I’ll append the extensive snippets below from the COAG Communique kindly provided by Gino Vumbaca on the ADCA list. First though, some thoughts on the details. My initial reaction is that for the ATOD sector, there’s not a significant gain except in the indigenous health area. The proposed social marketing campaign may include alcohol, tobacco and possibly some illicit drugs – hopefully it’s not just a continuation of current approaches. I’d like to see some real investment and research into Web 2.0 and preventing ATOD issues amongst particular age groups.
Onto the actual communique, and wold love to hear your thoughts below as well.
Indigenous Reform COAG has previously agreed to six ambitious targets for closing the gap between Indigenous and non-Indigenous Australians across urban, rural and remote areas:
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 years 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.
Since the targets were agreed in December 2007 and March 2008, all governments have been working together to develop fundamental reforms to address these targets. Governments have also acknowledged that this is an extremely significant undertaking that will require substantial investment. COAG has agreed this year to initiatives for Indigenous Australians of $4.6 billion across early childhood development, health, housing, economic development and remote service delivery.
In giving effect to this commitment to closing the gap on Indigenous disadvantage, COAG agreed to the first ever NP agreement in October 2008. This agreement comprises $564 million of joint funding over six years to address the needs of Indigenous children in their early years. As part of the initiative, 35 Children and Family Centres are to be established across Australia in areas of high Indigenous population and disadvantage to deliver integrated services that offer early learning, child care and family support programs. The funding will also increase access to ante-natal care, teenage reproductive and sexual health services, and child and maternal health services.
This NP is now joined by a new National Agreement on Indigenous reform and two new NPs which cover the areas of Economic Participation ($228.8 million – $172.7 million Commonwealth funding and $56.2 million State funding over five years) and Remote Service Delivery ($291.2 million over six years). Taken together with the Indigenous Health NP and the Remote Indigenous Housing NP, these new agreements represent a fundamental response to COAG’s commitment to closing the gap. Sustained improvement in outcomes for Indigenous people can only be achieved by systemic change. Through these agreements, all governments will be held publicly accountable for their performance in improving outcomes in these key areas.
National Indigenous Reform Agreement COAG agreed to the National Indigenous Reform Agreement (NIRA) which captures the objectives, outcomes, outputs, performance measures and benchmarks that all governments have committed to achieving through their various National Agreements and NPs in order to close the gap in Indigenous disadvantage. The NIRA provides an overarching summary of action being taken against the closing the gap targets as well as the operation of the mainstream national agreements in health, schools, VET, disability services and housing and several NPs. The NIRA will be a living document, refined over time based on the effectiveness of reforms in closing the gap on Indigenous disadvantage.
Closing the Gap COAG Meeting in 2009 In October 2008, COAG agreed to convene a dedicated meeting in 2009 on closing the gap on Indigenous disadvantage. COAG has asked for advice on how the NPs and National Agreements will collectively lead to a closing of the gap and what further reforms are needed. In addition to this, COAG has asked for a Regional and Urban Strategy to coordinate the delivery of services to Indigenous Australians and examine the role that private and community sector initiatives in education, employment, health and housing can make to the success of the overall strategy. COAG noted that the it will work to develop a further reform proposal, including benchmarks and indicators for improvements in services and related outputs relevant to family and community safety, for consideration at the Closing the Gap COAG meeting to be held in 2009.
Revised Framework of the Overcoming Indigenous Disadvantage Report In April 2002, COAG commissioned the Productivity Commission’s Steering Committee for the Review of Commonwealth/State Service Provision to produce a regular report against key indicators of Indigenous disadvantage, with a focus on areas where governments can make a difference. The resulting Overcoming Indigenous Disadvantage (OID) Report has been published every two years since 2003. COAG agreed to a new framework for the OID Report that is aligned with the closing the gap targets.
HEALTH AND AGEING COAG agreed today to a landmark deal providing $64.4 billion over five years, including an additional $8.6 billion over current forward estimates. This includes $60.5 billion over five years for the National Healthcare Agreement, which reverses the cuts of the previous Agreement and provides $4.8 billion in additional base funding. In the fifth year of this Agreement, the base will increase by $1.5 billion. This means that States are, on average, better off by nearly $1 billion each year over the five years. As part of this deal, the Commonwealth is offering a $500 million recurrent boost in base funding from 2008-09, increasing the starting point for the National Healthcare Agreement from $9.96 billion to $10.46 billion. The Commonwealth is also delivering a more generous indexation formula, which currently delivers indexation of 7.3 per cent per annum to put public hospital funding on a more sustainable footing.
Shared Accountability and Better Performance Reporting The Commonwealth and the States have also agreed to the following objectives and outcomes for the health and hospital system. These are:
children are born and remain healthy;
Australians manage the key risk factors that contribute to ill health;
Australians have access to the support, care and education they need to make healthy choices;
the primary health care needs of all Australians are met effectively through timely and quality care in the community;
people with complex care needs can access comprehensive, integrated and coordinated services;
Australians receive high-quality hospital and hospital related care;
older Australians receive high-quality, affordable health and aged care services that are appropriate to their needs and enable choice and seamless, timely transitions within and across sectors;
patient experience: Australians have positive health and aged care experiences which take account of individual circumstances and care needs;
social inclusion and Indigenous health: Australia’s health system promotes social inclusion and reduces disadvantage, especially for Indigenous Australians; and
sustainability: Australians have a sustainable health system.
The Commonwealth and the States have also agreed to report against a number of performance measures to address these outcomes including: preventable disease and injuries; timely access to GPs, dental and other primary health care professionals; life expectancy, including the gap between Indigenous and non-Indigenous Australians; waiting times for services; and net growth in the health workforce. The COAG Reform Council will report progress against these performance measures annually, commencing in 2009-10. In addition, the COAG Reform Council will report performance against a range of measures, including:
reduced incidence and prevalence of sexually-transmitted infections and sentinel blood borne viruses (for example, Hepatitis C, HIV) for Indigenous and non-Indigenous Australians;
increased immunisation rates for vaccines in the national schedule;
reduced waiting times for selected public hospital services;
a reduction in selected adverse events in acute and sub-acute care settings compared to 2008-09 levels;
a reduction in unplanned/unexpected readmissions within 28 days of selected surgical admissions compared to 2008-09 levels;
increased rates of services provided by public hospitals per 1,000 weighted population by patient-type compared to 2008-09 levels;
timely access to GPs, dental and primary health care professionals; and
a reduction in selected potentially avoidable GP type presentations to emergency departments.
The Commonwealth and the States have also agreed to provide a basis for more efficient use of taxpayer funding of hospitals, and for increased transparency in the use of those funds through the introduction of Activity Based Funding. It will also allow comparisons of efficiency across public hospitals.
Health Prevention NP The Commonwealth and the States have agreed to a Health Prevention NP, with the Commonwealth providing funding of $448.1 million over four years, and $872.1 million over six years starting from 2009-10 to improve the health of all Australians. This funding could support the following elements:
increased access to services for children to increase physical activity and improve nutrition;
provision of incentives for workplaces and local communities to provide physical activity and other risk modification and healthy living programs;
increased public awareness of the risks associated with lifestyle behaviour and its links to chronic disease;
a national social marketing campaign; and
enabling infrastructure, including a national preventative health agency, surveillance program, workforce audit, eating disorders collaboration, partnerships with industry and a preventative health research fund, leading to better oversight and research into prevention, leading to improved outcomes.
This funding will lead to reductions in the proportion of people who smoke, are at unhealthy bodyweight, and/or do not meet national guidelines for physical activity and healthy eating. Specifically, governments commit to:
increase the proportion of adults and children with healthy body weight, reduce rates of obesity and avert new cases of diabetes in adults each year;
increase the proportion of children and adults meeting national guidelines for physical activity and healthy eating; and
reduce the proportion of adults smoking daily, averting premature deaths and ameliorating costs.
Indigenous Health NP The Commonwealth and the States have agreed to an Indigenous Health NP worth $1.6 billion over four years, with the Commonwealth contributing $806 million and the States $772 million. This proposal will contribute to addressing the COAG-agreed closing the gap targets for Indigenous Australians, closing the life expectancy gap within a generation and halving the mortality gap for children under five within a decade. The proposal includes expanded primary health care and targeted prevention activities to reduce the burden of chronic disease. This NP is a down payment on the significant investment needed by both levels of government to close the unacceptable gap in health and other outcomes between Indigenous and non-Indigenous Australians. The NP will lead to:
reduced smoking rate among Aboriginal and Torres Strait Islander peoples;
reduced burden of diseases for Aboriginal and Torres Strait Islander communities;
increased uptake of Medicare Benefits Schedule-funded primary care services to Indigenous people with half of the adult population (15-65 years) receiving two adult health checks over the next four years;
significantly improved coordination of care across the care continuum; and
over time, a reduction in average length of hospital stay and reduction in readmissions.
This means that over a five-year period, around 55 per cent of the adult Indigenous population (around 155,000 people) will receive a health check with about 600,000 chronic disease services delivered. More than 90,000 Indigenous people with a chronic disease will be provided with a self-management program, while around 74,500 Indigenous people will receive financial assistance to improve access to Pharmaceutical Benefits Scheme medicines.