CONFERENCE DECLARATION
Working together to achieve better outcomes for people and communities
This conference recognises the importance of the social determinants of health framework as key to
protecting human rights and dealing with health inequalities in order to improve the way in which our society
becomes more socially inclusive and effective in the provision of services and support for individuals, families
and communities with complex needs.
It has long been acknowledged by service delivery organisations that people, families and communities with
complex needs are often excluded through lack of services, exclusion criteria or falling through the cracks in
service delivery – between national and jurisdictional service delivery, between government and nongovernment services, and between services delivered by different portfolio agencies. This conference initiated by public health and health sector organisations - has sought to identify and showcase successful
collaborative efforts in service delivery - and partnerships between a range of agencies working in different
sectors and genuine collaboration with individuals, families and communities - with a view to informing wholeof-government approaches to policy and program development.
We note that the national Social Inclusion Agenda has acknowledged this as an area of need and is working
toward reforming the delivery of Government services to improve outcomes for people with complex needs.
We also note and support recommendations of the recent Senate Community Affairs References Committee
report on Social Determinants of Health that would provide a foundation for eliminating some of the structural
and systemic barriers to addressing complex needs. Specifically we call for:
• all governments to adopt administrative practices that ensure consideration of the social
determinants of health in all relevant policy development activities, particularly in relation to
education, employment, housing, family and social security policy;
• the placement of responsibility for addressing social determinants of health within one agency,
with a mandate to address issues across portfolios; and
•
annual progress reports to parliament be a key requirement of the body tasked with responsibility
for addressing the social determinants of health.
Further we acknowledge that these approaches need to be guided by an overarching focus on - and
commitment to - the conceptual frameworks of human rights and addressing health and social inequalities,
and consistency with related legislation, international covenants and conventions.
With this context in mind, attendees endorsed the following actions in the final session at the conference to
progress an ongoing agenda for change in relation to addressing complex needs:
1. Creation of a formal National Complex Needs and Social Inclusion Alliance to:
‘progress a collaborative and ongoing agenda/program of stakeholder, individual, family and
community engagement and advocacy to remove red tape and break down structural and systemic
barriers to the development and implementation of comprehensive, multifaceted, cross-sectoral
approaches to achieving better health and social outcomes for people, families and communities with
complex needs.’
1
20 Napier Close Deakin ACT Australia, 2600 – PO Box 319 Curtin ACT Australia 2605
T (02) 6285 2373
F (02) 6282 5438
E phaa@phaa.net.au
W www.phaa.net.au
CONFERENCE DECLARATION
Organisations with representatives attending the conference will automatically be invited to join the
new National Alliance. The organisations listed overleaf were among those with representatives
attending the conference. It is envisaged that the Alliance will seek to progress the agenda via a
variety of activities, including through engagement with:
•
Not For Profit (NFP) Reform process and the Not-For-Profit Sector Reform Council;
•
Department of Human Services Service Delivery Reform agenda;
•
Australian Social Inclusion Board;
•
Premiers of each State and Territory;
•
Local Government leaders/authorities;
•
Justice Sector; and
•
Other relevant forums/bodies at the national and jurisdictional levels.
A process will be established to enable additional consumers, families, communities, NGOs and
government representatives and agencies to join the Alliance.
2. PHAA will hold biennial National Social Inclusion and Complex Needs Conferences to showcase
successful and new programs/approaches in addressing social inclusion, complex needs and social
determinants of health to assist with progressing the broader agenda of the Alliance.
Conference delegates further noted:
•
The depth and diversity of participants attending the conference – addressing complex needs is a
very taxing and critical challenge affecting so many organisations - but more importantly impacting
on our communities, with growing needs and demands on services combined with limited and
reduced resources.
•
The impact of recent government funding cuts at the State and Territory level for service delivery
by community/health organisations, that will significantly reduce and reshape delivery of
treatment and preventative community and health services impacting adversely on levels of
current and unmet need. These actions have further diminished the capacity to address complex
needs, and cuts to funding at the jurisdictional level will foreseeably have flow on effects for
federal funding of grants and programs. Cuts to funding at the jurisdictional level will foreseeably
contribute to overloads in other areas of public health which are not equipped, resourced or
capable of dealing with people, families and communities with multiple complex personal and
health needs.
•
The complex needs agenda needs to be built into current and future government policy and
programs - for instance, as part of the implementation of health reforms, the further development
of Medicare Locals and the implementation of the National Disability Insurance Scheme
(DisabilityCare Australia).
•
The importance of the public health tradition of analysis of inequality and scholarship aimed at
developing systems that are both efficient and effective in responding to health inequity- through
models of care, support, community control and action on determinants.
2
20 Napier Close Deakin ACT Australia, 2600 – PO Box 319 Curtin ACT Australia 2605
T (02) 6285 2373
F (02) 6282 5438
E phaa@phaa.net.au
W www.phaa.net.au
CONFERENCE DECLARATION
•
That the implementation of any annual progress reports to parliament on social determinants of
health (in line with the Senate Committee recommendations) must be inclusive of performance
indicators related to cross-portfolio efforts to address complex needs.
•
The role of the Australian Social Inclusion Board and the need for the new Alliance to seek to
engage with the ongoing work of the Board and related structures.
•
The opportunity for developing an ‘umbrella coordination’ role/function to facilitate the
implementation of person-centred, ‘wrap around’ approaches to case management.
•
The need for a multi-disciplinary approach to address the complex relationships between legal
issues and health.
•
That national action on complex needs requires a process of evolution in relation to existing
initiatives/programs. There are many examples of practical linkages that could assist those with
complex needs to navigate the maze of available interventions - for instance, linking health,
education and justice interventions for those who are homeless, people with Fetal Alcohol
Spectrum Disorder or people with acquired brain injury. There are some established models of
best practice in working with sub-sets of the complex needs population but these are currently ad
hoc with little supporting structure at the policy or funding level.
•
These existing best practice examples should be formally evaluated to inform broader uptake mapping out what exceptional front line services do to inform the development of cross-portfolio
policy and strategy in relation to respective roles and contributions. That the concept of ‘complex
needs’ goes far beyond just mental health and alcohol and other drug problems to encompass a
far broader scope of social determinants of health and disability.
•
The idea that while the ‘no wrong door’ concept is sound, it is often difficult for people, families
and communities with complex needs to find any door at all in terms of accessing service delivery
agencies/organisations.
•
That an ongoing agenda/program of engagement and advocacy is required to break down
structural and systemic barriers to the development and implementation of comprehensive,
multifaceted, cross-sectoral approaches to achieving better health and social outcomes for
people, families and communities with complex needs.
•
That engagement and advocacy efforts should also be underpinned by a commitment to the
following values, attitudes and principles:
o
Respect for each other, in terms of appropriate engagement with individuals and
communities;
o
Cultural safety;
o
Valuing lived experience – providing opportunities for consumer and carer voices to be
heard and supporting community-driven responses. It is important that policy and
program development in relation to community services is focused on and reflects client
and community needs;
o
Acknowledging the importance of cross-sectoral workforce capacity development; and
o
Regard for the specific needs of young people, youth and children.
3
20 Napier Close Deakin ACT Australia, 2600 – PO Box 319 Curtin ACT Australia 2605
T (02) 6285 2373
F (02) 6282 5438
E phaa@phaa.net.au
W www.phaa.net.au
CONFERENCE DECLARATION
List of organisations with representatives attending the conference:
ACT Corrective Services
ACT Government
ACT Health Directorate
ACT Hepatitis Resource Centre Inc.
ACT Medicare Local
ADIS, Alcohol & Drug Service, Inner City
Adults Surviving Child Abuse
Australian Federation of AIDS Organisations
Ageing, Disability and Homecare
A Gender Agenda
AIDS Action Council ACT
Alcohol & Drug Service, Inner City Health
Alcohol and Other Drugs Council of Australia
Alliance For Forgotten Australians
Anunipima Cape York Health Centre
Attorney-General's Department
Australia Post
Australian Bureau Of Statistics
Australian Catholic University
Australian Federal Police
Australian Injecting & Illicit Drug Users League
Australian Institute For Primary Care
Australian Institute Of Family Studies
Australian Institute Of Health And Welfare
Australian National Council On Drugs
Australian National Preventive Health Agency
Australian Red Cross
Baker IDI
BakerIDI Diabetes And Heart Institute
Barwon Health MHDAS
Bayside Medicare Local
Bridges Aligned Services
Calvary Health Care ACT
Camperdown Child And Family Health
Camperdown Clinic
Canberra Sexual Health Centre
Cancer Council NSW
Care Connect
Carers Australia
CatholicCare
Catholic Health Australia
Centacare Tasmania
Central Institute Of Technology
Central Queensland Medicare Local
Central Victorian Health Alliance
Centre For Oral Health Strategy
Centre For Research and Action In Population
Children By Choice
Childrens Protection Society
City Of Melbourne
Combined Universities Centre For Rural
Community Restorative Centre
Country Health SA
Country North SA Medicare Local
DCSI - Exceptional Needs Unit
Deakin University
Department Of Health
Department of Health and Ageing
Dietitians Association Of Australia
Directions
Disability ACT
Disability Services Commission
Doutta Galla Community Health
Drug And Alcohol Multicultural Education
Faces In The Street, St Vincent's Health Urban
Faculty Of Health University Of Technology
Faculty Of Law, University Of Wollongong
Families & Friends For Drug Law Reform
Families Australia
Flinders University
Flinders University Rural Clinical School
Goldbridge Rehabilitation Services
Health Improvement Branch
Health Promotion/ Food Security
Healthwest Partnership
Hepatitis Australia
Hepatitis Council Of Queensland
Hepatitis Queensland
HIV Outreach Team- South Eastern Sydney
HomeGround Services
Horizon Foundation
Housing ACT
Hunter New England Local Health District
Inanna Inc.
Indigo Program - Western Region Health
Inner East Social Inclusion Initiative
Inner North West Melbourne Medicare Local
Inspire Foundation
Institute Of Child Protection Studies
Integrated Services Program / Ageing,
Justice & Forensic Mental Health Network
Justice Action
Karralika Programs Inc.
Lifeline
Life Without Barriers
4
20 Napier Close Deakin ACT Australia, 2600 – PO Box 319 Curtin ACT Australia 2605
T (02) 6285 2373
F (02) 6282 5438
E phaa@phaa.net.au
W www.phaa.net.au
CONFERENCE DECLARATION
Loddon Campaspe Community Legal Centre
Macarthur Diversity Services Initiative
Marthakal Homelands Resource Centre
Mental Health Council of Australia
Mental Health Promotion Service, Sydney
Metro North Brisbane Medicare Local
Micah Projects
Micah Projects Mater Health Services
Mind Australia
Multicultural HIV And Hepatitis Service
Murray Bridge Soldiers' Memorial Hospital
National Aboriginal Community Controlled
National Disability Services Qld
National Heart Foundation
National Mental Health Commission
Ncoss
Network Of Alcohol And Other Drugs Agencies
Newtown Neighbourhood Centre
Northern Sydney Medicare Local
North Melbourne Legal Service Inc.
NSW Agency For Clinical Innovation
NSW Council For Intellectual Disability
NSW Ministry Of Health
NSW Office Of Preventive Health
Open Place
Port Augusta Hospital - Anangu Bibi Birthing Program
Pregnancy Advisory Centre
Public Advocate Of The ACT
Public Health Association of Australia
Public Health Association Of New Zealand
Qld Injectors Health Network
Qld Network Of Alcohol And Other Drug
Queensland University Of Technology
QuIHN
RACGP National Faculty of Special Interests
ReGen
Road House Liaison Officer, Red Cross
Royal Women's Hospital
Ruah Community Services
SA Dental Service
SalvoConnect
Samaritans Foundation
SESLHD
Sharc
Social Inclusions Branch
South Eastern Sydney Local Health District
Southern Health
South West Sydney Local Health District
St Bartholomew's House
Stimulant Treatment Program, Alcohol & Drug Services
St Vincent De Paul Society
St Vincent De Paul Society National Council
Substance Use And Mental Illness Training Team
Suicide Prevention Australia
Sunbury Community Health Centre
Supportive Tenancy, Woden Community
SWSLHD Health Promotion Service
Sydney Local Health District
Sydney Medically Supervised Injecting Centre
Sydney Medical School
Ted Noffs Foundation
The Australian Nursing Federation - ACT
The George Institute
The George Institute For Global Health
The Kirby Institute
The Langton Centre
The Royal Victorian Eye And Ear Hospital
The Second Story Youth Health Service
The University Of Adelaide
The University Of Melbourne
The University Of Technology Sydney
Toora Women Inc
UnitingCare ReGen
UnitingCare Wesley Bowden
UnitingCare West
University Of Adelaide
University Of Canberra
University Of Melbourne
University Of New England
University of New South Wales
University Of Queensland
University Of Queensland- Qcidd
University Of Sydney
University Of South Australia
University Of WA / CUCRH
University Of Western Australia
University of Wollongong
Vaccho
Victorian Aboriginal Health Service
Victorian Aboriginal Health Services
WANADA
Watto Purrunna Aboriginal Health Service
Winnunga Nimmityjah Aboriginal Health Service
Woden Community Service
Women's Health Victoria
5
20 Napier Close Deakin ACT Australia, 2600 – PO Box 319 Curtin ACT Australia 2605
T (02) 6285 2373
F (02) 6282 5438
E phaa@phaa.net.au
W www.phaa.net.au