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The National Aboriginal Community Controlled Health Organisation (NACCHO) is a living embodiment of the aspirations of Aboriginal communities and their struggle for self-determination.

NACCHO is the national peak body representing 143 Aboriginal Community Controlled Health Organisations (ACCHOs) across the country on Aboriginal health and well being issues. It has a history stretching back through nearly five decades, to a meeting in Albury in 1974.

NACCHO’s History

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1971

- The first ACCHO – Redfern Aboriginal Medical Service – was established
- The Aboriginal Tent Embassy was erected in Canberra, outside the former Parliament House
- After the 1967 Referendum, the 1971 census included Aboriginal and Torres Strait Islander people

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1972

- First census to include Aboriginal and Torres Strait Islander people

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1973

- The first national ‘Ten Year Plan for Aboriginal Health’ was developed by the Whitlam Government

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1975

- NACCHO’s predecessor, the National Aboriginal and Islander Health Organisation (NAIHO) was formed
- The Racial Discrimination Act was enacted
- Medibank was established

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1977

- About ten ACCHOs were operating
- The CDEP scheme was implemented in regional and remote Australia

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1978

- An Aboriginal delegation travels to Kazakhstan and influences the WHO Alma Ata Declaration on Primary Health Care with its community-controlled model

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1979

- The House of Representatives Standing Committee on Aboriginal Affairs’ Report on Aboriginal Health recognizes that the social determinants of health are fundamental to improving health outcomes

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1984

- Commonwealth funding for Aboriginal health was consolidated within the Department of Aboriginal Affairs with a plan to fund ACCHOs direct

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1987

- The Royal Commission into Aboriginal Deaths in Custody was established (report delivered in 1991).

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1989

- A ‘National Aboriginal Health Strategy’ was drafted by an Aboriginal-led health working group

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1990

- ATSIC was established by the Hawke Government, bringing many Aboriginal and Torres Strait Islander programs and policies under the one portfolio agency

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1992

- NACCHO was established, replacing NAIHO as the national peak
- Eddie Mabo’s seminal victory in the High Court
- Paul Keating’s ‘Redfern speech’ (first acknowledgement by the Australian Government of the dispossession of its First Peoples)

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1993

- The Native Title Act was enacted

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1997

- NACCHO established a permanent secretariat in Canberra with government funding
- The Bringing Them Home Report (Stolen Generation) was published

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1999

- Special arrangements were put in place to allow for the supply of pharmaceuticals covered by the PBS to clients of remote ACCHOs

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2003

- A national footprint of 140 ACCHOs had been achieved
- The Productivity Commission’s first Overcoming Indigenous Disadvantage report was released

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2005

- ATSIC was decommissioned by the Howard Government and the short-lived Office of Indigenous Policy Coordination was established

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2007

- NITV was launched
- The Howard Government initiated the NT intervention

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2008

- Prime Minister Rudd delivered the National Apology to the Stolen Generation
- Prime Minister Rudd signed the Closing the Gap Statement and the first agreement was set in place

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2014

- The first Abbott-Hockey Budget decreases funding of Aboriginal programs by $500m

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2016

- Aboriginal and Torres Strait Islander leaders came to together to issue the Redfern Statement, calling for Aboriginal and Torres Strait Islander autonomy, and community control
- The failed Closing the Gap ‘Refresh’ process commenced

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2017

- The Uluru Statement from the Heart was provided to the Australian people
- A new National Funding Agreement for the sector was implemented

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2018

- The Coalition of Peaks formed (led by NACCHO) to get the Closing the Gap process back on track and ensure genuine community engagement

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2020

- ACCHOs are delivering 3.1m episodes of care each year
- The COVID-19 pandemic is declared by WHO
- A new National Agreement on Closing the Gap was signed by all Australian Governments and the Coalition of Peaks

In mid 2006, the Indigenous population of Australia reached 500,000 , the number often quoted as the population prior to colonisation. The 500,000 milestone is both a symbolic and real victory for Aboriginal and Torres Strait Islander survival.

Australia now experiences an extraordinary paradox- while Aboriginal and Torres Strait Islander peoples make up more than 2.4% of the population and are a vibrant, integral part of Australian culture, there is compelling evidence of massive social and economic disadvantage experienced by Indigenous people

This disadvantage makes the excess morbidity and mortality of Aboriginal and Torres Strait Islander peoples utterly predictable. What Aboriginal and Torres Strait Islander people have always known – that racism and health are inexorably linked – is now supported by a number of research findings on the social determinants of healthThis has provided a significant body of evidence about how health is moulded by neighbourhoods, family and social connections, social marginalisation, and actual or perceived control over one’s life and workplace.

The unequal distribution of negative health-related behaviours adversely affects the already disadvantaged. Racially and ethnically biased clinical decision making has also been shown to contribute to poorer health care and outcomes.

Australia is alone among comparable developed nations in its failure to make significant inroads into the health status of its Indigenous population over the past 30 years. In particular, the massive excess of mortality among Aboriginal people in middle age is without comparison.

The evidence from North America and New Zealand is that a great deal can be achieved over relatively short periods of time. The fact that Aboriginal & Torres Strait Islander peoples comprise only 2.4 % of the population means that the necessary measures are eminently affordable.

Aboriginal community controlled health services and self determination. The first Aboriginal Medical Service (AMS) established at Redfern in 1971, following hot on the heels of the local service, was in part a reflection of the aspirations of Aboriginal people for self-determination in the intense, melting-pot environment of Redfern intellectual life.

Predating, Medibank, it was also a response to the urgent need to provide decent, accessible health services for the swelling and largely medically uninsured Aboriginal population of Redfern.

Aboriginal Medical Services (now known as Aboriginal Community Controlled Health Organisations) to distinguish them from state government controlled services) are controlled by the local Aboriginal community via elected boards of management.

The primary health care approach adopted by Redfern and other early ACCHOs was innovative. It mirrored international aspirations at the time for accessible, effective and appropriate needs-based health care with a focus on prevention and social justice (foreshadowing the 1978 WHO Alma-Ata Declaration on Primary Health Care).

The impact of ACCHOs in the Aboriginal community came to be more than just an effective health service provision; through employment, education of staff, engagement, empowerment and social action, ACCHOs became key strategic sites for Aboriginal community development.

The following goes some way to explaining their significance:

Thing is that we own the bloody thing and it is something that we can’t, I can’t explain – about the ownership and the pride that it actually brings... we used to be blamed for being the same as the mainstream, well , I can tell you, the ACCHS service activity reporting has reflected that we’re nowhere near the same as mainstream. Mainstream would love to do some of this stuff, but they can’t. I don’t know why, but that’s why we’re here...

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