The Australian newspaper reported this week that the Federal Department of Health has given a large Aboriginal community controlled health service in western Sydney notice of imminent loss of funding.
Patricia Delaney, a longstanding Aboriginal health advocate and policy advisor with a background in nursing and mental health, who helped set up the service, writes below that its closure will have wide-ranging devastating impacts.
(Update: A response from the Federal Health Department has been added at the end of the article below, and a further update from Patricia Delaney was added on June 28).
Patricia Delaney, AM, writes:
The phones are ringing hot at the Aboriginal Medical Service Western Sydney in Mt Druitt today as anxious patients contact us, alarmed about the Federal Government’s plans to shut us down.
They are worried about what this will mean, not only for the future of their health care but also for their privacy and confidentiality.
With 11,000 active patient files, and 22,000 files on our books, the Government’s sudden move against us is a health threat to thousands of people.
We provide our community with comprehensive primary health care, and mum’s and bubs’ programs, as well as dental services and aged care. Our successful mental health program has already been wound back due to the Government’s funding cuts.
The traumatic effects of this closure will be enormous for the community’s wellbeing, given the many years we have spent building up trust and relationships with community members and families.
Patient satisfaction surveys conducted as part of accreditation have shown that we deliver exceptional health care and programs that are relevant, acceptable and accessible by our community.
It’s not only the patients whose wellbeing is at stake. We are also dealing with the concerns of our 96 staff, some of whom are in tears today, and all of whom are anxious about their futures.
They were devastated to learn about the Government’s decision from the media, before our board even had a chance to let staff know of the outcome of their Wednesday night meeting with Federal Department of Health officers.
The decision is also devastating for the many Aboriginal and non-Aboriginal health professional trainees whose development we are supporting.
I helped set up this service more than 28 years ago, and we have worked hard over the years to expand our range of services and to meet the community’s needs, often operating with far less funding than comparable mainstream health organisations.
I remember when there were very few Aboriginal people over the age of 60 in our area. Now we have large numbers of old people and our service has contributed significantly to this improvement in peoples’ lives.
We have asked the Government to allow us time to trade out of our tax debt to the Australian Tax Office; we could meet this payment allowed time to sell some property.
Give us 12 months to trade out of our debt and get everything on track. Multiple audits have found we are accountable for how we spend our funding. The difficulty we find ourselves in is because we are guilty only of trying to do too much with not enough financial resources.
I urge Croakey readers to stand with us and show your support for a community controlled health service that is providing vital care for a large Aboriginal population. Contact Health Minister Sussan Ley’s office, and ask for her to review the Department’s decision.
This is what we have been providing and what the community is about to lose:
• Community ownership, as the community has developed and shaped the service;
• A built-in health care complaints system with prompt response;
• A service that is consumer driven and everyone is a consumer;
• A community elected AMSWS Board, Board members are consumers of the service, many of whom are elected to represent the community at a local, regional, state and national level. All associated responsibilities are met unpaid;
• A constant memorial of community members past and present who have worked tirelessly to develop services;
• A meeting place, teaching place, learning place – it’s our place;
• A place to go when you feel crook, need food or to make an urgent phone call;
• Emotional support and a safe place to cry, a place to heal;
• A supportive place to track and contact family members;
• Assistance when family and friends pass away; and
• Culturally respectful support and assistance provided wherever possible, including assistance with funeral preparations and the return of transporting loved ones back to country for burial.
Pat Delaney receiving the Hall of Fame Award for the NSW Aboriginal Health Awards (2005).
This response has been provided by a spokeswoman for the Federal Department of Health:
The Australian Government has offered a three month funding extension to the Aboriginal Medical Service in western Sydney but is unable to continue subsidising the service into the future because of the huge debts incurred by the health service administration.
This decision has been informed by the result of a show cause process that the Department issued on 16 April 2015 including advice from recent audit reports. This also follows on from work already happening with the service – including the engagement of a Funds Administrator to assist AMSWS address its financial and governance issues as far back as December 2014.
The federal Department of Health has this week informed the Board of AMSWS of this decision at a face to face meeting on Wednesday.
The Australian Government’s primary concern is to ensure that Aboriginal and Torres Strait Islander people living in western Sydney continue to have access to high quality culturally appropriate primary health care services.
The concern for the Government in this situation is to support as smooth a transition as possible for clients. Continuity of care and patient safety are critical.
AMSWS is in significant debt impacting on its ability to deliver comprehensive primary health care to the western Sydney Aboriginal and Torres Strait Islander community. It is the Government’s policy to use health care funding to provide services to the community rather than to assist an organisation to meet outstanding debts.
The Australian government acknowledges that this could be disruptive for patients, many of whom benefit by the community controlled model of care presently offered by AMSWS, but as this service is now no longer viable, every effort will be made to transition patients to other services, including local GPs and mental health and drug rehabilitation services.
The Department is hopeful that AMSWS will cooperate with the federal and state health authorities to assist in the transfer of patients to other services and to work towards a new provider potentially being found to continue the work of AMSWS.
AMSWS is an independent organisation with a Board and senior management responsible for delivering health and other services to the community consistent with its funding agreement.
Patricia Delaney responds (28 June):
The service’s debts reflect many factors that were outside of the board’s control. One major contributor was a change of policy with the change of government in NSW. The previous state government had committed (2011) to allowing the service to use grant savings for capital works, which were undertaken in order to house programs including mums and bubs and mental health services. The new State Government, however, reneged on this commitment, and recouped these funds from other payments, leaving us out of pocket and unable to meet our taxation liabilities.
AMSWS financial difficulties also reflect the high demand on services, and ongoing efforts to attempt to meet community needs, for example providing programs to Elders and senior citizens, and the Deceased Persons Van, which takes deceased people back to their communities for burial.
If given time to trade out of the situation – there is a buyer ready to do a lease-back deal on the property –the service would be able to continue. Apart from the disruption to patients – many of whom will not go to mainstream services – there will be disruption to staff, many of whom are undertaking higher education and training relevant to their employment, which will also be jeopardised.
It is also worth noting that the AMSWS is engaged with continuous quality improvements, and has been recently re-accredited by AGPAL to continue offering GP services for the next 3 years. A comprehensive survey of over 100 patients was conducted as part of the process, which provided very positive feedback.