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Health voices unite on the Commission of Audit recommendations

Such is the concern about the National Commission of Audit recommendations that a number of key health bodies, namely the Australian Health Care Reform Alliance, Australian Health Promotion Association, Consumers Health Forum of Australia, Foundation for Alcohol Research and Education and Public Health Association of Australia have today circulated the media release below. In addition the National Congress of Australia’s first peoples has also urged caution in their press release which follows.

Key health bodies slam National Commission of Audit recommendations

Five key health organisations have written to the Prime Minister to express deep concern in relation to the reports and recommendations of the National Commission of Audit, which advocate cuts to government spending in areas of critical importance to Australians.

In particular, the groups believe the absence of a national approach in key areas such as preventive health and communicable disease will jeopardise people’s health and put greater pressures on the health system.
Signatories to the letter include the: Australian Health Care Reform Alliance, Australian Health Promotion Association, Consumers Health Forum of Australia, Foundation for Alcohol Research and Education and Public Health Association of Australia.

“Among the Commission’s recommendations are calls for the dismantling of multiple agencies – including the National Preventive Health Agency – and the surrender back to the states of key areas of responsibility in education, health and other services.  From our perspective, such changes would represent an abrogation of responsibility by the Australian Government that is entrusted to progress national priorities for the nation’s health and wellbeing,” said Michael Moore, Chief Executive Officer of the Public Health Association of Australia.
“A compulsory $15 co-payment for GP visits is one way of providing extra funding for health care, but it is one of the least effective, targeted bizarrely at those who are sick.

Strong primary health care is internationally recognised as the cornerstone of an effective and lower cost health system.  Discouraging low-income people – who we know have the worst health status on average – from attending their local GP or emergency department when there are the early signs of sickness is counter-productive, cruel if they are in pain, and ultimately foolhardy.  Untreated diseases get worse and more expensive to cure,” said Tony McBride, Chair of the Australian Health Care Reform Alliance.
“The Australian Government Department of Health manages key national strategies in relation to communicable diseases, immunisation, mental health, alcohol and other drugs and Closing the Gap in health outcomes for Indigenous Australians, just to name a few.

The health portfolio takes into account the broader interests of all Australians.  Responses to outbreaks of communicable diseases and other public health emergencies, for instance, clearly need to be coordinated at the national level,” said Gemma Crawford, President of the Australian Health Promotion Association.
“The protection and improvement of health outcomes for all Australians are vital national government functions.  They can’t effectively be divested to the states and territories or privatised.  These are fundamentally Commonwealth responsibilities that require coordination and leadership at the national level.

To suggest that we don’t need a national focus on key issues is a dangerous nonsense,” said Mr Moore.
“We also oppose the introduction of mandatory $15 co-payments for every Medicare service, and increased co-payments for PBS medications.  Our commitment is to equitable and universal access to health care for all Australians.  Measures that would create a two-tiered health system for the ‘haves’ and the ‘have nots’ are simply un-Australian.  Australians fundamentally believe in a level playing field and a fair go for all.  Our tax dollars should be used accordingly.  We trust that the Government will review and reject the majority of the Commission’s recommendations with these considerations in mind,” said Adam Stankevicius, the Chief Executive Officer of the Consumers Health Forum.

Congress urges caution on the Commission of Audit

The National Congress of Australia’s First Peoples is deeply concerned at what it considers to be flawed and shallow recommendations by the National Commission of Audit in relation to Indigenous expenditure, and urges the Abbott Government to proceed with caution in its response.

“This is solely an accounting exercise.  This process counts dollars and ignores the people. It’s about cutting expenditure.  And there appears little rigour or evidence to justify the recommendations,” said Co-Chairs Les Malezer and Kirstie Parker.

Congress notes the Government is not obliged to implement the Commission’s recommendations and calls for talks between the Government and Congress, as the national representative body of Aboriginal and Torres Strait Islander Peoples.

“The Commission report quoted a Department of Finance’s Strategic Review of Indigenous Expenditure in 2010 observation that ‘The history of Commonwealth policy for Indigenous Australians over the past 40 years is largely a story of good intentions, flawed policies, unrealistic assumptions, poor implementation, unintended consequences and dashed hopes’,” Mr Malezer said.

“We couldn’t agree more. Unfortunately, the Commission’s recommendations look to perpetuate that sorry tale.

“Ill-considered amalgamation of about 150 Indigenous programs into just six or seven, as recommended, would lead to a confused and indefinite policy environment, ultimately resulting in cuts or losses by community-based organisations of their basic funding and services.

“Given the high levels of ongoing disadvantage experienced by our Peoples, compounded by historical neglect by successive governments of all persuasions, there should be no reduction in levels of Commonwealth expenditure on Indigenous affairs.”

Ms Parker said it was clear that some of the Commission’s general recommendations, if implemented, would impact disproportionately on Aboriginal and Torres Strait Islander Peoples.

“For example, the raising of the age pension age to 70 by 2053 when our Peoples have an average life expectancy of at least ten years less than other Australians[i], and the introduction of a Medicare co-payment given that our Peoples experience a much higher burden of ill-health[ii] and lower median incomes[iii],” she said.

“Congress strongly supports greater efficiency, accountability and reduction of red tape in the administration of Indigenous affairs.  However, there must be transparency around criteria upon which any programs are evaluated and, potentially, determined as ‘less effective’.  And our Peoples must be fully engaged in that process to ensure that adverse outcomes do not result from changes.”

The Commission has recommended the amalgamation of the Indigenous Land Corporation (ILC) and Indigenous Business Australia (IBA) and the review of a raft of other Indigenous bodies including the Torres Strait Regional Authority, Northern Territory land councils, Aboriginal Hostels Ltd, and the Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS).

“Congress cannot support merger, abolition or transfer of any Aboriginal and/or Torres Strait Islander body administered by the Government without more information and clarity on the intended outcomes,” Mr Malezer said.

Congress unequivocally rejects the Commission’s recommendation on Congress itself, which is the only national representative voice for Australia’s First Peoples.  Owned and controlled by its membership, Congress’ Co-Chairs and Board are elected, not appointed.

“The Commission’s recommendation to overturn the 2013 Budget commitments to Congress can only be interpreted as a decision to oppose the rights of the Aboriginal and Torres Strait Islander Peoples to self-determination,” Mr Malezer said.

“Ministers, bureaucrats, and Indigenous peoples working separately do not have all the answers required to improve the lives of Australia’s First Peoples.  But working together, without blame and prejudice, we may have a chance.  This chance should be given support and not be negated.”

Ms Parker said the Congress approach had been to deal with the Government with respect and goodwill and ‘we would ask that this approach be reciprocated and form the basis of a fresh and necessarily robust relationship based on goodwill and good faith’.

“In its statement to the Commission late last year, Congress recommended that government improve its accountability and transparency, support our Peoples’ self-determination, respect and properly resource our community controlled organisations, ensure no diminution of funding for Indigenous programs, and support a sustainable Congress.

“We would like to see government change the way it does business so that nothing is decided about us without us.”