins] had no right to claim that she was Aboriginal” — something I have never believed and never said of anyone?

But that’s our retribalised Australia. Criticise the opinions of someone of an ethnic minority and you’re ripe for sliming as a racist.

How dangerous this retreat to ethnic identities and what an insult to our individuality. And how blind are its prophets. Take Lisa Wilkinson, who actually uttered the most racist sentiment of the night, accusing Brandis of being a “white, able-bodied heterosexual male” suggesting this was “part of the reason why you can’t sympathise” with victims of racism.

White men can’t sympathise? Pardon?

And so today’s anti-racists become what they claim they oppose. Do I resist or run?

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

summit-2014-banner

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

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

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

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

SUMMIT WEBSITE FOR MORE INFO

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NACCHO political alert: Health Minister Dutton transforming communities – and the role of technology in the future of general practice

Peter

“I’d like to take a moment to acknowledge the GPRA as one of the many organisations dedicated to improving indigenous health outcomes and capacity of the indigenous workforce.

The Indigenous General Practice Registrars Network, which is now co-ordinated by GPRA, provides a forum for Aboriginal and Torres Strait Islander registrars to provide professional and cultural support for one another.

The GPRA is also very committed to the Australian Government’s Closing the Gap campaign and to supporting Aboriginal and Torres Strait Islander registrars on their way to becoming GPs.

Doctors need to be equipped to deal with the special health needs of Aboriginal and Torres Strait Islander people, especially in remote settings and the Remote Vocational Training Scheme – though small – is helping to deliver this much needed support.”

Minister Peter Dutton speaking at the Future of General Practice 2014 (#fgp14) conference, Parliament House Canberra

PICTURE ABOVE; Earlier this week the Health Minister Peter Dutton along with Indigenous Health Minister  Senator Fiona Nash met with the NACCHO board including Chair Justin Mohamed and Matthew Cooke. Picture Colin Cowell

FULL SPEECH

For the past four years I have spoken at the GPRA’s annual conference while in Opposition, so I’m pleased to have the opportunity to address this event as the Minister for Health.

Firstly thank you to the GPRA for continuing to look for innovative ways to further improve the quality of Australia’s health care through higher standards of education and training.

These conferences play an important role in the future of the health care sector, providing an opportunity for leaders in the field to share ideas and investigate ways we can support the next generation of GPs to provide the standards of care that Australians need and deserve.

Thank you also for your important work representing the nation’s future GPs – and I note the importance of the theme you have chosen for this conference –transforming communities – and your focus on the role of technology in the future of general practice.

New technology and social media have been transformative forces in modern Australia, touching virtually every aspect of our daily lives. I suspect your experience with Twitter is a little different to mine.

The many new young registrars we have coming through today, many of whom will be tomorrow’s GP in communities throughout Australia, are high users of online tech both personally and professionally.

You are part of a new generation of physicians for whom new online technology and social media tools will greatly influence their professional life. This opens up new opportunities – both for GPs as well as the communities and patients they support.

A large part of the challenge we face today is the need to think about how we can better utilise those tools to better support you – to help you do your job more efficiently and effectively, and to achieve better outcomes for patients.

From a Government’s perspective the remuneration around these challenging models is a great challenge.

But there are some other important issues that I’d like to talk about that go to the issue of transformation.

I’ll begin by reiterating some of the key points about Australia’s health system. It is important to any conversation about future workforce planning.

Comparatively speaking, Australia has a health system that delivers, but without strengthening our health system, it

will fall short of servicing the nation’s health needs over the coming years and decades.

Total expenditure on health care in Australia increased to $140 billion in 2011-12. That’s around $6200 per person per year. Only a decade earlier, the yearly figure was only $3300.

The pressure points are many—our ageing population, costs of new medical technologies, genomics, dementia, obesity, mental health and personalised medicines, to name a few.

At the moment, the Government is awaiting the findings and recommendations of the Commission of Audit and we will respond accordingly.

However, it won’t be a shock to anyone that the upcoming Budget will be tough – it has to be.

In short, we need to transform our health system. We need to take what is currently a 1980s model and transform it into an effective, efficient and stable system of health that delivers all Australians the quality care they need right now, as well as into the future.

Ten per cent of Australians utilise 46 per cent of MBS services. Clearly the system is not working for them.

To reduce the impact on services, we have a plan to improve efficiency, reduce duplication and red tape, redirect funding to patient services and continue to build a highly skilled health workforce.

In regards to the health workforce, there are both short and long term challenges to consider.

In the short term, we need to consider what the taxpayers’ investment is buying and where expenditure provides the greatest value for money.

In the long term, we need a stronger, more strategic focus in regards to workforce planning to ensure we have a sustainable and increasingly efficient health workforce.

I can say unequivocally that general practice will be at the front and centre of our plan. The Australian Government is committed to rebuilding general practice and putting GPs back at the centre of our health care system.

Now more than ever, the role of the GP is evolving.

I don’t need to tell anyone here today that patient health is becoming increasingly complex, with emerging challenges such as the growing burden of chronic disease, technology and the ageing population to name but a few.

One-third of Australia’s burden of disease is due to ‘lifestyle’ health risks such as poor diet, obesity, physical inactivity, smoking and alcohol misuse.

The number of overweight and obese adults continues to rise, with nearly two out of every three adults classified as overweight or obese.

Similarly, diabetes rates in adults have risen over the past decade.

Add to this the increasing consumer expectations regarding their health care, workforce pressures, inequity of services in some areas, and a challenging economic environment, and the need for a skilled and adaptable GP workforce has never been greater.

While there is concern around the increase in medical graduates, we are working with the private sector and the state and territory governments to ensure that training capacity for doctors—including GPs—is better managed through the development of national medical training plans.

As I’ve said many times before, I believe significant productivity gains can—and must—come through a combination of improved public sector efficiency and bold new ideas from the private sector.

We should be leveraging the private sector, not just for services, but also to meet workforce training challenges.

This Commonwealth Medical Internship initiative is one example of how this can work, and it will foster a strong network of private hospitals which can train interns, boosting the nation’s medical training capacity.

In some regions, such as Bundaberg, public and private partnerships have developed as a result of the initiative, giving interns invaluable experience in a variety of healthcare settings.

We will also keep working with states and territories to help them streamline their internship training systems, and I hope to update you on this work in the near future.

Priority for new training positions will be in rural and regional areas to help bolster the medical workforce in communities who need them most. And each Commonwealth funded intern has a rural return of service obligation.

This year alone, there will be 76 more doctors working in Australia than would otherwise have been the case.

I’d like to take a moment to acknowledge the GPRA as one of the many organisations dedicated to improving indigenous health outcomes and capacity of the indigenous workforce.

The Indigenous General Practice Registrars Network, which is now co-ordinated by GPRA, provides a forum for Aboriginal and Torres Strait Islander registrars to provide professional and cultural support for one another.

The GPRA is also very committed to the Australian Government’s Closing the Gap campaign and to supporting Aboriginal and Torres Strait Islander registrars on their way to becoming GPs.

Doctors need to be equipped to deal with the special health needs of Aboriginal and Torres Strait Islander people, especially in remote settings and the Remote Vocational Training Scheme – though small – is helping to deliver this much needed support.

I announced during the election campaign that in Government we would invest $119 million to double the Practice Incentive Program (PIP) teaching Payments for GPs who provide teaching opportunities. We are implementing that promise.

Rural and remote general practitioners will receive an additional benefit due to the rural loading that applied under the PIP in recognition of the additional challenges that these practitioners can face.

We are also committing $52.5 million in infrastructure grants to help rural and regional general practices build their training infrastructure, so that they can train more students, more junior doctors and more registrars.

These grants will be provided based on an equal commitment from the practice.

This will leverage private investment and help ensure the most efficient and productive use of the taxpayers’ dollars.

Before I finish, I’d like to take a moment to address the GP Registrars in the room this morning.

There’s no doubt that you are embarking on your careers at a challenging—but very exciting—time for Australia’s health system.

Throughout your careers you’ll have many opportunities to help many people in many communities – and that gives me great confidence.

I wish you the very best for the future and I hope that many of you – if not all of you – become agents of change and transformation

in the communities within which you will work

You can hear more about Aboriginal health at the NACCHO SUMMIT

summit-2014-banner

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

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

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

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

SUMMIT WEBSITE FOR MORE INFO

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NACCHO Aboriginal Health :The high cost of healthy eating in remote communities

foodabank

I feel strongly that we should as a nation have some kind of way of giving people in remote parts ccess to fresh food at capital city supermarket prices. It wouldn’t cost us much in relative terms,”

“We give a huge diesel fuel rebate to mining companies and yet we don’t invest in the health of people, particularly children.”

She advocates a junk food tax to reduce the cost of fresh food and encouraging more locally produced food

University of SA Professor Kerin O’Dea

The Ngaanyatjarra Health Service (NACCHO member) provides health care to 2300 people living in a dozen communities across the Great Victorian and Gibson Deserts of central WA.

Chief executive Brett Cowling said the burden of chronic disease was “huge” and still growing in many remote areas.

But he said the problem was being tackled, and in some cases reversed, by the communities themselves

PICTURE ABOVE : Foodbank WA runs breakfast programs in more than 400 schools across the state, providing shelf-stable food and working with communities to make positive health behaviour changes.

WOULD you pay about $9 for six mushrooms  at your  supermarket in Perth? Or a similar amount for a piece of broccoli?

Probably not – but this is what people living in some of the most remote parts of WA are being asked to fork out for fresh produce.

The cost of fruit and vegetables in some of the state’s indigenous communities can be as much as three to four times that of supermarkets in Perth.

It is a cited as one of the reasons for the high rate of chronic health problems, including obesity, diabetes and renal failure, in Aboriginal communities.

As Published NEWS LTD

FACTS

Aboriginal people and diabetes

– Aboriginal and Torres Strait Islander Australians have the fourth highest rate of type 2 diabetes in the world.

– It is estimated 10-30 per cent of Indigenous Australians may have the condition, but many are undiagnosed.

– Rates are between three and five times higher compared to non-Indigenous people in all age groups over 25 years.

– 39 per cent of the Aboriginal population over the age of 55 has diabetes.

– Deaths from diabetes were seven times more common for Indigenous people than for non-Indigenous people between 2006 and 2010.

– Hospitalisations for kidney complications among Indigenous people are 29 times higher than for other Australians.

Source: Diabetes WA

University of South Australia researcher Kerin O’Dea wants nutritious food to be subsidised and for doctors in remote areas to prescribe food like medicines.

University of SA Professor Kerin O'Dea.

University of SA Professor Kerin O’Dea. Source: News Limited

“I feel strongly that we should as a nation have some kind of way of giving people in remote parts ccess to fresh food at capital city supermarket prices. It wouldn’t cost us much in relative terms,” she said.

“We give a huge diesel fuel rebate to mining companies and yet we don’t invest in the health of people, particularly children.”

She advocates a junk food tax to reduce the cost of fresh food and encouraging more locally produced food.

The idea of subsidising fresh fruit and vegetables was supported by Winthrop Professor Jill Milroy of the Poche Centre for indigenous Health at the University of Western Australia.

“Getting good, healthy food is really important and it needs to be addressed. It probably has to be subsidies because there is a lot of cost factors in getting food up there,” she said.

Department of Health nutrition policy adviser Dr Christina Pollard said the cost of healthy food was up to 29 per cent higher in rural areas compared to capital cities.

Welfare recipients also need to spend 50 per cent of their disposable income to achieve a healthy diet compared with 15 per cent nationally, the author of the Department’s Food Access and Cost Survey said.

“To get the food there, to keep it fresh and of good quality costs a lot more,” the adjunct researcher at Curtin University said.

“Food in general is more expensive, but healthy food is disproportionately expensive, particularly things like fruit and vegetables which need to be transported under refrigeration and don’t have a long shelf life.”

The Ngaanyatjarra Health Service provides health care to 2300 people living in a dozen communities across the Great Victorian and Gibson Deserts of central WA.

Chief executive Brett Cowling said the burden of chronic disease was “huge” and still growing in many remote areas.

But he said the problem was being tackled, and in some cases reversed, by the communities themselves.

At community-owned stores the price of fresh food is being kept low by not applying transport costs and in some areas full-strength soft drinks have been pulled from the shelves.

“Subsidies are  being discussed, and are an option, but I have seen the same results through good community governance and where the community have worked towards that outcome themselves,” he said.

“That always has to be best possible solution.”

Outback Stores was established six years ago to ensure food security in remote communities and today manages 10 community-owned shops in Western Australia.

Chief executive Steve Moore said by keeping the cost of fresh food low consumption of fruit and vegetables was up 13 per cent compared to last year.

The sale of water bottles has also more than doubled since the firm did a deal with Coca-Cola Amatil to sell 600ml bottles of its Mount Franklin water for $1.

“I don’t believe a subsidy or a tax will solve the problem,” he said. “We are making ground, but it’s small steps. It’s time and education  that  will make the difference.

“People are more aware of what they should and shouldn’t consume. Restricting products has never worked because people will just travel to get it.”

Foodbank WA runs breakfast programs in more than 400 schools across the state, providing shelf-stable food and working with communities to make positive health behaviour changes.

As well as getting around the high costs by supplying frozen and tinned produce, Foodbank encourages residents of remote communities to use bushtucker.

“Traditional methods are important and it’s important culturally to keep those going,” Stephanie Godrich, Foodbank WA regional strategy co-ordinator, said.

“We need to acknowledge that Aboriginal people have a lot to offer us.”

Sugar

What is in a 600ml bottle of cola?

65.4 grams of sugar – The equivilant of 16 teaspoons

1044 kilojoules (100 per cent of energy comes from sugar)

How much sugar is in your favourite drink?

600ml Cola

– 16 teaspoons of sugar

600ml Iced Coffee Chill

– 14 teaspoons of sugar

600ml Orange juice

– 16 teaspoons of sugar

600ml Choc Chill

– 13 teaspoons of sugar

600ml Powerade

– 11 teaspoons of sugar

375ml Cola

– 10 teaspoons of sugar

350ml Apple juice

– Nine teaspoons of sugar

375ml Lemonade

– Eight teaspoons of sugar

500ml Lemon Ice Tea

– Eight teaspoons of sugar

250ml Red Bull

– Seven teaspoons of sugar

300ml V8 Juice

– Six teaspoons of sugar

500ml Vitamin Water

– Five teaspoons of sugar

300ml fresh cow’s milk

– Four teaspoons of sugar

Source: Livelighter.com.au

 

NACCHO health political alert : Minister Dutton tells NACCHO board he awaits audit to decide the future of the health system.

Peter

Health Minister Peter Dutton and Indigenous Health Minister Senator Fiona Nash  (pictured above meeting with the NACCHO Board at Parliament House  Canberra yesterday) told the NACCHO board they are awaiting the findings of the budget Commission of Audit, along with reviews of Medicare Locals and electronic health records, to decide the future of the health system.

Mr Dutton declared the system to be “riddled with inefficiency and waste” and foreshadowed changes to Medicare, with private health insurers likely to play a greater role and wealthy Australians asked to pay more for their care.

NACCHO will be reporting further outcomes from this meeting in the next 24 hours

Meanwhile in the Australian it is reported Treasury officials are working on a formula to determine whether health spending is sustainable

Tackling avoidable cost has to be at the heart of how the hospital system works : Sean Parnell From: The Australian

PUBLIC hospitals are wasting up to $1 billion a year and should be held to account for inefficient and substandard medical care, the Grattan Institute has warned.

In a report released last night, the think tank headed by long-time reform advocate Stephen Duckett has called for activity-based funding to be accompanied by measures that would reduce costs and rein in health inflation.

The institute’s report calls for states to exclude abnormally high costs from activity-based funding calculations to ensure the new average prices “drive hospital costs down towards achievable benchmarks”.

“But the reform won’t work on its own, the report concludes. “Tackling avoidable cost has to be at the heart of how the whole system works.

“Hospitals need data showing how much of their spending is avoidable and where that spending is concentrated.”

Last year, health fund Bupa and private hospital operator Healthscope entered into an Australian-first, quality-based funding system.

Under the arrangements Healthscope forgoes payment from the insurer if it makes a serious mistake treating any of its 3.5 million members, with reward payments likely to be considered in future for above-standard care.

Mr Dutton at the time welcomed the arrangements and said he expected providers to be more transparent and release data on avoidable costs.

“If we can bring that pressure to bear on both the public and private systems, we will end up with better health outcomes,” he said last October.

Mr Dutton has not taken the issue further and the so-called “budget emergency” has put any intergovernmental health reform talks on hold.

Treasury officials are working on a formula to determine whether health spending is sustainable.

NACCHO Chair JUSTIN MOHAMED will be telling the  Coalition Government at the NACCHO SUMMT  Investing in Aboriginal Community Controlled Health makes economic sense

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

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

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

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

SUMMIT WEBSITE FOR MORE INFO

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NACCHO political alert: ‘Cut the cash and we won’t close the gap’ says Dr Ngiare Brown

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“I know that it has been said within the Coalition that health and education will have to take some funding hits,” Dr Brown said. “We cannot possibly progress this nation unless we are investing more in health and education, public health and education, so that we all have an equal opportunity at what that represents. I will absolutely be pushing the health bandwagon.”

Dr Ngiare Brown, Warren Mundine’s deputy on the government’s indigenous council, says ‘it’s often the layers of red tape and bureaucracy that suck up the resourcing’. Source: News Corp Australia Exclusive: Patricia Karvelas Photo: Ray Strange

ABORIGINAL doctor Ngiare Brown and  NACCHO  Executive Research Manager has vowed to use her new role as deputy head of Tony Abbott’s indigenous council to argue that cuts to indigenous health or education would be detrimental to efforts to close the disadvantage gap.

Dr Brown, who was in one of the first groups of Aboriginal medical graduates in Australia and previously an indigenous health adviser to the Australian Medical Association, was yesterday appointed as Warren Mundine’s deputy after receiving the backing of council members and the Prime Minister.

In an interview with The Australian, Dr Brown said she supported the priorities of the new council to boost school attendance and enhance economic independence. Given her background in health, she would also articulate the need for better health for indigenous people.

Mr Mundine said Dr Brown was a fantastic choice for deputy.

“I’m glad that all the council members and the PM support this move,” he said. “She’s very well experienced and she’s a great asset as deputy chair.”

In January, Mr Mundine said it was unrealistic to expect indigenous affairs spending to be immune from expected budget cuts and that, despite being the head of Mr Abbott’s indigenous advisory council, he could not cast a “force field” to exempt Aborigines from the broader budget agenda.

Dr Brown said she believed existing funding could be better spent, with less on bureaucracy, but urged that there be no net reduction in health and education.

“It is about school attendance but also performance and successful completion, pathways into opportunities into employment and further education,” she said.

“Being economically stable, too, all of those things we can’t do unless we are healthy. And the best model that we have for health service delivery in this country and comprehensive primary care are the Aboriginal community control health services.”

She said she was “absolutely” worried about cuts.

“I know that it has been said within the Coalition that health and education will have to take some funding hits,” Dr Brown said. “We cannot possibly progress this nation unless we are investing more in health and education, public health and education, so that we all have an equal opportunity at what that represents. I will absolutely be pushing the health bandwagon.”

She said if targets were to be achieved, cuts should not come from indigenous affairs.

“They should not be coming from Aboriginal and Torres Strait Islander health,” she said. “They should not be coming from the public health system in particular nor the public education system. Because every child, every individual, every citizen has a right to those systems and they should be supported by government.”

She said waste on bureaucracy was concerning. “I am all about effectiveness and efficient spend,” she said. “But I am also about investment and if you look at community-based services they are extraordinary exemplars of how we can do it well and, in many instances, it’s often the layers of red tape and bureaucracy that suck up the resourcing.”

You can hear Dr Ngiare Brown speak at the NACCHO SUMMIT

summit-2014-banner

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

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

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

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

SUMMIT WEBSITE FOR MORE INFO

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