Section 2 – Department Outcomes – 8 Indigenous Health
Outcome 8
INDIGENOUS HEALTH
Closing the gap in life expectancy and child mortality rates for Indigenous
Australians, including through primary health care, child and maternal health, and
substance use services
Outcome Strategy
Through Outcome 8, the Australian Government aims to improve access for
Aboriginal and Torres Strait Islander people to effective health care services
essential to improving health and life expectancy, and reducing child mortality.
The Australian Government, through the National Indigenous Reform Agreement,
is committed to ‘closing the gap’ between Indigenous and non Indigenous
Australians in health, education and employment. This requires a concerted and
coordinated effort from all Government agencies and two of the targets in the
agreement relate directly to the Health and Ageing Portfolio: to close the gap in life
expectancy within a generation; and to halve the gap in mortality rates for
Indigenous children under five years of age within a decade.
In 2013-14, the Government will work with states and territories through a
renewed National Partnership Agreement (NPA) to consolidate and embed the
reforms implemented under the current NPA on Closing the Gap in Indigenous
Health Outcomes, including continuing implementation of the Indigenous Chronic
Disease Package. This commitment will provide a continued framework for
working collaboratively to close the gap in life expectancy within a generation.
The Australian Government recognises that closing the gap in life expectancy in
the Northern Territory continues to present a significant challenge. The Stronger
Futures in the Northern Territory - health initiative focusses on this challenge by
providing ongoing funding to deliver a comprehensive health package for
Aboriginal and Torres Strait Islander people in the Northern Territory.
The Department is working with Aboriginal and Torres Strait Islander people and
organisations, as well as in collaboration with state and territory government
agencies to implement these programs.
The Office for Aboriginal and Torres Strait Islander Health leads the work for
Outcome 8 by funding the delivery of primary health care services and other
153
Outcome I 08
The Australian Government is also developing a National Aboriginal and Torres
Strait Islander Health Plan, which will build on the gains already being achieved
through the Australian Government’s Closing the Gap initiatives. The Health Plan
is being developed as a collaborative effort and after extensive consultation with
Aboriginal and Torres Strait Islander people and their representatives and is being
informed by advice from the National Aboriginal and Torres Strait Islander Health
Equality Council. It will involve building links with current initiatives and
strategies, identifying gaps for further action and expanding existing initiatives
where appropriate.
Budget Statements – Department of Health and Ageing
programs. However, all Outcomes within the Health and Ageing Portfolio have a
responsibility to improve access to effective health care for Aboriginal and Torres
Strait Islander people.
Program Contributing to Outcome 8
Program 8.1: Aboriginal and Torres Strait Islander health
Outcome 8 Budgeted Expenses and Resources
Table 8.1 provides an overview of the total expenses for Outcome 8 by program.
Table 8.1: Budgeted Expenses and Resources for Outcome 8
Program 8.1: Aboriginal and Torres Strait Islander health1
Administered expenses
Ordinary annual services (Appropriation Bill No. 1)
Departmental expenses
Departmental appropriation2
Expenses not requiring appropriation in the budget year3
Total for Program 8.1
Outcome 8 totals by appropriation type
Administered expenses
Ordinary annual services (Appropriation Bill No. 1)
Departmental expenses
Departmental appropriation2
Expenses not requiring appropriation in the budget year3
Total expenses for Outcome 8
Average staffing level (number)
1
2
3
2012-13
Estimated
actual
$'000
2013-14
Estimated
expenses
$'000
701,959
800,730
46,809
1,484
45,077
2,005
750,252
847,812
701,959
800,730
46,809
1,484
45,077
2,005
750,252
847,812
2012-13
327
2013-14
307
This program includes National Partnerships paid to state and territory governments by the Treasury as part of
the Federal Financial Relations (FFR) Framework. National partnerships are listed in this chapter under each
program. For budget estimates relating to the National Partnership component of the program, please refer to
Budget Paper 3 or Program 1.10 of the Treasury Portfolio Budget Statements.
Departmental appropriation combines "Ordinary annual services (Appropriation Bill No 1)" and "Revenue from
independent sources (s31)".
"Expenses not requiring appropriation in the Budget year" is made up of depreciation expense, amortisation
expense, makegood expense and audit fees.
154
Section 2 – Department Outcomes – 8 Indigenous Health
Program 8.1: Aboriginal and Torres Strait Islander health
Program Objectives
Reduce chronic disease
Aboriginal and Torres Strait Islander people experience more than twice the
burden of disease than other Australians. A large part of the burden of disease is
due to high rates of chronic diseases such as cardiovascular disease, diabetes,
cancer and chronic respiratory disease. In 2013-14, the Department will work with
states and territories through a renewed National Partnership Agreement to
continue to implement a range of activities to improve chronic disease outcomes;
focusing on improving the prevention, detection and management of chronic
disease to assist Aboriginal and Torres Strait Islander people who have developed,
or are at risk of developing, preventable chronic disease.
Improve child and maternal health
The Australian Government is committed to improving the health of Aboriginal
and Torres Strait Islander mothers and children. In particular, the Government is
focussed on addressing low birth weights for babies, improving rates of childhood
immunisation and encouraging more women to adopt healthy lifestyle behaviours
during and after pregnancy.
To achieve this objective in 2013-14 the Department will continue the: New
Directions: Mothers and Babies Services program to improve access to antenatal and
postnatal care, child health and facilitate healthy entry into school; the Healthy for
Life Program to provide Aboriginal and Torres Strait Islander mothers and their
children with support in making healthy lifestyle choices; and the Indigenous
Early Childhood Development National Partnership initiatives to provide
antenatal care, teenage sexual and reproductive health and pre-pregnancy advice.
Improve access to effective health services including in remote areas
Through the Stronger Futures in the Northern Territory - health initiative, the
Department will continue to undertake improvements in the delivery of primary
health care and continue delivery of specialist and allied health services for high
disease burden conditions such as oral health, hearing and substance misuse.
The Government will also continue funding for the Remote Area Health Corps to
recruit urban-based health professionals for short-term deployments to help meet
workforce shortages in remote locations in the Northern Territory.
155
Outcome I 08
In 2013-14, the Government will fund approximately 275 organisations to provide
comprehensive primary and allied health care services to Indigenous people.
This will deliver prevention, treatment and integrated long-term management of
the health needs of Aboriginal and Torres Strait Islander people, including a focus
on delivering services into remote areas. The Department will continue working
with community based primary health care organisations to assist them to improve
their corporate governance and service delivery approach to ensure a strong focus
on community needs.
Budget Statements – Department of Health and Ageing
Improve social and emotional wellbeing
The Australian Government is committed to improving the social and emotional
wellbeing of Aboriginal and Torres Strait Islander people. In 2013-14, the Social
and Emotional Wellbeing Program will continue to enhance existing counselling,
family tracing and reunion services to Aboriginal and Torres Strait Islander
communities, including members of the Stolen Generations, through the existing
network of eight Link Up Services and staff in over 90 Aboriginal Community
Controlled Health Organisations.
Program 8.1 is linked as follows:



This Program includes National Partnership Payments for:
Stronger Futures in the Northern Territory – health

Hearing health services;

Mobile Outreach Service Plus; and

Oral health services.
Indigenous early childhood development – antenatal and reproductive health;
Improving ear health services for Indigenous Australian children (multilateral
project agreement with NT, SA, WA and Vic);
Improving ear health services for Indigenous Australian children (bilateral
project agreements with Qld and NSW);
Improving trachoma control services for Indigenous Australians (multilateral
project agreements with, SA, WA, NT (and NSW if required));
Reducing acute rheumatic heart fever among Indigenous children;
Accommodation related to renal services for Aboriginal and Torres Strait
Islander Peoples in the Northern Territory;
Renal dialysis services in Central Australia; and
Torres Strait health protection strategy – Saibai Island Health Clinic.
Partnership payments are paid to state and territory governments by the
Treasury as part of the Federal Financial Relations (FFR) Framework.
For Budget estimates relating to the National Partnership component of the
program, refer to Budget Paper 3 or Program 1.10 of the Treasury’s Portfolio
Budget Statements.
The Department of Innovation, Industry, Science and Research (Australian
Institute of Aboriginal and Torres Strait Islander Studies – Collection
Development and Management Output 1.3) for Aboriginal and Torres Strait
Islander Studies.
The Department of Human Services (Services to the Community –
Program 1.1) to administer Indigenous access to the Pharmaceutical Benefits
Scheme.
156
Section 2 – Department Outcomes – 8 Indigenous Health
Program 8.1: Expenses
Table 8.2: Program Expenses
2012-13
Estimated
actual
$'000
2013-14
Budget
Annual administered expenses
Ordinary annual services
$'000
2014-15
Forward
year 1
$'000
2015-16
Forward
year 2
$'000
2016-17
Forward
year 3
$'000
701,959
800,730
804,864
838,979
874,872
48,293
47,082
46,054
46,779
45,260
750,252
847,812
850,918
885,758
920,132
Program support
Total Program 8.1 expenses
Program 8.1: Deliverables
Qualitative Deliverable for Program 8.1
Improve social and emotional wellbeing
Qualitative Deliverable
2013-14 Reference Point or Target
Provide high quality social and emotional
wellbeing services to Aboriginal and Torres
Strait Islander people
Biennial Social and Emotional Wellbeing
Program conference to encourage good
practice and networking to be held by June
2014
Quantitative Deliverables for Program 8.1
Reduce chronic disease
Quantitative Deliverable
2012-13
Revised
Budget
2013-14
Budget
Target
2014-15
Forward
Year 1
2015-16
Forward
Year 2
2016-17
Forward
Year 3
Additional staff working on
prevention and management
of chronic disease including
Aboriginal and Torres Strait
Islander outreach workers,
practice managers and other
health professionals1
242
295
295
295
295
2012-13
Revised
Budget
2013-14
Budget
Target
2014-15
Forward
Year 1
2015-16
Forward
Year 2
2016-17
Forward
Year 3
85
85
85
85
85
Quantitative Deliverable
Number of organisations
funded to provide New
Directions: Mothers
and Babies Services
1
Totals are cumulative over the life of the measure.
157
Outcome I 08
Improve child and maternal health
Budget Statements – Department of Health and Ageing
Improve access to effective health services including in remote areas
Quantitative Deliverable
2012-13
Revised
Budget
2013-14
Budget
Target
2014-15
Forward
Year 1
2015-16
Forward
Year 2
2016-17
Forward
Year 3
Number of organisations
funded to provide
Aboriginal and Torres Strait
Islander specific primary
health care and social and
emotional wellbeing services
260
275
275
275
275
Program 8.1: Key Performance Indicators
Quantitative Key Performance Indicators for Program 8.1
Reduce chronic disease
2011
Revised
Budget
20122
Budget
Target
2013
Forward
Year 1
2014
Forward
Year 2
2015
Forward
Year 3
Aboriginal and Torres
Strait Islander
848-933
817-903
788-872
760-840
731-809
Non-Aboriginal and
Torres Strait Islander
465-471
456-462
447-453
438-444
429-435
Rate difference
379-465
358-444
338-422
318-399
298-377
Quantitative
Indicator
Chronic disease related
mortality rate per 100,0003



2
Due to improvements in the quality, collection and timing of publication of Indigenous mortality data, the time
lag for reporting in Annual Reports has lessened. Therefore, the revised budget figure now reflects 2011 data, for
reporting in the 2012-13 Annual Report instead of 2010 as originally proposed in the Portfolio Budget Statements
2012-13. The Budget target for these 2013-14 Portfolio Budget Statements reflects target projections for 2012 data
to be reported in the 2013-14 Annual Report.
3
Source: AIHW National Mortality Database, calendar years 1998-2011 (which is the most up-to-date data available)
and includes jurisdictions for which data are available and of sufficient quality to publish (NSW, Qld, WA, SA and
NT combined). Note that this data is reported on a calendar year basis, reflecting the ABS mortality data
collection and publication processes.
158
Section 2 – Department Outcomes – 8 Indigenous Health
Improve child and maternal health
2011
Revised
Budget
20124
Budget
Target
2013
Forward
Year 1
2014
Forward
Year 2
2015
Forward
Year 3
Aboriginal and Torres
Strait Islander
161-231
154-221
146-211
139-200
132-190
Non-Aboriginal and
Torres Strait Islander
81-92
79-90
78-89
77-87
75-86
Rate difference
75-145
69-136
63-128
57-119
51-110
Quantitative
Indicator
Child 0-4 mortality rate per
100,0005



Improve access to effective health services including in remote areas
Quantitative
Indicator
2012-13
Budget
Target
2013-14
Forward
Year 1
2014-15
Forward
Year 2
2015-16
Forward
Year 3
73.7%8
85%
90%
100%
100%
6Percentage
4
The 2012 Budget Target reflects the way mortality data will be reported in the Annual Report 2013-14, due to the
time lag in ABS mortality data publication. Due to improvements in the availability of the data, the Revised
Budget figure now reflects 2011 data for reporting in the Annual Report 2012-13 instead of 2010 data as originally
proposed in the Portfolio Budget Statements 2012-13.
5
Source: AIHW National Mortality Database, calendar years 1998-2011, (which is the most up to date data available)
and includes jurisdictions for which data are available and of sufficient quality to publish (NSW, Qld, WA, SA and
NT combined). Note that this data is reported on a calendar year basis, reflecting the ABS mortality data
collection and publication processes.
6
Accreditation is an important part of quality improvement in primary health care services. The indicator has been
revised to capture this approach and better reflect the effectiveness of health services
7
Organisations that meet the Royal Australian College of General Practitioners definition of a general practice are
eligible for accreditation.
8
Source: OATSIH Services Reporting Data Collection.
159
Outcome I 08
of eligible7
Aboriginal and Torres Strait
Islander Primary Health
Care Services that provide
GP services which have
achieved clinical
accreditation
2011-12
Revised
Budget
Budget Statements – Department of Health and Ageing
160