Garrie Gibson writes:

The Aboriginal community-controlled health sector, represented by its  peak body NACCHO, is starting to assert its perspectives as a part of the national debate about the health and hospitals reform process.

There was virtually no mention of Aboriginal health or the community-controlled sector in the Federal Government’s major policy announcements on health and hospital reform, despite the fact that over half a million Australians receive comprehensive primary health care through such services around the country.

One of the greatest reform challenges for the Federal Government in the health sector is breaking down the silo mentality of  departmental officers within the Department of Health & Ageing (DoHA).

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There appears to be little coordination of effort across the variety  of Government agencies and divisions within DoHA with the other  non-Government providers of health care to ensure that the objectives  set in the Close The Gap commitments of 2008 are fully realised.

The 151 Aboriginal community-controlled medical services (AMS) are funded by the Office of Aboriginal & Torres Strait Islander Health (OATSIH) within DoHA.

A completely different division runs the Close The Gap programs and funding.

Meanwhile, the Government is proceeding with the  introduction of Medicare Locals across the country and this reform is managed by another division within DoHA who appears to have little discussion with OATSIH on what Medicare Locals will mean for Aboriginal Medical services.

AMSs do not have any real information  about where the future will lie for their delivery of comprehensive  primary health care under this new structure.

Another agency which has a long history of delivering comprehensive  primary health care to rural and remote communities, the Royal Flying Doctor Service, is similarly excluded from the process and has no idea what this new structure will mean for their service delivery to  thousands of regional communities.

Meanwhile, the Federal Government is working with each State and  Territory Government to establish new Local Hospital Networks to  manage secondary health care and little consideration has been given  to the role of AMSs in these Networks.

NACCHO and other Aboriginal Health organisations are gearing up for a  national campaign in coming weeks to push for the establishment of a national coordinating body to break down these barriers and achieve  much better consultation, planning, delivery and evaluation of health  services across all Federal, State and non-Government agencies working  in Aboriginal Health.

The National Aboriginal & Torres Strait Islander  Health Authority will develop the national health policies and  strategies, set the key Performance Indicators to measure success and  evaluate ongoing effort to ensure every dollar spent is achieving the goals of the Close The Gap Accord. This is an idea that has been around a while and its establishment is long overdue.

Expect to hear more of this in coming months.

• Garrie Gibson is general manager of the Canberra office of the communications consultancy, CPR.

Declarations:
CPR’s clients include NACCHO and the ACT Aboriginal health service, Winnunga Nimmityjah.
This article was first published in the CPR March e-newsletter.