Home > For Consumers > Aboriginal and Torres Strait Islander Health > Closing the Gap: Tackling Chronic Disease

Closing the Gap: Tackling Chronic Disease

Overview of the Commonwealth Indigenous Chronic Disease Package

This page contains an overview of the Commonwealth Indigenous Chronic Disease Package.

Background
The Commonwealth Chronic Disease Package
Implementation of the package
Stakeholder engagement

Download PDF : Closing the gap: Tackling chronic disease - The Australian Government’s Indigenous Chronic Disease Package (PDF 418 KB)

Background

The Council of Australian Governments (COAG) has pledged to develop and implement strategies to address Indigenous disadvantage and has agreed six high level targets for closing the gap between Indigenous and non-Indigenous Australians. The targets are:

• To close the gap in life expectancy within a generation;
• To halve the gap in mortality rates for Indigenous children under five within a decade;
• To ensure all Indigenous four year olds in remote communities have access to early childhood education within five years;
• To halve the gap in reading, writing and numeracy achievements for Indigenous children within a decade;
• To halve the gap for Indigenous students in year 12 attainment or equivalent attainment rates by 2020; and
• To halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade.

On 29 November 2008 COAG agreed to an historic $1.6 billion National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes (the Indigenous Health NPA) to address the first of the COAG Closing the Gap targets – to close the life expectancy gap within a generation.

Within the Indigenous Health NPA, five priority areas have been identified:

• Tackling smoking;
• Primary health care services that can deliver;
• Fixing the gaps and improving the patient journey;
• Providing a healthy transition to adulthood; and
• Making Indigenous health everyone’s business.

The Commonwealth’s contribution to the Indigenous Health NPA is its Indigenous Chronic Disease Package (the package) which provides $805.5 million over four years from 2009-10. The package will contribute to the first three priorities while state and territory governments will contribute to all five priorities. Funding for the 14 measures which comprise the package will begin 1 July 2009.
Top of page

The Commonwealth Chronic Disease Package

Aboriginal and Torres Strait Islander peoples experience a burden of disease two and half times that of non-Indigenous Australians. Chronic diseases and associated risk factors are responsible for about two-thirds of the life expectancy gap, with the biggest contributors to excess mortality being circulatory diseases, cancer, diabetes and respiratory diseases. Smoking alone accounts for around 20% of all Indigenous deaths.

The Commonwealth’s Indigenous Chronic Disease Package will put in place a comprehensive approach to preventing and better managing the chronic diseases identified as major contributors to Indigenous mortality, including strategies to address many of the barriers that currently impede Indigenous Australians’ access to health services.

As a result, over the next four years, Aboriginal and Torres Strait Islander people will benefit from:
– More than 133,000 additional health checks;
– 400,000 additional chronic disease management services;
– More than 300,000 episodes of allied health care services and around 110,000 additional episodes of specialist care; and
– An expanded health workforce.

Implementation of the package

The Commonwealth’s package includes a mix of national program reform and targeted initiatives to address the main barriers Aboriginal and Torres Strait Islander people experience in accessing health care. The following describes how the Commonwealth’s chronic disease package is intended to work in practice.

Tackling chronic disease risk factors

The package provides a strong focus on initiatives to tackle the key risk factors for chronic disease in Indigenous communities, such as smoking and other lifestyle factors.
Top of page

• Community events and local education campaigns will provide opportunities for local Indigenous leaders and others to promote and reinforce healthy lifestyle choices.
• Local Indigenous anti-smoking campaigns will be conducted. Additionally a new regional tobacco control workforce will be trained to support Indigenous people to quit smoking;
• Training will be provided to existing health professionals and others so that they have the skills to encourage and assist people to quit.
• Healthy Lifestyle Workers will be trained and employed to reinforce local community campaigns and provide targeted education, support and guidance for families and individuals with or at risk of chronic illness to adopt healthier lifestyles eg healthy diets and exercise and added support to quit smoking.

Improving chronic disease management and follow-up care

A key focus of the package is on improving the detection and management of chronic disease and addressing known barriers to accessing health care. This will be achieved through an integrated suite of reforms to existing programs, supported by new initiatives, as outlined below.

• New financial incentives - via the Practice Incentives Program (PIP) - will support accredited general practices and Aboriginal Medical Services to provide better health care for Indigenous Australians, including best practice management of chronic disease.

The PIP Indigenous Health Incentive will include:
- A one-off payment to practices that agree to undertake certain activities to improve the provision of care to their Indigenous patients;
- An annual payment to practices for each Indigenous patient registered with the practice for chronic disease management for a 12 month period; and
- An annual payment to practices for each registered patient for whom a target level of care is provided by the practice in a 12 month period.
Top of pagePractices participating in this incentive will be able to refer those Indigenous patients identified as needing more complex chronic disease management for care coordination. They will also be able to access Pharmaceutical Benefit Scheme (PBS) co-payment relief for their Indigenous patients through the package.

• Flexible funding will be provided to:

- Provide care coordination to support individual patients to access follow up services consistent with their care plan; and
- Overcome barriers that could reduce access to follow up care provided by allied health professionals and specialists.

• Indigenous patients of general practices participating in the PIP Indigenous Health Incentive, and Indigenous health services, will be provided with financial assistance to reduce or eliminate co-payments when purchasing PBS medicines at community pharmacies.
• The Medicare Benefits Schedule (MBS) will be revised to allow Practice Nurses and Aboriginal Health Workers to provide additional follow up care – from 5 to 10 MBS billable care items per year, per Indigenous client. This will take effect from 1 November 2009.
• The Medical Specialist Outreach Assistance Program (MSOAP) will be expanded to provide multidisciplinary teams comprising specialists, GPs, and/or allied health professionals. These teams will specifically target rural and remote Indigenous communities, contributing to the better management of chronic and complex health conditions in these areas.
• Access to specialist care will be further boosted by funding to support private specialists to provide outreach services in urban areas.

Workforce training, expansion and support

The package provides funding for new and expanded training opportunities and additional workforce to increase the capacity of primary care services to deliver effective health care to Indigenous Australians.
Top of page

• Funding will be provided to boost the workforce in Indigenous health services. This includes new Indigenous Outreach Workers and practice managers. Funding is also available for additional health professionals in rural and remote areas.
• In addition, 38 additional GP Registrar Training Posts will be established in Indigenous health services.
• A new workforce – Indigenous Outreach Workers – will be trained, deployed and mentored in Aboriginal Medical Services and Divisions of General Practice. Indigenous Outreach Workers will reach out to local Indigenous communities, encouraging and assisting people to make contact with health services.
• A national recruitment campaign will encourage existing health professionals and Aboriginal and Torres Strait Islander people to work in Indigenous Health.
• The Nursing Scholarship and Clinical Placement Program will be expanded to provide 50 professional development scholarships per year to nurses who work in Indigenous health services and 50 clinical placements per year in Indigenous health for undergraduate nurses.
• Training will be developed and made available to a range of health professionals to build their capacity to promote and support patients to self manage their chronic disease.
• A primary health care resource, addressing the prevention and primary care management of key chronic diseases experienced by Indigenous Australians, will be developed for use by primary health care professionals. Mainstream chronic disease guidelines will be linked to Indigenous specific information as appropriate.

Stakeholder engagement

Implementation of the package involves comprehensive stakeholder engagement, consistent with the Government’s commitment to work in partnership with Indigenous Australians.

• Overarching advice on key policy issues affecting the Australian Government’s package is being provided by the National Indigenous Health Equality Council (NIHEC), consistent with its Terms of Reference.
• Advice relating to the development of the individual measures within the package is being provided through a number of technical reference and advisory groups, as well as direct engagement with key stakeholders.
• Advice on implementation of the package at a jurisdictional and regional level will be provided by the existing Indigenous Health Partnership Forums in each state and territory. The forums will advise on regional priorities, developing appropriate local and regional linkages across the package, and links with state and territory government activity.

Further information on the Commonwealth’s implementation plan will be made available following endorsement of the plan by the Australian Health Ministers’ Conference, and as the detail of each measure is finalised.Top of page