NACCHO Aboriginal Women’s Health #SistersInside #imaginingabolition : Our CEO Pat Turner address to @SistersInside 9th International Conference Decolonisation is not a metaphor’: Abolition for First Nations women

NACCHO supports the abolition of prisons for First Nations women. The incarceration of Aboriginal and Torres Strait Island women should be a last resort measure.

It is time to consider a radical restructuring of the relationship between Aboriginal people and the state.

Aboriginal and Torres Strait Islander people and their communities must be part of the design, decision-making and implementation of government funded policies, programs and services that aim to reduce – or abolish –the imprisonment of our women.

Increased government investment is needed in community-led prevention and early intervention programs designed to reduce violence against women and provide therapeutic services for vulnerable women and girls. Programs and services that are holistic and culturally safe, delivered by Aboriginal and Torres Strait Islander organisations.

NACCHO calls for a full partnership approach in the Closing the Gap Refresh, so that Aboriginal people are at the centre of decision-making, design and delivery of policies that impact on them.

We are seeking a voice to the Commonwealth Parliament, so we have a say over the laws that affect us. “

Pat Turner NACCHO CEO Speaking at  Sisters Inside 9th International Conference 15 Nov

See Pats full speaking notes below

Theme of the day: ‘Decolonisation is not a metaphor’: Abolition for First Nations women

About Sisters Inside

  • Sisters Inside responds to criminalised women and girls’ needs holistically and justly. We work alongside women and girls to build them up and to give them power over their own lives. We support women and girls to address their priorities and needs. We also advocate on behalf of women with governments and within the legal system to try to achieve fairer outcomes for criminalised women, girls and their children.
  • At Sisters Inside, we call this ‘walking the journey together’. We are a community and we invite you to be part of a brighter future for Queensland’s most disadvantaged and marginalised women and children.

Sisters Inside Website Website 

In Picture above Dr Jackie Huggins, Pat Turner, Jacqui Katona, Dr Chelsea Bond and June Oscar, Aunty Debbie Sandy and chaired by Melissa Lucashenko.

Panel: Why abolition for First Nations Women?

Panel members:

  • Dr Jackie Huggins AM FAHA (Co-Chair, National Congress of Australia’s First Peoples)
  • Pat Turner AM (CEO, National Aboriginal Community Controlled Health Organisation)
  • Dr Chelsea Bond (Senior Lecturer, University of Queensland)
  • Jacqui Katona (Activist & Sessional Lecturer (Moondani Balluk), Victoria University)
  1. Imprisonment, colonialism, and statistics
  • The Australian justice system was founded on a white colonial model that consistently fails and seeks to control and supress Aboriginal and Torres Strait Islander peoples.
  • Indigenous peoples are overrepresented in the prison system:
    • Aboriginal and Torres Strait Islander adults are 12.5 times more likely to be imprisoned than non-Indigenous Australians.[i]
    • Our women represent the fastest growing group within prison populations and are 21 times more likely to be imprisoned than non-Indigenous women.[ii]
  • Imprisonment is another dimension to the historical and contemporary Aboriginal experience of colonial removal, institutionalisation and punishment.[iii]
  • Our experiences of incarceration are not only dehumanising. They contribute to our ongoing disempowerment, intergenerational trauma, social disadvantage, and burden of disease at an individual as well as community level.
  1. Aboriginal and Torres Strait Islander women’s experiences of imprisonment
  • The Change the Record report found that most Aboriginal and Torres Strait Islander women who enter prison systems:
    • are survivors of physical and sexual violence, and that these experiences are most likely to have contributed to their imprisonment; and
    • struggle with housing insecurity, poverty, mental illness, disability and the effects of trauma.
  • Family violence must be understood as both a cause and an effect of social disadvantage and intergenerational trauma.
  • Risk factors for family violence include poor housing and overcrowding, substance misuse, financial difficulties and unemployment, poor physical and mental health, and disability.[iv]
  • Imprisoning women affects the whole community. Children are left without their mothers. The whole community suffers.
  1. Kimberley Suicide Prevention Trial
  • The Kimberley Suicide Prevention Trial, of which NACCHO is a member, provides a grim example of the link between trauma, suicide, incarceration and the social determinants of health.
  • The rate of suicide in the Kimberley is seven times that of other Australian regions.
  • Nine out of ten suicides involve Aboriginal people.
  • Risk factors include imprisonment, poverty, homelessness and family violence.
  • Western Australia has the highest rate of Aboriginal and Torres Strait Islander imprisonment.
  1. Imprisonment and institutional racism
  • The overrepresentation of Aboriginal peoples in prison systems is not simply a law-and-order issue.[v] The trends of over-policing and imprisoning of Indigenous peoples are examples of institutional racism inherent in the justice system. [vi]
  • Institutional racism affects our everyday encounters with housing, health, employment and justice systems.
  • Institutional racism is not only discriminatory; it entrenches intergenerational trauma and socioeconomic disadvantage.[vii]
  • Exposure to racism is associated with psychological distress, depression, poor quality of life, and substance misuse, all of which contribute significantly to the overall ill-health experienced by Indigenous people. We are twice as likely to die by suicide or be hospitalised for mental health or behavioural reasons.
  1. Ways forward see opening quote Pat Turner 
  2. The role of ACCHSs in supporting Indigenous women

Increasing access to the health care that people need

  • Racism is a key driver of ill-health for Indigenous people, impacting not only on our access to health services but our treatment and outcomes when in the health system.
  • Institutional racism in mainstream services means that Indigenous people do not always receive the care that we need from Australia’s hospital and health system.
  • It has been our experience that many Indigenous people are uncomfortable seeking help from mainstream services for cultural, geographical, and language disparities as well as financial costs associated with accessing services.
  • The combination of these issues with racism means that we are less likely to access services for physical and mental health conditions, and many of our people have undetected health issues like poor hearing, eyesight and chronic conditions.

Early detection of health issues that are risk factors for incarceration

  • The Aboriginal Community Controlled Health model provides answers for addressing the social determinants of health, that is, the causal factors contributing to the overrepresentation of Indigenous women’s experiences of family violence and imprisonment.
  • Aboriginal Community Controlled Health organisations should be funded to undertake comprehensive, regular health check of Aboriginal women so that risk factors are identified and addressed early.

Taking a holistic approach to health needs and social determinants of health and incarceration

  • Overall, the Aboriginal Community Controlled Health model recognises that Aboriginal and Torres Strait Islander people require a greater level of holistic healthcare due to the trauma and dispossession of colonisation which is linked with our poor health outcomes.
  • Aboriginal Community Controlled Health is more sensitive to the needs of the whole individual, spiritually, socially, emotionally and physically.
  • The Aboriginal Community Controlled Model is responsive to the changing health needs of a community because it of its small, localised and agile nature. This is unlike large-scale hospitals or private practices which can become dehumanised, institutionalised and rigid in their systems.
  • Aboriginal Community Controlled Health is scalable to the needs of the community, as it is inextricably linked with the wellbeing and growth of the community.
  • The evidence shows that Aboriginal Community Controlled organisations are best placed to deliver holistic, culturally safe prevention and early intervention services to Indigenous women.
  1. About NACCHO
  • NACCHO is the national peak body representing 145 ACCHOs across the country on Aboriginal health and wellbeing issues. In 1997, the Federal Government funded NACCHO to establish a Secretariat in Canberra, greatly increasing the capacity of Aboriginal peoples involved in ACCHOs to participate in national health policy development.
  • Aboriginal Community Controlled Health first arose in the early 1970s in response to the failure of the mainstream health system to meet the needs of Aboriginal and Torres Strait Islander people and the aspirations of Aboriginal peoples for self-determination.
  • An ACCHO is a primary health care service initiated and operated by the local Aboriginal community to deliver holistic, comprehensive, and culturally appropriate health care to the community which controls it, through a locally elected Board of Management. ACCHOs form a critical part of the Indigenous health infrastructure, providing culturally safe care with an emphasis on the importance of a family, community, culture and long-term relationships.
  • Our members provide about three million episodes of care per year for about 350,000 people. In very remote areas, our services provided about one million episodes of care in a twelve-month period. Collectively, we employ about 6,000 staff (most of whom are Indigenous), which makes us the single largest employer of Indigenous people in the country.

[i] https://www.alrc.gov.au/publications/over-representation

[ii] Human Rights Law Centre and Change the Record Coalition, 2017, Over-represented and overlooked: the crisis of Aboriginal and Torres Strait Islander women’s growing over-imprisonment: NB: The foreword is written by Vicki Roach, a presenter in the next session of the Abolition conference

[iii] file://nfs001/Home$/doris.kordes/Downloads/748-Article%20Text-1596-5-10-20180912.pdf – John Rynne and Peter Cassematis, 2015, Crime Justice Journal, Assessing the Prison Experience for Australian First Peoples: A prospective Research Approach, Vol 4, No 1:96-112.

[iv] Australian Institute of Health and Welfare. 2018. Family, domestic and sexual violence in Australia. Canberra.

[v] https://www.theguardian.com/australia-news/2017/feb/20/indigenous-incarceration-turning-the-tide-on-colonisations-cruel-third-act

[vi] ‘A culture of disrespect: Indigenous peoples and Australian public institutions’.

[vii] https://www.theguardian.com/australia-news/2018/jul/12/indigenous-women-caught-in-a-broken-system-commissioner-says

NACCHO Aboriginal Health and #Racism #VicVotes @VACCHO_org Survey finds 86 per cent of Aboriginal and Torres Strait Islander people living in Victoria have personally experienced racism in a mainstream health setting

“Racism hinders people from actually getting good medical care, getting good health care accessing services,

The results highlight the need for government to appoint an independent health commissioner and address cultural awareness at all levels of the health system.

“There are avenues that can be taken to overcome these issues and we are here to urge they be adopted by whichever party wins government at the Victorian election later this month,

Acting CEO for VACCHO, Trevor Pearce, says incidents of racism within the mainstream health system often lead to Indigenous Australians seeking treatment much later than non-Indigenous people or avoiding it all together, contributing to the gap in health and wellbeing outcomes.

“On an individual level, exposure to racism is associated with psychological distress, depression, poor quality of life, and substance misuse, all of which contribute significantly to the overall ill-health experienced by Aboriginal and Torres Strait Islander people.

Prolonged experience of stress can also have physical health effects, such as on the immune, endocrine and cardiovascular systems.”

Pat Anderson is chairwoman of the Lowitja Institute,  (and a former chair of NACCHO) see her opinion article below link ”

This article has been read over 22,000 times in past 4 years 

Read HERE 

 

Researchers have polled Aboriginal and Torres Strait Islander Victorians about their experiences of racism at hospitals and GP clinics.

The online survey, with 120 respondents, found high levels of everyday racism in the health sector.

FROM NITV

Of those polled, 88 per cent reported incidences of racism from nurses, and 74 per cent had experienced racism when dealing with GPs.

The survey was conducted by the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) and designed in partnership with Royal Melbourne Institute of Technology (RMIT) students.

The results revealed 86 per cent of Aboriginal and Torres Strait Islander people living in Victoria have personally experienced racism in a mainstream health setting at least once, while 54 per cent said they experienced racism in hospitals every time they attended.

The survey responses showed fewer incidents of racism when interacting with dentists (48 per cent) and the ambulance service (46 per cent).

Mr Pearce attributed the lower figures to the cultural competency work VACCHO has done with Dental Health Services Victoria and Ambulance Victoria, and said it showed how working with the Aboriginal community could achieve beneficial results for everybody involved.

“This is going to require Aboriginal people not just being heard, but actions being taken on what we say. We know what is best for us, we have the answers. Pay attention to us and act accordingly,” he said.

Victoria’s health minister Jill Hennessy says the government is taking the issue seriously.

“We are ensuring our services are more responsive to the needs of Indigenous Australians, so they can get the high quality and safe care they need, when they need it – free from discrimination,” she said in a statement.

NACCHO Aboriginal Health #NACCHOagm2018 Report 4 of 5 : Minister @KenWyattMP full text keynote speech launching @AIHW  report report solely focusing on the health and wellbeing of young Indigenous people aged 10–24

” Culturally-appropriate care and safety has a vast role to play in improving the health and wellbeing of our people. In this respect, I want to make special mention of the proven record of the Aboriginal Community Health Organisations in increasing the health and wellbeing of First Peoples by delivering culturally competent care.

I’m pleased to be here at this conference, which aims to make a difference with a simple but sentinel theme of investing in what works, surely a guiding principle for all that we do

Providing strong pointers for this is a new youth report from the Australian Institute of Health and Welfare.

Equipped with this information, we can connect the dots – what is working well and where we need to focus our energies, invest our expertise, so our young people can reap the benefits of better health and wellbeing “

Minister Ken Wyatt launching AIHW Aboriginal and Torres Strait Islander Adolescent and Youth Health and Wellbeing 2018 report at NACCHO Conference 31 October attended by over 500 ACCHO delegates 

In Noongar language I say, kaya wangju. I acknowledge the traditional custodians on the land on which we meet and join together in acknowledging this fellowship and sharing of ideas.

I acknowledge Elders, past and present and I also want to acknowledge some individuals who have done an outstanding job in the work that you all do and I thank you for the impact that you have at the local community level: John Singer, chair of NACCHO; Pat Turner AM, CEO of NACCHO; Donnella Mills; Dr Dawn Casey; Dr Fadwa Al-Yaman; Professor Sandra Eades; Donna Ah Chee; LaVerne Bellear; Chris Bin Kali; Adrian Carson – and I’m sorry to hear that Adrian’s not with us because of a family loss – Kieran Chilcott; Raylene Foster; Rod Jackson; Vicki Holmes; John Mitchell; Scott Monaghan; Lesley Nelson; Julie Tongs; Olga Havnen.

All of you I have known over a long period of time and the work and commitment that you have made to the pathways that you have taken has been outstanding. I’d also like to acknowledge Dr Tim Howle, Prajali Dangol, and Helen Johnstone, the report authors.

I’m pleased to be here at this conference, which aims to make a difference with a simple but sentinel theme of investing in what works, surely a guiding principle for all that we do.

Providing strong pointers for this is a new report from the Australian Institute of Health and Welfare.

I understand this is the very first study by the Institute that focuses solely on First Nations people aged 10 to 24.

Download a copy of report aihw-ihw-198

As such, it is a critical document.

Firstly because it puts at your fingertips high quality, targeted research about our young people.

Secondly, it gives us a clear understanding of where they are doing well, but also the challenges young people still face.

And thirdly, equipped with this information, we can connect the dots – what is working well and where we need to focus our energies, invest our expertise, so our young people can reap the benefits of better health and wellbeing.

I’m always passionate about all young people having the best start in life and marshalling the human resources necessary so that this care extends right through to early adulthood, laying strong foundations for the rest of their lives.

I want to run through some of the key findings of this report and then talk about Closing the Gap Refresh in our Government’s commitment to and support for our young people. I’m pleased some real positives have been identified.

The report found a majority of the 242,000 young First Australians, or 63 per cent, assessed their health as either excellent or very good. Further, 61 per cent of young people had a connection to country and 69 per cent were involved in cultural events in the previous 12 months.

As the oldest continuous culture, we know that maintaining our connections to country and our cultural traditions is a key to our health and wellbeing. Education is another important factor in our ability to live well and reach our full potential.

In the 20 to 24 age group, the number of young people who have completed Year 12 or the equivalent has increased from 47 per cent in 2006 to 65 per cent in 2016. Smoking rates have declined and there is also an increase in the number of young people who have never taken up smoking in the first place.

Eighty-three per cent of respondents reported they had access to a GP and between 2010 and 2016, the proportion of young people aged 15 to 24 who had an Indigenous health check – that’s the MBS Item 715 – almost quadrupled from 6 per cent to 22 per cent. These are some of the encouraging results, but challenges remain.

In 2016, 42 per cent of young First Australians were not engaged in education, employment or training. Although there has been a decline in smoking rates for young people, one in three aged between 15 and 24 was still smoking daily.

Sixty-two per cent of our young people aged 10 to 24 had a longer-term health challenge such as respiratory disease, eye and vision problems, or mental health conditions. These statistics inform us, and, critically in the work we are doing, point to an evidence-based pathway forward.

I know you’ll be interested to know that the Prime Minister has now confirmed the refresh of the Closing the Gap will be considered at the next COAG meeting on 12 December.

Closing the Gap requires us to raise our sights from a focus on problems and deficits to actively supporting the full participation of Aboriginal and Torres Strait Islander people in the social and economic life of the nation. There is a need to focus on the long term and on future generations to strengthen prevention and early intervention initiatives that help build strong families and communities.

The Government has hosted 29 national roundtables from November 2017 to August 2018 in each state and territory capital city and major regional centres. We’ve also met with a significant number of stakeholders. In total, we reached more than 1200 participants. More than 170 written submissions were also received on the public discussion paper about Refresh.

The Refresh is expected to settle on 10 to 15 targets. These targets are aimed at building our strengths and successes to support intergenerational change. Existing targets on life expectancy, Year 12 enrolment, and early childhood will continue.

Action plans will set out the concrete steps each government will take to achieve the new Closing the Gap targets, and we have to hold state and territory governments to account. The plans to be developed in the first half of 2019 will be informed by the lived experience of Aboriginal and Torres Strait Islander people, community leaders, service providers, and peak bodies.

Dedicated and continuous dialogue along with meaningful engagement with Aboriginal and Torres Strait Islander people and communities is fundamental to ensuring the refreshed agenda and revised targets meets the expectations and aspirations of First Australians and the nation as a whole.

These actions will be backed by positive policy changes in both prevention and treatment, such as the introduction from tomorrow of the new Medicare Benefits Schedule item to fund delivery of remote kidney dialysis by nurses and Aboriginal and Torres Strait Islander health workers and practitioners, further improving access to dialysis on country.

The COAG health ministers in Alice Springs just recently on 3 August met with Indigenous leaders and asked for their views on a range of issues, and all of the leaders in attendance had an incredible impact on each state and territory Minister.

I know that because I attended the Ministers’ dinner later in which the discussion came to the very issues that were raised by our leaders from all over the nation.

And COAG, the next morning, made the decision that Aboriginal health will be a priority on the COAG agenda for all future meetings, and that whoever the Minister for Indigenous Health is will be ex officio on the Health Ministers’ Forum to inform and to engage in a dialogue around the key issues that were identified, not only by the leadership, but by the evidence of the work that we do; and there are six national priorities now that COAG will turn its mind to, the COAG health ministers.

Over the next decade, the Australian Government has committed $10 billion to improve the health of First Australians.

This is a substantial sum of money, but we are only going to achieve better health and wellbeing outcomes if we work and walk together. We have to build mutual trust and respect in all that we do, and I include in this every state and territory system.

We have to increase cultural capability and responsibility in all health settings and services. We must support and encourage the development of local and family-based approaches for health. As I’ve said before, we need every one of our men and women to take the lead and perpetuate our proud traditions that have kept us healthy for 65,000 years.

Culturally-appropriate care and safety has a vast role to play in improving the health and wellbeing of our people. In this respect, I want to make special mention of the proven record of the Aboriginal Community Health Organisations in increasing the health and wellbeing of First Peoples by delivering culturally competent care.

And while they’re widely canvassing the importance of supporting the growth and potential of children and young adults, I would like to make special mention of the support required for our senior people as well, our Elders.

We must ensure that all older First Nations Australians who are eligible for age or disability support can access the care they deserve; either through the My Aged Care System or the National Disability Insurance Scheme. With a holistic grassroots approach of the Aboriginal Community Controlled Health Organisations, I believe ACCHOs should work to ensure that our older, Indigenous leaders receive assessments and support options that are available.

In August, as I indicated, I met with Indigenous leaders as part of the COAG Health Council Roundtable. Coming out of this was not only a resolution to make First Peoples health a continuing council priority, but a commitment to develop a National Aboriginal and Torres Strait Islander Health and Medical Workforce plan. I see this as being more about Aboriginal doctors, nurses and health workers working on country and in our towns and cities. It’s also about building capacity of health professionals across the entire health system to provide culturally safe services.

I was talking with Shelly Strickland some time ago, and she asked me a couple of questions, and I said to her: watch the movie Hidden Figures.

And at the time, I know she left me thinking what the hell is he talking about and why would you recommend a movie? When you look at that movie, it was about Afro-American women who put man on the moon.

The movie is based on the work of the women who gave the scientists the solutions to putting a rocket into space, landing man on the moon, and bringing them back; it was an untold story. And there are multiple layers when you look at that movie of overt racism. They were not allowed to use the same toilets as their white counterparts, they had to run two car parks away in any condition to use a toilet.

When something went wrong, people looked at them and saw them as the fault. But what they did very superbly was take their knowledge, apply science, apply the thinking that was needed, and demonstrated mathematically that man could land on the moon.

Not one NASA, non-Indigenous or non-American Afro-American had reached that solution. Those four women – I think it was four – provided the solution, but their story was never told. And they were the true leaders of space adventure and discovery. If they had not done the thinking and the tackling of the issue, then the solution would never have been reached. There are parallels in Aboriginal health.

We think of GP super clinics – they were modelled on our AMSs, about a holistic approach. There are other elements of what you do, and what we as a people do, that health systems have taken note of. But what we have to be better at is sharing where we have leadership.

I look at the work that Donna Murray is doing with Allied Health Staff – the outcomes that she achieves, they are stunning.

The work which she puts into helping make the journey a positive journey achieves outcomes that are disproportional to the work that we do as a government in many other areas in mainstream.

And we do lead – and if you haven’t seen that movie, you have to look at it and think of the parallels that our people went through. But, I think the other most salient point is, is that it was the Afro-American women who were the backbone of the space and science discovery program of America.

And I would like to acknowledge our women as well. I think the NAIDOC theme is one of the best themes I have seen in a long time; and I’ve been around a while. And I see it in health where our women play a very pivotal role and are the backbone of the frontline services that are delivered. Men always gravitate to the top; we tend to do that.

But, I do see that the actual hands-on work is done by our women, and so I thank you for that, because the progress we’ve made is because of the way in which you, like those Afro-American women, have helped shape the destiny and future. And I think of some of the people that I’ve known over the years who would be in a similar category.

And certainly, I’ll single out one because she was a great friend and taught me a lot, was Naomi Myers, whose leadership and dedication was parallel to that of the women in that movie Hidden Figures.

While the Medical Health Workforce Plan will be positive for Aboriginal Torres Islander jobs across Australia, it has particular potential for tackling chronic disease and improving the lives of our people in remote communities.

We are all well aware of the importance of health and wellbeing of our young children. There is ample evidence that investment in child and family health supports the health and development of children in the first five years; setting strong foundations for life.

And Kerry Arabena’s work certainly epitomises that along with many others. Good health and learning behaviours set in the early years continue throughout a young person’s life. Young people are more likely to remain engaged in education and make healthy choices when they’re happy, healthy and resilient, and supported by strong families and communities that have access to services and support their needs.

Connected Beginnings program is using a collective impact placed based approach to prepare children for the transition to school so they are able to learn and thrive. The program is providing children and their families with access to cohesive and coordinated support and services in their communities.

The Australian Nurse Family Partnership Program targets mothers from early pregnancy through to the child’s second birthday, and aims to improve pregnancy outcomes by helping women engage in good preventive health practices, supporting parents to improve their child’s health and development, and helping parents develop a vision for their own child’s future; including continuing education and work. Increasingly, research is also highlighting the long term value of investing in youth.

This investment benefits young people now as they become adults, and as they then have children of their own.

So I want to focus on some of the things that we are doing that is important, the take up of MBS 175, access to MBS items.

We’re improving the Practice Incentives Program, Indigenous Health Incentive which promotes best practice and culturally safe chronic disease care. We are reducing preventable chronic disease caused by poor nutrition through the EON Thriving Community programs in remote communities.

We’re tackling smoking rates through the Tackling Indigenous Smoking Program; and encouragingly, youth had the biggest drop. And we’re prioritising Aboriginal and Torres Strait Islander mental health in the first round of funding under the Million Minds Research Mission.

More broadly, for our First Australians and the wider population, we are investing in services for the one in four who experience mental illness each year.

And this also includes through Minister Hunt funding to headspace Centres, Orygen, beyondblue’s new school-based initiative BU, Digital Mental Health child, and youth mental health research and working alongside Greg has been a tremendous opportunity, because I’ve been able to get into his ear about the need for him also to consider our people in key initiatives that he launches, and he’s been a great ally.

And our work on the 10-year National Action Plan for Children’s Health continues. I want to continue setting strong foundations for making sure our people have access to culturally safe and appropriate health services.

Let me also just go quickly to the report. I had a look at the report online, and I was impressed with the way in which the writers – and FAD were in AIHW and have pulled together this one and have taken elements out of the two major better health reports.

And it was great to see our profiling, in some cases being better, in some cases being challenging. But this is a good guide for all of us to use and I commend everybody who’s been involved, and it gives me great pleasure to launch the Aboriginal and Torres Strait Islander Adolescent and Youth Health and Wellbeing 2018 report.

So, congratulations to all of those involved and congratulations to each and every one of you who have contributed to this report in the data that you provide, the work that you do but your commitment to our people. Thank you.

NACCHO and @RACGP a very productive partnership in Aboriginal health #NACCHOagm2018 Report 3 of 5 @RACGP supports the #National Guide #Ulurustatement #FirstNationsVoice and takes aim at racism in healthcare

NACCHO’s [National Aboriginal Community Controlled Health Organisation] conference was a great opportunity to engage directly with members and workforce in the Aboriginal community controlled health sector, and to share the important work the RACGP is doing to support the growth of the Aboriginal and Torres Strait Islander general practice workforce,’

Associate Professor Peter O’Mara see Part 1 Below

The RACGP strongly supports the recommendations in the Uluru statement as a way to make real progress to close the gap in health inequality,

‘The Uluru Statement encourages a stronger voice for Aboriginal and Torres Strait Islander communities, who are the best placed to make decisions about what is important to them and how to make the changes needed to make a difference.’

The RACGP is committed to improving the health and wellbeing of Aboriginal and Torres Strait Islander people. It is one of our greatest priorities,

President Dr Harry Nespolon see Part 2 Below

Racism is a major barrier for Aboriginal and Torres Strait Islander people in accessing quality and appropriate healthcare.

The reality for many Aboriginal and Torres Strait Islander people is that they are sometimes treated differently in healthcare settings, and as a result, their health outcomes are poorer than for other Australians.’

That is why our revised position statement considers the effects of racism on both patients and workforce, as well as the effects of systemic racism through our institutions.’

Chair of the RACGP Aboriginal and Torres Strait Islander Health Associate Professor Peter O’Mara said that racism was a major contributor to poor social and emotional wellbeing . See part 3 below

Part 1 RACGP at #NACCHOagm2018

The 2018 NACCHO member’s conference ran from 31 October – 2 November. Its theme for this year is ‘Investing in what works – Aboriginal community controlled health’. Keynote speakers included Minister for Indigenous Health, Ken Wyatt, NACCHO Chairman John Singer and Co-Director of the University of British Columbia’s Northern Medical Program, Professor Nadine Caron.

GP news report from  Amanda Lyons

Associate Professor O’Mara discussed how the RACGP is helping to meet a key goal – to increase the Aboriginal and Torres Strait Islander workforce in the health sector – that is enshrined in the partnership agreement between the Federal Government, the Council of Medical Colleges of Australia (CPMC), the Aboriginal Indigenous Doctor’s Association (AIDA) and NACCHO, to improve the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

‘The RACGP has focused both on strengthening opportunities for GPs to work sustainably in the sector, and to provide support for Aboriginal and Torres Strait Islander people to successfully navigate education and training pathways to becoming a GP,’ Associate Professor O’Mara said.

Key RACGP initiatives include annual awards for Aboriginal and Torres Strait Islander students, early career doctors and organisations working in the community sector, and advocacy work for improvements in key programs such as the Australian General Practice Training Salary Support Programme, which provides ACCHOs with financial support for general practice registrars.

Associate Professor O’Mara’s participation in the conference also underlines the strong relationship between NACCHO and the RACGP, formalised in a 2014 Memorandum of Understanding. This relationship has resulted in much fruitful work and the development of key resources in the field of Aboriginal and Torres Strait Islander health.

‘The RACGP has enjoyed a productive partnership with NACCHO over many years, which has resulted in important collaborations, such as the National Guide [to a preventive health assessment for Aboriginal and Torres Strait Islander people], and our current joint project to improve the quality of healthcare delivered to Aboriginal and Torres Strait Islander peoples,’ Associate Professor O’Mara said.

NACCHO CEO, Pat Turner, Former NACCHO Chair, John Singer, and Chair of RACGP Aboriginal and Torres Strait Islander Health Associate Professor Peter O’Mara at the launch of the National Guide earlier this year

Part 2 The RACGP supports developing the Uluru model so that it can be put to the broader community for agreement. 

The ‘Uluru statement from the heart’ calls for an independent voice enshrined in the Australian Constitution, and a Makarrata Commission to supervise agreement-making and truth-telling with governments.

The statement is supported by Aboriginal and Torres Strait Islander communities across Australia, and has been endorsed by the RACGP.

GP NEWS Report from  Amanda Lyons 

‘The RACGP is committed to improving the health and wellbeing of Aboriginal and Torres Strait Islander people. It is one of our greatest priorities,’ President Dr Harry Nespolon told newsGP.

‘Constitutional change of this kind must be considered a national priority to be successful.

‘The RACGP supports developing the Uluru model so that it can be put to the broader community for agreement. We encourage our members to support this process.’

The RACGP previously endorsed the Uluru statement as part of its submission to the Joint Select Committee on Constitutional Recognition Relating to Aboriginal and Torres Strait Islander Peoples 2018 (the Committee), which was formed with the purpose of investigating the recognition of Aboriginal and Torres Strait Islander peoples within the Australian constitution.

The Committee is due to present its final report by the end of this month.

‘The RACGP strongly supports the recommendations in the Uluru statement as a way to make real progress to close the gap in health inequality,’ Dr Nespolon said.

‘The Uluru Statement encourages a stronger voice for Aboriginal and Torres Strait Islander communities, who are the best placed to make decisions about what is important to them and how to make the changes needed to make a difference.’

The RACGP endorsed the ‘Uluru statement from the heart’ during NAIDOC week. 

According to Dr Anita Watts, an Aboriginal GP, academic and member of the RACGP Aboriginal and Torres Strait Islander Health board, the Uluru statement and constitutional recognition are vital to the health of Aboriginal and Torres Strait Islander peoples.

‘Without recognition, there cannot be self-determination for Aboriginal and Torres Strait Islander peoples,’ Dr Watts told newsGP earlier this year.

‘Health outcomes are inextricably linked to self-determination. There is overwhelming evidence to support improvement in health outcomes when Indigenous peoples take greater control over their health.’

PART 3 RACGP takes aim at racism in healthcare

Read previous NACCHO article HERE

And racism is a trigger for many health risk factors such as substance abuse, distress and mental health conditions and harm to physiological systems.

These are some of the reasons why the RACGP has updated its zero-tolerance position on racism in healthcare to focus more broadly on the effects of institutional racism.

GP News Report from  Doug Hendrie

RACGP President Dr Harry Nespolon said the revised position statement sent a clear message.

‘The RACGP wants to send the message that racism is unacceptable and harmful, not only for our patients, but also to the doctors, doctors in-training and staff members in our practices and health services,’ he said.

The RACGP’s updated position statement focuses on Aboriginal and Torres Strait Islander people, but the statement has wider applicability across Australia’s diverse patients and healthcare professionals.

‘Challenging institutional racism requires a systemic response … Action on institutional racism requires adapting approaches, attitudes and behaviours through up-skilling staff, reviewing policies, procedures and systems,’ the statement reads.

‘The RACGP strongly supports calls from the Close the Gap Steering Committee for a national inquiry into institutional racism.’

Racism also hurts Australia’s diverse health professional workforce.

‘Acts of racism and discrimination negatively impact the development of the Aboriginal and Torres Strait Islander medical workforce. Results from [the Australian Indigenous Doctors’ Association] 2016 member survey found that more than 60% of Aboriginal and Torres Strait Islander medical student, doctor and specialist members had experienced racism and/or bullying every day, or at least once a week,’ the statement reads.

‘The beyondblue National Mental Health Survey of Doctors and Medical Students similarly found that Aboriginal and Torres Strait Islander doctors reported racism as major source of stress, at nearly 10 times the rate of non-Indigenous counterparts.

The RACGP’s position is:

• a zero tolerance approach to racism
• that every practice provide respectful and culturally appropriate care to all patients
• GPs, registrars, health professionals, practice staff and medical students are supported to address any experience of racism
• that members are aware of, and advocate for patients who are affected by institutional racism

Chair of the RACGP Aboriginal and Torres Strait Islander Health Associate Professor Peter O’Mara said that racism was a major contributor to poor social and emotional wellbeing.

‘Racism is a major barrier for Aboriginal and Torres Strait Islander people in accessing quality and appropriate healthcare,’ Associate Professor O’Mara said.

‘The reality for many Aboriginal and Torres Strait Islander people is that they are sometimes treated differently in healthcare settings, and as a result, their health outcomes are poorer than for other Australians.’

‘That is why our revised position statement considers the effects of racism on both patients and workforce, as well as the effects of systemic racism through our institutions.’

Associate Professor O’Mara said GPs were well placed to show leadership in addressing racism, discrimination and bias.

‘In challenging racism, practice teams will be able to provide more culturally responsive healthcare for Aboriginal and Torres Strait Islander people and improve care for all patients,’ he said.

The RACGP is a supporter of the Australian Government’s Racism. It Stops With Me campaign, which encourages people to respond to prejudice and discrimination in their neighbourhoods, schools, universities, clubs, and workplaces.

The RACGP will next year roll out its Practice Experience Program, designed to boost support to often-isolated non-vocationally registered doctors, many of whom are international medical graduates, as they work towards Fellowship.

NACCHO Aboriginal Health and Racism Debate : “Racism ‘alive and it’s kicking’ @June_Oscar Indigenous commissioner challenges Chin Tan our new @AusHumanRights Race Discrimination Commissioner’s stance

” I’m hearing from women and girls across the country that racism is one of the key emerging issues. I know from my own personal experiences that racism is alive and it’s kicking.”

“It’s critical that he as the new race discrimination commissioner is aware of the prevalence of racism across the country and it’s experiences from the everyday lived realities of women and girls and Indigenous peoples … and personal experiences of racism in the schoolyard and in public places,”

Aboriginal and Torres Strait Islander social justice commissioner June Oscar has declared that racism in Australia is “alive and it’s kicking” in response to comments by the nation’s newly appointed race discrimination commissioner that Australia is not a racist country.

Calling out racism is very important, but I want to be very careful that we put things in context – because I do share a view that that can be overplayed sometimes,

It’s important to remember the race discrimination [commissioner] role is not meant to divide, it’s meant to enhance communities and strengthen them.”

In a clear departure from his predecessor,  Chin Leong Tan, Australia’s new race discrimination commissioner said there were limits to the power of “calling out” racism – even for the race discrimination commissioner. see interview Part 2 below 

 ” How do we balance the steps forward against the steps backwards to arrive at our answer that Australia is or isn’t a racist country? How we compare the arts against the justice system, or politics against social media?

How much weight do we give to the stated intentions of white people to the stated interpretations of non-white people? But these are not homogenous groups either. There are plenty of white people who understand racism exists, and then we have some people of colour who will say that they do not believe Australia is a racist country.

Racism is insidious. It impacts on people’s health, their education, housing and employment opportunities, and their sense of self and safety living in Australia.”

Luke Pearson is a Gamilaroi man, and is the founder and CEO of IndigenousX. see in full Part 3


NACCHO Aboriginal health and racism
:

Read HERE : What are the impacts of racism on Aboriginal health ?

 

 WATCH June Oscar interview 

Article by Patricia Karvelas 

Key points:

  • June Oscar travelling across Australia to hear from Aboriginal and Torres Strait women
  • Indigenous people are often “watched and followed” in supermarkets
  • Aboriginal communities are being punished under a “racist” employment scheme

The Morrison Government’s newly appointed race discrimination commissioner Chin Leong Tan has rejected claims that Australia is a racist country ahead of assuming his official role on Monday.

The lawyer has also revealed he will not use his position to solicit complaints.

But in an interview with the ABC’s National Wrap program, Commissioner Oscar said that she will inform the new race discrimination commissioner of “encounters of institutional racism” that confront Indigenous peoples on a “daily basis”.

“It’s critical that he as the new race discrimination commissioner is aware of the prevalence of racism across the country and it’s experiences from the everyday lived realities of women and girls and Indigenous peoples … and personal experiences of racism in the schoolyard and in public places,” she said.

Commissioner Oscar said she would work with Commissioner Tan to ensure that people were aware of the processes available to them when they do encounter experiences of vilification and discrimination.

Indigenous people subjected to everyday racism

Data obtained by the ABC has revealed the impacts of how Indigenous communities are being punished under a “racist” employment scheme.

Unemployed job seekers can be docked up to $50 per day for missing work-for-the-dole activities.

But statistics show that places with higher numbers of Indigenous participants were issued with more penalties.

Commissioner Oscar questioned why the sector is treated in this manner, offering a grassroots solution.

“I think we can help to address the employment and the active engagement of participants who are on this program by supporting local organisations and creating innovative work-for-the-dole programs informed by the people who live in these communities,” she said.

“We know that the access to different forms of employment may vary across these communities but we certainly shouldn’t be penalising people who are living in poverty.”

Commissioner Oscar has been travelling the country with the Wiyi Yani U Thangani (Women’s Voices) project, which she hopes will “elevate” the voices of the nearly 2,000 women and girls she has encountered.

She identified “racist attitudes” experienced in public spaces like supermarkets as one of the key emerging issues raised, revealing her own personal encounters of “being watched and followed”.

“Why would someone select to a focus on, you know, my right in accessing these public places and not others who may appear to look differently to myself?”

The Commissioner will head to the Torres Strait next week, continuing conversations with Aboriginal and Torres Strait Islander women after her most recent sessions in far north Queensland, Tennant Creek and Alice Springs.

The Women’s Voices project’s final report is expected to be handed down in mid-2019.

Interactive map: which regions are being issued with the most work-for-the-dole fines?

Part 2: ‘Balancing’ act: Australia’s new race commissioner is not inclined to commentary or advocacy

Chin Leong Tan, Australia’s new race discrimination commissioner, sees his role very differently to predecessor Tim Soutphommasane. For one thing, he is not inclined to commentary or advocacy. Instead, he approaches issues with a clinical dispassion befitting his background as a commercial and property lawyer. One of his favourite words is “balance”.

FROM SMH 

Take the most controversial debate in race politics last year: the bid to repeal or dilute section 18C of the Racial Discrimination Act, which makes it unlawful to offend, insult, humiliate or intimidate another person on the basis of race.

“It’s not for me to comment on legislation that’s been there for 40-odd years,” says Mr Tan, who takes up his new position today 8 October.

“Law is a living creature. If there’s the community sense that it’s time to perhaps look at some changes … my role is really to then arbitrate, and not to push for a view.”

When pushed, he praises section 18C as “a reflection of Australian values and views that we have”. But it is not clear if he believes those values should endure regardless of the prevailing sentiments in Canberra.

“I defend the existing section 18C for what it is … it’s there as a law and I comply with the law,” Mr Tan says.

It’s a similar story when it comes to African gang violence in Victoria. The debate has elicited claims of race-baiting and dog-whistling ahead of a state election – particularly directed at Home Affairs Minister Peter Dutton, who claimed Melburnians were afraid to go out to restaurants at night.

“He has a view and he expressed it. People had opposing views. That’s largely the debate that’s going on out there,” Mr Tan says.

“It’s not my role to canvass an opinion about what politicians say from time to time, unless it becomes a public issue of a dimension that requires my involvement within the confines the Act.”

The clash with Dr Soutphommasane’s approach, particularly during his final months, could hardly be more stark. In his final speech, the former commissioner warned “race politics is back”, and singled out Malcolm Turnbull, Mr Dutton, Tony Abbott, Andrew Bolt and others for criticism.

Dr Soutphommasane is a former Labor staffer and was appointed to the role by Labor in the dying days of the second Rudd government. Mr Tan unsuccessfully sought Liberal Party preselection in an on-again, off-again relationship with the party – he said he resigned his membership about a month ago after resuming it last year.

Attorney-General Christian Porter praised Mr Tan as “a well-known and recognised leader in the multicultural community” who would “represent all Australians”.

In a clear departure from his predecessor, Mr Tan said there were limits to the power of “calling out” racism – even for the race discrimination commissioner.

“Calling out racism is very important, but I want to be very careful that we put things in context – because I do share a view that that can be overplayed sometimes,” he said.

“It’s important to remember the race discrimination [commissioner] role is not meant to divide, it’s meant to enhance communities and strengthen them.”

Mr Tan was born in Malaysia to Chinese parents, and migrated to Melbourne in the 1980s. After leaving commercial law in 2011, he headed the Victorian Multicultural Commission, and since 2015 he has been director of multicultural engagement at Swinburne University of Technology.

His new $350,000-a-year job sits within the Australian Human Rights Commission, which has been the focus of political argy-bargy since the Coalition’s spectacular falling out with former president Gillian Triggs over asylum seekers. Some conservatives argued for the race discrimination role to be scrapped or renamed, but the government opted to do neither.

Part 3 Is Australia a racist country?”

From Indigenous X 

It’s a contentious question, and one that has no easy answer. (Well, it does have an easy answer – yes, but it takes some unpacking to understand the question and the answer).

First of all, what do we mean by ‘Australia’?

Do we mean 50% +1 of the total population? (or 50% + 1 of the white population?)

Are we talking about personal perspectives and experiences? One person in Australia might not see racism in their workplaces or their social groups. Or they might not define what they see as racism where someone else might. They might have all sorts of inbuilt response mechanisms they use to justify to themselves and to others how they couldn’t possibly be racist – ‘It was just a joke!’ ‘You’re being too sensitive’. ‘I didn’t mean it that way – you’re taking it out of context!’. ‘They can’t be racist, they are a lovely person!’. ‘I can’t be racist – I have an Aboriginal friend!’. ‘I can’t be racist, I’ve never even met an Aboriginal person!’. The list is endless.

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If a person experiences racism everyday of their lives is it fair for them to think ‘Australia is a racist country’? Especially if their experiences are compounded by the lack of other people standing up for them, or even believing them when they try to raise it.

Or is it not about individual or collective group experiences and is about ‘official Australia’, eg to what extent does racism exist in our public spaces and in our institutions? And importantly, how is racism responded to when it occurs.

How does Australia respond to racist people, or people who do racist things? Do we hold them accountable? Do we condemn them, fire them from their jobs, or do we elect them, promote them, or give them their own tv show?

There are examples of all of these that can be found. Which one you think happens more than others probably depends on who you listen to more. An average IndigenousX reader probably has a very different view on this than an average Andrew Bolt reader. But even that dichotomy isn’t clear cut. There are likely people who are reading this right now who do or say racist stuff, and there are probably Andrew bolt readers who don’t – not many, I admit, but I wouldn’t rule out the possibility.

How does Australia respond to racist people, or people who do racist things? Do we hold them accountable? Do we condemn them, fire them from their jobs, or do we elect them, promote them, or give them their own tv show?

Australia, as a collective group of people, has competing forces and competing views. No one person best exemplifies an ‘average Aussie’, so answering the question ‘is Australia racist?’ is an almost impossible question to answer if we don’t qualify it and contextualise it.

That’s why it is such a great quote to use in media spaces, or in politics. It’s click bait. It’s a dog whistle. It means nothing but is guaranteed to cause a controversy and polarise people.

One person saying ‘Australia is not a racist country’ can mean something very different from someone else who says it. A person could be saying this to appeal to the common humanity and empathy that exists in most of us, or someone could be saying it to appeal to the fervour for racism denialism that is so strong in Australia. It can be said to dismiss lived experience, or to optimistically appeal to our greater humanity.  It’s so loaded now though (and maybe it always was) that anyone who says it, regardless of intent, will rightly be met with much eye rolling and dismissive responses. It is now the national equivalent of ‘I’m not racist but’ except it doesn’t even get a ‘but’.

And what about the ‘alarming rise in anti-white racism’ that Pauline Hanson and Mark Latham complain about? Well, that’s nonsense and we probably don’t need to spend much time on that one. It is definitely worth considering the rise in white nationalism that their racist nonsense represents though. The new trend on framing white people as the victims of racism to justify actual  racism, and how seemingly innocuous slogans like ‘It’s ok to be white’ are actually deeply embedded within white supremacist movements.

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A better question might be to look at to what extent does it exist, and how is it responded to in Australia?

Racism in Australia exists. It exists in our institutions and in our public spaces. There are those who oppose it, but there is also a lot of racism among our self-proclaimed ‘white allies’. But how do we judge whether racism is growing or shrinking in Australia?

We have more black people commenting in the mainstream media on issues that affect black people, but we also have more people dying in custody. How do you balance that on the scales? We have governments spending more than ever on Indigenous businesses, but conversations about self-determination or reparations have entirely disappeared from federal politics.

How do we balance the steps forward against the steps backwards to arrive at our answer that Australia is or isn’t a racist country? How we compare the arts against the justice system, or politics against social media? How much weight do we give to the stated intentions of white people to the stated interpretations of non-white people? But these are not homogenous groups either. There are plenty of white people who understand racism exists, and then we have some people of colour who will say that they do not believe Australia is a racist country.

Racism is insidious. It impacts on people’s health, their education, housing and employment opportunities, and their sense of self and safety living in Australia.

Racism exists within our institutions and because so many white people deny it, and so many people of colour are uncomfortable discussing it for fear of the inevitable backlash it brings, and thanks to the myth of the meritocracy, this in turn perpetuates racism within our society.

We look at Aboriginal prison rates and label Aboriginal people as criminals rather than looking at racism in policing or in sentencing. We see Aboriginal suspension rates, or low attendance rates, in school and blame Aboriginal children and parents instead of looking at our curriculum, pedagogy, and how and when school policies are enforced.

We ignore Indigenous expertise and lived experiences and instead look at Aboriginal people as a problem to be solved through ‘carrot and stick’ approaches, usually with a big stick and tiny carrot. Instead of supporting Indigenous led solutions, we get Tony Abbott as our special envoy.

Speaking of Tony, we heard him when he was PM say that Australia was ‘nothing but bush’ before white people got here, or our current PM say that Australia was ‘born’ when white people got here, but we must remember that there are entire generations of white Australians who were taught the exact same thing when they were at schools. Some of those people are now teachers themselves. Or police, or judges, or doctors or nurses.

Aboriginal people were taught the same thing in school too, at least in the past generation or two where we’ve actually been allowed to attend. What lessons did we learn in school? That we were not respected, not good enough, not smart enough, not welcome. The same lesson we learn when we here our PMs talk so disrespectfully about us.

Racism is a vicious cycle.

We know its impacts affect intergenerational trauma, but its perpetuation is intergeneration too.

Racism is insidious. It impacts on people’s health, their education, housing and employment opportunities, and their sense of self and safety living in Australia. It isn’t just words and hurt feelings.

Anti-racism isn’t just saying that you oppose racism, it’s understanding what racism is and being aware of different strategies for responding it. Anti-racism isn’t just a value, it’s a skill set.

A skill set that I would expect a Race Discrimination Commissioner for the Human Rights Commission to have.

So, when our newest appointment to this role says that he doesn’t think Australia is a racist country, it does not fill me with confidence that he has the skills, or the desire, to help make Australia an anti-racist country.


Luke Pearson is a Gamilaroi man, and is the founder and CEO of IndigenousX.

 

NACCHO Aboriginal #Mentalhealth #SuicidePrevention and #RUOKday : If you ask #RUOK ? What do you do if someone says ‘no’? Plus Sponsorships for 10 #Indigenous young people to take participate #chatsafe campaign

R U OK Day today encouraging all of us to check in with others to see if they’re OK.

But what if someone says “no”? What should you say or do? Should you tell someone else?

What resources can you point to, and what help is available?

Read NACCHO Aboriginal Health articles over the past 6 Years

Mental Health 189 posts 

Suicide Prevention 124 Posts

Here is a guide 

Stop and listen, with curiosity and compassion

We underestimate the power of simply listening to someone else when they’re going through a rough time. You don’t need to be an expert with ten years of study in psychology to be a good listener. Here are some tips:

Listen actively. Pay attention, be present and allow the person time to speak.

Be curious. Ask about the person’s experience using open questions such as

what’s been going on lately?

you don’t seem your usual self, how are you doing/feeling?

Validate their concerns. See the situation from the person’s perspective and try not to dismiss their problems or feelings as unimportant or stupid. You can say things like

I can see you’re going through a tough time

it’s understandable to feel that way given everything you’ve been going through.

There are more examples of good phrases to use here.

Don’t try to fix the problem right now

Often our first instinct is wanting to fix the person’s problems. It hurts to see others in pain, and we can feel awkward or helpless not knowing how to help. But you don’t have to have all of the answers.

Instead of jumping into “fix it” mode right away, accept the conversation may be uncomfortable and allow the person to speak about their difficulties and experiences.

Sometimes it’s not the actual suggestion or practical help that’s most useful but giving the person a chance to talk openly about their struggles. Also, the more we understand the person’s experience, the more likely we are to be able to offer the right type of help.

Encourage them to seek help.

Ask:

how can I help?

is there something I can do for you right now?

Sometimes it’s about keeping them company (making plans to do a pleasant activity together), providing practical support (help minding their kids to give them time out), or linking them in with other health professionals.

Check whether they need urgent help

It’s possible this person is suffering more than you realise: they may be contemplating suicide or self-harm. Asking about suicidal thoughts does not worsen those thoughts, but instead can help ease distress.

It’s OK to ask them if they’re thinking about suicide, but try not to be judgemental (“you’re not thinking of doing anything stupid, are you?”). Listen to their responses without judgement, and let them know you care and you’d like to help.

Read more: How to ask someone you’re worried about if they’re thinking of suicide

There are resources and programs to help you learn how to support suicidal loved ones, and crisis support lines to call:

  • Contact the Social and Emotional team at your nearest ACCHO
  • Lifeline (24-hour crisis telephone counselling) 13 11 14
  • Suicide Callback Service 1300 659 467
  • Mental health crisis lines

If it is an emergency, or the person is at immediate risk of harm to themselves or others, call 000.

Encourage them to seek professional help

We’re fortunate to be living in Australia, with access to high quality mental health care, resources and support services. But it can be overwhelming to know what and where to seek help. You can help by pointing the person in the right direction.

The first place to seek help is the general practitioner (GP). The GP can discuss treatment options (psychological support and/or medication), provide referrals to a mental health professional or arrange access to local support groups. You can help by encouraging your friend to make an appointment with their GP.

There are great evidence-based online courses and self-help programseducational resources and free self-help workbooks that can be accessed at any time.

There are also online tools to check emotional health. These tools help indicate if a person’s stress, anxiety and depression levels are healthy or elevated.

What if they don’t want help?

People with mental health difficulties sometimes take years between first noticing the problem and seeking professional help. Research shows approximately one in three people experiencing mental health problems accesses treatment.

So even if they don’t want help now, your conversation may have started them thinking about getting help. You can try understanding what’s stopping them from seeking help and see if there’s anything you can do to help connect them to a professional. You don’t need to push this, but simply inviting the person to keep the options in mind and offering your ongoing support can be useful in the long run.

Follow up. If appropriate, organise a time to check in with the person again to see how they’re doing after your conversation. You can also let the person know you’re around and they are always welcome to have a chat with you. Knowing someone is there for you can itself be a great source of emotional support.

Read more: Five types of food to increase your psychological well-being

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.).

The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

SEE CONFERENCE WEBSITE

Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.). The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at jo.robinson@orygen.org.au. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

Anyone seeking support and information about mental health can contact beyondblue on 1300 22 46 36. For information about suicide and crisis support, contact Lifeline on 13 11 14 or the Suicide Callback Service on 1300 659 467

 

NACCHO Aboriginal Health and #Racism Debate #itstopswithme : Download @AusHumanRights Report, Anti-Racism in 2018 and Beyond : “Aboriginal people experience racism in systemic and institutional ways “

“The causes of racism are multiple. It can be caused not just by ignorance but also by arrogance; it can be caused by malice as well as by lazy assumptions.

While is some cases, the causes lay in attitudes and behaviour, in others, they lay within systems and institutions,”

The outgoing Race Discrimination Commissioner, Dr Tim Soutphommasane, has this week called for urgent action on measures to reduce racism at the  launch of his final report before stepping down this week.

Aboriginal and Torres Strait Islander people experience racism in systemic and institutional ways.

In 2016, 46 per cent of Indigenous respondents reported experiencing prejudice in the previous six months, compared to 39 per cent for the same period two years before.

Thirty-seven per cent reported experiencing racial prejudice in the form of verbal abuse, and 17 per cent reported physical violence

In 2015-16, Aboriginal and Torres Strait Islander people accounted for 54 per cent of complaints received by the Commission under the Racial Discrimination Act.

Download report here Anti-Racism in 2018 and Beyond

For many Aboriginal and Torres Strait Islander people, systemic racism is bound up in historical disadvantage and mistreatment. Practices such as that of removing Aboriginal children from their families have caused huge amounts of hurt and pain for individuals, families and communities. This shows up in lots of different ways – poor health, high rates of mental illness and family breakdowns.”

See Section 2 Below 

“On an individual level, exposure to racism is associated with psychological distress, depression, poor quality of life, and substance misuse, all of which contribute significantly to the overall ill-health experienced by Aboriginal and Torres Strait Islander people.

Prolonged experience of stress can also have physical health effects, such as on the immune, endocrine and cardiovascular systems.”

Pat Anderson is chairwoman of the Lowitja Institute,  (and a former chair of NACCHO) see her opinion article below link ” This article has been read over 22,000 times in past 4 years 

NACCHO Aboriginal health and racism : What are the impacts of racism on Aboriginal health ?

There is an underbelly of racism in this country, of ignorance, and of fear” Senator Pat Dodson responds to maiden senate speech by Senator Anning WATCH VIDEO

True or False? We fact-check Senator Fraser Anning on his comments regarding Muslims, crime and welfare. http://bit.ly/2PdDH8H

Human Rights Aboriginal and Torres Strait Islander Website

 

 

The Report, Anti-Racism in 2018 and Beyond, is part of the National Anti-Racism Strategy – a partnership-based strategy –  which was launched in 2012.

Watch Video

Today’s report reveals the increasing need for strong anti-racism policies and leadership, given the rise of anti-immigration and far-right populism.

“Since 2015, race has dominated headlines and driven public debates in a way that many would not have anticipated when the National Anti-Racism Strategy was last evaluated,” said Dr Soutphommasane.

“Anti-racism efforts must give voice to the individuals and communities who experience it. Racial prejudice and discrimination have profound silencing effects on those who are their targets,” he said.

The Report looks at the multiple causes of racism and the need for organisations, communities and individuals to not only identify racism, but call it out and build strategies that change behaviours.

Dr Soutphommasane says each and every one of us can make a difference.

 1.What is Racism 

Racism takes many forms and can happen in many places. It includes prejudice, discrimination or hatred directed at someone because of their colour, ethnicity or national origin.

People often associate racism with acts of abuse or harassment. However, it doesn’t need to involve violent or intimidating behaviour. Take racial name-calling and jokes. Or consider situations when people may be excluded from groups or activities because of where they come from.

Racism can be revealed through people’s actions as well as their attitudes. It can also be reflected in systems and institutions. But sometimes it may not be revealed at all. Not all racism is obvious. For example, someone may look through a list of job applicants and decide not to interview people with certain surnames.

Racism is more than just words, beliefs and actions. It includes all the barriers that prevent people from enjoying dignity and equality because of their race.

Many people experience racist behaviour.

The Challenging Racism Project has found that 20 per cent of Australians surveyed had experienced racial discrimination in the form of race hate talk, and about 5 per cent had been attacked because of their race. According to the Scanlon Foundation’s Mapping Social Cohesion survey in 2016, 20 per cent of Australians had experienced racial or religious discrimination during the past 12 months.

Some groups experience racism at higher rates. Aboriginal and Torres Strait Islander people, and those from culturally diverse backgrounds, often have to deal with systemic forms of discrimination. Such experiences limit the access that members of these groups enjoy to the opportunities and resources offered to many people from Anglo-Australian backgrounds.

For many Aboriginal and Torres Strait Islander people, systemic racism is bound up in historical disadvantage and mistreatment. Practices such as that of removing Aboriginal children from their families have caused huge amounts of hurt and pain for individuals, families and communities. This shows up in lots of different ways – poor health, high rates of mental illness and family breakdowns.

Migrants and refugees also regularly experience racism, in particular those who have recently arrived. Media reports and commentary that use negative stereotypes about refugees and migrants can fuel prejudice against these groups in the wider community. These attitudes can make it difficult for new arrivals to find housing and jobs, and to feel connected to their communities.

NACCHO #ANZACday2018 tribute : Our black history: #LestWeForget Aboriginal and Torres Strait Islander veterans

 

” Over 1000 Indigenous Australians fought in the First World War. They came from a section of society with few rights, low wages, and poor living conditions. Most Indigenous Australians could not vote and none were counted in the census. But once in the AIF, they were treated as equals. They were paid the same as other soldiers and generally accepted without prejudice.”

From the Australian War Memorial Indigenous Defence Service Website

Private Miller Mack served in World War I from 1916-17 alongside fellow Australian troops among the 7th Reinforcements in France.

 ” Private Miller Mack’s image is iconic – frequently used as a symbol of Indigenous Australians’ important contribution to the ANZAC war effort. Yet for nearly a century, the soldier himself has lain forgotten, in an unmarked pauper’s grave. Now, says his grand-niece Michelle Lovegrove, he has finally been given the burial he deserves, as his body has been re-interred on Ngarrindjeri land. ”

Read full story here

Aboriginal and Torres Strait Islander people have served in every conflict and commitment involving Australian defence contingents since Federation, including both world wars and the intervals of peace since the Second World War.

Artwork via Lee Anthony Hampton from Koori Kicks Art.

Researching Indigenous service

Little was known publicly about the presence of Indigenous men and women in Australia’s armed forces prior to the 1970s. Subsequent research has established a record of Indigenous service dating back to the start of the Commonwealth era in 1901, and even a small number of individual enlistments in the colonial defence forces before that.

It is impossible to determine the exact number of Indigenous individuals who participated in each conflict, and this research is ongoing. New names are constantly emerging, while some have been removed after research identified them as non-Indigenous.

Before 1980, individuals enlisting in the defence forces were not asked whether or not they were of an Indigenous background. While service records sometimes contain information which may suggest Aboriginal or Torres Strait Islander heritage, many servicemen have been identified as Indigenous by their descendants.

Here you can find a list of known indigenous service people: https://www.awm.gov.au/indigenous-service

First World War

Over 1000 Indigenous Australians fought in the First World War. They came from a section of society with few rights, low wages, and poor living conditions. Most Indigenous Australians could not vote and none were counted in the census. But once in the AIF, they were treated as equals. They were paid the same as other soldiers and generally accepted without prejudice.

When war broke out in 1914, many Indigenous Australians who tried to enlist were rejected on the grounds of race; others slipped through the net. By October 1917, when recruits were harder to find and one conscription referendum had already been lost, restrictions were cautiously eased. A new Military Order stated: “Half-castes may be enlisted in the Australian Imperial Force provided that the examining Medical Officers are satisfied that one of the parents is of European origin.”

This was as far as Australia – officially – would go.

Why did they fight?

Loyalty and patriotism may have encouraged Indigenous Australians to enlist. Some saw it as a chance to prove themselves the equal of Europeans or to push for better treatment after the war.

For many Australians in 1914 the offer of 6 shillings a day for a trip overseas was simply too good to miss.

Indigenous Australians in the First World War served on equal terms but after the war, in areas such as education, employment, and civil liberties, Aboriginal ex-servicemen and women found that discrimination remained or, indeed, had worsened during the war period.

The post First World War Period

Only one Indigenous Australian is known to have received land in New South Wales under a “soldier settlement” scheme, despite the fact that much of the best farming land in Aboriginal reserves was confiscated for soldier settlement blocks.

The repression of Indigenous Australians increased between the wars, as protection acts gave government officials greater control over Indigenous Australians. As late as 1928 Indigenous Australians were being massacred in reprisal raids. A considerable Aboriginal political movement in the 1930s achieved little improvement in civil rights.

Second World War

Lieutenant (Lt) T.C. Derrick, VC DCM (right) with Lt R. W. Saunders

Hundreds of Indigenous Australians served in the 2nd AIF and the militia. Many were killed fighting and at least a dozen died as prisoners of war. As in the First World War, Indigenous Australians served under the same conditions as whites and, in most cases, with the promise of full citizenship rights after the war. Generally, there seems to have been little racism between soldiers.

In 1939 Indigenous Australians were divided over the issue of military service. Some Aboriginal organisations believed war service would help the push for full citizenship rights and proposed the formation of special Aboriginal battalions to maximise public visibility.

Others, such as William Cooper, the Secretary of the Australian Indigenous Australians’ League, argued that Indigenous Australians should not fight for white Australia. Cooper had lost his son in the First World War and was bitter that Aboriginal sacrifice had not brought any improvement in rights and conditions. He likened conditions in white-administered Aboriginal settlements to those suffered by Jews under Hitler. Cooper demanded improvements at home before taking up “the privilege of defending the land which was taken from him by the White race without compensation or even kindness”.

Enlistment Second World War

At the start of the Second World War Indigenous Australians and Torres Strait Islanders were allowed to enlist and many did so. But in 1940 the Defence Committee decided the enlistment of Indigenous Australians was “neither necessary not desirable”, partly because white Australians would object to serving with them. However, when Japan entered the war increased need for manpower forced the loosening of restrictions. Torres Strait Islanders were recruited in large numbers and Indigenous Australians increasingly enlisted as soldiers and were recruited or conscripted into labour corps.

In the front line

With the Japanese advance in 1942, Indigenous Australians and Torres Strait Islanders in the north found themselves in the front line against the attackers. There were fears that Aboriginal contact with Japanese pearlers before the war might lead to their giving assistance to the enemy. Like the peoples of South-East Asia under colonial regimes, Indigenous Australians might easily have seen the Japanese as liberators from white rule. Many did express bitterness at their treatment, but, overwhelmingly, Indigenous Australians supported the country’s defence.

The post Second World War period

Returned soldiers

Wartime service gave many Indigenous Australians pride and confidence in demanding their rights. Moreover, the army in northern Australia had been a benevolent employer compared to pre-war pastoralists and helped to change attitudes to Indigenous Australians as employees.

Nevertheless, Indigenous Australians who fought for their country came back to much the same discrimination as before. For example, many were barred from Returned and Services League clubs, except on Anzac Day. Many of them were not given the right to vote for another 17 years.

Enlistment after the war

Once the intense demands of the war were gone, the army re-imposed its restrictions on enlistment. But attitudes had changed and restrictions based on race were abandoned in 1949. Since then Indigenous Australians and Torres Strait Islanders have served in all conflicts in which Australia has participated.

Other services

Little is known about how many Indigenous Australians have served in the Royal Australian Air Force (RAAF) and the Royal Australian Navy (RAN). The numbers are likely lower than for the army but future research may tell a different story.

RAAF

Throughout the Second World War the RAAF, with its huge need for manpower, was less restrictive in its recruiting than the army. However, little is known about Aboriginal aircrew. Indigenous Australians were employed for surveillance in northern Australia and to rescue downed pilots.

Leonard Waters

Leonard Waters, a childhood admirer of Charles Kingsford-Smith and Amy Johnson, joined the RAAF in 1942. After lengthy and highly competitve training he was selected as a pilot and assigned to 78 Squadron, stationed in Dutch New Guinea and later in Borneo. The squadron flew Kittyhawk fighters like the one on display inthe Memorial’s Aircraft Hall.

Waters named his Kittyhawk “Black Magic” and flew 95 operational sorties. After the war he hoped to find a career in civilian flying but bureaucratic delays and lack of financial backing forced him to go back to shearing. Like many others, he found civilian life did not allow him to use the skills that he had gained during the war.

RAN

As well as an unknown number of formally enlisted Indigenous Australians and Islanders, the RAN also employed some informal units. For example, John Gribble, a coastwatcher on Melville Island, formed a unit of 36 Indigenous Australians which patrolled a large area of coast and islands. The men were never formally enlisted and remained unpaid throughout the war, despite the promise of otherwise.

Kamuel Abednego

The United States Army recruited about 20 Torres Strait Islanders as crewmen on its small ships operating in the Torres Strait and around Papua New Guinea. Kamuel Abednego was given the rank of lieutenant, at a time when no Indigenous Australian or Islander had served as a commissioned officer with the Australian forces.

Life on the home front

The war brought greater contact than ever before between the whites of southern Australia and the Indigenous Australians and Torres Strait Islanders of the north. For the whites it was a chance to learn about Aboriginal culture and see the poor conditions imposed on Indigenous Australians. For the Indigenous Australians the war accelerated the process of cultural change and, in the long term, ensured a position of greater equality in Australian society.

Labour units

During the Second World War the army and RAAF depended heavily on Aboriginal labour in northern Australia. Indigenous Australians worked on construction sites, in army butcheries, and on army farms. They also drove trucks, handled cargo, and provided general labour around camps. The RAAF sited airfields and radar stations near missions that could provide Aboriginal labour. At a time when Australia was drawing on all its reserves of men and women to support the war effort, the contribution of Indigenous Australians was vital.

The army began to employ Indigenous Australians in the Northern Territory in 1933, on conditions similar to those endured by Aboriginal workers on pastoral stations: long hours, poor housing and diet, and low pay. But as the army took over control of settlements from the Native Affairs Branch during the war conditions improved greatly. For the first time Indigenous Australians were given adequate housing and sanitation, fixed working hours, proper rations, and access to medical treatment in army hospitals.

Pay rates remained low. The army tried to increase pay above the standard five shillings a week and at one stage the RAAF was paying Indigenous Australians five shillings a day. But pressure from the civilian administration and pastoralists forced pay back to the standard rate.

In some areas the war caused great hardship. In the islands of Torres Strait, the pearling luggers that provided most of the local income were confiscated in case they fell into Japanese hands. The Islanders enlisted in units such as the Torres Strait Light Infantry, in which their pay was much lower than whites and often not enough to send home to feed their families

Women

Aboriginal women also played an important role. Many enlisted in the women’s services or worked in war industries. In northern Australia Aboriginal and Islander women worked hard to support isolated RAAF outposts and even helped to salvage crashed aircraft.

Oodgeroo Noonuccal (Kath Walker)

Oodgeroo Noonuccal joined the Australian Women’s Army Service in 1942, after her two brothers were captured by the Japanese at the fall of Singapore. Serving as a signaller in Brisbane she met many black American soldiers, as well as European Australians. These contacts helped to lay the foundations for her later advocacy of Aboriginal rights.

Torres Strait Islander units

Since early the early twentieth century proposals were made to train the Indigenous Australians of northern Australia as a defence force. In the Second World War these ideas were tried out.

In 1941 the Torres Strait Light Infantry Battalion was formed to defend the strategically-important Torres Strait area. Other Islander units were also created, especially for water transport and as coastal artillery. The battalion never had the chance to engage the enemy but some were sent on patrol into Japanese-controlled Dutch New Guinea.

By 1944 almost every able-bodied male Torres Strait Islander had enlisted. However, they never received the same rates of pay or conditions as white soldiers. At first their pay was one-third that of regular soldiers. After a two-day “mutiny” in December 1943 this was raised to two-thirds.

In proportion to population, no community in Australia contributed more to the war effort in the Second World War than the Torres Strait Islanders.

Donald Thomson and the Northern Territory Special Reconnaissance Unit

Donald Thomson was an anthropologist from Melbourne who had lived with the East Arnhem Land Indigenous Australians for two years in the 1930s. In 1941 he set up and led the Northern Territory Special Reconnaissance Unit, an irregular army unit consisting of 51 Indigenous Australians, five whites, and a number of Pacific and Torres Strait Islanders. Three of the men had been to gaol for killing the crews of two Japanese pearling luggers in 1932. Now they were told that it was their duty to kill Japanese.

The members of the unit were to use their traditional bushcraft and fighting skills to patrol the coastal area, establish coastwatchers, and fight a guerilla war against any Japanese who landed. Living off the country and using traditional weapons, they were mobile and had no supply line to protect. Thomson shared the group’s hardships and used his knowledge of Aboriginal custom to help deal with traditional rivalries. The unit was eventually disbanded, once the fear of a Japanese landing had disappeared.

The Indigenous Australians in the unit received no monetary pay until back pay and medals were finally awarded in 1992.

Kapiu Masai Gagai

Kapiu Gagai was a Torres Strait Islander from Badu Island. He was a skilled boatman and carpenter and was working on pearling luggers when he joined Donald Thomson in Arnhem Land during the 1930s. In 1941 he again joined Thomson, this time in the Northern Territory Special Reconnaissance Unit. As bosun of Thomson’s vessel, the Aroetta, he patrolled the coast to prevent Japanese infiltration. Later he accompanied Thomson on patrol into Japanese-held Dutch New Guinea, where he was badly wounded. Gagai never received equivalent pay to white soldiers, which was also difficult for his family during and after the war.

Indigenous personnel are known to have served in later conflicts and operations (including in Somalia, East Timor, Afghanistan, Iraq, and on peacekeeping operations) but no numbers are available.

In the 1980s the Department of Defence began collecting information about Indigenous heritage, and these figures show that the number of Indigenous men and women serving in the Australian Defence Force has been increasing since the 1990s. The department claimed that in early 2014 there were 1,054 Indigenous service personnel (on both permanent and active reserve) in the Australian Defence Force, representing about 1.4 per cent of the ADF’s uniformed workforce.

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NACCHO Aboriginal Health and #CulturalSafety Debate : Media VS Health Sector : Should we have culturally appropriate spaces in hospitals ?

Once again the debate about cultural safety has escalated nationally thru News Ltd newspapers with the Daily Telegraph leading off on Tuesday (3 April ) with a front page “cultural safety expose “ and 4 hours nonstop coverage and commentary on SkyNews from the usual suspects Peta Credlin , Alan Jones , Andrew Bolt , Ben Fordham , Paul Murray, Troy Branston in addition to blanket radio coverage across Australia.

See 2 SkyNews Broadcasts below

The policy issue being heavily criticised by the media but not health authorities and experts is that the NSW Health has recommended its emergency departments to provide “culturally appropriate space’’ for the families of Aboriginal patients.

The new policy in NSW to provide a “culturally appropriate space’’ or “designated Aboriginal waiting room’’ was introduced after research found Indigenous patients were at least 1.5 times more likely to leave hospitals before emergency treatment.

In Victoria some hospitals and services have separate areas for Indigenous patients and their families to meet, rest or engage with specialist hospital staff.

See Part 1 Below for NSW Health policy extracts and download document

Above Editorial Daily Telegraph 3 April

Firstly those in favour of this cultural safety policy include

 ” Well, I think it’s good that issues like cultural safety are entering the popular narrative. We need to do better when it comes to delivering care to Aboriginal and Torres Strait Islander people, and I think we need to ask them what will and won’t work.

The truth is that health outcomes for Indigenous Australians are significantly worse than non-Indigenous Australians according to just about every possible metric.

The AMA strongly supports Aboriginal control when it comes to primary care and when it comes to Aboriginal and Torres Strait Islanders being in larger health facilities like our hospitals, I think we need to do everything we can to make them- the appropriate settings for them to seek care.

If that means spending a little bit of money on waiting areas, if that means making subtle changes to outpatient clinics or to inpatient wards to make Indigenous people feel more at home, I don’t think non-Indigenous people should find that threatening”

1.Dr Michael Gannon President AMA

For the Aboriginal and Torres Strait Islander population born in 2010–2012, life expectancy was estimated to be 10.6 years lower than that of the non-Indigenous population.

“Indigenous patients are over-represented in requiring public hospital services.

“In 2013-14, there were 392,142 public hospital emergency department presentations by Indigenous people, accounting for 5.4% of all such presentations.

As a doctor working in south western Sydney and at an Aboriginal Medical Service, I see every day the barriers to accessing healthcare faced by our Indigenous patients.

“Hospitals are complex, overwhelming places and care is too often fragmented.

“For this reason, everyone involved in healthcare has an obligation to break down the barriers to accessing care and to improve health outcomes.

2. AMA (NSW) President, Prof Brad Frankum

“ It isn’t mandatory in the sense they’ve got to do it, it’s mandatory in the sense you’ve got to think about what is culturally appropriate (and) what might help the local community,”

3.Health Minister Brad Hazzard­ said many hospitals had already decided to introduce a culturally appropriate­ space.

“Among other benefits, culturally competent care increases accurate and timely diagnosis and increases attendance rates at follow-up appointments

Positive results such as these worked to overcome reluctance to engage with mainstream healthcare services, as well as improving rates of self-discharge against medical advice.”

4.President Simon Judkins the Australasian College for Emergency Medicine said it believed emergency departments must move towards a place of respect and acknowledgment of Indigenous culture

The college also called for a focus on increasing the numbers of Aboriginal and Torres Strait Islander people working across all health professions, including emergency medicine.

“All healthcare providers need to consider the cultural dimension of the services they are providing, and embrace culturally safe care which is determined to be safe by Aboriginal and Torres Strait Islander patients and their families.

This includes making hospital waiting rooms a welcoming and supportive environment for Aboriginal and Torres Strait Islander people, which will help to build trust between them and their healthcare providers and enhance cultural sensitivity in medical treatment.

It is vitally important that these waiting areas are designed and implemented in close consultation with relevant local Aboriginal and Torres Strait Islander communities and Aboriginal Community Controlled Health Organisations.”

5.Carmen Parter, PHAA Vice-President (Aboriginal and Torres Strait Islander) affirmed PHAA’s support for such an initiative.

” The policy was about improving the health of Aboriginal people and people who are not Aboriginal should not be threatened by the fact we’re trying to look out for a very vulnerable part of our community ”

6.NSW Health deputy secretary Susan Pearce

” The policy is flexible, allowing local health districts to carry out initiatives in consultation with their local Aboriginal community to make their hospital settings more culturally inclusive, in ways that best suit the community,”

7.NSW Health spokeswoman .

“Within the hospital system Aboriginal and Torres Strait Islander people face racist barriers to gaining appropriate health care. Despite the increased burden of disease they carry, Aboriginal and Torres Strait Islander patients are only three-quarters (73%) as likely to undergo a procedure once admitted to hospital

Racism is a significant barrier to Aboriginal health improvement say Donna Ah Chee 2015 Read in full here or Part 4 Below

” Cultural safety requires embedding in not only course accreditation for each health profession — including measures to reduce resistance — but also in the standards governing clinical professionalism and quality, such as the Royal Australian College of General Practitioners Standards for general practices,19 and the Australian Commission on Safety and Quality in Health Care National safety and quality health service standards.20

Such commitment will need investment in clinician education and professional development, together with measures for accountability. The stewards of the National Aboriginal and Torres Strait Islander Health Plan5 (ie, the Department of Health and their expert implementation advisory group), accreditation bodies, and monitors of the existing frameworks of safety and quality standards in health care need to formally collaborate on a systematic revision of standards to embed culturally safe practice and develop health settings free of racism.”

Martin Laverty, Dennis R McDermott and Tom Calma see Part 5 Below

Part 1 NSW Policy

Download The Policy document in full

NSW Policy Doc

Local processes should be in place to monitor numbers of patients who ‘Did not Wait’ for treatment following triage, including rates for Aboriginal and non-Aboriginal patients.

Strategies to address issues identified should be implemented and evaluated

2.1.3 Considerations for Aboriginal patients

 Section 4.1 acknowledges the higher rates of Aboriginal patients who choose not to wait for treatment in ED when compared to non-Aboriginal patients.

An important contributor to this issue is Aboriginal patients feeling safe to stay and wait. The use of local Aboriginal art in ED waiting rooms can provide links to culture and community; advice should be sought on appropriate art from the local Aboriginal community.

If available in the hospital, relatives may access the designated Aboriginal waiting room for families and carers. If no room exists, a culturally appropriate space within the local hospital should be identified.

Patients identifying as Aboriginal people should be provided with information regarding access to Aboriginal Health Workers that may be available. Access to any of these services may

4.1 Monitoring of rates of patients who ‘Did not Wait’

 EDs should maintain a local auditing system to monitor trends in rates of DNW. Review of data should also be undertaken by Aboriginal and non-Aboriginal patients as there is significant evidence in the literature of higher rates of DNW among Aboriginal patients presenting to ED

Addressing this issue is in line with the Australian Commission on Safety and Quality in Healthcare’s guidance on Improving care for Aboriginal and Torres Strait Islander People.

Locally designed strategies to manage identified reasons for patients who DNW should be implemented with outcomes reviewed. Consideration may be given to follow up of patients who DNW who are considered to have high risk issues or are from a vulnerable patient group.

Part 2 AMA (NSW) President: culturally appropriate spaces in EDs are a welcome addition to NSW public hospitals

Access to healthcare is critical to the wellbeing of all Australians and removing barriers to it is important, AMA (NSW) President, Prof Brad Frankum, said.

“It is essential that hospitals and all healthcare facilities make an effort to provide safe and welcoming spaces to facilitate access to care.

“Public hospitals try to do this in a range of ways, including the design of spaces, the provision of information in different languages, access to translators and other services to ensure patients get the best from their healthcare.

“For this reason, AMA (NSW) applauds the NSW Government for encouraging hospitals to ensure that they consider the needs of Indigenous patients in creating a safe and welcoming environment in hospitals,” Prof Frankum said.

“Indigenous patients continue to suffer unacceptably poorer health outcomes compared to other Australians.

“For the Aboriginal and Torres Strait Islander population born in 2010–2012, life expectancy was estimated to be 10.6 years lower than that of the non-Indigenous population.

“Indigenous patients are over-represented in requiring public hospital services.

“In 2013-14, there were 392,142 public hospital emergency department presentations by Indigenous people, accounting for 5.4% of all such presentations,” Prof Frankum said.

“As a doctor working in south western Sydney and at an Aboriginal Medical Service, I see every day the barriers to accessing healthcare faced by our Indigenous patients.

“Hospitals are complex, overwhelming places and care is too often fragmented.

“For this reason, everyone involved in healthcare has an obligation to break down the barriers to accessing care and to improve health outcomes.

“It is disappointing to see those who clearly do not have the same personal experiences of navigating our healthcare system making inappropriate comments about such an important health policy,” Prof Frankum said

Part 3 : Culturally safe healthcare starts in the waiting room

The Public Health Association of Australia (PHAA) called for cultural safety in Aboriginal and Torres Strait Islander healthcare last week, along with a number of other leading health groups and medical practitioners.

As an extension of this, the PHAA supports all viable and suitable cultural safety measures in the provision of healthcare to Aboriginal and Torres Strait Islander people, including culturally appropriate waiting rooms.

Carmen Parter, PHAA Vice-President (Aboriginal and Torres Strait Islander) affirmed PHAA’s support for such an initiative, saying, “All healthcare providers need to consider the cultural dimension of the services they are providing, and embrace culturally safe care which is determined to be safe by Aboriginal and Torres Strait Islander patients and their families.”

 

“This includes making hospital waiting rooms a welcoming and supportive environment for Aboriginal and Torres Strait Islander people, which will help to build trust between them and their healthcare providers and enhance cultural sensitivity in medical treatment,” she said.

Ms Parter continued, “It is vitally important that these waiting areas are designed and implemented in close consultation with relevant local Aboriginal and Torres Strait Islander communities and Aboriginal Community Controlled Health Organisations.”

“The history of the stolen generations and the role that Australian hospitals held during these events has left a strong effect on Aboriginal and Torres Strait Islander people, and in order to overcome this and move toward Reconciliation we need to work together to ensure Australian hospitals are a safe space for all,” Ms Parter said.

Michael Moore, CEO of the PHAA supported Ms Parter’s statements, saying, “Evidence shows that healthcare has the best outcomes when the patient and provider can share knowledge and understanding in a respectful and welcoming environment.

We also know that Aboriginal and Torres Strait Islander patients are at least 1.5 times more likely to leave hospital before receiving treatment compared to non-Indigenous patients.”

“This resembles the gaps in health outcomes which Close the Gap campaigners are working hard to resolve, and a trial on the mid-north coast in NSW showed that culturally appropriate waiting rooms resulted in a 50% reduction in Aboriginal and Torres Strait Islander patients leaving before accessing treatment. This really demonstrates the strength of this type of cultural safety initiative in a tangible way,” Mr Moore said.

“We ensure that hospitals are safe environments for children, elderly people, disabled people, and other groups with certain needs, it’s now time we ensure that the cultural needs of patients are also taken into careful consideration,” Mr Moore said.

 

Part 4 Racism and the hospital system : Donna Ah Chee

 Read in full here

“Within the hospital system Aboriginal and Torres Strait Islander people face racist barriers to gaining appropriate health care. Despite the increased burden of disease they carry, Aboriginal and Torres Strait Islander patients are only three-quarters (73%) as likely to undergo a procedure once admitted to hospital (3).

This difference led one key study to conclude that ‘there may be systematic differences in the treatment of patients identified as Indigenous’ in Australia’s public hospitals (4), a conclusion supported by studies showing poorer survival rates for cancer for Indigenous people, due to their being less likely to have treatment, having to wait longer for surgery, and being referred later for specialist treatment (5). This is not good enough and we need to use the current spotlight on racism to look at these deeper issues as well”, she suggested.

“Such systemic differences in care provided by hospitals contribute to Aboriginal and Torres Strait Islander people’s low level of trust for hospitals as institutions – the 2008 National Aboriginal and Torres Strait Islander Social Survey found that little more than 60% of Aboriginal and Torres Strait Islander people said that they felt hospitals could be trusted (6).

This level of distrust is reflected in the fact that Aboriginal and Torres Strait Islander people are five times as likely to leave hospital against medical advice or be discharged at their own risk compared to other Australians (7).

“Addressing these institutional barriers to appropriate care is complex but possible and we can do it as a nation of we finally come to terms with the seriousness of the problem (8).

“It will take a strong commitment to action. There needs to be a greater awareness in the Australian community about the adverse health consequences of racism for Aboriginal people.

If any good is to come out of the racism shown towards Adam Goodes I hope it is an awareness of the harm this does to our people across the nation which is currently symbolised by the suffering of one man: Adam Goodes.

Racism is a serious problem that Australia is yet to properly address. It should never be trivialised. It needs to be dealt with”, she concluded.

References

  1. Paradies, Y., Harris, R. & Anderson, I. 2008, The Impact of Racism on Indigenous Health in Australia and Aotearoa: Towards a Research Agenda, Discussion Paper No. 4, Cooperative Research Centre for Aboriginal Health, Darwin.
  2. ANTaR website http://www.antar.org.au/node/2… accessed September 26 2011
  3. Australian Health Ministers Advisory Council (2012). Aboriginal and Torres Strait Islander Health Performance Framework 2012 Report. AHMAC. Canberra. page 131
  4. Cunningham J (2002). “Diagnostic and therapeutic procedures among Australian hospital patients identified as Indigenous.” Medical Journal of Australia 176(2): 58-62
  5. Condon J R, Barnes T, et al. (2005). “Stage at diagnosis and cancer survival for Indigenous Australians in the Northern Territory.” Medical Journal of Australia 182(6

 

 ” Cultural safety requires embedding in not only course accreditation for each health profession — including measures to reduce resistance — but also in the standards governing clinical professionalism and quality, such as the Royal Australian College of General Practitioners Standards for general practices,19 and the Australian Commission on Safety and Quality in Health Care National safety and quality health service standards.20

Such commitment will need investment in clinician education and professional development, together with measures for accountability. The stewards of the National Aboriginal and Torres Strait Islander Health Plan5 (ie, the Department of Health and their expert implementation advisory group), accreditation bodies, and monitors of the existing frameworks of safety and quality standards in health care need to formally collaborate on a systematic revision of standards to embed culturally safe practice and develop health settings free of racism.”

Martin Laverty, Dennis R McDermott and Tom Calma

Originally published by MJA here

Download a PDF of this Report Paper for references 1-20

MJA Cultural Safety

Read 20 + previous NACCHO articles Cultural Safety  

In Australia, the existing health safety and quality standards are insufficient to ensure culturally safe care for Indigenous patients in order to achieve optimum care outcomes.

Where “business as usual” health care is perceived as demeaning or disempowering — that is, deemed racist or culturally unsafe — it may significantly reduce treatment adherence or result in complete disengagement,1,2 even when this may be life-threatening.3

Peak Indigenous health bodies argue that boosting the likelihood of culturally safe clinical care may substantially contribute to Indigenous health improvement.4 It follows that a more specific embedding of cultural safety within mandatory standards for safe, quality-assured clinical care may strengthen the currently inadequate Closing the Gap mechanisms related to health care delivery.

The causes of inequitable health care are many. Western biomedical praxis differs from Indigenous foundational, holistic attention to the physical, emotional, mental and spiritual wellbeing of the person and the community.5 An article published in this issue of the MJA6 deals with the link between culture and language in improving communication in Indigenous health settings, a critical component of delivering cultural safety.

Integrating cultural safety in an active manner reconfigures health care to allow greater equity of realised access, rather than the assumption of full access, including procession to appropriate intervention.

As an example of the need to improve equity, a South Australian study found that Indigenous people presenting to emergency departments with acute coronary syndrome were half as likely as non-Indigenous patients to undergo angiography.7 More broadly, Indigenous people admitted to hospital are less likely to have a procedure for a condition than non-Indigenous people.8

Cardiovascular disease is the leading cause of death in Indigenous Australians.9 Cancer is the second biggest killer: the mortality rate for some cancers is three times higher for Indigenous than for non-Indigenous Australians.10 Clinical leaders in these two disease areas have identified the need for culturally safe health care to improve Indigenous health outcomes.

Cultural safety is an Indigenous-led model of care, with limited, but increasing, uptake, particularly in Australia, New Zealand and Canada. It acknowledges the barriers to clinical effectiveness arising from the inherent power imbalance between provider and patient,11 and moves to redress this dynamic by making the clinician’s cultural underpinning a critical focus for reflection.

Moreover, it invites practitioners to consider: “what do I bring to this encounter, what is going on for me?” Culturally safe care results where there is no inadvertent disempowering of the recipient, indeed where recipients are involved in the decision making and become part of a team effort to maximise the effectiveness of the care. The model pursues more effective practice through being aware of difference, decolonising, considering power relationships, implementing reflective practice, and by allowing the patient to determine what safety means.11

Along with an emphasis on provider praxis, cultural safety focuses on how institutional care is both envisaged and delivered.12 Literature on cultural safety in Australia is scant but growing.13 Where evidence is available, it identifies communication difficulties and racism as barriers not only to access but also to the receipt of indicated interventions or procedures.11

There is evidence of means to overcome these barriers. An Australian study undertaken across ten general practices tested the use of a cultural safety workshop, a health worker toolkit, and partnerships with mentors from Indigenous organisations and general practitioners.13 Cultural respect (significant improvements on cultural quotient score, along with Indigenous patient and cultural mentor rating), service (significant increase in Indigenous patients seen) and clinical measures (some significant increases in the recording of chronic disease factors) improved across the participating practices.

In addition, a 2010 study by Durey14 assessed the role of education, for both undergraduate students and health practitioners, in the delivery of culturally responsive health service, improving practice and reducing racism and disparities in health care between Indigenous and non-Indigenous Australians. The study found that cultural safety programs may lead to short term improvements to health practice, but that evidence of sustained change is more elusive because few programs have been subject to long term evaluation..

Newman and colleagues10 identified clinician reliance on stereotypical narratives of indigeneity in informing cancer care services. Redressing these taken-for-granted assumptions led to culturally engaged and more effective cancer care. In a similar manner, Ilton and colleagues15 addressed the importance of individual clinician cultural safety for optimising outcomes, noting that provider perceptions of Indigenous patient attributes may be biased toward conservative care.

The authors, however, went beyond the clinician–patient interaction to stress the outcome-enhancing power of change in the organisational and health setting. They proposed a management framework for acute coronary syndromes in Indigenous Australians.

This framework involved coordinated pathways of care, with roles for Indigenous cardiac coordinators and supported by clinical networks and Aboriginal liaison officers. It specified culturally appropriate warning information, appropriate treatment, individualised care plans, culturally appropriate tools within hospital education, inclusion of families and adequate follow-up.

Willis and colleagues16 also called for organisational change as an essential companion to individual practitioner development. Drawing on 12 studies involving continuous quality improvement (CQI) or CQI-like methods and short term interventions, they acknowledged evidence gaps, prescribing caution, and argued for such change to be undertaken in the service of long term controlled trials, as these would require 2–3 years to see any CQI-related changes.

Sjoberg and McDermott,17 however, noted the existence of barriers to change: the challenge (personal and professional) posed by Indigenous health and cultural safety training may not only lead to individual but also to institutional resistance.17 Dismantling individual resistance requires the development of a critical disposition — deemed central to professionalism and quality18 — but in a context of strengthened and legitimating accreditation specific to each discipline. The barriers thrown up by institutional resistance, manifesting as gatekeeping, marginalisation or underfunding, may require organisational change mandated by standards.

NACCHO Aboriginal Health and #Cultural Safety Media Debate : The Truth behind the Nurses Code of Conduct and the false claims enforcing #WhitePriviledge “to apologise to #Indigenous clients for being white’

 

” National media outlets ( Including Peta Credlin on SkyNews and News Corp Newspapers see Part 5 below plus Today Tonight SA ) have aired wrongful claims that the codes would force white nurses to ‘apologise to Indigenous clients for being white’.

The codes do not say that – that idea was invented and then pushed on these media programs.

These stories were not based in facts, but seem to have been driven by the partisan politics of a fringe nursing group, and conservative politicians who have been approached to comment on the wrongful claims.

I am sure that some of our nursing and midwifery members and community will be hearing disturbing claims.

Let me be clear, nurses and midwives under the new code do not have to announce their ‘white privilege’ before treating Indigenous clients.

 I am really proud of these new codes, and not only because the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) contributed to their development, which included extensive consultation across nursing and midwifery and at the time no one opposed the inclusion of cultural safety “

Janine Mohamed CEO CATSINaM see IndigenousX  Part 1 below

Read over 90 NACCHO Aboriginal Health and Racism articles published last 6 Years

Read 30 NACCHO Aboriginal Health and Cultural Safety published last 6 years

” It is clear from the 2018 Closing the Gap Report tabled by Prime Minister Turnbull in February 2018 that Aboriginal and/or Torres Strait Islander Peoples still experience poorer health outcomes than non-Indigenous Australians.

It is well understood these inequities are a result of the colonisation process and the many discriminatory policies to which Aboriginal and/or Torres Strait Islander Australians were subjected to, and the ongoing experience of discrimination today.

All healthcare leaders and health professionals have a role to play in closing the gap.

The approach the NMBA has taken for nurses and midwives (the largest workforce in the healthcare system) by setting expectations around culturally safe practice, reflects the current expectations of governments to provide a culturally safe health system.

(For more information please see the COAG Health Council 4 August 2017 Communiqué).

Combined Press Release Nursing and Midwifery Board of Australia ,The Australian Nursing and Midwifery Federation, the Australian College of Nursing, the Australian College of Midwives and the Congress of Aboriginal and Torres Strait see in full Part 2 Below

 ” I was stunned to read businessman Graeme Haycroft’s comments regarding nurses and indigenous Australians on the weekend, as part of his criticism of the new NMBA Codes and the term cultural safety which is defined in a glossary connected to the codes.

These codes were the subject of lengthy consultations with the professions of nursing and midwifery and other stakeholders including community representatives.

This review was comprehensive and evidenced-based. Our union and our national body the Australian Nursing Midwifery Federation (ANMF) were active participants in these consultations.

The codes, written by nurses and midwives for nurses and midwives, seek to ensure the individual needs and backgrounds of each patient are taken into account during treatment.”

QNMU Secretary Beth Mohle issued a statement clarifying misleading comments in the media around the NMBA’s new Codes of Conduct for nurses and midwives: See in Full part 3 Below

And just to reinforce that point, the entire premise for the segment was false.

There is no requirement for nurses to apologise for being white, which would be very awkward for the more the more than 1500 Indigenous nurses across Australia, and the countless others who also aren’t white to begin with. But, even for the nurses who are – THERE IS NO REQUIREMENT FOR THEM TO APOLOGISE FOR BEING WHITE.

So, why on Earth would Today Tonight run such a story?

Why would they base a story off the demonstrably false allegations of this Graeme Haycroft person? “

The truth behind the Nursing Code of Conduct lie ; Indigenous X Article Read in full Part 4

Watch Today Tonight TV

If you thought nursing was about quality health care, think again.

According to the Nursing and Midwifery Board of Australia, “’cultural safety’ is as important to quality care as clinical safety”. And there’s no objective test of ‘cultural safety’; it’s determined, so the Board says, by the “recipient of care”. You see, it’s not just what the nurse does that matters but “how a health professional does something”.”

Nurses’ Code of Conduct undermines those who care

 

So who is this Graeme Haycroft

Businessman . Director of Queensland Association Services Group (QAS Group), Political activist , Anti Unionist

And according to peak Nurses groups Graeme has has no previous health experience or qualifications

From a recent BIO

Graeme has spent a lifetime working in industrial relations and was the man who set up Haycroft Workplace Solutions, leading provider of workplace consulting and management that has nearly 2000 workers on the payroll.

He is chair of the Liberal National Party’s labour market policy committee, active in the HR Nicholls Society, is a regular commentator on labour market issues, and has published his thoughts in such places as the IPA Review, Courier Mail and Online Opinion. But Graeme’s most important contributions have come through what he has done, not what he has written or said.

In the 1990s Graeme famously fought the Australian Workers’ Union to set up sub-contracting for shearers in Charleville, and went on to battle the CMFEU in helping to set up union-free high-rise construction sites. When the Howard government allowed Australian Workplace Agreements (AWAs), Graeme was instrumental in creating the most widely copied template in the country, and his business helped set up about 30,000 agreements.

Lately, Graeme has been working on a exciting new project with the potential to fundamentally change the role and power of unions in this country, while improving services for workers.

He is not waiting for politicians to act; he is changing the system himself… and after years of planning he is finally ready to show us how.

So who is this new Nurses Professional Association of Queensland ? 

Queensland Association Services Group QAS Group and Sajen Legal have established a new business model for Employee Associations Queensland Association Services Group (QAS Group), who are the contracted service providers for the  NPAQ, in conjunction with Sajen Legal have developed and set up a new association business  model.

Extract from NPAQ website

Working with a small group of dedicated and experienced nurses, they have built in a strict separation  between the money earned and spent on the one hand, and the control of the Association on the other.

To launch NPAQ, the  QAS Group , have backed the provision of services for ten years under contract. They have provided all of the seed funding for the administrative and legal services including the member  Professional Indemnity Insurance policy required of the Association..

Whilst it will be many years before all the seed funding is fully repaid, at the end of our second year, the membership income was sufficient to fund all the running expenses of the NPAQ

 ” And they quote no party politics

The NPAQ executive is resolute that there will be no party politics. Every cent of your NPAQ membership money is spent on nurse services and issues

When NACCHO pointed out that NursesPAQ was ”  using the definitions of two America right wing commentators to justify mounting a political membership campaign in which you sensationalise and falsely quote out of context  aspects of our Indigenous cultural safety in Australia ”

These videos were then removed from the NPAQ news page

http://www.npaq.com.au/news.php

Part 1 Janine Mohamed CEO CATSINaM

Originally Published Indigenous X

I rang my dad over the weekend. We’d hardly begun yarning before he asked me: “What’s this about white nurses having to apologise to us for being white?”

I could have just said, “Dad, you should know better than to believe what the mainstream media says about us.”

But instead I took the time to explain the truth behind recent misleading media reports on new codes of conduct for nurses and midwives.

Media outlets have aired wrongful claims that the codes would force white nurses to ‘apologise to Indigenous clients for being white’.

The codes do not say that – that idea was invented and then pushed on these media programs.

As Luke Pearson recently wrote for IndigenousX, these stories were not based in facts, but seem to have been driven by the partisan politics of a fringe nursing group, and conservative politicians who have been approached to comment on the wrongful claims.

I took the time to have the conversation with my Dad because it is important people understand how significant these new codes are for efforts to improve the care of our people, hence I thought it important to reach out to the readers of IndigenousX too.

I am sure that some of our nursing and midwifery members and community will be hearing disturbing claims.

Let me be clear, nurses and midwives under the new code do not have to announce their ‘white privilege’ before treating Indigenous clients.

I also had the conversation because, to be honest, I am really proud of these new codes, and not only because the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) contributed to their development, which included extensive consultation across nursing and midwifery and at the time no one opposed the inclusion of cultural safety.

We are delighted the Nursing and Midwifery Board of Australia (NMBA) listened to CATSINaM in developing these new codes, and took on board our advice that cultural safety should be recognised as an integral part of ethical and competent professional practice. Further, they cited some of our work at CATSINaM in materials supporting the code.

CATSINaM has been at the forefront of advocating for cultural safety training for health professionals at all levels of health systems in order to improve care for both Indigenous clients and their families. Improving the cultural safety of workplaces is also a vital strategy for improving the recruitment and retention of Indigenous health professionals and staff. We need more of our people in the health system.

Rather than being criticised by sensationalist, inaccurate reports, the NMBA deserves credit for showing leadership in the area of cultural safety. They have set a great example for other health professions and organisations. It wouldn’t be the first time that nurses and midwives have been at the forefront of leading change.

In fact, this is also not the first time this has happened. In many ways, Australia is playing a game of ‘catch up’.

In New Zealand, cultural safety is part of the nursing and midwifery code of conduct and also in the laws that nurses and midwives must follow to be registered to practice. This happened well over 10 years ago because many Maori nurses worked hard for many years to teach their non-Maori colleagues about cultural safety and gain their support so they could provide better care for their people. This is considered completely normal in New Zealand.

Under the new codes, which took effect on 1 March, nurses and midwives must take responsibility for improving the cultural safety of health services and systems for Aboriginal and Torres Strait Islander clients and colleagues.

They are required to provide care that is “holistic, free of bias and racism”, and to recognise the importance of family, community, partnership and collaboration in the healthcare decision-making of Aboriginal and/or Torres Strait Islander people.

The codes advocate for culturally safe and respectful practice and require nurses to understand how their own culture, values, attitudes, assumptions and beliefs influence their interactions with people and families, the community and colleagues (for more information on our position on Cultural Safety please visit our website).

As part of such reflexive practice, nurses and midwives are encouraged to consider issues, such as white privilege, and how this can affect the assumptions and practices they bring to the care of clients and how they interact with their families. It must be said that privilege has been discussed in Australia for some time – although we are more used to talk about class privilege in Australia – those who have more financial resources compared to those who don’t.

Over time we have recognised there different forms of privilege – men have male privilege in contrast to women. Able-bodied people have able-bodied privilege compared to people living with different types of disabilities. Heterosexual people have heterosexual privilege compared to people who are lesbian, gay, bisexual, transgender, intersex or queer. Not to mention what we have been socialised to believe is normal!

Many people have campaigned for decades to help us learn about these different forms of privilege and do something to change inequity they cause. This has involved education, advocacy, legislation, policies and professional codes of conduct. The acknowledgement of these different forms of privilege and the non-acceptance of biased treatment has resulted in improved circumstances for women, people living with disabilities and lesbian, gay, bisexual, transgender, intersex or queer people. But there is still a long way to go in all of these areas, and especially so where they intersect.

There has been considerable work over the last 20-30 years to talk about white privilege and address the inequity that many white Australians don’t see or realise is there, although Aboriginal and Torres Strait Islander Australians live this every day.

Cultural safety training does include examining how Indigenous people have been locked out of the opportunities that most white people take for granted by past policies and this has resulted in intergenerational exclusion and Indigenous disadvantage. This means that white privilege is one of the areas that people must explore and understand. This is what the codes are asking nurses and midwives to do – to think this through so they do not make incorrect and unhelpful assumptions based on their idea of what is normal for non-Indigenous Australians, particularly white Australians.

A glossary accompanying the new codes cites CATSINaM materials. It identifies that the concept of cultural safety was developed more than 20 years ago in a First Nations’ context (in New Zealand) and holds that the recipient of care – rather than the caregiver – determines whether care is culturally safe. That means you determine if the care you receive is culturally safe.

Instead of providing care regardless of difference, such as when people say ‘I treat everyone the same’, to providing care that takes account of peoples’ unique needs. This includes their cultural needs.

While this is important for Indigenous clients, it also has the potential to improve all clients’ care by encouraging health practitioners to be more reflexive and responsive to the needs of different clients.

Despite what recent headlines might have us believe, there is widespread support for cultural safety’s implementation across the health system.

The National Aboriginal and Torres Strait Islander Health Plan: 2013-2023 (2015) and its associated Implementation Plan (both available here) identify the importance of cultural safety in addressing racism in the health system, and many health services already provide cultural safety training for their staff.

The Australian Nursing and Midwifery Federation, the Australian College of Nursing, the Australian College of Midwives are united with CATSINaM in strongly supporting the guidance around cultural safety in the new codes of conduct.

The Council of Deans of Nursing and Midwifery also considers cultural safety an integral part of competencies for registered nurses and midwives. Providing culturally safe care that is free from racism should be a normal expectation. All health professionals learning about cultural safety and building it into their codes of conduct is a very important step to this becoming a reality. Hence nurses and midwives are currently required to study Aboriginal and Torres Strait Islander health, culture, history, and cultural safety as part of their study programs.

Cultural safety is talked about and implemented in other fields, including education, and family and community services, although people in these fields are still learning about it so it is not always standard practice yet. In fact, CATSINaM recommended cultural safety training for journalists in our submission to the recent Senate Inquiry into the future of public interest journalism, and the latest media fracas indicates just how sorely this is needed.

It is important that we continue these conversations about the importance of cultural safety for healthcare and other systems – they are potentially life-saving.

 

For readers who wish to contribute to the discussion, I suggest you read the joint statement from nursing and midwifery organisations and the codes of conduct, which can be downloaded here.

Part 2

In response to Graeme Haycroft’s recent comments, we welcome the opportunity to provide further information on how important cultural safety is for improving health outcomes and experiences for Aboriginal and Torres Strait Islander Peoples.

It is clear from the 2018 Closing the Gap Report tabled by Prime Minister Turnbull in February 2018 that Aboriginal and/or Torres Strait Islander Peoples still experience poorer health outcomes than non-Indigenous Australians. It is well understood these inequities are a result of the colonisation process and the many discriminatory policies to which Aboriginal and/or Torres Strait Islander Australians were subjected to, and the ongoing experience of discrimination today.

All healthcare leaders and health professionals have a role to play in closing the gap.

The approach the NMBA has taken for nurses and midwives (the largest workforce in the healthcare system) by setting expectations around culturally safe practice, reflects the current expectations of governments to provide a culturally safe health system. (For more information please see the COAG Health Council 4 August 2017 Communiqué).

Culturally safe and respectful practice is not a new concept. Nurses and midwives are expected to engage with all people as individuals in a culturally safe and respectful way, foster open, honest and compassionate professional relationships, and adhere to their obligations about privacy and confidentiality.

Many health services already provide cultural safety training for their staff. Cultural safety is about the person who is providing care reflecting on their own assumptions and culture in order to work in a genuine partnership with Aboriginal and Torres Strait Islander Peoples.

Nurses and midwives have always had a responsibility to provide care that contributes to the best possible outcome for the person/woman they are caring for. They need to work in partnership with that person/woman to do so. The principle of cultural safety in the new Code of conduct for nurses and Code of conduct for midwives (the codes) provides simple, common sense guidance on how to work in a partnership with Aboriginal and Torres Strait Islander Peoples. The codes do not require nurses or midwives to declare or apologise for white privilege.

The guidance around cultural safety in the codes sets out clearly the behaviours that are expected of nurses and midwives, and the standard of conduct that patients and their families can expect. It is vital guidance for improving health outcomes and experiences for Aboriginal and Torres Strait Islander Peoples.

The codes were developed through an evidence-based and extensive consultation process conducted over a two-year period. Their development included literature reviews to ensure they were based on the best available international and Australian evidence, as well as an analysis of complaints about the conduct of nurses and midwives to ensure they were meeting the public’s needs.

The consultation and input from the public and professions included working groups, focus groups and preliminary and public consultation. The public consultation phase included a campaign to encourage nurses and midwives to provide feedback.

The Australian Nursing and Midwifery Federation, the Australian College of Nursing, the Australian College of Midwives and the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives all participated in each stage of the development and consultation of the new codes. The organisations strongly support the guidance around cultural safety in the codes for nurses and midwives.

Lynette Cusack

Chair Nursing and Midwifery Board of Australia

Ann Kinnear

CEO
Australian College of Midwives (ACM)

Kylie Ward

CEO
Australian College of Nursing (ACN)

Janine Mohamed

CEO
Congress of Aboriginal and Torres Strait Islander Nurses
and Midwives

Annie Butler

A/Federal Secretary Australian Nursing and Midwifery
Federation

For more information:

Part 3 QNMU Secretary Beth Mohle has issued a statement clarifying misleading comments in the media over the weekend around the NMBA’s new Codes of Conduct for nurses and midwives.



I was stunned to read businessman Graeme Haycroft’s comments regarding nurses and indigenous Australians on the weekend, as part of his criticism of the new NMBA Codes and the term cultural safety which is defined in a glossary connected to the codes.

These codes were the subject of lengthy consultations with the professions of nursing and midwifery and other stakeholders including community representatives. This review was comprehensive and evidenced-based. Our union and our national body the Australian Nursing Midwifery Federation (ANMF) were active participants in these consultations.

The codes, written by nurses and midwives for nurses and midwives, seek to ensure the individual needs and backgrounds of each patient are taken into account during treatment.

There’s no doubt cultural factors, including how a patient feels while within the health system, can impact wellbeing. For example, culture and background often determine how a patient would prefer to give birth or pass away.

Every day, nurses and midwives consider a range of complex factors, including a patient’s background and culture to determine the best treatment. These codes simply articulate what is required to support safe nursing and midwifery practice for all.

Mr Haycroft stated that the new code “has been sponsored and supported by the QNU to promote its party political social policy.”

This statement is disturbing on a number of levels. The Queensland Nurses and Midwives’ Union (QNMU) has repeatedly refuted Mr Haycroft’s allegations we donate to political parties. We do not. Nor are we affiliated with any political party. Yet Mr Haycroft continues to repeat these claims.

Secondly, this statement demonstrates a failure to understand the basics. It is the Nursing and Midwifery Board of Australia (NMBA) that regulates the practice of nurses and midwives through its standards, codes and guidelines.

The QNMU actively participates in NMBA consultations and represents the interests of our members individually and collectively.  However, the new codes have not been “sponsored” by our union.

As a not-for-profit organisation run by nurses and midwives for nurses and midwives, the QNMU will remain steadfastly focused on advancing the values and interests of our members and the safety of those in their care.  We will not be diverted by the political or business agendas of others.

Author Luke Pearson Indigenous X

But first tonight, the contentious new code telling nurses to say “sorry for being white” when treating their Indigenous patients.

That’s how Today Tonight Adelaide began last night.

It continued:

“Now, it’s the latest in a string of politically correct changes for the health industry, but this one has led to calls for the Nursing Board boss to resign.”

It was followed by a five minute story with the new code being condemned by someone you’ve probably never heard of, Graeme Haycroft, explaining that:

“According to how the code is written, the white nurse would come in and say, ‘before I deal with you, I have to acknowledge to you that I have certain privileges that you don’t have” followed by Cory Bernardi calling it divisive.

It goes on in this vein for a full five minutes before it cuts back to the presenter, who finally says, “The Nursing and Midwifery Board has told us that the code was drafted in consultation with Aboriginal groups and has been taken out of context as it’s not a requirement for health workers to declare or apologise for white privilege”.

And just to reinforce that point, the entire premise for the segment was false. There is no requirement for nurses to apologise for being white, which would be very awkward for the more the more than 1500 Indigenous nurses across Australia, and the countless others who also aren’t white to begin with. But, even for the nurses who are – THERE IS NO REQUIREMENT FOR THEM TO APOLOGISE FOR BEING WHITE.

So, why on Earth would Today Tonight run such a story?

Why would they base a story off the demonstrably false allegations of this Graeme Haycroft person?

To answer that, it might useful to cut back to a 2005 Sydney Morning Herald story about Mr Haycroft:

“A member of the National Party and the H.R. Nicholls Society, he (Mr Haycroft) boasts that, because of a tussle he had with the Australian Workers Union 15 years ago, the union does not have a single member shearing sheep in south-western Queensland today.

Now he runs a labour hire firm with a thriving sideline in moving small-business employees off awards and collective agreements and onto the Federal Government’s preferred individual contracts, Australian Workplace Agreements.

…Mr Haycroft’s business stands out because he is targeting lower-skilled, lower-paid workers, often with poor English – the people unions say have much to fear from individual contracts.”

Cut back to 2018, and Graeme Haycroft now runs the Nurses Professional Association of Queensland, which promotes itself as an alternative to the Qld Nurses Union.

So, a man with a long history of fighting Unions, who ‘saved’ the mushroom farming business by showing businesses how to move “small-business employees off awards and collective agreements and onto the Federal Government’s preferred individual contracts, Australian Workplace Agreements.”

According to the 2005 article, “Mr Haycroft said workers had been more than happy to sign on, most with their penalty rates, holiday pay and other conditions being rolled into a flat rate.”

“However, [there is always a ‘however’], Mr Haycroft was stripped of his preferred provider status with the Office of the Employment Advocate on Thursday, after a Sydney picker, Carmen Walacz Vel Walewska, said she was sacked after she contacted the Australian Workers Union for advice on AWAs.”

With that track record, it’s hard to imagine why nurses would want to leave their current union in favour of his ‘professional association’.

It seems as though, once again, Indigenous people have become a political football and a convenient scapegoat for issues that have nothing to do with us.

Queensland has a long history of political success found through anti-Aboriginal sentiment, so what better way to undermine a Union and recruit new members to a professional association than to accuse the Union of ‘racism against white people’ and ‘political correctness gone made’ by spreading the blatantly false and misleading accusation that white nurses now have to apologise to Aboriginal people for being white?

And just like Dick Smith’s anti-immigration campaign, Blair Cottrell’s anti-African ‘community safety group’, and Prue McSween’s call for a new Stolen Generation, it seems Channel 7 is always more than happy to ignore the facts and sensationalise issues about race and racism.

There is always one more thing.

We, and others, will soon publish articles explaining what the Code of Conduct actually calls for, and explain why cultural competence and cultural safety are important (editor’s note: we did, here’s one of them), but I can’t help but be reminded of this quote from Toni Morrison:

“The function, the very serious function of racism is distraction. It keeps you from doing your work. It keeps you explaining, over and over again, your reason for being. Somebody says you have no language and you spend twenty years proving that you do. Somebody says your head isn’t shaped properly so you have scientists working on the fact that it is. Somebody says you have no art, so you dredge that up. Somebody says you have no kingdoms, so you dredge that up. None of this is necessary. There will always be one more thing.”

So, instead of working on the very real business of ensuring best practice within the nursing industry, our Indigenous experts in this area will have to take a few days away from this important work to explain that no one is asking for white nurses to apologise for being white.

Just like we have to explain that not all Aboriginal parents abuse their children, or that we don’t want to steal white people’s backyards, or that we had (and have) science, or that Australia wasn’t Terra Nullius, or, as Malcolm Turnbull suggested last year, that acknowledging Indigenous history and addressing the issue of colonial statues and place names across Australia is not a “Stalinist exercise of trying to wipe out or obliterate or blank out parts of our history”.

So long as Australian media and politics finds value, profit and opportunity in promoting racism, there will always be one more thing.

So, I might as well clear up a few others while I’m here, and empty a few more buckets out of the endless ocean of racist misinformation.

Child abuse isn’t a ‘cultural’ thing.

Police are not scared to arrest Aboriginal people out of fear of being called racist.

We don’t get free houses.

Aboriginal people using white ochre on their faces in dance and ceremony is not the same thing as white people dressing up in blackface.

We don’t get free university.

The Voice to Parliament is not a third chamber of parliament.

We are not the problem.

Anything else?

We aren’t vampires?

We don’t shoot laser beams out of our eyes?

We aren’t secretly developing a perpetual motion machine that runs on white tears?

I’m sure I, and countless others, will undoubtedly need to keep adding to this list because, as Toni Morrison tells us, there will always be one more thing.

If you thought nursing was about quality health care, think again.

According to the Nursing and Midwifery Board of Australia, “’cultural safety’ is as important to quality care as clinical safety”. And there’s no objective test of ‘cultural safety’; it’s determined, so the Board says, by the “recipient of care”. You see, it’s not just what the nurse does that matters but “how a health professional does something”.

According to the commissars at the Board, “’cultural safety’ represents a key philosophical shift from providing care regardless of difference, to care that takes account of peoples’ unique needs”.

Changes to the Code mark a philosophical shift in the industry. (Pic: supplied)

What this means is that nurses are no longer required to be colourblind; instead, they must see colour and treat patients differently because of it.

According to the Code, the Board declares, “cultural safety provides a decolonising model of practice based on dialogue, communication, power sharing and negotiation and the acknowledgment of white privilege” (no, I am not making this up — it’s on page 15 of the Code effective 1 March 2018).

The Board decrees that “non-indigenous nurses must address how they create a culturally safe work environment that is free of racism”. Now I know many nurses, including my sister who has spent 20 years working selflessly in indigenous communities, and the idea that they are subtly racist or even insensitive to their patients’ needs is as offensive as the leftist sanctimony that has infected their professional body.

The changes to the Code were endorsed by COAG. (Pic: iStock)

When a body representing some nurses had the temerity to complain about this, Board Chair Associate Professor Lynette Cusack disdainfully replied that it had been endorsed by COAG.

Well, I checked with the Federal health minister Greg Hunt and that’s not accurate. The Minister’s own advice from his Chief Nursing Officer and health department noted that “while the Commonwealth Department of Health provided feedback in the public consultation process, the final changes to cultural safety were made after (this) process. The Department did not see the final version until it was publicly released in March 2018.”

Greg Hunt is one of the smartest politicians I know; I didn’t think he would have let this get through, had he known about it, without a fight.