The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) and key partners are calling on the next Victorian Government to introduce a comprehensive Aboriginal Cultural Safety Strategy.

They want more clinical placements in Aboriginal community controlled health organisations (ACCHOs), and funding for the further development and expansion of cultural safety training in Aboriginal health to state-funded service providers.

VACCHO also wants to see each Aboriginal community with its own community-based, locally owned, culturally appropriate and adequately resourced primary health care facility.

Beneath the VACCHO statement below are links to other Victorian election health statements.

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Statement by VACCHO: Aboriginal Health and #VicVotes: Strong Culture, Thriving Communities

In 2008, the Parliament of Victoria made a bipartisan commitment to addressing Aboriginal and Torres Strait Islander disadvantage, by signing the Statement of Intent to Close the Gap in Indigenous Health Outcomes.

It is imperative that the momentum gained since 2008 to achieve equality of health outcomes for Aboriginal and Torres Strait Islander peoples is not lost.

In the lead up to this Saturday’s election, Victorian Aboriginal Community Controlled Health Organisation (VACCHO) has produced two election platforms. The ten recommendations in both platforms are identical.

The first platform, Closing the Gap: Now More than Ever was released by the Coalition for Aboriginal Health Equality Victoria (CAHEV), a large group of civil society organisations which exists to ensure the principles of the Statement of Intent are upheld. Closing the Gap: Now More than Ever emphasises the need to maintain whole-of-system momentum towards closing the gap in Aboriginal health outcomes.

VACCHO also released its own platform, Strong Culture, Thriving Communities, which focuses on the need for real commitment to strengthening Aboriginal cultural qualities, sustainability of the community-controlled sector, and engagement with Aboriginal communities and their representative organisations in all aspects of their health and wellbeing.

A commitment to Cultural Qualities

VACCHO is at heart and by constitution an Aboriginal community organisation. VACCHO recognises that an understanding of Aboriginal culture is essential for partners who wish to engage with Aboriginal organisations effectively.

Successive Victorian governments have committed to ensuring services provided to Aboriginal clients are safe, positive, welcoming, culturally appropriate and non-discriminatory.

However, the recent Victorian Auditor General’s Report, Accessibility of Mainstream Services for Aboriginal Victorians, showed that there is still work to be done to ensure that Victorian service providers are compliant with existing frameworks.

Well-designed cultural awareness and cultural safety training which focuses on behavioural change effectively reduces prejudice and false perceptions of Aboriginal and Torres Strait Islander people.

VACCHO and key partners are calling on the next Victorian government to introduce a comprehensive Aboriginal Cultural Safety Strategy.

The proposed strategy includes expansion of clinical placements in ACCHOs and funding for the further development and expansion of Cultural Safety Training in Aboriginal health to state-funded service providers. Implementing a comprehensive approach to cultural safety is integral to successfully closing the gap in health outcomes and life expectancy for Aboriginal Victorians

A commitment to sector sustainability

VACCHO believes that each Aboriginal community needs its own community based, locally owned, culturally appropriate and adequately resourced primary health care facility.

There is strong evidence of the positive link between access to appropriate primary health care and improved health outcomes for Aboriginal and Torres Strait Islander people. In Victoria, 24 Aboriginal Community Controlled Health Organisations (ACCHOs) provide health and welfare services to the Aboriginal community. This requires sustained and substantial investment in infrastructure and capital.

Under the Statement of Intent, Victoria committed to supporting and developing Aboriginal and Torres Strait Islander community-controlled health services in urban, rural and remote areas. However, since the implementation of Closing the Gap few ACCHOs in Victoria have benefitted from infrastructure investments, as they are often forced to compete with mainstream services for available funding.

VACCHO and its key partners have asked for a substantial investment in infrastructure of $50 million over four years for Victorian Aboriginal Community Controlled Health Organisations. This amount is based on a needs assessment conducted by Aboriginal Affairs Victoria in 2012, which showed a ten year predicted infrastructure need of nearly $120 million.

A commitment to Engagement with communities

Partnership approaches to the delivery of care to Aboriginal Victorians must ensure equity; where ACCHOs are partnered with mainstream organisations to deliver services, ACCHOs should play a central role as the experts in culturally appropriate care.

Contract and partnership arrangements should ensure that roles and responsibilities of each partner are clear and where competitive tendering processes are employed, preference should be given to applicants with a strong history of equitable partnerships with the community controlled sector.

The Victorian Aboriginal Inclusion Framework provides guidelines to partnership with Aboriginal organisations. However, Aboriginal Inclusion Action Plans have not been finalised across all government agencies.

VACCHO and our partners want an approach to planning, implementation and evaluation of Aboriginal health in Victoria that involves Aboriginal people, their communities and representative organisations in planning, implementation and evaluation.

Political Engagement and Policy Commitments

In the month leading up to the election, VACCHO and our partners have held face-to-face consultations with all three major parties. All parties acknowledged the real need for increased infrastructure support and the need to ensure higher levels of cultural awareness and cultural safety across the Victorian health system.

The Liberal Party’s Building Healthier Communities: Aboriginal Health policy allocates $7.9 million to increasing clinical placements in Aboriginal health and building the skills of the Aboriginal health workforce, and $1.8 million to palliative care initiatives for Aboriginal Victorians. It also acknowledges the need for capital supports in ACCHOs and invites the community-controlled sector to apply for funding under the Rural Capital Support Fund.

VACCHO welcomes the Liberal Party’s commitment to expanded clinical placements and skills development, in addition to the announcement of enhanced support for palliative care. However, the need for infrastructure in the ACCHO sector stretches across the state and includes substantial need in urban and regional settings, particularly in southeastern Melbourne.

Victorian Labor released their Election Platform in May. Page 39 of the platform outlines specific commitments to Aboriginal health, including developing cultural protocols with Aboriginal communities, improving access and choice in birthing service, and improving access to mental health and drug and alcohol services.

VACCHO welcomes Labor’s commitment to developing cultural protocols. We strongly recommend that any cultural protocols be developed not only in partnership with, but led by, Aboriginal communities. The focus on maternal and child health, mental health and substance use reflects real need in the community; Aboriginal people across Victoria experience very high rates of mental illness and there is a need for improved coordination between community controlled and mainstream maternity services.

In face-to-face consultations, Labor representatives expressed support for the concept of expanded cultural safety and clinical placements, and acknowledged the real need for infrastructure investment. VACCHO and our partners would urge Victorian Labor to make commitments to both these vital areas.

The Victorian Greens released Close the Gap in Aboriginal Health on 20 November, which has adopted three key recommendations from VACCHO’s advocacy:

  • an investment of $50 million over four years in infrastructure and capacity upgrades for ACCHOs
  • strengthened engagement with the Aboriginal health sector; and
  • advocacy for cooperative action between the Commonwealth Government and Victorian Government

VACCHO and our partners commend the Greens on their commitments; we would make a further recommendation that the Greens consult with the ACCHO sector and it key partners on further developing their preventive health, mental health and maternity services policies.

All major parties have indicated they will continue to regularly consult with VACCHO, our members and key partners. VACCHO and the Coalition for Aboriginal Health Equality Victoria will continue to work closely with the next Victorian government to make sure our community across Victoria has access to community based, locally owned, culturally appropriate and sustainable health care.

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More on the Victorian election and health

• You can track Croakey’s coverage of health and the Victorian election here.

 

 

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