“The petrol sniffing problem was like a monsoon rain that flowed down and affected everyone
The liquid petrol was just pouring onto our lands and it was pushing people, particularly young people … and so we needed help with that, and that help came in the form of a different kind of liquid, which was Opal fuel.
That was a really triumphant moment and we knew that it would bring good things, and it has.
Everyone has been so happy since then because of the instant reduction in petrol sniffing. ”
It is the 10-year anniversary since the roll out of non-sniffable Opal fuel in Central Australia and the APY lands, and the woman who led the fight against petrol sniffing has reflected on her triumphant campaign directed at the Federal Government in an interview with the ABC
For decades petrol sniffing devastated the beloved Aboriginal communities of fuel campaigner Janet Inyika.
Ms Inyika fought tirelessly to introducer get non-sniffable low aromatic fuel, known as Opal.
Current CEO of the NPY Women’s Council, Andrea Mason, said Ms Inyika was the face of council advocacy long before Opal was introduced.
Ms Inyika was also a leader with Aboriginal corporation NPY Women’s Council for many years.
“She actually has another name and her other name is ‘never give up’,” Ms Mason said.
“Her family was being impacted by sniffing. She was seeing people die around her, become brain injured, disabled for life, and she put herself right in the middle of the fire.”
Ms Mason was working on the APY Lands in the 1990s and saw the problem first-hand.
“I look at this community of Central Australia and there is a line drawn in the sand – the life before Opal fuel and the life after Opal fuel, and the important for us living in the life after Opal fuel is we must never forget how devastating petrol sniffing is,” she said.
Tony Abbott changed position to back fuel rollout
Former Prime Minister Tony Abbott was the health minister when the Federal Government backed the rollout of Opal across bowsers in the region.
Mr Abbott initially said petrol sniffing could be solved by “parents taking petrol away from their kids”.
However, veteran youth worker Tristan Ray said Mr Abbott was ultimately persuaded by voices on the ground.
“I think that it was just so obvious that it was making a really big difference and there were politicians on all sides of politics that saw the benefit,” Mr Ray said.
Mr Ray said there was still resistance from a handful of fuel retailers, but most have made the switch to Opal.
CAYLUS estimated there had been a 94 per cent reduction in the number of sniffers in the region.
It said on the edges of Opal zones, there were about 20 sniffers remaining
“It is our view that continuing to deliver the same programs we have delivered for the past 40 years will do nothing for our people and, besides wasting more time and money, will condemn our children and future generations to a life of poverty and despair,
Our children will continue to be removed from their families because their families are not safe, many of our children will be born with FASD (fetal alcohol spectrum disorder) and never be able to receive a good education, and a large percentage of our people will go to prison and, in some cases, commit suicide. We believe that this trial could be the catalyst for breaking the cycle of poverty and despair in the East Kimberley.”
Wunan Foundation’s Ian Trust, MG Corporation’s Desmond Hill and Gelganyem Trust chairman Ted Hall,
Aboriginal leaders of the East Kimberley have urged MPs from all sides of politics to support a new cashless welfare card, saying refusal to back the trial will condemn future generations in the region to a “life of poverty and despair”.
Legislation to enable the proposed healthy welfare card will be introduced to parliament this week but requires the support of Labor or at least six crossbench senators to pass into law.
In a letter to Parliamentary Secretary to the Prime Minister Alan Tudge and Labor’s family and payments spokeswoman Jenny Macklin, three indigenous groups have pleaded for political support for the cashless card first proposed by mining chief Andrew Forrest last year.
Last month, the town of Ceduna on South Australia’s remote west coast became the first community to sign a memorandum of understanding with the government to implement the card.
In a trial to begin next year, 80 per cent of welfare payments will be allocated to a cashless card that cannot be used to buy alcohol or gambling products.
The East Kimberley communities of Halls Creek and Kununurra also have been slated as trial sites.
In a letter signed by the Wunan Foundation’s Ian Trust, MG Corporation’s Desmond Hill and Gelganyem Trust chairman Ted Hall, the East Kimberley leaders warn that without radical change, including welfare reform, the circumstances of Aboriginal people in the region will continue to deteriorate at “a rapid pace”.
The letter urges politicians to take a nonpartisan approach to allow the trial to proceed, saying vulnerable children and old people would bear the heaviest burden if reform was blocked.
The three groups backed the concept of a local community panel that could vary the amount of welfare payments restricted based on individual behaviour. A similar model operates in Cape York.
Mr Tudge said the government would listen to the East Kimberley leadership. “But we haven’t made a decision yet and we still have more work to do,” he said.
Mr Forrest joined the call for support for the card, which was a cornerstone of the Creating Parity review. “There is no possibility you can justify continuation of the current system when it has failed vulnerable Australians so badly,” he said.
The Australia Government has made a re-commitment to the Sector:
$1.4bn over 3 years or $448m / per year. This will include a 1.5% CPI increase over a 3 year period.
The Government has confirmed NACCHO and Affiliate funding for 18 months in the amount of $18m, with the Department of Health commencing a review of role and function.
In 2015-16, the Government will implement a National Continuous Quality Improvement Framework for Aboriginal and Torres Strait Islander primary health care, through the expansion of the Healthy for Life activity.
From 1 July 2015, the Government will progressively implement a new funding approach for the Indigenous Australian’s Health Programme.
The new approach will support the targeted use of funds in regions whose populations experience high health need and population growth.
The Budget papers explicitly mention NACCHO and Affiliates as being engaged as the nominated community stakeholders along with States/Territories in the development of this mechanism.
Indigenous Chronic Disease Package
The Budget has not provided any clear answers regarding the future of the Indigenous Chronic Disease package, outside of a stated commitment to “focus on improving the prevention, detection and management of chronic disease to improve health outcomes”.
Tackling Indigenous Smoking Program – a redesigned program will be implemented arising from the review undertaken in 2014-15. No detailed announcements were made in the Budget as the Minister is yet to sign off on the outcomes of the review.
Australian Nurse Family Partnership Program and New Directions: Mothers and Babies Services – the Australian Nurse Family Partnership Program will grow from three to five sites and New Directions: Mothers and Babies Services will reach an additional 25 services in 2015-16, bringing the total to 110 service, with an enhanced capacity to identify and manage Fetal Alcohol Spectrum Disorder in affected communities.
Close the Gap PBS Co-payment – expected to be an ongoing measure worth $85m, however there were no announcements in the Budget. NACCHO will look to identify this funding in a more detailed analysis.
MBS Practice Incentive Payments – expected to be ongoing funding and will form part of the MBS Review, with an intention to enhancing the program.
Indigenous Australians’ Health Programme
Initiatives funded under the Indigenous Australians’ Health Programme include primary health care services (including eye and ear health), maternal and child health activities, medical outreach to rural and remote areas, and targeted initiatives to improve prevention and primary health care management of chronic diseases.
The Budget papers outline the Department of Health’s commitment to a joint approach to the development of the Indigenous Australians’ Health Programme.
This provides an opportunity for ACCHSs to discuss the development of the Programme and funding methodology with local MPs.
National Aboriginal and Torres Strait Islander Health Plan Implementation Plan
In 2015, the Government will release the National Aboriginal and Torres Strait Islander Health Plan (2013-2023) Implementation Plan which is being developed in partnership with the National Health Leadership Forum (NHLF).
In 2015-16, the Government will commence the actions outlined in the Implementation Plan and will continue working with the NHLF to monitor and review progress.
Focus on rural and remote shortages. A new geographical classification system will ensure incentive payments are targeted to doctors and dentists who choose to practice in areas of greatest need.
A range of medical, nursing and allied health scholarships will be consolidated.
Expansion of GP training places to 1,500 commencing places every year under the Australian General Practice Training Program.
The Remote Vocational Training Scheme supports doctors practicing in some of Australia’s most remote locations to undertake vocational general practice training.
The Scheme supports 22 new training places each year. In 2015, a new cohort of 10 registrars training in Aboriginal Community Controlled Health Services commenced training under this scheme.
Health Budget Announcements
The Government has announced a review of Medicare. This will include a comprehensive review of all 5500 MBS items.
This process will also oversee the establishment of a Primary Health Care Advisory Group to focus on innovative ways to deliver primary care, especially chronic disease.
The Government has committed $34.3m over two years to undertake this process. The Taskforce is expected to report back with key priority areas for action late in 2015.
NACCHO has already initiated discussions with the Department of Health to influence the consultation process and ensure the Sector has a seat at the table in these processes.
In addition, NACCHO has secured confirmation of an extension of the Section 19.2 ACT which expires on 30th June 2015, which enables ACCHSs to receive financial benefit from Medicare rebates in addition to Government funding. Confirmation letters will be sent to member services confirming an extension of the exemption until 30th June 2018.
The Government remains committed to the freeze on MBS rebate indexation. This will cost the Sector critical funding to support services outside of grant funding. NACCHO will work with the Department to address gaps in MBS revenue.
Healthy Kids Check
The Budget cut Medicare funding for the “Healthy Kids Check”, a consultation with a nurse or GP to assess a child’s health and development before they start school.
Funding for the program will stop in November. This measure is considered a duplication with existing state and territory based programs.
This change does not impact ACCHS or Aboriginal and Torres Strait Islander children to the same degree. ACCHSs can continue to bill health assessments through a separate item (715) which is eligible to be billed at any age.
The Budget provides additional spending of $1.6b over five years, with a further $2.5b in recommendations which are in the final stage of negotiations.
Shingles vaccine for people 70-79.
The benefits for some of the measures, such as the cancer drugs, are undermined by others such as the fee reduction for the shingles vaccine. This covers an age cohort which largely excludes Aboriginal and Torres Strait Islander people, who have lower life expectancy. NACCHO is working with the Department to address this.
Sixth Pharmacy Agreement
The 6th Community Pharmacy Agreement (CPA) has reached the final stages of negotiation. NACCHO and the Pharmacy Guild of Australia have been negotiating 1 year transition funding of QUMAX to enable development of an Implementation Plan under the 6th CPA.
NACCHO will seek to expand QUMAX from 76 services to 134 services who currently receive funding from the Department rather than directly.
This Agreement introduces pilot trials for pharmacists to undertake basic functions usually undertaken by Doctors and Nurses, for example vaccinations, wound care and chronic disease management. This could be seen as money being taken out of the primary care sector and re-directed to pharmacists.
Current funding allocated to Medicare Locals will transfer to the PHNs. The 2015-16 Health Budget papers indicate that “identified primary mental health care services will [also] be transitioned to Primary Health Networks”. Additionally, the Minister for Health has advised in writing to NACCHO that funding for Complementary Care and Supplementary Services will transition from Medicare Locals to the PHNs.
This decision was based on notion that this would ensure greater access for Aboriginal and Torres Strait Islander people, regardless of where they access their primary health care. This position implies that Medicare Locals were providing universal care to Aboriginal and Torres Strait Islander people, despite a lack of evidence to support this.
NACCHO will continue to lobby the Minister and the Department to re-allocate Aboriginal Medicare Local funding to the Sector, rather than to PHNs.
Last year’s Budget foreshadowed $197.1m in cuts to the ‘Health Flexible Funds’ over three years.
This year, that figure has increased to $500m worth of cuts over four years, according to the Secretary of the Department of Health. There is still no clarity in relation to how these savings are to be achieved.
Among the 16 Flexible Funds which could be affected are those supporting the provision of essential services in rural, regional and remote Australia; working to Close the Gap in health outcomes for Indigenous Australians; managing vital responses to communicable diseases; and delivering substance use treatment services around the country.
NACCHO is currently working with the Public Health Association of Australia on a public campaign opposing these cuts.
There were no measures announced in response to the Mental Health Commission’s recent review of programs and services.
Instead, the Government has committed to develop and implement options for policy and program changes. This process will be driven through an expert reference group, which will develop short, medium and long-term implementation strategies based on reviews findings:
promotion, prevention and early intervention of mental health and illness;
the role of primary care in treatment of mental health, including better targeting of services; and
national leadership, including regional service integration.
NACCHO will monitor announcements for Mental Health in relation to the Federal Budget and the commencement of the Expert Reference Group. It is expected these announcements will be linked to the development of the Federation White Paper.
Medical Research Future Fund (MRFF)
The MRFF has been revived in this year’s budget. Funding for the MRFF will be derived from savings found in the Health budget. The MRFF will receive $400m over the next four years, starting with $10m in this financial year.
Last year NACCHO lobbied for the reinvestment of $121m in savings from the Aboriginal health budget, rather than its inclusion in the MRFF funding bucket. NACCHO will closely monitor which money is allocated to the fund and how it is used to promote research that benefits Aboriginal people.
This Budget commits $20 million over two years for a new stage of the National Drugs Campaign primarily aimed at the use of ice. No consultation has been undertaken in the lead up to the announcement of this health promotion campaign. It almost certainly will not achieve tangible outcomes for Aboriginal people.
In addition, it is unclear how this complements the recent development of a National Ice Taskforce, under the leadership of the Prime Minister, which is currently undertaking public consultations around the country. It is expected that reporting for this process will not commence until mid-year.
NACCHO is currently developing a response to the National Ice Taskforce and considering alternate strategies to progress development of a Sector-led response to Ice in Aboriginal and Torres Strait islander communities.
General Budget Announcements
Income Management — two year extension
The Government will provide $146.7 million over two years to extend existing income management arrangements in all current locations until 30 June 2017, despite evidence to the contrary that this approach is effective.
Income management will continue in: Perth Metropolitan, Peel and Kimberley regions, Laverton, Kiwirrkurra and Ngaanyatjarra Lands in Western Australia; Anangu Pitjantjatjara Yankunytjatjara Lands, Ceduna and Playford in South Australia; Cape York, Rockhampton, Livingstone and Logan in Queensland; Bankstown in New South Wales; Greater Shepparton in Victoria; and in the Northern Territory.
Youth Employment Strategy
The Government will provide over $330 million to implement a Youth Employment Strategy. This provides targeted support for groups of young people who are more susceptible to long term unemployment or are at risk of welfare dependence.
The Government will reverse the 2014-15 Budget measure Stronger Participation Incentives for Job Seekers under 30 and instead require young people under 25 years of age to actively seek work for a four week waiting period before receiving income support payments.
NACCHO will continue to lobby for an exemption for Aboriginal and Torres Strait Islander youth, who are disproportionately affected by unemployment.
Small Business Package
The Government has introduced a raft of tax measures and incentives that may be applicable to some ACCHSs.
The Government is reducing the tax rate for the more than 90 per cent of incorporated businesses with annual turnover under $2 million. The tax cut will apply from 1 July 2015.
The Government will also provide a 5 per cent tax discount to unincorporated businesses with annual turnover less than $2 million from 1 July 2015.
All small businesses will get an immediate tax deduction for any individual assets they buy costing less than $20,000. (Currently, the threshold sits at $1,000).
This $20,000 limit applies to each individual item. Small businesses can apply this $20,000 rule to as many individual items as they wish. These arrangements start Budget night and continue until the end of June 2017.
NACCHO will develop a paper which outlines entitlements for the sector through these measures.
“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 COUNCILCANBERRA 30TH AUGUST 2014
ADDRESS BYTHE MINISTER FOR INDIGENOUS AFFAIRS
THE NATIONALS’ SENATE LEADERSENATOR 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
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.
“Indigenous Australians should enjoy the same health, education and employment outcomes as other Australians. But, instead there remains a persistent and terrible gap between the two in major areas.
Closing the gap between Indigenous and non-Indigenous Australians is a priority for all Australian governments. But closing the gap is a long-term challenge—one which requires enduring vigilance and resources”
John Brumby Chair NACCHO reform Council Speaking at the NACCHO SUMMIT
I would like to begin by acknowledging the traditional owners and custodians of the land on which we meet today, the Wurundjeri people of the Kulin nation. I pay my respects to their Elders both past and present.
It is my pleasure to be with you today to report on national progress in indigenous health.
As you know, the COAG Reform Council was established by COAG in 2006 to report on Australia’s national reform progress.
Our job is to hold all nine Australian governments accountable for implementing national reforms that began rolling out in 2008.
Importantly, we publicly report our findings to the Australian people.
In 2008, COAG agreed to goals on healthcare, education, skills and workforce development, disability, housing and closing the gap on Indigenous disadvantage.
That was six years ago.
Today I will be launching a supplement that focuses on the health outcomes for Indigenous people. The supplement draws on the findings we have made in two reports that we provide to the Council of Australian Governments (COAG) each year – the National Healthcare Agreement and the National Indigenous Reform Agreement.
Indigenous Australians should enjoy the same health, education and employment outcomes as other Australians. But, instead there remains a persistent and terrible gap between the two in major areas.
Closing the gap between Indigenous and non-Indigenous Australians is a priority for all Australian governments. But closing the gap is a long-term challenge—one which requires enduring vigilance and resources.
The Genesis of Closing the Gap
The genesis of the closing the gap campaign was a report in 2005 by Dr Tom Calma, the then Aboriginal and Torres Strait Islander Social Justice Commissioner.
The report called on the governments of Australia to commit to achieving health equality for Indigenous people within a generation.
This report sparked the National Indigenous Health Equality Campaign in 2006 that culminated in a formal launch of the close the gap campaign in Sydney in April 2007, where NACCHO was a leading voice calling for action.
NACCHO’s very name—National Aboriginal Community Controlled Health Organisation—reflects the campaign for self-determination … the wish of Indigenous Australians to have their own representative bodies.
On 20 December 2007, the Council of Australian Governments answered the call of NACCHO, ANTAR, Oxfam Australia and many other organisations and pledged to close the life expectancy gap between Indigenous and other Australians within a generation.
In March 2008, the Indigenous Health Equality Summit released a statement of intent which committed the Australian government, among other things, to achieve equality of health status and life expectancy between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians by 2030.
NACCHO was a signatory to that statement. The parties also agreed to use benchmarks and targets to measure, monitor and report.
COAG & Closing the Gap
In November 2008, our nation’s leaders committed to closing the gap within a generation (25 years) in the National Indigenous Reform Agreement (NIRA).
Importantly, COAG agreed to be accountable for closing these gaps and appointed the COAG Reform Council to monitor progress.
As you well know, COAG has six targets as part of its objective of closing the gap.
To close the life expectancy gap within a generation, by 2031.
To halve the gap in mortality rates for Indigenous children under five within a decade, by 2018.
To provide access to early childhood education for all Indigenous four-year olds in remote communities within five years, by 2013.
To halve the gap in reading, writing and numeracy within a decade, by 2018.
To halve the gap in the rate of Year 12 or equivalent attainment, by 2020.
And, finally, to halve the gap in employment outcomes within a decade by 2018.
For the past five years, the COAG Reform Council has dissected the data, measured progress and independently reported on whether Australian governments are achieving these targets in both our NIRA report and our report under the National Healthcare Agreement.
Indigenous Supplement to Healthcare in Australia 2012–13
What we have found under the NIRA report, the National Healthcare agreement and the supplement I am releasing today is that the health of Indigenous Australians continues to be poorer than non-Indigenous Australians.
We found that Indigenous life expectancy at birth was 69.1 years for men and 73.7 years for women. This equates to a gap between Indigenous and non-Indigenous life expectancy of 10.6 years for men and 9.5 years for women.
Although the national gap in life expectancy did slightly narrow over the last five years, it is extremely unlikely that governments will be able meet the target to close the life expectancy gap within a generation (that is, by 2031).
The life expectancy gap and potentially avoidable death
Closing the gap on life expectancy is complex and requires action on a range of fronts.
We report on a range of indicators and targets about many things that may help to achieve improvements in Indigenous health. These include indicators relating to preventative health, primary care, hospitals and the medical workforce.
I would like to focus today on the results we have found in regards to death from potentially avoidable causes – either through prevention, or through early intervention via primary or community care.
In regards to deaths from potentially avoidable causes – we measure according to whether they could have been potentially prevented or potentially treated.
Deaths from potentially preventable causes are avoidable through primary healthcare (such as the care provided by a GP or community care), health promotion (such as by improving healthy habits and behaviours) and preventative health (such as vaccination against some diseases or help to quit smoking).
Deaths from potentially treatable causes are avoidable through appropriate therapeutic interventions, such as surgery or medication, before a condition worsens. This is often the case where diseases are prevented early, such as through screening programs.
What we found was that Indigenous people were three times as likely to die of an avoidable cause. This means that three-quarters of deaths of Indigenous people aged under 75 were avoidable either through early prevention or treatment.
By way of comparison, two-thirds of all Australians died from avoidable causes.
It is a tragedy to think of all of those taken before their time purely because they did not receive care early enough, or did not make the lifestyle changes to prevent disease.
Early intervention is vital
This finding underlines two things that NACCHO well knows if we are to close this terrible gap in life expectancy:
Good access to primary or community care is vital.
Prevention is better than cure.
There have been large increases in the rates of indigenous people having health checks claimable from Medicare over time, and this was true of all age groups.
The rate of child health checks has more than doubled, from 87.9 per 1000 in 2009-10 to 193.0 per 1000 in 2012-13. This is an average annual increase of 35.7 checks per 1000 children aged 0 to 14 years.
In the 15-54 years age group, the rate of health checks more than doubled from 74.5 per 1000 in 2009-10 to 196.0 per 1000 in 2012-13. This equated to an average annual increase of 40.3 checks per 1000 people.
In the 55 years or over age group, the rate of health checks more than doubled from 137.5 checks per 1000 people in 2009-10 to 304.6 per 1000 indigenous people in 2012-13. This equates to an annual average increase of 54.8 checks per 100 people from 2009-10 to 2012-13.
In child health we have also seen some pleasing improvement.
The rate of Indigenous child deaths decreased by 35% to 164.7 deaths per 100,000 Indigenous children compared to 77.2 per 100,000 for non-Indigenous children, and death rates are falling more quickly.
This means that the gap in the child death rate between Indigenous and non-Indigenous children decreased by 38% from 1998 to 2012, and we are on track to reach the current 2018 target.
This is a resounding achievement and is partly due to increases in immunisation rates and health checks:
In 2012, immunisation rates for Indigenous children aged 2 years and 5 years were the same as for all children. However, rates at 1 year still lag behind.
And, the rate of child (0–14 years) health checks doubled between 2009–10 and 2012–13
These results in access to immunisation and health checks are very positive and reflect the hard work and what can be achieved when governments and community stakeholders, such as NACCHO and others work together.
We should ensure that these gains are not undone.
As you know, the cost of healthcare is very topical at the moment. Australians are being asked to consider what they would pay for access to a primary care physician.
What we found in our results for this report was that one in eight (12%) indigenous people already delayed or did not go to a GP as a result of cost. More than two out of five (43.9%) Indigenous people delayed or did not see a dental professional due to cost. And one-third (34.6%) delayed or did not fill a prescription also due to cost.
When people start to avoid going to their primary or community care provider because of cost or other reasons, they often end up in hospital.
And, what we found was that rates of potentially preventable hospitalisations for Indigenous people were already three to four times higher than rates for other Australians.
These results provide context for governments when they are considering policies around access to primary care. Governments should be careful that they do not put up barriers to healthcare access for Indigenous people as it may undo the good work that has been done in this space over five years and end up creating a different burden on the hospital system.
Prevention is better than cure
The other component that we will need focus on to close the gap in life expectancy is prevention – particularly prevention of circulatory diseases, endocrine disorders (like diabetes) and some cancers.
The results we found this year show significantly more work needs to be done.
The heart attack rate for Indigenous people in 2011 was two and a half times higher than that of other people.
And Indigenous Australians are more than five times more likely to die of endocrine diseases (like diabetes), and one and a half times as likely to die from a circulatory disease or cancer.
One of the primary drivers in rates of heart attacks and endocrine disorders are rates of excess body weight.
Around 70% of adult Indigenous Australians have excess body weight, meaning that they are either overweight or obese. The rate of obesity by itself was 42%.
This compares poorly to the broader Australian population, where 63% of all adults had excess body weight and 27% were obese.
This high rate is extremely concerning. Particularly when you consider the increased risks it poses for chronic diseases and early death.
Finally, I would like to turn to lung cancer. In 2010, the rates of lung cancer for Indigenous Australians was nearly double the rate for non-Indigenous Australians.
What is most tragic about lung cancer is how preventable it is. Lung cancer is very strongly linked with whether or not a person smokes. We found that the Indigenous adult smoking rate is more than double the non-Indigenous rate (41.1% vs 16.0%).
So, that is a brief summary of the health report.
Without a doubt, the results are still not good enough to close the gap in many of the health outcomes for indigenous people.
We continue to have too many Indigenous people dying before their time, of preventable diseases and conditions.
However, there are green shoots; we have seen increases in access to primary care, and most pleasingly we are on track to close the gap in child deaths.
The social determinants of health
I think it is important to recognise that these health outcomes will also be critically determined by non-health factors, what’s referred to as the ‘social determinants of health.’ The recognition of these social determinants has, in the words of the National Rural Health Alliance, become a ‘rejuvenated agenda.’
Our working conditions — whether that be our incomes, job stability, or workplace safety — and factors like education and housing among many others, each make meaningful contributions to our health.
To draw on the words of Dr Margaret Chan, the Director General of the World Health Organisation:
‘…the social conditions in which people are born, live, and work are the single most important determinant of good health or ill health, of a long and productive life, or a short and miserable one.’
So, I would also like to discuss some results from our latest National Indigenous Reform Agreement report with you – particularly the results from education and employment.
We launched our latest NIRA report on government’s achievement against these targets in May.
We found that in literacy, numeracy and year 12 education, outcomes for Indigenous Australians are catching up with those of non-Indigenous Australians.
Between 2008 and 2013, the gap in the proportion of Indigenous and non-Indigenous students who met the national minimum standard narrowed in reading in all years and in Years 3 and 5 in numeracy.
In reading, the gap reduced most, by over 10 percentage points in Years 3 and 5. There were smaller reductions in Years 7 and 9 (1 to 3 percentage points).
In numeracy, the gap narrowed by 2 to 3 percentage points in Years 3 and 5 but widened in Year 9 by 4 percentage points. The gap widened in Year 7 by less than 1%.
The gap in the proportion of Indigenous and non-Indigenous 20–24 year olds who attained Year 12 or equivalent decreased significantly—by 12.2 percentage points .
And, over the past four years, the proportion of Indigenous Australians with or working towards a post school qualification increased from 33.1% to 42.3 %.
More work needed on childhood education, school attendance and employment
While most of this is heartening, our report also found that better results are needed in early childhood education, school attendance and in employment to meet COAG targets.
Early childhood education is a critical time for development as a successful learner. In 2012, 88% of Indigenous children in remote communities were enrolled in a preschool program in the year before school compared to 70% in major cities.
Similarly, 77% of children in remote areas attended a preschool program compared to 67% in major cities.
Another area of real concern we highlight is the falling rate of school attendance by Indigenous students in most year levels.
It’s very disappointing that—over four years—falls in Indigenous students’ attendance have outstripped any improvements made.
The worst drops in attendance were in South Australia the ACT and the Northern Territory, where attendance fell as much as 14 percentage points.
Only New South Wales and Victoria saw attendance rates improve and the gap narrow overall but even so, improvements were small —1 percentage point for most year levels.
Regular school attendance is vital for developing core skills in literacy and numeracy, and for successfully completing secondary education.
A slump in school attendance rates in all jurisdictions in the later years of compulsory schooling is particularly concerning given its potential to impact long-term economic participation.
Which leads me to employment – Australia is not on track to halve the gap in employment outcomes by 2018.
Since 2008, the gap between Indigenous and non-Indigenous employment outcomes has widened over the past five years by almost seven percentage points.
To give you some examples, we found just over 60% of Indigenous Australians were participating in the labour force, compared to almost 80% of non-Indigenous Australians.
And the overall unemployment rate for Indigenous Australians was four times that of non-Indigenous Australians—almost 22% compared to 5%.
Lower Indigenous employment and workforce participation has an impact right across the reform agenda, and must be prioritised for attention by COAG.
We, at the council, are pleased to see some positive outcomes under the Indigenous Reform Agreement, but are wary that there is still hard work and monitoring to be done in key areas.
Performance reporting matters
As you may be aware, the COAG Reform Council is being wound up on June 30, so we will no longer be reporting on these outcomes in the future.
In response to the news of the COAG Reform Council being abolished, Mick Gooda said:
“If we don’t have decisions made on the basis of the best evidence that we have available to us, we might as well be just making up things on the back of beer coasters again.”
The reports we release on Indigenous outcomes have not only enabled governments to monitor their performance. They have also equipped the public, and organisations such as NACCHO and the other peak bodies that are here today, with the information they need to hold governments to account for promises they have made in regards to Indigenous Australians.
Our reporting has provided the impetus for more focused effort to improve Indigenous health, education and economic participation and has highlighted important progress – reassuring governments and the community that change is indeed possible.
And after five years of reporting on governments’ performance, our reports have shown that we are still only at the beginning of the change required over a generation to close the gap.
I’ve been fortunate in my public life to have served in both federal and state parliaments, in opposition and in government.
And after all these years, I can honestly say that accountability—keeping governments honest—and evidence-based reform are not simply important ingredients – they are absolutely essential to getting results and keeping governments on track.
Although we do not know for sure who will be reporting on the targets to close the gap in the future, it has been suggested that the Prime Minister’s department will report on achievement of targets.
I have a great deal of respect for the Department of Prime Minister & Cabinet and I’m sure there are people with the skills to do that in PM&C.
However, what the COAG Reform Council did that was particularly special was hold governments to account on the promises they have made, but did so independently of any one government.
We report independently on the progress of all nine of Australia’s governments—the Commonwealth, the States and the Territories—in closing the gap.
That independence ensured that our reporting was impartial and objective.
Who will do this in the future?
We need to consider how to increase the effectiveness of our independent public reporting on government progress, such as improving the quality of indicators, and accessing better data.
It is important in the future that someone, or some organisation, will be there to properly measure what governments are achieving with the billions of dollars in taxpayers’ money they are spending.
Crucially, it is important that any future design of performance reporting frameworks and targets must involve indigenous stakeholders as equal partners.
Consultation with governments is required under the IGA. It should extend to key Indigenous stakeholders such as the Closing the Gap coalition.
With a tri-lateral coalition of the Commonwealth, State governments, and Indigenous representatives – we truly have a real chance of closing the gap.
So, in my last week as chairman of the COAG Reform Council, allow me to pay tribute to the work of NACCHO and extend my best wishes for the future of Indigenous health reform.
Your voice matters and I know it will shape a better future for Indigenous Australians. Thank you.
THE deputy chairman of Tony Abbott’s indigenous advisory council, doctor Ngiare Brown, has denounced budget cuts to indigenous affairs and says the $7 GP co-payment will hurt indigenous people and other vulnerable Australians who desperately need help to close the health gap.
Professor Brown will use next week’s meeting of the council to warn that the cuts to indigenous health will inevitably affect frontline services.
She told The Australian she would use her role on the council to push for reconsideration of the co-payment scheme and exemptions for vulnerable Australians and indigenous people based on income and burden of disease.
On overall cuts to the indigenous budget, she said she was determined to get detailed answers on where the cuts would come from and what they would affect.
“There have been anticipated cuts across the board for each portfolio and department,” Professor Brown said. “But what is most concerning is that there is talk about cuts to essential portfolios like health and education but currently there is no clarity on what this means.
“The Coalition claim they want to cut red tape, duplication and the bureaucracy, for example, but I’m concerned there are actually going to be cuts to frontline services, which we were promised would absolutely not be the case”.
On the cuts to preventative programs such as indigenous smoking campaigns, Professor Brown, one of the first group of Aboriginal medical graduates in Australia, said she considered this a frontline service.
“Public health and … prevention are absolutely frontline services, particularly in comprehensive primary care contexts like Aboriginal and Torres Strait Islander health,” she said. “So whether they are specific smoking programs or whether they are brief interventions delivered by our health workers, nurses and general practitioners, public health prevention programs are absolutely frontline services.
“How will departments define what a frontline service is, and then how will they make consistent determinations about what gets funded and what doesn’t.”
Indigenous Affairs Minister Nigel Scullion has vowed that the $239 million being cut from the general indigenous affairs budget will be achieved through “efficiencies” and less red tape and duplication — and not reductions to frontline services.
But with an additional $165m being cut from indigenous health, peak indigenous lobby groups fear that efforts to close the gap are being compromised.
Warren Mundine, chairman of the Prime Minister’s indigenous council, has said the Coalition originally intended to cut the portfolio’s budget by 10 per cent. The eventual 4.5 per cent cut announced in last week’s budget would come from ‘inefficiencies”, not frontline services, he said.
Professor Brown, who was previously the Australian Medical Association’s indigenous health adviser, said she was also concerned that the impact of the GP co-payment on indigenous people and closing the gap had not been taken into consideration.
“I don’t think there has been consideration of any kind for the financial, economic or social impacts or the intended and unintended consequences of co-payments,” she said. “Obviously the most vulnerable are going to be the ones that are hit the hardest: the young, the old and those with chronic diseases in particular. People needing multiple visits over long periods to manage their chronic disease or palliative care or children with special needs or disabilities for example — how are they going to afford multiple consultations at $7 a pop?
“One of my greatest concerns is not only that the most vulnerable will bear the brunt of a poorly conceived co-payment initiative, but that the health care system will not cope.
“The policy makers need to think very carefully about whether to go ahead with the co-payment and if they do, who will pay and who will have exemptions.
“It is already difficult enough for the Aboriginal community-controlled health sector to provide comprehensive care on the limited resources that we have. If you couple charging co-payments, which we may or may not collect, and getting less money in to the sector for public health and clinical care, then that is an extraordinary additional burden bear, particularly when we were promised that there would be no cuts to the frontline in health and education.”
Investing in Aboriginal Community Controlled Health Services will help address the increasing gap in employment outcomes between Aboriginal and non-Aboriginal people as revealed in the new report released by the COAG Reform Council.
Justin Mohamed, Chairperson of the National Aboriginal Community Controlled Health Organisation (NACCHO) said the COAG Reform Council report showed encouraging gains are being made in areas such as life expectancy, child mortality and immunisation, but unemployment and obesity rates needed greater attention.
“This is yet another report to add to the many before it which demonstrate that massive inequalities still exist between Aboriginal and non-Aboriginal people,” Mr Mohamed said.
“The take home message is that we can’t shift focus or we risk reversing the gains we have made. There is still a long way to go before Aboriginal people can expect the same levels of health, employment and education as other Australians.
“It’s pleasing to see Aboriginal child mortality rates are decreasing but Aboriginal kids are still twice as likely to die before they are five than non-Aboriginal children. As adults we still have a life expectancy more than ten years less than non-Aboriginal people.
“That’s why we need to keep up the investment in programs and services that are making a difference.
“Aboriginal Community Controlled Health Services are making huge contributions towards closing the gap across a range of indicators and demand for our services is growing.
“In addition to these significant health gains, our 150 health services employ more than 3,200 Aboriginal people – one of the largest employers of Aboriginal people in the country.
“Governments at all levels need to look to supporting and expanding the Aboriginal Community Controlled Health sector if they are committed to improving the health and employment outcomes of Aboriginal and Torres Strait Islander people.”
Mr Mohamed said NACCHO has concerns that we still do not have any concrete commitment of the future of the Close the Gap “National Partnership Agreement” or an alternative structure. This concern is further heightened by the fact that the COAG Reform Council will be abolished come 30 June.
“We are extremely concerned that the millions of dollars being cut from across Aboriginal affairs at the Federal level, plus the introduction of new arrangements in accessing primary health care and changes to unemployment benefits, could potentially push the closing the gap targets even further from reach.
“Yet at the state and territory level we also see apparent indifference to the challenges at hand.
“It’s now been more than twelve months since the National Partnership Agreement has lapsed and we still don’t have any clear advice how states, territories and the commonwealth plan to coordinate addressing the closing the gap targets. The Nation needs a long term agreement that has full support and buy in from all levels of Government.
“NACCHO also questions what replacement reporting mechanisms will be put in place to continue this specific, detailed state and territory reporting given the abolishment of the COAG Reform Council next month. These reports provide a level of accountability to the actions of the different levels of government which needs to be retained. ”
Concern over impact of the Budget on Aboriginal and Torres Strait Islander Peoples
Aboriginal and Torres Strait Islander Peoples will suffer disproportionately under the 2014 Federal Budget, according to the National Congress of Australia’s First Peoples.
“General and specific Aboriginal and Torres Strait Islander measures in the Budget are already causing considerable anxiety amongst our peoples,” said Congress Co-Chair Kirstie Parker.
“Our people are amongst the sickest, poorest and most marginalised Australians, so the pain of some measures will be felt especially hard by us.
“These include the introduction of GP co-payments and raising of the pension age, coupled with a cut of more than half a billion dollars to Aboriginal and Torres Strait Islander programs over the next five years. Yet another major overhaul of Aboriginal and Torres Strait Islander programs, no long-term funding certainty for our health and legal services or clarity around measures to Close the Gap, and undermining of Congress as the only national independent Aboriginal and Torres Strait Islander representative body.”
Ms Parker said scant detail had been provided in relation to the major overhaul of Aboriginal and Torres Strait Islander programs under a new ‘Indigenous Advancement Strategy’, and the reduction of about 150 existing programs to just five.
“We strongly support a reduction in red tape and duplication. However, in the absence of more information and any clear funding guidelines or criteria for that handful of programs, it is difficult to determine how a cut of nearly $550 million over five years to Aboriginal and Torres Strait Islander programs is justified. Days after the Budget, our peoples are in virtually no clearer position than we were before.
“Our community controlled health organisations have been offered no more than 12 months funding. Of course, that’s better than nothing but it’s no way to build longevity or attract and retain high quality staff. We join others in seeking clarification as to how the Government will deliver on its promised commitment – in terms of funding and national leadership – to Close the Gap.
“Our legal services and family violence prevention legal services will bear cuts they can ill-afford as they struggle to address the chronic over-representation of our people in the criminal justice system and protect victims of family violence, especially our women and children.
“This is the manifestation of Commonwealth confusion on Aboriginal and Torres Strait Islander Peoples needs and expenditure that we believe will damage rather than enhance our people’s lives.”
Ms Parker, who is also Co-Chair of the Close the Gap Campaign Steering Committee, said Aboriginal and Torres Strait Islander Peoples already experienced roughly twice the burden of ill-health as other Australians.
“So, anything – such as a GP co-payment – that further deters our peoples from managing their illness together with their doctor will inevitably compound our already higher rates of hospitalisation for chronic or acute conditions. That’s bad news for both us and the public purse,” she said.
“The pension age is to be lifted to 70 years but we’re unaware of any consideration being given to the fact that, with the average life expectancy of our men at 69.1 years and for our women 73.7 years. That’s roughly ten years less than the general Australian population – our people will be lucky to make it to retirement age, let alone collect superannuation.
“We call upon the Government to think more deeply about its plans, and to ensure it values and utilise the expertise that exists within Aboriginal and Torres Strait Islander peoples, organisations and communities. We want the Government to move forward in genuine partnership with us.”
Discontinuation of $15 million set aside in the Budget Forward Estimates for Congress from 2014-17 amounted to censorship of independent Aboriginal and Torres Strait Islander voices by stealth, Ms Parker said.
“The Government has said that it is willing to meet with and receive advice from Congress and we welcome this. However, it feels very much like our independent national representative body is being tolerated rather than supported.
“Our members have always aspired for Congress to be financially independent from government and self-sustaining in the long-term and this has not changed. It is sad that, whereas it was always clearly identified that an estimated ten years of investment and support was needed for us to achieve sustainability in a measured way, it was just three years before this particular government ‘pulled the plug’.
“The fact that the Government flagged this decision in December makes it no less nasty. However, while confirmation of it is a definite blow to Indigenous self-determination, it is by no means a knockout punch for Congress. Our membership continues to grow and, with restructuring already undertaken and considerable belt tightening, we expect our reserves to sustain us for the next two to three years while we work to diversify our funding base.
“As well as seeking ongoing support from our membership, we will be appealing to decent, fair-minded Australians to do what this Government apparently won’t – to champion and support an independent representative voice for our peoples, chosen by our peoples.”
The National Aboriginal Community Controlled Health Organisation (NACCHO) has welcomed continued funding for the 150 Aboriginal Community Controlled Health Services around Australia announced/confirmed in Budget 2014.
Justin Mohamed, Chair of the National Aboriginal Community Controlled Health Organisation, said the Aboriginal population is growing and demand for services is increasing at more than 6% per year.
“The 2014 Budget funding means we can continue to provide high quality, culturally appropriate health care to our people for another year,” Mr Mohamed said today.
“However, we also need long-term planning and budget resources to build on recent health gains and create lasting improvements to the health of Aboriginal people.
“There is great risk that the introduction of a $7 co-payment for doctor’s visits will create new barriers to healthcare for many Aboriginal and Torres Strait Islander Australians, including additional red tape for Community Controlled Health Organisations.
“Most Aboriginal and Torres Strait Islander Australians are low income earners and suffer the highest level of chronic disease, requiring regular GP visits.
“State and territories have also been given the green light to charge for hospital emergency visits, creating a dangerous situation where people may not present for serious medical treatment for fear of the cost.
“We will get the most benefit from policy that encourages Aboriginal people to seek medical attention and seek it early, not make it even harder for them to get the care they need.
“It is also vital that the Federal Government guarantees the $80-90 million cut across Aboriginal Health does not impact on-ground services and Aboriginal health outcomes.
“Aboriginal Community Controlled Health Organisations have a proven track record in providing a range of quality employment and education opportunities for Aboriginal people and boosting local economies.
“Given cuts to Aboriginal health and employment budgets they are even more valuable – providing employment and training opportunities to our people which in turn boost local economies and tackle some of the huge barriers to Aboriginal people achieving economic independence and quality of life.
“Healthy communities keep our kids in school, keep our adults in the workforce and allow great opportunities for Aboriginal contributions to the economy and broader community,” Mr Mohamed said.
“Many funding agreements for indigenous health programs were due to expire at the end of June. Extending the funding to June 2015 provides the continuity for these organisations to deliver important services to indigenous people over the next 12 months,” said a spokesman for Mr Dutton.
The spokesman said 90 organisations funded through five specific programs — Primary Health Care, Healthy for Life, Australian Nurse Family Partnership, New Directions: Mothers and Babies and Stronger Indigenous Health Services — would get funding of $98m for another year.
“This government is committed to improving indigenous health,” he said.
“The government examines all funding from time to time as part of the budget process to ensure that it is spent as effectively as possible with improving health outcomes.”
The NACCHO welcomed the 12-month lifeline, but warned a long-term plan was desperately needed.
NACCHO chairman Justin Mohamed said the extension recognised the significant contribution Aboriginal-run health services were making to closing the health gap between Aboriginal and non-Aboriginal people.
“This means we will be able to continue to provide high quality, culturally appropriate health care to our people for another 12 months,’’ Mr Mohamed said.
“Yet there remains a level of uncertainty about what we will be able to continue to provide after the 2014-15 financial year.”
He said demand for the services was increasing at a rate of more than 6 per cent a year.
You can hear more about Aboriginal health and Close the Gap at the NACCHO SUMMIT
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.