From #Mabo25 to #UluruStatement and #Treaty : Mabo Commemoration Oration : Senator Patrick Dodson

 ” Aboriginal and Torres Strait Islander people will continue to call for a treaty and a strong Indigenous voice if nothing is done.

These calls only highlight the need for constitutional reform.

Australia cannot move forward while our founding document, our birth certificate, embodies our racist past. The stubborn stains in our racist Constitution must be erased.

  • Eddie Koiki Mabo would expect nothing less.
  • Eddie Koiki Mabo was a great Australian.

We can find the Mabo spirit within each of us, and work together to build a great Australia, free from racism, honorable and just.”

Part 2

 “Last month at Uluru, in the spirit of constitutional conventions from which we had previously been excluded, many Aboriginal and Torres Strait Islander people gathered.

Their one page document, Uluru Statement from the Heart, issues a series of challenges to the Parliament and the people of Australia.

  • It calls for constitutional reforms to empower our people and take a rightful place in our own country.
  • It calls for the establishment of a First Nations Voice enshrined in the Constitution.
  • It calls for a Makarrata Commission to supervise a process of agreement-making between governments and First Nations and truth-telling about our history.

A treaty or agreement, whether one or many, would be an acknowledgment flowing from the Mabo decision that terra nullius is a discredited, outmoded legal fiction and that this land was taken from Aboriginal people.”

Senator Patrick Dodson on June 16 delivered  this year’s 2017 ANU Mabo Commemoration Oration at University House. The Mabo Commemoration Oration was held to recognise the 25th anniversary of the Mabo ruling.

In June 1992, the High Court of Australia recognised that a group of Torres Strait Islanders, led by Eddie Mabo, held ownership of Mer (Murray Island). In acknowledging the traditional rights of the Meriam people to their land, the Court also held that native title existed for all Indigenous people. This landmark decision gave rise to important native title legislation the following year and rendered terra nullius a legal fiction.

Senator Patrick Dodson is a Yawuru man from Broome in Western Australia. He has dedicated his life work to being an advocate for constructive relationships between Indigenous and non-Indigenous peoples based on mutual respect, understanding and dialogue. He is a recipient of the Sydney International Peace prize

Image above : On display at Parliament House Canberra in a careful hand with coloured pencils, Eddie Mabo drew this map in the shape of the Island of Mer, noting the family names associated with tracts of the Island, including his own family name.

Full Oration

Thank you very much Vice-Chancellor Professor Brian Schmidt and thank you for the Welcome to Country. I too join in the appreciation of the Ngunnawal and Ngambri people for their welcome to their lands.

It is a great honour for me to be here at the Australian National University tonight to deliver a speech in honour of the late Eddie Koiki Mabo.

  • Mr Mabo was a man of history.
  • He celebrated his Mer and Torres Strait Islander history.
  • He made Australian history.

So it is to history that I will turn to start my remarks.

On 26 January 1788, the British flag was raised at Botany Bay.

The land, now part of the City of Sydney, was the territorial property of the Gadigal and Bidigal people of the Eora nation. It was held and looked after by them, for countless generations.

With a cheer and a tot of rum, to the sounds of fife and drums, the colony of New South Wales was proclaimed.

Over time, other colonies were established in other parts of Australia or by separation of their territory from New South Wales.

• Queensland was one of those.

Over time, the boundaries of the Queensland colony were stretched to include offshore northern islands around 1859.

The lines on the map between Papua New Guinea and Australia included the Murray Islands, the largest of which is Murray Island or Mer.

  • In 1912, the Island of Mer was declared a Reserve under the Land Act 1910 (Qld).
  • In 1936, Eddie Mabo was born in Mer.
  • In 1982, Eddie Koiki Mabo and four other Murray Islanders commenced proceedings against the State of Queensland.

They claimed ownership of parcels of land on Mer as the holders of native title under their customary law.

This litigation, bearing the name of the man we commemorate tonight, transformed the modern Australian common law.

• The case changed our History.

• For the good. On the first floor of our Parliament, I walk past a display of foundation documents of  Australia’s law and society.

This week I watched a group of school children walk through the area on their tours of Parliament House, under a banner that reads, “Parliament is the law-making body which determines the rules of the society by which people live.”

A couple of young boys were looking at a case where a page out of an old-school notebook was on display.

In a careful hand with coloured pencils, Eddie Mabo had drawn the shape of the Island of Mer, noting the family names associated with tracts of the Island, including his own family name.

On the same floor, there are other important documents and paintings on display: The Yirrkala bark petition, the Barunga petition, the Kevin Rudd apology.

Each of these artefacts talks to our most significant national historical challenge.

How can we recognise and acknowledge the fact of Aboriginal and Torres Strait Islander prior ownership of this land we now call Australia?

Mr Mabo’s map and the petitions call for all of us to recognise and acknowledge the fact  of occupation.

• to re-think the received colonial settler narrative. They remind us of the exertion of force by and on behalf of the British authorities.

  • The fact is: the British did not ask permission to settle.
  • The fact is: no-one consented, no-one ceded.
  • The fact is: the judiciary and the legislature have become less generous since The Mabo ruling.
  • The fact is: we need an agreement or treaty to settle not only the ongoing legacy of terra nullius but also the legacy of its existence.

The first peoples were in this land as owners and governors of their respective countries before and when the colonists ‘arrived’ and began to gradually occupy their territories and rule over them. Today those native title holders under the Native Title Act are evidence of their descent from their ancestors and are the living testimony of their prior occupation of their lands and waters.

They and their people proclaim continuing occupation. This land was not, and is not, terra nullius.

The only thing that threatens this is the application of extinguishment written into the Native Title Act. It is more sinister than its existence as a legal mechanism, because in most cases it requires the consent of the very people that hold the Native Title.

This is neither honourable, nor generous.

This is treachery and brings shame to the Mabo name. It belittles the vision and motives of Mr Mabo and the other families who fought and won a seminal victory in the High Court.

The Chief Justice of Australia who heard the Mabo case, Justice Sir Gerard Brennan made this determination on 3rd June 1992 :

  • The common law of Australia rejects the notion that, when the Crown acquired sovereignty over territory which is now part of Australia it thereby acquired the absolute beneficial ownership of the land therein, and
  • accepts that the antecedent rights and interests in land possessed by the indigenous inhabitants of the territory survived the change in sovereignty.
  • Those antecedent rights and interests thus constitute a burden on the radical title of the Crown.

His decision in the Mabo case ruled that:

• the Meriam people are entitled as against the whole world to possession, occupation, use and enjoyment of the island of Mer.

Rejecting the notion of “terra nullius”, native title was found to have survived the acquisition of sovereignty.

Of course the High Court as an instrument of our Constitution cannot rule on the issue of sovereignty.

It took ten long years to resolve the Mabo claim. It is a poignant tragedy that Koiki Mabo did not live long enough to hear the decision of the High Court.

  • To celebrate the recognition of what he knew in his heart and mind to be the truth
  • His country was in Mer.

From our viewpoint in history, we see the Case that bears his name as a major landmark, a signpost for our future. But the road is long and at times the travelling is hard going.

The Mabo decision led to an eruption of controversy and alarm, in much of mainstream Australia.

Mabo was an affront to the security provided by the lie of terra nullius.

The Commonwealth Parliament, in 1993, under the Labor Government of Paul Keating, enacted the Native Title Act.

The Act sought to build on the common law as defined in the Mabo case.The integrity around this today raises serious questions.

In my own State of Western Australia, in which more than half of the land was legally unalienated and mineral rich, the Government objected. The State Parliament in Perth passed a law to extinguish native title from the moment of colonisation and challenged the Commonwealth Act.

The High Court upheld the validity of the Native Title Act and found the Western Australian law to be invalid.

On a personal note, that decision enabled the Yawuru people to pursue our own native title interests and reclaim our country. My brother Mick and I have good reason to be forever grateful to Koiki Mabo and his pioneering vision and courage.

Another major milestone took place in 1996. The High Court in the Wik case found that Native Title and pastoral leases could co-exist.

The pastoral leases were a feature of the colonial period, trying to reign in the peacocking of the best lands by squatters.

  • There was at least some consideration by the Colonial authorities of the rights of Aboriginal people to travel over the leases.
  • Such rights themselves became caveats on the pastoral lease until gradually modified.

The Wik case was a simple matter of concurrent and co-existing rights but with the Native Title rights yielding to the leaseholder if there is a conflict. The public reaction by some sectors was ill informed and disgraceful.

So the generosity of the Court already had begun to harden somewhat in the qualification they put on the notion of “concurrent and coexistent” rights.

The Government of Prime Minister John Howard, could have used this decision as a positive step, as an opportunity for advancing reconciliation.

The Howard “Ten Point Plan” led to the 1996 amendments to the Native Title Act, and in the words of his Deputy Tim Fischer, delivered ‘bucket-loads of extinguishment’.

That legislation was in my view intended to reinstate terra nullius or to remove what Justice Brennan called the ‘burden on the radical title of the Crown’.

As a sweetener they also delivered opportunity previously denied except under a statutory land rights Act.

They opened the opportunity for Agreement Making, which unfortunately is too often structurally tied to extinguishment. Indigenous Land Use Agreements could be negotiated under the Act whereby Native Title Holders and other parties could agree on the use of Native Title lands, for mutual benefit and economic development.

Far too often, the price of that opportunity has been too high, in my view, leading to the extinguishment of Native Title, forever and a day, leaving a lingering burden on the shoulders of the native title holders.

Nevertheless, hundreds of agreements have been negotiated and signed across the nation, especially in Queensland, but also in my state of Western Australia, where an ILUA Agreement for the Noongar people, had been hailed as a major landmark, a Treaty in all but name for the people of the South West.

In the Senate this week, the validation of Indigenous Land Use Agreements has been under debate. There is a tension between law-making in the Parliament, the decisions of the Courts and the aspirations of Aboriginal people to negotiate agreements that retain their rights.

The concept of separation of powers is not always empathetic to the sense of justice held by Aboriginal people.

The Noongar agreement came unstuck with the McGlade decision. With the recent amendments in the Parliament this Agreement will go back to the process of registration, for the Noongars to settle.

At every step, the Labor Party has pushed for consultation on these Bills, through a Senate Committee, through submissions and through consultations with representatives of the Native Title Representative bodies.

At every step, we have remembered the legacy of Koiki Mabo and understand the fact that Native Title rights, now recognised in the common law, should not be changed, extinguished or modified at the whim of Government.

They do not exist as a gift of the Parliament, or an act of largesse by the Government of the day.

Native Title rights are ongoing rights, with deep roots into our common law held exclusively by Native Title holders. Amending legislation should always require the ‘free, prior and informed consent of Native Title holders.

The Native Title Act, much amended over time, has evolved in complexity and function. Koiki Mabo would probably have some difficulty understanding how his vision has become brutalised by Parliament.

The Australian Law Reform Commission, in its 2015 review, Connection to Country, has identified key areas of reform that are yet to be implemented by the Government. Indeed, we still await a formal response from the Government to its recommendations.

From my own perspective, as a native title holder, and now as a legislator, I see five key areas where the functioning of the Act requires rework, not least to better align it to the vision of Eddie Koiki Mabo. These are, in summary:

  • The need to rethink the presumption that an Agreement for alternative uses of native title land requires extinguishment of native title rights;
  • The need to rethink the decision-making process required under the Act;
  • The need to improve the fungibility for native title land without needing extinguishment or loss of communal title;
  • The need to address the rights of compensation for the loss of enjoyment, access and use of Native Title lands.
  • The need to change the onus of proof burden from native title applicants to the Crown
  • The Native Title Act can be refashioned to shift the point of balance towards the ongoing rights, interest, needs and concerns of Indigenous Australians. Doing so would restore the Act to its fundamental purpose: to recognise and protect native title, in the interests of Indigenous Australians, and our shared national future.

Last month at Uluru, in the spirit of constitutional conventions from which we had previously been excluded, many Aboriginal and Torres Strait Islander people gathered.

They set out to deliberate and report back to the Prime Minister and the Leader of the Opposition, through the Referendum Council, on Constitutional recognition.

Their one page document, Uluru Statement from the Heart, issues a series of challenges to the Parliament and the people of Australia.

  • It calls for constitutional reforms to empower our people and take a rightful place in our own country.
  • It calls for the establishment of a First Nations Voice enshrined in the Constitution.
  • It calls for a Makarrata Commission to supervise a process of agreement-making between governments and First Nations and truth-telling about our history.

From a Parliamentary perspective, we look forward to the report on those consultations from the Referendum Council at the end of the month. Hopefully working through these issues in the Parliament, in the time ahead, will take place in the spirit of constructive optimism.

To formulate a successful referendum outcome, especially in the next year a bipartisan, indeed, cross party consensus will need to be carefully shaped.

In my personal view, Constitutional reform, a treaty and a strong Indigenous voice have never been mutually exclusive—one does not come at the expense of the others.

• Of course I support an Agreement making process

A treaty or agreement, whether one or many, would be an acknowledgment flowing from the Mabo decision that terra nullius is a discredited, outmoded legal fiction and that this land was taken from Aboriginal people.

It would also pick up the opportunity that was lost when the Native Title negotiations focused solely upon land tenure.

I have never held the view that Mabo was only about land tenure. In fact when my views clashed with the then negotiators I was asked to discontinue any involvement in the process and dutifully left it to those who settled the issues with Prime Minister Keating.

There was no treaty when this land was colonized. In the future a treaty will be a strong step for a mature and harmonious nation. The work of Labor Governments in our States of Victoria and South Australia show it can be done.

Of course we need a strong Indigenous voice.

For too long Aboriginal and Torres Strait Islander people have been denied a voice, excluded from decision making processes about their own lives.

Indigenous people want to reset our relationship with government.

  • We want to be heard.
  • We have been calling for this for a long time.

Working to make a Voice effective within the processes of Parliament and capable of support from the whole Australian population in a referendum is a key challenge. A challenge Labor will consider carefully.

We look forward to more information on how the idea of an entrenched Voice can become a systemic, secure and successful legislative reality.

• We need to address the systemic racism that exists in our nation’s founding document, Australia’s Constitution.

We want our past to be acknowledged and we want to be involved in decisions about our future.

The Uluru Statement called for a First Nations Voice enshrined in the Constitution and a Makarrata Commission to supervise a process of agreement-making between governments and First nations and truth-telling about our history.

Many rejected the  idea of any ‘symbolic’ acknowledgement in what they saw as a racist document, the  Constitution.

This may well have been a statement from the heart.

It is time we acknowledged that Indigenous people were not included in the Constitutional Conventions that were held all over Australia in the lead up to Federation.

The Australian Constitution was written by people who thought Indigenous people were lesser beings; a dying race with no sense of land use and development.

  • The dynamic of racism in Australia is institutional and it is structural.
  • The foundations of racism are entrenched, persistent, in this nation’s founding  document.

The question we need to work through is not about choosing between a treaty, a voice or constitutional recognition.

The question is whether Australia is able to move forward towards reconciliation —be that in the form of a Treaty, or an Indigenous voice enshrined in the Constitution —while the nation’s foundation document remains, in its DNA, a flawed and racist document.

I understand this because I was a member of the Expert Panel on Constitutional Recognition of Indigenous Australians, which was tasked to report to the Government on possible options for constitutional change to give effect to indigenous constitutional recognition and to assess any legal consequence that might flow.

In 2012, the Expert Panel delivered our report , which made a series of recommendations including:

  • a statement of acknowledgment in the Constitution, relevant to the lawmaking power in indigenous affairs (new Section 51 A);
  • a modification to the wording of the Commonwealth’s lawmaking power in

Indigenous affairs (s 51 (26);

  • a constitutional prohibition on racial discrimination (new S 116A); and
  • the removal of a provision that contemplates states disqualifying people from voting based on their race (s 25).

These recommendations recognise that the Government has the power to make laws about Indigenous people, but the laws must be beneficial and give the Parliament guidance.

It would be a mistake to consider this constitutional reform as merely ‘symbolic’.

Nothing about our Constitution is symbolic. There is not even a preamble that could point us to something symbolic.

The words in the Constitution reference powers that the Parliament uses to make laws.

They are words with real power. They are words that guide the Parliament in making laws and the Courts when they judge the validity of those laws.

Changing powers in the Constitution and giving clarification around how such powers can be used is not mere symbolism, “pretty words”.

Having an Indigenous voice enshrined in the Constitution, without amending the Constitution to remove racially entrenched ideologies, is puzzling.

It seems to assume that an Indigenous voice in the Constitution could be strong enough to challenge the entrenched structural racism which shapes the policies and laws that affect the lives of Aboriginal people without removing the racist elements of the Constitution.

We know these policies and laws. They are the policies of assimilation, of forced social and cultural change. These are the policies that continue to remove Aboriginal people from their families, country and culture.

These are the policies that have caused Aboriginal and Torres Strait Islander people to  make up approximately one quarter of Australia’s prison population, despite making up  just 3 per cent of the total population.

These are the policies which have led to Indigenous Australians dying a decade earlier than non-Indigenous Australians.

  • Policies that repeatedly fail Aboriginal people.
  • Policies that Koiki Mabo challenged with his life and would do so today if he were alive.

It is no coincidence that these policies exist alongside a constitution that is the legacy of a colonial settler narrative, a narrative that saw Aboriginal and Torres Strait islander people as lesser beings and Australia as a land belonging to nobody. If we are going to clean up the mess that racism has made in Australia, in the hope that we might one day achieve reconciliation, we have to do it properly and honorably.

The report of the Referendum Council at the end of this month deserves and requires weighty consideration. If the Referendum Council’s recommendations do not get broad parliamentary support it will fail and there will be no referendum.

If there is broad support then, it requires careful consideration of a Bill and Explanatory Memorandum that can pass through this challenging and complicated parliament.

It requires a question that can be put to the Australian people that will pass the high bar of a referendum.

Aboriginal and Torres Strait Islander people will continue to call for a treaty and a strong Indigenous voice if nothing is done.

These calls only highlight the need for constitutional reform.

Australia cannot move forward while our founding document, our birth certificate, embodies our racist past. The stubborn stains in our racist Constitution must be erased.

  • Eddie Koiki Mabo would expect nothing less.
  • Eddie Koiki Mabo was a great Australian.

We can find the Mabo spirit within each of us, and work together to build a great Australia, free from racism, honorable and just.

Kaliya. Thank you.

 

Aboriginal Health : Second Atlas of Healthcare Variation highlights higher Aboriginal hospitalisation rates for all 18 clinical conditions

 

“The report, compiled by the Australian Commission on Safety and Quality in Health Care, shows us that high hospitalisation rates often point to inadequate primary care in the community, leading to higher rates of potentially preventative hospitalization

The most disturbing example of this  has been the higher hospitalisation rates for all of the 18 clinical conditions surveyed experienced by Aboriginal and Torres Strait Islander Australians, people living in areas of relative socioeconomic disadvantage and those living in remote areas.

 Chairman of Consumers Health Forum, Tony Lawson who is a member of the Atlas Advisory Group.

 “Additional priorities for investigation and action are hospitalisation rates for specific populations with chronic conditions and cardiovascular conditions, particularly:

  • Aboriginal and Torres Strait Islander Australians
  • People living in remote areas
  • People at most socioeconomic disadvantage.

Please note

  • Features of the second Atlas include: Analysis of data by Aboriginal and Torres Strait Islander status

DOWNLOAD Key-findings-and-recommendations

Mr Martin Bowles Secretary Dept of Health  launches the Second Australian Atlas of Healthcare Variation

A new report showing dramatic differences in treatment rates around Australia signals a pressing need for reforms to ensure equitable access to appropriate health care for all Australians, the Consumers Health Forum, says.

“A seven-fold difference in hospitalisation for heart failure and a 15-fold difference for a serious chronic respiratory disease depending on place of residence, are among many findings of substantial variations in treatment rates in Australia revealed in the Second Australian Atlas of Healthcare Variation,” the chairman of Consumers Health Forum, Tony Lawson, said.

“While there are a variety of factors contributing to these differences,  the variation in health and treatment outcomes is, as the report states, an ‘alarm bell’ that should make us stop and investigate whether appropriate care is being delivered.

“These findings show that recommended care for chronic diseases is not always provided.  Even with the significant funding provided through Medicare to better coordinate primary care for people with chronic and complex conditions, fragmented health services contribute to suboptimal management, as the report states.

“We support the report’s recommendation for a stronger primary health system that would provide a clinical ‘home base’ for coordination of patient care and in which patients and carers are activated to develop their knowledge and confidence to manage their health with the aid of a healthcare team.

“The Atlas provides further robust reasons for federal, state and territory governments to act on the demonstrated need for a more effective primary health system that will ensure better and more cost effective care for all Australians.

“The Atlas also examined  variations in women’s health care, and its findings included a seven-fold difference in rates of hysterectomy and  21-fold  difference in rates of endometrial ablation.  The report states that rates of hysterectomy and caesarean sections in Australia are higher than reported rates in other developed nations.  These results highlight the need for continuing support and information on women’s health issues,” Mr Lawson said.

The Second Australian Atlas of Healthcare Variation (second Atlas) paints a picture of marked variation in the use of 18 clinical areas (hospitalisations, surgical procedures and complications) across Australia.

This Atlas, the second to be released by the Commission, illuminates variation by mapping use of health care according to where people live.  As well, this Atlas identifies specific achievable actions for exploration and quality improvement.

The second Atlas includes interventions not covered in the first Atlas, such as hospitalisations for chronic diseases and caesarean section in younger women. It also builds on the findings from the first Atlas – for example, examining hysterectomy and endometrial ablation separately, and examining rates of cataract surgery using a different dataset.

Priority areas for investigation and action arising from the second Atlas include use of:

  • Hysterectomy and endometrial ablation
  • Chronic conditions (COPD, diabetes complications)
  • Knee replacement.

Additional priorities for investigation and action are hospitalisation rates for specific populations with chronic conditions and cardiovascular conditions, particularly:

  • Aboriginal and Torres Strait Islander Australians
  • People living in remote areas
  • People at most socioeconomic disadvantage.

Healthcare Variation – what does it tell us

Some variation is expected and associated with need-related factors such as underlying differences in the health of specific populations, or personal preferences. However, the weight of evidence in Australia and internationally suggests that much of the variation documented in the Atlas is likely to be unwarranted. Understanding this variation is critical to improving the quality, value and appropriateness of health care.

View the second Atlas

The second Atlas, released in June 2017, examined four clinical themes: chronic disease and infection – potentially preventable hospitalisations, cardiovascular, women’s health and maternity, and surgical interventions.

Key findings and recommendations for action are available here.

View the maps and download the data using the interactive platform.

What does the Atlas measure?

The second Atlas shows rates of use of healthcare interventions (hospitalisations, surgical procedures and complications,) in geographical areas across Australia.  The rate is then age and sex standardised to allow comparisons between populations with different age and sex structures. All rates are based on the patient’s place of residence, not the location of the hospital or health service.

The second Atlas uses data from national databases to explore variation across different healthcare settings. These included the National Hospital Morbidity Database and the AIHW National Perinatal Data Collection.

Who has developed the second Atlas?

The Commission worked with the Australian Institute of Health and Welfare (AIHW) on the second Atlas.

The Commission consulted widely with the Australian government, state and territory governments, specialist medical colleges, clinicians and consumer representatives to develop the second Atlas.

Features of the second Atlas include:

  • Greater involvement of clinicians during all stages of development
  • Analysis of data by Aboriginal and Torres Strait Islander status
  • Analysis of data by patient funding status (public or private).

Table of Contents

Chapter 1 Chronic disease and infection: potentially preventable hospitalisations

1.1 Chronic obstructive pulmonary disease (COPD)
1.2 Heart failure
1.3 Cellulitis
1.4 Kidney and urinary tract infections
1.5 Diabetes complications

Chapter 2 Cardiovascular conditions

2.1 Acute myocardial infarction admissions
2.2 Atrial fibrillation

Chapter 3 Women’s health and maternity

3.1 Hysterectomy
3.2 Endometrial ablation
3.3 Cervical loop excision or cervical laser ablation
3.4 Caesarean section, ages 20 to 34 years
3.5 Third- and fourth-degree perineal tear

Chapter 4 Surgical interventions

4.1 Knee replacement
4.2 Lumbar spinal decompression
4.3 Lumbar spinal fusion
4.4 Laparoscopic cholecystectomy
4.5 Appendicectomy
4.6 Cataract surgery
Technical Supplement
About the Atlas
Glossary

Australian Atlas of Healthcare Variation data set specifications are available at http://meteor.aihw.gov.au/content/index.phtml/itemId/674758

 

Aboriginal Women’s Health : Download Report : Over imprisonment of Aboriginal women is a growing national crisis

“For too long our women have been ignored by policymakers. It is time for governments at all levels to put Aboriginal and Torres Strait Islander women’s experiences and voices front and centre, and listen to what we have to say about the solutions.

The report highlights the importance of Aboriginal and Torres Strait Islander women having access to specialist, holistic and culturally safe services and supports that address the underlying causes of imprisonment,

Experiences of family violence contribute directly and indirectly to women’s offending, If we are to see women’s offending rates drop, governments must invest in Aboriginal and Torres Strait Islander organisations that work with our women to stop violence.”

Antoinette Braybrook, Co Chair of the Change the Record Coalition and Convener of the National Family Violence Prevention Legal Services Forum.

New report launched to address skyrocketing Aboriginal and Torres Strait Islander women’s imprisonment rates

Download the report here : Aboriginal Woman OverRepresented_online

The over imprisonment of Aboriginal and Torres Strait Islander women is a growing national crisis that is being overlooked by all levels of government in Australia, the Human Rights Law Centre and Change the Record said in a new report launched today.

The imprisonment rate of Aboriginal and Torres Strait Islander women has skyrocketed nearly 250 per cent since the Royal Commission into Aboriginal Deaths in Custody.

Aboriginal and Torres Strait Islander women make up around 34 per cent of the female prison population but only 2 per cent of the adult female population.

The report, Overrepresented and overlooked: the crisis of Aboriginal and Torres Strait Islander women’s growing over imprisonment, calls for system wide change and outlines 18 recommendations to redress racialised and gendered justice system outcomes.

Adrianne Walters, Director of Legal Advocacy at the Human Rights Law Centre said,

“The tragic and preventable death of Ms Dhu is a devastating example of what happens when the justice system fails Aboriginal and Torres Strait Islander women. Ms Dhu was locked up under draconian laws that see Aboriginal women in WA disproportionately locked up for fines they cannot pay. She was treated inhumanely by police and died in their care. At a time when she most needed help, the justice system punished her.”

Annette Vickery, Deputy CEO of the Victorian Aboriginal Legal Service, said, “The vast majority of Aboriginal and Torres Strait Islander women in custody are mothers. While Aboriginal and Torres Strait Islander women are often in custody for short periods, even a short time can cause devastating and long term upheaval – children taken into child protection, stable housing lost, employment denied.

“Governments should be doing everything they can to help women avoid prison to prevent the devastating rippling effects of women’s imprisonment on children and families,” added Ms Vickery.

The report calls for governments to move away from ‘tough on crime’ approaches in reality and rhetoric, and to focus on evidence based solutions that tackle drivers of offending and prevent women coming into contact with the justice system in the first place.

Ms Walters said, “Overzealous policing and excessive police powers, driven by tough on crime politics, see too many Aboriginal and Torres Strait Islander women and men fined and locked up for minor offending. Only last month, the WA Coroner recommended the removal of police arrest and detention powers for public drinking after another Aboriginal woman died in police custody.”

“Governments can act now to remove laws that disproportionately and unfairly criminalise Aboriginal and Torres Strait Islander women, like fine default imprisonment laws in WA and paperless arrest laws in the NT,” added Ms Walters

Ms Walters said, “Aboriginal and Torres Strait Islander women are also being denied bail and options to transition away from courts and prisons to more rehabilitative alternatives. Too often this is because of a lack of housing and programs designed for their social and cultural needs, particularly in regional and remote locations.’

“Rather than enacting harsher laws and barriers to women accessing rehabilitative alternatives, governments must invest in programs that are designed for and by Aboriginal and Torres Strait Islander women and that tackle the root causes of offending,” said Ms Walters.

Response from contributor to the report, Vickie Roach Vickie Roach, a former prisoner turned writer and advocate said “punitive approaches don’t work for Aboriginal and Torres Strait Islander women. They punish our women, their families and communities, for actions that are often the consequence of forced child removal and assimilation policies.”

“Governments should be getting rid of laws that unfairly criminalise our women. They should be trying to close prisons and focusing on alternatives that are healing. You need to respect women’s dignity, but in my experience, so often the criminal justice system just takes it away,” added Ms Roach.

 

NACCHO Aboriginal Health Summary #ruralhealthconf : Indigenous health focus at 14th National Rural Health Conference

As we contemplate a culturally safe future from our current vantage point, let us reflect upon how each and every one of us can contribute to making this future that I’ve shared with you today a reality.

  • Embed cultural safety in your organisation’s strategic plan, and Reconciliation Action Plan.
  • Make anti-racism practice part of your everyday – whether you are at home or at work – and whether anyone is looking or not. Enact zero tolerance for racism.
  • Ensure your governance structures reflect the communities who you are serving. Privilege the voices and the wisdom of Aboriginal and Torres Strait Islander people and organisations.
  • Inform yourself about 18C and Constitutional Recognition.
  • Inform yourself about climate change and the actions you can take – and try to put aside non-Indigenous lenses when doing this. Learn from us about caring for country.
  • Practise trust, respect and reciprocity. Build and value your relationships with us

In 2037, let us look back on this conference – and this moment – as a time when we stood together, determined to make history and to create a better future.”

It’s no wonder the speech  ” Today is tomorrow’s history ”  from Janine Mohamed – CEO of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) – sparked such a big response at the National Rural Health Conference in Cairns.

She imagined a strong, positive, future for Australia 20 years from now – and what it might take to get us there.

See full speech below thanks to Janine and Croakey Team

The improvement of Indigenous health outcomes in rural and remote areas was the focus of many of the sessions and keynote presentations at the 14th National Rural Health Conference in Cairns .

Dr Mark Wenitong, Senior Medical Advisor with the Apunipima Cape York Council, spoke on health and cultural competence.

Addressing matters such as clinicians bringing their own cultural biases into practices, DrWenitong stressed the need for individuals to learn more about their own cultures.

“Reflective practice is important so that people recognise their own bias,” he said, also pointing out that some of the simplest are the most effective.

“You need to treat people nicely and with respect to improve engagement.”

Download  Cultural competency in the delivery of health services for Indigenous people referenced by Dr Mark Wenitong ctgc-ip13

Another of the keynote presenters was Professor of Nursing and Midwifery at CQ University, Gracelyn Smallwood.

Professor Smallwood discussed the need to better understand history in order to aid reconciliation.

“Captain Cook didn’t discover Australia. People were here for thousands of years and one day discovered Captain Cook.”

Audience member Dr Lucas de Toca tweeted that Professor Smallwood was perceived as “Absolutely killing it delivering hard truths in her outstanding keynote on cultural competency at #ruralhealthconf.”

The Assistant Minister for Health, Dr David Gillespie was present for the conclusion of proceedings and to receive the priority recommendations for rural and remote health to emerge from the Conference as put forward by the attending delegates through the Sharing Shed.

See all recommendations here DOWNLOAD

Recommendations14NRHC

 

Janine Mohamed: speech to the National Rural Health Conference

As published originally here thanks to Janine and Croakey Team

Good morning ladies and gentlemen, Elders, dignitaries and colleagues.

janineI would like to begin by paying my respects to the Traditional Custodians of this land, the Yirrganydji Gimyayg Yidinji people, and to Elders past and present, and future generations.

Thank you for your very warm welcome and for the invitation to talk to you today.

About two years ago I had the privilege of meeting Professor Moana Jackson, from Aeoteroa. He is truly an inspirational Maori leader, who challenged us at CATSINaM to ‘see beyond the mountain’, to vision our future at all costs, and to be brave because that is the way of our people.

He also reminded us that we are storytellers – Moana has inspired me to share our hopes for the future with you today.

So….hang on to your seats – we are going to be doing some time travel together!

Becoming advocates and agents of change

slide young JanineWhen I was a young girl I realised I wanted to become a nurse, after seeing my family members suffer traumatic experiences at the hands of the health system.

While I have worked in many different roles across the health system – clinically, in program development and delivery, academia and in policy –I am now very pleased to be leading the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, or CATSINaM since 2013.

I am proud to be an advocate for the unique and powerful roles that Aboriginal and Torres Strait Islander nurses have in the health system and their communities, as agents of change.

I like to begin my speeches by acknowledging May Yarrowick, who trained as an obstetric nurse in Sydney in 1903. She may well be our first Indigenous nurse qualified in Western nursing.

Let’s take a few moments to reflect upon the challenges that May must have overcome to train and work as a nurse in those times. Remember, this was just a few years after the new federation of Australia passed the Immigration Restriction Act of 1901.

This legislation enshrined the White Australia policy, embedding dominant culture worldviews and priorities into the very birth of the federation, and of course the exclusion of us from Australia’s birth certificate.

Some might say that to this day Australia has not yet grown up – or out of those views.

Too often, the limitations of these dominant culture worldviews stop non-Indigenous people from recognising the incredible strengths of our Aboriginal and Torres Strait Islander peoples and cultures.

Imagine this is now 2037….

Now, I’d like to invite you to cast your minds forward.

Imagine that we have travelled forward in time from May Yarrowick and 1903, all the way to 2037 – 20 years in the future from the time of this conference here in beautiful Cairns.

How old are you in 2037?

I am 62. – I think I look like I belong on the set of the Golden Girls – the Black Betty White. But I am not yet retired. Now that we all are living longer, the retirement age is now 70.

I am happy to still be working. In fact, I am happy to still be alive and in relatively good health.

When I think back to 2017, I remember that I was not at all sure this would be the case. In my early 40s I developed a chronic disease and worried about what it might mean for my future health. But my worries proved unfounded. As I grew older, I remained strong and well.

When I think back over the last few decades, I realise that what helped to keep me feeling good was the strength of my identity, my connection to community and country, and my mentors.

The health literacy that I developed through my nursing career also helped – just one of many ways that developing an Aboriginal and Torres Strait Islander health workforce helps to improve the health of our people.

At 62, I must admit that I am feeling pretty good about myself. My life has had – and continues to have – purpose and meaning, thanks to my passion for improving the health of my people.

So much of my work has been about re-writing national narratives that were once so detrimental to our well-being but are now a source of pride and strength in our identities as members of the world’s oldest living cultures.

One of the reasons I’m so happy is that I am now watching my grandchildren thrive.

I am seeing that their experiences at school and university are so different from my days , and even from those of my children – their parents.

My grandchildren are reading histories and textbooks that have been written by Aboriginal and Torres Strait Islander people.

My grannies are learning from Indigenous teachers and lecturers and television presenters. And they are proud and strong in their identities because of how and what they are learning.

It is such a far cry from when I was at school and university. Then our romanticised and exotic histories were being told by non-Indigenous people, who too often saw us through the overlapping lenses of deficit, unconscious bias and racism.

goodes pmMy grandchildren are learning about the tremendous achievements of our first Indigenous Prime Minister, Mr Adam Goodes.

From their classrooms, they scan in to hear the discussions from the First Nations Parliament.

Self-determination is not an aspiration or even a dream for my great grandchildren. It is their daily reality.

They grow up conscious of whose country they are on

In school, they learn about our many Indigenous health heroes — about people like Professor Tom Calma and Aunty Pat Anderson, & Aunty Gracelyn Smallwood…….

It is not only my grandchildren who are learning about the strengths and proud history of Aboriginal and Torres Strait Islander peoples  – so are their non-Indigenous classmates.

Together, they are learning a shared, true history of this place we call Australia.

My grandchildren and their non-Indigenous friends share in learning local language and they learn together about the importance of respecting and caring for country. They grow up knowing about whose country they were born on – because this is written on their birth certificates and is part of their identities from the day they are born.

slide signpostsThey grow up knowing to always be conscious of whose country they are on – the signs, GPS reminders and names on our maps and roads also remind them of this.

Thanks to the many outcomes of the Truth and Reconciliation Commission, when they go on fun school excursions, they visit fun exhibitions that are informed by our Indigenous knowledges and cultures.

They visit memorials that honour our First Nations people, including our brave Warriors and protectors of country such as Pemulway.

When they go on school excursions, the signage on the streets and highways is not only in English, but also honours the language and naming of the local First Nations peoples.

They grow up with intergenerational hope, not trauma

My grandchildren are growing up in a society that values them and their heritage. They are growing up with intergenerational hope, rather than intergenerational trauma.

They are relative strangers to the experiences of racism that were part of the daily experience of their ancestors over so many generations — including for me, my parents and my children.

The health professionals of the future are learning, from their earliest days, when they first set step into early childhood learning and development centres, about cultural safety. Not that they call it that any more.

Cultural safety has become so embedded into all systems that it has become the norm – rather than something exceptional that people have to learn when they start training to be a nurse or a doctor.

In 2037, cultural safety doesn’t begin in the health system; it begins in our homes and schools. It is evident in our private conversations, and our public debate and discourse.

In 2037, there is no longer a disconnect between public and political discourse – and the language used in the education and training of health professionals.

Politicians of ALL persuasions now understand – just as well as do ALL health professionals – that racism is an attack on people’s health and well-being, and our capacity to live productive, self-determining lives.

slide health careIn 2037, cultural safety has become a societal norm. The cultures, knowledges and practices of Aboriginal and Torres Strait Islander people are central to the national narrative; they are valued and respected.

We have fixed the “racism problem”. Embedding cultural safety into all aspects of society has helped us to transform Eurocentric systems and worldviews.

In 2037, I no longer feel the need to put on my heavy “armour” when I venture outside of my home. It’s a far cry from 20 years ago, when this armour was part of my defence system against the everyday insults of unconscious bias born of racism. Experiences such as deflecting or swallowing hard when I hear:

  • ‘You’ve done well for yourself’
  • ‘Aboriginal people get so much given to them’
  • ‘You’re too pretty to be Aboriginal’
  • ‘Yes, but you’re not like the rest of them, you’re different’
  • or ‘You’re not a real Aboriginal, you’re a half caste’
  • being asked to see my receipt at Woolworths self-serve because ‘they’ve had problems with my sort of people’.

In 2037, I know that when non-Indigenous people see me in the street or at work, their first reaction will not be of prejudice or fear, but of gratitude and pride.

This reflects their understanding of the profound value that Aboriginal and Torres Strait Islander peoples and cultures bring to Australian society.

We have closed the gap in health outcomes

In 2037, when my grandchildren get sick or need to go to the hospital, I no longer even think to worry about whether their care and treatment will be respectful.

No longer do my people leave seeing a doctor or visiting a hospital to the last possible moment because of the fear of being humiliated or traumatised.

The real-time reporting of national safety and quality healthcare data shows that cultural safety is now so embedded across all health systems that Aboriginal and Torres Strait Islander patients are as likely as any other Australians to have proper access to respectful and appropriate care.

The Health Barometer – which was established some years ago to measure our health outcomes, race relations and the cultural safety of health services, programs and policies – has become redundant.

The dual governance boards which Local Area Health Networks established to eradicate racism at the organisational and direct service delivery level are also no longer needed.

There is no longer a gap between the safety and quality of healthcare provided to Aboriginal and Torres Strat Islander people and that provided to other Australians. Our health status is now comparable with other Australians.

The health sector has long ago acknowledged its role in colonisation and such traumatic practices as removal of children and the medical incarceration of Aboriginal and Torres Strait Islander people. Nursing and midwifery now learn this history at the same time as learning about our founders, for example Florence Nightingale.

Health professions and systems have apologised and provided reparation and justice for harmful practices.

Over the past 20 years the sector learnt how to be part of healing, rather than causing harm.

The persistence, hard work and brilliance of our Indigenous health leaders paved the way for a sea change that became evident around the time this century celebrated its 21st birthday.

Climate change prompted a global sea change

I must admit that things were looking pretty grim in the years leading up to 2021. We were still dealing with the aftermath of President Trump, fake news, climate deniers, and the rise of nationalistic, xenophobic movements.

 But as the impacts of climate change started to hit – earlier and harder than expected – there was a profound sea change around the world.

People realised the limitations of the usual Western ways of doing business. Globally, Indigenous knowledges were not only legitimised, but valued and centred in responses to such complex problems as climate change; social and economic inequality; and the protection and management of land and water resources.

As new social and economic structures emerged in response to these challenges and in response to what was then called the Fourth Industrial Revolution, the voices of Indigenous peoples were heard – not only in Australia but also globally.

Our ways of doing business – informed by practices of respect, reciprocity, caring for country, and relationship-based ways of working – are now centred.

Power no longer rested in self-interested hierarchies but became de-centralised. People and organisations were valued for what they could do for the well-being of the community and the planet.

Just imagine what a wonderful difference this has made for rural and remote people and communities!

At the same time as these wider shifts were occurring in society, some fundamental shifts were occurring in health systems.

The health system changed its way of doing business

slide health planIt wasn’t just that the Aboriginal and Torres Strait Islander health plan was fully resourced and implemented – and that this became remembered as one of the landmark achievements of Minister Ken Wyatt, along with establishment of the National Aboriginal and Torres Strait Islander Health Authority.

It wasn’t just that the Rural Health Commissioner’s role was reformed – after some sustained, behind-the-scenes lobbying – to ensure that the Commissioner had a more wide-ranging and meaningful remit.

It wasn’t just that in the wake of the abolition of the Indigenous Advancement Strategy, the Goodes Government set up a Productivity Commission for Indigenous Health. This quarantined, money so that we were able to self-determine the way we invested in our health. And what a difference that made!

It wasn’t just that insurance laws were changed and health systems were reformed to enable women, both Aboriginal and Non- Indigenous women, to birth on country.

It wasn’t any one of these changes alone that led to us closing the gap in life expectancy and health outcomes – years earlier than we had hoped for in our wildest dreams.

It was these things, but it was more than this.

When I look back now, it seems incredible that most of our health dollars and efforts were once spent on centralised, institutional systems of care that contributed relatively little to health outcomes for the large investment they incurred.

It now seems unbelievable that we once invested so little effort and money into providing the conditions that empowered people and their families and communities to have to healthy, contributing lives.

Such a fundamental shift occurred. As Indigenous knowledges and practices were centred in wider systems, so too did the health system change its way of doing business.

.The mainstream health system learnt from the successes of the Aboriginal community controlled health sector. The mainstream re-oriented itself around our ways of doing business – to focus on primary health care, communities, prevention, social justice, and the social and cultural determinants of health.

Health services moved towards providing long-term contracts and seamless services addressing peoples’ needs for inclusion, housing, transport and integrated care.

For our members at CATSINaM, the changes have brought profound transformations to the way they work and how they are valued.

 Our members now work at their full scope of practice. They are involved in diagnosing and managing dental caries, for example, while dentists are incorporating population health strategies into their daily work. Their work has been funded for many years now by ….the sugar tax (dare I say this in Queensland?).

It is so thrilling too to see that the mainstream politic has learnt from the ingenuity of Aboriginal and Torres Strait Islander peoples. Creativity and innovation are not only valued — but properly funded and rewarded.

After its unpromising early years, visionary leadership transformed the NBN to provide equitable access to connectivity right across the country.

Aboriginal and Torres Strait Islander people capitalised on this opportunity, supporting our creativity, entrepreneurialism and innovation. We used the NBN to drive innovation in healthcare and health promotion, as well as to contribute to a better future for all.

We are all making history right now

twitter historyAs I stand before you in 2037, I am not only happy, but I am proud.

One of the highlights of my career has been working to use the virtual world  – cyberspace – to embed cultural safety, not only into the training and education of all who work in the health system – but also into wider societal systems. Along with my newly released cookbook, written in conjunction with the CWA of course.

As we contemplate this potential future together now from our present reality, in 2017, let us remember that history is not something that happens in the past.

It is happening right now. We are all making history right now.

Over the next few years, as we move to embedding cultural safety into our systems and services, supported by the forthcoming Version 2 of the National Safety and Quality Health Service Standards and CATSINaM’s current campaign to have Cultural Safety embedded into our Health Practitioners legislation, let us ensure that this brings meaningful improvement to rural and remote health services.

Let us remember that cultural safety is a philosophy of practice that is about how a health professional does something, not simply what they do. Its focus is on systemic and structural issues and on the social determinants of health.

Cultural safety is as important to quality care as clinical safety. It includes regard for the physical, mental, social, spiritual and cultural components of the patient and the community.

Cultural safety represents a key philosophical shift from providing care regardless of difference, to care that takes account of peoples’ unique needs – and to be regardful of difference.

For Aboriginal and Torres Strait Islander health, cultural safety provides a decolonising model of practice based on dialogue, communication, power sharing and negotiation, and the acknowledgment of white privilege.

These actions are a means to challenge racism at personal and institutional levels, and to establish trust in health care encounters.

Culturally safe and respectful practice therefore is not about learning about Aboriginal and Torres Strait Islander peoples – in fact you can never know this.

Cultural safety requires having knowledge of how one’s own culture, values, attitudes, assumptions and beliefs – influence interactions with patients or clients, their families and the community. Being aware of our racial orator.

As we contemplate a culturally safe future from our current vantage point, let us reflect upon how each and every one of us can contribute to making this future that I’ve shared with you today a reality.

I’d like to conclude this presentation by inviting you to journey with me into the future. I ask each and every one of you to think deeply about how you might contribute to creating this future.

How can YOU help to make history?

Here are some suggestions:

  • Embed cultural safety in your organisation’s strategic plan, and Reconciliation Action Plan.
  • Make anti-racism practice part of your everyday – whether you are at home or at work – and whether anyone is looking or not. Enact zero tolerance for racism.
  • Ensure your governance structures reflect the communities who you are serving. Privilege the voices and the wisdom of Aboriginal and Torres Strait Islander people and organisations.
  • Inform yourself about 18C and Constitutional Recognition.
  • Inform yourself about climate change and the actions you can take – and try to put aside non-Indigenous lenses when doing this. Learn from us about caring for country.
  • Practise trust, respect and reciprocity. Build and value your relationships with us.

In 2037, let us look back on this conference – and this moment – as a time when we stood together, determined to make history and to create a better future.

Because today is tomorrow’s history – be brave.

Thank you.

Aboriginal Health #racism and #cancer #WCPH2017 : The inoperable, unstoppable @Proudblacksista Colleen Lavelle and other strong stories

“People will forget what you said, people will forget what you did,

but people will never forget how you made them feel. – Maya Angelou

These strong words are so true. I look at how my behaviour has changed with the brain tumour. I shudder when I think of the things I have said to my children.

I think it was about eight or nine years ago I was diagnosed with a brain tumour,

The reason I’m vague on it is I actually don’t think it’s a day to remember. It’s not a celebratory day.

Thinking about my four children motivates me to keep going

I’ll be buggered if I am going to have the [child safety] department or someone like that come in and take care of my kids.”

Cancer is a leading cause of death among Indigenous Australians, but fear, stigma and shame mean it is rarely spoken about.

Ms Colleen Lavelle’s a Wakka Wakka woman, from Queenslandknown as @Proudbacksista  tumour has been deemed inoperable, which means it’s considered terminal.

Hear or Download hear her Radio National Interview 

Or

Watch ABC TV report

Photo above from previous NACCHO News Alert

NACCHO Aboriginal Health : Death by #racism: Is bigotry in the health system harming Indigenous patients ?

NACCHO and Cancer over 60 articles

NACCHO Cultural Safety

Federal Government Website

Cancer in Aboriginal and Torres Strait Islander people of Australia

Colleen lives in Brisbane and through her blog she has become a support person for other Aboriginal people facing cancer, helping them with practical matters and being a friendly voice on the other end of a phone line.

She also accompanies some patients to hospital appointments and would like to see it made easier for Aboriginal volunteers to do such work.

“If you come from the Torres Strait and you’ve come down here and someone’s speaking to you really fast, rattling off all these medical things you’ll kind of be going, ‘what?’,” she said.

“If you’ve got someone, one of your own mob there it makes it easier.”

 Recently Colleen wrote for Croakey /We Public Health

Close the Gap should be so much more than a photo opportunity or a morning tea. There are ways that everyone can help. I am going to share ten simple ones that I have been trying to get happening for years.

  1. More Indigenous hospital liaison officers – Whatever title you use, we need more people in the hospital working for us. Big hospitals often only employ two, that is not even close to being enough. They should be employed around the clock.
  2. Indigenous hospital volunteers – Hospitals need to have a separate army of volunteers, who deal exclusively with Indigenous patients, to spend time with the person from a remote area in a city hospital. To sit with someone having a long treatment. Just a friendly face in an alien environment.
  3. Cultural Awareness Training (CAT) – Should be compulsory with all hospital staff, from the cleaner to the director. This training should address the issues and problems in health, but also needs to be localised to have the Traditional Owners from the area to share their knowledge. To truly let people understand, I am not talking a one of two-hour session a year, but a long, fully-formed training, with refresher courses each year. All medical and Allied Health professionals should do, and be assessed on, Cultural Awareness on a regular basis, and this needs to be registered. It is not good enough when a health professional does one course on Indigenous People and 20 years later still think that was enough. General Practice also need to have CAT, even if they are not signed on to CTG, because they are going to be seeing Indigenous patients.
  4. General Practice incentive payments – GPs must lose their incentive payments if they sign on for the incentive and, during that time they don’t see an Indigenous patient. Again, they should lose the bonus if they are signed up and do not annotate the prescriptions for patients.
  5. Indigenous people have the right of choice – We should be able to see a private GP or the local Indigenous Medical Service, or both if we want, but some funding seems to steer us towards the Indigenous Medical Service. This can be hard if it’s a long way from your home and you have to depend on public transport.
  6. Employ more Indigenous people in the health sector, not just  doctors – It can be as simple as a receptionist, who makes a difference.
  7. Indigenous patients must be heard – Not just in the surgery but on national committees. Our experiences must be more than just fodder for researchers or funding applications.
  8. Buck-passing – PHNs, Division of General Practices and other organisations, must stop handing over Indigenous units to others. You have patients that see so many doctors, you have to be responsible. Handing units over to Indigenous Medical Services etc, is passing the buck. It takes away our free choice. It is a way of saying you are not interested in our wellbeing.
  9. Respect – Invite Elders to your hospital, clinic, whatever, on a regular basis, consider having an Elder in residence at your local hospital.
  10. Recognise and celebrate our important dates – It smacks of racism if a hospital is decked out in green and shamrocks everywhere for St Patrick’s day and come NAIDOC, there is a morning tea, hidden away, with only a few people involved. Share it. Don’t even get me started on Australia Day. (Okay, just a little bit) Understand that we don’t think it’s great to wave the flag or want to be in your premises when you have complete overkill of decorations and start talking about how wonderful it is.

The unspoken illness: Cancer in Aboriginal communities

Cancer is a leading cause of death among Indigenous Australians, but fear, stigma and shame mean it is rarely spoken about.

Aboriginal Australians are less likely to be diagnosed with cancer, but significantly more likely to die of the disease.

Often, symptoms and diagnoses are ignored because of the fear surrounding cancer.

Cancer in Aboriginal communities:

  • Indigenous Australians have a slightly lower rate of cancer diagnosis than non-Indigenous Australians
  • The Aboriginal cancer mortality rate is 30 per cent higher
  • Indigenous Australians are more likely to be diagnosed when cancer is advanced
  • They are less likely to participate in cancer screening programs
  • Lung cancer is the most common cancer among Indigenous Australians

Lateline spoke to some Aboriginal people about how they dealt being diagnosed and how they’re trying to break down taboos in their communities.

Rodney Graham: Bowel cancer

Rodney

Rodney Graham literally ran away from his diagnosis in 2015.

For seven months he didn’t go back to his doctor after he was told he had bowel cancer.

Eventually though, he mustered the courage to deal with the diagnosis and get treatment.

He had to travel 700 kilometres from his community of Woorabinda, in central Queensland, to Brisbane to be operated on.

“A big city like that, I don’t even like going to [Rockhampton] really. I can’t stand Rocky. But Brisbane that was a step up you know,” he said.

Now Mr Graham is happy to talk about his illness and wants to help others in his community face up to cancer.

“It might happen to someone else and they say, ‘Well we’ll go see Rodney, he knows all about it’,” he said.

“I’ll give them some advice and see how it goes from there.”

Mr Graham gave up drinking years ago and he said it probably saved his life.

“I think if I was still drinking I wouldn’t be here, you know what I mean,” he said.

Aunty Tina Rankin: Cervical cancer

Aunty Tina has survived cancer, but seen several close relatives succumb to the disease.

“One minute you’re sitting down there with that person, that person is so healthy, and then the next time you see them they’re that sick, they’re that small you can hardly recognise them,” she said.

“People think of it as the killer disease.

“They see people in cancer wards and to look at those people it puts them into a depressed state, and they go home thinking that they’re going to end up like that.”

Aunty Tina said people need to know there is help available for cancer sufferers.

She is part of the Woorabinda Women’s Group who are working to raise awareness in the community about cancer so sufferers don’t feel isolated.

“When you’re well and up and running, you’ve got that many friends,” she said.

“All of a sudden you get sick, you find out you’ve got cancer, you’ve got nobody, it feels as if you’re on your own.

“There were times when I just wanted to go and commit suicide through the depression.

“But I sit down and think about things, I pull myself out of that deep hole.”

Sevese Isaro: Lost his father to cancer

Sevese Isaro, or Tatay as he’s known locally, is Woorabinda’s radio host.

He knows first-hand how hard it can be to talk about cancer, having lost his father to the disease just a few years ago.

“Everyone just tried to stop talking about it,” he said.

“I fell back into drinking, everybody just went their own way.”

He said many people don’t go to the doctor when they suspect they could have cancer.

“They know that there’s something wrong with them, but they don’t want to go because they’re frightened of the answer,” he said.

“I guess people once they hear the word cancer they start getting frightened and they automatically give up hope.”

If you or anyone you know needs help contact your local ACCHO or call

NACCHO Aboriginal Health Workforce : @KenWyattMP meets medical colleges to boost Aboriginal health care

” Providing health care that was culturally appropriate for Indigenous people was crucial.

Ultimately, what I want to see is that Aboriginal people, if they come into a hospital, they take the full patient journey,

The procedures and treatment regimes are the same as any other Australian receives so that we push out life and we move to closing the gap.

Increasing the number of Aboriginal and Torres Strait Islander people working in health care will also be discussed.

If we don’t get our initial training and ongoing education right, we will never deliver a culturally safe health system,

The colleges are critical partners in getting this right with ideas on training and recruitment and retention initiatives.”

Indigenous Health Minister Ken Wyatt

Photo above : Danielle Dries  pictured above with the minister in an inspiring final-year Aboriginal medical student from the Australian National University was the recipient of the MDA National and Rural Doctors Association of Australia (RDAA) Rural Health Bursary for 2016. Read full Story here

NACCHO Background Info

Read NACCHO Articles Cultural Safety

Aboriginal Health ” managing two worlds ” : How Katherine Hospital, once Australia’s worst for Indigenous health, became one of the best

Senior representatives from Australia’s medical colleges are converging on Canberra today for a roundtable aimed at improving treatment for Aboriginal and Torres Strait Islander people.

As reported by ABC NEWS this morning

Indigenous Health Minister Ken Wyatt will host the 12 colleges at Parliament House in a bid to boost outcomes and access to health care over the next decade.

The powerful groups include the Royal Australasian College of Surgeons, the Australian College of Rural and Remote Medicine and the Royal Australian College of General Practitioners.

“[They’re] important for me to partner with if I’m going to close the gap,” Mr Wyatt told the ABC.

“I believe that they can make an incredible difference, it’s just we’ve never asked them to in this sense.”

Prime Minister Malcolm Turnbull’s Closing the Gap report to Parliament last month showed six of the seven targets were off track, including life expectancy and child mortality.

Mr Wyatt earlier this year became Australia’s first-ever Indigenous federal government minister.

 

Aboriginal Health ” managing two worlds ” : How Katherine Hospital, once Australia’s worst for Indigenous health, became one of the best

 

” Katherine Hospital in the Northern Territory has gone from one of the worst facilities in the country when it comes to Indigenous health care to one of the best.

Their secret: engaging with Indigenous patients and supporting doctors.”

Dr Quilty his high level of specialist training has meant that patients who would have had to be evacuated to Royal Darwin Hospital can now receive treatment in Katherine. Full Story below

Photo above : Gaye is a 50 year-old cancer patient from Mataranka in the NT. Supplied: Simon Quilty

NACCHO support INFO

Aboriginal Patient Journey Mapping Tools Project:

Communicating complexity

The Managing Two Worlds Together project aims to add to existing knowledge of what works well and what needs improvement in the system of care for Aboriginal patients from rural and remote areas of South Australia (and parts of the Northern Territory). It explores their complex patient journey.

The relationship between patients and health care providers is the foundation of care and requires communication across cultures, geography and life experiences. As a staff member in one rural Aboriginal Community Controlled Health Service put it: ‘It’s like managing two worlds together, it doesn’t always work’.

Download Stage 3 Study Managing Two World Study Report

NACCHO Aboriginal Health News Alert :

Do we need to close the gap on Aboriginal hospital experiences ?

How Katherine Hospital, once Australia’s worst for Indigenous health, became one of the best

As published ABC NEWS  By Hagar Cohen for Background Briefing

When physician Simon Quilty arrived at the hospital, it was going through a major crisis.

“What had happened in 2010 is that the hospital found itself in a situation where things were falling apart,” he says.

A number of doctors complained to the NT Medical Board about a lack of supervision and the impractical workload. The hospital was on the verge of shutting down.

More than one in four Indigenous patients left Katherine Hospital before completing treatment, often without informing staff, the worst rate in the nation. These “take own leave” cases are complex, but one factor is Indigenous patients’ perception of inadequate treatment.

It’s an issue plaguing the health system nationally: a 2014 Federal Health Department report found that racism contributes to the low rates of access to health services by Aboriginal people.

Similarly, the number of patients who “discharge against medical advice” is recorded and recognised by health departments as a key indicator for the quality of Aboriginal healthcare.

In the NT, 11 per cent of all Indigenous patients discharge themselves against medical advice.

“These people have very complex illnesses,” says Dr Quilty. “Many of them are highly likely, if not treated well, to resolve in significant injury or death. Hospitals in remote locations really need high expertise to deal with the very sick patients that turn up here.

“Thirteen and 15-year-olds are developing type 2 diabetes, they’ve got kidney impairment by the time they’re 22 and they’re on dialysis in their early 30s. It’s a bit terrifying really.”

Back from the brink

The NT Department of Health conducted an investigation into the staffing crisis at the Katherine Hospital. Its findings weren’t released publicly.

Background Briefing can reveal that the final report concluded that there were “significant deficiencies in nearly all the essential dimensions of safe clinical service provision”, adding that the “root cause is that the medical service model is unsustainable and becomes more unsustainable with each passing year”.

Six years ago, a new general manager and a group of new doctors arrived with an ambition to turn things around.

Katherine Hospital

They’ve brought highly trained specialist doctors who are invested in the community, interpreters are used regularly and families of Indigenous patients are consulted on complex treatment plans.

In the past, interpreters were available but rarely used. Families weren’t a part of the consultation process. Many of the doctors were junior, and staff turnover was high.

The new management has made huge inroads in the way the hospital cares for Aboriginal patients.

This year, only 4 per cent of the Indigenous patients “took own leave”, making Katherine one of the best performing hospitals in the nation when it comes to caring for Aboriginal patients.

Systematic use of interpreters

In 2006, when respected Indigenous lawman Peter Limbunya, from the remote community of Kalkarindji, stayed in the hospital for 10 days, he did not have access to an interpreter, despite not speaking English.

At the end of his treatment, Mr Limbunya, who was part of the legendary Wave Hill walk off in the 60s, was flown to a remote airstrip 5 kilometres away from his community.

His family wasn’t told he’d be back that day and nobody was there to meet him. He died of dehydration.

During the inquest into his death, the coroner found that interpreters were not in use at the hospital.

His cousin, lifetime activist and advocate for Aboriginal people Josie Crawshaw, remains outraged. She says her uncle would have known “absolutely nothing” about his treatment and what was going on.

But things have come along way since then. The hospital’s Aboriginal liaison officer, Theresa Haidle, says improving the way doctors communicate is the key to developing Indigenous patients’ trust in their treatment plans.

Regular use of interpreters has been an essential part of Ms Haidle’s work. She says they’ve been key in making sure patients understand their illnesses and treatment options.

“English isn’t their first language. It may not even be their second or third either. If there’s any doubt, we get interpreters in, or even on the phone.”

The systematic use of interpreters is a big change at Katherine Hospital.

Ms Haidle says the hospital has a lot further to go when it comes to providing a culturally safe environment, but overall, the relationship with the Aboriginal community is getting better all the time.

“It’s like a big learning process for everybody,” she says.

“We have to break it down as simple as we can,” she says. “There’s not an Aboriginal word that means cancer, so how do you explain those things?

“I remember one day a lady had this fungus, and there’s no words for those things on women’s bodies, or inside. So I heard the interpreter telling her: ‘You know, like mushrooms growing?’ They got her to stay and get it treated.”

Changing doctors’ attitudes

Pip Tallis, who is training to be a physician at Katherine Hospital, has worked in hospitals in Alice Springs and Darwin, where she says many of her Indigenous patients left before their treatment was complete.

“I found it really hard to understand why,” she says.

“It was frustrating as a doctor, and there was a lot of frustration among the staff and no-one really took the time to understand why people were taking their own leave, or really did anything to change it.

“I think, there was a bit of hands up in the air. ‘Whatever, what can we do about it? It’s their problem.'”

The NT town of Katherine, seen from the air

Dr Tallis says that her perspective has changed since coming to work at Katherine Hospital.

“I’ve spent six months working with the team here and observing how they engage with the patients, and I think that they do significant things to result in people not taking their own leave,” she says.

“Previously I was very inflexible. Now I spend a lot more time appreciating why people take their own leave.

“I’m also picking up the subtle signs on a patient who’s starting to not engage. I’ll sit down with them and explore their issues. And if they say they want to just go for a walk, you just say, ‘Would you like to take some medicine with you just in case you don’t come back?'”

Care plans to lower ‘take own leave’ rates

The introduction of weekly meetings to go over care plans for the Indigenous patients means everyone in the hospital can keep up with what’s happening with individual patients

These meetings are attended by social workers, doctors, nurses and admin staff.

At one such meeting, Dr Tallis mentions Jason, a 30-year-old patient from the remote community of Ngukurr, 330 kilometres south-east of Katherine.

Jason has tuberculosis, and has left the hospital during treatment once before. His family has convinced him to return. Dr Tallis explains at the meeting that Jason doesn’t like the hospital food, and that special food is being provided for him.

“We tried really hard to engage him,” she says. “We even got bacon and eggs for him in the mornings so he doesn’t complain about porridge, he’s got a DVD player, USB drive, he got pizza the other day. So we tried really hard to make it possible.”

But there’s still a cultural divide. At the end of the meeting, Jason explains to another doctor that he thinks “white fella” medicine is too slow.

“I want to go back to bush medicine,” he says. “It’s better and works fast because we learned it from old people.”

More support for staff

The hospital’s general manager, Angela Brannelly, says the 2010 investigation into the staffing crisis recommended major changes to the way the hospital operates, its level of staffing and supervision.

She says supporting the medical staff was one of her first priorities.

“We took it very seriously and made some really serious changes to the way that the medical team was supported here. It was around ensuring that someone’s got their back,” she says.

Dr Quilty, who joined the hospital in 2012, was the first physician to have ever been employed at the hospital. Last year he won the Royal Australian College of Physicians’ medal for clinical service in rural and remote areas.

A dark-skinned doll

His high level of specialist training has meant that patients who would have had to be evacuated to Royal Darwin Hospital can now receive treatment in Katherine. Since 2012, there has been a decrease of 43 per cent in the number of total aeromedical evacuations to Darwin.

Many Indigenous patients who live in remote communities don’t like going to Darwin to receive medical treatment because it’s far from family and the hospital is bigger and less personal.

Gaye, 50, a cancer patient who was transferred to Darwin for chemotherapy says she felt lonely in Darwin. “In Darwin I was always sad and crying a lot,” she says.

No-one in Darwin had realised that Gaye was deaf, which made communication with medical staff virtually impossible. In Katherine her deafness was recognised by the nurses and she was given a hearing aid, which she says made a huge difference to her mental health.

Katherine Hospital now employs two full-time physicians.

Still no Aboriginal doctors

Katherine Hospital employs 24 doctors but none of them are Indigenous.

Ms Brannelly admits the hospital hasn’t done enough to attract Aboriginal doctors.

“That’s good advice for us, and it’s probably where we need to go in that space around seeking out Aboriginal medical officers to come and work for us,” she says.

“I think we have some work to do there, absolutely.”

NACCHO Press Release : Aboriginal Health #18C and #Racism : Proposed changes to #18C will throw Reconciliation out the window

It is so disappointing that after all the talk in Canberra in February and the goodwill that was generated, the Government is sending such a poor message to Aboriginal people about acceptance in our own country,

“Racism and discrimination have well documented negative impacts on mental health. If we fail to deal with the alarming rates of poor Mental Health in Aboriginal people, it will have ongoing detrimental impacts in preventing and managing chronic disease

 Young Aboriginal and Torres Strait Islander people take their own lives at a rate five times that of other Australians and infant mortality rates are going backwards “

NACCHO Chair Matthew Cooke said just a month after the Prime Minister committed to a new partnership with Aboriginal people through the Redfern Statement, he has put forward measures that would have potentially devastating impacts on the health and well-being of Aboriginal people.

Download a copy of the NACCHO Press Release or read in full below

NACCHO Press Release response to 18c amendments

Download NACCHO full submission to #RDA #18c enquiry here

submission-to-inquiry-into-freedom-of-speech-and-rda-draft

The Kenbi land claim was a hard-fought land rights battle, but it represents so much more than a battle over land. It was a story that epitomised the survival and the resilience of the first Australians, the survival and resilience of the Larakia people“.

Prime Minister Malcolm Turnbull

Great photo opportunity above for the PM during the 2016 election campaign , but what would be the #healthyfutures for these children with increased racial hate speech ?  

 ” In question time today, I asked Senator Brandis about the watering down of section 18C of the Racial Discrimination Act.

What insulting, offensive or humiliating comments does the Prime Minister think people should be able to say to me?

It’s sad that on Harmony Day, a day that celebrates Australia’s cultural diversity, inclusiveness and builds a sense of belonging for everyone, the Government wants to give permission for more racial hate speech

  Being the target of racist, hurtful comments is deeply distressing and causes deep harm “

Senator Malarndirri McCarthy addressing the Senate see video and text below

Along with powerful videos of MPs Linda Burney and Tony Burke addressing Parliament over 18C

“The challenging thing with regard to proposals to change the act is that they are being put forward by those who have never felt vulnerable. These are the people who have never been on the receiving end of racist comments or attacks.

“Our first Australians hold a special place in the Australian community. Our government should be taking action to empower, rather than to disempower them. To be serious about ‘Closing the Gap’, the evidence is clear around racism and all Australian governments should be doing everything in their power to address these issues .”

Members of the Public Health Association of Australia (PHAA) were shocked by the Government’s announcement being made on World Harmony Day the intention to change Section18c of the Racial Discrimination Act 1975, according to PHAA CEO Michael Moore.

”  The government’s reforms should, as the Inquiry recommended, address that problem specifically, and not be distracted with an abstract ideological debate, divorced from the social realities.

Section 18C is not needed to protect members of minority groups who are popular in the wider community. It is needed to protect members of unpopular minorities, and also vulnerable minorities, especially our First Peoples, Aboriginal & Torres Strait Islanders.

We support the idea of improving the process for handling section 18C complaints, so that trivial or spurious complaints are terminated quickly.”

Rod Little and Dr Jackie Huggins, Co-chairs, National Congress of Australia’s First Peoples

As leaders of 10 organisations representing a wide range of culturally diverse communities in Australia, we are profoundly disappointed at today’s announcement by the Federal government of its intention to amend section 18C of the Racial Discrimination Act.

The Government’s planned changes to the Racial Discrimination Act and the Human Rights Commission will weaken the protection of Aboriginal Australians from racial abuse in this country at a time when suicide rates in Indigenous communities are among the worst in the world, the peak body for Aboriginal medical services said today.

NACCHO Chair Matthew Cooke said just a month after the Prime Minister committed to a new partnership with Aboriginal people through the Redfern Statement, he has put forward measures that would have potentially devastating impacts on the health and well-being of Aboriginal people.

Mr. Cooke said all Senators must carefully consider the issues and rise above petty point scoring politics to defeat these amendments – which are based on an hysterical media campaign about the merits of the legislation due to a single court case and a recently published cartoon.

“Any changes to section 18C will alienate the very Aboriginal people the government says it is trying to support, and create even deeper divisions in our community,” he said.

“I urge all Senators to respect the voice of the first Australian peoples in this debate, listen to Aboriginal people about what needs to be done to close the gap, and vote down changes to laws that are likely to make it even wider.”

Mr Cooke said it was outrageous that watering down racial hate laws is a priority for the Government when the latest Closing the Gap report showed just one of seven targets are on track, and the Don Dale Royal Commission is shining a light on the treatment of Aboriginal children in detention.

Young Aboriginal and Torres Strait Islander people take their own lives at a rate five times that of other Australians and infant mortality rates are going backwards.

“It is so disappointing that after all the talk in Canberra in February and the goodwill that was generated, the Government is sending such a poor message to Aboriginal people about acceptance in our own country,” Mr Cooke said.

“Racism and discrimination have well documented negative impacts on mental health. If we fail to deal with the alarming rates of poor Mental Health in Aboriginal people, it will have ongoing detrimental impacts in preventing and managing chronic disease.

“The Government’s priorities should be on positive measures like the National Aboriginal and Torres Strait Islander Health Plan, which recognises the impacts of racism and discrimination inherent in the health system, and supporting the Aboriginal Community Controlled Health sector to fix the national crisis in Aboriginal health.”

PHAA urges all MPs and Senators to leave 18c alone

“Members of the Public Health Association of Australia (PHAA) were shocked by the Government’s announcement being made on World Harmony Day the intention to change Section18c of the Racial Discrimination Act 1975,” according to PHAA CEO Michael Moore.

Earlier this week Mr Moore attended a meeting on Aboriginal and Torres Islander Health where the issue of impact of racial discrimination on health was discussed at length. “The challenging thing with regard to proposals to change the act is that they are being put forward by those who have never felt vulnerable. These are the people who have never been on the receiving end of racist comments or attacks”.

“Our first Australians hold a special place in the Australian community. Our government should be taking action to empower, rather than to disempower them. To be serious about ‘Closing the Gap’, the evidence is clear around racism and all Australian governments should be doing everything in their power to address these issues”.

“A similar impact on health will be experienced by anyone who is discriminated against on the grounds of their racial or ethnic background,” said Mr Moore.

“It really is those who are vulnerable, and those who have been subjected to hateful jibes and vilification, who should be the ones making suggestions for change rather than those who are in the dominant group,” added Mr Moore.

“The PHAA calls on all MPs and Senators to leave the Act as it is”.

“People who already feel exposed to inappropriate comments do not need to be made even more vulnerable,” Mr Moore added.

The Report of the Parliamentary Joint Committee on Human Rights “Freedom of Speech in Australia” set the tone. Over ten thousand submissions were made and the Committee did not recommend changes. Of the twenty two recommendations, there was no consensus about a change to Section 18c.

Mr Moore concluded that “MPs and Senators should be taking guidance from the Parliamentary Committee on Human Rights that examined the issue rather than kowtowing to a small hump of ultraconservatives who have played political games in order to get the numbers for a proposal that will undermine the health of the most vulnerable groups in Australia”.

Harmony Day 21 March 2017

As leaders of organisations representing a wide range of culturally diverse communities in Australia, we are profoundly disappointed at today’s announcement by the Federal government of its intention to amend section 18C of the Racial Discrimination Act.

If implemented, these proposals will weaken, perhaps emasculate, existing legal protections against racist hate speech. They will give a free pass to ugly and damaging forms of racial vilification which do not satisfy the stringent legal criteria of harassment and intimidation. The publication of virtually any derogatory generalisation about an entire community group would, of itself, be permissible.

To offend, insult or humiliate a person or group because of their race or ethnic background necessarily sends a message that such people, by virtue of who they are, and regardless of how they behave or what they believe, are not members of society in good standing.

This cannot but vitiate the sense of belonging of members of the group and their sense of assurance and security as citizens, and constitutes an assault upon their human dignity. This has nothing to do with a contest of ideas or free speech – which is in any event protected under section 18D – and falls far short of the mutual respect about which we have heard.

Under the government’s proposals vulnerable community groups will now have no peaceful, legal means of redress against these kinds of attacks against their dignity. This would send a signal from government of a more lenient attitude to racism and would damage social cohesion. It is especially ironic that the government has put forward these proposals on Harmony Day.

The proposal to insert a generic “reasonable person” standard into the legislation has superficial appeal, but is unfair and unworkable. The proverbial person in the pub or on the “Bondi tram” does not have the background knowledge and insight into the particularities of a minority group that would be needed to make a fair and informed assessment of what is reasonably likely to “harass or intimidate” members of that group.

Under the existing law, the assessment is made by a reasonable member of the targeted community, that is, by a member of that community who is neither overly sensitive nor overly thick-skinned. This is both more logical and more just.

A generic reasonable person test would also create the possibility that members of a group that happens to be unpopular at any time for any reason would be unfairly treated. Section 18C is not needed to protect members of minority groups who are popular in the wider community. It is needed to protect members of unpopular minorities, and also vulnerable minorities, especially our First Peoples, Aboriginal & Torres Strait Islanders.

We support the idea of improving the process for handling section 18C complaints, so that trivial or spurious complaints are terminated quickly.

We note that the Parliamentary Joint Committee on Human Rights was unable to reach a consensus, or even a majority opinion, in favour of any of the government’s proposals to amend the substantive law. Its recommendations were all limited to suggested reforms to the complaints-handling process.

This is the sensible way forward. The problems identified by the QUT case and the Bill Leak complaint all related to deficiencies of process. The government’s reforms should, as the Inquiry recommended, address that problem specifically, and not be distracted with an abstract ideological debate, divorced from the social realities.

Rod Little and Dr Jackie Huggins, Co-chairs, National Congress of Australia’s First Peoples

John Kennedy, President, United Indian Association

George Vellis, Co-ordinator, and George Vardas, Secretary, Australian Hellenic Council NSW

Peter Wertheim AM, Executive Director, Executive Council of Australian Jewry

Patrick Voon, Immediate Past President, Chinese Australian Forum

Tony Pang, Deputy Chair/Secretary, Chinese Australian Services Society

Randa Kattan, CEO, Arab Council Australia

Vache Executive Director, Armenian National Committee of Australia

 

Senator McCarthy:  My question is to the Minister representing the Prime Minister, Senator Brandis. The Prime Minister has on at least 16 occasions ruled out his government amending section 18C of the Racial Discrimination Act. Today, on Harmony Day, we learned that the Turnbull government is proposing the removal of the words ‘insult’, ‘offend’ and ‘humiliate’ from section 18C. What insulting, offensive or humiliating comments does the Prime Minister think people should be able to say to me?

Senator Brandis: Might I begin by correcting the premise of your question: the Prime Minister has never, not on 16 occasions and not once, said that the government would never reform section 18C of the Racial Discrimination Act. He did say, as was the case at the time, that it was not a priority for the government.

Nevertheless, I think we all know that events have happened in this country in the recent past, in particular, the treatment of the QUT students, which was disgraceful, and the treatment of the late Bill Leak, which was disgraceful. The report of the Parliamentary Joint Committee on Human Rights, to which Labor senators and members of the House of Representatives continue, proposed beneficial law reform. What the Prime Minister and I announced a short while ago was a strengthening of the antivilification provisions of the Racial Discrimination Act.

What you did not mention in your question, which I think is a very important consideration, is the insertion, into section 18C of the Racial Discrimination Act, of a prohibition against racial harassment. Did you know that in 1991, when the then—

Senator Brandis: If your leader, Senator Wong, would just control herself, I might be able to address your question. You may or may not know that in 1991 the then Human Rights and Equal Opportunity Commission—

Senator Cameron: On relevance. The question was: ‘What insulting, offensive or humiliating comments does the Prime Minister think that people should be able to say to the senator?’ That was the question, and he has not gone near it. He should actually take off that Harmony Day badge. It is absolutely crazy that he has that on.

The PRESIDENT: On the point of order, the Attorney-General has been giving a detailed response to a detailed question. He is aware of the question.

Senator BRANDIS: In 1991, when the current part IIA of the Racial Discrimination Act was recommended, the Human Rights and Equal Opportunity Commission actually recommended to the parliament that one of the grounds of racial vilification should be harassment. That was one of the grounds recommended by the predecessor body of the Human Rights Commission. For some unaccountable reason that was not done by the then Labor government.

The PRESIDENT: Senator McCarthy, a supplementary question.

Senator McCarthy:  Minister Wyatt has twice indicated he would cross the floor to vote against changes to section 18C. What consequences will there be for members of the coalition who vote against the Turnbull government’s attempt to water down protections against racism?

Senator Brandis: I am absolutely certain that every member of the coalition will be voting for these changes to strengthen section 18C, every last one of them.

The PRESIDENT:  Senator McCarthy, a final supplementary question.

Senator McCarthy:  When asked why the government had no plans to amend section 18C, the Prime Minister said, ‘We did not take an 18C amendment proposal to the election.’ Why is Prime Minister Turnbull willing to cave in to the Right of his party room on section 18C, while he continues to refuse a free vote on marriage equality, despite the defeat of his proposed plebiscite?

Senator Brandis: Although I am a little loath to dwell on internal politics, may I say that strengthening protections against racial vilification and vindicating freedom of speech are causes that are embraced by all elements of the Liberal Party and the coalition. You may say that section 18C of the Racial Discrimination Act and the complaint-handling procedures of the Australian Human Rights Commission Act are perfect and incapable of reform. You may say that, but if you do you would be alone because there is no serious person in this country who has followed human rights debate who says that section 18C in its current form, which actually omits to prohibit racial harassment, or the complaint-handling procedures of the Human Rights Commission cannot be improved. Certainly, that is what Professor Gillian Triggs has said, and I agree with her. (Time expired)

 

QUESTIONS WITHOUT NOTICE: TAKE NOTE OF ANSWERS

Racial Discrimination Act 1975

Senator McCarthy:  The answer was incredibly disappointing, in particular on this day, Harmony Day. As we reflect on Harmony Day, I want to go to some of the answers to me and my questions by Senator Brandis. I want to begin with Senator Brandis’s response in terms of Prime Minister Malcolm Turnbull. I asked, first up, about the fact that Mr Turnbull has said on at least 16 occasions that he had ruled out his government amending section 18C of the Racial Discrimination Act. Senator Brandis said that he had not said that—certainly not that many times. I just want to point out some very important media coverage of the moments when Mr Turnbull denied that it was a distraction for his government. In news.com, on 31 August 2016: ‘The government has no plans to make changes to section 18C’. He said it again on 30 August in The Australian:

It’s filled the op-ed pages of newspapers for years and years but the government has no plans to make any changes to section 18C. We have other more pressing, much more pressing priorities to address.

Then again on 14 November 2016, on ABC 7.30, Mr Turnbull said:

18(C) is talked about constantly on the ABC. It’s talked about constantly in what’s often called the ‘elite media’. I’ve focused overwhelmingly on the economy.

It appears that Prime Minister Turnbull has changed tack. Today is one of the most significant days in Australia and across the world. The purpose behind Harmony Day is to reflect on the diversity of culture across this country, something that unfortunately has been really stained by the Prime Minister’s move to change the Racial Discrimination Act on this day in particular. It is incredibly sad. It really is a watering down of protections against racial vilifications. The irony of it being done on this day! The Attorney-General says he does not believe the Australian people are racist.

Senator Brandis: No, I do not.

Senator McCarthy:  As a white man growing up in Petersham, attending private schools, I am sure you have never been denied access or service in a shop. You have never had taxis drive past, pretending not to see you. You have never received hateful letters and emails because of your race or the colour of your skin. I really wish I could believe there are not any racists in Australia. But certainly my personal experience, and my family’s experience, informs me of the reality that I live in this country. It is deeply unfortunate.

I asked you in my question: what else do you need to say to me and to many other people of different races in this country that you cannot say now? What is it that you are so determined to say that you cannot say to people now?

My predecessor, Senator Nova Peris, had a disgraceful time in this Senate, standing here, being called all sorts of things—in fact, even on her Twitter account today—in terms of what racism she received from the general public. Just to clarify, in case you were thinking I meant it occurred in the Senate; I meant this is where she raised the issue about the racism that was displayed against her by the general public across Australia. It is really important to put this on the record. She stood courageously here to point out from her own personal experiences that racism is very much alive and strong in this country. We as parliamentarians in both the Senate and the House of Representatives must show leadership about the importance of harmony, diversity and cultural respect. That is something that is not happening now today in the Turnbull government.

Being the target of racist, hurtful comments is deeply distressing and causes deep harm. expired)

 

Aboriginal Health #18C #RDA and International Day for the Elimination of #Racial Discrimination 21 March

  ” In an extraordinary case of timing, the Coalition will debate on March 21 (today ) removing protections in Australia’s race hate laws on what is also the International Day for the Elimination of Racial Discrimination.”

James Massola Canberra Times 21 March HERE

  ” The theme in 2017 for is Racial profiling and incitement to hatred, including in the context of migration.

Australia has continuing challenges regarding racial abuse and discrimination, evidenced for example by the disproportionate incarceration rates for Indigenous Australians, the current Royal Commission into the Protection and Detention of Children in the Northern Territory and the treatment of asylum seekers in detention centres both onshore and offshore.”

Posted 20 March Australian Parliament Website see in full below

International Day for the Elimination of Racial Discrimination \

“ Surveys suggested racism was already a near-universal experience for Aboriginal and Torres Strait Islanders, with 97% having experienced it in the past year and more than 70% reporting eight or more incidents in that period. Almost one-third said they had experienced racism in the health setting.

By settings standards of conduct, the law had an important role in containing the spread of racism and race hate, and described the watering down of sections 18c & d of the RDA as a “major risk” for the effective implementation of the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.

The Plan envisages a health system free of racism, offering effective, high quality, appropriate and affordable health services to Indigenous Australians “

Matthew Cooke Chair of NACCHO

NACCHO Aboriginal Health and #FU2racism :

Research shows majority of Australians believe #18C protections should stay

” Groundhog Day this week and that hoary old favourite of the clearly oppressed and downtrodden right-wing commentariat, section 18C of the Racial Discrimination Act.

Let’s start with the latter, which is a touchstone for conservatives who, as Attorney-General George Brandis once put it, want to enshrine their legal rights to be bigots.

Put aside for a minute that none of the people who claim 18C is the gravest threat to free speech Australia has ever faced can actually answer the following question: “What exactly is it that you want to say, but the law as it stands prohibits you from saying now?”

Paul Syvret is assistant editor at The Courier-Mail 21  March

Instead realise that the RDA has some fairly iron-clad protections in the form of section 18D.

This is a section you don’t often hear the free-speech warriors discussing a lot, and it reads as follows:

“Section 18C does not render unlawful anything said or done reasonably and in good faith:

(a) in the performance, exhibition or distribution of an artistic work; or

(b) in the course of any statement, publication, discussion or debate made or held for any genuine academic, artistic or scientific purpose or any other genuine purpose in the public interest; or

(c) in making or publishing: (i) a fair and accurate report of any event or matter of public interest; or (ii) a fair comment on any event or matter of public interest if the comment is an expression of a genuine belief held by the person making the comment.”

As Queensland MP and deputy chairman of the bipartisan Parliamentary Joint Committee on Human Rights Graham Perrett points out, that committee – after a 112-day inquiry with 11,000 submissions – decided NOT to recommend any changes to the RDA.

As the forests of newsprint continue to be devoted to lionising The Australian’slate and controversial cartoonist Bill Leak, an aggressive crusader for repealing section 18C, Perrett has this to say: “The untimely passing of cartoonist Bill Leak is very distressing for his family and friends.

“Most Australians, including me, recognise his undoubted creative talent. Nevertheless, Mr Leak’s cartoons are not relevant to any discussion about changing section 18C.

“Indeed, the legislation makes it very clear that Leak’s cartoons would not be caught by section 18C due to the exemptions in section 18D.”

International Day for the Elimination of Racial Discrimination

 

The United Nations’ International Day for the Elimination of Racial Discrimination is observed with a series of worldwide events on 21 March every year.

Proclaiming the Day on 26 October 1966, the General Assembly called on the international community to redouble its efforts to eliminate all forms of racial discrimination (resolution 2142 (XXI)).The date of 21 March was chosen to commemorate that day in 1960 when police opened fire and killed 69 people at a peaceful demonstration in Sharpeville, South Africa, against the apartheid ‘pass laws’.

Since those earlier days, the UN observes there has been progress:

… the apartheid system in South Africa has been dismantled. Racist laws and practices have been abolished in many countries, and we have built an international framework for fighting racism, guided by the International Convention on the Elimination of Racial Discrimination. The Convention is now nearing universal ratification, yet still, in all regions, too many individuals, communities and societies suffer from the injustice and stigma that racism brings.

The International Convention on the Elimination of All Forms of Racial Discrimination was adopted on 21 December 1965 and entered into force on 4 January 1969.

2017 theme: Racial profiling and incitement to hatred, including in the context of migration

Every year the International Day is held under one specific theme. The theme in 2017 is Racial profiling and incitement to hatred, including in the context of migration.

Racial and ethnic profiling is defined as ‘a reliance by law enforcement, security and border control personnel on race, colour, descent or national or ethnic origin as a basis for subjecting persons to detailed searches, identity checks and investigations, or for determining whether an individual is engaged in criminal activity’ according to a report of the Special Rapporteur on contemporary forms of racism of 20 April 2015.

Refugees and migrants are particular targets of racial profiling and incitement to hatred. In the New York Declaration for Refugees and Migrants adopted in September 2016, United Nations Member States strongly condemned acts and manifestations of racism, racial discrimination, xenophobia and related intolerance against refugees and migrants, and committed to a range of steps to counter such attitudes and behaviours, particularly regarding hate crimes, hate speech and racial violence.

Campaigns and events

The UN is promoting the following campaigns and events in relation to the International Day:

Together is a United Nations initiative to promote respect, safety and dignity for refugees and migrants. It was initiated during the UN Summit for Refugees and Migrants on 19 September 2016.

Stand up for someone’s rights today is a campaign launched by the UN Human Rights Office on Human Rights Day, 10 December, 2016. It aims to: encourage, support and amplify what you do in your everyday life to defend human rights.

The Week of solidarity with the peoples struggling against racism and racial discrimination begins on 21 March each year. It was first established as part of the Programme for the Decade for Action to Combat Racism and Racial Discrimination adopted by the General Assembly in 1979 (A/RES/34/24).

To commemorate the 2017 International Day, on 17 March the UN Human Rights Council in Geneva held a debate on racial profiling and incitement to hatred, including in the context of migration. In New York. there will be a General Assembly plenary meeting in observance of the International Day, on 21 March 2017.

Australia’s action

In Australia the Racial Discrimination Act 1975 (Cth) was a landmark in race relations. The Act was a legislative expression of a new commitment to multiculturalism and it reflected the ratification by Australia of the International Convention on the Elimination of All Forms of Racial Discrimination.

As the first Commonwealth legislation concerning human rights and discrimination, the Racial Discrimination Act set an important precedent. As described by Prime Minister Gough Whitlam at a ceremony for its proclamation in October 1975, the Act was ‘a historic measure’, which aimed to ‘entrench new attitudes of tolerance and understanding in the hearts and minds of the people’.

Since 1999, 21 March in Australia has also been celebrated as Harmony Day. Timed to coincide with the International Day for the Elimination of Racial Discrimination, Harmony Day is dedicated to celebrating Australia’s cultural diversity. Harmony Day events are supported by the Department of Immigration and Border Protection and each year a wide range of community sporting and cultural organisation have held events including sporting activities, food festivals, dance and music performances  or simply bringing people together to talk and share stories.

While Harmony Day has shifted Australia’s commemorative focus to the more positive celebration of cultural diversity and racial harmony, the UN International Day with its focus on the prevention and eradication of racism is still relevant. Australia has continuing challenges regarding racial abuse and discrimination, evidenced for example by the disproportionate incarceration rates for Indigenous Australians, the current Royal Commission into the Protection and Detention of Children in the Northern Territory and the treatment of asylum seekers in detention centres both onshore and offshore.

Parliament too, has more recently been involved in a debate on whether racial vilification laws impose unreasonable restrictions on freedom of speech and the Joint Standing Committee on Human Rights has recently completed an inquiry into free speech and Australia’s laws against racial vilification.

The Australian Human Rights Commission’s view, which was also supported by the majority of submissions to the Committee, is that ‘the laws against racial vilification have served Australia well over the last 20 years in sending the message that racial abuse will not be tolerated in our multicultural society’. Ultimately, there was no consensus from the Committee on whether any reform was necessary and, for the moment, the laws remain as they are.

NACCHO #ClosetheGapday Editorial Comment and Download #CTG 2017 Progress and Priorities Report

 ” Achieving health equality for Aboriginal and Torres Strait Islander people will be impossible without a sincere, committed effort to understand and address racism in this country. That is why the Close the Gap Campaign continues to call for a national inquiry into the prevalence of racism and its impact.

The old cliché about persisting with the same failure in the hope of a different outcome is sadly the lived reality of much of the government policies regarding our people.

It is time to do something different.”

NACCHO CEO Pat Turner AM and Co- Chair Close the Gap Campaign

Opinion editorial 16 March see below in full ” It’s time to re-think Aboriginal and Torres Strait Islander health

Closing the gap in health equality between Aboriginal and Torres Strait Islander people and other Australians is an agreed national priority but governments are failing to meet nearly every key measure. This has to change.”

That’s the blunt assessment delivered by Close the Gap Campaign co-chairs, Jackie Huggins and Patricia Turner :

Photo : NACCHO CEO Pat Turner and #CTG co chair Dr Jackie Huggins launch 2017 #CloseTheGap Progress & Priorities Report

Dr Huggins, who is also co-chair of the National Congress of Australia’s First Peoples, and Ms Turner, who is chief executive of the National Aboriginal Community Controlled Health Organisation, released the Close the Gap Campaign 2017 Progress and Priorities Report in Sydney today (  16 March ) to mark National Close the Gap Day.

Download the report HERE     CTG Report 2017

CTG 2017 report : 15 Recommendations :  “We have the Solutions

New Engagement ( The remaining 12 below )

  1. The Federal, State and Territory governments renew the relationship with Aboriginal and Torres Strait Islander peoples, by engaging with sector leaders on the series of calls in the Redfern Statement, and that they participate in a National Summit with Aboriginal and Torres Strait Islander leaders in 2017, to forge a new path forward together.
  2. The Federal Government restore previous funding levels to the National Congress of Australia’s First Peoples as the national representative body for Aboriginal and Torres Strait Islander peoples, and work closely with Congress and the Statement signatories to progress the calls in the Redfern Statement.
  3. The Federal Government hold a national inquiry into racism and institutional racism in health care settings, and hospitals in particular, and its contribution to Aboriginal and Torres Strait Islander inequality, and the findings be incorporated by the Department of Health in its actioning of the Implementation Plan of the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.

It’s time to re-think Aboriginal and Torres Strait Islander health

Op-ed by Patricia Turner, CEO, National Aboriginal Community Controlled Health Organisation and co-chair of the Close the Gap Campaign.

Today [16 March 2017] is National Close the Gap Day. It is a day to acknowledge our resilience and a day to focus attention on the significant gap in health equality between Aboriginal and Torres Strait Islander people and non-Indigenous Australians.

The facts are indisputable. Governments at all levels are failing Australia’s First Peoples. We have shorter lifespans and we are sicker and poorer than the average non-Indigenous Australian.

The Close the Gap Campaign began in 2006. One of the Campaign’s first accomplishments was to convince the Federal Government of the need to plan and set targets to improve health equality for Aboriginal and Torres Strait Islander people.

We’ve now had almost a decade of Closing the Gap Strategy by successive federal governments. Prime Minister Malcolm Turnbull’s most recent report to Parliament, in February 2017, was not good news. Most of the Closing the Gap targets are unlikely to be met by 2030. Frustratingly, child mortality rates are going backwards.

Today, the Close the Gap Campaign’s Progress and Priorities Report 2017 reflects on the continuing failure of the Government’s Closing the Gap Strategy and outlines a series of recommendations that can begin to turn the tide.

As a co-chair of Close the Gap Campaign and CEO of the National Aboriginal Community Controlled Health Organisation, I see the impact of a lack of coordination between federal, state and territory governments on addressing Aboriginal and Torres Strait Islander health.

The Federal Government’s recent announcement to refresh the strategy is timely and a dialogue should begin with Aboriginal and Torres Strait Islander peak health organisations on how to address the health challenges our people face.

We expect much more from the state and territory governments. The Federal Government has a clear leadership role but the states are simply not doing enough to address inequality in their jurisdictions.

New arrangements between state, territory and federal governments must begin with a clear focus on addressing the social and cultural determinants of health.

Aboriginal and Torres Strait Islander affairs should not be managed in siloes. Instead, we need to take account of the factors that contribute to good health: housing, education, employment and access to justice. Aboriginal and Torres Strait Islander leaders from across these sectors are already working together to make these policy connections – governments must follow suit.

Cultural determinants matter. There is abundant evidence about the importance of self-determination, freedom from the grind of casual and systemic racism, discrimination and poverty. For over 200 years we have been burdened with laws, systems and institutes that perpetuate disadvantage.

But our cultures and traditions still endure; we remain the traditional custodians of the land you walk on.

Last year, 140 Aboriginal community-controlled health organisations (ACCHOs) provided nearly 3 million episodes of care to over 340,000 clients by more than 3,000 Indigenous staff. It is clear that putting Aboriginal health in Aboriginal hands works.

Recently, Flinders University highlighted the success of the Central Australian Aboriginal Congress in Alice Springs, noting its ability to provide a one stop-shop with outreach services, free medicine and advocacy.

The benefits of having Aboriginal health in Aboriginal hands are evident in other case studies which show reductions in the numbers of young smokers, increased immunisations rates, and increased numbers of child health checks in our local communities.

The Federal Government’s rhetoric about economic empowerment and opportunity should be replaced with significant public policy initiatives and the delivery of specific outcomes. Politicians often speak about the optimism, resilience and determination of our people but how about speaking today, right now, about meaningful actions, engagement and self-determination for us all.

CTG 2017 report 15 Recommendations :  “We have the Solutions

Prime Minister, and all Members of Parliament I say to you that Aboriginal and Torres Strait Islander people have the solutions to the difficulties we face.

Consider for a moment the 2.5 million episodes of care delivered to our people by Aboriginal Community Controlled Heath Organisations each year.

This community-controlled work is echoed by many of our organisations here today, and amplified by countless individual and community efforts working for change.

Imagine this work stretching out over decades as it has.

We need a new relationship that respects and harnesses this expertise, and recognises our right to be involved in decisions being made about us.

A new relationship where we have a seat at the table when policies are developed.”

Dr Jackie Huggins Redfern Statement Parliamentary Event, 14 February 2017

Reinvigorating the national approach to health inequality

4.     State and Territory governments recommit to the Close the Gap Statement of Intent, and develop and implement formal partnerships with the Federal Government with agreed roles, funding and accountability with the provision of annual reports on their efforts to close the gap from each jurisdiction.

 

5.     The Federal, State and Territory governments work together to develop a National Aboriginal and Torres Strait Islander Health Workforce Strategy to meet the vision of the National Health Plan.

Social and Cultural Determinants of Health

6.     The Federal Government develop a long-term National Aboriginal and Torres Strait Islander Social and Cultural Determinants of Health Strategy.

Implementation Plan

The Implementation Plan is a major commitment by the Federal Government and must be adequately resourced for its application and operation. As such, the Government should:

7.     Identify geographic areas with both high levels of preventable illnesses and deaths and inadequate services, and development of a capacity-building plan for Aboriginal Community Controlled Health Organisations (ACCHOs) in those areas.

8.     Fund the process required to develop the core services model and the associated workforce, infrastructure, information management and funding strategies required.

9.     Ensure Aboriginal and Torres Strait Islander health funding is maintained at least at current levels until the core services, workforce and funding work is finalised, when funding should be linked directly with the Implementation Plan.

10. Ensure the timely evaluation and renewal of related frameworks upon which the Implementation Plan relies.

 

11. Finalise and resource the National Plan for Aboriginal and Torres Strait Islander Mental Health and Social and Emotional Wellbeing. This plan should incorporate and synthesise the existing health, mental health, suicide and drugs policies and plans – and should be an immediate priority of all governments.

12. Ensure that the consultation process for the next iteration of the Implementation Plan be based on genuine partnership with Aboriginal and Torres Strait Islander people, in a way that is representative and properly funded so that First Peoples can be full and equal development partners.

Primary Health Networks

13. The Federal Government mandate formal agreements between Primary Health Networks (PHNs) and ACCHOs in each region that:

a.     specify Aboriginal and Torres Strait Islander leadership on Indigenous issues and identify the specific roles and responsibilities of both the PHNs and the ACCHOs.

b.     include workforce targets for Aboriginal and Torres Strait Islander health professionals and include mandatory Aboriginal and Torres Strait Islander representation on the clinical committees of every PHN.

14. The Federal Government mandate ACCHOs as preferred providers of health services for Aboriginal and Torres Strait Islander people provided through PHNs.

15. The Federal Government develop and implement agreed accountability, evaluation and reporting arrangements to support the provision of primary health care for Aboriginal and Torres Strait Islander peoples in each PHN area.[i]

Summary

The Campaign believes that the PHN program has the potential to make a significant positive difference in health outcomes for all Australians if they are culturally safe and properly engaged with the Aboriginal and Torres Strait Islander community within their network area.

The ability of PHNs to deliver culturally safe, high-quality primary health care for Aboriginal and Torres Strait Islander people will be seen in the lived experience of the people.

Engagement

It is essential that Federal Government ensure that the PHNs are engaging with ACCHOs to ensure the best primary health care is afforded to Aboriginal and Torres Strait Islander people, as well as the broader community. Competitive tendering processes for PHNs that award contracts to organisations that are able to write the best proposal may well be at the expense of organisations that can provide the best services in terms of access, quality and outcomes.

However, formal partnerships between PHNs and ACCHOs should reduce rather than exacerbate current funding inequities and inefficiencies.

It is the Campaign’s view that ACCHOs must be considered the ‘preferred providers’ for health services for Aboriginal and Torres Strait Islander people.

Where there is either no existing ACCHO or insufficient ACCHO services, capacity should be built by the establishment of new ACCHOs or within existing ACCHOs (or have capacity development of existing ACCHOs) within the PHN area to extend their services to the identified areas of need.

Where it is appropriate for mainstream providers to deliver a service, they should be looking to partner with ACCHOs to better reach the communities in need.[i]

The Campaign welcomes the collaboration between the Department of Health and the National Aboriginal Community Controlled Health Organisation to develop the Primary Health Networks (PHNS) and Aboriginal Community Controlled Health Organisations (ACCHOS) – Guiding Principles which are intended to provide:

…guidance for actions to be taken by each party across six key domains: Closing the Gap; cultural competency; commissioning; engagement and representation; accountability, data and reporting; service delivery; and research.[ii]

Having a shared understanding of the key domains of focus and the principles of engagement and collaboration are a good start, however, more can be done to formalise the relationship between PHNs and ACCHOs.

Cultural Safety

The need for culturally safe services, with safe spaces that support the holistic concept of health is well established.

ACCHOs continue to be the exemplar for cultural safety standards as they are, by their very existence, best placed to respond to the health needs of the community based on implicit cultural understanding.[iii]

Again, it is encouraging to see some indications that the PHNs are looking to incorporate culturally safe practices as evidenced by the Guiding Principles document between PHNs and ACCHOs. The Guiding Principles state:

‘An understanding of Aboriginal and Torres Strait Islander culture is important to partners who wish to engage with Aboriginal and Torres Strait Islander people effectively and as equals.

Underpinning the Guiding Principles is a shared knowledge that will ensure:

  • respectful culturally sensitive consultation
  • recognition that Aboriginal and Torres Strait Islander health outcomes will be achieved when Aboriginal and Torres Strait Islander people control them, and
  • that commissioned service delivery will be a strengths-based approach reflecting the United Nations Declaration on the Rights of Indigenous Peoples.’[iv]

Respect of culture must be embedded in all PHN practice and management, from formalised cooperation with ACCHOs, the delivery of services and the investments made in the non-Indigenous workforces so that they understand and value Cultural Safety and its importance for Aboriginal and Torres Strait Islander people seeking care.

 The Close the Gap Campaign

Close the Gap Campaign co-chair Jackie Huggins highlighted the resilience of Indigenous people and cautioned against feeling disheartened by the slow pace of change.

“When Tom Calma started the Close the Gap Campaign in 2006, he set a 25-year goal to achieve health equality between Aboriginal and Torres Strait Islander peoples and non-Indigenous peoples,” Dr Huggins said.

This was an intentionally ambitious time frame. Nevertheless, Tom and the other early Campaign members knew that every inch the gap closed between First Australians and non-Indigenous Australians translated into lives saved and lives improved.

The Australian community agreed. Since then more than 220,000 Australians have signed the close the gap pledge for change.

“Despite the significant challenges we face to make health equality a reality in this country, it is the commitment of the hundreds of thousands of people that have pledged their support to closing the gap that give us courage and strength to press on.

“In communities across Australia we are seeing more and more of our people rising above the obstacles of institutional racism, generational trauma and low expectations to become nurses, doctors, social workers, youth workers, health workers, administrators, teachers and community leaders.

Our people, with the support of the many non-Indigenous people committed to health equality, are best placed to lead the changes needed today, tomorrow and over the next decade,” Dr Huggins said.