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Issue #1642      June 11, 2014

Budget 2014-15

Gap concern over big cuts

Treasurer Joe Hockey and Prime Minister Tony Abbott have been asked to explain how the Budget will help to Close the Gap after cutting $534.4 million from Aboriginal and Torres Strait Islander programs, including $121.8 million from Indigenous health over the next four years.

Indigenous and social service organisations have also voiced grave fears about the effects changes to health and welfare will have on already disadvantaged Indigenous people.

Health and Indigenous groups are particularly concerned that the new $7 Medicare charge to see a doctor could discourage Indigenous people from seeking medical help when needed. National Aboriginal Community Controlled Health Organisation (NACCHO) chair Justin Mohamed welcomed the continued funding for 150 Aboriginal Community Controlled Health Organisations (ACCHOs), but said there was a lack of detail on how the $7 Medicare co-payment would work.

“ACCHOs are not like a mainstream medical practice,” he said. “Its primary purpose for operation is delivering holistic, comprehensive and culturally appropriate health care to the community it serves, not turning a profit. We’d expect most ACCHOs would not increase the barriers to health care for many Aboriginal and Torres Strait Islanders by charging the co-payment for doctors’ visits.

“However, this would have a serious flow-on impact on other on-ground services provided by the organisation and Aboriginal health outcomes in the local community. NACCHO believes Aboriginal and Torres Strait Islander people should be exempt from any health co-payments to prevent any backward steps in Aboriginal health.”

Close the Gap campaign co-chair and Aboriginal and Torres Strait Islander Social Justice Commissioner Mick Gooda said the Budget cuts to mainstream services could have a disproportionate impact on Indigenous people.

“The cuts to preventative health could also have significant impact on Aboriginal and Torres Strait Islander people because of the negative impact this will have on addressing chronic disease,” he said. “Chronic disease is a significant contributor to the health equality gap. Cuts to preventative health now will only cost many more dollars in future health expenses.”

Indigenous Affairs Minister Nigel Scullion said that as Aboriginal Medical Services (AMS) received federal grant funding, they had the capacity to exercise discretion regarding the $7 Medicare charge.

“I would think AMSes would waive the co-payment. I would certainly encourage them to waive it in the circumstances where that was needed,” he said. “It’s also important to note that a range of other services provided by AMSes aren’t subject to that payment – seeing a practice nurse for example.”

While changes to the Pharmaceutical Benefits Scheme mean that the general population will face an extra charge to many prescriptions, Senator Scullion said he believed Indigenous people on the Close the Gap prescription scheme for medicines would be quarantined from the new charge.

Northern Territory General Practice Education (NTGPE) said the decision to scrap funding to the Prevocational General Practice Placements Program meant the program would end in December.

“Each year, NTGPE place up to 90 prevocational doctors on 12-week placements in rural and remote locations across the NT,” a spokesperson said. “Closure of the program will result in a loss of 25 fulltime equivalent prevocational doctors working in remote communities at any time in the Northern Territory.”

Chief executive of Apunipima Cape York Health Council in far north Queensland Cleveland Fagan said it was a very shortsighted Budget that would severely affect the health of all Australians, particularly those in remote communities.

“The introduction of co-payments will mean many with the greatest need will simply not access the health services they need for fear of being unable to pay,” he said.

“With rates of chronic illness like diabetes at epidemic proportions in the Cape, this will lead to higher rates of hospital admissions, emergency evacuations, co-morbidities and preventable deaths.”

Labor and Greens spokespeople on Indigenous Affairs, Shayne Neumann and Rachel Siewert, said the Budget made a mockery of Tony Abbott’s promise to be the “Prime Minister of Indigenous Affairs”.

“I am very concerned to see family violence services in line to be cut, given Aboriginal women are 31 times more likely to be hospitalised for assault,” Senator Siewert said.

“This is a very disturbing Budget and I’m deeply concerned about its impact on Aboriginal and Torres Strait Islander peoples.”

Koori Mail

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