improving social determinants of indigenous health unified approach to implementing the national...
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Improving Social Determinants of Indigenous HealthUnified approach to implementing the National Partnership
Mr Brian Gleeson
Coordinator General for Remote Indigenous Services
The lay of the land
Closing the GapA COAG initiative
Remote Service DeliveryA new way of working
The Office of the Coordinator Generalfor Remote Service Delivery
A watchful eye
Closing the Gap
BUILDING BLOCKS
EarlyChildhood
Schooling HealthyHomes
Health
EconomicParticipation
SafeCommunities
Governanceand
Leadership
Closing the Gap
TARGETS
1. Closing the life expectancy gap within a generation.
2. Halving the gap in mortality rates for Indigenous children under 5 within
a decade.
3. Ensuring all Indigenous 4 year olds in remote communities have access
to early childhood education within 5 years.
4. Halving the gap for Indigenous students in reading, writing and numeracy
within a decade.
5. Halving the gap for Indigenous students in year 12 attainment or
equivalent attainment rates by 2020.
6. Halving the gap in employment outcomes between Indigenous and
non Indigenous Australian within a decade.
Closing the Gap
INDIGENOUS SPECIFIC NATIONAL PARTNERSHIPS
1. Closing the gap in Indigenous health outcomes.
2. Indigenous Early Childhood Development.
3. Indigenous Remote Service Delivery (RSD).
4. Remote Indigenous Housing.
5. Indigenous Economic Participation.
6. Remote Indigenous Public Internet Access.
What will RSD Achieve
Improve services – make sure the right ones are there and that they do things properly.
Help communities to be able to manage their dealings with governments and organisations better (governance and leadership).
Set up offices in each community to make is easier to understand what
governments can do for communities and their members.
Ensure that communities are determining their own future.
Help make communities better places to live in.
The question should not be, ‘why do women not accept the service that we offer?’BUT
‘Why do we not offer a service that women will accept?’World Health Organization 2005
RSD Works at 3 Levels
Governments working differently by themselves and together – looking at places rather than programs and levels of government.
Governments and communities working differently together – a proper
partnership with joint decisions about what will be done and how it is
done.
Communities working differently – being properly informed, making
decisions, holding governments and service providers accountable.
"If you talk to a man in a language he understands, that goes to his head.
If you talk to him in his language, that goes to his heart."
Nelson Mandela
Why is RSD Different
Focuses investment in specific locations.
Whole of community approach.
Focused on location not policy domains.
Scope for innovative approaches, trial “what works.”
Work in partnership with communities / community development approach.
Ongoing government presence – closer to communities.
Governments in partnership.
RSD Priority Communities
Indigenous health
The level of service delivery varies across the 29 priority communities.
Many communities are over 250km away from a hospital
Some only see a GP every two weeks and one has no GP service at all.
Indigenous health
In communityLess than 10km10km-24km50km-99km100km-249kmover 249km
Distance to nearest hospital
27% of communities travel 50-249km to go to a hospital
41% of communities travel more than 249km to go to a hospital
Indigenous health
GP work/ visit in community
Every dayEvery week dayWeeklyFortnightlyFrequency unknownNo serviceUnknown
62% of communities do not have daily access to GP’s
Indigenous health
Dentist work/ visit in community
WeeklyFortnightlyMonthly6 weekly3 monthly6 monthlyFrequency unknownNo service
96% of communities do not have weekly access to a dentist
Indigenous health
Aged accommodation
ServiceNo service
68% of communities have no aged accommodation
Indigenous health
The incidence of treated end stage renal disease in Indigenous Australians is eight times that of other Australians.
In remote areas it is more than twice this and in the Northern Territory it is more than 28 times.
PREVENTATIVE HEALTH NEEDS GREATER PRIORITY.
Case Study
• In early 2007 Kurra decided to support Warlpiri renal patients forced to dislocate from their communities to Alice Springs to access dialysis treatment.
• Using $1.6 million in Kurra royalty money, a dialysis clinic will open in Yuendumu in early 2010. • The funding will also pay for patients from nearby communities to travel to Yuendumu for regular overnight visits and longer holidays at home, where they will be treated in the unit by the renal nurse.
• The renal service in Yuendumu will cater for patients in Yuendumu, Nyirripi, Yuelamu and Willowra.
• With the money from Kurra, the renal service in Yuendumu will last for around twelve months. • Kurra are hoping that governments and philanthropists will agree to put some money towards the renal service to help keep it running.
Accountability breeds responsibility.
The Establishment of the Office
Statutory office established under the
Coordinator General for Remote Indigenous Services Act 2009
Oversee the implementation of the RSD partnership.
Formally report twice a year on progress, and ensure that all government agencies are held accountable for their implementation responsibilities.
Have the authority to work across agencies to cut through red tape and bureaucratic blockages and to make sure services are delivered effectively.
Work with the whole of government Regional Operations Centres established to coordinate services in communities and the single government contact points located within the priority communities.
Our role
Community driven solutions.
Challenge the “business as usual” approach.
Name and fame the outstanding work of many individuals and organisations.
Get Governments to work together.
Turn promises into results.
Our approach
1. Great willingness generally from individuals to see change and support RSD.
2. Frustration with lack of results.
3. Complexity of Closing the Gap strategy.
4. Many layers of Government and reporting.
5. Governance and leadership needs attention.
6. Importance of effective communications.
Key lessons learned
Questions?
cgris.gov.au