Fancy joining the Remote Area Health Corps? Details are lacking, but it’s bound to be an interesting ride given the making-it-up-as-we-go-along nature of the NTER.
When I first heard that $100m was to go towards remote health services, my head was spinning with the possibilities; bolstering community clinics and Aboriginal Community Controlled Health Organisations (ACCHOs), expanding the range of services, preventative primary health care initiatives, increasing Aboriginal Health Worker numbers, the possibilities seemed endless. Then I had a look at what scant details were available and my enthusiasm shrivelled. I had assumed that this funding would be directed to existing health services, either the NT Government or Aboriginal health services, ie, bolstering the already existing health infrastructure. Unfortunately, it looks like the Govt envisages a separate Commonwealth controlled structure of visiting health providers. That in itself is no problem as fly-in fly-out services are part of the picture, but this should be part of an integrated health system.
From what little information is available it seems that this is the only plan for the $100m. And that is a problem. Visiting health practitioners rely on a functioning and adequately resourced community clinic to work from, and with. When the visitors leave there is usually follow-up required and if the capacity of existing community clinics is unchanged, this initiative will fail to deliver on its promise. Directing part of this funding to ACCHOs would be a very sensible option, but the Minister appears to have an inexplicable aversion to this. Worryingly, there is a scent of the temporary around this measure. The funding commitment is for 2 years and if it is to be a stand-apart Commonwealth controlled service, it would be very easy to simply end the measure after an announcement of ‘mission accomplished’. Some of the language used in the Minsters’ press release reinforces this impression. For instance it is suggested that the ‘Corps’ will be involved in “blitzes” on selected health issues, such as middle ear disease in children. This is a worry. The current ‘blitz’, known as the child health checks, is the perfect demonstration of its’ limitations. What is required is an increased and sustained commitment to comprehensive health care over the long-term to address chronic health issues. A ‘blitz’ on middle ear disease will not solve the problem of high rates of ear infections in Aboriginal kids. Middle ear disease is a condition associated with overcrowding and poverty, and without simultaneously addressing the causative factors, the ‘blitz’ will fail.
The extra funding announced for health is welcome and much needed, but is likely to be highly flawed in application owing to two clear characteristics of the intervention to date; the desire for highly centralised control, and a lack of interest in involving those being affected, especially Aboriginal organisations.