To the Editor: The summation by Russell that “the inescapable reality is that current primary care interventions are not working”1 overlooks evidence of significant improvements in the Northern Territory. The latest “closing the gap” report indicates that the Indigenous mortality gap in the NT should close within a generation.2
Mortality among NT Indigenous adults has declined by a third since 2000.2 We attribute this positive outcome primarily to effective use of primary health care funding, which has been progressively increased and equitably distributed, since 2001. This money has funded universally adopted e-health solutions and NT key performance indicators, which drive continuous quality improvement initiatives. These are backed by common clinical guidelines, with increasing adherence rates, that are used in all Aboriginal primary health care clinics.3
The statement “ACCHOs [Aboriginal community controlled health organisations] have had little influence on the mainstream health system”1 neglects experience in the NT, where the ACCHO sector is a co-owner of the NT Medicare Local and remains a critical driver in the NT Aboriginal Health Forum (NTAHF). Now in its 15th year, the NTAHF has secured government support for community control as the preferred model for delivering Aboriginal primary health care. The ACCHO sector is also a leader in developing and using clinical guidelines, mental health services, e-health, and continuous quality improvement programs. National policy should support the expansion and enhancement of Aboriginal community controlled primary health care services.
- 1. Russell L. Reports indicate that changes are needed to close the gap for Indigenous health. Med J Aust 2013; 199: 737-738. <MJA full text>
- 2. COAG Reform Council. Indigenous reform 2011–12: comparing performance across Australia. Report to the Council of Australian Governments. 2013. http://www.coagreformcouncil.gov.au/sites/default/files/files/National%20Indigenous%20Reform%20Agreement%20-%2030%20April%202013%281%29.pdf (accessed May 2014).
- 3. Bailie R, Si D, Dowden M, et al. Improving organisational systems for diabetes care in Australian Indigenous communities. BMC Health Serv Res 2007; 7: 67.
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