Indigenous Program

INDIGENOUS CHRONIC DISEASE MANAGEMENT: IMPROVEMENTS BUT STILL WORK TO BE DONE

By Leanne Wells ACTML CEO and Dawn Nusa, ACTML Program Manager, Indigenous Health

An evaluation of the Commonwealth’s $805m Indigenous Chronic Disease Package (ICDP) was released earlier this month and its conclusion – there has been progress in the right direction but a lot more work to do – rings true for us here in the Closing the Gap (CtG) team at ACTML. The ICDP aims to reduce the barriers Aboriginal and Torres Strait Islander Peoples face accessing health care.

Funding under the Care Coordination and Supplementary Services (CCSS) program allows our team to work closely with clients and their GPs to ensure they have access to medication, allied health professionals, medical specialists, medical equipment and transport.

Chronic disease accounts for two-thirds of the premature deaths among our Indigenous population – that’s why our CCSS program, funded under the ICDP initiative, targets people with cancer, diabetes, cardiovascular, respiratory or renal disease.

This is done in a very non-bureaucratic, grass-roots way. It may be that one of our Care Coordinators phones a client and explains what services are available to them; goes with them to see a specialist or drives them to their physiotherapy appointment. From our day-to-day work we can see the benefits of linking patients in with culturally sensitive and accessible health – either at Winnunga Nimmityjah Aboriginal Health Service or at a general practice.

ACTML’s Aboriginal Outreach Worker, Mr Clyde “Cookie” Chatfield describes our CtG team as being passionate about improving the health of the Aboriginal and Torres Strait Islander community.

“I go out and talk to GPs and nurses about Aboriginal and Torres Strait Islander culture, the trauma that so many of us carry within ourselves on a daily basis, and about the difficulties we face from past laws and practices. I also talk about some of the hurdles that prevent our mob from accessing primary health care services. And when I get the opportunity to drive clients to their appointments we discuss how best I can improve their journey within the health system. I also provide cultural awareness workshops for health professionals, to enhance their knowledge and understanding when working with Aboriginal and Torres Strait Islander Peoples,” says Cookie.

An evaluation of the ICDP program is a timely opportunity for us to see if our day-to-day experience correlates nationally.

The ACT was one of 24 sites across Australia that provided feedback on the effectiveness of ICDP implementation as part of the Sentinel Sites Evaluation conducted by Menzies School of Health Research (Menzies). The Menzies evaluation identified the following achievements of the ICDP nationally:

  • improved access to primary health care services and to affordable medication
  • improved orientation of the general practice sector to the needs of Aboriginal and Torres Strait Islander Peoples
  • significant steps towards the early establishment of a new workforce that is focused on health promotion and in development of local health promotion initiatives
  • increased attention to enhancing access to specialist, allied health and team-based approaches to chronic disease care.

The ICDP is work in progress. The report clearly shows the complex challenges in reorienting a health system to provide culturally sensitive, accessible and high quality care to Aboriginal and Torres Strait Islander populations. It also shows that a dedicated workforce, given adequate funding and direction, can make inroads on the gross health inequity that plagues this country.