Policies and strategies
The Aboriginal and Torres Strait Islander Health Performance Framework is used to inform policy development and monitor progress in Indigenous health. An effective, efficient and equitable health system is an essential component for any whole-of-government effort to address the health of Aboriginal and Torres Strait Islander peoples. In addition, action is required in areas such as education, employment, safety and housing to achieve sustainable health gains.
The existing six Closing the Gap targets were agreed by the Council of Australian Governments (COAG) in 2008:
- closing the life expectancy gap within a generation by 2031 (see measure 1.19)
- halving the gap in mortality rates for Indigenous children under five within a decade by 2018 (see measure 1.20)
- ensuring all Indigenous four year olds in remote communities have access to early childhood education within five years by 2013
- halving the gap for Indigenous students in reading, writing and numeracy within a decade by 2018 (see measure 2.04)
- halving the gap for Indigenous Australians in Year 12 attainment or equivalent attainment rates by 2020 (see measure 2.05)
- halving the gap in employment outcomes between Indigenous and non‑Indigenous Australians within a decade (see measure 2.07).
In May 2014, COAG agreed to a new five-year target of closing the gap between Indigenous and non‑Indigenous school attendance by 2018.
The Australian Government is investing $4.8 billion in the Indigenous Advancement Strategy (IAS) to replace more than 150 individual programmes with five streamlined programmes:
- jobs, land and economy
- children and schooling
- safety and wellbeing
- culture and capability
- remote Australia strategies.
The IAS will support the Government's priorities of getting children to school, adults into jobs and making communities safer. The Government will work in partnership with Aboriginal and Torres Strait Islander people in implementing the IAS. Communities will be at the centre of the design and delivery of local solutions to meet local needs.
The Australian Government Indigenous Australians' Health Programme commenced on 1 July 2014, consolidating four existing funding streams (primary health care base funding, child and maternal health programmes, Stronger Futures in the Northern Territory and the Aboriginal and Torres Strait Islander Chronic Disease Fund). The aim of this programme is to improve the focus on local health needs, deliver the most effective outcomes, and better support efforts to achieve health equality between Indigenous and non‑Indigenous Australians.
Chronic disease programmes provided through the Indigenous Australians' Health Programme include nationwide tobacco reduction and healthy lifestyle promotion activities, a care coordination and outreach workforce based in Medicare Locals and Aboriginal Community Controlled Health Organisations and GP, specialist and allied health outreach services serving urban, rural and remote communities.
Additionally, the Australian Government provides GP health assessments for Aboriginal and Torres Strait Islander people under the MBS, along with follow-on care and incentive payments for improved chronic disease management, and cheaper medicines through the PBS. These programmes assist better chronic disease prevention and management by primary health care services.
The National Aboriginal and Torres Strait Islander Health Plan 2013–2023 provides a long-term, evidence-based policy framework as part of the overarching COAG approach to Closing the Gap in Indigenous disadvantage. The key goal of the Health Plan is that 'Aboriginal and Torres Strait Islander peoples have the right to live a healthy, safe and empowered life with a strong and healthy connection to culture and country'. The objectives of the Health Plan will be supported by the successful implementation of the IAS through early childhood initiatives and measures to address the underlying social determinants of poor health. The Health Plan also builds on other governments' plans and strategies which support better health outcomes for Aboriginal and Torres Strait Islander people, including the COAG National Indigenous Reform Agreement and the previous National Strategic Framework for Aboriginal and Torres Strait Islander Health 2003–13.
- The NSW Aboriginal health plan 2013–2023, incorporates six strategic directions www.health.nsw.gov.au/aboriginal/Documents/aboriginal-health-plan-2013-2023.pdf).
- In SA, the Aboriginal Health Care Plan 2010–2016 identifies six priorities for comprehensive action by SA Health based on the burden of disease and population profile and sets a framework for the Regional Aboriginal Health Improvement www.sahealth.sa.gov.au/wps/wcm/connect/829485804451c671811f8d23cd3dffcb/Aboriginal+HC+Plan+1010.pdf?MOD=AJPERES&CACHEID=829485804451c671811f8d23cd3dffcb).
- In Victoria the Koolin Balit: Strategic Directions for Aboriginal Health 2012–2022, builds on the Victorian Health Priorities Framework 2012–2022. Whole-of-government strategies are outlined in the Victorian Aboriginal Affairs Framework 2013–2018 (see www.health.vic.gov.au/aboriginalhealth/).
- In WA, the Aboriginal Health strategic policy approaches include promoting Aboriginal health as everyone's business, addressing broader social and structural determinants and culturally secure best practice across WA Health. The WA Aboriginal Health and Wellbeing Framework 2015–2030 outlines the way forward for Aboriginal health www.aboriginal.health.wa.gov.au/home/).
- In the NT, an Aboriginal Health Framework is scheduled to be released in 2015.
- The Queensland Government is developing an investment strategy that will outline strategies for closing the life expectancy gap and sustaining health outcomes for Aboriginal and Torres Strait Islander Queenslanders. Consistent with this, The Queensland Plan identifies a number of targets and goals relating to improving Aboriginal and Torres Strait Inlander Health.
- ACT Health is working on the development of the ACT Aboriginal and Torres Strait Islander Health Plan 2014–2019.
Figure 20 shows how progress in the key priorities of the Health Plan could be monitored through the Health Performance Framework. The key priorities of the health plan are: a culturally respectful and non-discriminatory health system; the social determinants of health; health system effectiveness and clinically appropriate care; evidence-based practices; mental health and social and emotional well-being; human and community capability; health impacts across the lifecourse.