Since July 2007, the health components of the Northern Territory Emergency Response (NTER) have evolved from their initial focus on the roll-out of child health checks into a program of follow-up service delivery which will continue through until 30 June 2009.
From 1 July 2008, implementation of the longer term responses to Indigenous health needs in the Northern Territory began with the Expanding Health Service Delivery Initiative as well as continuing commitments in Child Special Services and Alcohol and Other Drug services.
In 2007-08, $53.4 million was expended on NTER-related health measures including:
- child health checks
- follow-up primary health care services
- follow-up specialist services in ear, nose and throat (ENT), hearing and dental health
- alcohol and other drug treatment, rehabilitation and outreach services
- child special services including the commencement of a Mobile Outreach Service for children affected by the trauma of sexual abuse and their families.
From July 2008, the Australian Government has provided funding of $99.7 million over two years for the Expanding Health Service Delivery Initiative. Under this initiative the Australian Government is working in close partnership with the Northern Territory (NT) Department of Health and Families and the Aboriginal community-controlled health sector, through the Aboriginal Medical Services Alliance NT (AMSANT) to strengthen regionalised approaches to service delivery to ensure a more efficient and coordinated primary health-care service-delivery system.
Also from July 2008, an additional $13.6 million has been provided for the delivery of follow-up dental, hearing and ENT services for Aboriginal children in remote communities and town camps in the Northern Territory. This funding will also enable the continuation of drug and alcohol treatment, rehabilitation and outreach services and child special services.
In addition, under the NTER the Australian Government is funding a Mobile Outreach Service connected to the existing regional NT Sexual Assault Referral Centres to deliver counselling, support and education services to children and families in remote communities who have suffered child-abuse-related trauma. These services commenced in 2007-08 and will continue for a further four years from 2008-09 to 2011-12 with a budget of $6.2 million.
As of 17 October 2008, a total of 12,263 valid CHCs have been performed through the NTER and Medicare Benefits Scheme Item 708 since NTER implementation commenced on 1 July 2007.
An analysis of 8324 child health checks shows that:
- 68.6 per cent of children have received one or more referrals
- 33.9 per cent of children have been referred for dental care
- 38.9 per cent of children have been referred for further primary health-care follow-up for issues such as treatment of skin conditions, immunisation updates and treatment for ear infections
- 11.9 per cent of children have been referred to a pediatrician and smaller numbers have been referred to other specialists and allied health personnel
- 8.3 per cent of children have been referred for specialist ENT services.
Expanding Health Service Delivery Initiative
The Australian Government has committed to providing $99.7 million to expand health-service delivery in remote NT Indigenous communities over two years from July 2008. The Expanding Health Service Delivery Initiative (EHSDI) aims to deliver long-term, sustainable improvements in the NT primary health-care system and provides for:
- increased primary health-care service delivery in remote locations
- delivery of more regionally-based primary health care services in remote communities
- recruitment of health professionals with a Remote Area Health Corps (RAHC) being established for this purpose.
In 2008-09, EHSDI will enable a sustained focus on the delivery of child health checks and primary health-care follow-up services, providing significant additional capacity for the expansion of health services across the NT.
Child health check feedback sessions have been conducted in 14 communities to date.
Along with workforce issues, infrastructure limitations within the NT Aboriginal primary health-care sector remain among the most significant constraints to improving health services within the NT. The EHSDI Investment Plan for 08-09 includes up to $6 million for infrastructure support, which will be allocated along with funding to support increased primary health-care services. The Department of Health and Ageing has also allocated funds during 2008-09 specifically for refurbishment of NT Primary Health Care Health Centres
On 10 May 2008 an advertisement was placed in the national media for existing organisations or consortia to establish and operate the Remote Area Health Corps. As a result of the assessment of the applications received, a preferred applicant, Aspen Medical, was identified. A Funding Agreement was executed with Aspen Medical on 17 October 2008 and the RAHC commenced operations.
The RAHC will be a primary health-care professional recruitment and deployment agency and will be responsible for recruiting, readying and transporting health professionals to remote communities.
Child Special Services
The Australian Government has provided a $6.2 million commitment in new funding for expanded sexual assault services (as part of Better Outcomes for Hospitals and Community Health) in the NT. This commitment also provides funds for the service to be independently evaluated during the first three years.
Two initiatives funded in 2007-08 under the NTER - Improving Child and Family Health measure have addressed the issue of children abuse:
- Male Health Summit: Taking Care of our Children - convened in July 2008 by the Central Australian Aboriginal Congress, providing an opportunity for Central Australian Aboriginal men to come together in a safe environment to discuss the challenges of child abuse-related trauma and its impact on victims, families and communities
- A Healing Model for Adolescent Sex Offenders - the Central Australian Aboriginal Congress was funded to gauge and develop the readiness of families and communities to participate in the design and implementation of a service to address the needs of children and adolescent victims and adolescent perpetrators of child abuse.
Alcohol and Other Drugs
The Australian Government has implemented measures to address the need for increased alcohol and other drug treatment and rehabilitation services in the NT, including increasing the alcohol and other drugs (AOD) workforce in Aboriginal primary health-care services and the capacity of AOD treatment and rehabilitation services.
AOD outreach workers have been engaged in selected Aboriginal primary health-care services in regional centres across the NT, with outreach services provided to numerous remote communities in each region. The AOD outreach workers, including AOD registered nurses and locally-engaged Indigenous community support workers, provide brief interventions, referrals, health promotion activities and capacity building through mentoring and education of staff.
Additional funding is also being provided to five AOD treatment and rehabilitation services in 2008-09 to continue enhanced capacity and services provided under the NTER in 2007-08. These services are located in Darwin, Katherine, Tennant Creek, Alice Springs and Yuendumu.
For more information, go to the Department of Health and Ageing website.