Sector Leader – Federal Election edition – March 2025
Our health, our vote: What’s at stake?
QAIHC calls for real commitments to First Nations health
Too slow for too long: The reality of Closing the Gap Crunching the data on CTG targets Federal Election Special
First Nations health on the ballot: Party priorities revealed
The ACCHO sector and QAIHC
Aboriginal and Torres Strait Islander community controlled health organisations (ACCHOs) were established as a practical expression of Aboriginal peoples’ self-determination over health matters.
These services were created by Aboriginal and Torres Strait Islander peoples independently of government and driven by the need to receive a better quality of care.
What is an ACCHO?
An ACCHO is a primary health care organisation initiated and operated by the local Indigenous community to deliver holistic, comprehensive, and culturally appropriate health care to the community which controls it, through a locally elected Board of Management.
ACCHOs understand the role they play in supporting their local Aboriginal and Torres Strait Islander communities to live better lives. The ACCHO approach has evolved out of an inherited responsibility to provide flexible and responsive services that are tailored to the needs of local Aboriginal and Torres Strait Islander communities. ACCHOs often provide many services over and above their funded activities to ensure their community members gain the services they need.
In line with their holistic health approach ACCHOS support the social, emotional, physical and cultural wellbeing of Aboriginal and Torres Strait Islander peoples, families and communities.
Who is QAIHC?
The Queensland Aboriginal and Islander Health Council (QAIHC) is a leadership and policy organisation. QAIHC was established in 1990 and is the peak organisation representing many of the ACCHOs in Queensland at both a state and national level.
The QAIHC Membership is comprised of 31 ACCHOs and two regional bodies (NATSIHA and IUIH) located throughout Queensland. Nationally, we represent Queensland through its affiliation and Membership on the board of the National Aboriginal Community Controlled Health Organisation (NACCHO).
It’s a federal election year and Aboriginal and Torres Strait Islander health must be at the forefront of the debate.
Despite repeated commitments to Closing the Gap, we have yet to see a clear, robust plan and investment from any political party to drive real progress for our people.
Since the referendum on the Voice was lost, it has become harder to get governments to listen. Too often, when we call for equity, we are met with accusations of being divisive. Unfortunately, Indigenous policy has become a political hot potato.
But here’s the thing; we do not accept a future where the health and wellbeing of Aboriginal and Torres Strait Islander people is not a priority.
CHAIRMAN’S ADDRESS
If political parties want our votes, we need to know: What is your plan for Indigenous health?
The path forward is clear. We need governments to invest in our communities by funding our organisations directly and empowering local leadership.
Aboriginal and Torres Strait Islander people know what is best for our communities — our ACCHOs have proven time and again that we can deliver culturally safe, primary health care.
The only way we will close the gap is by ensuring that decision-making power is in the hands of those who understand the challenges and have the solutions.
We have just six years left to meet the Closing the Gap targets. Without urgent, systemic change, those targets will remain out of reach. The time for talking is over — now is the time for action.
We will be watching this election closely. Our people deserve more than empty promises and platitudes; we demand real commitments.
To our Members — your voice counts. Vote for a party who believes that health equity for Aboriginal and Torres Strait Islander people involves real, practical reform.
To every political party seeking our support: show us that you are ready to take real steps toward Indigenous health equity. Show us your plan and investment.
Yours sincerely,
Matthew Cooke Chairman
We welcome submissions from our Members and Associates on the great work being undertaken within the Aboriginal and Torres Strait Islander community controlled health organisation (ACCHO) sector.
If you would like to contribute story ideas for consideration or comment on items in the current issue, please contact our Communications team at communications@qaihc.com.au. Previous issues can be viewed online at qaihc.com.au
Aboriginal and Torres Strait Islander readers are warned that this publication may contain images or names of people who have passed away.
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Our Members
Apunipima
Gindaja
Gurriny Yealamucka
Mookai Rosie Bi-Bayan Ngoonbi
Wuchopperen
Mutkin Residential and Community Care Indigenous Corporation Biddi
Normanton Recovery and Community Wellbeing Services
Ferdy’s Haven NATSIHA
Palm Island Community Company
Gidgee Healing
ATSICHS Mackay Mudth-Niyleta
Gumbi Gumbi
LEGEN D
QAIHC Member
QAIHC Associate Member
QAIHC Regional Member
Hospital and Health Services*
Cairns and Hinterland
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Metro South
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*Children’s Health Queensland is not depicted on the map as it is a statewide specialist HHS
GRAICCHS T/A Nhulundu Health Service
Link-Up Gallang Place
QAIAS Winangali Marumali
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NPA Family and Community Services
Pormpur Paanth Aboriginal Corporation
Torres Health
Biddi
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NCACCH
Weak progress on CtG targets exposes government systems failures
With the 2025 federal election approaching, QAIHC is calling on political parties to make a strong, tangible commitment to advancing progress on Closing the Gap targets. Sector Leader takes a closer look at what’s at stake.
Just over four-and-a-half years ago, the National Agreement on Closing the Gap (the National Agreement) was re-established as a commitment to improve the lives of all Aboriginal and Torres Strait Islander people.
The historic National Agreement marked a watershed moment for Indigenous health advocacy in Australia, with Australian governments and the Coalition of Aboriginal and Torres Strait Islander Peak Organisations agreeing to work together to ‘close the gap’ and overcome inequality experienced by Indigenous Australians.
Today, progress on the Closing the Gap targets, which include health and wellbeing, education, justice and job prospects, has been embarrassingly slow.
Of the 19 national socio-economic targets under the National Agreement, only five are on track to be met by 2031 (only one of these is related to health and wellbeing).
A further five targets show improvement but are not on track to be met, while progress towards four targets are worsening. Targets going backwards include Indigenous adults in incarceration, Indigenous children in out-of-home care and Indigenous Australians dying by suicide.
In February 2024, the Productivity Commission released its three-year review into progress of the National Agreement. The report found governments had largely not fulfilled their commitments.
Although pockets of “good work” had been done, the report found government progress on meeting the targets had been “weak”.
The report stated governments had failed to “fully grasp the nature and scale of change” required to meet the obligations they signed up to under the National Agreement.
To date, most government actions and plans to implement the agreement relabel business-as-usual, or simply tweak existing ways of working,” said Commissioner Natalie Siegel-Brown.
With the Albanese Government expected to call an election any day now at the time of publication, and Australians facing the prospect of welcoming a new federal government in 2025, the likelihood of closing the health gap in the next six years look uncertain.
If there is any hope of achieving the targets under the National Agreement, the Prime Minister of the day must have a strong plan for progressing the Closing the Gap targets, and for ensuring shared decision-making with Indigenous Australians.
What progress has been made?
The National Agreement has 19 national socio-economic targets across 17 socio-economic outcome areas that have an impact on life outcomes for Aboriginal and Torres Strait Islander people.
The five targets on track to be met by 2031 are: increase the proportion of Indigenous children enrolled in a preschool program before full-time schooling, babies born at a healthy birthweight, employment goals, an increase in Australia’s land mass subject to Aboriginal and Torres Strait Islander people’s legal rights or interests and an increase in sea covered by Aboriginal and Torres Strait Islander people’s legal rights or interests.
Only four of the 19 targets are related to health-and-wellbeing, with three of these not on track to be met by 2031.
Image courtesy of IUIH’s Birthing in Our Community program
The life expectancy gap (Socioeconomic target 1) between Aboriginal and Torres Strait Islander people and non-Indigenous people is improving but the target of a zero-life expectancy gap is not on track to be met by 2031.
For Aboriginal and Torres Strait Islander people, the rate of deaths by suicide is increasing. The target of a ‘significant and sustained reduction’ is not on track to be met (Socioeconomic target 14).
In 2022, 33.8 per cent of Queenslander Aboriginal and Torres Strait Islander children starting school were assessed as being developmentally on track in all five AEDC domains. This outcome is improving (Socioeconomic target 4). A trajectory is not available for Queensland but nationally, the target is not on track to be met by 2031.
On the upside, a higher proportion of Aboriginal and Torres Strait Islander babies are being born at a healthy birthweight (Socioeconomic target 2) and is on track to be met by 2031.
What needs to be done?
According to the review of the National Agreement on Closing the Gap, one of the key findings was that governments had failed to grasp how fundamentally they needed to transform the way they operated and were instead mainly pursuing only “piecemeal changes”.
This is at odds with Priority 3 of the National Agreement, which was specifically written to achieve the ‘systemic and structural transformation of mainstream government agencies and institutions to ensure that governments are accountable for Closing the Gap and are culturally safe and responsive to the needs of Aboriginal and Torres Strait Islander people’.
Selwyn Button, Indigenous Policy Evaluation Commissioner at the Productivity Commission, told Sector Leader:
Again, governments at all levels — federal, state and territory — have provided little evidence to demonstrate how they are doing this, and many are continuing business as usual, with no sign of improving outcomes.”
For real change to occur, Mr Button said governments must be willing to relinquish decision making power to ACCHOs when making new policies and programs.
“This is directly connected to governments transforming the way they do business with Indigenous people and communities,” he said.
If there is no change in the power dynamic between governments and ACCHOs when it comes to providing services to communities, then we will not see progress against the Closing the Gap targets.
“Governments must be able to share power with ACCHOs because where this has happened, and government has invested in ACCHO solutions, we have seen tremendous gains in outcomes.
A great example of this approach has been through the Birthing in Our Community (BiOC) program across South East Queensland, where governments have invested in a program that has been designed and led by the community controlled sector.
“Thanks to this program, the share of Indigenous babies in South East Queensland with healthy birthweights is now higher than the national average, above that of non-Indigenous babies, and ahead of where we need to be to achieve target 2 of the Closing the Gap indicators.”
QAIHC Acting Chief Executive Officer Paula Arnol agreed the findings demonstrated governments were not sharing responsibility or using the skills and knowledge of Aboriginal and Torres Strait Islander community controlled organisations.
The Priority Reforms under the National Agreement were meant to ensure governments listened to Aboriginal and Torres Strait Islander people, we know what is best for our communities,” Ms Arnol said.
“Governments need to strengthen the structures that empower Aboriginal and Torres Strait Islander people and share decision-making authority, and the quality of the data available to us. We often rely on data that is updated infrequently to measure progress.
We are not just statistics in a report. Aboriginal and Torres Strait Islander people want and deserve healthy, fulfilled lives with opportunities equal to those of non-Indigenous people.”
The future
“They must recognise the expertise of Aboriginal communitycontrolled organisations in what works for their communities.
We need stronger involvement from communitycontrolled organisations if we’re really going to close the gap. Our Members live and work in our communities and regions, their strength is in building solutions for mob.
“Aboriginal and Torres Strait Islander partnerships and collaboratives are essential to achieve real change.”
She said urgent action was needed now and a new government needed a strong plan to address the health inequities that Aboriginal and Torres Strait Islanders face on a day-to-day basis.
“Our communities and services live with real inequity. Life expectancy targets aren’t on trajectory, and suicide rates amongst our people are climbing,” she said.
Following the release of the Productivity Commission’s review last year, the Albanese Government stressed there would be improvements.
In a speech to Parliament, Prime Minister Anthony Albanese said the Australian Government was still committed to Closing the Gap targets, but the change would not be immediate.
“If we want to close the gap, we have to listen to people who live on the other side of it,” he said.
Canberra must be willing to share power with communities. To offer responsibility and ownership and self-determination.
FEATURE STORY
To let local knowledge design programs, to trust locals to deliver them and to listen to locals when they tell us what’s working and what isn’t.
“That’s a culture change we have to drive — in this building, in the public service and across governments at all levels.
The price of failure — over successive governments — isn’t just counted in dollars, it’s measured in lives.
existing expenditure on Indigenous programs, before focusing on improving Closing the Gap targets.
“We need an audit into spending on Indigenous programs. If we do not examine what is working and what is failing, nothing will improve,” she said.
“So much has been spent in this portfolio over the years, there are game-changing lessons just sitting and waiting to be unearthed with a proper forensic examination.”
“Not every community-driven initiative will be an overnight success, but we know that we cannot just keep doing things the same way. The Productivity Commission has outlined the case for a new approach.”
Following release of the review, the government announced two measures to close the gap — a national Commissioner for First Nations Children and Young People, and a job program for remote areas (the Remote Jobs and Economic Development Program).
In contrast, the Shadow Minister for Indigenous Australians Jacinta Price said there needed to be a serious examination of
Four-and-a-half years after the refreshed launch of the National Agreement on Closing the Gap, the lack of significant progress on its targets is a stark reminder of the challenges in addressing entrenched inequalities faced by Aboriginal and Torres Strait Islander peoples.
This slow progress reflects not only systemic inefficiencies within government agencies but also underscores the critical need for transformative internal change among decision-makers.
Regardless of which political party forms government after the election, they must prioritise meaningful action to ensure these commitments lead to tangible outcomes.
Closing the Gap health outcomes progress
The National Agreement on Closing the Gap has 19 national socio-economic targets across 17 socio-economic Of the 17 socio-economic outcome areas, there are four health and wellbeing targets. Three of the four health
CTG
Outcome
1
People enjoy long and healthy lives
The life expectancy gap between Aboriginal and Torres Strait Islander people and non-Indigenous people is improving but the target of a zero life expectancy gap is not on track to be met by 2031.*
For example:
Remoteness
In 2020–2022, Aboriginal and Torres Strait Islander people in remote areas of Australia had a life expectancy about 5 years shorter than Indigenous people in major cities or inner and outer regional areas.
Gender
The life expectancy gap between Aboriginal and Torres Strait Islander and non-Indigenous men is decreasing at a smaller rate than women
QLD vs National
The life expectancy gap between Indigenous and non-Indigenous people in Queensland is decreasing faster, than the national rate
Good news in preventative health!
Queensland Aboriginal and Torres Strait Islander people aged 18 years or over who
socio-economic outcome areas that have an impact on life outcomes for Aboriginal and Torres Strait Islander people. health and wellbeing outcomes are not on track to be met by 2031.
Certain conditions originating in the perinatal period
Congenital malformations Sudden Infant
(SIDS) and Sudden Unexpected Death in Infancy (SUDI)
causes of deaths of Aboriginal and Torres Strait Islander people in Queensland, 2018 to 2022
CTG Outcome
Children are born healthy and strong — healthy birthweight
A higher proportion of Aboriginal and Torres Strait Islander babies are being born at a healthy birthweight and the target is on track to be met by 2031.*
Number of live-born, singleton babies of healthy birthweight (2,500-4,499g), born in Queensland, 2014-2021
Age standardised rate of mothers who smoke during pregnancy in Queensland, 2021
Children thrive in their early years
In 2022, 33.8% of Queensland Aboriginal and Torres Strait Islander children commencing school were assessed as being developmentally on track in all five AEDC domains — this outcome is improving. A trajectory is not available for Queensland, but nationally the target is not on track to be met by 2031.*
Percentage of Queensland children compared to Australian children assessed as developmentally on track in all five domains of the Australian Early Development census+
*Source: based on Productivity Commission 2024 data, Closing the Gap Annual Data Compilation Report July 2024, Canberra. +Trajectories are only available nationally. The final trajectory year value is the target value.
For Aboriginal and Torres Strait Islander people, the rate of deaths by suicide is increasing and the target of a significant and sustained reduction is not on track to be met.*
of Queenslanders aged 18 years+ who report experiencing racial prejudice
Mortality due to suicide, age standardised rate per 100,000 — 5 year aggregate, Queensland
Due to the frequency of data collection and reporting, data is updated only as it becomes available, which is the following: CTG Outcome 1 — every 5 years, CTG Outcome 2 — annually, CTG Outcome 4 — every 3 years, and CTG Outcome 14 — annually.
A better future for Indigenous health
As Australia approaches the next federal election, the political landscape regarding the health of Aboriginal and Torres Strait Islander communities is at a crossroads.
Following the failure of the Voice to Parliament referendum in October 2023, and the subsequent abandonment of the treaty pathway by Queensland, as well as a slowdown or halting of treaty processes in other states, Aboriginal and Torres Strait Islander Australians are left questioning: what now?
What do political parties intend to do for the future health of Aboriginal and Torres Strait Islander communities if they reject a Voice and treaty frameworks? How will they address systemic inequalities and achieve meaningful change?
QAIHC is calling for genuine, tangible commitments from political parties to address these questions.
QAIHC Chairman Matthew Cooke believes ACCHOs must be recognised and funded as integral participants in our federated health system. This recognition requires action, not rhetoric.
We need fair and transparent funding arrangements based on clear evidence of need, and governance structures that grant the ACCHO sector a substantial role in shaping health service planning, funding, and delivery,” Mr Cooke said.
Mr Cooke highlighted the pressing need to address medication shortages and improve access to pharmacists within ACCHOs, stating, “Urgent action is needed to ensure Indigenous communities have the same access to essential medications and pharmacy services as other Australians.
“There is a lot of chronic disease in our communities and there is more difficulty for our patients to access medicines than other Australians.”
While governments often cite commitments to improving Indigenous health outcomes, the reality has fallen short.
The National Agreement on Closing the Gap, signed in July 2020, outlined four priority reforms:
1. establishing formal partnerships and shared decision-making;
2. strengthening the community-controlled sector;
3. transforming government organisations to better serve Indigenous communities; and
4. sharing access to data and information at a regional level.
However, the Productivity Commission reported in February 2024 that governments have failed to adequately progress these commitments. Despite “pockets of good practice,” progress against the priority reforms had been “weak.” The absence of robust mechanisms to measure progress against these reforms highlights a persistent gap between policy intention and implementation.
Additionally, the failure of the Voice referendum has left governments wary of prioritising Aboriginal affairs, viewing it as a politically sensitive issue that does not win votes. This fear has led to a retreat from commitments like Path to Treaty, with Queensland repealing its legislation and other states slowing their efforts. This reluctance has created a general malaise among political parties in addressing Indigenous issues, including much-needed health reforms.
“These varying approaches highlight the lack of a cohesive national strategy to address Indigenous self-determination,” said Mr Cooke.
“Without clear commitments, governments risk deepening divisions and perpetuating inequities.
“Aboriginal and Torres Strait Islander communities have made it clear: they want practical, community-driven solutions over inappropriate and often tokenistic strategies.
Kerry Crumblin CEO, Cunnamulla Aboriginal Corporation for Health
What is QAIHC advocating for?
ACCHOs must be recognised and funded as integral participants in our complex federated system. This requires:
Fair and transparent funding arrangements that respond to evidence of need.
Governance arrangements that give the ACCHO sector a seat at the table and a substantial role in shaping health service planning, funding and provision.
Direct actions to address medication shortages and improve access to pharmacists in ACCHOs (please see our position statement on pharmacists in ACCHOs on page 22).
“Investments must empower Aboriginal and Torres Strait Islander communities through local and regional place-based solutions, and promote shared decision-making that allows communities to identify their own priorities and solutions.”
Mr Cooke emphasised the need for equitable investment guided by evidence.
We need publicly accessible data dashboards and mechanisms to ensure investments are targeted where they’re needed most. This is how we create real change,” he added.
Such measures would enable Indigenous communities to take control of their own futures, fostering practical solutions that are culturally appropriate and locally relevant.
Australia’s National Health Reform Agenda provides an opportunity to incentivise partnerships between hospitals and ACCHOs. Some hospital-delivered services — whether in the community or at home — could be transitioned to ACCHOs to ensure culturally appropriate care is prioritised. This approach would strengthen local expertise as well as address workforce capability gaps in Hospital and Health Services.
We need to see direct investment in ACCHOs. This will better meet community needs rather than relying solely on hospital systems that have historically struggled to deliver culturally safe care,” said Mr Cooke.
As we move closer to the federal election, QAIHC is asking political parties to clarify their plans for Indigenous Australians. If they reject a Voice to Parliament and treaty pathways, what alternative frameworks will they propose? How will they:
Close the gap in health and socioeconomic outcomes?
Empower Aboriginal and Torres Strait Islander communities to lead decision-making processes?
Ensure sustained investments that deliver measurable, effective outcomes?
The National Agreement on Closing the Gap has been in place for over three years, yet progress remains elusive. Achieving the 17 socio-economic targets under the agreement requires urgent action and rigorous measurement (please see pages 10-20 for detailed analysis). Without genuine commitment to shared decision-making and practical reforms, governments risk continuing to make investments that fail to deliver effective outcomes for Aboriginal and Torres Strait Islander communities.
Mr Cooke urged Members to advocate for their local communities and highlight the needs of Indigenous communities in the lead-up to the election, so their voices were heard.
He said this would be important for governments developing practical, actionable plans.
“Aboriginal and Torres Strait Islander peoples deserve more than symbolic gestures,” he said.
“They deserve meaningful action that respects their autonomy, acknowledges their expertise and invests in their futures.
Leading up to the election, political leaders must provide detailed, actionable plans for addressing the systemic challenges faced by Aboriginal and Torres Strait Islander communities.”
For Aboriginal and Torres Strait Islander peoples, the question remains: who will step up and deliver the change they need and deserve?
Sector Leader asked our Member CEOs, as leaders in the ACCHO sector, what issues were most important to them in the upcoming federal election.
Ailsa Lively
Proud Gunggandji woman, CEO of Gindaja Treatment and Healing Indigenous Corporation, Yarrabah.
As the CEO of an Indigenous-run, communitycontrolled Alcohol and Other Drugs rehabilitation, treatment and healing service, the most important issue in the upcoming federal election is support for culturally safe, locally-led services for Aboriginal and Torres Strait Islander communities. We need increased funding for programs designed, delivered, and governed by Indigenous people to ensure culturally appropriate care for those battling alcohol and drug dependence, particularly in remote areas.
Manjit Sekhon Acting CEO of Gidgee Healing, Mount Isa
Current health systems fail to meet the needs of health care providers in creating a conducive environment for effectiveness and growth. These systems promote a reactive approach, responding to events by working towards solutions for specific problems rather than fostering long-term, sustainable change.
For instance, if a patient experiences a heart attack, the system focuses on reducing the risk of further heart attacks and preventing early death. While this response is
We call for greater investment in holistic rehabilitation that respects traditional knowledge, empowers community leaders, and addresses the root causes of substance misuse.
Our services are designed to meet the unique challenges of remote Indigenous communities, and we urge the government to work with us to sustain community-led, evidence-based programs.
There must also be urgent action to close the gap in health outcomes, especially regarding the overrepresentation of Indigenous Australians in substance misuse statistics. Government policies should focus on long-term, community-driven solutions that ensure Indigenous voices are central to decision-making.
critical, it highlights a broader issue: the lack of emphasis on proactive, preventative measures that could stop the heart attack from occurring in the first place.
However, the challenge extends beyond primary and secondary health care measures — it lies in the systems that underpin them.
Without structural support that enables preventative and community-driven health care, Australia struggles to become a major player in the field of effective and successful primary health care models, despite access to a competent, economical health care environment and a highly trained workforce.
Indigenous — Aboriginal Party of Australia (IAPA)
Sector Leader caught up with Marnie Laree Davis (Darug), Indigenous — Aboriginal Party of Australia candidate for the Gold Coast seat of Fadden in the 2025 federal election, to discuss the party’s First Nations health policy.
Ms Davis, a proud Darug woman raised on Quandamooka and Kombumerri country, has worked across government advocacy, domestic violence services, and Aboriginal Medical Services.
“Because we’re a grassroots community party, we are contacted by community members across Australia seeking us to advocate to address the cultural and practice gaps in our current government practices and responses,” she said.
The IAPA website outlines 16 policies, one addressing primary health: the establishment of a dedicated Indigenous suicide help line, which was implemented in 2022.
13Yarn is mob-led and informed by national Aboriginal organisations such as NACCHO. Ms Davis noted that while Mob-led initiatives are effective, long-term funding is uncertain.
“It’s hard to get that consistency of staff where community are building rapport, and they build trust, and they’re engaging well, and in the end the programme finishes,” she said.
“There’s accountability issues — for government identified roles being paid less than mainstream roles, despite mob doing double the workload in addition to cultural load.
“This needs to be addressed so we have mob supporting mob, with Indigenous trauma-informed practice in position descriptions and performance reviews.”
The IAPA website also outlines two policies concerning mental/emotional health: ending juvenile incarceration due to its psychological harms and ending the psychological harm of lack of recognition of Aboriginal and Torres Strait Islander traditional ownership — through constitutional recognition and treaty.
She stressed that better housing, prevention of forced child removal, and local, community-based supports are crucial in reducing domestic violence, suicides, and incarceration.
Drawing on her domestic violence sector experience, she highlighted how inadequate government responses perpetuate high domestic violence rates.
Ms Davis referred to successful local solutions such as referral pathways to culturally-safe prevention measures in home family wellbeing supports.
“Despite the successful outcomes of these organisations, the department continues old ways and removal of children which is psychologically damaging to our families, community and jarjums,” she said.
Intensive rehab programmes or intensive family wellbeing supports in the house work really well.
“Elders come into the family home and provide support in home.
“It’s culturally appropriate, supportive, and there’s no intergenerational fear of child safety coming in and saying, ‘you must do XYZ or we’re taking your children off you’.
It’s time for justice and it’s our time for a First Nations party, for a voice in parliament not to parliament.”
ieLaree Davis(Da )
Katter’s Australian Party (KAP)
Katter’s Australian Party (KAP) is acutely aware that many Queensland families, including First Australians, face severely limited access to healthcare. In the Kennedy electorate, represented by the KAP’s Bob Katter, First Australians comprise 14.8 per cent of the population, significantly higher than the national average of 3.2 per cent and Queensland’s 4.6 per cent.
Our commitment lies in ensuring improved access to healthcare services. We highly regard and value our doctors and healthcare professionals, and we want to provide them with the necessary support to deliver continued improvements in health outcomes for First Australians, as well as remote and rural residents.
To address this issue, we support the following:
1. Cut red tape for fast-track access to essential treatments: We are particularly interested in supporting proposals that simplify access to essential healthcare by expanding the role of GPs and other trained health professionals, particularly in smaller towns and remote areas. Many of our constituents and their children living in rural and remote areas face critical care challenges due to limited access to medical or allied health specialists who can assist them. We support programs that aim to expand rural healthcare services to address these patients’ needs.
2. Greatly improved patient travel support: KAP is conscious that remote and rural residents, including First Australians, will, on occasion, need to travel to larger centres for specialist treatment. Current supports for this travel, including accommodation, are grossly inadequate. Patients should never be faced with a financial burden to access the care they need.
3. Significant increase in Renal Services: First Australians are five times more likely to suffer from kidney disease. Current renal services across Australia in remote and rural communities are in need of significant expansions. First Australians and remote and rural people must never be faced with the harrowing decision to move away from home for extended periods, if not forever, to access ongoing life-giving care.
4. Invest in the next generation of general practitioners and healthcare professionals: We support expanded funding to train more general practitioners and healthcare professionals, but we hold firm that this funding must be directed towards training doctors and professionals who will practice in areas of workforce shortage — particularly in rural and remote communities.
The KAP is a strong supporter of First Australians outside of the health sphere too, successfully implementing programs for First Australians to own their own home, as well as advocating against the Queensland Blue Card system which has been disproportionately keeping First Australians out of gainful employment.
K
ader , Hon BobKatt MP
The Australian Greens
ACCHOs have been severely under-funded and under-recognised by successive governments. This has prevented ACCHOs from fully investing in infrastructure, workforce and service programs required to meet community need.
The Australian Greens recognise that, despite this, ACCHO services are consistently some of the most effective and culturally safe community services in the country.
In this context, and in full knowledge of the significant health and mental health disparities experienced by First Nations Peoples, the Australian Greens have committed to the following:
Funding for ACCHOs
The Greens will provide an additional $750m for ACCHO services over 10 years. This would include specialists’ services to address intersectional health needs, such as those of First Nations LGBTIQA+ people and those with disabilities.
Funding for FAS-D diagnosis and treatment
The Greens will provide more funding for Foetal Alcohol Syndrome Disorder (FAS-D) diagnosis and treatment - $20m annually, $180m in total. This policy would decrease the costs associated with treatment and diagnosis of FAS-D. Programs funded by this commitment would be co-designed and co-delivered with First Nations People and First Nations-led organisations.
Increasing
access to bulk-billing GP appointments
The Greens will triple the Medicare Benefits Schedule (MBS) bulk billing incentive payments for all Medicare card holders, and resource doctors to spend more time with patients to spend more time with patients by implementing a 20 per cent increase to Medicare patient rebates for longer appointments.
Establishing 1000 free healthcare clinics
The Greens will establish 6 free local healthcare clinics in each federal electorate where people can access a GP, psychologist, nurse, or dentist for free.
Better resourcing for public hospitals
The Greens will commit to a pathway to 50/50 funding of public hospitals between the Federal Government and states and territories, and remove the 6.5 per cent cap on funding growth. This will ease pressure on the public hospital system and allow hospitals to continue providing high-quality essential healthcare.
Putting dental care into Medicare
The Greens will add dental services to Medicare to ensure that every person who holds a Medicare card will be able to access the essential dental services they need.
Our plan will see an improvement in health and wellbeing, a decrease in dental disease, infection and follow-on conditions such as heart disease and dementia.
Providing universal mental health care through Medicare
The Greens will expand the Better Access Scheme to ensure everyone can access the mental health they need by removing the cap on the number of sessions available, increasing the referral pathways, expanding access to provisional psychologists, and increasing rebates.
Other parties
Sector Leader contacted the Australian Labor Party, the Coalition and Pauline Hanson’s One Nation to provide statements; however, the ALP and One Nation were not ready to announce First Nations health policies. The Coalition was unable to provide a statement in time for publication.
Australian Labor Party
The Australian Labor Party (ALP) was formed out of the labour movement in pre-federation colonies. The party’s structure allocates 50 per cent of delegate representation at state and national conferences to affiliated unions, with the remaining 50 per cent to rank-and-file party members.
Scan the QR code to be taken to the ALP policy page, where you can find policies on Medicare, medicines and housing, among others.
Coalition
The Coalition — known as the LNP in Queensland — is an alliance between the Liberal Party of Australia and National Party of Australia. Despite retaining separate organisational wings and parliamentary groups, they work together through formal deals and informal arrangements. In 2008, Queensland merged its state parties into the Liberal National Party, though federal MPs continue to sit with either the Liberals or Nationals.
Scan the QR code to download LET’S GET AUSTRALIA BACK ON TRACK: The Priorities of a Dutton Coalition Government, the Coalition’s 12-point policy platform including health and First Nations policies.
Pauline Hanson’s One Nation
Pauline Hanson’s One Nation (PHON) also known as One Nation or One Nation Party is led by Senator Pauline Hanson.
Scan the QR code to be taken to the PHON policy page where they have policies on housing, health, Medicare, COVID-19 vaccination, medicinal cannabis and abortion.
QAIHC Position Statement:
Put pharmacists into ACCHOs
QAIHC Public Health Medical Director, Associate Professor Sophia Couzos provides an overview of the QAIHC position statement on pharmacists in ACCHOs.
QAIHC is advocating for a funded program to enable Queensland and other states’ ACCHOs to employ non-dispensing pharmacists within their health services.
A national trial completed in 2021, led by QAIHC and the National Aboriginal Community Controlled Health Organisation (NACCHO), proved that integrating pharmacists into ACCHOs significantly improved patient outcomes. Pharmacists joined clinic teams to directly support patients, working alongside doctors, nurses and Aboriginal health workers to improve medication management and chronic disease care.
The presence of pharmacists reduced prescribing errors, quadrupled the number of medicine reviews by doctors, and made patients feel healthier overall.
The study findings were independently reviewed and endorsed by the Medical Services Advisory Committee (MSAC), which recommended public funding for this model.
MSAC advised the Federal Health Minister that integrating pharmacists into ACCHOs is a cost-effective, safe, and culturally appropriate approach to improve chronic disease management for Aboriginal and Torres Strait Islander peoples.
The study showed remarkable health improvements for Aboriginal and Torres Strait Islander patients with chronic diseases, including better diabetes and blood pressure control, improved kidney function, and more patients took their medicines more regularly and as needed, compared to before.
Pharmacists worked as part of the clinic team, assisting doctors with medication management and supporting patients to understand their medications. They addressed complex medication regimens, especially for patients on multiple prescriptions, ensuring safer and more effective use of medicines. Unlike traditional pharmacists, these professionals engaged with patients in clinics or homes, rather than in pharmacies.
The Integrated Pharmacists within Aboriginal Community-Controlled Health Services (IPAC) Study tracked over 1,400 patients across Queensland, the Northern Territory, and Victoria.
Results demonstrated that pharmacists reduced medication errors, helped patients take their medicine, and contributed to better health outcomes.
MSAC noted that this model offers better value for money compared to existing medication programs that First Nations people rarely access.
There is a higher prevalence of chronic disease in Aboriginal and Torres Strait Islander communities, coupled with limited access to medications.
The pharmacist model addresses these disparities by ensuring patients receive the care they need to manage their health, stay out of hospitals, and return to work faster. This approach is especially beneficial for older people and those managing complex medication routines.
MSAC estimated that the cost per patient would range from $1,300 to $1,700 annually, with a total program cost of around $15 million per year. This is lower than other medication review programs that have limited reach within First Nations communities.
NACCHO, QAIHC, and the Pharmaceutical Society of Australia are ready to implement this program, with support from the Australian Indigenous Doctors Association.
QAIHC is calling on the federal government to collaborate on implementing this proven model to improve health outcomes for Aboriginal and Torres Strait Islander peoples. The evidence is clear: this program works, is cost-effective, and can make a meaningful difference in closing the health gap.
Read the full position statement on our website via the QR code below.
QAIHC Position Statement:
Aboriginal and Torres Strait Islander community-based palliative care
QAIHC Senior Program Officer Annie Parks provides an overview of QAIHC’s position on palliative care.
Many Aboriginal and Torres Strait Islander communities experience unusually high levels of grief due to frequent losses and near-constant Sorry Business. According to the Australian Institute of Health and Welfare, 42 per cent of Aboriginal and Torres Strait Islander respondents reported the death of a family member or close friend within the past year. These profound losses contribute to what is described as “malignant grief,” a form of cumulative grief that spans generations and significantly impacts the well-being of Aboriginal individuals and communities.1
Evidence suggests Aboriginals and/or Torres Strait Islanders often have a poor experience navigating the mainstream health system’s palliative care structures. Experiences of institutional racism and fear of the services, due to a lack of culturally appropriate and adequately trained personnel, create barriers to accessing suitable services and often contribute to their late referral to palliative care.
Palliative care admittance data from 2020-21, released by the Australian Institute of Health and Welfare, demonstrates Australia’s clear underinvestment in First Nations communityled palliative care capacity.2
Consultation with communities found most people prefer to receive palliative care at home or within their community. ACCHOs with their deep cultural knowledge and networks, are ideally positioned to provide comprehensive, culturally safe palliative care services in their community.
Key elements of this community-based palliative care framework include:
1. Culturally informed and safe quality palliative care: Healthcare providers need to understand and respect cultural and spiritual considerations (e.g., cultural protocols, traditional medicine, passing on Country). Service delivery co-designed with Aboriginal and Torres Strait Islander communities to promote self-determination and reflect cultural knowledge.
2. Community-led, team-based care: Palliative care is best delivered by a team comprising Aboriginal and Torres Strait Islander Health Workers, nurses, case managers, family members, and carers. Access to specialist palliative care supplements — not replaces — community-led services.
2. Australian Institute of Health and Welfare. (2023, May 25). Data tables: Admitted patient care and specialised facilities for palliative care 2020–21 [Data table]. In Palliative care services in Australia. Australian Government. https://www.aihw.gov.au/getmedia/2859d11c-bb2e-4a1c-8573-1b3daec50e3d/Data-tables-Admitted-patient-care-palliative-care-andexpenditure_2020-21.xlsx.aspx
1. Parker, R., & Milroy, H. (2014). Mental illness in Aboriginal and Torres Strait Islander peoples. In P. Dudgeon, H. Milroy, & R. Walker (Eds.), Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (2nd ed., pp. 113–125). Commonwealth of Australia.
3. Family-centred care:
Palliative care focuses on the holistic well-being of the patient and their family.
Kinship systems are recognised, ensuring the right family members are included in care discussions and decisions.
4. Returning to Country:
Place of passing holds strong cultural and spiritual significance for Aboriginal and Torres Strait Islander people. People need to be supported to pass on Country if possible.
Challenges like access to high-risk medications and specialist services in remote areas need to be addressed to facilitate this.
5. Grief and bereavement support:
Grieving is a complex process that affects individuals emotionally, mentally, physically, and spiritually. Frequent losses compound grief.
Support mechanisms to help families and communities through their loss.
Ensuring Aboriginal and Torres Strait Islander people have access to culturally appropriate, holistic, family-centred, community-led palliative care is essential. Given their role as trusted health providers within their communities, ACCHOs need to receive adequate funding, training, and resources to deliver these vital services. Palliative care led by ACCHOs can significantly improve the quality of life for Aboriginal and Torres Strait Islander people with life-limiting illnesses, their families, and communities. Queensland Health’s budget commitment to reshape the system supports shifting healthcare from hospitals to community health services run by ACCHOs and recognises the cost-effectiveness of ACCHOs to provide comprehensive community based health services.
Read the full position statement on our website via the QR code.
SECTOR SUPPORT QAIHC ADVOCACY
QAIHC Position Statement: Prison health
QAIHC Public Health Medical Director, Associate Professor Sophia Couzos, provides an overview of the QAIHC Prison health position statement.
QAIHC advocates for Aboriginal and Torres Strait Islander peoples in Queensland prisons to have equal access to healthcare. Despite being just 3.8 per cent of the total population, First Nations people make up 33 per cent of the prison population, reflecting historical injustices, intergenerational marginalisation and disproportionate contact with the justice system. Many experience chronic illnesses, disabilities and mental health issues, yet face limited preventive care and cultural support.
Barriers include constrained funding arrangements preventing full use of Medicare and the Pharmaceutical Benefits Scheme, inconsistent assessments that depend on custodial staff, and minimal cultural training for prison personnel. Multiple record-keeping systems also hinder continuity of care when individuals re-enter the community. Recognising prisons as part of public health, QAIHC stresses the need for integrated, culturally appropriate services.
ACCHOs provide culturally safe, holistic care and already serve many First Nations people in the wider community. However, few inmates
receive ACCHO-led support, missing opportunities for early detection and ongoing management of health conditions. The Department of Health and Aged Care’s National Review of First Nations Health Care in Prison acknowledges the need for systemic reform, including better partnerships with ACCHOs and clear quality standards for culturally safe healthcare.
Reducing barriers to health and wellbeing: The Queensland Prisoner Health and Wellbeing Strategy 2020–2025 recognises the severe over-representation of First Nations people but offers no specific targets or strong ACCHO collaboration. QAIHC concludes that urgent partnerships between government agencies and ACCHOs are essential. Approaches such as trauma-informed training, integrated record systems and continued Medicare/Pharmaceutical Benefits Scheme entitlements would improve continuity of care, reduce health inequities and lower recidivism among Aboriginal and Torres Strait Islander people.
Recommendations
Recommendation 1:
Queensland Corrective Services support a partnership with QAIHC and ACCHOs, in relevant regions, to allow for appropriate and effective healthcare focused on holistic health and safe transition back to the community for Aboriginal and Torres Strait Islander offenders.
Recommendation 2:
Queensland Corrective Services co-develop with QAIHC a policy framework which encompasses actions to ensure that all offenders have access to quality, comprehensive, culturally safe and holistic primary healthcare provision whilst in custody, an optimised program of cultural education for prison staff; effective data sharing to optimise transitions of care; and performance measures including vital statistics on prison health.
Recommendation 3:
Queensland Corrective Services co-develop a program to support the safe transition of care from prison health services to local communitybased primary healthcare services for all prisoners.
Recommendation 4:
The Queensland Government fund ACCHOs to provide culturally safe primary healthcare and rehabilitation programs within the justice system to Aboriginal and Torres Strait Islander inmates. This includes programs that allow increased access to allied health services and improved referral pathways from primary care to specialist services.
Recommendation 5:
The Queensland Government fund evidence-based support programs outside and within the justice system that can assist prisoners and people at risk of committing crime to enhance their social, emotional and physical health and wellbeing.
Recommendation 6:
The Commonwealth and Queensland governments negotiate the retention of prisoners’ entitlements to the Medicare Benefits Scheme (MBS) and the Pharmaceutical Benefits Scheme (PBS) throughout all stages of the custodial cycle, or permits custodial services exemptions to Section 19(2) of the National Health Insurance Act (1973)19 to ensure consistent access to essential healthcare and treatment for individuals in custodial settings.
Recommendation 7:
Queensland Corrective Services establish tailored MBS items that ‘mirror’ those available in the community, particularly Item 715 (Aboriginal and Torres Strait Islander Peoples Health Assessment), emphasising preventive care and targeted interventions to address prevalent health issues (e.g. smoking), and ensuring the well-being of individuals in custody.
Recommendation 8:
Queensland Corrective Services and Queensland Health to support an integrated health information electronic record system for those in custody that integrates with public and private medical records systems to ensure continuity of healthcare.
Recommendation 9:
Queensland Corrective Services and Queensland Health to support the implementation of effective screening and supports for First Nations children with disability.
Read the full position statement on our website via the QR code.
Federal election advocacy resources available for Members
QAIHC is committed to supporting our Members with tools and resources to advocate effectively during the upcoming federal election period.
QAIHC has launched a comprehensive online suite of resources, including template letters and suggested social media content, to help Members engage with local MPs, political parties, and candidates. Advocating to political parties will be critical in the lead-up to the election. Indigenous Queenslanders experience significantly poorer health outcomes compared to other Australians, with large life expectancy gaps for both males and females. These disparities demand urgent action from governments and political parties. They cannot remain passive observers to this inequity.
When is the federal election?
QAIHC’s election advocacy will be grounded in our Strong sector, strong system: QAIHC’s Ten-Year Blueprint 2024-2034. It’s our strategic vision to build a strong sector and health system for Indigenous Queenslanders. Through this framework, we will advocate for practical, evidence-based programs and investments that address the health needs of our communities (for more information about our priorities see pages 20-23).
We encourage our Member services to advocate for local priorities. To support this effort and amplify your voice in the lead up to the election, QAIHC has developed:
Key messages
Template letters
Adaptable social media content
Find our resources online via the QR code.
The next federal election must take place on or before 27 September 2025.
The exact timing is a matter of judgement for the Albanese Government, influenced by the constitutional and legislative rules that outline the electoral process.
Key factors influencing the election date include the scheduling of major state and territory elections.
If the government opts for a full three-year term, it may wait until after the Western Australian election in March 2025, potentially scheduling the federal election mid-year.
With timing uncertain (as of the date of publication, the federal election had not been called), it’s important for the ACCHO sector to begin advocacy efforts now.
For more on the constitutional and legislative factors in setting election dates, check out So When is the Next Federal Election? A Quick Guide published by the Parliament of Australia, via this QR code.
