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Calls for greater investment in Aboriginal community controlled health sector

As previously reported at Croakey, an Indigenous health Twitter fest will be held on Thursday, May 1, using the hashtag #IHMayDay to enable a wide-ranging discussion at a time of funding uncertainty.

In a recent article worth reading in full, Professor Ian Ring, a professorial fellow at the Australian Health Services Research Institute at the University of Wollongong, says Aboriginal Community Controlled Health Organisations run by and for Aboriginal people perform better than mainstream general practice in caring for Aboriginal and Torres Strait Islander patients.

He nominates three critical issues that need addressing by the Federal Government:

“First, bureaucratic reform is essential. That means substantially fewer public servants but those that remain need to have the requisite skills and experience. There is broad agreement that the main functions of Aboriginal health should remain with the Department of Health, preferably led by an indigenous official, but a small, high-level group in the Department of the Prime Minister and Cabinet, to ensure the new Prime Minister’s requirement to deliver for Aboriginal people, is an essential component of the new arrangements.

Second, the recently formulated National Aboriginal and Torres Strait Islander Health Plan isn’t really a plan in any meaningful sense but could become one if the implementation plan foreshadowed in it is developed in genuine partnership with Aboriginal people and involves officials with the requisite skills, experience and training. But that implementation plan needs to also include mental health and, this time, to wrestle successfully with mainstreaming.

Third, and most important, there seems to be an increasing recognition that non-Aboriginal people really can’t make indigenous people healthy. It is time for Aboriginal communities to play a more central role in the design and conduct of their own services, bearing in mind that some of the best health services in Australia are run by the ACCHS sector.”

The Australian Medical Association has also backed the need to expand the ACCHO sector in light of its economic, health and social benefits. AMA President Dr Steve Hambleton called for “appropriate funding and investment to build on the great services they provide”, and said in a recent statement:

The AMA believes that an analysis should be conducted to determine needs in Aboriginal and Torres Strait Islander health at a regional level. Based on that analysis, Aboriginal Community Controlled Health services should be established and appropriately funded in areas of need according to the demand for services.

Funding differences between jurisdictions should also be reviewed to ensure equitable distribution of resources for Aboriginal Community Controlled Health services, again according to need.”

Another 150 services needed

Meanwhile, Sandy Davies, a Yamatji man from Western Australia and chair of the Geraldton Regional Aboriginal Medical Service, has called for an extra 150 Aboriginal community controlled health services to be established.

In an interview with Croakey after speaking at the March in March rally in Canberra last month, he criticised the Federal Government for not consulting properly with remote Aboriginal communities in WA.

Film credit: Mitchell Ward

Transcript

“My name is Sandy Davies, and I am a Yamatji man from the central part of Western Australia, which takes in the Gascoyne, Murchison, mid-west regions, which is from Carnarvon to the north, Geraldton, Dongara to the south, and out to Meekethara and Sandstone to the east, to the remote areas.

I’m the chairperson of the Aboriginal Medical Service in Geraldton and have been involved in that service since the beginning of time and involved with many, many organisations, ten years as the chairperson of the Yamatji Regional Council for ATSIC in the ATSIC days. I’ve spent three years as the chairperson of the West Australian Legal Service and the list goes on.

The Government’s decision and the cuts that they’re making and the conditions they’re putting on Aboriginal people to receive funding in this country now is going to have a terrible impact on Aboriginal people who’ve lived in remote areas and have lived in those remote communities forever. They’ve never lived anywhere else, their families have never lived anywhere else.

Nobody in Government has been out to talk to them, no Government service providers have been out to talk to them, they don’t have access to the same media and information that Aboriginal people in the cities and big towns do, so they don’t really know what is happening until somebody rocks up with a piece of paper for us to sign and say, this is going to be your funding and these are the programs you’re going to (get) – that is what we call inequity.

We want people, we want Government to engage with our remote communities, and there are thousands of Aboriginal people living in remote communities in Western Australia, we want governments to engage with them face to face on a one on one basis, so they can have an input to what they see as their priorities for themselves, for their communities, for their children, for their education, for their employment. It is absolutely disgraceful that the government of this country has totally ignored Aboriginal people in remote Western Australia.

We call on Tony Abbott and his Government to go out and engage with Aboriginal people. Not do what Nigel Scullion and Warren Mundine did – come to Yamatji country, do what they had to do, and leave, and not engage with Aboriginal people. We were so insulted by the disrespect shown to us by those two people that we decided we would travel three and a half thousand kilometres to come here, and give them the opportunity to engage with us where they feel most comfortable, because obviously they were afraid to engage with us in our own country.

…mental health issues is a number one priority, no matter where you go in this country. Mental health is an absolute priority – 400 suicides in the last three years around Australia.

Q: Specifically in health what would like to see – you mentioned you’d like to see more Aboriginal Community Controlled Health services?

Absolutely. The fact is that in Aboriginal community controlled services, we employ more Aboriginal people than any other government or non-government service provider in this country. We train more Aboriginal people than any other government or non-government service provider. We have a larger Aboriginal client base collectively, the 150 Aboriginal medical services than any other government or non-government service provider in this country.

We are doing in the Aboriginal health sector exactly what Tony Abbott and Warren Mundine and Nigel Scullion are saying – we employ people, we educate people, we train people. We are the people you should be engaging. And if you have a look in the AMS’s where it’s 80 per cent plus about the number of Aboriginal people who use the Aboriginal medical services – because governments won’t do it, but if you look at the health of Aboriginal people and the services they get, compared to where there are no Aboriginal services – there is a marked difference.

So if this government and the state governments are serious about closing the gap on Aboriginal people, two things will happen: we will continue to establish more Aboriginal controlled health services and if we want to close the gap in this country, we must take health services to the remote areas for Aboriginal people.

Because at the moment in the remote areas where they don’t have Aboriginal community controlled services, they have to travel thousands of kilometres to get to health services. And more times than not, the Aboriginal people in those communities don’t attend services until they’ve gone past the point of no return.

Q: How many more community controlled services are needed? Has anyone scoped that?

We haven’t but I believe that, if you have a look at what the current 150 deliver around this country with the support of the state affiliates and of course the national NACCHO – which is one of the best health structures in this country, Aboriginal structures in this country – at a national level, another 150 would go a long way to closing the gap on Aboriginal health in this country.

• On Twitter: @SandyDavies8

Update, 27 April

ABC reports: 

“The head of the Prime Minister’s Indigenous Advisory Council, Warren Mundine, has warned his fellow councillors to be prepared to be among the most hated people in Australia after next month’s federal budget.

Mr Mundine has told the ABC he expects there will be cuts to Indigenous funding in the budget as the number of program areas is reduced from about 150 to five as part of a “realignment” of spending.

The five key program areas identified by Mr Mundine are: health, education, jobs, law and sustainable communities.”