Annual Report - Outcome 8 – Indigenous Health

Table of contents

Part 3: Management Arrangements

Part 4: Accountability Reporting

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Outcome Summary

Outcome 8 aims to ensure that Aboriginal and Torres Strait Islander people have access to essential care, services and programs that improve their health and life expectancy. The Department worked to achieve this outcome by managing initiatives under the program outlined below.

Program Administered Under Outcome 8 (Program Objectives in 2008–09)

Program 8.1 – Aboriginal and Torres Strait Islander Health

Provide funding for high quality, coordinated primary health care, substance misuse, and social and emotional well-being services for Aboriginal and Torres Strait Islander people.

This chapter reports on the major activities undertaken by the Department during the year, addressing each of the key strategic directions and performance indicators published in the Outcome 8 chapters of the 2008–09 Health and Ageing Portfolio Budget Statements and 2008–09 Health and Ageing Portfolio Additional Estimates Statements. It also includes a table summarising the estimated and actual expenditure for this outcome.

The Office for Aboriginal and Torres Strait Islander Health was responsible for Outcome 8 in 2008–09. The Health Workforce Division, the Mental Health and Chronic Disease Division and the Department’s State and Territory Offices also contributed to the achievement of the outcome. In addition, other areas across the Department managed programs to ensure effective and accessible health care for Indigenous Australians.
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Major Achievements for the Outcome:

Created 175 additional health professional positions through the Northern Territory Emergency Response initiative, to help increase Indigenous Australians’ access to primary health care services (see Improved Access to Services for Aboriginal and Torres Strait Islander People);
Deployed over 100 urban-based health professionals into primary health care services in the Northern Territory, to target the health needs of Indigenous people in remote communities (see Improved Access to Services for Aboriginal and Torres Strait Islander People);
Increased access to maternal and child health care and chronic disease management through 101 Healthy for Life program services across Australia (see Improving Child and Maternal Health); and
Decreased petrol sniffing in regional and remote communities through the distribution of low aromatic Opal fuel (see Performance Information for Outcome 8 Administered Programs).

A Challenge for the Outcome:

There was a backlog of clients awaiting reunions in Link Up services which assist Aboriginal and Torres Strait Islanders who were forcibly removed from their families in the past, to trace, locate and reunite with their kin (see Improved Access to Services for Aboriginal and Torres Strait Islander People).

Key Strategic Directions for 2008–09 – Major Activities

Improved Access to Services for Aboriginal and Torres Strait Islander People

Access to primary health care is critical for preventing ill health, effectively managing chronic disease, and improving health outcomes to close the gap in life expectancy between Indigenous and non-Indigenous Australians. In 2008–09, the Department delivered a number of Government initiatives to improve Aboriginal and Torres Strait Islander people’s access to Indigenous-specific substance use treatment; social and emotional wellbeing services; and preventative health programs.
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Drug and Alcohol Treatment and Rehabilitation

Alcohol and substance misuse are major risk factors for chronic disease, and can have a significant effect on the safety, health and wellbeing of individuals, families and communities. In 2008–09, the Department expanded on drug and alcohol treatment and rehabilitation services provided through the Aboriginal and Torres Strait Islander Substance Use Program, through the implementation of two Council of Australian Governments substance use measures for Indigenous Australians, with a particular focus on remote and regional areas.

The Department worked with State and Territory Governments, as well as service providers, to establish new substance use services, sobering-up shelters, multidisciplinary teams with skills in substance use and transition services to assist Indigenous people exiting rehabilitation. In addition, the Department supported the expansion of residential rehabilitation centres, improvements in treatment and prevention services, and training for substance use workers. Implementation of these activities will continue in 2009–10.

The Department also increased the number of funded Aboriginal and Torres Strait Islander substance use services to 105. Of these, 51 were Aboriginal and Torres Strait Islander-specific substance use services (including 37 providing residential care), and 54 were Indigenous primary health care services. In addition, funding was provided to State or Territory Governments to increase the alcohol and other drug workforce, provide support and training to alcohol and other drug workers, and to provide residential care.

Social and Emotional Wellbeing Services

During the year the Department focused on helping Aboriginal and Torres Strait Islander people affected by the past practice of forcibly removing children from their families, to reunite with their families, culture and community, and to restore their social and emotional wellbeing. Through the Bringing Them Home Counsellor Program, which provides counselling and other related services to individuals and families, the Department worked closely with services such as Aboriginal Community Controlled Organisations to employ 20 additional Bringing Them Home Counsellors. This brought the total number of counsellors in 2008–09 to 150.

The Department also funded an extra 17 staff in Link Up services to support people to trace, locate and reunite with their families. While this is good news, there is currently a critical backlog of clients awaiting reunions in Link Up services, which the Department will address in 2009–10 through funding for additional caseworkers and administrative support. The Department will also support Link Up services to provide up to 140 Return to Country and Institutional Reunions.

The recommendations contained in the Evaluation of the Bringing Them Home and Indigenous Mental Health Programs in 2006–07 by Urbis Keys Young have been used as a framework to better support the Indigenous Social and Emotional Wellbeing workforce. The Department restructured the Social and Emotional Wellbeing Regional Centres program to better support the social and emotional wellbeing and mental health workforce in Department-funded services through peer support, the development of cross-sector linkages/interagency cooperation and improved coordinated delivery of mental health and social and emotional wellbeing training through Registered Training Organisations.
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Northern Territory Emergency Response

The Australian Government’s Northern Territory Emergency Response was established to protect Aboriginal children, make communities safe, and create a better future for Aboriginal people in the Northern Territory. One of the Department’s roles in the response during 2008–09, was to work with Aboriginal Medical Services and the Northern Territory Government to improve access to health care services. A major achievement was the increase in the number of staff in primary health care service in remote areas. The Department provided funding to the Northern Territory Department of Health and Families and Aboriginal Medical Services in the Northern Territory for an additional 175 full time equivalent positions.

Another major workforce achievement was the placement of over 100 urban-based health professionals on short-term placement in 36 primary health care services, through the Remote Area Health Corps. The corps was established by the Australian Government in 2008 to recruit and deploy doctors, nurses and allied heath workers in Northern Territory Indigenous communities. These health professionals deliver core primary health care, and where necessary, refer patients to secondary and tertiary care services. Furthermore, the Department funded 14 positions in six Aboriginal Medical Services across the territory, to improve people’s access to alcohol and other drug treatment in primary health care settings; and assisted seven substance use treatment services to improve their capacity to provide services for people in need.

During the year, the Department also continued its role in funding the delivery of child health checks and follow up services. Working with the Northern Territory Department of Health and Families and the Aboriginal Medical Service Alliance Northern Territory, the Department saw 3,901 child health checks conducted in 2008–09, bringing the total number of checks since July 2007 to more than 14,000. Follow up services included 4,245 dental services (including surgery) for 2,792 children, and 3,232 audiological services to 2,636 children. Two hundred and fourteen children received ear, nose and throat surgery, and 37 children received an ear, nose and throat hospital consultation.

A priority was to provide children, young people and families in remote communities experiencing trauma related to sexual assault with culturally safe assessment, prevention and therapeutic services. In 2008–09, Sexual Assault Mobile Outreach Service teams funded by the Department made 119 visits to 43 remote communities and town camps in 11 of 14 Health Service Delivery Areas across the Northern Territory.

The Department will continue to expand these health and related services in 2009–10, working closely with stakeholders such as the Northern Territory Government and the Aboriginal Medical Services Alliance Northern Territory. A focus will be on delivering health improvements, through sustainable regional models of service delivery.
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Capital Works Projects

Accessible, fit for purpose health infrastructure is essential to support effective health service delivery and attract and retain a skilled and experienced health workforce in Aboriginal and Torres Strait Islander communities. In 2008–09, the Department managed funding for over 100 capital works projects, to construct, upgrade and maintain health clinics, substance use facilities and staff housing. Of these, 23 health staff houses and 23 health facility projects were completed, with many of these in rural and remote areas.

Quality Health Standards

Ensuring that the quality and effectiveness of primary health care services available through Aboriginal and Torres Strait Islander community controlled health organisations is equivalent to services generally available within the Australian health care system continued to be a priority in 2008–09.

The Department provided funding to help Aboriginal and Torres Strait Islander community controlled health organisations to become accredited under Australian health care standards. The assistance included one-on-one expert advice provided by Department-funded Quality Improvement and Accreditation Facilitators, grants to help organisations to overcome specific barriers to accreditation, and access to local support provided by the national and state and territory peak bodies for the Aboriginal community controlled health sector.

At 30 June 2009, over 90 per cent of Aboriginal and Torres Strait Islander community controlled health organisations had indicated their intention to pursue accreditation under Australian health care standards with support from the Department, with around 50 per cent of these already participating in some form of Department-funded accreditation related activity.
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National Qualifications for Aboriginal Health Workers

Aboriginal Health Workers provide a range of services, such as primary health care, immunisations and community health education. In 2008–09, the Department collaborated with State and Territory Governments and the Aboriginal and Torres Strait Islander community controlled health sector, to develop and implement new national qualifications for Aboriginal and Torres Strait Islander Health Workers. These nationally agreed competencies will ensure all Aboriginal Health Workers are working towards a consistent standard across Australia. The Council of Australian Governments signed an Intergovernmental Agreement to implement a National Registration and Accreditation Scheme for all health professions, and national registration for Aboriginal and Torres Strait Islander Health Workers is to be implemented from 1 July 2012.

As part of the National Indigenous Health Workforce Training Plan, the Department funded a National Aboriginal Health Worker Assessor training program, which saw 65 nationally accredited Aboriginal Health Worker Assessors at the end of the financial year. In 2009–10, these trained assessors will take part in workplace assessments on the ground to identify gaps and upskill Aboriginal and Torres Strait Islander Health Workers in line with the new national qualifications. The Department supported the Aboriginal and Torres Strait Islander Health Registered Training Organisation National Network, comprising 14 Aboriginal community controlled Registered Training Organisations, to provide the education and training for Aboriginal and Torres Strait Islander health workers across Australia.

The Department also helped establish the new National Aboriginal and Torres Strait Islander Health Worker Association to provide support to Aboriginal and Torres Strait Islander Health Workers. Once established in 2009–10, the National Aboriginal and Torres Strait Islander Health Worker Association will provide mentoring, support and advocacy for Aboriginal and Torres Strait Islander Health Workers across Australia.

Support for Indigenous Australians Studying Health Disciplines

Unfortunately Aboriginal and Torres Strait Islander people entering health studies can be faced with significant financial barriers due to a range of factors, including the need to provide financial support to dependent children or extended families. As such, there has been an under-representation of Indigenous Australians in health professions.

To assist in addressing this issue, the Department has funded 359 scholarships since 2002 under the Puggy Hunter Memorial Scholarship Scheme, to assist Aboriginal and Torres Strait Islander people to undertake study across a range of health related disciplines including; medicine, nursing, allied health, dentistry, and mental health. This number also included students wanting to become Aboriginal Health Workers or specialise in health management. Since commencement of the scheme, 175 Indigenous Australians have graduated with health related qualifications.
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Figure 2.3.8.1: Number of Scholarships Funded by the Department for the 2002–08 Academic Years

Source: Royal College of Nursing Reports 2009.

Funding for the above activities was sourced from Program 8.1 – Aboriginal and Torres Strait Islander Health. Discussion on other workforce issues can be found in the Outcome 12 Health Workforce Capacity chapter.

Improving Child and Maternal Health

Maternal health before and during pregnancy has an impact on the health of a developing fetus, and can have long-term consequences into childhood and adult life. In addition, the social, emotional and physical environment in the early years of life has a significant impact on health in later years. Improving access to maternal and child health for Indigenous people is a key strategy in working towards closing the gap in life expectancy within a generation and halving the gap in mortality rates for Indigenous children under five within a decade.
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New Directions: An Equal Start in Life for Indigenous Children

During the year, the Department worked to improve maternal and child health, by collaborating with Aboriginal Medical Services and State and Territory Governments to implement the Australian Government’s New Directions: An equal start in life for Indigenous children initiative. Under the Mothers and Babies Service component of this initiative, the Department funded 30 primary health care services in areas across Australia, including Far North Queensland and East Kimberley, to provide mothers and babies with the antenatal and postnatal care needed to reduce the high rates of infant mortality and low birth weight among Indigenous babies. Mothers were able to access information about substance use during pregnancy; advice on baby care, breastfeeding and nutrition; and details on child health services such as immunisation, monitoring weight gain, infections and developmental milestones. Also available were information relating to child health checks and referrals for treatment; and parenting support and advice.

The Department also worked to address the rates of acute rheumatic fever for Indigenous children in remote communities, which are amongst the highest in the world. For example, the Australian Institute of Health and Welfare reported that at the end of 2006, there were 1,053 people with chronic rheumatic heart disease registered in the Top End of the Northern Territory and 349 in Central Australia. In 2008–09, the Department funded the Northern Territory, Queensland and Western Australian governments to establish and maintain registers and programs to support the monitoring and recall of Indigenous patients with, or at risk of, acute rheumatic fever or rheumatic heart disease. Work will continue with these states in 2009–10, to implement ongoing initiatives that use the registers to improve program coordination and patient self-management, and to monitor the use and effectiveness of antibiotic use. Community education and associated health promotion activities relating to the registers and patient care will also be a priority.
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Healthy for Life

The Healthy for Life program seeks to improve health outcomes in the areas of child and maternal health, chronic disease care and men’s health. Primary health care providers are funded by the Department to implement a process of continuous quality improvement that will contribute to improved service delivery.

A major achievement for the Department during 2008–09, was the provision of Healthy for Life program funding to an extra 12 sites, bringing the total number of funded services to 101. As well as increasing access to maternal and child health services, chronic disease management and prevention, this expansion resulted in a better geographical distribution of services, as the new services were located across urban, rural, regional and remote sites.

Health outcomes data reporting as part of the program has shown positive results in 2008–09, including an increase in the proportion of women attending antenatal care before 13 weeks and an increase in the proportion of child and adult health checks. An evaluation of the Healthy for Life program was undertaken between January and June 2009.

Australian Nurse Family Partnership Program

In 2007–08, the Department established an international collaboration with Professor David Olds, and the Centre for Family and Child Health Research, at the University of Colorado, to implement a home visiting program for women pregnant with an Aboriginal and Torres Strait Islander child. The program is informed by the US Nurse-Family Partnership model of home visiting developed by Professor Olds. Studies of the Nurse-Family Partnership model have shown that it improves health outcomes across the antenatal, early childhood and maternal life course, and increases positive health effects for women who receive home visits from nurses. The Australian Nurse Family Partnership Program aims to improve health outcomes for mothers and their children up to the age of two, by helping women to engage in good preventative health practices during and after their pregnancy; providing ongoing parent and social support; and helping parents and children to access other support services.

In 2008–09, the Department funded a further two Aboriginal community controlled health services to deliver the home visiting program, bringing the total in 2008–09 to five. Three Aboriginal community controlled health services commenced home visits in 2008–09 and will increase the number of clients accessing the program in 2009–10. The Department anticipates a further two primary health care sites will be selected to implement the program in 2009–10.

Funding for the above activities was sourced from Program 8.1 – Aboriginal and Torres Strait Islander Health. Further information relating to maternity services can be found in the Outcome 3 Access to Medical Services and Outcome 5 Primary Care chapters.
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Collaboration across Governments and the Health Sector to Improve Health Outcomes

Council of Australian Governments National Targets

While there have been some improvements in health outcomes for Aboriginal and Torres Strait Islander people in recent years, particularly in the areas of infant mortality and immunisation, there are still significant disparities in health status between Indigenous and non-Indigenous Australians. In 2008–09, the Department focused on implementing initiatives to help meet the Council of Australian Governments’ targets of closing the gap in life expectancy within a generation; and halving the gap in mortality rates for Indigenous children under five within a decade.

The Department worked with the Department of Education, Employment and Workplace Relations and State and Territory Governments to prepare for implementation of the National Partnership Agreement on Indigenous Early Childhood Development, which aims to help halve the gap in mortality rates for Indigenous children under five. An achievement for the Department in 2008–09 was the signing of the agreement by the Council of Australian Governments leaders in October 2008.

In November 2008, the Australian Government announced $805.5 million over four years for an Indigenous Chronic Disease Package as its contribution to the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. This will be implemented from 2009–10 and will work towards closing the gap in life expectancy between Indigenous and non-Indigenous Australians within a generation. In 2008–09, the Department coordinated a series of consultations with State and Territory Governments, peak Indigenous health organisations and the broader health sector, and completed the implementation plan for the delivery of the Commonwealth’s Indigenous Chronic Disease Package under the National Partnership Agreement.

The Department also contributed to the data development and specifications underpinning the Indigenous Health performance indicators for the National Indigenous Reform Agreement and National Healthcare Agreement.
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Improved Quality and Availability of Health Data

Quality and accessible Indigenous health data is important in providing the evidence base for closing the gap in Indigenous health. In 2008–09, the Department collaborated with the Australian Institute of Health and Welfare on an enhanced mortality dataset involving data linkage with other key health data sets and comparative analysis of alternative methods for calculating Indigenous life expectancy. This was important in informing the most appropriate methods for calculating Indigenous life expectancy.

The Department worked with the Australian Institute of Health and Welfare on guidelines to improve the collection of Indigenous data in key national health data sets through setting out best practices for data collectors, data managers and data custodians. The Department also managed production of the Aboriginal and Torres Strait Islander Health Performance Framework 2008 Report, which was endorsed by the Australian Health Ministers’ Conference and published online at www.aihw.gov.au in November 2008. The framework was designed to inform policy analysis, planning and program implementation, providing high quality data and analysis on progress towards the Council of Australian Governments’ closing the gap agenda. The framework has also been used to guide the development of Indigenous Health performance indicators in the National Indigenous Reform Agreement and National Healthcare Agreement.

Furthermore, the Department provided funding to the Cooperative Research Centre for Aboriginal Health and the Onemda VicHealth Koori Health Unit at the University of Melbourne, to support research to build the evidence base and inform policy and program initiatives. The Department liaised regularly with chief investigators, and reviewed and distributed key findings among policy makers and other stakeholders to ensure widespread ‘research transfer’.

Indigenous Coordination Centres

The Department provided financial support to whole-of-government projects which addressed issues such as employment, environmental health, community resilience and leadership, nutrition, child protection and diversionary activities to prevent substance use. It also engaged with Aboriginal and Torres Strait Islander communities at a regional level, to allow flexible, tailored, local approaches to addressing local health issues through participation on Shared Responsibility Agreements, Regional Partnership Agreements and priority interventions.

In 2008–09, the Department contributed financially to two new Shared Responsibility Agreements and one new Regional Partnership Agreement. The Shared Responsibility Agreements, which provide complementary health services to Indigenous communities, and usually have a mutual obligation component, will focus on reducing chronic disease and improving health including improving social and emotional wellbeing. The Regional Partnership Agreement will focus on leadership and governance, education, economic development, housing, community health and safety and local government engagement.

Funding for the above activities was sourced from Program 8.1 – Aboriginal and Torres Strait Islander Health.
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Performance Information for Outcome 8 Administered Programs

Program 8.1 – Aboriginal and Torres Strait Islander Health
Indicator:	Increased episodes of primary health care for Aboriginal and Torres Strait Islander people.
Reference Point/Target:	At least 1.7 million episodes of primary health care provided.
Result: Indicator exceeded.
In 2007–08, Australian Government-funded Aboriginal and Torres Strait Islander primary health care services provided over 1.8 million episodes of care. This compares with 1.65 million episodes in 2006–07. Data for 2008–09 is expected to be available in June 2010 and will be published at www.health.gov.au.
Indicator:	Demonstrated access to culturally appropriate social and emotional wellbeing and mental health services.
Reference Point/Target:	At least 100,000 client contacts with social and emotional well-being staff.
Result: Indicator met.
In 2007–08, there were approximately 120,000 client contacts with social and emotional wellbeing staff or psychiatrists within Australian Government-funded Aboriginal and Torres Strait Islander primary health care services. Approximately 120,000 client contacts also occurred in 2006–07. These client contacts do not include contacts with other staff, such as doctors or Aboriginal and Torres Strait Islander health workers that are not designated as social and emotional wellbeing staff. The client contact numbers are therefore considered an underestimate of total access to culturally appropriate social and emotional wellbeing and mental health services within these services. Data for 2008–09 is expected to be available in June 2010 and will be published at www.health.gov.au.
Indicator:	Improved health and wellbeing outcomes for Aboriginal and Torres Strait Islander children and their families by providing health, parenting and social support, coordinating health care and assisting parents and children to access other support services.
Reference Point/Target:	Two home-visiting sites will be established by the end of 2008–09.
Result: Indicator met.
Two home visiting sites were selected in 2008–09 to deliver services under the Australian Nurse Family Partnership Program. This will improve maternal and child health outcomes through ongoing parent and social support; coordinated health care; and assistance for parents and children to access other support services.
Indicator:	Purchase/construction/refurbishment of clinics (through the Capital Works Program) for the provision of primary health care services to Indigenous communities, including remote areas.
Reference Point/Target:	At least 18 clinics purchased/constructed/ refurbished.
Note: This performance indicator was amended in the 2008–09 Health and Ageing Portfolio Additional Estimates Statements, to include reference to ‘18’ not ‘10’ clinics.
Result: Indicator exceeded.
Twenty-three clinic redevelopments/improvements were completed, with ten in very remote areas and two in remote areas. This compares with 18 clinic redevelopments/improvements in both 2007–08 and 2006–07.
Indicator:	Accommodation for health professionals providing primary health care services to Indigenous communities, including remote areas, through the Capital Works Program.
Reference Point/Target:	At least 10 houses purchased/constructed/ refurbished.
Note: This performance indicator was amended in the 2008–09 Health and Ageing Portfolio Additional Estimates Statements, to include reference to ‘10’ not ‘18’ houses.
Result: Indicator exceeded.
Twenty-three houses/duplexes for health professional staff were completed, with 20 in very remote areas and one in a remote area.
Indicator:	Support for Aboriginal and Torres Strait Islander people to study health-related disciplines.
Reference Point/Target:	At least 200 scholarships awarded through the Puggy Hunter Memorial Scholarship Scheme.
Result: Indicator met.
Through the Puggy Hunter Memorial Scholarship Scheme, the Department will provide 245 full time equivalent scholarship places in 2009 academic year. This is an increase from 215 places in 2008. It is anticipated 265 places will be funded in 2010.
Indicator:	Increased number of communities being supplied with Opal fuel.
Reference Point/Target:	At least 85 communities using Opal fuel by the end of 2008–09.
Result: Indicator exceeded.
Opal fuel was supplied to 122 sites (85 remote Aboriginal communities, 33 service stations and roadhouses and four pastoral properties). This included the rollout of Opal fuel to an additional five sites in 2008–09. More than 20 million litres of Opal fuel was distributed. A major achievement for the Department in 2008–09 was the demonstrated decrease in petrol sniffing in regional and remote communities resulting from this initiative. The Evaluation of the Impact of Opal Fuel, completed in 2008–09, measured a 70% reduction in petrol sniffing across the sample between baseline and follow up data collections. The regions of Central Australia and the Anangu Pitjantjatjara Yankunytjatjara Lands had the largest decreases in petrol sniffing, with 93% and 94% decreases respectively. The Executive Summary of the report is accessible at www.health.gov.au.
Indicator:	Establish a remote health area workforce agency capable of delivering increased numbers of health professionals to remote areas of the Northern Territory.
Reference Point/Target:	Remote area health workforce agency established in the Northern Territory in 2008‑09.
Result: Indicator met.
The Remote Area Health Corps was established in October 2008 and has placed 100 short-term urban-based health professionals into primary health care services in the Northern Territory.
Indicator:	Strengthen the capacity of Registered Training Organisations to implement new Aboriginal Health Worker qualifications.
Reference Point/Target:	At least 15 Aboriginal Health Worker assessors nationally accredited.
Result: Indicator exceeded.
The National Aboriginal Health Worker Assessor training program resulted in 65 Aboriginal Health Worker assessors becoming nationally accredited in 2008–09.

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Performance Information for Outcome 8 Departmental Outputs

Output Group 1 – Policy Advice
Indicator:	Quality, relevant and timely advice for Australian Government decision-making measured by ministerial satisfaction.
Reference Point/Target:	Ministerial satisfaction.
Result: Indicator met.
Ministers were satisfied with the quality, relevance and timeliness of advice provided for Australian Government decision-making.
Indicator:	Production of relevant and timely evidence-based policy research.
Reference Point/Target:	Relevant evidence-based policy research produced in a timely manner.
Result: Indicator met.
Relevant and timely evidence based research and data was provided through the 2008 Aboriginal and Torres Strait Islander Health Performance Framework. This included analysis of 50 national datasets and preparation of over 1,000 pages of policy and statistical analysis. This work informed policy analysis, planning and program implementation by providing a ready reference to verified data and research. The Department also funded the Australian Indigenous HealthInfoNet (www.healthinfonet.ecu.edu.au); an internet resource designed to make policy and research material on Aboriginal and Torres Strait Islander health available to policy makers, planners, health service providers, researchers, and the broader community.

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Output Group 2 – Program Management
Indicator:	Administered budget predictions are met and actual expenses vary less than 0.5% from budgeted expenses measured by comparison of actual expenses against budget.
Reference Point/Target:	0.5% variance from budgeted expenses.
Result: Indicator not met.
The actual Administered expenses for Outcome 8 were 1.6% greater than budgeted expenses. This was due to better than expected progress on some capital works projects.
Indicator:	Stakeholders participate in program development through consultative bodies and processes including meetings, conferences and all jurisdictional Health Forums.
Reference Point/Target:	Stakeholders participate in program development.
Result: Indicator met.
The National Indigenous Health Equality Council was established by the Australian Government in July 2008 to bring together Indigenous and non-Indigenous health expertise from across the country to provide advice to Government on the implementation of, and progress towards its commitments to close the gap in health inequality. The Department provided secretariat support to the council to meet quarterly; and to the council’s working groups to meet regularly throughout the year. The Department also provided support for Indigenous Health Partnership Forums in each jurisdiction. These forums (or working groups established by the forum partners) provide advice on implementation of measures in the Commonwealth’s Indigenous Chronic Disease Package.

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Outcome 8 – Financial Resources Summary

	(A) Budget Estimate 2008–09 $’000	(B) Actual 2008–09 $’000	Variation (Column B minus Column A) $’000	Budget Estimate 2009–10 $’000
Program 8.1: Aboriginal and Torres Strait Islander Health
Administered Items
Annual Appropriation Bill 1 (Ordinary Annual Services)	505,197	513,762	8,565	614,330
Departmental Outputs
Annual Appropriation Bill 1 (Ordinary Annual Services)	57,127	56,523	(604)	63,010
Revenues from other sources	986	1,373	387	1,042
Subtotal for Program 8.1	563,310	571,658	8,348	678,382
Total Resources for Outcome 8	563,310	571,658	8,348	678,382
Outcome 8 Resources by Departmental Output Group
Department of Health and Ageing
Output Group 1: Policy Advice	21,029	21,132	103	23,379
Output Group 2: Program Management	37,083	36,764	(320)	40,673
Total Departmental Resources	58,112	57,896	(217)	64,052
Average Staffing Level (Number)	414	423	9	449

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