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This will require improving processes to ensure needs based assessment of resource allocations, as well as targets and benchmarks across a range of matters. The Aboriginal and Torres Strait Islander Health Performance Framework contains appropriate measures for access to primary health care. These include proxy indicators such as access to Medicare and the Pharmaceutical Benefits Scheme, rates of hospitalisation from preventable diseases, rates of Sexually Transmitted Infections and so on. Prior to 2000, the Aboriginal and Torres Strait Islander National Performance Indicators were linked to health targets. A selection of these are set out in Table 1 below. They indicate the type of targets that could be aimed for, with appropriate commitments of resources and effort to match. A focus solely on such a goal would be impractical and difficult. This point has been acknowledged through the Aboriginal and Torres Strait Islander Health Performance Framework and the development of COAG’s Overcoming Indigenous Disadvantage Framework. This recommendation seeks to place a time dimension on the goal and aims of the National Strategic Framework for Aboriginal and Torres Strait Islander Health as well as on the commitments of the Council of Australian Governments to overcome Aboriginal and Torres Strait Islander disadvantage. It provides a long term vision to focus government activity. At the beginning of this chapter I set out my first recommendation for addressing Aboriginal and Torres Strait Islander health inequality. setting targets and benchmarks which enable the community to determine whether government progress is sufficient. We should not be timid about setting a timeframe for when the solid commitments of government will be realised. The absence of such timeframes promotes a lack of accountability of governments. It sends a tacit message that it is fine for things to simply drift along. The antecedents to chronic disease in adulthood require a focus on maternal and child health to prevent low birth weights, improve childhood nutrition, reduce early onset ear infections, and enhance immunisation coverage. The much higher rates of these problems affecting Aboriginal children impact directly on higher rates of chronic diseases such as kidney failure, diabetes and heart disease in adulthood. Maternal and child health should be an urgent priority. The new arrangements for the administration of Indigenous affairs have not engaged sufficiently with the health sector in settling regional priorities and engaging with Aboriginal and Torres Strait Islander communities. The replacement on the Aboriginal Health Forums of ATSIC representation with State Managers of the Office of Indigenous Policy Coordination is not appropriate to ensure regional or informed representation of Aboriginal and Torres Strait Islander peoples in decision making and planning processes. While there have been some positive developments in identifying

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