NACCHO Opinion The Australian : Aboriginal self-determination key to life-saving health efforts


” Malcolm Turnbull’s decisive response, in the form of a royal commission into the unforgivable treatment of young Aboriginal detainees, shows that action can be taken quickly where needed.

Let’s hope this speed is the starting point for a wider inquiry — one that looks not just at what’s happening in Northern Territory detention centres, but why young Aboriginal people are 25 times more likely to end up in detention centres than non-Aboriginal youth, and what is going so wrong in regions such as the Kimberley that Aboriginal children left behind are up to six times more likely to commit suicide than non-Aboriginal children.

The fact that our children are living in a world where suicide and incarceration are so familiar is a national disgrace that should break the heart of every parent, politician and decent human being.”

Matthew Cooke is chairman of the National Aboriginal Community Controlled Health Organisation.

The Australian 1 August 2016


With the swift leadership shown by the Prime Minister, echoed by strong bipartisan support, this year must be the year that Australian government works with Aboriginal people to make a strong commitment to reverse policies that until now have hindered efforts to meet Close the Gap targets.

A new cabinet is a new beginning and the onus is on Health Minister Sussan Ley, Indigenous Affairs Minister Nigel Scullion and others to follow up on Turnbull’s response with a commitment to empowering and resourcing Aboriginal organisations in our own communities.

Now more than ever, self-determination must feature front and centre. It is imperative that Aboriginal communities and indigenous-controlled medical services are empowered to develop and run programs for Aboriginal people that are culturally appropriate and reach those who desperately need support. We know it’s the only model that works.

The Productivity Commission’s progress report from last November on the implementation of the National Indigenous Reform Agreement illustrates this in two statements: first, that inadequate progress is being made in Closing the Gap; second, more than 80 per cent of investments under the NIRA implementation have gone to non-indigenous organisations.

Unless investments under the NIRA — and in all indigenous-­focused programs — support self-determination and are channelled through reputable Aboriginal organisations, we will not make any gains. Aboriginal people need to be central to decision-making — their leadership as well as participation must be welcomed.

Better progress is being made in the area of Aboriginal health than in the other five NIRA target areas because successive Australian governments have channelled some of their Aboriginal grant funds through National Aboriginal Community Controlled Health Organisations — often referred to as Aboriginal Medical Services.

NACCHOs are Australia’s largest single national and preferred primary healthcare system for Aboriginal people. The importance of the sector is widely and formally acknowledged across the Australian health and social sectors — from GPs to hospital emergency facilities.

Importantly, the NACCHO sector is held accountable to national key performance indicators — which means it can demonstrate that it is a model that is showing the most health gains. NACCHOs increased the proportion of clients who received care in 10 out of 16 indicators. The sector also made the biggest contribution to achieving a 66 per cent reduction in child mortality rates and a 33 per cent reduction in overall mortality rates. NACCHOs are tangible evidence of the benefits of Aboriginal self-determination.

Crucially, the NACCHO sector is also the only nationwide network of service providers accountable to Aboriginal communities. NACCHO directors are elected by Aboriginal people from communities in urban, rural and remote locations all across Australia.

Last year all major political parties supported the 10-year implementation plan for the National Aboriginal and Torres Strait Islander Health Plan.

The plan communicates the ­integral role of the NACCHO ­sector, and the role it will play in more than 30 areas to improve the health and wellbeing of Aboriginal people. We are still to see any outline of how it will be fully funded.

During this new term of government, the complex set of policy and funding relationships that underpin the NACCHO sector must be acknowledged in a permanent and secure partnership, to reflect the glowing statements from current and former government ministers about the performance and value of the sector.

The royal commission needs to look at what’s happening in detention centres.

It also needs to look at why so many of our Aboriginal young people are ending up there in the first place and what’s broken in a system that is causing so many of our young people to despair.

Investing in non-indigenous services and organisations to deliver indigenous health and social services is widely acknowledged as failed policy — the solution must come from the indigenous community itself.

Matthew Cooke is chairman of the National Aboriginal Community Controlled Health Organisation.

Leave a Reply

Your email address will not be published. Required fields are marked *