A decade of AMA Report Cards on Indigenous health - assessing the outcomes

20/05/2012

Each year since 2002, the AMA has produced a high profile Report Card bringing to public attention outstanding problems in Aboriginal and Torres Strait Islander health. Each report has made well-considered and practical recommendations to governments about how these problems should be resolved, and also highlighted success stories where improvements have been made. The issues reported on over the last decade have ranged from child and maternal health and the importance of appropriate primary care and workforce, through to models of best practice service provision to close the gap in health and life expectancy between Aboriginal peoples and Torres Strait Islanders and other Australians.

The development of the Report Cards has benefited from the guidance and expertise of the members of the AMA, which includes representatives from Aboriginal and Torres Strait Islander peak bodies and health organisations, as well as AMA doctors who work at the coalface providing services to Aboriginal people. As a result of this guidance, many of the recommendations that the AMA has made for change and improvement in its Report Cards have been acted on by the Federal Government or other governments through the Council of Australian Governments (COAG) and other forums. While many would agree that some of the measures implemented have not been completely well-considered or sufficiently funded, or targeted in exactly the right ways, there has been a recognition that the problems that the AMA has identified over the years have been real ones, and the solutions proposed have been robust.

A key question that the AMA is now asking itself is: what progress has been made overall by governments in improving the health of Aboriginal peoples and Torres Strait Islanders, when measured against the AMA’s recommendations over the last decade? Also, where do the challenges remain?

To coincide with its 50th anniversary National Conference, the AMA is producing an “Audit Report” that tracks government activity in the light of AMA recommendations in the areas of:

  • provision of primary health care to Aboriginal people and Torres Strait Islanders commensurate with their level of need;
  • the availability of a skilled health and medical workforce for Aboriginal and Torres Strait Islander health;
  • the provision of high quality and best-practice primary care, including support for the Aboriginal community controlled sector;
  • how well the risk factors and social determinants of poor health have been tackled; and
  • how well governments have performed in engaging Aboriginal peoples and Torres Strait Islanders in genuine partnership in the planning and implementation of policy and programs.

In many of these areas, the government track record over the last decade has been variable, and in some cases disappointing. The AMA believes this is changing, however, and that the $1.6 billion commitment made by governments through COAG in 2008, has added a significant and proportionate impetus to the prospect for closing the gap within a generation.

A major focus of the COAG National Partnership on Closing the Gap is better provision of quality primary care, including through the mainstream health sector. There is also a concerted focus on chronic disease and tackling health risk factors and social determinants. The AMA welcomes all of this, and recognises how well it resonates with the recommendations made over the last decade in AMA Report Cards. However, with this said, the AMA believes there are still gaps and weaknesses, and challenges that remain. In particular:

  • much greater effort is needed to build the necessary health and medical workforce for Aboriginal and Torres Strait Islander health;
  • greater priority must be given to building the potential of Aboriginal community-controlled health services to provide even better primary care;
  • the rate of incarceration of Aboriginal peoples and Torres Strait Islanders (with its compounding health effects) is a national shame, and must be addressed;
  • greater support must be given to Aboriginal and Torres Strait Islander communities to develop workable solutions to local health-related problems; and
  • the partnerships and funding levels that have been established through the COAG agreements must be maintained after these agreements end in 2013. Otherwise the momentum to close the gap will dissipate.

The full details of these observations and the government track record over the last decade will be provided in the AMA Aboriginal and Torres Strait Islander Health Audit Report 2012 – Progress to date and Challenges that Remain, which will be launched at the AMA 2012 National Conference on Saturday May 26.

The AMA’s Aboriginal and Torres Strait Islander Health Report Cards for the last ten years can be accessed at http://ama.com.au/aboriginal-reportcards