“The Report and its statistics provide a good reminder that ongoing efforts to improve outcomes for Indigenous Queenslanders is being achieved through community controlled health services, where local people are involved in decision-making processes that effect their overall health and well-being.”
Selwyn Button, CEO, QAIHC (pictured above)
QAIHC Press Release September 2013
A report on primary health care data extracted from community controlled clinics across Queensland shows significant gains in health access and improvements, whilst demonstrating there is more work needed in coming years.
The Queensland Aboriginal and Islander Health Council (QAIHC) External Report 2013 (the Report) is a clear indication that the National Close the Gap effort is working.
The Report is a compilation of primary health care data collected from a number of QAIHC clinics across Queensland from 2009 to 2013.
It shows that QAIHC member services are providing regular care to around 70,000 patients across Queensland. This represents close to 45 percent of the Queensland Indigenous population, an astonishing number considering QAIHC member clinics are not located in all parts of the state.
Additionally, over twenty percent of the Queensland Indigenous population passed through the doors of QAIHC member services and clinics in the past six months alone.
Selwyn Button, CEO, QAIHC has welcomed the Report and the timeliness of its release.
“QAIHC member clinics are the largest provider of primary health care services to Indigenous people across Queensland,” Mr Button said.
“This Report demonstrates that the demand for more community controlled services continue to grow throughout the state, particularly in areas where a QAIHC service is yet to be developed.
“The Report is evidence that QAIHC’s services are integral in providing a much needed and significant contribution to improving the health of Indigenous Queenslanders.
“It is a reminder to us all that short term solutions simply are not the answer, and we require ongoing quality care to make a difference. Our Indigenous health clinics are up for the task and these numbers clearly show this fact.”
“QAIHC has over 40 Indigenous controlled health clinics throughout Queensland, and these community controlled health clinics are all proven success stories.”
“The growth in numbers clearly demonstrates this, but the growth in activities, including increasing number of health checks, chronic disease management plans and other related activities shows that our services are improving the quality of care
through systematic and best-practice approaches to patient care and continuity.”
The Report and its statistics provide a good reminder that ongoing efforts to improve outcomes for Indigenous Queenslanders is being achieved through community controlled health services, where local people are involved in decision-making processes that effect their overall health and well-being.
The Report shows that the fundamental principles of local community governance and autonomy in decision-making can make a significant difference to Indigenous health and well-being.
“There is still much work to be done to improve health outcomes for Indigenous Queenslanders,” Mr Button acknowledged.
“However, the foundations are now in place to support ongoing improvements, and the statistics in The Report are there as proof.
It is time for the Government get on board and show support community control for the Indigenous community of Queensland.”
Highlights of The External Report 2013 outlined:
• The development of QAIHC Primary Health care indicators and process for data collection and monitoring of outcomes commenced in 2007
• 20% of Indigenous Queenslanders seen in past 6 months
• 70,000 of all patient numbers across all QAIHC member services
• 200,00 patients visits across all services in past 6 months
• 41% of total patient population is made up of male patients
• 60% on average of all patients have had a health check in past 12 months
• 70% of hypertension patients on recommended medication
• 50% of diabetics on GPMP
• 49% of patients in AICCHS were smokers
• 27% of patients are overweight and 41% are obese
•15% of patients screened were identified as having poor kidney function and at risk of renal disease
“An Aboriginal community controlled comprehensive primary health care service?
A bloody mouthful of a description, but nonetheless a symbol and practical evidence of what Aboriginal people and their supporters have achieved—and continue to achieve.”
Chips Mackinolty NT Aboriginal health legend (Ex AMSANT)
Photograph by Therese Ritchie
This is a guest post by Chips Mackinolty that was first published, in edited form, in the NT News on 7 September 2013
NACCHO would also like to acknowledge a pay tribute to the support Chips has given NACCHO over the years
After more than 30 years in the Territory, Chips Mackinolty is taking a year off: for “a pre-pension gap year” as he describes it. After all, he says, “gap years are wasted on the young”.
Across most of that time he has worked for organisations which haven’t allowed him to have a public personal opinion. This has included working for Aboriginal organisations, writing as an interstate journalist for both Fairfax and Murdoch, designing for private enterprise clients, and even a stint as a Labor Party ministerial appointee. For the last four years he has worked for the Aboriginal Medical Services Alliance Northern Territory [AMSANT].
Apart from an irreverent political approach in his artwork, which has occasionally been touted by the NT News, Mackinolty has pretty much stayed out of the world of public opinion.
A day after quitting AMSANT, he writes an opinion piece for the NT News on an ongoing commitment: Aboriginal health. It is published on the day of the Federal election, but with no intent to influence votes. In his words, “that’s deliberate: whoever wins the election today must commit to the most successful bipartisan strategy in recent Territory history, closing the gap in Aboriginal health outcomes”. He tells a story that suggests that the Territory is hitting well above its weight.
But it’s not as simple as that, as he tells us.
Four or five years ago I made the decision to pretty much stop going to funerals. Of course since then I have been to many—too many. There came a time when it had got too much, with the vast majority of funerals for Aboriginal people. And the people were dying younger.
It was a difficult decision, for many were from the Katherine region. It might sound peculiar to readers, but Katherine was where I “grew up”. I got there in the early ’80s in my late 20s. An evening of fireworks for the third celebration of Self Government in Darwin then, bizarrely a day or so later for the final shoot in Mataranka of We of the never never with Aboriginal artists I then spent the next four years with.
But nevertheless it was a town, at that age, in which I “grew up”. Whatever I thought I had learnt on the streets of inner city Sydney were, frankly, SFA when it came to the Territory.
Most of that learning was with Aboriginal people across an area greater than Victoria: from Borroloola to Elliot; to Lajamanu and Kalkarindji and west to the Kimberley: Halls Creek, Kununurra and Wyndham. And then across via Timber Creek to Bulman, Numbulwar and Angurugu, south through Numbulwar to Ngukurr and back up through Jilkminggan, Barunga, Manyallaluk and Wugularr. It was an astonishing education in land, language and law. But it was a period I spent far too much time learning about death: the death of the artists I worked with, their families, and their children.
But I also learnt from whitefellas in Katherine: from the legendary Judy King and John Fletcher; from Francesca Merlan, Paul Josif, Mick Dodson and Toni Bauman, to Anne and John Shepherd and John O’Brien.
In different ways they, and many others, all taught me about living in the Territory.
In the late 1990s the CEO of the Jawoyn Association, the late Bangardi Lee, recruited me, Jawoyn woman Irene Fisher and Dr Ben Bartlett to put together a seemingly endless series of submissions that resulted—some years later—in the establishment of the Sunrise Health Service: an Aboriginal community controlled comprehensive primary health care service.
An Aboriginal community controlled comprehensive primary health care service? A bloody mouthful of a description, but nonetheless a symbol and practical evidence of what Aboriginal people and their supporters have achieved—and continue to achieve.
Across the NT, from remote clinics such as that run by the Pintupi Homelands Health Service to Danila Dilba in Darwin, the Aboriginal community controlled primary health sector serves roughly half our Aboriginal population, the rest through NT Government health services.
Over time, the process of privatising into the community controlled health sector will increase as services are devolved from government. It’s not been an easy process—and slower than many of us want. Nevertheless, it has had bipartisan support federally and locally for more than a decade. Famously, former CLP health minister Steve Dunham “rescued” the Sunrise Health Service in its early development stage when it met resistance from some health bureaucrats. His intervention saved what is now one of the NT’s great success stories.
The evidence, internationally, nationally and locally is that community controlled primary health care is more efficient and effective in delivering the goods.
According to recent data produced by COAG, the Northern Territory is the only jurisdiction in Australia on track to meet the closing the gap target of reducing the difference in life expectancy between Aboriginal and non-Aboriginal people. This is a good news story that has been barely reported in the NT outside the pages of this newspaper.
There are a number of reasons for this success. The last decade has seen a dramatic rise in hospital spending; more importantly greater resources have been distributed more equitably to the bush. The increased resources to primary health care through the Intervention, now known as Stronger Futures, has been a prime reason this has been possible.
But we are also doing it better—and in many instances better than anywhere else in the nation. For example, childhood immunisation rates in the community controlled sector is better than in many affluent suburbs down South.
And we are doing it smarter: led by the Aboriginal community controlled health sector, there has been an increased use of electronic data collection and analysis. Clinical Information Systems are used at the individual patient level to keep up-to-date, easily accessible health histories, as well as to alert clinicians to possible allergies, and efficiently prompt clinics to recall patients for regular checks as well as follow ups.
The data analysed can be tailored by individual health services, but all clinics in the NT now contribute the to Northern Territory Aboriginal Health Key Performance Indicators, which have a commonly shared set of clinical measures. Access to this data is strongly protected through privacy protocols.
The big picture of this is the capacity for these systems to allow for public health data to be analysed at a community and regional level, and for subsequent follow up. For example, a regular system of patient interaction through Child and Adult Health Checks has the capacity to identify “spikes” in particular conditions such as childhood and maternal anemia or otitis media in children.
This not only keeps an individual clinic alert to changes in local health, but also in ways to respond. This is achieved through a process called Continuous Quality Improvement [CQI], and is carried out by all clinicians at a service and the data collected is a key part of this process. For example, with otitis media it will guide individual treatment (are we always checking following the national guidelines? what evidence-based treatments are we giving? are we referring the patients to specialist diagnosis and care?), but also to the community as a whole (are we working with the council, school and families? what sort of other public health campaigns might we undertake?)
At regional level this data can be very powerful. As well as the regional Aboriginal Community Controlled Health Services we already have, such as Katherine West Health Board and the Sunrise Health Service, other regions are now working together through Clinical and Public Health Advisory Groups [CPHAGs]. The CPAHGS meet regularly and work cooperatively to share experiences and data, and ways to do things better. Some have identified particular regional health problems which would otherwise might be “lost” in large scale data bases.
The Northern Territory is the first jurisdiction in Australia in which all remote clinics now have electronic health records for their patients.
Further to this, our sector, along with government clinics, has pioneered the idea of a “shared electronic health record”. Over half the Aboriginal people in the NT have signed up to such a record, and we are in the process of readying the system so as to be part of a national network. This allows, with full permission from the patient or carer at every consultation to update their health record to a data base that can then be accessed by other clinics and hospitals. For example, a patient at Ngukurr may fall ill at another community, and get the appropriate treatment through their shared electronic health record. A hospitalisation will allow the clinicians to see someone’s record, know what medications they are on, and past conditions. After discharge from hospital, the health records are updated, and an electronic discharge summary is available to the home clinic.
These and many other innovations are behind the improved statistics—but there is a long way to go. It’s a welcome trend—but the good results will flatten out and perhaps reverse if we do not tackle the other social determinants of health. These include housing, education, early childhood development, substance abuse, food security, incarceration rates and social exclusion. It is reckoned that health services alone will only be able to deal with about 25 per cent of “the gap”: the rest is down to the other social determinants.
And that’s where governments of all stripes come in, and where the need for truly bipartisan approaches must prevail. Whatever the result of today’s election, Aboriginal health remains the Territory’s major challenge. Aboriginal children yet to be born will benefit if only our politicians are working, in the words of the AMSANT slogan, “together for our health”.
Since the election of the new Abbott government on Saturday night the new head of the Coalition government’s Indigenous advisory committeee Warren Mundine has done a number of major interviews for both print and television (see below)
Please note: NACCHO is a bipartisan organisations and this information is supplied for the information of our members and stakeholders and the views are not endorsed by the NACCHO board.
Ellen Fanning: … ‘the great national failure’ … what will you do with the Indigenous Council – what will he do with it?
Warren Mundine:Well, the interesting thing is that we are not going to do much differently, because there is just so much stuff that people have done over the years, we are gunna look at “Why has it failed and why hasn’t it worked?” First thing we are gunna do is an audit for want of a better word, a review, look at what has been done over the last 30 or 40 years. I’ve got to report back to the Prime Minister by February. A couple of things are missing from indigenous affairs – we tend to go on process. We tend to spend a lot of money for very limited outcomes and we’ve got to change that.
EF: And do you take the axe to things that don’t work? You have a clear idea, saying, “That’s not measuring up, off you go?”
WM: Look, to be honest we’ve avoided that kind of conversation because as soon as it gets out that you are going to axe a program you get resistance, fighting and brawling.
EF: How hard is it …
WM: What we want to bring people – and this is the important part – what we want to do is bring them on a journey, so that we, so that they explain to us how they operate and why this has happened and we understand that then they understand that we want outcomes in this area and then we start moving forward. It is not about axing programs or XX programs it is about results and that’s what we are focusing on.
EF: And would it ever be about sending the military back into indigenous communities as you have done under the intervention?
WM: Not as far as I am concerned. Actually the military does have a place – one of the ideas we are looking at is how do we get surgery and medical stuff into indigenous communities? And I just had a sit there one day with a cup of tea as you normally do and I said, well, you know … in the tsunami of Indonesia, you know at Sumatra and the Indian Ocean. And I said the military has got to train for emergency services and war situations – they’ve got to go in there and set up a hospital, do surgery and move it on.
EF: So can you see field hospitals in indigenous communities?
WM: I … reckon that is something we could place. One, the Military could be trained for state emergency operations in communities and setting these things up. The Aboriginal community medical services could tap in to that. We’ve got to get innovative, we’ve got to think differently and it is not about cutting programs or bringing new programs in. It is about focusing on the outcomes and then putting in place how we do that outcome
FORMER Labor Party president Warren Mundine has delivered a stinging rebuke of his former party, declaring the ALP under its current administration has “betrayed” him and his working-class father by backing “false messiahs” that have driven it into a brick wall.
In an opinion piece on Labor’s loss in today’s The Australian, the new head of the Coalition government’s indigenous advisory committee writes that Labor has lost both him and his working-class friends from Sydney’s western suburbs unless it embraces massive change.
“Last year I decided not to renew my ALP and AWU membership. Occasionally on social media people call me a traitor for leaving the party. In fact, I feel that it is the Labor Party under its current administration that has betrayed me; and my father; and the people I grew up with,” he says.
“This was our party and over 20 years the faceless men, spin doctors and false messiahs have driven it into a brick wall. Labor is now in need of fundamental structural reform.”
In an interview
Mr Mundine, who admits he voted Liberal for the first time on Saturday and was at Tony Abbott’s victory event on Saturday night, said the party needed to better reflect the communities it represented. He said candidates should be elected by a vote of rank-and-file members who were registered on the electoral rolls in that electorate to make branch stacking more difficult.
“The relevant national or state executive council should only be able to override a rank-and-file vote in exceptional circumstances — no more candidates parachuted in by party headquarters,” he says.
Secondly, the party power base needed to embrace a genuine federation. Currently the relevant state secretary officiates candidate elections at both the national and state level.
“Candidate elections in federal electorates should be officiated by the national secretary, not the state secretary. This broadens the power base and provides balance. It also makes it harder for one powerful state executive to gain disproportionate national power”.
Mr Mundine argues that while union voting entitlement at state and national conferences needs to be reduced, removing it altogether is unrealistic.
“In the end, the real problem is that Labor has become all talk and no substance. It has abandoned its core constituents after having lifted their aspirations. Political success requires substance and sticking to your values, not populism and looking after your mates.
“It requires well thought out policy based on both principles and pragmatism that is delivered, not just written on a glossy media release or tweeted on the run.
“That was the approach of four of Australia’s most successful leaders — Menzies, Hawke, Keating and Howard. It is also the approach of Tony Abbott.
“Saturday’s election and the six years before it left me seriously wondering if the Labor Party might become a spent force in Australian politics.
“I hope not. But it will need to reacquaint itself with its heartland and implement some serious reforms,” he says.
The NACCHO chair Justin Mohamed welcomes the release of the Coalition Indigenous policy document and if successful on Saturday hopes that the Coalition will work closely with peak bodies like NACCHO to develop policy and invest in healthy futures for generational change. We look forward to more detail
The Coalition believes indigenous Australians deserve a better future, with more job opportunities, empowered individuals and communities, and higher standards of living.
The Coalition aims to ensure that right around Australia, children go to school, adults go to work and the ordinary law of the land is observed – in indigenous communities no less than in the general community.
The Coalition will establish a Prime Minister’s Indigenous Advisory Council, to be chaired by Mr Warren Mundine. The Council will help ensure that the Indigenous programmes achieve real, positive change to the lives of Aboriginal people.
We will transfer responsibility for Indigenous programmes to the Department of the Prime Minister and Cabinet. Under a Coalition government Australia will, in effect, have a Prime Minister for Indigenous Affairs and a dedicated Indigenous Affairs Minister.
All Australian children, but particularly disadvantaged Indigenous children, need access to a proper education. Much more needs to be done in this area. The Coalition will work with the States and Territories to improve educational outcomes for Aboriginal children.
Within 12 months of taking office, the Coalition will put forward a draft amendment for constitutional recognition and establish a bipartisan process to assess its chances of success. The key objective of a referendum will be to achieve a unifying moment for the nation, similar to that achieved by the 1967 constitutional referendum.
The Coalition will provide support for Jawun’s Empowered Communities initiative, which is a new regionalised model to be applied in eight opt-in communities. Empowered Communities will give more authority to local indigenous leaders with a view to achieving Closing the Gap targets more quickly.
The Department of the Prime Minister and Cabinet will review indigenous training and employment programmes to ensure that such programmes are more effectively linked to employment outcomes. This review will be headed by Mr Andrew Forrest.
We will provide up to $45 million for GenerationOne’s demand-driven training model. This commitment, through GenerationOne’s Australian Employment Covenant, will train up to 5,000 Indigenous people for guaranteed jobs
HEALTH
The Coalition will work collaboratively with State and Territory Governments, as well as the community health sector through existing national frameworks, to ensure that our efforts to close the Indigenous health gap achieve the real and lasting outcomes that all Australians expect.
Aboriginal and Torres Strait Islander Health continues to be an urgent priority for the Coalition. We have a long and proud record of improving Indigenous health outcomes and we remain fully committed to achieving health equality between Indigenous and non-Indigenous Australians within a generation.
Despite good intent and considerable investment by successive governments, there remains a significant disparity in health outcomes for Indigenous Australians as evident by key indicators such as life expectancy, age-standardised death rates and rates of chronic disease.
Continued investment in clinical health services for all Indigenous Australians will remain a priority for the Coalition. However, the Coalition is also determined to address the social determinants of health that will be key to improving Indigenous health outcomes.
The Coalition has provided in-principle support for Closing the Gap initiatives and will maintain the funding in the Budget allocated to Closing the Gap in Health. We have also committed to a range of initiatives to improve school attendance, employment opportunities and appropriate housing options in remote and Indigenous communities.
The Choice
The ANAO reports that in 2011 there were 210 Indigenous specific Australian Government programmes and sub-programmes included in its Closing the Gap activities, administered by more than 40 agencies across 17 separate portfolios, with the best estimate of expenditure totalling $4.2 billion in 2011-12.
Unfortunately, you do not have to look very closely at the Prime Minister’s recent report on Closing the Gap to conclude that Labor’s approach to Indigenous Affairs has not worked.
While a target for access to preschool programmes appears to have been met, there is no indication that Aboriginal children are availing themselves of these places. The life expectancy gap is stuck stubbornly where it was five years ago. There has been an improvement in the infant mortality rate, but the trend was established under the Howard Government as far back as 1998 and the decline in infant mortality has not accelerated under Labor. Despite all the expenditure on job programmes, unemployment remains unacceptably high. Tragically, a number of the education or NAPLAN indicators are going backwards.
Too many young Indigenous people in remote areas are not attending school and are not able to read or write at anywhere near an acceptable standard. Labor has clearly not done enough to address this.
Economic development on Aboriginal land and land tenure reform has stalled because the Labor Government has no appetite for changing the status quo. They abandoned the Indigenous Home Ownership on Indigenous Land programme because of their complete lack of progress on land tenure reform. Indigenous people in remote areas remain dependent on welfare, have no jobs, no property rights and are over run by bureaucrats; while Labor’s priority is the protection of vested interests.
They dropped the ball on the Northern Territory intervention and have replaced it with the self-serving bureaucratic Stronger Futures programme, leaving future generations condemned to a life on welfare.
The Coalition’s Policy
The failure to properly manage the expenditure of hundreds of millions of dollars for remote Indigenous housing under their Strategic Indigenous Housing and Infrastructure programme (SIHIP) is an absolute disgrace.
In the end, despite all the money Labor has spent, it will not have achieved its objective of reducing overcrowding in remote communities.
Labor’s failure to properly monitor and evaluate Indigenous programmes has led to chronic waste and lost opportunities, a prime example of this is the mismanagement of the Strategic Indigenous Housing and Infrastructure programme.
Resources meant to improve the lives of Indigenous Australians are being squandered on overlapping and inconsistent services and bloated bureaucracies that disempower local people and their communities.
The Labor Indigenous affairs landscape is littered with bureaucratic failure and incompetence. The ANAO found that the key Australian Government agency responsible for coordination arrangements for Indigenous programmes “is failing to adequately perform its lead agency role and needs to be more proactive at monitoring and reporting on expenditure.”
Labor has shown that it has not been prepared to apply the same standards and expectations for Indigenous Australians that it would apply to other Australians. Like Labor’s approach to housing, when they set targets and as usual fail to meet them they simply reduce the standard to be achieved.
The result of all this is that after more than six years and lots of money, Labor has not made sufficient inroads into Aboriginal welfare dependency, incarceration rates, overcrowding, poverty or school attendance and achievement.
The Coalition will continue the current level of funding expended on Closing the Gap activities, but will examine these costly programmes to make sure that they are directly working to meet the Closing the Gap targets.
We will take steps to ensure that the people who the programmes and services are intended to assist take advantage of those programmes and services. We would also make sure that programmes are targeted on the basis of need, not race alone, and are delivered in the most effective way possible.
Attending school is an absolute must. Opportunities for employment must be grasped. The Coalition will operate on the principle of offering a hand up rather than a hand out.
The Coalition will make sure that the same standards and the same expectations apply to Indigenous Australians as are applied to other Australians. Importantly, we would not attempt to deny local people the opportunity to solve their own problems.
The Coalition’s Policy for Indigenous Affairs will invest $94 million over the forward estimates in a better future for indigenous Australians
“No party has yet produced a comprehensive Indigenous health policy that would provide significant new funding and direction to build on the modest but welcome successes to date of the Closing the Gap strategy.
“The ideal health policy for this election would combine elements of each of the policies on offer from Labor, the Coalition and The Greens – topped with a ‘big bang’ Indigenous health policy and a well-articulated approach to dealing with the growing impact of chronic disease.
AMA President, Dr Steve Hambleton, (picture above left with NACCHO CEO Lisa Briggs, Chair Justin Mohamed and DoHA Department Secretary Jane Halton)
AMA PRESS RELEASE
AMA President, Dr Steve Hambleton, today urged the major parties to plug the gaps in their election health platforms before Saturday’s election.
Dr Hambleton said that there are lots of votes in positive, forward-looking health policies and there is still time for Mr Rudd and Mr Abbott to pitch more comprehensive health policies to the electorate.
“I set a health policy challenge at the National Press Club in July,” Dr Hambleton said.
“We currently have a new set of problems and challenges in meeting the health needs of the Australian community, and they require a new set of solutions – and that is the great task for the major parties.
“Any change must be tested against the reasons we need proper health reform – mainly our increasing burden of chronic disease and our ageing population.
“Proposals should be moving us toward a joined-up, strengthened primary health care system built on team-based solutions.
“The Labor emphasis to date in this campaign has been on hospital infrastructure, while the Coalition is concentrating on primary care, especially general practice.
“The Greens have focused on access to healthcare, public health and environmental health. They have a policy that supports the AMA proposal for an independent panel to assess the health of asylum seekers.
“No party has yet produced a comprehensive Indigenous health policy that would provide significant new funding and direction to build on the modest but welcome successes to date of the Closing the Gap strategy.
“The ideal health policy for this election would combine elements of each of the policies on offer from Labor, the Coalition and The Greens – topped with a ‘big bang’ Indigenous health policy and a well-articulated approach to dealing with the growing impact of chronic disease.
“We encourage the major parties to commit to practical and affordable policies that would improve public health, help the most vulnerable and disadvantaged in the community, and ensure a strong, highly skilled medical workforce to meet the future health needs of the community.
“The AMA released a Key Health Issues plan in July, which set out achievable policies that would deliver health service improvements at the front line, directly to patients.
“Some elements have been addressed, but many haven’t.
“We remind our political leaders of what they can do to bolster their health credentials in the final days of the campaign.”
Indigenous Health No significant new funding or direction to build on the modest but welcome successes to date of the Closing the Gap strategy.
Scrap the Cap The Government deferred its ill-considered cap on the tax deductibility of self-education expenses, but no party has yet been prepared to dump this policy, which is bad for education, productivity, and the economy, as well as the safety and quality of our health services.
Medical Training The AMA remains committed to working with the next Government to come up with a long-term policy that supports medical education and training.
Despite the major parties announcing additional intern places in the private sector, which were welcomed, no party has tackled the need to better coordinate the medical training pipeline or address the looming shortage of prevocational and specialist training positions as predicted by Health Workforce Australia.
There needs to be a concerted effort through COAG processes to commit to additional prevocational and specialist training places, including in general practice, with funding to match, in order to ensure that Australia can properly address future community health needs
Chronic Disease The major parties need to do more to tackle the impact of chronic disease so that we can keep people well and out of hospital. Current Medicare arrangements impose too much paperwork on GPs and limit access to services for patients with higher health care needs.
The major parties need to do more to support GPs in caring for these patients by streamlining current Medicare arrangements and by looking to adopt innovative approaches such as the Department of Veterans’ Affairs Coordinated Veterans Care program more broadly.
We note and welcome the proposed Australian Prevention Partnership Centre, launched today by Federal Minister for Health and Minister for Medical Research Tanya Plibersek, to research what works and what doesn’t in helping people make lifestyle changes to prevent chronic disease.
Rural Health Rural health has still missed out on the big funding boost it needs to address rural medical workforce shortages.
The AMA/RDAA Rural Rescue Package outlines the funding required to get more doctors into rural and remote Australia, with the right mix of skills to deliver services to these communities
Healthier Australian Families There has been no specific policy announcement from Labor or the Coalition on significant public health concerns around Better Environmental Health (effects of climate change, better standards for clean air, greater health monitoring of non-conventional gas mining projects), Preventing Harms of Alcohol (curbs on alcohol marketing to young people, minimum pricing for alcohol products), or Asylum Seeker Health (independent panel).
Dementia, Aged Care and Palliative Care We acknowledge and welcome recent policy announcements around palliative care and dementia, but they do not go to the key issue of access to medical care.
The major parties need to ensure that people with dementia, those who require palliative care, and older Australians with complex and multiple conditions can receive appropriate medical care. The major parties need to do more to ensure the Medicare arrangements are geared to deal with the increasing numbers of these patients and the need to better manage these patients in the community.
Better recognition of and support for the time that doctors spend assessing patients, organising services and providing support to the patient’s family and carers would ensure that quality dementia, palliative and medical care for the elderly is provided inappropriate settings. This would relieve the counterproductive use of acute services.
Affordable Medical Services Immediately restore indexation of MBS patient rebates. Reverse the decision to raise the Extended Medicare Safety Net threshold from 2015. Restore tax deductibility of out-of-pocket medical and health care gaps.
Authority Prescriptions While the major parties mention tackling red tape, no party has committed to reducing the time wasted by doctors having to telephone the Department of Human Services (DHS) to obtain an authority to write prescriptions for certain PBS medicines. Based on DHS information, up to 25,000 patient consultations are lost while doctors wait for their calls to DHS to be answered.
The National Congress of Australia’s First Peoples (Congress) has written to its 172 member organisations and almost 6500 individuals members, asking them to hold major political parties accountable for their policies and pledges regarding Aboriginal and Torres Strait Islander Peoples in the 2013 federal election.
An open letter by Co-Chairs Les Malezer and Kirstie Parker (pictured above top left) provides an overview of the policies and pronouncements both before and during the election campaign of the Australian Greens (Greens), Australian Labor Party (ALP), the Liberal Party of Australia and the Nationals (the Coalition).
Congress wrote to the parties in August asking for responses on key principles outlined in our document ‘Rights, Respect and Recognition: Congress’ Expectations of Australia’s Political Leadership’.
THE peak body representing Aborigines has criticised Tony Abbott for his lack of commitment to the organisation and failure to acknowledge the UN Declaration on the Rights of Indigenous Peoples, in an evaluation of the major parties that was sent to its members.
The National Congress of Australia’s First Peoples questioned the major parties on their commitment to advancing the interests of Aborigines.
It says the ALP supported the UN declaration in April 2009, and in 2010 gave moral and financial support for the establishment of the congress, but “regrettably the ALP has yet to address the declaration to any meaningful extent”.
The congress said it was not aware of the Coalition having made any official announcements on the UN declaration or the rights of first peoples.
“The Coalition has not expressed support for representation and decision-making,” it said.
It noted that the Opposition Leader had instead made commitments to manage indigenous affairs from the portfolio of prime minister and cabinet, and to establish an indigenous advisory council headed by Warren Mundine. Mr Abbott had also pledged to spend time in Aboriginal and Torres Strait Islander communities as prime minister and this promise extended to his ministers.
They say that the Coalition says it will change the Racial Discrimination Act 1975 to accede to freedom of speech and remove legal remedy to racial vilification.
“No party has yet committed to the proposed reforms of the Constitution that were recommended by the expert panel, particularly to the reform to prevent laws that are racially discriminatory.
“The ALP and the Coalition remain focused upon intervention in the Northern Territory through the Stronger Futures laws despite strong concerns identified by the Joint Parliamentary Committee on Human Rights over breaches of Australia’s international human rights obligations under the race convention.
“The ALP has reinstated the Racial Discrimination Act 1975 to apply to the Stronger Futures laws but congress considers that this is not a sufficient response to end discriminatory provisions”.
On closing the gap they say the Coalition supports the continuing strategy but “it is unclear whether the Coalition would maintain or extend existing programs”.
They write that the ALP has made some changes to the Native Title Act 1993 during the last two terms of government, but “arguably not in ways that improve the return of lands, territories and resources to ownership and management by the First Peoples”.
“In particular, the ALP has not reversed the onus of proof, as has been widely recommended. The Coalition has made no commitment to increasing ownership of lands, territories and resources but Warren Mundine, who would chair a Coalition Indigenous advisory council, has flagged changes to Aboriginal statutory bodies including land councils, regional councils, homeland councils, and corporations”.
“None of the major parties have provided detailed proposals to advance the land rights aspirations of the Aboriginal and Torres Strait Islander Peoples”.
They say the major parties are mostly silent on the cultural interests of the first peoples and offer no major policy developments or investments.
“By providing this overview to you, Congress does not seek to tell you how or whether to vote in the federal election. It is your decision. We hope that the information that we have provided adds to your understanding of the political landscape and gives you ideas as to how to influence the Parliament of Australia to respect the rights of Aboriginal and Torres Strait Islander Peoples”.
CONGRESS PRESS RELEASE
5 key questions to political leaders
1.How will you work with Congress to ensure our legitimate role as a national representative body for Aboriginal and Torres Strait Islander people is respected?
2.What measures will you take to ensure the rights and purposes set out in the
3.How will you support Aboriginal and Torres Strait Islander Peoples to achieve self-determination?
4.What support will you provide Congress to fully participate in the development, implementation and monitoring of government laws, policies and programs, including through COAG?
5.What steps will you take to ensure that policies and strategies that affect us have the agreement of Aboriginal and Torres Strait Islander Peoples
“We are not telling people how to vote or whether to vote in the federal election, and we have not endorsed any political party over another,” said Co-Chair Parker.
“Rather, Congress has provided our members with information to help them ask key questions of their local candidates in the federal election, draw their own conclusions about policies, and cast an informed vote on Saturday.
“Congress’ role is to promote and protect the identity and rights of the First Peoples, and this includes informing Aboriginal and Torres Strait Islander Peoples of election promises by the next Australian Government.
“We are pleased the major parties remain committed to achieving equality through ‘Closing the Gap’ strategies,” said Ms Parker.
“We applaud this approach to set targets and to measure performances.
“The parties accept close scrutiny and accountability against housing, education, employment and health goals, and Congress notes that the ALP and the Greens now also accept our proposal to incorporate justice targets in the strategies.
“But achieving equality in social indicators is only one of six priority areas.”
Co-Chair Malezer said the most important objective, from the view of Congress, is the commitment to implement in Australia the United Nations Declaration on the Rights of Indigenous Peoples.
“The Declaration upholds our right to self-determination and embodies the framework for development of Indigenous Peoples through community-based decision-making.
“Self-determination is essential, and our history in Australia proves centralised and unrepresentative government in Canberra cannot succeed, no matter how many advisors exist.
“Congress remains concerned that Aboriginal and Torres Strait Islander Peoples are still harmed through racism at the individual and institutional levels.
“Constitutional reform to prohibit racism is recommended by Congress but the parties remain vague on the details for Constitutional reform.
“It is important that Congress members and our supporters are well informed and motivated about the important Aboriginal and Torres Strait Islander policies of the next Australian government.
“We believe the performances during this election period are not up to the standard we deserve and should expect in this land,” said Mr Malezer.
The five questions are contained in the document: ‘Rights, Respect and Recognition: Congress’ Expectations of Australia’s Political Leadership’ and can be downloaded from nationalcongress.com.au
This time next week Tony Abbott could be the PM and Peter Dutton Health Minister but:
Closing the health gap between Indigenous and non-Indigenous Australians should be one of the highest priorities for government. Yet Indigenous health has barely been mentioned by either major party during this campaign.
NACCHO chairman Justin Mohamed says the only thing missing is political attention, with indigenous health hardly mentioned so far in the federal election campaign. At the National Press Club Health debate last week Peter Dutton announced that Tony Abbott would be making an announcement before Saturday about Aboriginal health but so far nothing.
“I think to be honest both parties at different times do talk about Aboriginal community control, do talk about Aboriginal health, but I think what we’re seeing in the election process at the moment is that I would like to see more of the parties to let us know what their platform is or what their thoughts are around Aboriginal health, not just health in general.”
Mr Mohamed argues that Aboriginal community-controlled health bodies have proven their expertise and efficiency, and whoever wins government on September 7 must show greater faith in the sector.
Press release from Australian Healthcare Reform Alliance (AHCRA).
Health care is one of the most important issues to voters at this election but the policies of both major parties fail to deliver on key measures, according to the Australian Healthcare Reform Alliance (AHCRA). “Whilst there are some valuable initiatives from both sides, they fail to add up to a genuine effort to address the scale of the current health system problems.
There is insufficient action to address serious inequities in health and health care or longer term problems – they have taken their eye of the ball,” said Tony McBride, AHCRA chair.
“Closing the health gap between Indigenous and non-Indigenous Australians should be one of the highest priorities for government. Yet Indigenous health has barely been mentioned by either major party during this campaign.
“The current Labor Government has introduced some promising reforms, such as Medicare Locals and national funding of children’s dental services and more public adult services, a move that will address inequities. AHCRA therefore welcomes the Coalition’s broad support for these positive reforms, but is very concerned that there are too few details of how they will be progressed if they win power.
“Another major threat to our health system is the increasingly high co-payments faced by people when accessing care. Unless co-payments are addressed, they will continue to be a severe barrier that undermines the equity and universality of health programs such as Medicare and reverses any gains made by the reform process.
“Most importantly, neither major party has their eyes on the future and on how the looming health funding crisis in the next decade can be avoided as health care costs escalate. Neither party has a robust plan to keep people well and out of hospital by supporting prevention, by seriously addressing the social determinants of health that cause so much ill-health or by effectively managing chronic disease in the community. Without such action, the pressure on hospitals will simply grow to unaffordable levels and society as a whole and health care will become increasingly inequitable.
AHCRA welcomes Labor’s commitments to mental health, medical research, and better stroke care. But overall its initiatives and vision are far too modest.
AHCRA welcomes the Coalition’s significant investment in support for general practice teaching and the 500 additional nursing and allied health scholarships for students and health professionals in areas of need. AHCRA also supports the Coalition’s more detailed plans for mental health research and other initiatives to improve care, especially for young people. However it is concerned about the
Coalition’s plans to hand back hospitals to local rather than regional boards which will not serve consumers’ needs for a highly integrated system unless there is a universal commitment to consumer-centred care. Additionally the plan to restore the private health insurance rebate to the wealthiest Australians makes no financial or health policy sense given the take up of private health insurance has actually increased since the rebate was cut.
AHCRA strongly supports the Greens’ universal dental plan but disappointingly even they do not place health among their top ten policies.
Mr McBride called on both major parties to “address the holes in your health policies before the 7th September and commit to building on the early gains of the reform agenda. Deliver a world class health system for Australia’s future that is effective and financially sustainable by addressing equity and focussing much more on prevention and primary health care” he concluded.
“Both major parties say they are committed to Aboriginal health care – the NGO’s major activity – but until the dollar numbers are made public, there’s a question mark over the size of their commitment.
There are something like 15 health providers. This is ridiculous. We need to be working in partnership. I don’t give a hoot who gets the kudos out of that, as long as the outcomes for our clients is better.” Des Rogers
Des Rogers pictured above left with Dr Mark Wenitong and Kevin from Jimmy Little Foundation making recommendations at a recent Male health summit.
The wish list of the Central Australian Aboriginal Congress, for whomever will gain power in Canberra, contains not what it wants to get, but what it doesn’t want taken away.
In a swirl of rumored spending cuts, where will the money come from to drive the NGO’s newly chosen direction?
It is 40 years old, has a budget of $38m a year, for both town and “auspiced” services. More than 70% comes from the Feds. Congress has 300 employees, half of them Aboriginal. It has a new chairman (William Tilmouth), a new CEO (Donna Ah Chee) and a new Deputy CEO
The NGO has emerged from the bunker where the previous regime resided, until it got its marching orders after a string of scandals and a Federal review.
Both major parties say they are committed to Aboriginal health care – the NGO’s major activity – but until the dollar numbers are made public, there’s a question mark over the size of their commitment.
Congress now wants to go further, earning back a place in town it occupied decades ago, not only as the voice of Aboriginal people, but engaging with the broad community and economy.
On the health scene, care for children from conception to age four is a key part of the main mission, in tandem with an attack on domestic violence where the facts are horrendous, mostly “Aboriginal male violence on Aboriginal women,” says Mr Rogers.
“You only need to go to the hospital emergency department, or sit in the mall, and you’ll see young and old Aboriginal women who are bruised, battered and in some cases disabled because of violence.
“Because of customs, kinship and cultural law, particularly Aboriginal women on a community attract violence. They either end up dead or they walk into the desert and end up dead. We’ve got to do something about that.
“There are plenty of Aboriginal men who would love to stand up for Aboriginal women but they don’t get the opportunity.”
Mr Rogers quotes some figures from the Justice Department: mothers of NT children are 48 times more likely to be admitted to hospital for reasons of assault than all Australian women.
In 2009/10, more than 840 Aboriginal women had assault-related admissions to hospital in the NT, compared with 27 “other” women. In the year ending June 2012, the rate of “assault offences” recorded in Alice Springs was nearly six per 100 people (almost double the NT average). 68% of domestic violence is alcohol related. The rate of domestic violence assaults is 98% greater than the NT average.
Aboriginal women in the NT are 80 times more likely than other Australian women to be hospitalised as a result of assault.
But the news is not all bad, says Mr Rogers: “In the NT, in terms of Aboriginal health improvement, there has been a 30% decline in the all-cause mortality rate over the last decade or so, and we want to build on what is working, and not throw the baby out with the bathwater.”
Congress has a major clinic, open seven days a week; a male health unit, family partnership program, birthing centre and other programs. It has spread beyond the town limits, “auspicing” five bush clinics at Amoonguna, Santa Theresa, Areyonga, Hermannsburg and Mutitjulu.
Congress is seeking Aboriginal Benefits Account money for a truck carrying three small offices on the back for doctors, paramedics or social workers, which will do the rounds of communities, spending several weeks in each one, as long as it takes, finding out from the locals what their issues and concerns are.
“It could be alcohol, suicide, violence,” says Mr Rogers. “We’ll let the community come to us, encourage them through activities, kids, women, fellas.
“Then we would encourage other agencies which have the expertise to come out and talk to the community. It’s grassroots stuff. You might say it’s an Aboriginal problem. In fact it affects all of us, the town, the economy.”
Mr Rogers, currently on three months’ probation but willing to serve Congress for five years, says he has never been on the dole, has run a produce business for 13 years, “trained, employed and mentored more than 200 Aboriginal people” most of whom “went on to bigger and better things”.
He says some of his employees left because they didn’t like the hours – 4am starts: “On the Mondays, during footy season, I employed backpackers,” he says. “You needed to be flexible as an employer.”
He was briefly a town council alderman, and the Labor Party candidate last year in the NT seat of Namatjira. He’s had a hand in several other businesses, including hospitality and security services.
NEWS: What about self-help to end the blight of welfare dependency? Drinking, not taking children to school, not feeding them properly – isn’t all of this up to the individual, or the community?
ROGERS: Yes and no. The main problem with Aboriginal children is neglect. It’s not deliberate neglect. It’s partly because young mothers and families don’t know how to look after young people, it is partly due to addictions and other mental health conditions and it is partly due to the often very adverse social environment that parents are trying to raise their children in. It is also a lack of knowledge caused by low levels of education.
A couple of my daughters are foster carers. Young babies, one or two years old, they certainly know what a straw is but you try to bottle feed them and they have never been bottle fed.
NEWS: How can that be changed?
ROGERS: It’s about education. We can blame us mob for everything – we drink and we fight and we argue, we smell and we’re untidy, we don’t want to be part of society. My view has been for a long time that it’s the system that has created that.
If you sit under that tree over there, regardless of what colour you are, and all the service providers come to you – as hard as it is to comprehend – you accept that as normal behaviour. And the media perpetuate that.
I’ve had a fortunate life, in a sense. I was sent to school down south, to Gawler, north of Adelaide. They were establishing Elizabeth at that time, for “ten pound Poms”. You go back there today, and you see four generations of welfare recipients. And I would strongly suggest that if you went to any major city in this country, you would find suburbs with welfare recipients.
The media is quite quick to point the finger of blame at the blackfellas, look how lazy they are, ripping off the welfare system. But the system has created that, nationally.
NEWS: Isn’t this the litany we’ve heard for decades? Should the dole be withdrawn for people not reasonably accepting employment offered?
ROGERS: It’s hard when your mum and dad have never worked, your grandparents have never worked. As a welfare recipient – going back to Elizabeth, you learn to manipulate the system.
But the days of sitting on your bum and having all the services come to you are over. We’re not going to come and wake you up in the morning. But we can demonstrate we are a good employer, we have a good process in place, you show potential and we’ll mentor you into senior positions. I think that’s a great outcome.
NEWS: Could that be exported to other companies?
ROGERS: Yes, it can.
NEWS: Is such a process under way? Are you in touch with the Chamber of Commerce, for example?
ROGERS: I must say, no.
NEWS: This is the number one question today: How do you put an end to passive welfare, the issue often spoken of by Noel Pearson?
ROGERS: Sitting under that tree – if you start to withdraw some of those services, for example, the doctor and nurses, then I’ll have to get off my bum and go and see them.
What that does is instil a bit of responsibility. And I think that’s what we have to do, change the system, change the mentality. The Toyota dreaming – whitefellas coming in and out every day, yet making very little difference.
NEWS: How do you translate that into reality?
ROGERS: In this organisation, through the cross-cultural awareness program for staff.
NEWS: But these are people who have a job. What about the recipients of Congress services, how can they be motivated to help themselves?
ROGERS: Pre-birth to four, these are the formative years in terms of the development of responsibility and initiative, no matter what colour you are. We’ve got a number of generations out there who, to be honest, are a bit of a lost cause. And I’m not saying we should forget about them.
Congress does a whole bunch of stuff but we can drill it down to basically three things: we look after the elderly, we try to help the sick, and the other thing we do is preventative care. And it’s that which in the next couple of generations will make the difference. Give people a healthy upbringing then they can make choices.
NEWS: How grave is your fear that funding cuts will affect Congress work?
ROGERS: Taxation revenue is now less than 22% of GDP which is almost the lowest in the OECD and both sides want to reduce taxes further although the Coalition is planning bigger cuts than the ALP in this regard. Where is the money going to come from?
NEWS: Can the funding be streamlined?
ROGERS: There are something like 15 health providers. This is ridiculous. We need to be working in partnership. I don’t give a hoot who gets the kudos out of that, as long as the outcomes for our clients is better.
We are adopting the “collective impact” model, promoted here by Desert Knowledge here but in use world-wide now. It is about everyone working together. Here in Alice Springs, perhaps because of the funding models, we’ve had everyone working in parallel, especially Aboriginal organisations, diving into the same bucket, trying to get hold of the same money, being possessive about that as well, but serving the same clients.
That’s changing. For example, the Department of Families, Housing, Community Services and Indigenous Affairs is changing their funding model from something like 100 different funding contracts down to six. That alone is fantastic. Congress is currently dealing with some 160 projects with a string of agencies, this will cut down on a mountain of paperwork.
NEWS: Are there too many NGOs?
ROGERS: It’s up to the government. It’s a question of compliance. Are NGOs actually spending the money they get appropriately and effectively?
NEWS: How do they decide what’s working and what’s not?
ROGERS: We have an open book policy with our funding providers, and I think that needs to occur. If we get money for a specific program and we see it’s not working, we want to have the ability to say to the funding agency, we think you need to change the parameters, because we can get better results by doing it this way.
Congress is very good at presenting evidence data, we can back our outcomes or outputs with evidence. There are problems when funding agencies allow their money to be spent willy nilly. The Office for Aboriginal and Torres Strait Islander Health, which is part of the Commonwealth Department of Health and Ageing, have been very good with us. We have built a very good, honest, open relationship with them.
NEWS: What are the job opportunities right now? There used to be a cattle industry on what is now Aboriginal land, there are wild horses, camels, lots of land, idle labour and enough water. Road trains are going empty one way and could provide cheap transport of produce to markets. Should Congress develop some of these opportunities? Congress is picking up where people are already damaged. Is there not a case for that damage to be prevented?
ROGERS: Primary production has been tried here in the past but it has failed because it is a foreign industry, so to speak. We are hunters and gatherers. Where do you start? Is it housing, is it education? I’ve had a long time to think about this, and I think it starts from a health perspective. If you are a healthy child, regardless of your race, the other things will come.
NEWS: Could primary health care not include having a purpose in life, a job?
ROGERS: We are the largest primary health care provider in the NT but we’re not going to be able to fix all the problems.
NEWS: What changes is Congress making to its structure?
ROGERS: We now require people with tertiary qualifications to be in the top positions, not appointing Aboriginal people into management positions, irrespective of qualification, as a report 20 years ago recommended.
Unfortunately, that set some Aboriginal people up to fail. We are mentoring Aboriginal people into management roles. This is big business, and needs to be treated like big business.
IMAGES from the Congress annual report 2010-11, as published on the World Wide Web.
The health services were also inspired by the US civil rights movement. The health of Aborigines today is among the worst on Earth, but there’s broad consensus it would be far worse were it not run by Aboriginal people.
But if Aboriginal control of Aboriginal lives can work in health and in NSW land rights, why hasn’t it been allowed to work in all other aspects of our lives?
From Sol Bellear is the chairman of the Aboriginal Medical Service Redfern
I also have a dream. A lot of people my age remember where they were when man landed on the moon. As a lifelong Aboriginal activist, I prefer to remember where I was when Martin Luther King delivered his iconic ”I have a dream” speech.
That was our moon landing, a feat, until then, considered impossible – the rallying of people of colour around the globe to stand up against inequality and injustice.
This week was the 50th anniversary of King’s speech. When he delivered it, I was a young man in school at Mullumbimby on the NSW far north coast. Our teachers discussed the speech the next day in class but, in a place like Mullumbimby, it was hard to grasp the importance of the occasion.
It wasn’t until I came to Sydney in the late ’60s to attend a memorial service marking King’s assassination that the enormity of what King had said, and what it represented, finally dawned on me. King, Malcolm X and other great black leaders had challenged and dismantled much of the apartheid state in the US, and the March on Washington was part of a growing push to see civil rights legislation enacted there.
Much of the focus was on jobs and the right of African Americans to get access to the real economy.
Of course, discrimination remains very much alive and well in the US today, but the gains of African Americans can’t be denied. But sadly, as we mark the 50th anniversary, the truth of that era and the Aboriginal struggle also dawns on me.
Yes, King’s speech inspired my people. And yes, King’s speech shone an international light on the appalling treatment of Aboriginal Australians. But while King was arguing for basic civil rights, in Australia we were still fighting for basic human rights, a fight that continues today.
”I have a dream” was delivered in 1963, when Aborigines were still classed as ”flora and fauna”. It would take another half a decade before our nation voted to count Aborigines in the census, and afford us citizen status.
But the great promise that the referendum held forth – justice and equality before the law – has never fully materialised.
I’m not suggesting there haven’t been some gains in Australia. The activism of the 1970s and ’80s, strengthened by the determination of men such as King and women such as Rosa Parks, brought us modest land rights.
In NSW, there exists a land rights system that costs the taxpayer nothing, and which is leading economic development in many metropolitan and regional Aboriginal communities. The NSW system is not perfect – indeed it has returned to Aboriginal people less than one-tenth of 1 per cent of the total NSW land mass – but, according to the United Nations Special Rapporteur on the Rights of Indigenous Peoples James Anaya, it is the best land rights legislation on Earth.
The 1970s also saw the creation of Aboriginal Medical Services, community-controlled groups that resulted in Aboriginal people solving Aboriginal problems.
The health services were also inspired by the US civil rights movement. The health of Aborigines today is among the worst on Earth, but there’s broad consensus it would be far worse were it not run by Aboriginal people.
But if Aboriginal control of Aboriginal lives can work in health and in NSW land rights, why hasn’t it been allowed to work in all other aspects of our lives?
Why, 50 years after King’s speech, does the most basic human right – self-determination – still elude my people? Why, today, do we seem further away from this dream than ever before?
Opposition Leader Tony Abbott recently promised to appoint a national indigenous council if he is elected to office. Hand-picking our leaders to get the advice you want to hear didn’t work in the 1960s, ’70s, ’80s, ’90s and 2000s. It won’t work now. It’s as far from self-determination as you can get.
And why is the other most basic of human rights – justice – still denied Aboriginal people?
Mr Abbott is promising compensation for Australian victims of global terrorism, including legislation to compensate for victims of the 2002 Bali bombing.
”When people suffer because of the fact they are Australian, a decent nation should offer some acknowledgment, some recognition,” Mr Abbott said.
I agree, and I applaud the promise. But I also look forward to Mr Abbott extending that same fine principle to my people, who suffered because they were Aboriginal Australians.
Prime Minister Kevin Rudd launched himself onto the international human rights stage with the national apology to victims of the stolen generations. Mr Abbott, if elected, can actually make it meaningful by delivering reparations – a basic human right – denied those people.
If, 50 years after King’s speech, either of the two main parties really want to engage with Australia’s first people on a basis of equality and respect, they’ll find us ready, willing and able. Aboriginal people have always had the solutions to Aboriginal problems.
Martin Luther King dreamed of a day when his people would be judged not on the colour of their skin, but on the content of their character.
Fifty years on, I dream of a day when Australians will face up honestly to the failures of their past, regardless of the kindness of their intent. I dream of a day when non-Aboriginal Australians demand not a dream about a future for my people, but a simple plan to restore our basic human rights.
Most of all, I dream of the day when Aboriginal Australians will be judged not on the colour of our skin, but on the strength of our self-determination.
Sol Bellear is the chairman of the Aboriginal Medical Service
Call for incoming government to commit to Close the Gap
A renewed COAG National Partnership Agreement on Closing the Gap and action on the National Aboriginal and Torres Strait Islander Health Plan should be key priorities for the next government, according to an incoming government brief prepared by the Close the Gap Steering Committee.
Picture above Tanya Plibersek and Peter Dutton National Press Club Health Debate
The briefing paper, to be released today, outlines the key steps needed in the next parliament to ensure progress on closing the life expectancy gap between Aboriginal and Torres Strait Islander and other Australians.
The paper says that within its first hundred days, a new government should:
Reaffirm the commitment for the Prime Minister to annually report at the beginning of Parliament on progress towards closing the gap;
Secure a new COAG National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes, with a minimum Commonwealth investment of $777 million over the next three years; and
Begin the implementation of the National Aboriginal and Torres Strait Islander Health Plan in partnership with Aboriginal and Torres Strait Islander people and their representatives.
Campaign spokesperson and Chair of National Aboriginal Community Controlled Health Organisation, Justin Mohamed said that closing the gap is literally a life or death issue for Aboriginal and Torres Strait Islander people.
TEAM NACCHO at the NATIONAL PRESS CLUB Health Debate
“We’re only at the beginning of the journey to close the gap in life expectancy by 2030. We can’t turn back now because closing the gap needs long-term commitment and policy continuity. Aboriginal and Torres Strait Islander health in our hands is having an impact and we must keep supporting our people to deliver their own health outcomes,” Mr Mohamed said.
AMA President, Dr Steve Hambleton said that both Kevin Rudd and Tony Abbott have been strong supporters of Close the Gap.
AMA President, Dr Steve Hambleton with Department of Health Secretary Jane Halton .NACCHO’S Lisa Briggs and Justin Mohamed
He said that Tony Abbott gave the campaign strong encouragement in its early days when he was Health Minister and Kevin Rudd committed to the targets and deadlines we proposed and secured the first National Partnership Agreement through COAG.
“It’s important that momentum towards closing the gap is maintained regardless of who wins the election. Closing the gap is a generational effort and we are beginning to see signs of progress,” Dr Hambleton said.
Lowitja Institute Chair, Pat Anderson said the Close the Gap Steering Committee welcomed the attention given to Aboriginal and Torres Strait Islander education and employment in the election campaign.
“Along with racism, education and employment are key social determinants of health. But action on these needs to proceed at the same time as action on health because kids can’t study and parents can’t hold down a job if they have poor health,” Ms Anderson said.
The Close the Gap Campaign was launched by Olympians Catherine Freeman and Ian Thorpe in April 2007. Since then almost 200,000 Australians have signed up to the campaign, which has also received multi party support by all Federal, State and Territory Governments.
