Closing the gap is a government strategy that aims to 

reduce disadvantage among Aboriginal and Torres Strait Islander people 

with respect to:

1. life expectancy
2. child mortality
3. access to early childhood education
4. educational achievement
5. employment outcome

set measurable targets:

• close the gap in life expectancy by 2031
• halve the gap in child mortality by 2018
• ensure 95 percent of Aboriginal and Torres Strait Islander four-years-olds are enrolled in early childhood education by 2025
• halve the gap in reading, writing and numeracy by 2018
• halve the gap in year 12 attainment by 2020
• halve the gap in employment by 2018.
• close the gap in school attendance by 2018

CTG PBS Co-payment Program

Established: July 2010

Objective: Improve access to affordable PBS medicines for Aboriginal and Torres Strait Islander people with chronic diseases or at risk of them.

Key Features

1. Cost Reduction:
   • Eligible patients receive PBS medicines at concessional rates or without co-payment, depending on their usual payment status, when obtaining PBS General Schedule medicines.
   • Patients who normally pay the full PBS co-payment (currently $39.50 per item) pay the concessional rate (currently $6.40 per item).
   • Patients who normally pay the concessional price receive PBS medicines without being required to pay a PBS co-payment.
2. Remote Access:
   • The Remote Area Aboriginal Health Services (RAAHS) Program allows clients of approved RAAHS in remote areas to receive medicines without charge.
3. Enhancements (June 2020):
   • Expanded eligible registrants.
   • Removed the need for CTG annotation on prescriptions.
   • Extended eligibility to prescriptions dispensed by public hospitals.
4. Continued Dispensing:
   • Applies to medicines supplied under Continued Dispensing from July 1, 2022, for eligible Indigenous patients.

Patient Eligibility

• Aboriginal and Torres Strait Islander people of any age registered with Medicare.
• Must be deemed by their prescriber or Aboriginal Health Practitioner as likely to experience setbacks in managing their condition without the program’s assistance.
• Likely to experience setbacks in the prevention or ongoing management of chronic disease if they did not take the prescribed medicine.
• Unlikely to adhere to their medicines regimen without assistance through the Measure.

Registration Process

• Eligible individuals can be registered by any PBS prescriber or eligible Aboriginal Health Practitioner via the Services Australia Health Professional Online Services (HPOS) portal.
• No need for re-registration for those already enrolled by June 30, 2021.
• Eligible patients can register at:
  • General practices participating in the Indigenous Health Incentive Practice Incentives Program (PIP).
  • Indigenous Health Services (located in urban and regional areas).

Dispensing and Eligible Medicines

• CTG prescriptions can be dispensed only at community pharmacies or Section 94 Approved Private Hospital pharmacies.
• Applies to PBS General Schedule medicines, excluding brand premiums.

Eligible Prescribers

• Must be a member, employee, or contractor of a general practice participating in the Indigenous Health Incentive under the PIP or an Indigenous Health Service in a rural or urban setting.
• Practices must meet the Royal Australian College of General Practitioners (RACGP) definition of a ‘general practice’ and be accredited or registered for accreditation against the RACGP Standards for general practices.

Other Close the Gap (CTG) initiatives

involves several considerations to ensure safe and effective treatment while addressing the specific needs of Indigenous communities.

1. Culturally Competent Care:
   • Ensure cultural sensitivity and respect in interactions with ATSI patients.
   • Acknowledge and respect cultural beliefs, practices, and preferences.
   • Engage with Indigenous health workers or cultural liaison officers if available.
2. Health Promotion and Prevention:
   • Provide education on preventive health measures tailored to the specific needs of ATSI communities.
   • Promote screening and early detection of chronic diseases such as diabetes, cardiovascular disease, and cancer.
3. Regular Health Checks:
   • Offer regular health checks to monitor the patient’s overall health and address any emerging issues promptly.
   • Include assessments for chronic diseases, mental health, and social determinants of health.
4. Access to Services:
   • Facilitate access to culturally appropriate healthcare services, including Aboriginal Community Controlled Health Organizations (ACCHOs) and specialist services.
   • Provide information on available support services and programs addressing social determinants of health, such as housing, employment, and education.
5. Chronic Disease Management:
   • Implement evidence-based management plans for chronic diseases, focusing on holistic care and patient empowerment.
   • Collaborate with multidisciplinary teams, including Indigenous health workers, nurses, and allied health professionals, to support comprehensive care.
6. Medication Management:
   • Ensure appropriate prescribing and monitoring of medications, taking into account cultural considerations and potential barriers to adherence.
   • Provide education and support for medication management, including the importance of compliance and regular review.
7. Advocacy and Empowerment:
   • Advocate for the needs and rights of ATSI patients within the healthcare system.
   • Empower patients to actively participate in their healthcare decisions and advocate for their own health needs.
8. Cultural Safety:
   • Create a culturally safe healthcare environment where ATSI patients feel respected, valued, and able to express their health concerns openly.
   • Continuously reflect on and improve cultural competence through education and training.