Rachel Katterl, PHC RIS
 The Flinders University, together with the Cooperative Research Centre for Aboriginal Health released The Overburden report on 17 August. This report was the result of a three year project which examined the form and complexity of funding provisions to Aboriginal Community Controlled Health Organisations (ACCHOs).
ACCHOs are funded on the basis of short term contracts from a multitude of sources. These include commonwealth and state and territory governments, non-government organisations, as well as Medicare and the Pharmaceutical Benefits Scheme. Each of these funding sources is subject to its own accountability mechanisms, with scheduled reporting systems. The Overburden Project found that ACCHOs multiple funding sources, reporting systems, and short-term funding cycles has resulted in a highly complex system of accountabilities.
An average Aboriginal Community Controlled Health Organisation in this study generated revenue of $5 million annually. This was derived from an average of 22 sources, though this number increased to 51 sources in some organisations. A majority of these grants were to provide targeted health programs, and most are renewed on a yearly basis. This inevitably creates a significant reporting burden on the ACCHOs, and detracts the funding from serving a disadvantaged population towards administration. In addition, the targeted funding undermines the ability of the health organisations to provide the task with which they are charged: comprehensive, culturally appropriate primary health care.
The Overburden report points to the need for serious reformation of funding to Aboriginal Community Controlled Health Services. Overall, the need for a ‘single bucket’ of funding for Aboriginal primary health care services is highlighted. In addition, a greater focus on long-term funding cycles, funding flexibility to meet local needs, and a reduction in administrative and transaction costs are necessary for the operation of ACCHOs in Australia.
The Overburden report is available from the Cooperative Research Centre for Aboriginal Health website: <www.lowitja.org.au/crcah/list-crcah-publications>
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