- The NHLF calls for self-determination across our national institutions through constitutional reform and supporting the recommendations that arose from the Uluru Statement from the Heart. If Australia can take the significant step towards constitutional reform; self-determination across all aspects of government and public policy will in time, follow. The NHLF calls
- for all Australian governments to support and enact the Uluru Statement from the Heart.
- We maintain that to close the gap in life expectancy and the disproportionate burden of disease on Aboriginal and Torres Strait Islander people, a system-wide investment approach for the National Aboriginal and Torres Strait Islander Health Plan is required. This includes endorsement from all jurisdictions, so that all governments are contributing to achieving the vision through addressing the Social and Cultural Determinants of Health. The NHLF calls
- for the new National Agreement on Closing the Gap refresh to be formalised under the federal financial relationship.
- for Aboriginal and Torres Strait Islander-led research and research funding allocations.
- The National Aboriginal and Torres Strait Islander Health Workforce Plan is an essential element to closing the gap in Indigenous disadvantage and will contribute to improving Aboriginal and Torres Strait Islander health and wellbeing by growing the Aboriginal and Torres Strait Islander workforce across all professions and levels. To improve health outcomes the NHLF calls for the all governments to
- honour the commitment to work with us on implementation of the commitment made around Aboriginal and Torres Strait Islander health workforce at the COAG Indigenous Heath Roundtable in August 2018 – developing, implementing a health workforce strategy.
- Commit to working in partnership with the NHLF and others on the development of cultural safety workforce training for the Australian health workforce.
- The NHLF also calls on for the Health Workforce Plan to include sustain investment for:
- Indigenous-led pathway programs from VET in schools, greater support for VET programs with the articulation onto Tertiary studies.
- Increase and expand support for cadetships and traineeships supported by an Indigenous-led pathway program.
- Increase the funding level for the Puggy Hunter Memorial Scholarship Scheme and evaluate the effectiveness for student outcomes.
- Create consistency across jurisdictions in their drugs and poisons Act for all health professionals.
- Increase data and research capacity building to grow the Aboriginal and Torres Strait Islander health research workforce.
- Racism has an adverse impact on the health and wellbeing of Aboriginal and Torres Strait Islander people. Experiences of racism in the health system prevents people from accessing and receiving the health care they require.
- Until racism is addressed in a systematic and open way across the breadth and depth of the health system, Aboriginal and Torres Strait Islander people will continue to be at risk of having unsatisfactory experiences within the Australian health system, preventing them from getting the health care they have a right to expect and receive.
- A well-trained health workforce is key to ensuring the health system is accessible, culturally safe and responsive to the needs of Aboriginal and Torres Strait Islander people. This requires a contribution from all health professionals and the systems they work in, including how they interact to ensure appropriate, holistic and continuous care. The NHLF calls
- for all Governments to recognise and respect the self-determination process for Aboriginal and Torres Strait Islander people across all key health priority areas, through embedding co-design and co-decision making processes.
- For all governments to agree to a partnership with the NHLF and other Aboriginal and Torres Strait Islander health experts, to develop and implement a barometer to measure the experiences of patient care within the health system.
- For all governments to embed cultural safety and responsive practices within public service systems and the designing and implementation of public policy; and
- the Aboriginal and Torres Strait Islander specific actions in the National Safety and Quality Health Service (NSQHS) Standard should include assessment and reporting on institutional racism.
Key Areas of Advocacy
Members of the NHLF are advocating strongly in a number of key areas that have
significant national implications for Aboriginal and Torres Strait Islander health:
National Aboriginal and Torres Strait Islander Health Plan
Members of the NHLF have been involved in the development of the second Implementation of the National Aboriginal and Torres Strait Islander Health Plan 2013-23.
The Implementation Plan outlines the actions to be taken by the Australian governments, the Aboriginal Community Controlled Health Sector (ACCHS), and other Non-Indigenous services sector, to give effect to the vision, principles, priorities and strategies of the Health Plan.
NHLF members have been able to reshape the Implementation Plan so that the focus is on
- Embedding the social determinants of health and cultural determinants of health;
- Ensuring alignment with government policies and priorities; and
- Simplifying goals and actions to improve accountability.
The social determinants identified and included:
- The social determinants recognise the holistic nature of Aboriginal and Torres Strait Islander health and social and emotional wellbeing.
- The Implementation Plan recognises the role of cross-sector partnerships in addressing determinants, including early childhood development; education and youth; employment and income; housing; environment and infrastructure; poverty; racism; interaction with government systems and services; law and justice; alcohol, tobacco and other drug dependency; and food security.
- These social determinants were identified in the My Life, My Lead consultations.
The cultural determinants of health?
- The cultural determinants of health are the things that support good health, including country and caring for country, knowledge and beliefs, language, self-determination, kinship, and cultural expression.
- The cultural determinants in the proposed Implementation Plan framework are informed by the Mayi Kuwayu study on Aboriginal and Torres Strait Islander wellbeing and further work by the Lowitja Institute, Australia’s national institute for Aboriginal and Torres Strait Islander health research.
Coalition of Peaks and Closing the Gap Refresh
Members of the NHLF are part of the Coalition of Peaks, which is a collection of peak organisations working together to co-design a new national agreement on closing the gap.
The Coalition of Peaks is Aboriginal and Torres Strait Islander Peaks, a representative organisation made up of almost 50 community-controlled organisations, is working with governments to finalise a new national agreement on Closing the Gap. This is the first time that Aboriginal and Torres Strait Islander people, through their peak body representatives, will share formal decision making with governments on policies that affect us.
The Partnership Agreement, formally agreed by the Council of Australian Governments (COAG) and the Coalition of Peaks, sets out how they will work together over the next ten years on Closing the Gap.
It sets a new standard for partnerships between Aboriginal and Torres Strait Islander people and governments. It is also an acknowledgement that Aboriginal and Torres Strait Islander people have been silenced on policies and approaches to close the gap in the past and that outcomes for Aboriginal and Torres Strait Islander people are not going to change without their genuine involvement in policies and programs.
Click here for more information on the Coalition of Peaks
National Aboriginal and Torres Strait Islander Health Workforce Plan
In August 2008, Health Ministers from all jurisdictions (COAG Health Council), agreed to the development of a National Aboriginal and Torres Strait Islander Health and Medical Workforce Plan. This plan aims to focus on the recruitment and retention of Aboriginal and Torres Strait Islander people in all health professions. This plan will form the implementation plan to the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2015-2023, which for a number of years has not included any concrete actions or accountability measures for Government to be judged by.
The Commonwealth Department of Health is leading the development of the Workforce Plan but does so with the input of a reference group, made up of people and organisational representatives from the across jurisdictional National Aboriginal and Torres Strait Islander Health Standing Committee; the NHLF, NACCHO, NATSIHWA, state and territory governments.
The target date for the Workforce Plan to be completed and endorsed is mid-2020.
Cultural Fusion have been engaged by the Department of Health, to conduct consultations about the workforce plan. Click here for more information about Cultural Fusion and the their consultation project.