While this Health Plan focuses on directing implementation by the Australian Government, it is important to acknowledge the essential role of the partners - individuals, families, communities and their representatives, Aboriginal and Torres Strait Islander community controlled health organisations, mainstream health service providers and state and territory governments - and foster their support to implement the Health Plan. This will be achieved through the development of a Commonwealth cross-sectoral implementation plan, as well as implementation plans with each state and territory in the context of their existing targeted activity. The Australian Government also encourages the non-government sector to demonstrate their commitment to this Health Plan by aligning their strategic planning and public reporting to reference this Health Plan.
The initial Australian Government implementation plan will be developed within 12months of the release of this Health Plan, and will be reviewed and re-developed regularly thereafter (no less than every three years) to give effect to this Health Plan. Each implementation plan will build on existing arrangements and collaborative processes such as the ongoing Closing the Gap effort, to ensure a cohesive approach to health outcomes. Each implementation plan will set measureable benchmarks and progress targets, identify how strategies will contribute to the Closing the Gap targets, outline accountability mechanisms, and specify the roles and responsibilities of each stakeholder in progressing this Health Plan.
Each government implementation plan will also acknowledge that investments outside of the health system, such as in education, housing and employment, offer great returns on health outcomes. This requires a two-tiered approach of good policy and programs in health services and policy, and interventions in other sectors related to the social determinants of health.
Policy intervention will present strategic choices about which frame to use to best leverage change. Where possible, improved outcomes for Aboriginal and Torres Strait Islander people can be delivered through broader public policy interventions or general health policy interventions. Change can also be pursued through specific Aboriginal and Torres Strait Islander health policy interventions if these broader routes are not available.
Targeted population health strategies will continue to be developed within the broad context established by this Health Plan. Such strategies play a key role in organising actions as they:
- address a significant proportion of the Aboriginal and Torres Strait Islander burden of disease and risk, such as chronic disease or tobacco control;
- provide an organising framework for health conditions that coordinate activities across primary care, specialist services and other non-health services, such as eye health, ear health, oral health or injury control;
- address the health needs of specific and often vulnerable populations such as Aboriginal and Torres Strait Islander people with disability or those who are in or have recently been released from prison;
- address issues that are politically and socially challenging such as sexual health or strategies to address violence, self-harm and abuse; and
- address those diseases and conditions which may be increasingly uncommon but are usually associated with extremes of poverty and marginalisation, such as rheumatic heart disease, trachoma and tuberculosis, and which require specific expertise and services to address them.
Monitoring and accountabilityThis approach enables the monitoring of health systems performance in improving Aboriginal and Torres Strait Islander health outcomes. The progress against social determinants of health will continue to be reported as part of the broader Closing the Gap Framework and other reporting such as the Prime Minister’s Closing the Gap Report, the Overcoming Indigenous Disadvantage Report, the Indigenous Expenditure Report and individual agency Annual Reports.
In addition, public reporting on the Australian Government’s progress in meeting this Health Plan’s policy objectives will occur through two mechanisms:
The Health Performance Framework was developed as the primary report for measuring the impact of the 2003-13 National Strategic Framework for Aboriginal and Torres Strait Islander Health. The results from each Health Performance Framework report have been used to review Australian Government commitments and guide further comprehensive and coordinated effort, and will continue to do so for this Health Plan.
- a high-level annual report to the Australian Parliament; and
- detailed biennial reporting through the Health Performance Framework.
Underpinning the Health Performance Framework reporting will be data and monitoring and evaluation material collected and analysed at all levels of government. This information will provide good evidence to track the impact of the directions set out in this Health Plan, including factors such as smoking, health status and outcomes (for example, mortality disease rates, hearing loss, low birthweight) and health system performance (for example, antenatal care, chronic disease management, access to services compared with need). The Australian Government remains committed to improving the coordination, collection and monitoring of data and to working with other governments and the Aboriginal and Torres Strait Islander health sector to support this aim.
This Health Plan commits to the development of Health Plan implementation progress targets using the national target setting instrument developed by the National Indigenous Health Equality Council 54(NIHEC, currently known as NATSIHEC, played a key role in the development of monitoring of progress towards a set of health-related goals and targets to support the Australian Government’s commitments on life expectancy and child mortality through its National Target Setting Instruments). Targets can be an effective tool in the development and monitoring of health policy where they are developed in consultation with all relevant stakeholders and there is a shared commitment to their achievement. Targets need to be SMART: Specific, Measurable, Achievable, Realistic and Time-Bound.
In the context of this Health Plan, a commitment to continued collection, refinement and use of the information contained in the Health Performance Framework will continue to inform policy development across governments and be a source of information for reporting against targets once developed.
The annual report to the Australian Parliament is a new reporting mechanism being introduced in support of this Health Plan.
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