This review’s major findings are:

    First, the Close the Gap Statement of Intent (and close the gap approach) has to date only been partially and incoherently implemented via the Closing the Gap Strategy:

    –– An effective health equality plan was not in place until the release of the National Aboriginal and Torres Strait Islander Health Plan Implementation Plan in 2015 – which has never been funded. The complementary National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023 needs an implementation plan and funding as appropriate. There is still yet to be a national plan to address housing and health infrastructure, and social determinants were not connected to health planning until recently and still lack sufficient resources.

    –– The Closing the Gap Strategy focus on child and maternal health and addressing chronic disease and risk factors – such as smoking through the Tackling Indigenous Smoking Program – are welcomed and should be sustained. However, there was no complementary systematic focus on building primary health service capacity according to need, particularly through the Aboriginal Community Controlled Health Services and truly shifting Aboriginal and Torres Strait Islander health to a preventive footing rather than responding ‘after the event’ to health crisis.

    Second, the Closing the Gap Strategy – a 25-year program – was effectively abandoned after five-years and so cannot be said to have been anything but partially implemented in itself. This is because the ‘architecture’ to support the Closing the Gap Strategy (national approach, national leadership, funding agreements) had unraveled by 2014-2015.
    
    Third, a refreshed Closing the Gap Strategy requires a reset which re-builds the requisite ‘architecture’ (national approach, national leadership, outcome-orientated funding agreements). National priorities like addressing Aboriginal and Torres Strait Islander health inequality have not gone away, are getting worse, and more than ever require a national response. Without a recommitment to such ‘architecture’, the nation is now in a situation where the closing the gap targets will measure nothing but the collective failure of Australian governments to work together and to stay the course.
    
    Fourth, a refreshed Closing the Gap Strategy must be founded on implementing the existing Close the Gap Statement of Intent commitments. In the past ten years, Australian governments have behaved as if the Close the Gap Statement of Intent was of little relevance to the Closing the Gap Strategy when in fact it should have fundamentally informed it. It is time to align the two. A refreshed Closing the Gap Strategy must focus on delivering equality of opportunity in relation to health goods and services, especially primary health care, according to need and in relation to health infrastructure (an adequate and capable health workforce, housing, food, water). This should be in addition to the focus on maternal and infant health, chronic disease and other health needs. The social determinants of health inequality (income, education, racism) also must be addressed at a fundamental level.
    
    Fifth, there is a ‘funding myth’ about Aboriginal and Torres Strait Islander health – indeed in many Indigenous Affairs areas – that must be confronted as it impedes progress. That is the idea of dedicated health expenditure being a waste of taxpayer funds. Yet, if Australian governments are serious about achieving Aboriginal and Torres Strait Islander health equality within a generation, a refreshed Closing the Gap Strategy must include commitments to realistic and equitable levels of investment (indexed according to need). Higher spending on Aboriginal and Torres Strait Islander health should hardly be a surprise. Spending on the elderly, for example, is higher than on the young because everyone understands the elderly have greater health needs. Likewise, the Aboriginal and Torres Strait Islander population have, on average, 2.3 times the disease burden of non-Indigenous people.  Yet on a per person basis, Australian government health expenditure was $1.38 per Aboriginal and Torres Strait Islander person for every $1.00 spent per non-Indigenous person in 2013-14.3 So, for the duration of the Closing the Gap Strategy Australian government expenditure was not commensurate with these substantially greater and more complex health needs. This remains the case. Because non-Indigenous Australians rely significantly on private health insurance and private health providers to meet much of their health needs, in addition to government support, the overall situation for Aboriginal and Torres Strait Islander health can be characterised as ‘systemic’ or ‘market failure’. Private sources will not make up the shortfall. Australian government ‘market intervention’ – increased expenditure directed as indicated in the recommendations below – is required to address this. The Close the Gap Campaign believes no Australian government can preside over widening mortality and life expectancy gaps and, yet, maintain targets to close these gaps without additional funding. Indeed, the Campaign believes the position of Australian governments is absolutely untenable in that regard.

We need multi-million dollar oncology clinics in settlements with a hundred peopoe. Makes sense.

Mr Hammer wrote on Jul 22^nd, 2019 at 3:19pm:


No, we just have to provide access to the million dollar oncology clinics and the means to diagnose the need to visit those clinics when necessary in the remote settlements, Hammer.

You get Cancer, you visit your GP who refers you to an Oncologist and your visit the clinic.  If you're an indigenous Australian, unless you live in a major town or better yet, in a capital city, you don't get that level of care.   

The report you posted shows that aborigines recieve  per capita, 43% more health funding than non-aborigones. My mother recently overcame cancer while being treated in the public system. Can you explain to me, Brian, why a 70 year old aboriginal woman deserves 43%  more health funding than my mum? I can promise you, my mum never poisoned a well or desecrated  a sacred site.

Mr Hammer wrote on Jul 22^nd, 2019 at 5:18pm:


A combination of circumstance and often location, Hammer.  Read the report in toto and you might come to understand the problems facing Indigenous Australians today.  I am glad your mother overcame Cancer.  Good on her and good on the health system for helping her do it.  Now, imagine an Indigenous woman out in the boondocks...