The following table outlines a number of relevant, major strategies, and highlights which of the priorities of the National Maternity Services Plan (the Plan) they address.
These strategies include:
National Primary Health Care Strategy
- On 11 June 2008, the Australian Government announced the development of a National Primary Health Care Strategy to manage the health challenges of the 21st century supported by an External Reference Group of health experts.
- The 2010 National Primary Health Care Strategy provided a road map to guide future policy and practice in primary health care in Australia. Of its four priority areas, three are directly related to needs identified in the Maternity Services Review:
- Key priority area 1: Improving access and reducing inequity
- Key priority area 3: Increasing the focus on prevention
- Key priority area 4: Improving quality, safety, performance and accountability.
National Preventative Health Strategy
- The National Preventative Health Taskforce was established in April 2008 to develop the National Preventative Health Strategy. It initially focused on obesity, tobacco and excessive consumption of alcohol.
- The Taskforce considered the keys to prevention during pregnancy and the early years of life as:
- early identification of family risk and need, starting in the antenatal period
- response to needs in pregnancy, early years and through parent support
- monitoring of child health, development and wellbeing
- service redevelopment and workforce training to meet family and childhood needs.
- Australia:The Healthiest Country by 2020: National Preventative Health Strategy31 was released in 2009 and focused on a primary prevention agenda reflecting the social determinants of health such as housing, welfare, justice, immigration, employment, agriculture, education, family and community services, Aboriginal and Torres Strait Islander people affairs, and communications.
- The Strategy included recommendations that directly support the National Maternity Services Plan.
- The Australian Government’s response to the National Preventative Health Strategy was released on 11 May 2010. All the Taskforce’s recommendations that related to maternal and child health, enhancing early life, and growth patterns were either supported by the Australian Government or were consistent with current Australian Government initiatives.
National E-Health Agenda
- On 12 February 2010, AHMAC affirmed their commitment to advancing an e-health agenda for the Australian health system with a focus on developing electronic health records and accompanying unique health care identifiers for consumers.
- Other potential elements of e-health initiatives include:
- e-discharge summaries that allow the electronic exchange of comprehensive and accurate patient reports between hospitals and primary health care sectors
- e-referrals that will facilitate the seamless exchange of significant patient information from one treating health care provider to another.
- The E-Health agenda will enhance collaboration and communication between maternity professionals and maternity services by facilitating the timely transfer of information between providers of maternity services throughout pregnancy, birth and postpartum care.
National health workforce initiatives
National Health Workforce Taskforce
- In 2006, COAG established the National Health Workforce Taskforce (NHWT) to undertake projects that inform development of practical solutions on workforce innovation. The taskforce reported directly to the Chair of AHMAC’s Health Workforce Principal Committee (HWPC). This taskforce has subsequently been subsumed by a new agency, Health Workforce Australia (HWA).
National Health Workforce Planning and Research Collaboration
- On 24 November 2009, a consortium comprising the Australian Health Workforce Institute (AHWI) and PricewaterhouseCoopers was selected to undertake the National Health Workforce Planning and Research Collaboration.
- The collaboration between the NHWT and the consortium have informed the establishment of HWA, which will undertake a substantial program of national health workforce planning and research projects over three years.
Health Workforce Australia
- On 12 February 2010, COAG established a new agency, HWA, to manage and oversee major reforms to the Australian health workforce, such as increasing workforce supply and reforming the workforce.
- HWA is governed by a board that includes a representative of each jurisdiction.
Early childhood initiatives
National Early Childhood Development Strategy
- On 2 July 2009, COAG endorsed the Investing in the Early Years — A National Early Childhood Development Strategy,64 which reflected the commitment of Australian governments to take a leadership role in early childhood development now and into the future.
- The strategy seeks to achieve positive early childhood development outcomes, and address concerns about individual children’s development early to reduce and minimise the impact of risk factors before problems become entrenched.
- The strategy aims to improve outcomes for all children and reduce inequalities in outcomes between groups of children. It covers children from the antenatal period to eight years.
- The strategy proposes six priority areas for reform to be further developed for COAG in 2010, including strengthening universal maternal, child and family health services, and strengthening the early childhood development and family support services workforce.
- Strategies aligned with the National Maternity Services Plan are the development of the evidence-based clinical guidelines for antenatal care.
- The strategy also recommended the development of a National Maternity Services Plan (this Plan), drawing on the Maternity Services Review.
National Framework for Protecting Australia’s Children 2009–2020
- The first National Framework for Protecting Australia’s Children 2009–2020 has been endorsed by all Australian governments. It is a long-term, national approach to help protect all Australian children, developed in response to an increasing number of reports of child abuse and neglect.
- The Framework calls for a paradigm change, from seeing ‘protecting children’ merely as a response to abuse and neglect to one of promoting the safety and wellbeing of children. It argues that applying a public health model to care and protection will provide better outcomes for children and young people and their families.
- This Framework is aligned with the Plan as it identifies the role of health professionals in working with child protection services to identify and prevent at-risk children and families.
Draft National Framework for Universal Child and Family Health Services
- Victoria is overseeing this project as part of a steering committee consisting of representatives from South Australia, the Australian Capital Territory, Western Australia, New South Wales and the Department of Health and Ageing. Consultation has occurred with key stakeholders in assessing the Draft National Framework for Universal Child and Family Health Services. This project has been conducted on behalf of the Child Health and Wellbeing Subcommittee of the Australian Population Health Development Principal Committee of AHMAC.
- This 2009 draft national framework includes the vision, objectives, principles and core activities of a universal child and family health service. Its main aim is to promote consistency in child and family health services across Australia.
- The framework covers children and their families from birth to eight years. It also recognises the antenatal period as being important for children’s health and development, and in need of further integration.
Healthy Eating and Physical Activity Guidelines for Early Childhood Settings
- The Healthy Eating and Physical Activity Guidelines for Early Childhood Settings65 was launched in October 2009. They form part of the Australian Government’s plan for tackling obesity in early childhood, with a budget of $4.5 million over five years.
- The guidelines and resources were developed by a consortium comprising the Murdoch Children’s Research Institute Centre for Community Child Health, Early Childhood Australia and the Royal Children’s Hospital Melbourne.
- The Get Up and Grow guidelines and resources provide early childhood education and care settings (centre based care, family day care and pre-schools) and families with children attending these settings with practical information to support and promote healthy eating and physical activity in children under five years of age.
Review of Infant Feeding Guidelines for Health Workers
- The 2003 NHMRC Infant Feeding Guidelines for Health Workers (Infant Feeding Guidelines) includes guidance on the establishment and maintenance of breastfeeding, the management of breastfeeding problems and the safe use of infant formula. The revised Infant Feeding Guidelines will complement the revised suite of NHMRC’s Australian dietary guidelines.
National Mental Health Plan 2009–2014
- On 13 November 2009, the Australian Health Ministers’ Conference launched the Fourth National Mental Health Plan: An agenda for collaborative government action in mental health 2009–2014.
- The National Mental Health Plan features national actions to implement targeted prevention and early intervention programs for children and their families through partnerships between mental health, maternal and child health services, schools and other related organisations.
- Within the National Mental Health Plan, the National Perinatal Depression Initiative61 recognises that depression is common in the perinatal period and that maternal wellbeing is critical for early attachment. The National Perinatal Depression Initiative is discussed below.
National Health and Hospitals Reform Commission
- The National Health and Hospitals Reform Commission (NHHRC) was established by the Australian Government in February 2008 to report to the Australian Government on long-term health reform.
- The NHHRC’s 2009 report, A Healthier Future for all Australians: Final Report66 presented more than 100 recommendations to transform the Australian health system.
- This report outlined very specific recommendations that directly support the National Maternity Services Plan. These include:
- providing targeted services to help teenage girls at risk of pregnancy
- universal child and family health services providing a schedule of core contacts
- determining a pathway for targeted care where the universal child and family health services identify a health or developmental issue or support need such as an enhanced schedule of contacts and referral to allied health and specialist services
- subsidies to bring the price of fresh food in line with large urban and regional centres, investment in nutrition education and community projects, and food and nutrient supplementation for schoolchildren, infants, and pregnant and breastfeeding women; the strategy would be developed in consultation with Aboriginal and Torres Strait Islander communities building on existing successful initiatives in this area
- increased care and support for people living in remote and rural locations.
Australian Health Care Agreements
- Under the Australian Health Care Agreements (AHCAs), state and territory governments provided free public hospital services to public patients and were responsible for the day-to-day operations of public hospitals. They also determined the major public hospital funding and guidelines on the budget over a five-year period.
- The primary objective of the AHCAs was to secure access for the Australian community to public hospital services based on three principles that broadly guide the provision of public maternity services:
- eligible persons are given the choice to receive free health and emergency services of a kind or kinds that are currently, or were (on 1 July 1998) provided by hospitals as a public patient
- access to such services by public patients is on the basis of clinical need and within a clinically appropriate period
- Arrangements were to be in place to ensure equitable access to such services for all eligible persons, regardless of their geographical location.
- The AHCA’s have now been replaced by the National Healthcare Agreement, and the National Health and Hospitals Network Agreement.
State of our public hospital reports
- Under the AHCAs, the Australian Government was responsible for publishing an annual report on the performance of public hospitals in each state and territory.
- The State of our Public Hospitals, June 200967 report described the performance of public and private hospitals in 2007–08 and included chapters on national hospital reform activities, Aboriginal and Torres Strait Islander people in hospitals, maternity services in Australian hospitals and state and territory public hospital performance reporting.
- This 2009 report identified four important issues for the hospital system. Two of these issues are relevant to the Plan — Aboriginal and Torres Strait Islander Australians in hospital, and improving maternity services.
- This report was authored at a time when major reforms were being orchestrated by the Australian Government. This reform agenda has resulted in Australian governments agreeing to move towards a more comprehensive framework for the new health agreement, including increased investment.
National maternity services initiatives
Expanding Medicare support
- Establishing new arrangements under Medicare for eligible midwives will expand their role in providing maternity care for Australian mothers and their babies.
- This initiative, through arrangements for Medicare Benefits Schedule (MBS) rebates (including a range of associated MBS services, such as requesting pathology and diagnostic imaging services) for eligible midwives and access to the Pharmaceutical Benefits Scheme (PBS), for authorised midwives (subject to state and territory legislation enabling midwives to prescribe) will:
- reduce family disruption through greater access to services close to home
- expand the range of birthing options available to women by supporting them in their choice of practitioner and their preference for continuity of care
- ensure Australian women and their babies continue to access maternity services that are safe and high quality, but which will provide greater access to midwives.
- Recognising midwives as primary maternity care providers under Medicare will improve service delivery by optimising the existing workforce. It will also increase participation and retention rates among midwives.
- This initiative will reduce the pressure on rural medical practitioners providing maternity services and enable the development of new, more innovative models of care tailored to local needs.
- This initiative also applies to rural, remote, Aboriginal and Torres Strait Islander and Continuity of Carer programs.
- $66.6 million over four years.
- 1 This initiative will provide additional support for GPs and midwives, particularly in rural and remote Australia, to undertake training that will help overcome workforce shortages and increase the availability of maternity services for women and their families.
- Funding will be provided for:
- GPs to undertake additional training to become GP obstetricians or GP anaesthetists
- midwives to undertake additional education and training to enable them to provide MBS-subsidised services and prescribe PBS-subsidised medicines.
- Women, their partners and families will benefit from improved access to a greater range of models of care, particularly in rural and remote areas, and access to maternity care for Aboriginal and Torres Strait Islander mothers and babies.
- This initiative also applies to rural, remote and Aboriginal and Torres Strait Islander programs.
- $8 million over four years.
Professional indemnity insurance
- From 1 July 2010, all health professionals, including midwives, must be covered by professional indemnity insurance under the National Registration and Accreditation Scheme.
- Professional indemnity insurance for eligible midwives will underpin the benefits to Australian families of improved choices and access to a range of services and supports for women and their babies during the antenatal, intrapartum and immediate post natal period (with the exception of planned delivery in the home).
- This initiative also applies to rural, remote, Aboriginal and Torres Strait Islander and Continuity of Carer programs.
- $25.2 million over four years.
Australian National Breastfeeding Strategy 2010–2015
- On 22 April 2010, Australian Health Ministers endorsed the 2010 implementation plan for the Australian National Breastfeeding Strategy 2010– 2015.37 This followed endorsement of the strategy by Health Ministers on 13 November 2009. The strategy provides a framework for priorities and action for Australian governments at all levels to protect, promote, support and monitor breastfeeding throughout Australia.
- Implementation of the strategy will be progressed by governments both independently and nationally under AHMAC, with ongoing leadership from the Australian Government and input from community stakeholders.
Breastfeeding education and training
- $1.8 million is being provided over four years (from 2007–08) to support training and educational opportunities for breastfeeding counsellors and health professionals. This includes:
- development and delivery of nationally accredited courses in breastfeeding that are recognised under the Australian Quality Training Framework
- ensuring volunteer counsellors staffing the national breastfeeding helpline receive comprehensive training (a Certificate IV in Breastfeeding) to equip them to support breastfeeding women and their families
- seminars and workshops to support the continuing education of health professionals working with pregnant women and breastfeeding mothers
- delivery of four pilot breastfeeding education workshops for Aboriginal health workers.
National Perinatal Depression Initiative 2008–09 to 2012–13
- On 13 November 2009, Australian Health Ministers agreed on the framework for the National Perinatal Depression Initiative.61
- This strategy specifically addresses the mental health issues surrounding maternal health and establishes a specific framework for addressing perinatal depression between 2008–09 and 2012–13.
- Following agreement of the national framework, the Australian governments are progressing the initiative as set out in the framework.
- Key elements of the framework that complement the Plan are:
- routine and universal screening for perinatal depression using the Edinburgh postnatal depression scale
- follow-up support and care for women assessed as being at risk of or experiencing perinatal depression
- workforce training and development for health professionals
- community awareness initiatives.
- A National Guidance for Collaborative Maternity Care is under development by the NHMRC to support collaborative care arrangements between health care professionals involved in maternity care.
- Funding for collaborative care is part of expanding Medicare support.
Information for women and their families
- Women, their partners and families will be assisted by a special 24-hour-a-day, seven-day-a-week telephone helpline available during their pregnancy and up to 12 months after the birth of the baby.
- The pregnancy and perinatal support helpline will provide information and support on the services available to women and their families.
- Up-to-date maternity-related information will be provided through a single online gateway on the web.
- This initiative also applies to rural, remote, Aboriginal and Torres Strait Islander and Continuity of Carer programs.
- $9.4 million over four years.
National Breastfeeding Helpline
- $2.5 million is being provided over five years (from 2007–08) to enable the Australian Breastfeeding Association (ABA) to establish and maintain a toll-free 24-hour telephone helpline providing breastfeeding information and peer support for mothers and their families.
- The number is 1800 MUM 2 MUM (1800 686 2 686).
- The helpline is staffed by trained volunteer counsellors.
- NHMRC, in partnership with the Department of Health and Ageing, is reviewing national nutrition recommendations including those in the Core Food Groups68; the Australian dietary guidelines for infant, children, adolescents, adults, older Australians and pregnant and breastfeeding women; and in the Australian Guide to Healthy Eating69 publications.
- The review is expected to be completed by mid-2011 when revised dietary guidelines and appropriate publications for consumers, health professionals and policy makers will be issued by the NHMRC.
- Research into the use of growth charts with children up to five years of age by key health professionals is expected to be completed by the end of 2010.
- Outcomes of the research project will inform options and recommendations to progress the adoption of a single national child growth chart and supporting materials in Australia.
- Enhanced national data collection, a small program of targeted research and overarching evaluation of the Commonwealth Maternity Reform Budget Package, will ensure ongoing quality and safety for maternity services.
- This initiative will encourage greater adherence to evidence-based practice.
- Funding for enhanced data collection is part of Expanding Medicare support.
Australian National Infant Feeding Survey (ANIFS)
- The NIFS will collect national baseline data on infant feeding practices, including the prevalence of breastfeeding initiation and duration in Australia.
- A random sample of mothers of children aged birth to two years from all jurisdictions
Expansion of the Medical Specialist Outreach Assistance Program (MSOAP)
- The MSOAP expansion will introduce outreach maternity service teams (comprising obstetricians and/or registered midwives, registered maternal and child health nurses and allied health professionals) that will contribute to better antenatal and postnatal care, and better health outcomes for women and their babies in rural and remote communities.
- Expansion of the existing MSOAP program will increase access to services locally and reduce the need for women to travel to access services.
- This initiative will also improve the capacity of rural and remote communities to recruit and retain the medical services workforce through opportunities for local health professionals to enhance their skills through interaction with the outreach teams.
- This initiative also applies to rural, remote, Aboriginal and Torres Strait Islander programs.
- $11.3 million over four years.
Rural Procedural Grants Program
- The Rural Procedural Grants Programs (formerly the Training for Rural and Remote Procedural GPs Program) enables procedural GPs in rural and remote areas to access a grant to attend relevant training, upskilling and skills maintenance activities.
- This will encourage procedural GPs to maintain important procedural skills and assists in the retention of procedural GPs in rural communities.
- Procedural GPs provide an invaluable service to rural communities and through this program they are encouraged to maintain their skills to ensure high standards of care for rural communities.
Practice Incentives Program (PIP) Procedural General Practitioner (GP) Payment
- The PIP Procedural GP payments aim to encourage rural GPs to provide procedural services in obstetrics, surgery and anaesthetics.
- The payments are available to practices located in Rural, Remote and Metropolitan Areas (RRMA) 3-7.
- The PIP Procedural GP payments support procedural GPs in rural and remote areas to develop and maintain their skills and encourage GPs to remain in rural and remote areas for longer.
Rural maternal services initiatives
National Consensus Framework for Rural Maternity Services
- The 2008 National Consensus Framework for Rural Maternity Services57 was developed by the Rural Doctors Association of Australia (RDAA), the Australian College of Rural and Remote Medicine (ACRRM), Australian College of Midwives (ACM), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the National Rural Faculty of the Royal Australian College of General Practitioners (RACGP) and Rural Health Workforce Australia, with funding from the Australian Government Department of Health and Ageing.
- The framework was developed in response to community and professional concerns about access to birthing services in rural and remote Australia.
- The purpose of the project was the codification of a set of principles to provide a framework for policy and planning to support quality maternity services in rural Australia.
- The framework presents a set of agreed principles that encompass quality and safety, access, models of care, infrastructure, workforce and funding, which have been formally endorsed by the boards of each of the participating organisations.
Specialist Obstetrician Locum Scheme (SOLS)
- SOLS assists rural GPs and specialist obstetricians with accessing a locum. The GP Anaesthetist Locum Scheme (GPALS) provides the same assistance to rural GP anaesthetists. These programs allow existing rural obstetricians and GP anaesthetists to have time to rest, and to undertake ongoing education and training.
- These programs support the continuity of obstetric services to Australian women in rural communities, and contribute to the retention of medical practitioners in rural communities.
- $6 million over three years from 2008–09.
Aboriginal and Torres Strait Islander people initiatives
Closing the Gap
- In 2007, COAG committed to closing the gap in life outcomes and opportunities between Aboriginal and Torres Strait Islander people and non- Aboriginal and non-Torres Strait Islander people.
- In November 2008, COAG endorsed the National Aboriginal and Torres Strait Islander Reform Agreement (NIRA), which comprises the following six key targets:
- Close the life expectancy gap within a generation.
- Halve the gap in mortality rates for Aboriginal and Torres Strait Islander children under five years old within a decade.
- Halve the gap in employment outcomes between Aboriginal and Torres Strait Islander people and non-Aboriginal and non-Torres Strait Islander people within a decade.
- Halve the gap in reading, writing and numeracy achievements within a decade.
- Ensure all four year olds in remote communities have access to early childhood education within five years.
- At least halve the gap for Aboriginal and Torres Strait Islander students in Year 12 attainment or equivalent attainment rates by 2020.
- The NIRA also established a number of strategic areas for action or ‘Building Blocks’, which formed the structure for the Closing the Gap report. The Building Blocks underpinning COAG reforms are Early Childhood, Schooling, Health, Economic Participation, Healthy Homes, Safe Communities and Governance and Leadership.
- Under National Partnership Agreements, the Australian Government has allocated the following funds across Australia:
- $564 million over six years for Aboriginal and Torres Strait Islander Early Childhood Development
- $291.2 million over six years for Aboriginal and Torres Strait Islander Remote Service Delivery
- up to $228.8 million over five years for Aboriginal and Torres Strait Islander Economic Participation
- $5.48 billion over 10 years on Remote Aboriginal and Torres Strait Islander Housing
- $1.58 billion over four years on Closing the Gap on Aboriginal and Torres Strait Islander Health Outcomes
- $6.967 million over four years on Remote Aboriginal and Torres Strait Islander Public Internet Access.
- Within Closing the Gap, a number of specific initiatives address issues relating to the provision of maternity care to Aboriginal and Torres Strait Islander women and babies within the scope of the Plan. These initiatives are described below.
Aboriginal and Torres Strait Islander people maternal services initiatives
Indigenous Early Childhood Development National Partnership (IECD NP)
- The IECD NP has three priority areas:
- Element 1 — Integration of early childhood services through the establishment of 35 Children and Family Centres.
- Element 2 — Increased access to antenatal care, pre-pregnancy and teenage sexual and reproductive health, which will cost $20 million in the 2010–11 financial year.
- Element 3 — Increased access and use of maternal and child health services by Aboriginal and Torres Strait Islander families. This builds on an existing Australian Government election commitment of $90.3 million for New Directions: An Equal Start in Life for Indigenous Children (Mothers and Babies Services program) and includes a complementary state/territory investment of $75 million.
- Service delivery varies between state and territory governments and is detailed in their individual implementation plans.
- The Australian Government funds a range of programs for Aboriginal and Torres Strait Islander families that address the needs of their children in their early years, including maternal and child health services and support for breastfeeding. These are the Healthy for Life Program, New Directions Mothers and Babies Services and the Australian Nurse Family Partnership Program.
Healthy for Life Program
- This program provides the necessary funding for primary health care services to improve the availability and quality of Aboriginal and Torres Strait Islander child and maternal health, Aboriginal and Torres Strait Islander men’s health, and chronic disease services. The program will be supported by up to $38 million in administered funds annually.
- This program is delivered in a number of metropolitan, rural and remote Aboriginal and Torres Strait Islander communities, and will provide Aboriginal and Torres Strait Islander women with improvements in availability and quality of antenatal and postnatal care.
- This program will assist to increase the capacity of the Aboriginal and Torres Strait Islander people health workforce through the employment of appropriate health workers as required, and through providing funding to increase the number of health scholarships available to Aboriginal and Torres Strait Islander people through the Puggy Hunter Memorial Scholarship Scheme.
- This program provides funding for primary health care services to develop better infrastructure and improve data collection to increase capacity in the areas of Aboriginal and Torres Strait Islander child and maternal health services, men’s health and chronic disease care.
- The program began in 2005–06 as a budget measure offering $102.4 million over four years, but has since become an ongoing program supported by up to $38 million in administered funds annually.
New Directions Mothers and Babies Services
- This program directs funding to organisations to provide new or additional Aboriginal and Torres Strait Islander child and maternal health services in areas of high need across Australia. Funding is $90.3 million over five years from 2007–08, including $1.6 million for Puggy Hunter Memorial Scheme scholarships.
- This program is delivered in a number of metropolitan, rural and remote Aboriginal and Torres Strait Islander communities.
- This program specifically focuses on providing Aboriginal and Torres Strait Islander children and their mothers with increased access to antenatal care, standard information about baby care, practical advice and assistance with parenting, nutrition and breastfeeding, monitoring of developmental milestones, immunisation status and infections, and health checks and treatment for Aboriginal and Torres Strait Islander children before starting school.
- This program will also increase the capacity of the Aboriginal and Torres Strait Islander people health workforce through the employment of appropriate health workers as required, and by increasing the number of health scholarships available to Aboriginal and Torres Strait Islander people through the funding of $1.6 million over five years from 2007–08 for the Puggy Hunter Memorial Scholarship Scheme.
- The New Directions: An equal start to life for Aboriginal and Torres Strait Islander children initiative sits across three Australian Government portfolios: the Department of Families, Housing, Community Services and Aboriginal and Torres Strait Islander Affairs (FaHCSIA), the Department of Education, Employment and Workplace Relations (DEEWR), and the Department of Health and Ageing (DoHA). The three elements that comprise this Closing the Gap initiative are:
- child and maternal health services
- early development and parenting support
- literacy and numeracy in the early years.
- The child and maternal health services component consists of the New Directions: Mothers and Babies Services program, the rheumatic fever strategy and the Aboriginal and Torres Strait Islander Mother’s Accommodation Fund.
- The child and maternal health element provides $112 million over five years and commenced in 2007–08.
Aboriginal and Torres Strait Islander Mother’s Accommodation Fund
- The Aboriginal and Torres Strait Islander Mother’s Accommodation Fund (IMAF) component of New Directions is an example of an existing initiative that supports combined Australian Government effort across portfolios to improve outcomes for Aboriginal and Torres Strait Islander mothers and babies.
- FaHCSIA has primary carriage of the provision of housing, parenting programs and child protection and welfare in Aboriginal and Torres Strait Islander communities. IMAF provides $10 million in capital funds over three years (2008–11) for new and expanded accommodation facilities in major cities and regional centres to support Aboriginal and Torres Strait Islander women who need to leave their communities temporarily to have their babies.
- The implementation of IMAF includes supporting management models that appropriately address the needs of Aboriginal and Torres Strait Islander women, locating facilities in close proximity to child and maternal health services, and ensuring that facilities can support newborn babies and, where possible, other children staying with their mothers. The first site was approved at Cairns in 2009, with plans for a further two sites in Darwin and Port Hedland.
Australian Nurse Family Partnership Program (ANFPP)
- The ANFPP aims to support pregnant women with an Aboriginal or Torres Strait Islander baby to improve their own health and the health of their child, through nurse-led sustained home visiting until the child is two years of age. The 2007–08 Budget provided $37.4 million over four years for this program.
- The ANFPP aims to improve pregnancy outcomes by helping women engage in good preventative health practices, support parents to improve Aboriginal or Torres Strait Islander child health and development, and help parents develop a vision for their own future, including continuing education and finding work. This is a sustained home visiting program providing step-by-step life course guidance and education, rather than clinical services, to mothers pregnant with an Aboriginal or Torres Strait Islander child.
- This program will also increase the capacity of the Aboriginal and Torres Strait Islander people health workforce through the employment of nurses, Aboriginal and Torres Strait Islander family partnership workers and administrators to deliver the program, and by increasing the number of health scholarships available to Aboriginal and Torres Strait Islander people through the funding of $1.5m over four years from 2007–08 for 30 new Puggy Hunter Memorial Scholarship Scheme scholarships.
AHCA = Australian Health Care Agreements; AHMAC = Australian Health Ministers’ Advisory Council; COAG = Council of Australian Governments; GP = general practitioner; NHMRC = National Health and Medical Research Council
The Commonwealth’s workforce initiatives are backed by significant investments to support the health workforce. This includes $1.1 billion as part of the November 2008 COAG agreement to train more doctors, nurses and allied health professionals. This provided: $497 million to expand clinical training places for undergraduate medical, nursing and allied health students; $28 million to help train approximately 18,000 nurse supervisors, 5,000 allied health and VET supervisors, and 7,000 medical supervisors; 212 additional ongoing GP training places per annum — a 35% increase on the limit imposed since 2004; and 73 additional specialist training places in the private sector each year.
To address current workforce shortages and better equip Australia’s health system to meet the growing demand for health services into the future, the Australian Government will invest $1.2 billion in training more GPs and specialists, and better supporting nurses working in general practice, aged care and rural areas, and allied health professionals working and training in rural areas over the next four years.
The Australian Government will deliver: 1,375 more GPs practising or in training by 2013, and 5,500 new GPs or GPs undergoing training over the next decade ($345 million); 975 places each year for junior doctors to experience a career in general practice during their postgraduate training period ($150 million); 680 more specialist doctors over the next decade ($145 million); a comprehensive package of measures to deliver greater support to nurses and other workers in the aged care system ($103 million); support for the equivalent of almost 4600 full-time practice nurses in general practice in 2013–14 ($390 million); for the first time, support for up to 7,500 rural nurses and 1,000 rural allied health professionals over the next decade to take leave to access professional development courses to keep their skills up to date ($34 million over four years); and 1,000 extra clinical training scholarships for allied health students over the next decade ($6 million over four years).
Table B.1 illustrates the intersections between the major strategies and the scope of the Plan in terms of timelines.