Introduction by Croakey: Only four of the 19 Closing the Gap targets are on track to be met nationally – early childhood education, employment, land rights and sea rights – according to the latest data update released by the Productivity Commission today.
This indicates a decline from last year when five targets were on track – the proportion of babies with a healthy birthweight is no longer on track.
Alarmingly, the latest update shows the number of Aboriginal and Torres Strait Islander people in prisons increased by 15 percent between 2023 and 2024, and the rate of suicide among Aboriginal and Torres Strait Islander people in 2023 is the highest rate since the baseline year in 2018.
“In our review of progress towards the National Agreement on Closing the Gap, we found that governments had not taken enough meaningful action to meet their commitments under the Agreement,” said Productivity Commissioner Selwyn Button.
“The continued worsening of outcomes we’ve seen in some Closing the Gap target areas shows the importance of governments taking their commitments to the National Agreement seriously, and taking meaningful actions to fully implement the priority reforms.”
In an address to the Select Committee on Measuring Outcomes for First Nations Communities last week, Pat Turner, CEO of the National Aboriginal Community Controlled Health Organisation and Lead Convenor of the Coalition of Peaks, called for immediate and meaningful action to reverse the worsening Closing the Gap targets.
Below, Turner calls for sustainable funding for Aboriginal Community Controlled Health Organisations (ACCHOs), investment in the Aboriginal and Torres Strait Islander health workforce, and long-term support for programs that work.
Pat Turner writes:
Last Thursday, when I addressed the Select Committee on Measuring Outcomes for First Nations Communities, I carried with me the voices of the hundreds of Aboriginal Community Controlled Health Organisations (ACCHOs) and the communities they serve.
Our message to government was clear: the time for half-measures is over. We need action, accountability, and unwavering commitment to closing the gap.
The data is alarming. Fewer Aboriginal and Torres Strait Islander children are starting school developmentally on track. Incarceration rates are climbing. More children are being removed from their families. Suicide remains devastatingly high.
These aren’t just statistics – they reflect the daily struggles of our people. Change cannot wait.
Community-led solutions that work
ACCHOs have long been at the forefront of healthcare for our people, providing holistic, culturally safe, trauma-informed care that mainstream providers cannot replicate.
When Aboriginal and Torres Strait Islander people have control over their own health and wellbeing, outcomes improve.
Yet, despite their proven success, ACCHOs remain critically underfunded. The Department of Health and Aged Care’s own review found that ACCHOs receive significantly less funding than comparable mainstream clinics, even though they serve communities with far greater health needs.
If governments are serious about closing the gap, they must commit to sustainable, needs-based funding that allows ACCHOs to grow and strengthen their services.
Culture Care Connect
Suicide among Aboriginal and Torres Strait Islander people continues to rise.
The Culture Care Connect program, a NACCHO-led initiative, is proving that community-driven solutions work.
Through this program, 110 Aboriginal and Torres Strait Islander people have been employed to provide mental health support, 30 Community-Controlled Suicide Prevention Networks have been established, and 37 Aftercare services have been set up to ensure culturally safe, wraparound care for those at risk.
The early results are promising, but short-term, project-based funding threatens the program’s future.
Governments cannot continue to take a piecemeal approach to Aboriginal and Torres Strait Islander mental health. Long-term investment is critical.
Strengthening the workforce
A strong Aboriginal and Torres Strait Islander health workforce is essential to closing the gap. Our people remain underrepresented at every level of the health sector.
We know that when our communities lead their own healthcare, outcomes improve. This isn’t just about jobs – it’s about ensuring our people receive care from professionals who understand their culture, history, and lived experience.
One of the biggest barriers is the chronic underfunding of health training and workforce development. Without targeted investment and structured career pathways, the workforce shortfall will persist, and real change will be out of reach.
Through the First Nations Health Worker Traineeship Program (FNHWTP), NACCHO is actively addressing this gap.
This program, designed to train 500 new Aboriginal Health Workers and Practitioners, is already making an impact – more than 300 people have enrolled, and 100 have completed their qualifications through Aboriginal Community Controlled Health Registered Training Organisations (ACCHRTOs). Demand far exceeds supply, and further investment is crucial.
Beyond frontline workers, NACCHO has also identified an urgent need for more Aboriginal and Torres Strait Islander trainers.
To tackle this, we secured $1.2 million to pilot a training program, producing 21 new trainers in critical health disciplines. With proper investment, this initiative could expand, strengthening the entire health workforce pipeline.
Time and again, ACCHOs have delivered extraordinary results with modest funding. But to truly meet workforce demands, we need long-term, sustainable investment.
Aboriginal Community Controlled Health Registered Training Organisations play a critical role in training health professionals in culturally safe environments and must be supported to expand.
The evidence is clear – when Aboriginal and Torres Strait Islander people lead healthcare, our communities thrive.
Preventing the preventable
Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) should have been eradicated in Australia decades ago. Instead, they remain a devastating reality in our communities due to overcrowded housing, poor healthcare access, and environmental conditions – failures that governments have yet to fix.
The numbers are staggering. In 2023, 91 percent of ARF cases in Australia were among Aboriginal and Torres Strait Islander people. More than 9,000 of our people are currently receiving treatment for ARF or RHD, and 75 underwent heart surgery last year due to this preventable disease. These are not just statistics – they represent lives at risk and futures stolen by a failure to act.
At NACCHO, we know the solution: Aboriginal and Torres Strait Islander-led action.
Our NACCHO-led acute rheumatic fever and rheumatic heart disease program, launched in 2021, is a world-first – funding 29 ACCHOs across high-risk regions, reaching over 100 clinics and homelands.
The results speak for themselves: in 2024, participating ACCHOs saw a 27 percent increase in clients receiving their full antibiotic treatment, and more than 10,000 skin infections – a major precursor to ARF – were treated.
This progress cannot be undone by short-term thinking. The sector fought for over a decade to get a real commitment from government on RHD prevention.
If we want to end new cases by 2030, we need long-term funding to keep ACCHOs leading this work. That means securing the workforce, scaling up prevention, and expanding community-led early detection.
Our co-designed Echo in ACCHOs pilot is already training Aboriginal and Torres Strait Islander Health Workers to conduct echocardiograms to screen for RHD in communities – ensuring early diagnosis and better outcomes.
We cannot let this momentum stall. Ending new cases of ARF and RHD is not just a goal – it’s an obligation to future generations.
Accountability matters
The National Agreement on Closing the Gap, signed in 2020, was a historic commitment to change.
It promised to embed four Priority Reforms: shared decision-making, a strengthened community-controlled sector, transforming government institutions, and improving data transparency.
Five years later, implementation remains patchy at best.
The Productivity Commission’s review confirmed what our communities already knew – governments are failing to embed the Priority Reforms in policy and funding decisions.
This is unacceptable. Governments must be held accountable.
A critical step is ensuring the Productivity Commission routinely monitors and publicly reports on the implementation of the Priority Reforms, just as it does for the socio-economic targets.
Without transparency, progress will stall, and our communities will continue to suffer.
A call to action
The message from NACCHO and the Coalition of Peaks is clear: we do not need more agreements or policies – we need action.
Governments must fully implement the Priority Reforms.
They must commit to sustainable funding for ACCHOs, strengthen the Aboriginal and Torres Strait Islander health workforce through investment, and provide long-term support for impactful programs like Culture Care Connect and the ARF and RHD Program.
The time for excuses is over. The time for action is now.
If governments are serious about closing the gap, they must listen to our communities and invest in the solutions we know work. Anything less is just another broken promise.
You can also read the article in Croakey Health Media here.
