Minister for Health and Aged Care, speech – 4 December 2024

Thank you, I think, Donella, for that kind introduction.

I’m really looking forward to tonight, so thank you very much for the introduction.

Can I acknowledge that we're meeting on the traditional lands of the Ngunnawal and Ngambri people.

I pay my respects to their Elders, past, present, and emerging.

And I also acknowledge all the many First Nations people here today and all the lands and waters from which you've come, and your Elders past and present.

And as we heard, emerging leaders, as well – so importantly.

It is my absolute pleasure to be here with you all.

My thanks to Donella, Pat and Dawn for inviting me to be with you again, inspite of my appalling performance at karaoke last year.

It’s very kind of you.

There has been quite a spirited debate in my office about what song I could do.
Factions have formed, as they always do - certainly in the Labor Party, they do.
One faction said “don’t go, I can’t handle the embarrassment again.”

The more constructive factions are workshopping different songs.

So I'm looking forward to tonight, I really am.

This year's theme of your Conference, "Our Health in Our Hands: Building Our Workforce" is another timely one, because the promises we took to the last election to grow and support the workforce are beginning to bear fruit.

It is often said, that you can't be what you can't see.

And ACCHOs have been a visible and overwhelmingly positive force in First Nations communities for half a century, providing community controlled health care that is grounded in Country, founded upon Culture, and connected to Community.

Aboriginal and Torres Strait Islander Health Workers and Health Practitioners are at the heart of that connection to community.

That’s why at the last election, we promised to build that workforce by training 500 new workers and practitioners.
 
My thanks to NACCHO for delivering the program, to the six community controlled registered training organisations for delivering the training, and to the 67 ACCHOs who are participating.

There are 223 trainees currently enrolled in program, with more trainees enrolled to start next year.

And already the program has delivered 60 new graduates.

60 new First Nations health workers and practitioners.

60 health professionals who are highly visible in their communities, and make it so much more likely that more First Nations kids will grow up to be, what they can see.

They can see practitioners like Jannah De Bressac, an Aboriginal and Torres Strait Islander Health Practitioner at an ACCHO in south-east Queensland, Carbal Medical Services.

Jannah came to Canberra last month, invited as one the truly incredible cohort of finalists recognised in the Stronger Medicare Awards – awards set up to commemorate the 40 years of Medicare.

During the pandemic, Jannah was among the first to complete First Nations COVID-19 vaccination training, helping her to educate and also vaccinate her community.

Jannah has continued her focus on immunisation, pursuing further study to become accredited to administer every vaccine on the National Immunisation Program, the NIP, to every patient, at every stage of life.

Jannah has got this lovely quote. She says: “I feel I am a product of all these people who have helped me grow and passed on their knowledge. I hope one day, I will be the same for others.”

To my mind, she already is.

She already is, just as the 60 new First Nations health workers and practitioners who have trained under this program already are.

And just as 440 graduates who are still to come from that program will one day be.

That program was a key election promise from Labor, and just one of the ways we’re seeking to build the workforce.

In the May Budget this year, we committed to ongoing funding for the Australian Indigenous Doctors' Association, for them to keep working with the specialty medical colleges, to improve cultural safety in training settings and, ultimately, to boost the number of First Nations specialists.

We also delivered funding certainty to the ACCHO sector, with our announcement in June – to support your idea of rolling four-year funding agreements, that started this financial year.

This involved a $300 million funding uplift to help you retain staff and provide continuity of care.

The community controlled sector really is an exemplar to the broader health sector -  not just delivering great care to your community, but an exemplar for the broader system.

It’s not just me saying that, although it is something I firmly believe.

In just the past few months, we have seen three separate, independent reviews all come to the same conclusion.

The highly-awaited COVID Inquiry Report repeatedly praised the ACCHO sector for your work during the pandemic, and the health outcomes that you were able to bring about because of your trusted connections with community.

The independent Scope of Practice Review also praised the ACCHO sector as exemplars of high-quality multidisciplinary team-based care, where every role and every practitioner is working at, or at least close to, the full scope of their skills, training, experience and competence.

We know that scope of practice and scope of purpose drive career satisfaction.

Which might be why, after surveying thousands of GPs across the country, the Royal Australian College of GPs, in their Health of the Nation Report this year found that GPs working in ACCHOs are the happiest GPs in the nation.

In November last year, we tripled the bulk billing incentive for children under 16, for pensioners and for concession cardholders.

In regional, rural and remote communities, the Medicare payments for a standard bulk billed consult – a level B – is now 50% higher than it was before last November.

This is the largest investment in bulk billing in Medicare history and it has helped drive more than $1.1 billion in additional Medicare payments into general practice sector.

Now, of course, AMSs and ACCHOs can bill Medicare and can certainly claim the tripled bulk billing incentive, though we know that some health services, in the Aboriginal community controlled sector and beyond, aren’t claiming it, even though they can.

In the first year since the incentive was tripled, across the eligible MBS items, more than 6 million visits were bulk billed, but that tripled incentive was not claimed.

Hundreds of millions of dollars in funding left on the table.

I want to take the opportunity to urge you, as ACCHOs, to bill the Medicare Benefits Schedule for every consult you can, and to take advantage of the incentive whenever you can.

Because every extra dollar from the MBS boosts your capacity to deliver programs that your communities need.

Because when services for First Nations people are delivered by First Nations people, better outcomes follow.

And that’s something I want to see grow.

Case in point: the Puggy Hunter Memorial Scholarship Scheme.

I think I was in this room at my first attendance at your Conference as Health Minister BACK IN 2022, when I promised that the scholarship, this competitive scholarship, will return to First Nations control.

Here was a scholarship, after all, named in honour of a great First Nations man in health, to train more First Nations people in health, and yet it was not being delivered by a First Nations health organisation.

I'm glad to report that earlier this year, Indigenous Allied Health Australia won a competitive tender and assumed management of this terrific scheme.

It is the first time in over 20 years that the program has been delivered by a First Nations-led organisation.

And it is the first of many programs that will be redesigned in partnership with, or transitioned to, First Nations-led organisations over the next few years.

This is part of our government's commitment not just to Closing the Gap, but also the Coalition of Peak's Priority Reform number two.

One of Dawn's many, many contributions and roles - is to co-chair the First Nations Health Funding Transition advisory group, which is working through, line by line, the various programs my Department funds for First Nations peoples, to build a plan to transition them to First Nations control, where appropriate.

That group is working through a transition roadmap for 32 programs and is also reviewing 85 population-based programs to make them more responsive to the needs of First Nations peoples.

Services for First Nations peoples, being delivered by First Nations organisations.

When I stood before you last year in Perth, I announced that we would be forming a First Nations Health Governance Group within the health portfolio.

The Group will advise on priorities in First Nations health, call out systemic discrimination and look at structural reform to close the gap.

The Governance Group will oversee the implementation, monitoring and evaluation of the National Aboriginal and Torres Strait Islander Health Plan.

From now until the end of that Health Plan in 2031, the group will provide its expert guidance directly to the Health Minister, whoever may hold that role.

NACCHO will always be represented on this group. My thanks again to Dawn for her contribution so far.

Because in the past fortnight, the Governance Group met for the first time and commenced its early thinking on the way forward on the Health Plan.

Another critical contribution has been through the Aboriginal and Torres Strait Islander Health Collaboration, which has helped guide the development of the next National Health Reform Agreement – the key hospital funding agreement between the Commonwealth, states and territories.

The next Agreement will - for the first time ever - include a dedicated Aboriginal and Torres Strait Islander Schedule.

As co-chair of the Health Collaboration, NACCHO as well as state affiliates, have helped lead this process.

The Schedule will embed Aboriginal and Torres Strait Islander leadership and decision-making, and address the inequity that First Nations people experience across the health system and, in particular, in the hospital system.

This represents one of the most significant reforms to enact the National Agreement on Closing the Gap in the mainstream health system in recent years.

One of the priorities in the Schedule is to recognise ACCHOs as an integral part of the health system and legitimate partners in joint planning and commissioning arrangements.

Two weeks ago, the sector shared the draft Schedule with all jurisdictions and I'll be discussing it with my health minister colleagues when we gather together in Hobart later this week.

We'll also consider the National Review of First Nations Health Care in Prisons, which has also now been completed.

I'd like to thank the sector for its work in contributing to the development of the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy.

I know that many in this room have been working hard to feed into the development of that Strategy, led by Gayaa Dhuwi.

I'll have more to say on that, when we launch the Strategy in coming weeks.

That work is going to be critical, if we are to see an improvement in rates of suicide.

As you know, Closing the Gap Target 14 commits us to a significant and sustained reduction in suicide.

Tragically, that target is worsening. It is not improving.

Lives continue to be cut short.

That’s why programs like Culture, Care, Connect are so important – supporting locally developed solutions that put culture and community priorities right at the heart of service delivery and care.

I can announce today that we will extend Culture, Care, Connect with an additional investment of around $21 million, bringing the total investment in this lifesaving program to around $77 million.

It is one of a number of First Nations-focussed programs that I can announce today that we are extending – for at least a year and up to three years, in some cases.

Including $70 million for health infrastructure, nearly $15 million to eliminate trachoma, and another $15 million for NACCHO’s Rheumatic Heart Disease program.

Together, we have committed an additional $121.5 million to extend these programs.

The details will be released later this month when the Treasurer releases the Mid-Year Budget.

I know there is more to do and there more programs and priorities that the sector would like to see funded.

We are committed to continuing to grow and support this sector and I look forward to continuing to work with you to progress those priorities.

Because, while we are closing the gap in life expectancy, it is not closing nearly fast enough.

We need to do much, much better, particularly on those preventable disease burdens.

After heart disease, the leading cause of potentially avoidable deaths among First Nations communities is diabetes, and the kidney disease it leads to.

Which is why we went to the election promising better renal care and 30 dialysis units in communities.

We have invested more than $73 million and identified 16 sites so far, including – close to my heart - the first dialysis unit in Coober Pedy, in my home state of South Australia.

And it is already having a lifechanging impact.

Before that dialysis unit in Coober Pedy, Raelene had to move away from her community to receive dialysis in Port Augusta, five hours away.

To receive that life sustaining treatment, Raelene had to move away from the community and Country that sustains her spirit.

Since the Coober Pedy dialysis unit opened in June, Raelene has been able to move back onto her Country.

This is just the beginning.

Planning or construction is already underway in another eight communities across WA, the NT, South Australia and the Torres Strait.

In February next year, a grant opportunity will open to establish dialysis units in another seven remote communities.

We’ve also invested $3.5 million to expand the Deadly Choices program, which is doing terrific work to encourage more people to get their regular health checks and prevent the need for that dialysis treatment in the long term.

Deadly Choices is expanding across the south-eastern states and has partnered with the Australian Open, the NRL and AFL, including the PM's beloved Rabbitohs – the Bunnies – and AFL teams like Essendon, Collingwood, Hawthorn and the Western Bulldogs.

No one has yet been able to explain to me why my team, Port Adelaide, has been overlooked.

A Public Service Medal to anyone who can answer that question for me later tonight, over a drink and a song.

In conclusion, can I say thank you for inviting me to speak -- and perhaps later tonight, to sing -- with you again this year.

We have worked hard to deliver on the promises we took to the last election and stay true to our principles, whether that be in training more First Nations health practitioners, transitioning more programs to First Nations-led organisations,  or embedding more First Nations voices into the governance structures of the health system and health portfolio.

But we know there is so much more to do. So much more to do.

And we are absolutely committed to doing that work, in partnership with you and your organisations.

Because that is the only way we will achieve lasting and long term improvements, to finally close the gap.

Thank you for the invitation.

I look forward to seeing some of you later tonight.