NatioNal aborigiNal aNd torres strait islaNder HealtH PlaN · HealtH PlaN Companion document on...
Transcript of NatioNal aborigiNal aNd torres strait islaNder HealtH PlaN · HealtH PlaN Companion document on...
www.health.gov.au/natsihpAll information in this publication is correct as at July 2013
NatioNal aborigiNal aNd torres strait islaNder HealtH PlaN Companion document on Commonwealth government strategies and reforms — July 2013
1030
6 Ju
ly 2
013
NAtioNAl AborigiNAl ANd torres strAit islANder HeAltH PlAN – ComPANioN doCumeNt oN CommoNweAltH goverNmeNt strAtegies ANd reforms
isbN: 978-1-74241-983-1
online isbN: 978-1-74241-984-8
Publications approval number: 10306
Copyright statements:
Paper-based publications© Commonwealth of Australia 2013
this work is copyright. You may reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. requests and inquiries concerning reproduction and rights are to be sent to the online, services and external relations branch, department of Health and Ageing, gPo box 9848, Canberra ACt 2601, or via e-mail to [email protected].
Internet sites© Commonwealth of Australia 2013
this work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. requests and inquiries concerning reproduction and rights are to be sent to the online, services and external relations branch, department of Health and Ageing, gPo box 9848, Canberra ACt 2601, or via e-mail to [email protected].
Please be aware that this document may contain the images and names of Aboriginal and Torres Strait Islander people who may have passed away.
Introduction 2Australia’sHealthSystem 2Expenditureon,andInvestmentin,AboriginalandTorresStraitIslanderHealth 4InvestmenttoClosetheGapinIndigenousDisadvantage 5InvestmentsintheSocialDeterminantsofHealth 7 EarlyChildhoodEducation,SchoolingandTertiaryEducation 7 EarlyYears 8 AboriginalandTorresStraitIslanderEducation 8 EducationReform 8 EducationPrograms 9 HigherEducationandVocationalEducationandTraining 10 Housing 11 EnvironmentalHealth 11 AccommodationandHousing 11 EconomicDevelopment,ParticipationandEmployment 13 EconomicDevelopment 13 EconomicParticipationandEmployment 13 SafeCommunities 16 Justice 16 LegalServices 17 CommunitySafety 17InvestmentstoImprovetheEnablerstoHealth 18 ACulturallyRespectfulandNon-DiscriminatoryHealthSystem 18 HealthSystemEffectivenessandClinicallyAppropriateCare 19 Evidence-BasedPractice 23 MentalHealthandSocialandEmotionalWellbeing 25 HumanandCommunityCapability 29InvestmentstoImproveOutcomesAcrosstheLifeCourse 31 BroaderHealthAcrosstheLifeCourse 31 MaternalHealthandParenting 34 ChildhoodHealthandDevelopment 35 AdolescentandYouthHealth 38 HealthyAdults 38 HealthyAgeing 40References 42
Contents
22
IntroduCtIon
Thisdocumenthighlightsexistingactivities,partnershipsandprogramsthatcontributetoclosingthegapinhealthoutcomesforAboriginalandTorresStraitIslanderpeople.Whilenotanexhaustivelistofactivitiesandprograms,thisdocumenthighlightsexamplesofinvestments,recognisingtheimpactofwiderpoliciesandprogramsandreformagendasacrossareassuchasmentalhealth,housingandhomelessness,educationandeconomicparticipation,andtheircontributiontoaddressingAboriginalandTorresStraitIslanderdisadvantageandachievingsustainablehealthgains.
AustrAlIA’s heAlth system
Australia’shealthsystemsupportsuniversalandaffordableaccesstohighqualitymedical,pharmaceuticalandhospitalservices,whilehelpingpeopletostayhealthythroughhealthpromotionanddiseasepreventionactivities.
TheMedicare Benefits Scheme(MBS)subsidisespaymentsforservicesprovidedbydoctorsincludingspecialists,optometrists,nursesandmidwives,andinsomecircumstancesotheralliedhealthprofessionalssuchasclinicalpsychologists.ThePharmaceutical Benefits Scheme(PBS)subsidisespaymentsforasignificantproportionofprescriptionmedicinespurchasedfrompharmacies.TheAustralianGovernmentandstateandterritorygovernments
alsojointlyfundpublichospitalservices.ThissystemaimstogiveallAustralians,regardlessofpersonalcircumstance,accesstoaffordableorno-costhealthcare,andissupportedbyadditionalinvestmentthrougharangeofhealthprograms,healthresearchactivityandpublichealthinitiatives.1
Primaryhealthcareisintendedtobethefirstlevelofcontactanindividualhaswiththehealthsystem.Primaryhealthcareprovidersplayakeyroleintheprevention,promotion,screening,detection,treatmentandmanagementofillnessanddiseaseandhelppreventmorecomplexandexpensiveservicedeliveryatthesecondaryandtertiarylevel.
TheimplementationofNational Health Reformactivitiesisstrengtheninglocaldecision-makingandcommunityinvolvementinhealthservicedelivery.Toachievegreaterlocalengagement,National Health Reform isdeliveringbetteraccesstoservices,improvedlocalaccountabilityandtransparencyandgreaterresponsivenesstolocalcommunities,through:
• theestablishmentof61MedicareLocals,whicharecoordinatingprimaryhealthcaredeliveryandaddressinglocalhealthcareneedsandservicegaps,bydrivingimprovementsinprimaryhealthcare(includingafterhoursprimarycare)andensuringthatservicesaretailoredtomeettheneedsoflocalcommunities;and
• 136LocalHospitalNetworks,fundednationallytolocalisethemanagementofpublichospitals.
3
UnderNational Health Reform,theAustralianGovernmentwillinvestatleast$16.4billioninadditionalefficientgrowthoffundingfrom2014-15to2019-20toensureallAustralianscanaccessthecaretheyneed,whereandwhentheyneedit.
Thefollowingagencieshavealsobeenestablishedtosupportimprovedperformanceacrossthehealthsystemthroughnationalperformancestandardsandpublicaccountability:
• theNationalHealthPerformanceAuthority(NHPA)isanindependentagencythatprovidesinformationontheperformanceofeveryLocalHospitalNetworkandthehospitalswithinit,everyprivatehospitalandallMedicareLocalsthroughtheirHospitalPerformanceReportsandHealthyCommunitiesReports.TheperformancemeasuresandstandardscontainedinthePerformance and Accountability Framework willallowtheNHPAtoidentifyhigh-performingLocalHospitalNetworks,MedicareLocalsandhospitalstoenablethesharingofinnovativeandeffectivepractices,whilealsoidentifyingthosethatareunder-performingtoenableeffectiveperformancemanagement.
3
• theIndependentHospitalPricingAuthority(IHPA)isanindependentagencythatdeterminestheNationalEfficientPriceofpublichospitalservicesunderanewmodelofhospitalfunding:activity-basedfunding.Thenewnationalsystemofactivity-basedfundingwillmakepublichospitalfundingmoretransparent,andhelptodriveefficiencyinthedeliveryofpublichospitalservices.Publichospitalswillbefundedaccordingtothenumberandkindofservicestheyprovide.ThispricingsystemtakesintoaccounttheIndigenousstatusofpatientsthroughadjustments.In2013-14,theseadjustmentsprovideanadditional4percentifthepatientisflaggedasAboriginaland/orTorresStraitIslanderandisanadmittedacute,emergencyornon-admittedpatient.Anadjustmentof17percentisprovidedforanAboriginaland/orTorresStraitIslanderadmittedsubacutepatient.Thisnewapproachwillprovideincentivesforhospitalstotreatpatientsmoreefficientlyandforhospitalsandgovernmentstoensurepatientsaretreatedinthemostappropriatesetting.Forserviceswhereactivity-basedfundingwouldnotbeappropriate,includingsmallcountryhospitals,fundingwillcontinuetobeprovidedthroughblockgrants.
44
expendIture on, And Investment In, AborIgInAl And torres strAIt IslAnder heAlth
Between2001-02and2010-11,therehasbeenanincreaseinAboriginalandTorresStraitIslanderhealthexpenditure,andthisexpenditurehasincreasedatafasterratethanforotherAustralians.Overthisperiod,perpersonhealthexpenditurebythestateandterritorygovernmentsforAboriginalandTorresStraitIslanderpeoplegrewby54.2percent,whileAustralianGovernmentexpendituregrewby101.3percent.MBSandPBSbenefitswereasubstantialcomponentofthatgrowth,accountingfor50.9percentofAustralianGovernmentgrowthbetween2001-02and2010-11.2ThisgrowthinexpenditurereflectsthecommitmenttoimprovehealthoutcomesforAboriginalandTorresStraitIslanderpeoplethroughconsistent,long-termeffortandinvestments.
StrengtheningthesystemofcomprehensiveprimarycareforAboriginalandTorresStraitIslanderpeopleisintegraltoaneffectiveandefficienthealthsystemtocontributetowardsclosingthegap.In2012-13,theDepartmentofHealthandAgeingprovided$555.3millioningrantfundingtoapproximately280organisationstosupportspecificAboriginalandTorresStraitIslanderhealthactivities,includingthedeliveryofprimaryhealthcare,substancemisuseservices
andsocialandemotionalwellbeingservicestoAboriginalandTorresStraitIslanderpeople.Thisinvestmentincludedfundingtoapproximately170AboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationstodeliverarangeofcomprehensiveservices.
TheAustralianGovernmenthascommitted$777millionoverthreeyearsfrom1July2013to30June2016,asitsshareofarenewedNational Partnership Agreement on Closing the Gap in Indigenous Health Outcomes.WhenMBSandPBSestimatesaretakenintoaccount,theCommonwealthcontributionisaround$992millionoverthreeyears.Aspartofthis,theAustralianGovernmentiscontinuingitsfundingcommitmentsandisseekingstateandterritoryagreementtocontinuefundingfortheirinitiativesunderthisNationalPartnershipAgreement.ThisfundingwillensureAboriginalandTorresStraitIslanderpeoplecontinuetobenefitfromimprovedhealthservicestosupportthecommitmenttoclosethegapinAboriginalandTorresStraitIslanderdisadvantage.
55
Investment to Close the gAp In IndIgenous dIsAdvAntAge
TheNational Indigenous Reform Agreement (NIRA),endorsedbytheCouncilofAustralianGovernments(COAG)in2008,commitsallgovernmentstosixambitioustargetsrelatingtolifeexpectancy,infantmortality,educationandemployment.TheNIRAissupportedbysignificantinvestmentthroughaseriesofNationalPartnershipAgreementswithstateandterritorygovernmentsinthekeyareasofhealth,earlychildhood,education,economicparticipationandremoteservicedelivery.
TheClosing the Gap Frameworkemphasisestheinter-relationshipbetweensevendifferent‘buildingblocks’notingthattherealityofachievingtargetsrequiressustainedeffortacrossallareas.GovernmentshaveagreedtoworkinpartnershipwithAboriginalandTorresStraitIslanderpeopleandcommunities.ThiscommitmentisevidencedintheClose the Gap Statement of Intent,whichidentifiestheneedtosupportanddevelopAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationsinurban,ruralandremoteareasinordertoachievelastingimprovementsinAboriginalandTorresStraitIslanderhealthandwellbeing.
COAGhascommittedtoreportingtransparentlyonexpenditureonservicesforAboriginalandTorresStraitIslanderpeopletoinformbetterpolicy-makinginAboriginalandTorresStraitIslanderaffairs.TheIndigenous Expenditure Report(IER)providesanationalframework
forcollectingandreportinginformationonallCommonwealthandstateandterritorygovernmentexpenditureonbothAboriginalandTorresStraitIslanderspecificandmainstreamservicestoAboriginalandTorresStraitIslanderpeople.EstimatesonexpenditurearebroadlyalignedtotheCOAGClosing the Gapbuildingblocks,includingthehealthbuildingblock.
ThelatestIERwasreleasedin2012andreportsthatnationallyin2010-11,theAustralian,stateandterritorygovernments’directexpenditureonservicesforAboriginalandTorresStraitIslanderpeoplewas$25.4billionor5.6percentofallgovernmentdirectexpenditurein2010-11.TheIERreportsthatestimateddirectgovernmentexpenditureperpersononallserviceswas$44,128perAboriginalandTorresStraitIslanderpersonand$19,589pernon-Indigenouspersonin2010-11.Thatis,anestimated$2.25wasspentperAboriginalandTorresStraitIslanderpersonforeverydollarspentpernon-Indigenouspersoninthepopulationin2010-11.
Estimatesbybroadareaofexpenditurein2010-11includes:
• Early child development, and education and training:includesexpenditureonpreschoolandchildcare;schooleducation;andtertiaryeducation.$2.44wasspentperAboriginalandTorresStraitIslanderpersoninthepopulationforeverydollarspentpernon-Indigenousperson,withthelargestareaofdifferenceinexpenditureperheadofpopulationbeingschooleducation(aratioof$2.99to1),whichreflectstheyoungerageprofileoftheAboriginalandTorresStraitIslanderpopulation.
66
• Healthy lives:includesexpenditureonhospitalservices;publicandcommunityhealthservices;andotherhealthcaresubsidiesandsupportservices.$2.02wasspentperAboriginalandTorresStraitIslanderpersoninthepopulationforeverydollarspentpernon-Indigenousperson.
• Economic participation: includesexpenditureonlabourandemploymentservicesandsocialsecuritysupport.$1.96wasspentperAboriginalandTorresStraitIslanderpersoninthepopulationforeverydollarspentpernon-Indigenousperson;thelargestareaofdifferenceinexpenditureperpersonwaslabourandemploymentprograms(aratioof$5.22to1).
• Home environment: includesexpenditureonhousingservices;communityandenvironmentservices;andtransportandcommunicationsservices.$2.16wasspentperAboriginalandTorresStraitIslanderpersoninthepopulationforeverydollarspentpernon-Indigenousperson.Thelargestareaofdifferenceinexpenditureperheadofpopulationwashousing(aratioof$4.85to1),whichreflectsthehigherpercapitausebyAboriginalandTorresStraitIslanderpeopleofsocialhousingandrentalmarketassistance.
• Safe and supportive communities: includesexpenditureonpublicorderandsafety;communitysupportandwelfare;andrecreationandculture.$4.50wasspentperAboriginalandTorresStraitIslanderpersoninthepopulationforeverydollarspentpernon-Indigenousperson.
• Other government services: includesexpenditureongeneralgovernment(suchastheoperationsoflegislativeandexecutiveaffairsanddefenceservices);andsupporttoindustry.$1.19wasspentperAboriginalandTorresStraitIslanderpersoninthepopulationforeverydollarspentpernon-Indigenousperson.
7
Investments In the soCIAl determInAnts of heAlth
Avoidablehealthinequalitiesarisebecauseofthecircumstancesinwhichpeoplegrow,live,workandage,aswellasthesystemsputinplacetodealwithillness.3Thesocialdeterminantsofhealthaffectthehealthofindividualsandcanalsoinfluencehowapersoninteractswithhealthandotherservices.
Anumberofstudieshavefoundthatbetweenone-thirdandone-halfofthehealthgapbetweenAboriginalandTorresStraitIslanderandnon-IndigenousAustraliansisassociatedwithdifferencesinsocioeconomicstatussuchaseducation,employmentandincome.4,5Thesestudieshighlighttheimportanceofaddressingthesocialdeterminantsofhealthtocontributetothetargettoclosethegapinlifeexpectancy.Thefollowingexamplesofpoliciesandprogramsandreformsacrossearlychildhood,education,housingandcommunitysafetyhighlighttherangeofinvestmentinthesocialdeterminants.
eArly ChIldhood eduCAtIon, sChoolIng And tertIAry eduCAtIon
early Childhood
Foranequalstartinlife,Indigenouschildrenneedearlylearning,developmentandsocialisationopportunities.Accesstoqualityearlychildhoodeducationandcareservices,includingpre-school,childcareandfamilysupportservicessuchasparentingprogramsandsupports,iscritical.Appropriatefacilitiesandphysicalinfrastructure,asustainableearlychildhoodeducationandhealthworkforce,learningframeworksandopportunitiesforparentalengagementarealsoimportantandrequireattention.Actionintheareasofmaternal,antenatalandearlychildhoodhealthisrelevanttoaddressingthechildmortalitygapandtoearlychildhooddevelopment.6
schooling
Humancapitaldevelopmentthrougheducationiskeytofutureopportunity.Responsiveschoolingrequiresattentiontoinfrastructure,workforce(includingteacherandschoolleadersupplyandquality),curriculum,studentliteracyandnumeracyachievementandopportunitiesforparentalengagementandschool/communitypartnerships.Transitionpathwaysintoschoolingandintowork,postschooleducationandtrainingarealsoimportant.7
Closing the gap targets
• ToensureaccesstoearlychildhoodeducationforallIndigenousfouryearoldsinremotecommunities(by2013);
• Tohalvethegapinreading,writingandnumeracyachievementsforchildren(by2018);and
• TohalvethegapforIndigenousstudentsinYear12(orequivalent)attainmentrates(by2020).
buIldIng bloCks
8
eArly yeArsEvidencesupportsthatearlyaccesstoqualityearlychildhoodeducationandcarecanleadtoincreasedschoolreadinessandimprovedparticipationinpreschoolandschool,particularlyforvulnerablechildren.
TheAustralianGovernmentisproviding$660.1millioninfundingoverthenext18monthsforanewNational Partnership Agreement on Universal Access to Early Childhood Education,including$655.6milliontostatesandterritoriestosupportcontinuedaccesstoqualityearlychildhoodeducationprogramsforallchildren,andaCommonwealthinvestmentof$4.5millionfornationalearlychildhooddatadevelopment,reviewandresearchactivities.Thisinvestmentexpandsonthe$970millioninvestedbytheAustralianGovernmentsince2008toensurethatallchildrenhaveaccesstoaqualityearlychildhoodeducationprogram,deliveredbyadegree-qualifiedearlychildhoodteacher,for600hours,intheyearbeforefull-timeschooling.
TheAustralianGovernmentisprovidingapproximately$62.7millionin2013-14tocontributetotheoperationalcostsofaround342earlychildhoodeducationandcareandschoolagecareservices.ServicesfundedundertheBudget Based Funded Programprovidechildrenandtheirfamilieswithaccessible,affordableandculturallyappropriateearlychildhoodeducationandcareandschoolagecareservicesmainlyinruralandremotecommunities.Thisprogramisbeingreviewedtoensurethattheprogramcontinuestomeettheneedsofcommunities,thatfundingistargetedinlocationswhereitismostneeded,andtosupportqualityimprovementtowardstheNational Quality Framework.
TheAustralianGovernmentisalsofundingarangeofinitiativesaspartoftheStronger Futures in the Northern Territorypackage,includingaround$28millionover10yearsforcontinuedoperationalfundingtosupportupto225earlylearningandchildcareplacesatninecrèchesinveryremoteAboriginalandTorresStraitIslandercommunitieswhichwereestablishedundertheNorthern Territory Emergency Response.
AborIgInAl And torres strAIt IslAnder eduCAtIonTheAboriginal and Torres Strait Islander Education Action Plan 2010-2014,endorsedbyCOAGin2011,commitsallgovernmentsinAustraliatoaunifiedapproachtoclosingthegapineducationoutcomesbetweenAboriginalandTorresStraitIslanderandnon-Indigenousstudents,bybringingtogethermainstreameducationreforms,witharangeofactionsspecifictoimprovingoutcomesforAboriginalandTorresStraitIslanderstudents.TheActionPlanwasdevelopedwiththesupportofstakeholdersviaawiderangingconsultationprocesswhichreceivedover100submissions.
eduCAtIon reformTheAustralianGovernmentisinvestinginanewNational Plan for School Improvementtoestablishanewschoolfundingapproachbasedontheneedsofindividualstudents.UndertheNationalPlan,anewSchoolingResourceStandardwouldincludedirectadditionalfunding,throughaloadingarrangement,tohelpAboriginalandTorresStraitIslanderstudentsachieveimprovedoutcomes.
9
eduCAtIon progrAmsTheAustralianGovernmentwillinvest$659milliontocontinuefundingundertheIndigenous Education(Targeted Assistance) ActtoalignwiththeimplementationoftheNational Plan for School Improvement andmaintaineducationprogramsforAboriginalandTorresStraitIslanderstudents,suchasthe:
• Parental and Community Engagement Program,acommunitydrivenprogramforparentsandcarersofAboriginalandTorresStraitIslanderyoungpeople.Itsupportsinitiativesthatassistfamiliesandcommunitiesto‘reachin’toschoolsandothereducationalsettingstoengageintheirchildren’seducationthroughparticipationineducationaldecision-making,developingpartnershipswitheducationprovidersandsupportingandreinforcingtheirchildren’slearningathome;
• Sporting Chance Program,whichisdesignedtousesportandrecreationasavehicletoengageAboriginalandTorresStraitIslanderyoungpeopleintheirschooling;
• Indigenous Youth Leadership Program,whichprovidessecondaryandtertiaryscholarshipstosupportAboriginalandTorresStraitIslanderstudentsfrommainlyveryremoteandremoteareastocompleteYear12and/oranundergraduatedegreewhiledevelopingleadershipskills;
• Indigenous Youth Mobility Program,whichsupportsyoungAboriginalandTorresStraitIslanderpeopleaged16-24years,primarilyfromremoteareas,whoneedtomoveawayfromhometogainthequalificationstheyneedtohaveagreaterchanceofobtainingsustainableemployment;and
• Focus Schools Projects,whichsupportschoolswithhighAboriginalandTorresStraitIslanderstudentenrolmentstoaccelerateimprovementsineducationaloutcomesforthosestudents,withanemphasisonengagement,attendanceandEnglishliteracyandnumeracy.
education Workforce
InvestmentunderStronger Futures in the Northern Territorywill:
• continuetosupport200teachersandengagementofficersinremoteNorthernTerritoryschools;
• provideaten-yearinvestmentinsupportandtrainingprogramstoensureteachershavetheskillstoachievebetterliteracyandnumeracyresultsforAboriginalandTorresStraitIslanderchildren.ProgramswillalsoensureteachershavetheskillstheyneedtoteachchildrenwithEnglishasasecondlanguageandhowtoensurechildrenwithhearingorlearningdifficultiesgetthebestpossibleeducation;and
• buildaround100teacherhousesinremoteNorthernTerritorycommunitiesoverthenextnineyearstoaddresscriticalstaffhousingshortagesandhelpattractandretainhighqualityteachersinremoteschools.
Teach Remote Stage 2willhelptheNationalAllianceofRemoteIndigenousSchoolstocontinueitsworktoattractandretainhighcalibreteachersinremoteareas.
financial Assistance
AboriginalandTorresStraitIslanderstudentsandapprenticesmaybeabletogetfinancialhelpfromtheAustralianGovernment.ThishelpisavailablefromCentrelinkthroughtheABSTUDYprogram.ABSTUDYprovidesameans-testedlivingallowanceandotherbenefitstoeligiblesecondaryandtertiaryAboriginalandTorresStraitIslanderstudentsandapprentices.
10
hIgher eduCAtIon And voCAtIonAl eduCAtIon And trAInIngTheAustralianGovernmentprovidesfinancialassistancetohighereducationinstitutionstoimproveoutcomesforAboriginalandTorresStraitIslanderpeopleandfundsarangeofprogramsthatareaimedatincreasingAboriginalandTorresStraitIslanderparticipationinhighereducation,including:
• theIndigenous Youth Careers Pathway Program,whichprovidessupporttoAboriginalandTorresStraitIslanderstudentsinYears11and12tostayinschoolandundertakeschool-basedtraineeships.6,400traineeshipswillbeoffered,toincreasethenumberofyoungpeopletransitioningfromschoolintofurthereducationandtraining.Fundingof$50.7millionhasbeenallocatedoverfouryearsuntil2014-15fortheprogram;
• Away From Base,whichcoverstravelcostsforVocationalEducationTraining(VET)andhighereducationstudentsstudyinganapproved‘mixed-mode’course,wherestudentsarerequiredtotravelfromtheirpermanenthomeforshortperiodstoundertakeapprovedcourse-relatedactivities;
• theIndigenous Support Program,whichprovidesgrantstohighereducationproviderstoassistthemtomeettheneedsoftheirAboriginalandTorresStraitIslanderstudents.ThisincludestheestablishmentofIndigenousEducationSupportUnits,assistancewithstudyskills,personalcounsellingandculturalawarenessactivities;
• theIndigenous Tutorial AssistanceScheme for Tertiary Tuition,whichprovidesfundingforsupplementarytuitiontoAboriginalandTorresStraitIslanderstudentsstudyinguniversityaward-levelcourses,andsomespecifiedAustralianQualificationsFrameworkaccreditedVETcoursesatIndigenousTutorialAssistanceSchemefundedinstitutions;
• theIndigenous Tutorial Assistance Scheme for Vocational Education Training,whichisavailabletoeligiblenon-governmentVETinstitutionstoassistAboriginalandTorresStraitIslanderstudentsundertakingVETcoursesleadingtotheattainmentofaCertificateLevelIIIorabovequalification;
• Supplementary Recurrent Assistancewhichprovidessupplementarypercapitafundingtonon-governmenteducationprovidersintheVETandpreschoolsector;and
• Arangeofawardsandscholarships,suchas:
> Endeavour Research Fellowships for Indigenous Australians,whichprovidesfinancialsupportforAboriginalandTorresStraitIslanderpostgraduatestudentsandpostdoctoralfellowstoundertakeshort-termresearch(4–6months)inanyfieldofstudyintheAsia-PacificorMiddleEast;
> Excellence in Leadership in Indigenous Education Awards,anacknowledgementofoutstandingworkandleadershipinAboriginalandTorresStraitIslandereducation,whicharepresentedtoschoolsthatexcelacrossallcriteria;
> Commonwealth Scholarships,whichprovidefinancialsupporttoeligibleAboriginalandTorresStraitIslanderstudentstoassistwiththecostsassociatedwithhighereducation;and
> Indigenous Staff Scholarships,whichprovideprofessionaldevelopmentopportunitiestoAboriginalandTorresStraitIslanderstaffworkingatuniversities.
11
health Workforce education and training
HealthWorkforceAustraliahasbeenfundedtosupporttheupskillingofAboriginalandTorresStraitIslanderHealthWorkersinregionalandremoteareas,toassistthemtoachievenewnationalregistrationrequirementswhichcommencedinJuly2012.Theprojecthasthreeelements:
• totrainseniorAboriginalandTorresStraitIslanderHealthWorkersinthenationallyaccreditedVETCertificateIVinTrainingandAssessment(TAE40110)toenablethemtosuperviseandassessAboriginalandTorresStraitIslanderHealthWorkersundertakingtheirtraining.Inparticular,empoweringtheroleofqualifiedon-sitementorsandassessorstosupportstudentsinhealthservicesisanessentialcomponenttothesuccessfulcompletionoftraining;
• toundertakeskillsrecognitionandgaptrainingforAboriginalandTorresStraitIslanderHealthWorkersacrossAustraliatomeetnationalAboriginalandTorresStraitIslanderHealthPractitionerregistrationrequirements;and
• toincreasethenumberofRegisteredTrainingOrganisationswhichmeettheaccreditationstandardsforthedeliveryoftheCertificateIVAboriginaland/orTorresStraitIslanderPrimaryHealthCare(Practice)requiredforAboriginalandTorresStraitIslanderHealthWorkerPractitionerregistrationafter1July2012.
review of higher education Access and outcomes for Aboriginal and torres strait Islander people
TheReportoftheReview of Higher Education Access and Outcomes for Aboriginal and Torres Strait Islander Peoplehighlightstherolethathighereducationplaysinimprovinghealth,educationandeconomicoutcomesforAboriginalandTorresStraitIslanderpeopleandrecommendsacollaborativeapproachbygovernments,universitiesandprofessionalbodiestoincreasingthenumberofAboriginalandTorresStraitIslanderstudents,staffandresearchers.
housIng
healthy homes
Ahealthyhomeisafundamentalpreconditionofahealthypopulation.Importantcontributorstocurrentunsatisfactorylivingconditionsincludeinadequatewaterandseweragesystems,wastecollection,electricityandhousinginfrastructure(design,stockandmaintenance).Childrenneedtoliveinaccommodationwithadequateinfrastructureconducivetogoodhygieneandstudyandfreeofovercrowding.8
envIronmentAl heAlthTheAustralianGovernmentisproviding$44.1millionfrom2013-14tocontinuetosupportthedeliveryofmunicipalandessentialservicesforAboriginalandTorresStraitIslanderpeopleinabout340remotecommunities.Thisfundingisinadditiontothe$206.4millioninvestmentover10yearstosupportthedeliveryofmunicipalservicesforoutstationsandhomelandsintheNorthernTerritory,underStronger Futures in the Northern Territory.$21.2millionoverfouryearsfrom2012-13isbeingprovidedtowardsarangeofenvironmentalhealthinfrastructureprojectsintheTorresStraitrelatedtowatersupplyandreticulation,sanitationandwastewater,communityroaddrainageandservicedhousinglots.
ACCommodAtIon And housIngCOAGhasidentifiedhousingaffordabilityasapressingissueforAustraliansandrecognisedtheimportanceofimprovingaffordabilityandaccesstosafeandsustainablehousing,includinginAboriginalandTorresStraitIslandercommunities.TherehavebeenarangeofCOAGagreementstosupporttheachievementoftheseoutcomesincluding:
• theNational Affordable Housing Agreement;
• theNational Partnership Agreement on Homelessness;and
buIldIng bloCk
12
• theNational Partnership Agreement on Remote Indigenous Housing.
ThroughtheNational Affordable Housing Agreement,theAustralianGovernmentandstateandterritorygovernmentshavecommittedtoachievingIndigenous-specificoutcomes,including:
• AboriginalandTorresStraitIslanderpeoplehavethesamehousingopportunitiesasotherAustralians;and
• AboriginalandTorresStraitIslanderpeoplehaveimprovedhousingamenitiesandreducedovercrowding,particularlyinremoteareasanddiscretecommunities.
SpecificinitiativesfundedundertheNational Partnership Agreement on Homelessness includeAboriginalandTorresStraitIslanderadvocacyandtenancysupportservices,assistanceforAboriginalandTorresStraitIslanderyoungpeopleleavingcare,legalassistanceforAboriginalandTorresStraitIslanderwomenandoutreachforindividualsandfamiliesexperiencingroughsleeping.
TheNational Partnership Agreement on Remote Indigenous Housing($5.5billionovertenyearsto2018),seekstoaddresskeyenvironmentalhealthandhousingissuesincluding:
• significantovercrowding;
• homelessness;
• poorhousingconditions;and
• severehousingshortagesinremoteAboriginalandTorresStraitIslandercommunities.
FundingisbeingprovidedtothestatesandtheNorthernTerritoryover10yearsto2018to:
• deliverupto4,200newhousesandrebuildorrefurbisharound4,800existinghousesinremoteAboriginalandTorresStraitIslandercommunitiesaroundAustralia;
• deliveremployment-relatedaccommodationinregionalareastoenableAboriginalandTorresStraitIslanderpeoplefromremotecommunitiestoaccesstraining,education,employmentandsupportservices;and
• provideAboriginalandTorresStraitIslanderemploymentopportunitiesthrougha
20percentlocalIndigenousemploymenttargetoverthelifeoftheprogramfornewhousingconstruction.
Inaddition,long-termstructuralreformswillputremoteAboriginalandTorresStraitIslanderhousingonamoresustainablefootingbyensuringthat:
• securetenurearrangementsareputinplaceasapre-conditiontonewhousing;
• standardtenancymanagementarrangementsexistsothatrentscanbecollectedandrepairsandmaintenancecarriedout;and
• tenantsofnewhousesreceivelivingskillstrainingtotransitiontonewtenancyarrangementsandtohelpthemunderstandtheirrightsandresponsibilities.
Sofar,underthisAgreementover5,300homesinremoteAboriginalandTorresStraitIslandercommunitieshavebeenrefurbishedorrebuiltagainstatargetof4,876homes,significantlyexceedingtherefurbishmenttargettwoyearsaheadofschedule.Todatemorethan1600homeshavebeenconstructed,onthewaytomeetthetargettoconstruct4,200homesby2018.
AboriginalHostelsLimited’s(AHL’s)primarypurposeistoprovideAboriginalandTorresStraitIslanderpeoplewithsafe,comfortable,affordableandculturallysensitiveaccommodation.ThisaccommodationenablesAboriginalandTorresStraitIslanderpeopletoaccessessentialservicessuchaseducation,health,legaladvice,trainingandemploymentthatmightnototherwisebeavailableintheirhomecommunities,andoperateswithanincreasedemphasisonsupportingbettereconomicandsocialoutcomes,throughworkinginpartnershipwithotherorganisations.In2013-14,theAustralianGovernmentwillbeprovidingAHLwith$6.2millionovertwoyearstoundertakecapitalupgradestonineofitshostels.
TheIndigenous Home Ownership Programwillassistapproximately2,200AboriginalandTorresStraitIslanderpeopletobuytheirownhomeoverfouryearsfromJuly2013,byprovidingarangeofconcessionalhomeloansandpriorityofaccessandextraassistanceforapplicantspurchasinghomesonAboriginalandTorresStraitIslanderland.
13
eConomIC development, pArtICIpAtIon And employment
economic participation
Individualsandcommunitiesshouldhavetheopportunitytobenefitfromthemainstreameconomy–realjobs,businessopportunities,economicindependenceandwealthcreation.Economicparticipationneedstoextendtodisadvantagedjobseekersandthoseoutsideofthelabourmarket.Accesstolandandnativetitleassets,rightsandinterestscanbeleveragedtosecurerealandpracticalbenefitsforIndigenouspeople.Otherfinancialassets,capacitybuilding,employmentandtrainingprograms,incentivestructuresandsocialandphysicalinfrastructure,includingcommunicationsandtransport,areneededtofostereconomicparticipationandcommunityengagement.
Throughthisparticipation,parentsandotheradultscanbecomeeffectiverolemodelsfortheirfamiliesandcommunity.Thedesignanddeliveryofwelfare(bothtransferpaymentsandservices)needstopromoteactiveengagement,enhancedcapabilityandpositivesocialnorms.Ensuringthatcommunitieshavesupporttoaddressfactorsthatareabarriertoengagementsuchasproblemgamblingiscritical.Life-longlearningisimportantandattentionisalsoneededregardingadultliteracyandnumeracyskills.9
Closing the gap target
• TohalvethegapinemploymentoutcomesbetweenIndigenousandotherAustralians(by2018).
eConomIC developmentTheIndigenous Economic Development Strategy 2011–2018 isanAustralianGovernmentpolicyframeworkthataimstoincreasethepersonalandeconomicwellbeingofAboriginalandTorresStraitIslanderpeoplethroughgreaterparticipationintheeconomy.TheStrategyhasfivepriorities:
• strengthenfoundationstocreateanenvironmentthatsupportseconomicdevelopment;
• investineducation;
• encourageparticipationandimproveaccesstoskillsdevelopmentandjobs;
• supportthegrowthofAboriginalandTorresStraitIslanderbusinessandentrepreneurship;and
• assistindividualsandcommunitiestoachievefinancialsecurityandindependence.
eConomIC pArtICIpAtIon And employmentJobServicesAustraliaistheAustralianGovernment’snationalemploymentservicessystemandisthemainproviderofemploymentservicesforAboriginalandTorresStraitIslanderjobseekers.TheGovernmentlaunchedJobServicesAustraliaon1July2009withtheaimofincreasingemploymentparticipation,buildingskillsindemandandhelpingindividualjobseekers,particularlydisadvantagedparticipants,findsustainableemployment.JobServicesAustraliaprovidersworkwithlocalcommunitiestodevelopjobsandtrainingopportunities.
TofurtherenhanceJobServicesAustraliaachievementsforAboriginalandTorresStraitIslanderjobseekers,theGovernmenthasputinplacevariousmeasures,including:
buIldIng bloCk
14
• theIndigenous Mentoring Pilot:thePilotcommencedon1July2012andaimstodetermineifongoingculturallyappropriatementoringsupportwillassistinimprovingretentionratesforAboriginalandTorresStraitIslanderjobseekers;and
• culturalawarenesstraining:theGovernmenthasdevelopedanonlineculturalawarenesstrainingpackageforproviderstofurtherstrengthentheperformanceofJobServicesAustraliaandDisabilityEmploymentServices(DES)forAboriginalandTorresStraitIslanderjobseekers.
DESistheAustralianGovernment’snationalemploymentserviceforpeoplewithdisability.TheGovernmentlaunchedDESon1March2010withtheaimofprovidingtailoredassistancetoindividualswithinjury,disabilityorahealthconditiontosecureandmaintainsustainable,openemployment.DESprovidesemploymentservicesforeligibleAboriginalandTorresStraitIslanderparticipantswhoarelocatedinnon-remoteareas.
Whererequired,DESoffersongoingsupportintheworkplacetohelpparticipantsretaintheiremployment.DESisalsofocusedontheneedsofemployers,providingparticipantswiththeskillsandtrainingtomeetemployerneeds.Providershelpbuilddisabilityconfidenceintheworkplaceandsupportemployerstomaintainqualityandsustainableoutcomesforpeoplewithdisability,includingwhereappropriate,arrangingworkplacemodificationsthroughtheEmployment Assistance Fund.DESproviderscanalsoaccessassistancetosupportemployerstoemploypeoplewithdisabilitythroughtheSupported Wage System, Wage Subsidy SchemeandtheNational Disability Recruitment Coordinator.
DESofferstwodemand-drivenprogramstohelppeoplewithinjury,disabilityorhealthconditionstofindandretainopenemployment:
• Disability Management Service,whichprovidesservicestoeligiblejobseekerswithtemporaryorpermanentinjury,disabilityorahealthconditionwhorequiretheassistanceofadisabilityemploymentserviceandwhomayrequireflexible,ongoingsupportbutarenotexpectedtoneedregular,long-termsupportintheworkplace;and
• Employment Support Service,whichisavailabletothoseeligiblejobseekerswithpermanentdisabilitywhoareassessedasneedingregular,long-term,ongoingsupportintheworkplace.TheGovernmentputtheEmployment Support Serviceouttoopencompetitivetenderforthefirsttimeinlate2012.Theresultofthetendermeansjobseekerswithdisabilitynowhaveaccesstoahigherstandardofsupport,inmorelocationsthaneverbefore.
TheIndigenous Employment Program(IEP)fundsarangeofactivitiesinurbanandregionalAustraliathat:
• encourageandsupportemployerstoprovidesustainableemploymentopportunitiesforAboriginalandTorresStraitIslanderpeople;
• encourageandsupportAboriginalandTorresStraitIslanderpeopletotakeuptrainingandemploymentopportunitiestostayinjobsandenhancetheirfutureemploymentprospects;
• assistAboriginalandTorresStraitIslandercommunities,industrybodiesandgroupsofemployerstodevelopIndigenousworkforceandeconomicdevelopmentstrategiesthatsupportregionaleconomicgrowth;and
• assistAboriginalandTorresStraitIslanderpeopletodevelopsustainablebusinessesandeconomicopportunitiesinurbanandregionalareas.
15
On1July2013theIEP,alongwiththeDES,CommunityDevelopmentEmploymentProjects(CDEP)andJobServicesAustralia,transitionedintotheRemote Jobs and Communities Program(RJCP)inremoteareas.TheRJCPbuildsonthestrengthsofthesefourprogramsinremoteAustralia,deliveringamorestreamlinedandflexibleapproach,providingbetterparticipationandemploymentservicesforpeoplelivinginremoteAustralia.
UndertheRJCP:
• providershaveapermanentpresenceineachofthe59identifiedremoteregionsacrossAustralia,andareasingle,localpointofcallforjobseekersandemployers;
• a‘jobsfirst’approachistakenwhichhelpspeoplebuildthefoundationalskillstheyneedtotakeupavailablejobsandsupportscommunitydevelopment.Jobseekersareprovidedwithpersonalisedsupportandcasemanagement,includingaccesstojobopportunities,skillsdevelopmentandtrainingthatmeetstheirneeds;
• RJCPprovidersworkwithcommunities,employersandindustriesintheirregiontodevelopandimplementaCommunityActionPlanthatidentifiestheregion’semployment,economicandcommunitydevelopmentgoals;
• the$500millionParticipationAccountisaflexiblefundthatcanbeusedtopurchasereasonableinterventionsthatincreaseaRJCPparticipant’semployability,overcomevocationalandnon-vocationalbarrierstoemploymentorfundeconomicdevelopmentandbusinesssupport;
• $237.5millionoverfiveyearsfrom1July2013fortheCommunityDevelopmentFundwillsupportprojectsthatprovideemploymentandparticipationopportunitiesforlocalpeoplethatareconsistentwiththedirectionoftheregion’sCommunityActionPlan;
• theAustralianGovernmenthasextendedthepaymentofCDEPwagesuntil30June2017forparticipantscurrentlyreceivinggrandfatheredCDEPwages;and
• youngpeopleinremotecommunitiesarebenefitingfroman$89millioninvestmentintheRemoteYouthDevelopmentandLeadershipCorps,whichisproviding12,000youngpeopleaged24yearsandunderwithaclearpathwayintoemploymentinremotecommunities.
TheAboriginalandTorresStraitIslanderartsandculturalsectorsarecreativeindustriesbuildingonuniquelyAboriginalandTorresStraitIslanderassetsandprovidingmeaningfulemploymentopportunitiesforAboriginalandTorresStraitIslanderpeople.Forexample,artcentres,particularlyinremotecommunitiesareoftenamajorsourceofincome.TheAustralianGovernmentisprovidingongoingfundingtogenerateincomeandemploymentopportunitieswhilemaintainingandtransmittingculturethrough:
• Indigenous Visual Arts Industry Supportfunding,whichwillprovidearound$48.8millionoverfouryearsfrom2013-14tosupportAboriginalandTorresStraitIslanderartcentresandindustrysupportorganisations,inordertohelpbuildastrongerAboriginalandTorresStraitIslandervisualartsindustry;and
16
buIldIng bloCk
• the Indigenous Employment Initiativeintheartsandculturalsectors,whichwillprovidearound$89.4millionoverfouryearsfrom2013-14toIndigenousarts,culture,languageandbroadcastingorganisationstoemploycloseto600AboriginalandTorresStraitIslanderpeopleannuallyinrolessuchasartworkers,culturalofficers,languageassistantsandbroadcastingtechnicians.ThesejobsaredirectlyhelpingtolinkAboriginalandTorresStraitIslanderculturetothemainstreameconomyandsociety.
TheWorking on Country Indigenous Ranger Program,whichcommencedin2007,hasacommitmentof$244millionuntilJune2013toemployover690Indigenousrangerstoundertakeenvironmentalwork.From1July2013anadditional$335millionhasbeencommittedoverfiveyearstosupporttheworkoftherangersandsupporttheexpansionoftheprogramto730rangersbyJune2015.TheWorking on Country Indigenous Ranger Programaimstoencourageanactiveconnectiontocountry,whichhasapositiveimpactonhealth,economicandsocialwellbeing,andenablesculturallearningbetweenyoungandold.
sAfe CommunItIes
safe Communities Indigenouspeople(men,womenandchildren)needtobesafefromviolence,abuseandneglect.Fulfillingthisneedinvolvesimprovingfamilyandcommunitysafetythroughlawandjusticeresponses(includingaccessibleandeffectivepolicingandanaccessiblejusticesystem),victimsupport(includingsafehousesandcounselling),childprotectionandalsopreventativeapproaches.Addressingrelatedfactorssuchasalcoholandsubstanceabusewillbecriticaltoimprovingcommunitysafety,alongwiththeimprovedhealthbenefitstobeobtained.10
JustICeToreducetheoverrepresentationofAboriginalandTorresStraitIslanderpeopleinthejusticesystem,theNational Indigenous Law and Justice Framework 2009–2015providesanationalapproachtoaddressseriousandcomplexissuesthatexistforAboriginalandTorresStraitIslanderpeopleinthecriminaljusticesystem.
TheIndigenous Justice Program(IJP),fundedbytheAustralianGovernment,seekstoincreasecommunitysafetyforAboriginalandTorresStraitIslanderpeoplebyfundingprojectsdesignedtoreducetheadversecontactofAboriginalandTorresStraitIslanderpeoplewiththecriminaljusticesystem.Theseprojectsmakecommunitiessaferbyreducingtheratesofoffending,andthroughthatreducevictimisationandincarcerationofAboriginalandTorresStraitIslanderpeople.IJPhasanationalfocusandseekstocomplementstateandterritoryinitiatives.Fundingisprovidedforprisonerthroughcare,youthpreventionanddiversion,communitypatrolsandrestorativejusticeprojects.In2012-13,fundingfortheIJPwas$11.66million,with40projectsbeingfunded.In2013-14,fundingtotals$11.95million.
17
legAl servICesTheFamily Violence Prevention Legal Services Programprovidesculturallyappropriateassistancetovictim-survivorsoffamilyviolenceandsexualassault,toprevent,respondtoandreducetheincidenceoffamilyviolenceandsexualassault.Fourteenorganisationsprovideservicesfrom30outletsinallstatesandterritories,exceptTasmaniaandtheACT,tohigh-needrural,regionalandremotelocations.FundingfortheFamily Violence and Prevention Legal Services Programin2012-13was$19.09million.Fundingin2013-14is$19.6million.
TheIndigenous Legal Assistance and Policy Reform Programoffersculturallysensitiveandaccessiblelegalassistanceservices.AboriginalandTorresStraitIslanderorganisationsarefundedundertheprogramtodeliverlegalassistanceservicesatanumberofpermanentsites,courtcircuitsandoutreachlocationsinurban,ruralandremotesareas.Fundingfortheseorganisationsin2012-13was$68.22million,andfundingin2013-14is$73.84million,whichincludesnewfundingof$12millionidentifiedinthe2013-14AustralianGovernmentBudgettobeprovidedovertwoyears.
TheAustralianGovernmentalsofundsCommunityLegalCentres(CLCs),whichareindependentandcommunitymanagednon-profitservicesthatprovidearangeofassistanceonlegalandrelatedmatterstopeopleonlowincomesandthosewithspecialneeds.WhilstnotallAustralianGovernmentfundingprovidedundertheCommunity Legal Services ProgramistargeteddirectlytowardAboriginalandTorresStraitIslandermatters,anumberofCLCsdoprovideservicestoAboriginalandTorresStraitIslanderclients.
CommunIty sAfetyThe Indigenous Family Safety Agenda,theNational Plan to Reduce Violence against Women and their ChildrenandtheNational Framework for Protecting Australia’s Childrenacttosupportsafecommunitiesandaimtoimprovecommunitywellbeingandreducetheprevalenceofinjury.
UndertheStronger Futures in the Northern Territorypackage,fundingof$619millionisbeingprovidedbytheAustralianGovernmentoverthe10yearperiodfrom1July2012tosupportincreasedcommunitysafetyinNorthernTerritoryAboriginalcommunities.Aspartofthisfunding,theAttorney-General’sDepartmentadministerstheCommunity Night Patrol Program.Patrolsundertakeactivitiessuchassafetransportation,referraltoinformationandservices,andearlyinterventiontoimprovecommunitysafetyandpreventunnecessaryadversecontactwiththecriminaljusticesystem.Peopleatriskofcommittingorbecomingavictimofharmcanbetakentoasafeplacewheretheirneedscanbeassessed,and,whereappropriate,referredtootherservicesforfurtherassistance.FundingfortheprogramisallocatedthroughtheCommunity Safety and Justice Measure($28.83millionin2012-13and$29.29millionin2013-14)andincludessupportforsupplementarylegalservices.
buIldIng bloCk
Investments to Improve the enAblers to heAlth
A CulturAlly respeCtful And non-dIsCrImInAtory heAlth system
health
IndigenousAustralians’accesstoeffective,comprehensiveprimaryandpreventativehealthcareisessentialtoimprovingtheirhealthandlifeexpectancy,andreducingexcessmortalitycausedbychronicdisease.AllhealthservicesplayanimportantroleinprovidingIndigenouspeoplewithaccesstoeffectivehealthcare,andbeingresponsivetoandaccountableforachievinggovernmentandcommunityhealthpriorities.ClosingtheIndigenoushealthgaprequiresaconcertedeffortintheprevention,managementandtreatmentofchronicdisease.Indigenouschildrenandtheirparentsneedtoaccessprogramsandservicesthatpromotehealthylifestyles.11
Closing the gap targets
• Toclosethegapinlifeexpectancywithinageneration(by2031);and
• TohalvethegapinmortalityratesforIndigenouschildrenunderfive(by2018).
TheDepartmentofHealthandAgeingprovidesfundingtoAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationsfortheprovisionofhealthcareservicestoAboriginalandTorresStraitIslanderpeople.IncreasingtheaccessofAboriginalandTorresStraitIslanderpeopletoqualityprimaryhealthcareservicesthatareculturallysafeandareplannedanddeliveredaccordingtoatransparentneedsassessment,isapriority.TheDepartmentofHealthandAgeingisalsocurrentlydevelopingawiderangeofculturallyappropriatetrainingresourcesforAboriginalandTorresStraitIslanderagedandcommunitycareworkers.
TheNationalCongressofAustralia’sFirstPeoplesgivesAboriginalandTorresStraitIslanderpeopleastrongnationalvoiceonissuesthataffectthem.TheGovernmentcontinuestosupportAboriginalandTorresStraitIslanderrepresentationwithafurther$15millionbeingprovidedoverthreeyearsfrom2014-15.
Since1997,theDepartmentofHealthandAgeinghasfundedtheNationalAboriginalCommunityControlledHealthOrganisation(NACCHO)asthenationalpeakbodyforAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisations.NACCHOhasapproximately150membersnationwide,comprisingmainlyofprimaryhealthcareorganisations.
TheDepartmentprovidesfundingtoNACCHOto:
• providesupportandassistancetoAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisations;
• representandadvocateonbehalfofitsmemberorganisations;and
• provideadviceandpolicyviewsonhealthissuesaffectingAboriginalandTorresStraitIslanderpeople.
Inadditiontoprovidingcorefundingfortheactivitiesnotedabove,theDepartmentofHealthandAgeingalsoprovidesfundingtoNACCHOforspecificprojectssuchas:
• NACCHO Governance - tofacilitatepartnershipsthatcontributetogovernanceenhancementintheAboriginalandTorresStraitIslandercommunitycontrolledhealthsector;
18
19
• Smoke Free - toprovideleadershipandsupportacrossallAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationsastheydevelop,implementandmonitoreffectivesmoke-freepoliciesandbecomesmoke-freeworkplaces;
• Ear Health - toprovideearhealthandhearingscreeningtrainingtoAboriginalandTorresStraitIslanderHealthWorkers.
• Indigenous Chronic Disease -toemployanIndigenousHealthProjectOfficertosupporttheimplementationofarangeofIndigenous Chronic Disease Package(ICDP)measuresrelevanttotheAboriginalandTorresStraitIslandercommunitycontrolledhealthsector;and
• Telehealth Support Program - toenhanceAboriginalandTorresStraitIslanderpeople’saccesstospecialiststhroughtheprovisionofsupportforqualityTelehealthfacilitatedpatientconsultationsusingvideoconferencingfacilitieswithinAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisations.
Whileaculturallycompetenthealthsystemiscritical,sustainablechangestoaddressracismmustbereinforcedbybroadersystemicactionacrossarangeofsettings.
TheAustralianGovernmentisaddressingracismthroughanumberofinitiatives,includingtheNational Anti-Racism Strategy,whichaimstopromoteaclearunderstandingintheAustraliancommunityofwhatracismis,andhowitcanbepreventedandreduced.
Inadditiontotheseinitiatives,inFebruary2013,theAustralianGovernmentannouncedfundingforReconciliationAustraliaof$14.4millionoverfouryearsfrom2013-14topromotereconciliationandbuildstrongerrelationshipsbetweenAboriginalandTorresStraitIslanderandnon-IndigenousAustralians.InJuly2012,theAustralianGovernmentalsoprovided$10milliontoReconciliationAustraliaovertwoyearstopromotepublicawarenessandcommunitysupportforAboriginalandTorresStraitIslanderconstitutionalrecognition.$1.3millionovertwoyearswillbeprovided
tosupporttheJointSelectCommitteeonConstitutionalRecognitionofAboriginalandTorresStraitIslanderPeoples.
heAlth system effeCtIveness And ClInICAlly ApproprIAte CAre
prImAry heAlth CAreUndertheNational Health Reform Agreement(August2011),itwasagreedthattheCommonwealthandthestateswillworktogetheronsystem-widepolicyandstate-wideplanningforgeneralpracticeandprimaryhealthcaregiventheirimpactontheefficientuseofhospitalsandotherstate-fundedservices,andtosupporteffectiveintegrationacrossAustralianGovernmentandstate-fundedhealthservices.
InApril2013,theAustralianGovernmentandthestatesfinalisedtheNational Primary Health Care Strategic Framework.TheFrameworksetsoutagreedfuturepolicydirectionsandpriorityareasforprimaryhealthcareincludingthefollowingfourstrategicoutcomes:
• buildaconsumer-focusedintegratedprimaryhealthcaresystem;
• improveaccessandreduceinequity;
• increasethefocusonprevention,screeningandearlyintervention;and
• improvequality,safety,performanceandaccountability.
Thesestrategicoutcomes,whichhaveparticularrelevanceforvulnerableandhardtoreachpopulationgroupsincludingAboriginalandTorresStraitIslanderAustralians,willbethefocusofthebilateralplansforeachstateandterritory,whichwillsupporttheimplementationoftheFramework.
ImprovIng ACCessTheabilitytoaccesshealthservices,includingtheservicesofspecialistsandalliedhealthprofessionals,isessentialtoimprovinghealthoutcomesforAboriginalandTorresStraitIslanderpeople.Arangeoffactors(bothbarriers
20
andenablers)affectAboriginalandTorresStraitIslanderpeople’saccesstohealthcareservicesincludinggeography,cost,appropriatecommunication,therelationshipbetweenprimary,secondaryandtertiaryhealthservices(coordinatedcare),theavailabilityofspecialistsandalliedhealthprofessionals,varyinglevelsofculturalcompetencyacrossthehealthsystem,healthworkforceandtransport.12
The Quality Assurance for Aboriginal and Torres Strait Islander Medical Services(QAAMS)pathologyprogramsupportsbettermanagementofdiabetesinAboriginalandTorresStraitIslandercommunitiesbyenablingparticipatingAboriginalMedicalServicesandAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationsinpredominantlyruralandremoteareasacrossAustraliatoprovideculturallyappropriateandclinicallyeffective‘point-of-care’diabetes-relatedpathologytestingonsite.
TheICDPincludesinitiativestoprovidefinancialincentivesforaccreditedprimaryhealthcareservicestoimprovethequalityofcareincludingbestpracticemanagementofchronicdisease.Thepackagealsoaimstoincreaseaccesstoessentialfollow-upservicessuchasalliedhealth,specialistcareandPBSmedicines.
AspartoftheICDP,fundinghasbeenprovidedtoAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationsandMedicareLocalstoemployAboriginalandTorresStraitIslanderOutreachWorkers(OutreachWorkers).OutreachWorkerswillencourageandsupportAboriginalandTorresStraitIslanderpeopleto
accessprimaryhealthcareservicesandhelpensurefollowuptreatmentisaccessed.Thismayincludeassistingpeopletotraveltoandfromappointments.IndigenousHealthProjectOfficerpositionsarealsobeingfundedtoprovideleadershipinAboriginalandTorresStraitIslanderhealthissueswithintheMedicareLocalsnetworkandNACCHOanditsaffiliates,includingincreasedawarenessandunderstandingofthevariousClosing the Gapinitiativesrelevanttomainstreamprimarycare.
ThePractice Incentives Program - Indigenous Health IncentivesupportsgeneralpracticesandAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationstoprovidebetterhealthcareforAboriginalandTorresStraitIslanderpeople,includingbestpracticemanagementofchronicdisease.Incentivesareofferedforpracticesto:identifyAboriginalandTorresStraitIslanderpatientswithchronicdisease;undertakeandreviewchronicdiseasemanagementplans;andprovideatargetlevelofcare.
21
Access to pharmaceuticals
TheAustralianGovernmentiscommittedtoensuringAboriginalandTorresStraitIslanderpeoplehavetimelyandaffordableaccesstoPBSmedicines,aswellasQualityUseofMedicines(QUM)andmedicationmanagementsupportservices.Inrecognitionofthis,anumberofprogramshavebeenimplementedinremote,urbanandrurallocations.ThePBSalsohasarangeofmedicinesthathavebeenlistedspecificallytohelpwiththehealthneedsofAboriginalandTorresStraitIslanderpeople.
The Remote Section 100 Remote Area Aboriginal Health Service (RAAHS) ProgramisadministeredunderSection100(s100)oftheNational Health Act 1953andallowsforthesupplyofPBSmedicinestoclientsofeligibleremoteareaAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationsatthetimeofmedicalconsultationwithouttheneedforanormalprescriptionform,andwithoutcharge.TheProgramaimstoaddressidentifiedbarriersexperiencedbyAboriginalandTorresStraitIslanderpeoplelivinginremoteareasofAustraliainaccessingessentialmedicinesthroughthePBS.
TheSection 100 Pharmacy Support AllowancefinanciallysupportsvisitsbypharmaciststoprovidearangeoftargetedQUMandmedicationmanagementsupportservicestoremoteareaAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationswhoparticipateinthes100RAAHSProgram.TheProgramaimstoassistinimprovinghealthoutcomesforclientsbysupportingQUMatthoseservicesthroughpharmacistvisitsandadvice.
TheQuality Use of Medicines Maximised for Aboriginal and Torres Strait Islander Peoples (QUMAX) ProgramisaQUMsupportinitiativethataimstoimprovehealthoutcomesforAboriginalandTorresStraitIslanderpeople.ThefocusoftheQUMAXProgramistoimproveQUMthrougharangeofsupportservicesprovidedtoAboriginalandTorresStraitIslanderpatientsthroughparticipatingAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationsandcommunitypharmaciesin
ruralandurbanAustralia.TheQUMsupportservicesincludeDoseAdministrationAids,QUMdevices(e.g.asthmaspacers),andQUMeducationtoclientsandstaffofAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisations.
Addressing geographic barriers to Accessing health Care
ArangeofprojectshavebeenfundedundertheHealthandHospitalsFund(HHF)toassistinclosingthegapinhealthoutcomesbetweenAboriginalandTorresStraitIslanderandnon-IndigenousAustralians.21oftheseprojects,withatotalvalueofwellover$200million,specificallytargetAboriginalandTorresStraitIslandercommunitiesandthereareanumberofotherprojectsthatareexpectedtohaveasignificantimpactonimprovinghealthoutcomesforAboriginalandTorresStraitIslanderpeople.
regional Cancer Centres
TheAustralianGovernmentisinvestingatotalof$672millioninanationalnetworkof25regionalcancercentreprojectstohelpclosethegapincanceroutcomesbetweenthecityandthecountry.Thisunprecedentedinvestmentwilldramaticallyimproveaccesstoessentialcancercareservicesformanypeople,includingAboriginalandTorresStraitIslanderpeople.11ofthe25regionalcancercentreprojectsarecompleted,oralmostcompleted,andareoperational.13projectsareunderconstruction,withsixoftheseanticipatedtobecompletedby30June2014.
transport
AboriginalandTorresStraitIslandercommunitiesfacevariouschallengesinrelationtotransport.Thesechallengeshaveabroaderimpactonsocialandeconomiccircumstances,andspecificimpactsonaccesstohealthservicesparticularlyinregionalandremoteareasofAustraliawherepatientsmayneedtotravellongdistancestoaccesscare.
Aeromedicalservicescanplayakeyroleindeliveringemergencycareandtransportingpatientstohospitalsinlargeregionalcentresandmetropolitanareas.Tosupportthedeliveryoftheseservices,theAustralianGovernmentisproviding$59.4millionfrom2008-09to2014-15toupgraderegionalandremoteaerodromesthroughtheRegional Aviation Access Program. The Remote Aerodrome Upgrade Program,afundingcomponentoftheRegional Aviation Access Program,providesfundingwhichwillassisttheownersofremoteairstripsforcapitalworksprojectstoimprovethesafetyandaccessibilityofairstripsandfacilitatetheprovisionofnon-commercialessentialcommunityairservices.Theseairstripssupportflightsessentialtoremotecommunitiessuchasthosedeliveringfreshfoodandmail,transportingresidentsandemergencypersonnel,andtheRoyalFlyingDoctorService.TheAustralianGovernmentalsoprovides$1millionperannumthroughtheAirservices Australia Enroute Charge Payment Schemetoassistaeromedicaloperatorswiththecostofoperatinginremotelocations.Inaddition,theAustralianGovernmentprovidessupportfordriversafetyandroadmaintenanceandupgradeprogramsinremotepartsofAustralia,toaddressthenegativeimpactsoftransportuse,includingmotorvehicleaccidents.
e-health and telehealth
Thedevelopmentandimplementationofe-Health,theelectronicmanagementofhealthinformation,willalsosupportthedeliveryofsafer,moreefficientandhigherqualityhealthcare,helpingtoaddressexistingbarrierssuchasinformationsilos,geographicdistanceorhealthsectorboundaries.E-HealthincludesthePersonallyControlledElectronicHealthRecord(PCEHR),whichenablesthoseindividualswhovoluntarilyregisterforaPCEHR,andtheirauthorisedhealthcareproviders,toaccessasummaryofkeyhealthinformationonlinewhenandwhererequiredprovidingtheindividualwithhealthcare.Thisisparticularlyhelpfulforhighlymobileindividualswhoseekhealthcarefromarangeofdifferenthealthcareprovidersindifferentlocations.
Telehealthisalsoimprovingaccesstospecialisthealthcareservicesforpatientswholiveinregional,ruralandremoteareas.Insteadofhavingtotraveltothenearestmajorcitytoseeaspecialist,anincreasingnumberofpatientsareusingvideo-conferencing.Medicare-fundedhealthservicesareavailableforvideoconsultationswithspecialistsandarealsoavailabletopatientsofeligibleAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationsacrossAustralia.
The National Partnership Agreement for Remote Indigenous Public Internet Access Training and MaintenancewillprovidesupportforAboriginalandTorresStraitIslandercommunitiestoaccessgovernmentservicesonline,inanefforttoreducegeographicalisolationandimproveserviceaccess.TheAustralianGovernmentwill
22
23
becontributing$6.5millionoverthreeyearsto30June2016tosupporttheongoingoperationandmaintenanceofpublicinternetfacilitiesdeliveredundertheoriginalAgreementanddelivertrainingtoAboriginalandTorresStraitIslanderpeopleintheuseofonlinetechnologies.
TheGovernmentprovidedfundingfortheTorres Strait Health Protection StrategytoenhancethehealthservicecapacityintheTorresStraittoprotectcommunitiesfromcommunicablediseases.ThisstrategyincludesbuildingaclinicandstaffaccommodationonSaibaiIsland,increasedservicedelivery,amosquitocontrolprogramandtheemploymentofacommunicationsofficer.Additionalfundingisbeingprovidedfortheperiod2013-14to2016-17tocontinuethemosquitocontrolprogramandthecommunicationsofficerrole.
heAlth lIterACyActionstoimprovehealtheducationandliteracyarefoundacrossarangeofrelatedhealthactivitiessuchashealthpromotionandprevention,healthprotection,diseaseprevention,earlyinterventionandmanagementandhealthcaremaintenance.
Healthliteracyisincreasinglybeingrecognisedasanimportantcomponentofsafeandhighqualityhealthcare.TheAustralianCommissiononSafetyandQualityinHealthCare(ACSQHC)hasidentifiedhealthliteracyasaprioritythroughanumberofnationalpolicies,including:
• theAustralian Safety and Quality Framework for Health Care,whichidentifieshealthliteracyasakeyactionarea;
• theNational Safety and Quality Health Service (NSQHS) Standards,whichimplicitlyreferstohealthliteracyinnineofthetenStandards;and
• theAustralian Safety and Quality Goals for Health Care,whichincludespartnershipswithconsumersasagoalandbecomingahealthliterateorganisationasacoreoutcome.
evIdenCe-bAsed prACtICe
heAlth surveysTheresultsfromthe2012-13 Aboriginal and Torres Strait Islander Health SurveywillmakeasignificantcontributiontothemonitoringandevaluationoftheNationalAboriginalandTorresStraitIslanderHealthPlan(HealthPlan).Thissurveybuildsonthe2004/05National Aboriginal and Torres Strait Islander Health Surveybyintroducingnewdatacollectionsonfoodandnutritionandphysicalactivityaswellasavoluntarybiomedicalcomponentthatwillprovideobjectivemeasuresofnutritionalstatusandchronicdiseaseriskfactors.High-levelresultsfortheAboriginal and Torres Strait Islander Health SurveyareduetobereleasedinSeptember2013forCOAGreportingpurposes,withmoredetailedresultsreleasedfromJune2014.FuturesurveyswillenablemonitoringofchangesinthehealthstatusofAboriginalandTorresStraitIslanderpeopleandstrengthenthemonitoringandevaluationoftheHealthPlan.
nAtIonAl heAlth And medICAl reseArCh CounCIlEvidenceisavaluabletoolinmakingtheargumentforanypolicy.Themostcompellingevidenceclearlyarticulatesbothchallengesandopportunities,providingactionableguidanceforpolicyandprogramdevelopment.AstheAustralianGovernment’speakfundingbodyforhealthandmedicalresearch,the
NationalHealthandMedicalResearchCouncil (NHMRC)investsinresearchthroughavarietyoffundingmechanismsincludinginvestigator-initiatedresearchprojectsandclinicaltrials,broadprogramsofresearch,trainingawardsforscholarsandpostdoctoralfellows,careerresearchfellowshipsandspecialstrategicresearchprograms.TheNHMRCiscommittedtosupportinghealthandmedicalresearchandstatedthatonanannualbasis,itwillaimtocommitatleastfivepercentofitstotalresearchbudgettohealthandmedicalresearchinvolvingAboriginalandTorresStraitIslanderpeople.
24
footprInts In tImeThe Longitudinal Study of Indigenous Children (LSIC) ‘Footprints in Time’isconductedbytheDepartmentofFamilies,Housing,CommunityServicesandIndigenousAffairsundertheguidanceoftheFootprintsinTimeSteeringCommittee,chairedbyProfessorMickDodsonAM.Thestudyaimstoimprovetheunderstandingof,andpolicyresponseto,thediversecircumstancesfacedbyAboriginalandTorresStraitIslanderchildren,theirfamiliesandcommunities.
CooperAtIve reseArCh CentreTheAustralianGovernmentisextendingfundingfortheCooperativeResearchCentreforAboriginalandTorresStraitIslanderHealth(CRCATSIH),providing$25millionoverfiveyearsfromJuly2014.TheCRCATSIH,hostedbytheLowitjaInstitute,bringstogethertheAboriginalandTorresStraitIslanderhealthsector,governmenthealthagenciesandresearchinstitutionstoensurethatresearchconductedintoAboriginalandTorresStraitIslanderhealthiscontrolledby,andbenefits,AboriginalandTorresStraitIslanderpeople.
ClosIng the gAp CleArInghouseTheClosingtheGapClearinghouseaimstobuildacumulativeevidencebaseforwhatworkstoclosethegapinAboriginalandTorresStraitIslanderdisadvantage.TheClearinghousewebsiteprovidesaccesstothefollowingevidence-basedmaterial:
• ageneralcollectionofresearch,evaluationsandreportscataloguedbytheCOAGbuildingblocks(withover4,600itemscurrentlyavailable);
• anassessedcollectionofselectedresearchandevaluations(about300peryear);
• IssuesPapersreviewingthefindingsonwhatworksonspecifictopics(2-3peryear);and
• ResourceSheetssummarisingtheevidenceonmorenarrowlydefinedtopicsanditsapplicabilityforspecificpoliciesand/orprograms(around10peryear).
Subjectspecialistsareengagedtorigorouslyassessandsummariseselectedresearchandevaluationsandratetheeffectivenessoftheparticularactivityorprogram.TheClearinghousemaintainsanonlineregisterofresearchandevaluationprojectsacrossAustraliarelevanttoAboriginalandTorresStraitIslanderoutcomes(inprogressorcompletedinthelastthreeyears).ThefocusoftheRegisterisonprojectscommissionedorfundedbytheAustralianGovernment.
IndIgenous IdentIfICAtIonOn1February2013,theAustralianBureauofStatistics(ABS)releasedanInformation Paper: Perspectives on Aboriginal and Torres Strait Islander Identification in Selected Data Collection Contexts, 2012. ThePaperexploresfactorsthatcontributetoanindividual’sdecisiontodisclosetheirIndigenousstatus.TheABSplanstoundertakefurtheranalyticalworktounderstandthedemographicandnon-demographicfactorscontributingtochangesintheAboriginalandTorresStraitIslanderpopulation.Itisanticipatedthatthefirstreleaseoftheanalyticalworkwillbein2013.
25
mentAl heAlth And soCIAl And emotIonAl WellbeIngTheAustralianGovernmentisinvesting$2.2billionoverfiveyearsfrom2011-12todeliverNational Mental Health Reform,includinginpreventionandprimarycare,andaccountabilityandinnovationinmentalhealthservices.Thisinvestmentaimstoensurethatpeoplelivingwithmentalillnesscanaccessthecaretheyneedwhentheyneedit.
InDecember2012COAGendorsedtheRoadmap for National Mental Health Reform 2012-22.TheRoadmapoutlinestargetedstrategiesforAboriginalandTorresStraitIslanderpeoplewithinsixpriorityareas:
• promoteperson-centredapproaches;
• improvethementalhealthandsocialandemotionalwellbeingofallAustralians;
• preventmentalillness;
• focusonearlydetectionandintervention;
• improveaccesstohighqualityservicesandsupports;and
• improvethesocialandeconomicparticipationofpeoplewithmentalillness.
TheAustralianGovernmentisworkinginpartnershipwithstateandterritorygovernmentsandkeystakeholderstodevelopamentalhealthsystemthatvaluesandpromotestheimportanceofgoodmentalhealthandwellbeing;maximisesopportunitiestopreventandreducetheimpactofmentalhealthissuesandmentalillness;andsupportspeoplewithmentalhealthissuesandmentalillness,theirfamiliesandcarerstolivecontributing,fulfillinglives.
In2013-14,newgovernanceandaccountabilityarrangementswilldirectlyengagegovernmentsandstakeholdersonfurtheringmentalhealthreform.TheCOAGWorkingGrouponMentalHealthReform(theCOAGWorkingGroup)willoverseeadetailedprogramofworktoensurethatmentalhealthreformremainsapriorityacrossgovernments.TheCOAGWorkingGroupisco-chairedbytheMinisterforMentalHealthandAgeingandtheVictorianMinisterfor
MentalHealth,andwillbeassistedbyanExpertReferenceGroupchairedbytheNationalMentalHealthCommission.
TheCOAGWorkingGroupwillfocusonactivitiesthatwillimproveaccesstomentalhealthdata;developindicatorsthattracktheprogressofnationalreform;settargetsforasmanyindicatorsaspossible,wheresupportedbyevidence;anddevelopasuccessortotheFourth National Mental Health Planbymid-2014whichwillsetouthowtheRoadmapwillbeimplemented.
Aspartofthe$2.2billioninvestment,the2011-12Budgetprovided$200millionoverfiveyears(2011-12to2015-16)foranationalfundingpooltoencouragestatesandterritoriestoaddressknownservicegapsforpeoplewithamentalillness,particularlythoseaffectingpeoplewithsevereanddebilitatingmentalillness.On13April2012,COAGagreedtotheNational Partnership Agreement Supporting National Mental Health Reform asthevehicletodisseminatethisfunding.
UndertheNationalPartnershipAgreement,fundingwillbeprovidedtostatesinthepriorityareasof:
• stableaccommodationandsupport;and
• presentation,admissionanddischargeplanninginemergencydepartmentsandmajorhospitals,andrelatedsupportservices.
ThiswillhelpmoveAustralia’smentalhealthsystemawayfromcrisis-drivenactivitytowardsprevention,earlyinterventionandcareinthecommunity.Itwillparticularlybenefitpeoplewithsevereandpersistentmentalillnesswhoarefrequentusersofemergencydepartmentswhoneedstableaccommodationtokeepwellandbreakthecycleofhospitalisationandhomelessness.
Thefirstnationalwhole-of-governmentstrategyspecificallyaddressingAboriginalandTorresStraitIslandersuicideissupportedby$17.8millioninnewfundingoverfouryears.TheNational Aboriginal and Torres Strait Islander Suicide Prevention Strategyfocusesonearly
26
interventionandbuildingstrongercommunitiestoreducetheprevalenceofsuicideandtheimpactonindividuals,theirfamiliesandcommunities.
TheStrategyidentifiessixbroadactionareas,whichare:
• buildingstrengthsandcapacityinAboriginalandTorresStraitIslandercommunities;
• buildingstrengthsandresilienceinindividualsandfamilies;
• targetedsuicidepreventionservices;
• coordinatingapproachestoprevention;
• buildingtheevidencebaseanddisseminatinginformation;and
• standardsandqualityinsuicideprevention.
TheNational Suicide Prevention Program supportssuicidepreventionprojectsatboththenationalandlocallevel.Italsofundsarangeofuniversalprogramsaswellastargetedprogramsforindividualsandpopulationsathigherriskofsuicide.$9.4millionofthe$49.4millionallocatedover2011-12and2012-13isforprojectstargetingAboriginalandTorresStraitIslandercommunitiesspecifically.Thisisinadditiontofundingof$6millionfrom2011-12to2014-15providedthroughtheCommunity Prevention for High Risk Groups Initiative ofthe Taking Action to Tackle Suicide packageforsuicidepreventionactivityspecificallytargetedatAboriginalandTorresStraitIslanderpeople.
Supportingaholisticviewofhealth,theAustralianGovernmentiscommittedto,andinvestingin,initiativestogrowandsupportthesocialandemotionalwellbeingofAboriginalandTorresStraitIslanderpeople.
TheDepartmentofHealthandAgeingisleadingtherenewaloftheNational Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social Emotional Wellbeing (2004-2009).TheFrameworkwillbeanimportantdocumentforgovernmentsandserviceproviderstouseinmakingdecisionsabouthowpoliciesandpracticestoimprovethesocialandemotionalwellbeingofAboriginalandTorresStraitIslanderpeoplesshouldbedeveloped,includingwherefundingshouldbespent,how
servicesandpoliciesshouldbeprioritisedandthestandardsthatshouldbeappliedtoservices.TheFrameworkneedstoreflectthecurrentknowledgeandunderstandingofAboriginalandTorresStraitIslandersocialandemotionalwellbeingandtheexperiencesofAboriginalandTorresStraitIslanderpeople.
In2013-14,theSocial and Emotional Wellbeing Programwillcontinuetoenhanceexistingcounselling,familytracingandreunionservicestoAboriginalandTorresStraitIslandercommunities,includingmembersoftheStolenGenerations,throughtheexistingnetworkofeightLinkUpServicesandstaffinover90AboriginalandTorresStraitIslandercommunitycontrolledhealthorganisations.
Inaddition,fundingof$269.3millionoverfiveyearsfrom2011-12isbeingprovidedthroughtheTargeted Community Care (Mental Health) ProgramfornewandexpandedPersonalHelpersandMentors,additionalMentalHealthRespite:CarerSupportservices,andafurther40FamilyMentalHealthSupportservices.Thisincludesfundingforthedeliveryofspecialistremoteservicesthathaveastrongfocusoncultural,mentalandphysicalhealingforAboriginalandTorresStraitIslanderpeople.
Inthe2013-14Budget,theAustralianGovernmentcommittedanadditional$26.4million,until2017,totheAboriginalandTorresStraitIslanderHealingFoundation.RecognisingtheimportanceofexistingframeworksforhealingwithinAboriginalandTorresStraitIslandercommunities,theHealingFoundationseekstobuildthesocialandemotionalwellbeingofAboriginalandTorresStraitIslanderpeoplebyfundingculturallystrongcommunityhealingprograms.MembersoftheStolenGenerationsareaparticularfocusfortheworkoftheFoundation.TheHealingFoundationalsofundseducationandtrainingprogramstobuildtheleadershipandcapacityofcommunitiesandworkerstodealwithtraumaanditsintergenerationalimpacts,inadditiontofundingresearchandevaluationprojectstobuildtheknowledgebaseonculturallyappropriatehealingmodels.
27
Investment In keepIng Culture strong ACross the lIfespAnTheAustralianGovernmentiscommittedtosupportingAboriginalandTorresStraitIslanderpeopletokeeptheirculturestrong.Throughitsnationalculturalpolicy,Creative Australia,theAustralianGovernmentarticulatesthegoalofrecognising,respectingandcelebratingthecentralityofAboriginalandTorresStraitIslanderculturestotheuniquenessofAustralianidentity.
TheAustralianGovernmentiscontinuingtosupportAboriginalandTorresStraitIslanderpeople’sculturethrough:
• Indigenous Culture Supportfunding,whichwillprovidearound$31.6millionoverfouryearsfrom2013-14toassistthecontinueddevelopment,maintenanceandtransmissionoftraditionalcultureandcontemporaryAboriginalandTorresStraitIslanderculturalexpression;
• Indigenous Languages Supportfunding,whichwillprovidearound$54.2millionoverfouryearsfrom2013-14toaddresstheseriousconditionofAustralia’sIndigenouslanguages.Thisincludes$11.98millioninnewfundingfrom2013-14forthedevelopmentofinnovativedigitalandmulti-medialanguagelearningresourcesprovidedunderthenationalculturalpolicy,Creative Australia.IndigenouslanguagesfundingisdeliveredinthecontextoftheAustralianGovernment’sNational Indigenous Languages Policy,whichisacommitmenttohelpAboriginalandTorresStraitIslanderpeopletokeeptheirlanguagesaliveandconnecttotheirlanguagesandculture;and
• theIndigenous Repatriation Program,whichwillprovidearound$5.7millionoverfouryearsfrom2013-14tofacilitatethereturnofAboriginalandTorresStraitIslanderancestralremainsfromoverseasinstitutionsandancestralremainsandsecretsacredobjectsheldinmajorAustralianmuseumstotheircommunitiesoforigin,therebyaddressingtheinjusticeofAustralia’ssharedpastasitrelates
totheremovalofancestralremainsandsecretsacredobjectsandempoweringAboriginalandTorresStraitIslanderpeopletomeettheirculturalobligations.
TheIndigenous Broadcasting ProgramsupportsIndigenousradioandmediainmetropolitan,regionalandremotecommunitiesbyprovidingassistanceforoperationalexpenses,contentproduction,trainingandprofessionalskillsdevelopment.TheprogramfundsprojectswhichcontributetotheAustralianGovernment’sClosing the Gapagendathroughthebroadcastingofkeyeconomic,education,employment,environmental,health,emergencyservicesandothercommunityservicesinformation.ThemainobjectivesoftheIndigenous Broadcasting ProgramaretohelpAboriginalandTorresStraitIslanderbroadcastersbecomestrongerandbuildamoresustainableAboriginalandTorresStraitIslanderbroadcastingsector.In2013–14,$15.8millionwillbemadeavailableinfundingtoadministerthe Indigenous Broadcasting Program.
28
substAnCe mIsuseTheNational Drug Strategy,acooperativeventurebetweenAustralian,stateandterritorygovernmentsandthenon-governmentsector,isaimedatimprovinghealth,socialandeconomicoutcomesforAustraliansbypreventingtheuptakeofharmfuldruguseandreducingtheharmfuleffectsoflicitandillicitdrugsinoursociety.
ANational Aboriginal and Torres Strait Islander Peoples Drug Strategy(NATSIPDS)(asub-strategytotheNational Drug Strategy)iscurrentlybeingdeveloped,withtheNationalIndigenousDrugandAlcoholCommittee(NIDAC)undertakingconsultationsinsixlocationsinAustraliatoinformthedevelopmentoftheNATSIPDS.TheconsultationsbeingconductedbyNIDACwillbuildonworkthathasbeenundertakenbytheNATSIPDSWorkingGroupandfeedbackfromtheevaluationoftheNational Aboriginal and Torres Strait Islander Peoples Complementary Action PlanandtheYarningCircle,conductedatthe2ndNationalIndigenousDrugandAlcoholConferenceheldinFremantle,WesternAustraliainJune2012.
TheAustralianGovernmentalsosupportsinvestmentinprogramsthroughtheSubstance Misuse Service Delivery Grants Fund.In2013-14,$75millionwillbedirectedtoassistingAboriginalandTorresStraitIslandercommunitiestoprovideservicedeliveryortosupportservicesfocusingonAboriginalandTorresStraitIslanderpeople.
ThePetrol Sniffing Strategyisawhole-of-governmentinitiativethataimstoreducetheincidenceandimpactofpetrolsniffingandsubstancemisuseinremotecommunitiesacrossWesternAustralia,Queensland,NorthernTerritoryandSouthAustralia.Adramaticreductioninpetrolsniffinghasbeenachievedunderthestrategy,primarilythroughtherolloutoflowaromaticfuelandtheintroductionofadditionalyouthservices.TheAustralianGovernmentisproviding$113.3millionoverfiveyearsfrom2011-12tosupporttherolloutoflowaromaticfuel.Complementaryprojectsincludingyouthactivitieswillsupporttherollout.
AdramaticreductioninpetrolsniffinghasbeenachievedundertheStrategy,primarilythroughtherolloutoflowaromaticfuelandtheintroductionofadditionalyouthservices.
$20millionoverthreeyearsfrom2011-12willassistanumberofcommunitiesinremote,regionalorurbanareasaddressalcoholandsubstancemisuseissuesthroughtheBreaking the Cycle of Alcohol and Drug Abuse in Indigenous Communities Program.Thoughthisprogram,communitiesaresupportedtoworkwithgovernmentandnon-governmentorganisationsatalocalleveltodevelopaCommunityAlcoholandSubstanceAbuseManagementPlanandprovidepreventionprogramstotackleyouthsubstanceabuse.
IntheNorthernTerritory,throughtheStronger Futures in the Northern Territorypackage,$75.6millionhasbeenprovidedtosupportcommunitiestodevelopandimplementalcoholmanagementplansand$13.7millionhasbeenprovidedtocontinueinvestmentintheAlice Springs Transformation Planforarangeofprojectsthatincludealcoholtreatment,schoolenrolmentandattendance,safetyandwellbeingofwomenandchildren,parentingskillseducationandsupportforat-risktenants.
buIldIng bloCk
29
humAn And CommunIty CApAbIlIty
governance and leadership
Strongleadershipisneededtochampionanddemonstrateownershipofreform.Effectivegovernancearrangementsincommunitiesandorganisationsaswellasstrongengagementbygovernmentsatalllevelsareessentialtolongtermsustainableoutcomes.Indigenouspeopleneedtobeengagedinthedevelopmentofreformsthatwillimpactonthem.ImprovedaccesstocapacitybuildingingovernanceandleadershipisneededinorderforIndigenouspeopletoplayagreaterroleinexercisingtheirrightsandresponsibilitiesascitizens.13
The National Partnership Agreement on Remote Service DeliveryisacommitmentfromAustralian,stateandterritorygovernmentstoimprovethelevelofgovernanceandleadershipwithinAboriginalandTorresStraitIslandercommunitiesandcommunityorganisations.
ThroughtheNational Partnership Agreement on Remote Service Delivery,theAustralianGovernment,relevantstatesandtheNorthernTerritoryareinvesting$291.2millionfrom2009-10to2013-14,tochangethewaytheyworkwithAboriginalandTorresStraitIslanderpeopleacrossanumberofprioritycommunities.TheAgreementalsoaimstoachievebettercoordinatedgovernmentservices,improvefamilies’accesstoarangeofgovernmentservicesandtoraisetheseservicestothestandardprovidedtootherAustralianslivingincommunitiesofsimilarsizeandlocation.
TheNationalPartnershipAgreementisbeingimplementedthroughLocalImplementationPlans(LIPs).TheobjectiveofLIPsistoreflectservicedeliveryprioritiesagreedbetweencommunitygroupsandgovernments,aswellasnon-governmentandprivatesectororganisations,inawaythatisconsistentwiththeCOAGtargets.LIPsareoverseenbytheCoordinatorGeneralfor
RemoteServiceDelivery,whoreportstwiceayear.
TherearearangeofprogramsdesignedtoimprovegovernanceandleadershipfundedbytheAustralianGovernment,suchastheIndigenous Leadership Program,whichencouragesparticipantstocontinuetheirjourneyinbecominginspiringandeffectiveleaderswhowillmakeapositivedifferencetothelivesofAboriginalandTorresStraitIslanderpeople.
heAlth WorkforCeInrecognitionoftheimportancetohealthoutcomesofAboriginalandTorresStraitIslanderpeople’sinvolvementinthedeliveryofhealthservices,theAustralianGovernmentissupportingthegrowthandretentionoftheAboriginalandTorresStraitIslanderhealthworkforce.
TheAustralianGovernment’seffortisguidedbytheoverarchingNational Aboriginal and Torres Strait Islander Health Workforce Strategic Framework (2011-2015),andimplementedthroughprogramsthatprovideeducation,training,mentoring,supportandscholarships.Itstargetistoachieve2.6percentoftheAustralianhealthworkforcebeingAboriginalorTorresStraitIslanderby2015.ThiswasendorsedbytheAustralianHealthMinisters’AdvisoryCouncil(AHMAC)inFebruary2011.AllstatesandterritoriesandNACCHOhavedevelopedtheirstrategicframeworksandactionplansbasedontheStrategicFramework.ThedocumentwasdevelopedbytheAboriginalandTorresStraitIslanderHealthWorkforceWorkingGroup(ATSIHWWG).Eachjurisdiction,NACCHOandthepeakAboriginalandTorresStraitIslanderhealthgroupsregularlyreportagainstKeyPerformanceIndicatorsatATSIHWWGmeetings.The2.6percenttargetisalsoinlinewiththeCOAGagreedtarget.
TherearearangeoftargetedAustralianGovernmentprogramsassistinginthesupportoftheStrategicFramework.TheseareaimedatincreasinganddevelopingtheAboriginalandTorresStraitIslanderhealthworkforceandareadministeredand/ordeliveredbyarange
oforganisationsincludingHealthWorkforceAustralia,peakorganisationsandnetworks,andtheVETsector.
Specificprogramsinclude:
• theNational Aboriginal and Torres Strait Islander Health Workforce Training Package,whichprovidesfundingto:
> theAustralianIndigenousDoctors’Association;
> theNationalAboriginalandTorresStraitIslanderHealthWorkerAssociation;
> IndigenousAlliedHealthAustralia;
> theCongressofAboriginalandTorresStraitIslanderNurses;
> theWorkforceInformationPolicyOfficersNetwork;
> theAboriginalandTorresStraitIslanderHealthRegisteredTrainingOrganisationNationalNetwork;and
> theLeadersinIndigenousMedicalEducationNetwork.
• thePuggy Hunter Memorial Scholarship Scheme;
• theAboriginal and Torres Strait Islander Pharmacy Scholarship SchemeandPharmacy Assistant Training Scheme;
• theIndigenous Transition Pathways to Medicine Program;
• measuresundertheICDP;and
• theIndigenous Public Health Capacity Building Project whichdeliversamainstreamMastersofPublicPolicyProgram,tailoredspecificallyforAboriginalandTorresStraitIslanderstudentsnationally.
On24May2013,theMason Review of Australian Government Health Workforce Programs wasreleased.TheReviewmakes87recommendationscoveringAustralianGovernmentprogramsthattargetthemedical,dental,alliedhealth,nursingandmidwiferyandAboriginalandTorresStraitIslanderhealthworkforces.Currentruralandworkforceclassificationsystemswereconsideredaspartofthereview,includingtheAustralianStandardGeographicalClassification–RemotenessAreasandDistrictsofWorkforceShortagesystems.TheReviewprovidesanoverviewofthecurrentstatusoftheAboriginalandTorresStraitIslanderhealthworkforceandAustralianGovernmenthealthworkforceprogramsthatareintendedtostrengthenAboriginalandTorresStraitIslanderhealthworkforcecapacityandimprovetheabilityofthebroaderhealthworkforcetoaddresstheneedsofAboriginalandTorresStraitIslanderpeople.
30
31
Investments to Improve outComes ACross the lIfe Course broAder heAlth ACross the lIfe Course
dIsAbIlItyAboriginalandTorresStraitIslanderpeoplehaveasignificantlyhigherrateofdisabilitycomparedtonon-Indigenouspeople,duetoincreasedratesofriskfactorssuchaslowbirthweight,chronicdisease,infectiousdiseases(e.g.otitismedia),accidentsandviolence.Thisiscompoundedbybarrierstoaccessingsupportasmainstreamdisabilityservicesmaynotbeculturallyappropriateoraccessible.RemotenessisalsoasignificantbarriertoaccessingappropriateservicesforsomeAboriginalandTorresStraitIslanderpeople.Withlimitedaccesstoearlytreatmentprogramsandrehabilitationservices,theriskofacquiringdisabilityincreases.
TheNational Disability Strategy 2010-2020 (NDS),aten-yearpolicyreformframeworkendorsedbyCOAGinFebruary2011,acknowledgesthemultiplelayersofdisadvantageexperiencedbyAboriginalandTorresStraitIslanderpeoplewithdisability.ItrecognisesandalignsitselftoCOAG’sClosing the GapagendaandcallsonpolicymakersandserviceproviderstoengageeffectivelywithAboriginalandTorresStraitIslanderpeoplewithdisabilitytobetterunderstandandrespondtotheirneeds.This
objectiveisdemonstratedinthedevelopmentofDisabilityCareAustraliawhichisoneofmanyimportantreformsbeingpursuedundertheNDS.
TheAustralianGovernmentwillinvest$19.3billionoversevenyearsfrom2012-2013torolloutDisabilityCareAustralia,theNational Disability Insurance Scheme.Thisinvestmentcontributestothecostofindividualcareandsupportpackages,administrationofthenationalschemeandothersupportsforpeoplewithdisability,theircarersandfamilies.UnderDisabilityCareAustralia’sSectorDevelopmentFund,theFirstPeople’sDisabilityNetworkAustraliawillbeprovided$900,000overthreeyearstoprovideservicestoassistAboriginalandTorresStraitIslanderpeopletobenefitfromDisabilityCareAustralia.
DisabilityCareAustraliawillbeworkingwithalljurisdictionstoensureimprovedsupportforpeoplewithdisability,theirfamilyandcarers,andtodeliverthefirststageofDisabiltyCare.ThefirststagecommencedinJuly2013inlaunchsitesinSouthAustralia,Tasmania,theHunterinNewSouthWalesandtheBarwonareaofVictoriaprovidingcareandsupportforthousandsofpeoplewithsignificantandpermanentdisabilities.LaunchsitesintheACTandtheBarklyregionoftheNorthernTerritorywillcommenceinJuly2014.
DisabilityCareAustraliaislookingtoensurethattheschemeisabletomeetthespecificneedsofAboriginalandTorresStraitIslanderpeople,andwillbe:
• workingwithlocalcommunitiestounderstandthebestwaysthatAboriginalandTorresStraitIslanderpeoplewithdisabilitycangetthesupportsthattheyneed;
• buildingrelationshipswithAboriginalandTorresStraitIslandercommunitiesthroughtrustedintermediaries;
• trainingLocalAreaCoordinatorsandplannersinthebestwaystoworkwithAboriginalandTorresStraitIslanderpeoplewithdisability,theirfamilies,carersandcommunities;
• ensuringthatAboriginalandTorresStraitIslanderpeoplewithdisabilityandtheir
32
families,carersandcommunitiesareawareofDisabilityCareAustraliaandthesupportsavailableunderthescheme;
• lookingatwaystomakesurethesupportsthatanAboriginaland/orTorresStraitIslanderpersonwithadisabilityreceivesmakeadifferencetotheirlife;and
• gatheringinformationabouthowsupportsassistapersontohelptheschemetoworkproperly.
DisabilityCareAustraliaisalsoseekingtoemployAboriginalandTorresStraitIslanderplannersandlocalareacoordinatorswhereverpossible,andisengagingatalocallevelwithAboriginalandTorresStraitIslanderorganisations.Also,DisabilityCareAustraliaisdevelopingculturaltrainingpackagesforitsstaffaswellasdevelopinginformationabouttheschemeforAboriginalandTorresStraitIslanderpeopleusingculturallyappropriatemethods,includingoutreachandinterpreters.
On16May2013,theMinisterforFamilies,CommunityServicesandIndigenousAffairsandMinisterforDisabilityReform,theHonJennyMacklinMPannouncedaproposednewtargettoconcentrateeffortsonclosingthegapforAboriginalandTorresStraitIslanderpeoplewithdisabilityandensuretheyarenotleftbehindintheimplementationofDisabilityCareAustralia.
ToassistjurisdictionstointegrateappropriateprinciplesintotheirserviceaccessandplanningframeworkstoincreaseAboriginalandTorresStraitIslanderpeoples’accesstodisabilityservices,aNational Indigenous Access FrameworkhasbeendevelopedundertheNational Disability Agreement.TheFrameworkaimstoensurethattheneedsofAboriginalandTorresStraitIslanderpeoplewithdisabilityareaddressedthroughaccessibleandappropriateservicedeliveryarrangements.
TheNational Carer Strategycontainsavision,anaimandsiximportantpriorityareasforaction:recognitionandrespect;informationandaccess;economicsecurity;servicesforcarers;educationandtraining;andhealthandwellbeing.Collectively,thesepriorityareasoutlinehowthe
contributionofAustralia’scarerswillbebettervalued,supportedandshared.TheNational Carer Strategy Action Plan (2011-2014)setsouttangibleshort-termactionswithscorecardstomeasuresuccessagainsteachoftheStrategy’ssixpriorityareas.Manyoftheseactionsaredesignedtomakesurethatbroaderreformagendasconsiderandsupportthecrucialroleofcarersinthecareandsupportsystem.
nutrItIonTheAustralianGovernmentwillleadthedevelopmentofaNational Nutrition Policy withinputfromstateandterritorygovernments.IndevelopingtheoverarchingframeworkforaNational Nutrition Policy,publichealthandindustrystakeholdersandnutritionexpertswillbeengagedtoensureobjectivesarepracticalandachievableandmeettheneedsoftheAustralianpopulationnowandinthefuture.TheNational Nutrition PolicywillconsiderhowvulnerablegroupsandAboriginalandTorresStraitIslandernutritioncanbebetteraddressed.ItisanticipatedthatdevelopmentoftheNational Nutrition Policywillbecompletedin2014.
TheAustralianGovernmenthasdevelopedAustralia’sfirsteverNational Food Plantohelpensurethatthegovernment’sfoodpolicysettingsarerightforAustraliaovertheshort,mediumandlongterm.TheAustralianGovernment’sNational Food Planisaroadmapthatsetsthedirectionforgovernmentpolicyonfoodintothefuture.TheNational Food Planisunderpinnedbythefourkeythemesof‘growingexports’,‘athrivingindustry’,‘people’and‘sustainability’andcontains16goals,includingagoalwhichstatesthatby2025“Australiawillhavebuiltonitshigh
33
leveloffoodsecuritybycontinuingtoimproveaccesstosafeandnutritiousfoodforthoselivinginremotecommunitiesorstrugglingwithdisadvantage”.TheNational Food Planidentifiesseveralpathwaystoachievethisgoal,includingaplantoreviewtheNational Strategy for Food Security in Remote Indigenous Communitiesandimplementanychangesarising.
Theissueofhealthandnutritionissignificantandthereforerequiresaspecific,strongandmultifacetedfocusseparatefrom,butcomplementaryto,theNational Food Plan.
TheAustralianGovernmentisinvestinginimprovingtheaffordability,qualityandavailabilityofhealthyfoodstoreducethediet-relatedburdenofdiseaseforAboriginalandTorresStraitIslanderpeopleinremoteAustralia.Alongwitharangeoftargetednutritionandhealthactivitiesandinitiatives,forexamplesocialmarketinginitiativestoaddresspoornutritionandinactivity,theAustralianGovernmentisproviding$40.8millionover10yearsthroughStronger Futures in the Northern Territory,tocontinuethelicensingofstoresintheNorthernTerritory.Thisinvestmentwillexpandtheschemetoincludemorestoresandprovidemoresupporttohelpstoresstayopentoservicelocalpeopletocontinuetoimprovetheavailabilityoffreshandhealthyfoodintheselocations.
Inaddition,theAboriginals Benefit Account hasprovided$55.8milliontoupgradeandconstructnewstoresandstoremanagers’housingin18communitiesthroughouttheNorthernTerritory.Participatingstoresarecurrentlyownedby,orintheprocessoftransferringownershipto,licencedIndigenouscorporations.Workcommencedin2012andisexpectedtocontinuethroughto2015.
dentAl heAlthUnderthe2012-13Budget,$344millionofadministeredfundswasallocatedforaNational Partnership Agreement on Treating More Public Dental Patientswiththestatesandterritoriestoalleviatepressureonpublicdentalwaitinglists.Thefundingwillbeusedtoprovideadditionaldentalservicesforupto400,000publicdentalpatientsestimatedtobeonwaitinglists.ThisprogramhasaparticularfocusonAboriginalandTorresStraitIslanderpatients,patientsathighriskof,orfrom,majororalhealthproblemsandthosefromruralareas.
On29August2012,theMinisterforHealth,theHonTanyaPlibersekMP,announcedapackageofdentalreformsthattargetedspecificareasofthepopulationmostinneedofdentalcare.Thepackageincludes:
• $2.7billionforGrow Up Smiling,achildren’sdentalschemethatwillcommenceon1January2014for2-17yearoldswhoreceive,orwhosefamilyreceives,arangeofgovernmentpaymentsincludingFringeBenefitsTax-AandABSTUDY;
• $1.3billionforstatesandterritoriesfrom1July2014toexpandservicesforadultsinthepublicsystem;and
• a$225millionFlexibleGrantsProgramcommencingin2014toprovidedentalinfrastructure(bothcapitalandworkforce)inoutermetropolitan,ruralandregionalareas.
34
mAternAl heAlth And pArentIngTheAustralianGovernmentiscommittedtoimprovingthehealthofAboriginalandTorresStraitIslandermothersandchildren.Inparticular,theGovernmentisfocusedonaddressinglowbirthweightsforbabies,improvingratesofchildhoodimmunisationandencouragingmorewomentoadopthealthylifestylebehavioursbefore,duringandafterpregnancy.
The2009National Partnership Agreement on Indigenous Early Childhood Development provided$564millionoversixyearsto30June2014,toimproveoutcomesforAboriginalandTorresStraitIslanderchildrenintheirearlyyears.TheAustralianGovernment’scontributiontothisNationalPartnershipAgreementthroughtheHealthandAgeingportfolioconsistsof$107millionforElementTwo(AntenatalCare,Pre-pregnancyandTeenageSexualandReproductiveHealth)andupto$34millionperannumforElementThree(IncreaseAccesstoandUseofMaternalandChildHealthServicesbyIndigenousFamilies,alsoknownastheNewDirectionsMothersandBabiesServicesprogram).
TheAustralianGovernmentwillprovideongoingsupportforthefollowingAboriginalandTorresStraitIslanderhealthprograms:
• New Directions: Mothers and Babies Services-$145.7millionoverfouryearsfrom2013-14toprovideAboriginalandTorresStraitIslanderfamilieswithyoungchildrenaccesstoantenatalcare;informationaboutbabycare,includingpracticaladviceandassistancewithbreastfeeding,nutritionandparenting;monitoringofdevelopmentalmilestones;immunisationservices;andhealthchecksforAboriginalandTorresStraitIslanderchildrenbeforestartingschool.
• Healthy for Life-$191.8millionoverfouryearsfrom2013-14toprovideAboriginalandTorresStraitIslandermothersandtheirchildrenwithsupportinmakinghealthylifestylechoices.
TheAustralianGovernmentisproviding$24.3millionin2013-14tostatesandterritoriesundertheNational Partnership Agreement on Indigenous Early Childhood Development,toincreaseaccesstoanduseofantenatalcarebyyoungAboriginalandTorresStraitIslandermothersandsupportyoungpeopletomakeinformeddecisionsabouttheirsexualandreproductivehealth.TheAgreementalsoaimstoincreaseaccesstomaternalandchildhealthservicesbyyoungAboriginalandTorresStraitIslanderpeople.
TheAustralian Nurse Family Partnership Program(ANFPP)($32.4millionoverfouryearsfrom2013-14)isanevidence-basedprogramthataimstoimprovepregnancyoutcomesbyhelpingwomenengageingoodpreventivehealthpractices,supportmotherstoimprovetheirchild’shealthanddevelopment,andhelpparentsdevelopavisionfortheirownfutureincludingcontinuingeducationandfindingwork.TheANFPPiscurrentlyatthreesites.Theseare:
• WuchopperenHealthService–Cairns;
• CentralAustralianAboriginalCongress–AliceSprings;and
• WellingtonAboriginalCorporationHealthService–Wellington.
Strong Fathers Strong FamiliesaimstoincreaseaccessforAboriginalandTorresStraitIslandermalestoculturallyappropriatehealthservicesandantenatal,parentingandotherrelatedprogramsandhealthmessages;helptoimproveAboriginalandTorresStraitIslandermales’abilitytocontributepositivelytothehealthandwellbeingofthemother’spregnancyandanurturingandsupportingfamilyenvironment;andsupportthedevelopmentneedsofchildrenbyencouragingfathers,unclesandgrandfatherstobehealthyrolemodelsandengagefullyinthechild’slifeasearlyaspossible,withinthecontextoflocalcommunityneedsandculturalpractices.
35
TheNational Maternity Services Plan recognisestheexistinghealthgapbetweenAboriginalandTorresStraitIslanderandnon-Indigenouspopulationsandtheimportantrolematernitycarecanhaveinaddressingthisgap.ThePlanconsidersculturalpracticesincare,andbirthingoncountry.In2013-14theNational Antenatal Care Guidelineswillbecompletedandmadeavailabletohealthprofessionals.TheGuidelinesarebeinginformedbyadvicefromaworkinggroupwithexpertiseinAboriginalandTorresStraitIslanderwomen’santenatalcare.Thecompletedguidelineswillhelphealthprofessionalstoprovideevidence-basedandculturallyappropriatehealthservicestoAboriginalandTorresStraitIslanderwomenthroughoutpregnancy.
UndertheNational Tobacco Campaign – More Targeted Approach,theAustralianGovernmentlaunchedanewcampaign‘QuitforYou,QuitforTwo’.Thecampaigntargetspregnantwomen,andthoseplanningonbecomingpregnantandtheirpartnerswhosmokefromsociallydisadvantaged,AboriginalandTorresStraitIslanderandculturallyandlinguisticallydiversecommunities.Thecampaigncomprisedtwotelevision,printanddigitalcommercials,aradioadvertisementandaniPhoneandAndroidapp.
ChIldhood heAlth And developmentFamily-centredprimaryhealthcaretakesalifecourseapproach,which,withoutneglectingadulthealth,focusesattentiononchilddevelopment,specificallyearlyliferesilienceandadvantages.Thisapproachmovesbeyondprovidingcareandsupporttoanindividual,asitseestheindividualembeddedinafamily-withservicesprovidedonthatbasis.Thisapproachattemptstodrawareasnormallyconsideredonlyaspartofthesocialdeterminantsofhealthbackground,forexampleeducationandfamilywelfare,intotheforegroundofprimaryhealthcarepractice.14ThisapproachisreflectedininitiativessuchastheNational Early Childhood Development StrategywhichwasendorsedbyCOAGon2July2009.TheStrategyincludesexistingcommitments,areasforimmediateactionwithincurrentresources,andfutureareasforreformacrossthehealth,communityandeducationdomains.
TheNational Early Childhood Development Strategyprovidestheframeworkforgovernmentandcommunityresponsetoachievethevisionthat,by2020,allchildrenhavethebeststartinlifetocreateabetterfutureforthemselvesandforthenation.TheStrategyidentifiestheoutcomesthatallgovernmentsareseekingtoachieveforchildrenby2020,andcapturesexistingcommitments,areasforimmediateactionandfutureareasforreform,includingsupportforvulnerablechildren,strengtheningtheworkforceacrossearlychildhooddevelopmentandbuildingbetterinformationandasolidevidencebase.
TheAustralianGovernmentisinvesting$333.5million,overthreeyears,from2011to2014,toprovidewhole-of-community,locallytailoredpreventionandearlyinterventionservicestoincreasechildsafetyandwellbeingindisadvantagedcommunitiesthroughoutAustralia,throughtheCommunities for ChildrenProgram.Thisinvestmentincludes$91.3millionforanIndigenousParentingServicescomponent,whichprovidesfundingforservicessuchasparentingsupportprograms,
36
supportedplaygroupsandhomevisitingservicestoaddressknownriskfactorsthatimpactontheparentingcapacityoffamilies.$99millionovertenyears(to2022)isbeingprovidedforIntensiveFamilySupportServiceswhichwillprovidecontinuingpracticalparentingsupportinupto23locationsforfamilieswithchildrenatriskofenteringthechildprotectionsystem.Thisprogramwillbeimplementedin15remoteNorthernTerritorycommunitiesinthreephases.ThefirstfivecommunitiestoimplementtheStronger Communities for Children ProgramfromJuly2013areNgukurr,SantaTeresa,Ntaria(Hermannsburg),WadeyeandGaliwinku.ThenextfivecommunitiestoimplementtheProgram,currentlyscheduledfromJuly2014,areGunbalanya,Lajamanu,Maningrida,UtopiaHomelandsandEngawala.
UndertheNational Partnership Agreement on Indigenous Early Childhood Development,38ChildrenandFamilyCentresarebeingestablishedacrossAustralia.Thecentresareconcentratedinareaswherethereisdemonstratedneed,highdisadvantageandahighproportionofAboriginalandTorresStraitIslanderchildrenunderfiveyearsofage.Thesecentreswillprovidearangeofservices,includingchildcareandearlylearningforchildrenandsupportforparentsandfamilies.
Participationinqualityserviceshelpsveryyoungchildrenandtheirparentstoestablishlearningandattendancehabitswhichcanbeastrongbasisforsuccessinschoolingandlaterinlife.TheAustralianGovernmentcommitted$55.7millionfromthe2012-13BudgettocontinuetheHome Interaction Program for Parents and Youngsters(HIPPY)intheexisting50locationsandexpandtheprogramtoanadditional50locations,withanemphasisonAboriginalandTorresStraitIslandercommunities,with25newlocationscommencinginearly2014andtheremaining25commencinginearly2015.HIPPYisatwoyearhome-basedparentingandearlychildhoodenrichmentprogramthatempowersparentsandcarerstobetheirchild’sfirstteacher.Theprogrambuildstheconfidenceandskillsofparentsandcarerstocreatea
positivelearningenvironmenttopreparetheirchildforschool.
‘Get Up and Grow’: Healthy Eating and Physical Activity Guidelines for Aboriginal and Torres Strait Islander Early Childhood Settingsprovidespracticalinformationandadviceonnutritionandphysicalactivitytopromotehealthybehavioursinchildrenaged0-5yearsattendingearlychildhoodservices.TheseresourceshavebeendevelopedtomeettheneedsofAboriginalandTorresStraitIslanderearlychildhoodeducationstaff,parentsandcarersnationallyandhelpsupportaconsistentnationalapproachtohealthyeatingandphysicalactivity.Theresourcesarebasedonthreekeynationalhealthydocuments:
• theInfant Feeding Guidelines (2012) andtheAustralian Dietary Guidelines (2013)whichformthebasisfornutritionpolicyinAustralia;
• theNational Physical Activity Recommendations for Children 0 to 5 Years,whichhasbeendevelopedtoguidepolicyandpracticearoundphysicalactivityforyoungchildren;and
• theNational Quality Frameworkwhichappliestolongdaycare,familydaycare,preschool(orkindergarten)andoutsideschoolhourscareservices.TheNational Quality Frameworkaimstoraisequalityanddrivecontinuousimprovementandconsistencyineducationandcareservices.
37
TheAustralianGovernmentadministersanumberofimmunisationprogramsforAboriginalandTorresStraitIslanderpeoplethroughtheNational Immunisation Program(NIP)andtheNational Indigenous Pneumococcal and Influenza Immunisation (NIPII) Program.TheNIPaimstoincreasenationalimmunisationratesbyfundingfreevaccinationprograms.AboriginalandTorresStraitIslanderchildrenlivinginsomestatesandterritoriesalsohaveaccesstoaHepatitisAvaccine.Thenationalschool-basedHuman Papillomavirus (HPV) Vaccination Program,providedthroughtheNIP,hasbeenextendedtoincludemales.FromFebruary2013,malesandfemalesaged12-13yearswillreceivetheHPVvaccineatschool.Malesaged14-15yearswillalsoreceivethevaccineaspartofacatch-upprogramuntiltheendofthe2014schoolyear.
TheAustralianGovernment’sHearing Services Programprovidestertiaryhearingservices,includinghearingassessmentsanddevices(ifrequired),toeligibleAboriginalandTorresStraitIslanderpeoplethroughtheCommunityServiceObligations(CSO).Inadditiontotheeligibilitycategoriesthatapplygenerally,AboriginalandTorresStraitIslanderpeoplewhoareeligiblefortheProgramincludethose:
• under26yearsofage;or
• over50yearsofage;or
• whoparticipateinspecifiedemploymentprojects.
CSOservicesaredeliveredbytheAustralianGovernmenthearingservicesprovider,AustralianHearing,througharound115permanenthearingcentres,350visitingsitesand220AboriginalandTorresStraitIslanderoutreachsitesnationally.TheseservicesincludetheAustralian Hearing Specialist Program for Indigenous Australians(AHSPIA),whichprovidesforthedeliveryofservicesthroughculturallyappropriateoutreachlocations,including100AboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationsinurban,ruralandremoteareasofAustralia.AHSPIAservicesarecollaborativelynegotiatedwithindividualcommunitiestomeettheneedsofcommunitymembers.Inmost
casestheagreedservicesaredocumentedinserviceagreementsbetweenAustralianHearingandthecommunity.
The2013-14Budgetcommittedapproximately$66millionoverfouryearsfortheClosing the Gap - Improving Eye and Ear Health Services for Indigenous Australiansmeasure.Theearhealthcomponentofthispackagewillcontinuetosupportprimaryhealthcareservicestobettermanageeardiseasethrough:
• trainingofAboriginalandTorresStraitIslanderHealthWorkersandotherprimaryhealthcareproviders;
• provisionofearandhearingscreeningequipment;
• implementationofup-to-dateclinicalcareguidelines;and
• earhealthpromotionresourcesforparents,carersandhealthprofessionals.
Fundinghasalsobeenprovidedtostatesandterritoriesforadditionalearhealthservices.
Eyehealthfundsmaintainthefocusoneliminatingtrachoma(aninfectiouseyediseasethatcanleadtoblindness),expansionofvisitingoptometryservices,andeyesurgery.
38
AdolesCent And youth heAlthAboriginalandTorresStraitIslanderyoungpeoplecurrentlyexperiencehigherratesofpoorhealthacrossarangeofhealthareas,andarethreetimesmorelikelytoreporthighlevelsofpsychologicaldistressasnon-Indigenousyoungpeople.15Youngpeopleinthisagegrouptendtobelowusersofprimaryhealthcareservices.ItisimportanttofindwaystoengageyoungAboriginalandTorresStraitIslanderpeopleandencouragepositivelifechoicestoimprovewellbeing,asthisagegrouphasthebestopportunitytosetupahealthyadulthood.Inparticular,itisimportanttoworkwithyoungpeopleonpreventivehealthandwellbeing,includingencouragingthemtouseappropriateservices,whileensuringthatservicesavailabletothemareaccessibleandconfidential.
Throughthe$2.2billionMental Health Reformpackage,anadditional$197.3millionoverfiveyearsfrom2011-12hasbeenprovidedtoexpandyouth-focusedmentalhealthservicesthroughtheheadspaceprogram.Theheadspacemodelprovidesaserviceplatformforholisticcareinmentalhealth,relatedphysicalhealth,alcoholandotherdruguse,andsocialandvocationalsupport.Asamainstreamservice,headspaceisensuringthedeliveryofculturallyappropriateservicesthroughanAboriginalandTorresStraitIslanderStrategyManagementCommitteewhichprovidesexpertandhighlevelstrategicadviceoneffectivemechanismstoengageandmeettheneedsofAboriginalandTorresStraitIslanderyoungpeople.StrongengagementisbeingachievedwithoversixpercentofallyoungpeopleseenbyheadspacecentresidentifyingasbeingofAboriginalandTorresStraitIslanderdescent.
Therearearangeofprotectivefactors(positivemoderatorsofriskoradversity)forthisagegroupthathavethepotentialtoencourageresilienceandincreaseself-careandself-esteem,includingparticipationincommunityevents,attendingorre-engagingwithschool,contributingtocommunitywellbeingandengagingin
culturalactivities.TheAustralianGovernmentisinvestingover$100millionoverthenextdecadeto2022intheYouth in Communities Program,amajoryouthinitiativethatishelpingthousandsofyoungAboriginalandTorresStraitIslanderpeopleintheNorthernTerritorybecomemoreengagedwithschool,workandcommunitylife.TheYouth in Communities ProgramsupportslocaldiversionaryactivitiesinremotecommunitiesforAboriginalandTorresStraitIslanderyouthaged10-20years,particularlythoseatriskofsubstanceabuse,suicideorself-harm,enteringthejusticesystemanddisengagementfromeducation,training,employmentandcommunity.
heAlthy AdultsTherearearangeofhealthriskfactorsthatcontributetotheburdenofdiseaseexperiencedbytheAboriginalandTorresStraitIslanderpopulation.Thesehealthriskfactorsimpactontheonset,maintenanceandprognosisofavarietyofchronicdiseases.Prematuremortalityfromchronicdisease,suchascirculatorydisease,cancer,diabetesandrespiratorydiseasesisamajorconcernforthisagegroup.16
Chronicdiseasepreventionandmanagementprogramsarevitaltoaddresstheearlieronsetofchronickidneydisease,diabetes,andcardiovasculardiseasethatAboriginalandTorresStraitIslanderpeopleexperienceintheir20s,30s,40s,and50s.
TheCOAGNational Partnership Agreement on Preventive Health(NPAPH)isprovidingupto$932.7millionovernineyearsfrom2009-10toaddresstherisingprevalenceoflifestyle-relatedchronicdiseasethroughthepromotionofhealthybehavioursincommunities,earlychildhoodeducationandcareenvironments,schoolsandworkplaces.
39
TheNPAPHalsosupportsinfrastructurerequiredtomonitorandevaluatetheprogressofinterventions,includingtheestablishmentoftheAustralianNationalPreventiveHealthAgency.TheAgencyassistsallgovernmentstosupportpeopletoadoptandmaintainhealthylifestylechoices,educateallAustraliansabouttherisksofchronicdisease,andaddressobesity,tobaccoandalcoholuse.
TheICDP,theAustralianGovernmentcontributiontotheNational Partnership Agreement on Closing the Gap in Indigenous Health Outcomes,hasthreemainelements:
• tacklingchronicdiseaseriskfactors;
• improvingchronicdiseasemanagementandfollow-upcare;and
• workforceexpansionandsupport.
Throughtheseelements,theICDPprovidessignificantfundingforpreventivehealthfocusingonAboriginalandTorresStraitIslanderindividuals,familiesandcommunities.Italsoprovidessupportandfundingformorecoordinatedandpatient-focusedprimaryhealthcare,bothinAboriginalandTorresStraitIslandercommunitycontrolledhealthorganisationsandmainstreamprimaryhealthcareandgeneralpractices.ThiswillensurethatAboriginalandTorresStraitIslanderpeople,regardlessofwheretheylive,willreceivehighqualityandculturallysecuremedicalcare.
TheNational Tobacco Strategy 2012-2018,developedaspartoftheNational Drug Strategy,prioritisesactiontoprotectpublichealthpoliciesfromtobaccoindustryinterference,eliminatetheremainingadvertising,promotionandsponsorshipoftobaccoproducts,andreducetheaffordabilityoftobaccoproducts.ThegoaloftheStrategyistoimprovethehealthofallAustraliansbyreducingtheprevalenceofsmokinganditsassociatedhealth,socialandeconomiccosts,andtheinequalitiesitcauses.Italsodetailsobjectivesandtargetsfortobaccocontroluntil2018andsetsoutninepriorityareasforaction,includingapriorityactionto“bolsterandbuildonexistingprogramsandpartnershipstoreducesmokingratesamongAboriginalandTorresStraitIslanderpeople.”
40
heAlthy AgeIngAged Care
TheLiving Longer Living Better,agedcarereformpackagewasannouncedon20April2012.Thepackageinvolvesacomprehensivetenyearplantoreshapeagedcare,andwillprovide$3.7billionoverfiveyearstobuildabetter,fairerandmorenationallyconsistentagedcaresystem.
TherearetwoIndigenous-relatedmeasuresunderLiving Longer, Living Better:
• thecontinuationofpreviousbudgetmeasurestobecomeanongoingpartoftheviabilitysupplementtoproviders,(aviabilitysupplementiscurrentlypaidtoeligibleprovidersoperatinginregional,ruralandremoteareasaswellasthosethatcareforspecificgroupsofhighlyvulnerableolderAustralians,includingAboriginalandTorresStraitIslanderpeopleandolderpeoplewhoarehomelessoratriskofbeinghomeless).Thesemeasuresare:
> a40percentincreaseintheleveloftheviabilitysupplement;
> additionalfundingforagedcarehomesinveryremotetomoderatelyaccessiblelocationsthattargetlowcare;
> continueexistingfundingforeligibleagedcarehomesthatprovidespecialistagedcareservicestoAboriginalandTorresStraitIslanderpeople;and
> continueexistingfundingforeligibleagedcarehomesthatprovidespecialistagedcareservicestopeoplewithahistoryof(orwhomaybeatsevereriskof)homelessness.
• theexpansionoftheNational Aboriginal and Torres Strait Islander Flexible Aged Care Program.Thismeasurewillresultintheestablishmentofnewresidentialagedcareservicesinareasofhighneed,includingintheNorthernTerritoryatMutitjulu(CentralAustralia)andNhulunbuy(EastArnhemLand).Theexpansionwillseearound200additional
agedcareplacesbeingmadeavailableforAboriginalandTorresStraitIslanderpeoplelocatedinremotecommunities.
TheNational Aboriginal and Torres Strait Islander Flexible Aged Care Program,establishedin1994,seeksto:
> providequality,flexible,culturallyappropriateagedcareservicestoolderAboriginalandTorresStraitIslanderpeopleclosetotheirhomeandcommunity;
> enablethesecommunitiestoprovidearangeofserviceswhichareabletorespondtotheindividualneedsofolderpeoplewithinthecommunity;
> developfinanciallyviable,efficient,andcoordinatedservices,outsidetheexistingconventionalprogramstructures;and
> facilitatecommunityinvolvementinthecareoftheirolderpeoplethroughthemanagementoftheservice.
41
pAllIAtIve CAreTheAustralianGovernmentcurrentlysupportsculturallyappropriatetrainingandeducationinpalliativecareandendoflifeissuesforhealthcareworkersprovidingservicesforAboriginalandTorresStraitIslanderpeoplethroughfundingvariousnationalpalliativecareprojectsincluding:
• theGuidelines for a Palliative Approach in Residential Aged Care anditscompaniondocument, theGuidelines for a Palliative Approach for Aged Care in the Community Setting,aimtoprovidesupportandguidanceforthedeliveryofapalliativeapproachinresidentialandcommunityagedcareacrossAustralia.BothGuidelinesincludeprinciplesandstrategiestosupportpalliativecarewhichisculturallyappropriatetoAboriginalandTorresStraitIslanderpeople;
• theAustralian Palliative Care Knowledge Network (CareSearch) isaninteractivewebsitethatincludesasearchabledatabaseofpalliativecareliteratureandonlineforumsthatallowgroupstoshareresearch,reportsandinformation.Thewebsiteprovidesinformationresourcesforresearchersandpalliativecarespecialists,alongwithinformationforpatientsandtheirfamilies,carers,generalpractitioners,otherhealthcareprofessionalsandthegeneralpublic.TheinformationincludespracticeprinciplesandeducationalresourcestosupporthealthprovidersinprovidingculturallyappropriatepalliativecaretoAboriginalandTorresStraitIslanderpeople;
• thePalliative Care Curriculum for Undergraduates (PCC4U)isdevelopingandpromotingtheuseofpalliativecareeducationalresourcesinallhealth-relatedundergraduateandentrytopracticecourses.ThePCC4UsuiteofmodulesincludesoneentitledCaringforAboriginalPeoplewithLifeLimitingConditions.ThemoduleisintendedtodeveloptheknowledgeandskillsneededtoprovidequalitycaretoAboriginalandTorresStraitIslanderpeoplewithlifelimitingillnessesandtheirfamiliesacrossavarietyofsettings;
• theProgram of Experience in the Palliative Approach(PEPA)providesaworkplacementtrainingprogramforhealthprofessionalsthroughclinicalplacementsinspecialistpalliativecareservicesorinteractiveworkshops.PEPAhasadedicatedsub-programforAboriginalandTorresStraitIslanderhealthworkersunderpinnedbytheprincipleofculturalrespect.Thissub-programhasbeendevelopedinconsultationwithrepresentativesfromAboriginalandTorresStraitIslanderhealth,policyandeducationsectorsandiscustomisedtolocalneedswithineachstateandterritory;and
• theRespecting Patient Choices(RPC)projecttodevelopanationalprogramforadvancecareplanningpromotionandcapacitybuildingthatcanbeimplementedacrossAustralia.RPCiscurrentlydevelopingtargetedadvancecareplanningapproachesforpeoplefromAboriginalandTorresStraitIslandercommunities.
42
referenCes1AustralianInstituteofHealthandWelfare2012,Australia’shealth2012,Australia’shealthseriesno.13.Cat.No.AUS.156,Canberra:AIHW.
2Ibid.
3AustralianGovernment,Development of a National Aboriginal and Torres Strait Islander Health Plan, DiscussionPaper,2012.
4AboriginalandTorresStraitIslanderSocialJusticeCommissioner2005,Social Justice Report 2005,Sydney.
5Booth,A&Carroll,N2005,The health status of Indigenous and non-Indigenous Australians, Centre for Economic Policy Research,AustralianNationalUniversity,Canberra.
6CouncilofAustralianGovernments(COAG)ReformCouncilNationalIndigenousReformAgreement:COAGReformCouncil,(www.federalfinancialrelations.gov.au/content/npa/health_indigenous/indigenous-reform/national-agreement_sept_12.pdf)
7Ibid.
8Ibid.
9Ibid.
10Ibid.
11Ibid.
12AustralianHealthMinisters’AdvisoryCouncil,2012,Aboriginal and Torres Strait Islander Health Performance Framework 2012 Report,AHMAC,Canberra.
13CouncilofAustralianGovernments(COAG)ReformCouncil,op.cit.
14Griew,R,Tilton,E,Stewart,J,Eades,S,Lea,T,Peltola,C,Livingstone,Harmon,KandDawkins,Z2007,Family Centred Primary Health Care.
15AustralianInstituteofHealthandWelfare2011,Young Australians: their health and wellbeing 2011, Cat.No.PHE140Canberra:AIHW.
16AustralianHealthMinisters’AdvisoryCouncil,2012,op.cit.
NAtioNAl AborigiNAl ANd torres strAit islANder HeAltH PlAN – ComPANioN doCumeNt oN CommoNweAltH goverNmeNt strAtegies ANd reforms
isbN: 978-1-74241-983-1
online isbN: 978-1-74241-984-8
Publications approval number: 10306
Copyright statements:
Paper-based publications© Commonwealth of Australia 2013
this work is copyright. You may reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. requests and inquiries concerning reproduction and rights are to be sent to the online, services and external relations branch, department of Health and Ageing, gPo box 9848, Canberra ACt 2601, or via e-mail to [email protected].
Internet sites© Commonwealth of Australia 2013
this work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. requests and inquiries concerning reproduction and rights are to be sent to the online, services and external relations branch, department of Health and Ageing, gPo box 9848, Canberra ACt 2601, or via e-mail to [email protected].
Please be aware that this document may contain the images and names of Aboriginal and Torres Strait Islander people who may have passed away.
www.health.gov.au/natsihpAll information in this publication is correct as at July 2013
NatioNal aborigiNal aNd torres strait islaNder HealtH PlaN Companion document on Commonwealth government strategies and reforms — July 2013
1030
6 Ju
ly 2
013