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Is the NT leading the way in primary health care reform and Indigenous health partnerships?

The NT seems to be making some strides in primary health care reform. The Aboriginal Medical Services Alliance Northern Territory (AMSANT) has provided this report of a launch that took place today:

The launch on Remembrance Day of Pathways to community control was a poignant moment for Stephanie Bell, chairperson of AMSANT.

For the first time, the Commonwealth and a “state” government—the Northern Territory—had reached an agreement with the Aboriginal Community Controlled health sector to expand community-controlled primary health care across a whole jurisdiction.

It was an historic agreement after three decades of struggle by the community-controlled sector and various governments—not least in the Northern Territory.

Stephanie Bell said that, in a very real way, this Remembrance Day marked “the end of the war”. While there is still a long way to go in Closing the Gap in Indigenous health, Ms Bell pointed out that the National Health and Hospitals Reform Commission recently gave strong support to Aboriginal community-controlled comprehensive primary health care.

Here is an excerpt from Ms Bell’s speech at the launch:

“As recently as five years ago—let alone 15 years ago—an event such as this would simply not have been possible. We have moved in a decade and a half, from an atmosphere of antagonism and conflict—to one of mutual cooperation and commitment in the cause of Closing the Gap in Aboriginal health.

And here we are.

As a representative of the community-controlled sector, it is with great pride—and considerable hope—that I am happy to be here at the launch of Pathways to Community Control. It is an important milestone in a history that stretches back at least three decades—a history in which Aboriginal communities throughout the nation have worked at the coalface to overcome the legacy of colonisation that has produced so much ill health in every single one of our families and our communities.

At the core of what we have achieved over those many years has been an aggressive approach to basing our work on evidence. Our accumulated achievements have always been based on what works—in clinical as well as social practice.

At the heart of what we have strived to achieve is the development of a practice—both clinical and social—that displays our strong and central commitment to Comprehensive Primary Health Care.

This model was codified at an international level at Alma Ata in 1978, and subsequently endorsed by the World Health Organisation (WHO) and the United Nations:
Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.

Primary health care is socially and culturally appropriate, universally accessible, scientifically sound, first level care.

It is provided by health services and systems with a suitably trained workforce comprised of multidisciplinary teams supported by integrated referral systems in a way that:
·     gives priority to those most in need and addresses health inequalities;
·     maximizes community and individual self-reliance, participation and control and;
·     involves collaboration and partnership with other sectors to promote public health.

Comprehensive primary healthcare includes health promotion, illness prevention, treatment and care of the sick, community development, advocacy and rehabilitation services.

Recommendations of the National Health and Hospitals Reform Commission clearly indicate that—at a national level—Primary Health Care is critical to the future health of all Australians.

The launch of Pathways recognises the absolute necessity of developing and strengthening Comprehensive Primary Health Care [CPHC] through planning, development and delivery at local and regional levels here in the Territory.

That means Aboriginal community control.

The Aboriginal Health Forum in the Territory has taken a strong stand on developing an evidence-based approach to CPHC, and recognises the strong gains that can be developed through Aboriginal Community Control at the grass roots level.

The Northern Territory Aboriginal Health Forum represents one of the strongest and most productive partnerships between government and the Aboriginal community-controlled health sector in the nation, and Pathways provides a road map for the principal of “working together for our health” as part of the long term vision of Closing the Gap.

This principle—of “working together for our health”—is an AMSANT catch cry, but I like to think of it as summing up the partnership we have built with the Australian and Territory governments.

Our partnership does not mean we will always agree—in fact we have some pretty decent blues from time to time.
Nor does it mean we all do the same thing, or that we are in bed with each other 24 hours a day.

What the partnership means is that we work together using our respective skills and our respective knowledge in the common purpose of “working together.

I said that today is an important milestone—but in saying that all of us here know that we have a long way to go.

The recent revision by the Australian Bureau of Statistics of Aboriginal life expectancy reduced the apparent “gap” between Indigenous and non-Indigenous health at a national level.

However, because the data is better from the Northern Territory, the gap is still just as wide in the Northern Territory. While we have what is probably the best partnership between governments and our sector in the nation—that is as it should be—as the task in front of us is so huge.

Thank you—everyone here—who has contributed so much to the process that has led us here to the launch of Pathways.

May these small pathways lead to the highway that will take us to Closing the Gap.”

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