NACCHO Aboriginal Health #ClosingtheGap : Pat Turner Convener #CoalitionofPeaks Speech at the National #PHN Conference : Challenging the way Governments and Primary Health Networks work with us

The reform priorities, and that they are being discussed in a COAG forum with Aboriginal and Torres Strait Islander people at the table, as well as the upcoming engagements is a demonstration of how the conversation and approach is changing as a result of the Partnership Agreement on Closing the Gap.  

But this changed approach is not to be just contained to the Partnership Agreement and governments work with the Coalition of Peaks. It is to be applied to all your policy practice and service delivery.

It is a challenge for you (PHN’s) to reconsider how you develop policies and programs with and for Aboriginal and Torres Strait Islander people and communities.

The Partnership Agreement means that:

  • Aboriginal and Torres Strait Islander people are no longer government ‘stakeholders’ but are full partners in the development of policies and programs that impact on us.
  • Primary Health Networks need to develop formal arrangements with us, through our community controlled health organisations, to agree policy and programs, based on our own structures and not your own appointed advisory bodies.
  • The knowledge of Aboriginal and Torres Strait Islander peoples to determine their own solutions must be given primacy in policy and program design and delivery.

I ask that you all consider what the Partnership Agreement will mean to your own Primary Health Network, to the area and team that you work with, to start a conversation with your team members about it, to read further about the work we are doing and set up a time to speak to one of our Coalition of Peaks members to learn more.

The Partnership Agreement presents a significant opportunity for you all to think creatively and with innovation, to not just think about what is possible in the relationship between government and Aboriginal and Torres Strait Islander people, but to be at the forefront of the change.”

Pat Turner NACCHO CEO speaking at the PHN NATIONAL FORUM, 11TH September 2019 HYATT HOTEL, Canberra

Hello everyone, thank you for inviting me here today to speak to at the seventh Primary Health Network National Forum.

It is testament to the changing times that you now have delegates from national health peak bodies like mine, the National Aboriginal Community Controlled Health Organisation (NACCHO), attending your forums and being invited to share our own stories.

My name is Pat Turner. I am the CEO of NACCHO, and the Lead Convener of the Coalition of Peaks. Foremost, I am an Aboriginal woman, the daughter of an Arrente man and a Gurdanji woman.

Before we start, I want to acknowledge the traditional custodians of the lands where we are meeting today.

Canberra is Ngunnawal country. The Ngunnawal are the Aboriginal people of this region and its first inhabitants.

The neighbouring people are the Gundungurra to the North, the Ngarigo to the South, the Yuin on the coast, and the Wiradjuri inland.

It is a harsh climate and difficult country for hunter-gatherer people. To live here required great knowledge of the environment, skillful custodianship of it and close cooperation.

It is this knowledge and ways of working that continue to guide Aboriginal and Torres Strait Islander peoples across the in today’s Indigenous policy landscape.

As we navigate the changing policy environment, Aboriginal people draw strength from our lands and our customs. And we continue the cooperation amongst our many nations for the betterment of all of us. This is the approach that we take to the Coalition of Aboriginal and Torres Strait Islander Peaks Bodies and our work on Closing the Gap.

The Coalition of Peaks are made up of some forty national and state/territory community controlled Aboriginal and Torres Strait Islander Peak Organisations. We have come together to be formal partners with Australian Governments on Closing the Gap.

Today I want to share with you how a group of Aboriginal community controlled organisations, led by NACCHO, have exercised political agency by leading the way, challenging the possibilities and imagining a future of shared decision-making with governments on policies and programs that impact on our people and our communities.

Together, we are changing the way governments work with Aboriginal and Torres Strait Islander peoples on policies and programs that impact on us: we are setting a new benchmark for how our voices are heard in the design and implementation of policies and programs that impact on us.

I come before you to not only share the story of the Coalition of Peaks and their work with governments. Importantly, I also want to talk to you about what these new arrangements mean for Primary Health Networks and for your own daily work practices.

The new approach to Closing the Gap is a challenge you to change the way you work with and engage with Aboriginal and Torres Strait Islander people in the development of policies and delivery of health and wellbeing programs.

BACKSTORY

I will start by going back, to tell you how the Coalition of Peaks got to where we are today.

You might recall the Council of Australian Governments (COAG) in 2007 committed to ‘closing the gap’ in life expectancy between Aboriginal and Torres Strait Islander and other Australians, and a range of targets to end the disparity between Aboriginal and Torres Strait Islander peoples and other Australians in areas like infant mortality, employment and education.

  1. It was the first time that Australian Governments had come together in a unified way to address the disadvantage experienced by too many Aboriginal and Torres Strait Islander peoples.
  2. An unprecedented investment of around 4.6 billion dollars in programs and services to ‘close the gap’ as also made.
  3. Governments also agreed to new oversight, monitoring and reporting arrangements, including an annual report to the Commonwealth Parliament by the Prime Minister.

Aboriginal and Torres Strait Islander leaders at the time welcomed this new approach from governments and some of us were consulted in the early stages of the Commonwealth’s thinking.

However, despite this unprecedented coming together of Australian Governments and investment and initial engagement with our peoples, we were not formally involved in Closing the Gap, it was not agreed by us and it was a policy of governments and not for our people.

Many Aboriginal and Torres Strait Islander people felt that Closing the Gap presented the issue of our disadvantage as a technical problem built around non-Indigenous markers of poverty. This only served to hide the extent to which Aboriginal and Torres Strait Islander peoples’ disadvantage is a political problem requiring deep structural reforms about the way governments work with us.

Closing the Gap did not address the biggest gap that we face: the gulf between the political autonomy and economic resources of Aboriginal and Torres Strait Islander peoples and non-Indigenous people.

The policies and programs that then followed whilst making some difference to our peoples lives did not achieve their potential.

Over time government commitment to work together fell away. Funding to our programs and services were cut or not continued.

It is not surprising then, that, now ten years later, we have not made the progress against the closing the gap targets that had been hoped.

“REFRESH”

As you know, in 2017 the Commonwealth Government embarked on a ‘refresh’ of the Closing the Gap framework and undertook a series of consultations. In the view of many Aboriginal and Torres Strait Islander organisations, the consultations were inadequate and superficial. There was no public report prepared on their outcomes.

The lack of transparency and accountability surrounding these consultations were very disappointing, but also not surprising. Many of our organisations made submissions to government on Closing the Gap but we felt like our voices were ignored.

We were worried that governments commitment to work differently with us going forward was not backed by meaningful demonstrations. And we were concerned that governments wanted to walk away from the intergovernmental arrangements that brought a national integrated policy strategy needed to close the gap.

No new funding was announced to accompany the ‘refresh’ and there were no specific actions being discussed that we could see or feel confident would make a positive change to our lives.

As the ‘refreshed’ Closing the Gap strategy was being prepared for sign off by the Australian Governments, our dismay and disappointment galvanised a small group of community controlled organisations to come together to write to the Prime Minister, Premiers and Chief Ministers asking that it not be agreed.

We weren’t going away, and there were three important messages that we wanted governments to hear. These were:

  • When Aboriginal and Torres Strait Islander peoples are included and have a real say in the design and delivery of services that impact on them, the outcomes are far better;
  • Aboriginal and Torres Strait Islander peoples need to be at the centre of Closing the Gap policy: the gap won’t close without our full involvement; and
  • the Council of Australian Governments cannot expect us to take responsibility and work constructively with them to improve outcomes if we are excluded from the decision making.

Eventually, we were invited to meet with the Prime Minister, who acknowledged that the current targets were ‘government targets’ not ‘shared targets’, and that for Closing the Gap to be realised Aboriginal and Torres Strait Islander people had to be able to take formal responsibility for the outcomes through shared decision making.

On 12 December 2018, COAG publicly committed to developing a genuine, formal partnership with Aboriginal and Torres Strait Islander people, through their representatives, on Closing the Gap; and that through this partnership a new Closing the Gap policy would be agreed.

THE PARTNERSHIP AGREEMENT ON CLOSING THE GAP

The initial fourteen organisations then became almost forty, as we brought together Aboriginal and Torres Strait Islander Peaks bodies across the country to form a formal Coalition to negotiate a new Closing the Gap framework with Australian Governments. We include both national and state and territory based Aboriginal and Torres Strait Islander Peaks representing a diverse range of services and matter that are important to us as Aboriginal and Torres Strait Islander peoples and to Closing the Gap.

As a first step and through our initiative, we negotiated and agreed a formal Partnership Agreement between the Council of Australian Governments and the Coalition of Aboriginal and Torres Strait Islander peak organisations which came into effect in March 2019.

The Partnership Agreement sets out that the Coalition of Peaks will have shared decision making on developing, implementing and monitoring and reviewing Closing the Gap for the next ten years.

This is an historic achievement. It is the first time that Aboriginal and Torres Strait Islander Peaks have come together in this way, to work collectively and as full partners with Australian Governments. It’s is also the first time that there has been formal decision making with Aboriginal and Torres Strait Islander peoples and Australian Governments in this way.

WHERE ARE AT NOW

Progress is being made under the Partnership Agreement on Closing the Gap:

  • All Council of Australian Government members, including the local government association, have signed the Partnership Agreement.
  • The National Indigenous Reform Agreement (NIRA) has been reviewed by the Coalition of Peaks and officials from Australian Governments.
  • It has been agreed that the NIRA will be replaced with a new National Agreement on Closing the Gap covering the next ten years, to be signed off by the Council of Australian Governments and the Coalition of Peaks. It will continue the NIRA’s successful elements, strengthen others and address foundational areas that were previously excluded from consideration.
  • New accountability, monitoring and reporting arrangements are being developed for the new National Agreement that will strengthen public transparency and accountability.

Most importantly, the Coalition of Peaks have also proposed reform priorities to underpin the new National Agreement on Closing the Gap.

The reform priorities seek to change the way Australian Governments work with Aboriginal and Torres Strait Islander peoples and organisations, and accelerate life outcomes for Aboriginal and Torres Strait Islander peoples, these are:

  1. Establishing shared formal decision making between Australian governments and Aboriginal and Torres Strait Islander people at the State/Territory, regional and local level to embed ownership, responsibility and expertise on Closing the Gap.
  2. Building and strengthening Aboriginal and Torres Strait Islander community-controlled organisations to deliver services and programs in priority areas.
  3. Ensuring all mainstream government agencies and institutions undertake systemic and structural transformation to contribute to Closing the Gap.

These reforms have been agreed in principle by the COAG established Joint Council on Closing the Gap, made up of Ministers from each jurisdiction and Coalition of Peak representatives on 23 August 2019. And they have direct relevance to the Primary Health Networks and our work together.

The Joint Council also agreed to the Coalition of Peaks leading engagements with Aboriginal and Torres Strait Islander representatives of communities and organisations on new National Agreement.

These engagements are happening over the next two months and include open meetings across Australia agreed to and supported by governments. The Coalition of Peaks are also consulting with their own memberships and there is an online public opportunity for people to have their say.

The primary focus of the engagements is to build understanding and support for the reform priorities and to have a detailed discussion on what is needed to make those reform priorities a success. The discussions and input from Aboriginal and Torres Strait Islander communities will help inform the finalisation of the negotiations on the New National Agreement on Closing the Gap.

This is also a significant shift in the approach to policy development. It is the first time that governments have agreed to leaders of Aboriginal and Torres Strait Islander organisations engaging with representatives from our communities and organisations about important government policy.

Pat Turner Lead Convener of the Coalition of Peaks invites community to share their voice on #ClosingtheGap

This week a survey will be sent to hundreds of Aboriginal and Torres Strait Islander community-controlled organisations and their networks, inviting responses from both individuals and organisations.

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

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