” The pandemic should not be used by governments as a reason to delay the new agreement on closing the gap targets, a coalition of more than 50 Aboriginal peak organisations has warned ahead of the next scheduled meeting in June.
The Coalition of Peaks said the “quick and decisive” efforts of Aboriginal and Torres Strait Islander health organisations has kept Covid-19 from devastating communities so far, and shows that strong partnerships with governments make a big difference to Aboriginal health and safety.
But the virus has exposed the inequality between Indigenous and non-Indigenous people on many fronts, the lead convenor of the Coalition of Peaks, Pat Turner, said.
“Covid-19 is a pathogen, but it is also a diagnostic test being run on Australia – and the results are not good,” Turner said. “
Indigenous organisations say their success with Covid-19 shows strong partnerships with governments make a big difference
While Australians over 65 are considered at high risk of suffering the worst effects of Covid-19, in Aboriginal communities, where there is a higher chronic disease burden, anyone over 50 is considered vulnerable.
“Covid-19 doesn’t discriminate so the gap in potential outcomes is a result of the structural inequity that exists in Australia,” Turner said.
“It is not natural occurrence but the direct result of years of neglect, disinvestment and failed policies, developed without our input.”
In March last year, Australian governments signed a historic partnership agreement with the Coalition of Peaks on closing the gap. They have since developed four reform priorities that are yet to be formally adopted.
“This pandemic has shown just how important those reforms are,” Turner said.
The reforms are to have greater Aboriginal involvement in decision making and service delivery at a national, regional and local level. There is also a commitment to making sure government agencies and institutions undertake systemic and structural transformation, and strengthening community-controlled organisations to deliver the services Aboriginal people need.
Scott Morrison has already committed $1.5m for the fourth priority – a data project to support evidence-based policy and decision making by Indigenous communities.
“Our organisations and communities are best placed to respond to this crisis and yet are the same organisations and communities that have borne the brunt of repeated funding cuts and a rollercoaster of policy and administration changes,” she said.
Turner also said the absence of an Aboriginal and Torres Strait Islander national body or voice to parliament, bringing its collective expertise to respond to Covid-19, was “stark” in its absence.
“People have labelled Covid-19 as some sort of great equaliser but, in reality, its impact is not shared equally,” she said.
“The truth is that there can be no equality until we work together to dismantle structural inequity. Collective will is the only real equaliser.”
“ These Closing the Gap reports tell the same story of failure every year
The danger of this seemingly endless cycle of failure is that it breeds complacency and cynicism, while excusing those in power.
People begin to believe that meaningful progress is impossible and there is nothing governments can do to improve the lives of our people.
The truth is that the existing Closing the Gap framework was doomed to fail when it was designed without the input of Aboriginal and Torres Strait Islander people. We know what will work best for our communities and the Prime Minister even acknowledges in this report that our voice was the missing ingredient from original framework.
The Coalition of Peaks has signed a formal partnership agreement with every Australian government, where decision-making on design, implementation and evaluation of a new Closing the Gap framework will be shared. Through this partnership, the Coalition of Peaks has put forward structural priority reforms to the way governments work with and deliver services to Aboriginal and Torres Strait Islander people.
Governments say they are listening to Aboriginal and Torres Strait Islander people. However, the true test in listening is translating the priority reforms into real, tangible and funded actions that make a difference to Aboriginal and Torres Strait Islander people right across our country.
This historic partnership could be the circuit-breaker that is needed. However, if they view this process as little more than window dressing for the status quo, the cycle of failure evident in today’s report is doomed to continue.”
Pat Turner, CEO of NACCHO and Co-Chair of the Joint Council on Closing the Gap, said that governments need to learn from these failures, not continue to repeat them.
“Every year for the last 12 years we have listened to a disappointing litany of failure – it’s not good enough, Indigenous Australians deserve better.
We are heartened by the developments last year with COAG and the Prime Minister agreeing to a formal partnership with the Coalition of Peaks on the Closing the Gap strategy.
Indigenous involvement and participation is vital – when our peoples are included in the design and delivery of services that impact their lives, the outcomes are far better.
However, now that partnership is in place, Australian governments must commit to urgent funding of Indigenous healthcare and systemic reform.
Preventable diseases continue to take young lives while unrelenting deaths in custody and suicide rates twice that of other Australians continue to shame us all.
As governments reshape the Closing the Gap strategy, we cannot afford for the mistakes of the past to be repeated. “
Close the Gap Campaign co-Chairs, Aboriginal and Torres Strait Islander Social Justice Commissioner June Oscar AO and National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA) CEO Karl Briscoe, have called on the government to invest urgently in health equity for Aboriginal and Torres Strait Islander peoples
Download full Close the Gap campaign press release HERE
” There was one glaring omission from the Prime Minister’s Closing the Gap speech this week. Housing did not rate a mention. Not a word about action on Aboriginal housing or homelessness.
Housing was not even one of the targets, let alone one we were meeting, but it must be if we are to have any chance of finally closing the gap between Indigenous and non-Indigenous Australians on all the other targets for life expectancy, child mortality, education and jobs.
Aboriginal and Torres Strait Islander people make up 3 per cent of Australia’s population but 20 per cent of the nation’s homeless. Aboriginal people are 2.3 times more likely to experience rental stress and seven times more likely to live in over-crowded conditions than other Australians.”
“For the first time ever, there is a commitment from all Australian governments, through COAG, to work with Aboriginal leaders through the peak bodies of Aboriginal organisations to negotiate key strategies and headline indicators that will make a difference.
So long as the negotiations continue in good faith and we stay the course together this should lead to a greater rate of improvement in coming years. Of this I am sure.
There is a commitment to supporting Aboriginal people by giving priority to our own community controlled organisations to deliver the services and programs that will make a difference in our communities while at the same time ensuring mainstream services better meet our needs”
Donna Ah Chee, Chief Executive Officer of the Central Australian Aboriginal Congress : Read full Report Part 1 below.
“Today is another day we reflect on the Federal Government’s inability to meet the Closing the Gap targets.
This report clearly shows that the gap will continue to widen if reforms aren’t translated into tangible, fully funded actions that deliver real benefits to Aboriginal and Torres Strait Islander people throughout the country.
The report reveals that progress against the majority of Closing the Gap targets is still not on track. The gap in mortality rates between Aboriginal and Torres Strait Islander people and non-Indigenous
Australians increased last year and there are very worrying signs on infant mortality.
The Federal Government needs to commit to funding solutions to end over-imprisonment of Aboriginal and Torres Strait Islander people and they must be implemented alongside other areas of disadvantage in the Closing the Gap strategy – health, education, family violence, employment, housing – in order to create real change for future generations.”
Cheryl Axleby, Co-Chair of NATSILS.
“We are deeply concerned about the Federal Government’s decision to not continue funding for remote Indigenous housing. Access to safe and affordable housing is essential to Closing the Gap,”
” SARRAH welcomes the bipartisan approach by Parliamentarians who committed to work genuinely and collaboratively with Aboriginal and Torres Strait Islander leaders.
The potential contribution of Aboriginal and Torres Strait Islander Australians is far greater than has been acknowledged or supported to date.
There are many organisations working hard to close the gap, such as Aboriginal community controlled health organisations right across Australia, and Indigenous Allied Health Australia, the national Aboriginal and Torres Strait Islander peak allied health body.
Governments, through COAG, working with the Aboriginal and Torres Strait Islander Coalition of Peaks have the opportunity to reset the trajectory.”
“ Many of our communities are affected by a range of adverse experiences from poverty, through to violence, drug and alcohol issues and homelessness.
Without an opportunity to heal from the resultant trauma, its impact can deeply affect children’s brain development causing life-long challenges to the way they function in the world.
It is experienced within our families and communities and from one generation to the next.
We need urgent action to support better outcomes and opportunities for our children.”
“Mr Morrison will keep failing First Nations peoples and this country until a genuine commitment to self-determination is at the heart of closing the gap.
The Prime Minister’s same old “welfare” rhetoric indicates that the Government really hasn’t got it. While they say they are committed to the COAG co-design process the PM ignores the point that it is his Government continuing to drive discriminatory programs such as the Cashless Debit Card, the CDP program, ParentsNext and who are failing to address the important social determinants of health and wellbeing.
There are a few things this Government needs to do before they just “get people into jobs”, like invest in the social determinants of health and wellbeing and a housing first approach.”
Australian Greens spokesperson on First Nations peoples issues Senator Rachel Siewert
” Australia’s efforts to close the gap are seemingly stuck in a holding pattern.
Though Prime Minister Scott Morrison has hailed the beginning of a ‘new era’ of improving the health and life expectancy of Aboriginal and Torres Strait Islander people in the launch of the 12th Closing the Gap report, the results are all but unchanged.”
Part 1 : Donna Ah Chee, Chief Executive Officer of the Central Australian Aboriginal Congress
Continued
“It’s also important to recognise that there has been progress here in Central Australia both over the longer term and more recently. Since 1973, the number of Aboriginal babies dying in their first year of life has reduced from 250 to 10 per 1000 babies born, and life expectancy has improved on average around 13 years.
As recently as 2019 we have seen significant improvements across multiple areas.
“Alice Springs has experienced a remarkable 40% reduction in alcohol related assaults and a 33% reduction in domestic violence assaults. This is 739 fewer assaults year on year, or 14 fewer assaults per week”.
“There has been a 33% reduction in alcohol related emergency department presentation which is 1617 fewer presentations year on year or a reduction of 31 per week. Corresponding with this, there has been a decline in hospital admissions and, as noted in the MJA recently, ICU admissions. These are dramatic improvements,” she said.
“The proportion of babies born of low birth weight has halved and the rates of childhood anaemia and anaemia in pregnancy have declined markedly.”
“In addition to this the number of young people who reoffend and therefore recycle through youth detention has dropped dramatically.”
“Combining all of these factors, we are closing the gap on early childhood disadvantage and trauma and this will make a big difference in coming years in other health and social outcomes.”
There are however, still many issues to be addressed, especially with the current generation of young people, as too many have already experienced the impacts of domestic violence, trauma and alcohol and other drugs. Unfortunately, this has led to the youth issues experienced now in Alice Springs.
The NT government recently advised Congress that they are implementing strategies that are aimed at making an immediate difference while at the same time we know key strategies that will make a longer-term difference are already in place. New immediate strategies include:
14 additional police undertaking foot patrols and bike patrols in the CBD
Police now taking young people home where it is safe to do so, rather than telling them to go home themselves
The employment of two senior Aboriginal community police officers from remote communities and the recruitment of three others in town and two at Yuendumu
The flexible deployment of the YOREOs to meet peaks in the numbers of young people out at different hours of the night
The much more active deployment of the truancy officers to ensure all young people are going to school.
Access to emergency accommodation options for young people at night
While progress overall is slower than it should be, it is important to acknowledge the successes we are having because of the good work of many dedicated community organisations and government agencies working together in a supportive environment, where governments are adopting evidence based policies.
” In March 2019, I entered into the Partnership Agreement on Closing the Gap, a landmark agreement to work together to develop the new Closing the Gap framework
For the first time, we have constructed something that sits at the very centre of government and demonstrates a strong commitment to Indigenous Australians having a real say.
That’s what was missing from the original Closing the Gap framework.
As we turn the last page on that framework, we take the evidence of the last twelve years and provide the final results. These results are not what we had hoped for, and it’s important to acknowledge them.
But it’s also important to celebrate the stories and successes that lie beyond the targets. On almost every measure, there has been progress.
I look forward to honouring our commitment to partnership. I want to make sure Indigenous Australians are genuinely positioned to make informed choices, forge their own pathways and reach their goals.
I want to make sure all governments renew our efforts to help close the gap.
We can all play a part.
Together we can all improve the lives of Aboriginal and Torres Strait Islander people in this generation and the next. “
Selected extracts from Prime Minister Scott Morrison’s forword to the Closing the Gap report
“Never have Aboriginal and Torres Strait Islander peak bodies from across the country come together in this way, to bring their collective expertise, experiences, and deep understanding of the needs of our people to the task of closing the gap.
We have an unprecedented opportunity to change the lived experience of too many of our people who are doing it tough.
It is hard not to get overwhelmed by the lack of progress ( 2020 CTG Report ) , a widening gap in life expectancy, soaring rates of incarceration, with our people dying in custody
I’m hopeful the renewed policy will be a “circuit breaker”.
There is “goodwill” and “desire for change”, and the new Closing the Gap targets could be signed off by June.
We’re aiming for a maximum of 15 targets [and] all the targets should be national.
[There will be] new ones like justice, for example … and for the first time there will be actual Aboriginal involvement in designing this process.”
Ms Pat Turner AM, CEO of the National Aboriginal Community Controlled Health Organisation and co-chairing a project to refresh the Closing the Gap framework.
“This demonstrates the need to adopt a new approach to Closing the Gap.
Key to this is shared accountability and shared responsibility – governments, Indigenous Australians and their communities and organisations.”
Minister for Indigenous Australians Ken Wyatt welcomed the gains in early childhood and school education, but acknowledged progress has been slow in other areas . See Part 3 below for the Ministers CTG Editorial
Part 1 :This year, the Closing the Gap report marks a new era. An era of partnership based on an historic agreement with Aboriginal and Torres Strait Islander people.
Last year, I hoped this report would be on a new Closing the Gap framework.
But, this is not a process we should rush. Getting it right is worth the time it takes. So while we don’t yet have a new framework in place, a new process has begun. A process that is truthful, strengths-based, community-led, and that puts Aboriginal and Torres Strait Islander people at the centre.
In March 2019, I entered into the Partnership Agreement on Closing the Gap, a landmark agreement to work together to develop the new Closing the Gap framework.
It’s a commitment by the Commonwealth, all states and territories, the Australian Local Government Association and the Coalition of Aboriginal and Torres Strait Islander Peak Organisations to work together in genuine partnership.
This is no small achievement. For the first time, we have constructed something that sits at the very centre of government and demonstrates a strong commitment to Indigenous Australians having a real say.
That’s what was missing from the original Closing the Gap framework.
As we turn the last page on that framework, we take the evidence of the last twelve years and provide the final results. These results are not what we had hoped for, and it’s important to acknowledge them. But it’s also important to celebrate the stories and successes that lie beyond the targets.
On almost every measure, there has been progress.
There have been heartening improvements in key areas of health and education. These are the things that create pathways to better futures.
It’s clear we have more to do, but we must do things differently. Without a true partnership
with Aboriginal and Torres Strait Islander people, we will hamper our own progress.
The new framework is based on true partnership, and on a commitment by all governments
to work together, and to work with Aboriginal and Torres Strait Islander people.
The new Joint Council on Closing the Gap is developing priorities, realistic targets and metrics that all governments and the Coalition of Peaks can commit to achieving. At the core of this new process is the expertise of Aboriginal and Torres Strait Islander people, guiding local action and local change.
Our refreshed Closing the Gap will focus on how we deliver services, as well as what is being delivered, and on solutions, not problems.
This means changing the way we work. It means expanding the opportunities for shared decision-making and making sure all mainstream agencies provide high quality programs and services. It means making sure Aboriginal and Torres Strait Islander people have better access to
high-quality services, including building community-controlled sectors, and ensuring we have the data needed for ongoing improvement. It means making sure we have the systems in place to share responsibility, and to measure our progress. Without this, we can have no meaningful action and no real progress.
For example, we are investing in Aboriginal and Torres Strait Islander-led data to support
decision-making at a local level. This will mean richer data to build programs that work for people in the place they live. It will also help to develop regional profiles to better understand how we are tracking towards Closing the Gap targets and other community priorities.
In making this commitment, together we have made a new path. Together we are setting out towards a goal we all share: that is, for every Aboriginal and Torres Strait Islander child to grow up with at least the same opportunities in life as every other Australian.
I look forward to honouring our commitment to partnership. I want to make sure Indigenous Australians are genuinely positioned to make informed choices, forge their own pathways and reach their goals. I want to make sure all governments renew our efforts to help close the gap.
We can all play a part. Together we can all improve the lives of Aboriginal and Torres Strait Islander people in this generation and the next.
Part 2 : Key findings from the 12th Closing the Gap report
Child Mortality
Target: Halve the gap in mortality rates for Indigenous children under five within a decade by 2018 – Not met.
In 2018, the Indigenous child mortality rate was 141 per 100,000 – twice the rate for non-Indigenous children (67 per 100,000). While the Indigenous child mortality rate has improved slightly, the rate for non-Indigenous children has improved at a faster rate.
Early Childhood Education
Target: 95 per cent of all Indigenous four-year-olds enrolled in early childhood education by 2025 – On track.
In 2018, 86.4 per cent of Indigenous four-year-olds were enrolled in early childhood education compared with 91.3 per cent of non-Indigenous children.
School Attendance
Target: Close the gap between Indigenous and non-Indigenous school attendance within five years by 2018 – Not met.
Most Indigenous students attended school for an average of just over four days a week in 2019. Gaps in attendance start from the first year of schooling and widen into high school.
Literacy and Numeracy
Target: Halve the gap for Indigenous children in reading, writing and numeracy within a decade by 2018 – Not met but some improvements.
In 2018, about one in four Indigenous students in Years 5, 7 and 9, and one in five in Year 3 remained below national minimum standards in reading. Year 3 literacy rates are improving.
Year 12 Attainment
Target: Halve the gap for Indigenous Australians aged 20-24 in Year 12 attainment or equivalent attainment rates by 2020 – On track.
In 2018/19, 66 per cent of Indigenous Australians aged 20-24 years had attained Year 12 or equivalent. Over the decade, the proportion of Indigenous Australians aged 20-24 years attaining Year 12 or equivalent increased by 21 percentage points.
Employment
Target: Halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade by 2018 – Not met (stable).
In 2018, the Indigenous employment rate was 49 per cent compared with 75 per cent for non-Indigenous Australians.
Life Expectancy
Target: Close the life expectancy gap within a generation by 2031 – Not on track.
Life expectancy is 71.6 years for Indigenous males (8.6 years less than non-Indigenous males) and 75.6 years for Indigenous females (7.8 years less than non-Indigenous females). While there have been improvements in Indigenous mortality rates from heart disease, stroke and hypertension, cancer rates are increasing.
Part 3 : A good education can lay solid foundation blocks for a successful life.
Through these foundations we have the ability to close the gap for indigenous Australians across a range of areas – getting it right at an early age can mean getting it right for life.
I am heartened by gains, including in early childhood and education and its long-term impact.
As a government, we do however, acknowledge that progress has been slow in other areas.
The past ten years have not delivered the results they should have – and there’s no shying away from the responsibility we share to get the next ten right, and the ten after that.
This demonstrates the need to adopt a new approach to Closing the Gap.
So, how do we take our successes in the education field and replicate them across other markers and indicators?
It’s not a simple answer but key to this is shared accountability and shared responsibility – between all governments and indigenous Australian communities and organisations.
We are committed working in partnership with indigenous Australians to optimise outcomes over the life course
And we have issued a call to all governments to continue to work together on national priorities for collective action and supporting local communities to set their own priorities and tailor services to their unique context.
For the first time in the Closing the Gap process, indigenous expertise is at the centre of decision making – this represents an opportunity to set, implement and monitor closing the Gap along with indigenous Australians.
2020 marks the next stage in an unprecedented partnership between Aboriginal and Torres Strait Islander peak organisations, the Australian government, states and territories.
The Morrison government, through the leadership of the Prime Minister, is bringing together COAG and the Coalition of Peaks to deliver the new Closing the Gap National Agreement.
Our Closing the Gap Refresh will deliver shared responsibility and accountability.
Indigenous Australians at local, regional and national engagements are embedding knowledge and leadership, co-designing systems, policy and operational frameworks, and working with government to action change.
We are taking the time to ensure indigenous Australians and traditional owners are empowered and in a genuine position to make informed decisions.
In this new way of working, we share priorities – with indigenous Australians and with state and territory governments – in the fields of early childhood, education, employment and business opportunity, community safety, suicide prevention and health, as well as supporting local people to drive local solutions.
We must also continue to encourage conversations across the nation – so we become more comfortable with each other, our shared past, present and future. This has often led to local action to realise positive change.
This is why as the Minister for indigenous Australians, I have been tasked by the Prime Minister to develop a new whole of government indigenous early childhood strategy.
This will be a new way of working together to achieve our shared goal – working with experts, families, frontline service providers and communities.
Longer term we know that education has a direct impact on the ability for indigenous Australians to obtain employment.
The employment gap between indigenous and non-indigenous Australians narrows as education levels increase.
Since 2014 through the indigenous Advancement Strategy we have provided significant investments to indigenous youth and education initiatives throughout Australia.
Currently some 30,000 Aboriginal and Torres Strait Islander youth are being supported on their education journey through mentoring, scholarships and leadership programs like AIME, Yalari, Clontarf and the GO Foundation.
With this support, we will see this cohort of youth come through completing year 12 and progressing through further education, training and employment.
There was effectively no gap in the 2016 employment gap between indigenous and non-Indigenous Australians with a Bachelor degree or above (around 83 per cent employed for both)
Completion of Year 12 also considerably boosts employment outcomes for younger indigenous Australians compared with early school leavers.
The employment rate in 2016 for young indigenous Australians aged 18-29 who had completed Year 12 was between 1.5 and 3 times the rate for those without Year 12 qualification, depending on gender and remoteness locations.
Young, employed indigenous Australians with Year 12 qualifications were more likely than early school leavers to be employed full time, and be in a skilled occupation.
In the last 10 years, the number of indigenous Australians accessing higher education as more than doubled and currently almost 20,000 indigenous Australians are attending university.
This is worth celebrating. Every improved outcome and achievement needs to be celebrated and used to build momentum for greater improvements.
Governments, indigenous Australians and communities have a shared commitment to closing the gap; change will happen and we must not be afraid to learn from each other.
Indigenous Australians are the key agents of change. Governments need to draw on their insights, knowledge and lived experiences to deliver on Closing the Gap, for current and future generations.
We owe it to future Australians, both indigenous and non-Indigenous to build a better future.
We owe it to all Australians that they feel as though they have a future ahead of them that will deliver worth and value for work.
We will continue to work every day, to get more children to school, to support pathways into long-term employment, to address and reduce suicides right across the nation and to empower and give a voice to those who need it most.
For the first time government is walking this journey hand-in-hand with indigenous Australians.
I am optimistic that we can Close the Gap, not overnight, but overtime, in partnership and through genuine engagement with all indigenous Australians.
Ken Wyatt is the Minister for indigenous Australians
“Closing the Gap was well meaning and policy makers were genuine in wanting to achieve equality for our peoples.
However, we also said from the outset that the problem was that only governments had been involved in negotiations of the agreement and only the views of governments about what had to be done and how to achieve it were included
Our people weren’t asked or given any role in Closing the Gap.
Now it looks like governments and both major parties have finally realised that it was a mistake to exclude us and that this is an important reason why the policy failed
More than anything else we were determined that in the next phase, we must be in charge of our own development
Now the election is over, we will make sure we stay at the decision making table. It’s a big shift, but it’s critical for our people.”
Central Land Council policy manager Josie Douglas said while this is good news “it wouldn’t have happened except for the hard work of nearly 40 members of national and state/territory Aboriginal and Torres Strait Islander peak bodies, including the Central and Northern land councils and the NT’s Aboriginal Medical Services Association.
“ This historic achievement of a hard-fought partnership between peak Aboriginal organisations and governments on Closing the Gap should be celebrated.
From this day forward, expert Aboriginal and Torres Strait Islander voices in health, education and community services will be working as equal partners with COAG in crafting the best solutions to achieve better life outcomes within our communities.
The health disparities and widening gaps between Aboriginal and Torres Strait Islanders and other Australians are unacceptable and as leaders in our fields, we are ready to do the hard work to reverse these trends.”
The journey of Aboriginal representatives to the table where the policy decisions are made has been long and difficult.
Pat Turner, CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO) said the joint council meeting was “a culmination of many years of negotiations and hard work.
Download the CTG FACT Sheet and Partnership Agreement from Here
Ten years after Australian governments launched Closing the Gap it looks like Aboriginal and Torres Strait Islander peoples finally have a real say about the policy.
The policy was meant to improve their lives by getting Australian governments to work together, but has mostly failed because it was designed without Aboriginal representatives in the room.
The first joint Closing the Gap council meeting between the Council of Australian Governments (COAG) and a coalition of national Aboriginal peak bodies in late March in Brisbane promises to turn a decade of failure into success.
The joint council has 12 representatives elected by the coalition of peaks, a minister nominated by the Commonwealth and each state and territory government, plus one representative from the Australian Government Association.
The council was set up under a historic partnership agreement under which the peak bodies will, for the first time, have an equal say in the design, implementation, monitoring and evaluation of a ‘refreshed’ Closing the Gap policy.
In 2008, the COAG signed up to an agreement which for the first time had national targets and committed state and federal governments to reducing the gap in life expectancy, infant mortality, access to early childhood education, educational achievement and better employment outcomes.
This raised some hopes but, for the last five years, each time a Prime Minister reported to the federal parliament on the progress of Closing the Gap they had to admit that most of the targets were not on track to be achieved.
That does not mean that there had been no progress at all, but Aboriginal Territorians know that their lives are not much better than they were 10 years ago, especially when it comes to housing and jobs.
Early last year, public servants invited these organisations to workshops to ask them what they thought about Closing the Gap.
Like most others, CLC representatives left the workshops feeling that the governments had already made up their minds and were going to repeat the mistake they made over a decade ago and exclude them from their proposed ‘refresh’ of the policy.
Last October, the NACCHO asked the CLC and other peak bodies across Australia for help to try and stop the governments from deciding on a new Closing the Gap policy without Aboriginal representatives.
“We were up for it because we know how hard life is for our people and that we couldn’t afford governments to keep making decisions about us without us,” Ms Douglas said.
“We couldn’t afford the harm that means for our people and the waste – just look at the federal government’s punitive and failed work for the dole scheme.
“We wrote to Prime Minister Scott Morrison, the state premiers and Chief Minister Michael Gunner, asking them not to agree to changes to the Closing the Gap policy without us,” she said.
The coalition of peaks asked to be signatories to a formal Closing the Gap partnership agreement on behalf of Aboriginal and Torres Strait Islander peoples.
They met with Mr Morrison last December and he changed his mind.
NACCHO Aboriginal Health and #ClosingTheGap Prime Minister Scott Morrison announces new #ClosingtheGap Partnership Agreement 2019-2029 with 40 Indigenous peak bodies able to engage and negotiate as equal partners with governments to design and monitor
— Aboriginal Health in Aboriginal Hands ❤️💛🖤 (@NACCHOAustralia) March 26, 2019
“We didn’t expect that,” Ms Douglas said.
The partnership agreement on Closing the Gap they signed three months later came with a Commonwealth grant paying the costs of the coalition for being in the partnership.
In May this year, also for the first time, the coalition met to work out what should be in a new Closing the Gap policy.
“The Closing the Gap Partnership Agreement will focus all of our efforts to deliver better health, education and employment outcomes for Indigenous Australians.
It recognises that Aboriginal and Torres Strait Islander peoples must play an integral part in making the decisions that affect their lives. This agreement will put Indigenous peoples at the heart of the development and implementation of the next phase of Closing the Gap, embedding shared decision making and accountability at the centre of the way we do business.
In order to effect real change, governments must work collaboratively and in genuine, formal partnership with Aboriginal and Torres Strait Islander peoples because they are the essential agents of change. The change we all want to see will only come if we work together.”
Prime Minister Scott Morrison said the new Closing the Gap Partnership Agreement between the Federal Government, states, territories and the National Coalition of Aboriginal and Torres Strait Islander Peak Organisations (Coalition of Peaks) would ensure decision makers worked closer than ever to deliver real change for Indigenous Australians.
Download the CTG FACT Sheet and Partnership Agreement from Here
“The historic Partnership Agreement means that for the first time Aboriginal and Torres Strait Islander peoples, through their peak bodies, will share decision making with governments on Closing the Gap.
Closing the gap is not just about targets and programs. It is about making sure that Aboriginal and Torres Strait Islander peoples can share in the decision making about policies and programs that impact on them and have a real say over their own lives.
The Partnership Agreement is a significant step forward in this direction and the Coalition of Peaks is looking forward to working closely with the Council of Australian Governments to honour our shared commitment to closing the gap.”
Patricia Turner (CEO of NACCHO ) on behalf of the Coalition of Aboriginal and Torres Strait Islander Peak Organisations said almost 40 Aboriginal and Torres Strait Islander Peak Bodies across Australia had come together as partners with governments on Closing the Gap. See Also NACCHO Press Release Part 2
PRIME MINISTER
THE HON. SCOTT MORRISON MP
MINISTER FOR INDIGENOUS AFFAIRS
SEN. THE HON. NIGEL SCULLION
PATRICIA TURNER
ON BEHALF OF THE COALITION OF ABORIGINAL AND TORRES STRAIT ISLANDER PEAK ORGANISATION
PARTNERING WITH INDIGENOUS AUSTRALIANS TO CLOSE THE GAP
An historic agreement is set to change the way governments and Indigenous Australians work together on Closing the Gap.
The Agreement was developed collaboratively with the Coalition of Peaks, the largest group of Indigenous community controlled organisations, and committed to by all levels of government. It builds on the December 2018 decision by the Council of Australian Governments to establish a formal partnership on Closing the Gap between governments and Indigenous Australians.
The partnership will include a Joint Council on Closing the Gap, which for the first time will include ministers nominated by jurisdictions, together with Aboriginal and Torres Strait Islander representatives chosen by the Coalition of Peaks.
Minister for Indigenous Affairs Nigel Scullion will co-chair the first meeting of the Joint Council alongside Pat Turner, CEO of the National Aboriginal Community Controlled Health Organisation and on behalf of the Coalition of Peaks.
“The Joint Council represents an historic step forward in the practical working relationship between Aboriginal and Torres Strait Islander peoples and governments,” Minister Scullion said.
“This is the first time Aboriginal and Torres Strait Islander representatives and ministerial leaders have met formally as part of a Joint Council to progress the Closing the Gap agenda and improve the lives of Indigenous Australians no matter where they live.
“To support this historic partnership, we will deliver $4.6 million to the National Coalition of Aboriginal and Torres Strait Islander Peak Organisations to ensure the representatives of Aboriginal and Torres Strait Islander Australians are able to engage and negotiate as equal partners with governments to design and monitor Closing the Gap.
“This is a new way of doing business that reflects that the top-down approach established in 2008 while well-intentioned, did not truly seek to partner with Aboriginal and Torres Strait Australians. We enter this partnership recognising that Canberra cannot change it all and that we need more then lofty goals and bureaucratic targets.
“Finalising the refresh of the Closing the Gap framework and monitoring its implementation over the next ten years is critical to the future and prosperity of all Australians.
“We are committed to working closely with Aboriginal and Torres Strait Islander people across Australia to improve the lives of Indigenous Australians.”
Patricia Turner on behalf of the Coalition of Aboriginal and Torres Strait Islander Peak Organisations said almost 40 Aboriginal and Torres Strait Islander Peak Bodies across Australia had come together as partners with governments on Closing the Gap.
The refreshed Closing the Gap framework and targets will be finalised through the Joint Council by mid-2019, ahead of endorsement by COAG. The Joint Council will meet for the first time on 27 March 2019 in Brisbane.
“Closing the gap is not just about targets and programs. It is about making sure that Aboriginal and Torres Strait Islander peoples can share in the decision making about policies and programs that impact on them and have a real say over their own lives.
“The Partnership Agreement is a significant step forward in this direction and the Coalition of Peaks is looking forward to working closely with the Council of Australian Governments to honour our shared commitment to closing the gap.”
The National Aboriginal Community Controlled Health Organisation (NACCHO) has welcomed the signing of an historic Partnership Agreement on Closing the Gap between the Commonwealth Government, State and Territory Governments and the Coalition of Aboriginal and Torres Strait Islander Peak Bodies.
The announcement will be made at the first Joint Council Meeting between the new partners in Brisbane
The Coalition of Peaks is made up of around forty Aboriginal and Torres Strait Islander community controlled organisations that have come together to negotiate with governments and be signatories to the Partnership Agreement.
NACCHO Chief Executive, Pat Turner, said the Agreement means that for the first time Aboriginal and Torres Strait Islander people, through their peak body representatives, will share decision making with governments on Closing the Gap.
“For some time now, NACCHO, along with other Aboriginal and Torres Strait Islander Peak Organisations have been calling for a greater say with governments on efforts to close the unacceptable gaps in life outcomes between Aboriginal and Torres Strait Islander peoples and the broader community,” said Ms Turner.
“The Coalition of Peaks believe that shared decision making between governments and Aboriginal and Torres Strait Islander community-controlled representatives in the design, implementation and monitoring of Closing the Gap is essential to closing the gap”.
The Partnership Agreement sets out how governments and Aboriginal and Torres Strait Islander Peaks bodies will work together to agree a refreshed national agreement on Closing the Gap, including any new Closing the Gap targets and implementation and monitoring arrangements.
Ms Turner said the Partnership Agreement also marks the establishment of a new, Joint Council on Closing the Gap that will be co-chaired by a Minister and a representative of the Coalition of Aboriginal and Torres Strait Islander Peak Bodies.
“We look forward to a hardworking and constructive partnership with the Commonwealth, State and Territory Governments to secure better outcomes for Aboriginal and Torres Strait Islander Peoples,” said Ms Turner.
4. Indigenous Australians in the city and country have different needs
5.Closing the Gap Failures are firmly rooted in racism
” Scott Morrison last week became the fifth prime minister to deliver a Closing the Gap report to parliament – the 11th since the strategy began in 2008. Closing the Gap has aimed to reduce disadvantage among Aboriginal and Torres Strait Islander people with particular respect to life expectancy, child mortality, access to early childhood education, educational achievement and employment outcomes.
Almost every time a prime minister delivers the report, he or she states the need to move on from a deficits approach.
Which is exactly what Morrison did this time. But he also did something different. Four of the seven targets set in 2008 were due to expire in 2018.
So last year, the government developed the Closing the Gap Refresh – where targets would be updated in partnership with Indigenous people.
Nicholas Biddle ANU : Four lessons from 11 years of Closing the Gap reports : See in full Part 1 Below
” Once again, minimal progress has been made towards closing the gap on Indigenous disadvantage.
Racism has been mentioned as an issue, but exactly how does racism make a contribution to this “unforgivable” state of affairs ?.
The answer is in the criminal justice system. Studies have shown mass incarceration has a profoundly negative effect on the health, education, and employment of families and communities-and Indigenous Australians are the most incarcerated group on Earth.
The US, the mother of all jailers imprisoned 655 people per 100,000 in 2018. Australia imprisoned 164 non Indigenous people and 2481 Indigenous people per 100,000. Western Australian imprisoned 3663 Aboriginal people per 100,000.
In 1991, when the report on Aboriginal Deaths in Custody was handed down, 14% of all prisoners were First Nations people. By last year, the figure was 28%. ”
Lesson 5 Dr Meg Perkins is a registered psychologist, researcher and writer : See Part 2 Below
The current report and the work leading up to it has led to new targets, such as a “significant and sustained progress to eliminate the over-representation of Aboriginal children in out-of-home care” and old targets framed differently.
For example, the headline new outcome for families, children and youth is that “Aboriginal and Torres Strait Islander children thrive in their early years”. This is on top of more specific targets such as having 95% of Aboriginal and Torres Strait Islander four-years-olds enrolled in early childhood education by 2025 – which this year is on track.
Looking back on the past 11 years, there are several things we’ve learned. This includes those targets that seem easiest to meet, as well changes in the demographics of the population that complicate the measuring of the targets. Below are three lessons from the last decade of the policy.
The targets where there has been some success tend to be those where government has more direct control. Consider the Year 12 attainment compared to the employment targets. To increase the proportion of Indigenous Australians completing year 12, the Commonwealth government can change the income support system to create incentives to not leave school, while state and territory governments can adjust the school leaving age.
That is not to downplay the efforts of parents, teachers, community leaders, and the students themselves. But, there are some direct policy levers.
To improve employment outcomes, on the other hand, discrimination among employers needs to be reduced, human capital levels increased, jobs need to be in areas where Indigenous people live and to match the skills and experiences of the Indigenous population. These are solvable policy problems with the right settings and community engagement. But, they are substantially more complex.
The main target has always been related to Aboriginal and Torres Strait Islander life expectancy. The 2019 report shows the target of closing the gap by 2031 is not on track.
Unfortunately, the life expectancy target is one of the more difficult to measure, as it uses multiple datasets that are potentially affected by different ways Indigenous people are counted in the census and changing levels of identification. The most recent estimates, based on data for 2015-17, are that life expectancy at birth is 71.6 years for Indigenous males and 75.6 years for Indigenous females.
While the gaps with the non-Indigenous population of 8.6 years and 7.8 years respectively are smaller than they were in 2010-12 (the previous estimates) the Australian Bureau of Statistics (ABS) and most demographers suggest extreme caution around the interpretation of this change. The ABS writes:
While the estimates in this release show a small improvement in life expectancy estimates and a reduction in the gap between 2010-2012 and 2015-2017, this improvement should be interpreted with considerable caution as the population composition has changed during this period.
More people have been identifying as being Aboriginal and/or Torres Strait Islander over recent years. What’s more, the newly identified Indigenous people tend to have better outcomes on average (across health, education, and labour market outcomes) than those who were identified previously. This biases our estimates, making it appear there is more rapid progress than there might otherwise be.
The Closing the Gap framework was implicitly designed around improving the circumstances of the 2008 Indigenous population relative to the 2008 non-Indigenous population. However, both populations have changed substantially over the intervening years. There has been a growth of the non-Indigenous population due to international migration. It is hard to measure and track differences in changing populations.
3. On-track one year, off-track the next
There is also the yearly reporting cycle. The target of child mortality, for instance, no longer appears to be on track. This is despite it being on track in previous years. Yearly fluctuations make it hard to gauge the effectiveness of long-term policy settings.
For other indicators, such as employment, the data is available far less frequently than it could be, and we are less able to judge the effect of individual policies and interventions. Having said that, in my view, the sophistication and nuance with which data in the Closing the Gap reports has been presented has improved considerably.
It seems most policies prioritise Indigenous Australians living in remote areas than those in the city.David Clode/Unsplash
4. Indigenous Australians in the city and country have different needs
This isn’t always reflected in policy settings. The current report shows many outcomes are worse in remote compared to non-remote Australia. It also makes the point (though less frequently), that the vast majority of Indigenous Australians live in regional areas and major cities. This creates a tension between relative and absolute need. Unfortunately, the policy responses of government often don’t get that balance right.
Take the signature policy proposal announced with the current report – a suspension or cancelling of HECS debt for teachers who work in remote schools. What the policy ignores is that the vast majority of Indigenous students live outside remote Australia, that outcomes for Indigenous students in non-remote areas are well behind those of non-Indigenous students, and that the schools Indigenous students attend in non-remote areas tend to be very different from those of non-Indigenous students.
Attracting and keeping more high quality teachers in remote areas is a worthwhile policy aim. Alone, it is not sufficient.
The current report and speech by the prime minister states that “genuine partnerships are required to drive sustainable, systemic change” and that the government needs “to support initiatives led by Aboriginal and Torres Strait Islander communities to address the priorities identified by those communities”.
These are admirable goals. But, they require significant resources, a genuine engagement with the evidence (even if it isn’t positive), taking the Uluru Statement from the Heart seriously, and real ceding of control to Aboriginal and Torres Strait Islander people
5.Closing the Gap Failures are firmly rooted in racism
Some people think Aboriginal people must be uniquely anti-social and/or make very bad choices, but research tells us the majority of people in prison are suffering from severe cognitive impairments and/or mental health issues such as post-traumatic stress disorder and major depression.
Why are we punishing people with disabilities for behaviour that may not be intentional ?.
When we look at children in school, we find three times as many Aboriginal children are suspended from school than non-Aboriginal children. Some of the special purpose schools in NSW are filled with Aboriginal children only.
Many youth detention centres in the country have 100 per cent Aboriginal inmates. Why are so many Aboriginal children being suspended from school and set on the road to crime and punishment, and what happens to white Australian children who are not able to behave appropriately in the classroom ?.
It seems mainstream Australian children are referred to health professionals when they have difficulties at school. They are seen as suffering from learning disabilities, autism, or ADHD. Speech therapists and other allied health professionals work to help them catch up with peers and stay in school.
Due to intergenerational disadvantage, Indigenous people often don’t have the resources to find a therapist to assist their child. People born before 1972 were not guaranteed a place in school, and so grand parents may not have had much education.
Parents may have left school in Year 8 or 9 and are not familiar with developmental norms or disabilities. If they know that their child is falling behind at school, they often do not have the money to pay for expensive psychological assessments, which cannot be done in Medicare. Without an assessment, and a diagnosis , the school cannot make allowances for a child with brain-based disabilities.
The racist policies of the past have left many Aboriginal people disadvantaged when it comes to dealing with the education system. If their child is having difficulties, suspensions are often the consequence. Once suspended and out on the street, racism sets in again.
Aboriginal children are searched and arrested more often. We will never close the disadvantage gap until we can offer support to the children of young people. We need to raise the age criminal responsibility from 10 to 15 years, and spend money on supporting children, not punishing them.
” This report provides detailed information and analyses on the Closing the Gap targets, including the key drivers of change underpinning these targets.
This report provides context for policy debate and discussion for the Closing the Gap Refresh, a joint initiative of the Council of Australian Governments (COAG).
Today’s report summarises evidence on progress towards the seven Closing the Gap targets. These targets include: child mortality, school attendance, literacy and numeracy, employment, and life expectancy. Read the full report:
” Malcolm Turnbull’s crucial 10th annual Closing the Gap report on Monday is on track for disaster, with only one of seven targets to end indigenous disadvantage set to be achieved amid questions about the program’s relevance.
Targets to close the gap on child mortality rates, early childhood education, school attendance, literacy, employment and life expectancy are either unlikely to or definitely will not be met, key data obtained by The Australian shows. As with last year’s report, only Year 12 attainment rates are on track to halve the gap for indigenous Australians aged 20-24 by 2020.”
Monday 12 Feb, the PM provides his #ClosingtheGap report to Parliament 11.00 am
” The 10-year review launched yesterday suggests the program’s health targets be retained but that they be “complemented by targets or reporting on the inputs to those health targets”, as well as calling for a specific increase in health infrastructure and spending, and for greater First Nations participation in decision-making.”
The trends are contained in an Australian Institute of Health and Welfare assessment distributed to participants at a hastily called two-day summit bringing together prominent indigenous Australians in Canberra to consider a Closing the Gap “refresh”, including expanding the number of targets.
That summit ended in bitterness yesterday with a formal statement from the powerful four Northern Territory Land Councils denouncing it as peremptory and rushed. “Governments had 10 years to get it right,” the statement from the chairmen of the Northern Land Council, Central Land Council, Tiwi Land Council and Anindilyakwa Land Council said. “Ten years ago, they did not talk to us.
After 10 years of failure why are they rushing us now? Why don’t they give us time to consult our people and elected members properly about these life and death issues?”
The NLC and CLC will not hold their next executive meetings until June, by which time the government plans to have completed its refresh — leaving the two councils unable to present their proposals to their members.
The pushback came after a 10-year review of the Council of Australian Governments scheme found it had been marred by poor accountability and a lack of indigenous policy input, and was badly implemented from the beginning.
Malcolm Turnbull angered participants at the Parliament House launch of that study yesterday when he left to meet another commitment halfway through.
Labor indigenous affairs spokesman Patrick Dodson called the Prime Minister’s departure “indicative of the deafness, the absolute derision and the contempt which this government is meting out to the Aboriginal people”.
Reconciliation Australia co-chair Tom Calma, who launched the Close the Gap steering committee’s review after Mr Turnbull had gone, admitted the departure “wasn’t a surprise” but said it was “unfortunate he had to leave; it’s never a good look when we’ve all come together”. Further fire came with the revelation the government hopes to conduct 14 regional indigenous consultations in coming weeks as it pushes ahead with its refresh.
The regional process would mirror last year’s multi-million-dollar Referendum Council regional dialogues on indigenous constitutional recognition, whose results at Uluru were dismissed out of hand by Mr Turnbull.
Critics say the government could find it hard to encourage participants in the earlier process to show up for more of the same, having believed the resulting Uluru Statement from the Heart contained practical measures for improving indigenous outcomes — including its parliamentary advisory voice and treaty mechanism.
Kyllie Cripps, acting director at the University of NSW indigenous law centre, said the fact latest Closing the Gap figures closely mirrored last year’s was a case of governments “pretending they’re doing something when they’re not”.
“This has been a constant criticism of Closing the Gap reporting, because it’s a reduplicating of data that’s already out there,” Dr Cripps said. “It would easily cost $200,000 to produce the report each year, which is money that could be better put elsewhere, for instance a women’s refuge or other services.”
Referendum Council member and UNSW pro-vice chancellor Megan Davis described the report as “regulatory ritualism, pretending to fix something when you’re not”.
Bill Shorten said Mr Turnbull’s “disdainful attitude” towards the Uluru Statement was perpetuating the poor outcome. “The idea that you could paternalistically, in the Prime Minister’s office, make decisions on behalf of hundreds of thousands of Australians without them being involved in the decision-making, is just guaranteed (to not work),” the Opposition Leader said.
” Understanding and respecting Aboriginal and Torres Strait Islander cultures—our strengths, traditions and our family, kinship, values and knowledge—is a fundamental foundation for better Indigenous health.
Consideration of the social and cultural determinants of health is vital, because a strong connection to culture correlates with good health, through strengthened identity, resilience and social and physical wellbeing.
In the words of the Prime Minister, we are committed to doing things with Aboriginal and Torres Strait Islander people, not to them, empowering local community solutions and better personal choices.
This will require the involvement of individuals, families, communities and Aboriginal organisations at all levels, in shaping the future and achieving improved health.
The Closing the Gap refresh and the next Implementation Plan will be important opportunities to build on what we have learned, and help ensure our people live better, longer and healthier lives and are able to achieve their full potential.”
Extract from Minister Ken Wyatt’s ” Better Indigenous Health ” overview in this weeks the AHHA’s #ClosetheGap Magazine Read in Full Part 4 below
Thursday 8 th Februarythe #ClosetheGap Campaigns Parliamentary Breakfast 7.00 AM event and the launch of a ten-year review: the #ClosingtheGap Strategy and Recommendations for Reset.
The Prime Minister has established a group of 10 Aboriginals to inform governments this week on the next phase of the #ClosingtheGap agenda. #CTGRefresh
The Aboriginal panel will meet from 7th – 8th February.
Ministers will join the Indigenous group on the afternoon of Thursday 8th.
Friday 9th February, The 10 Indigenous participants will formally present the gathering’s proposals to the Council of Australian Governments #COAG meeting.
Monday 12 Feb, the PM provides his #ClosingtheGap report to Parliament 11.00 am
Tuesday 13 Februaryseveral key events to mark 10 years since the Apology, including the public concert on the lawns of Parliament House – hosted by The Healing Foundation. #Apology10
” The Australian Government, on behalf of the Council of Australian Governments (COAG), is asking all Australians for their views to help construct the next phase of the Closing the Gap agenda and has released a COAG discussion paper to support ongoing consultations that have been held this year and will continue into 2018.
Over the past decade, important progress has been made in improving health, employment and education outcomes for First Australians since Australian governments agreed to a Closing the Gap framework to address Indigenous disadvantage.
However, it is clear that the Closing the Gap agenda can be better designed and more effectively delivered. This is a view shared among Aboriginal and Torres Strait Islander people, governments and the broader community.”
Part 3 #Refresh CTG Example from NACCHO Member Congrees Alice Springs
Congress Alice Springs notes the Council of Australian Government’s (COAG’s) commitment in their meeting of 9 June 2017 to refreshing the Closing the Gap (CtG) agenda, “focussing on a strength-based approach that supports Indigenous advancement, working in partnership with Aboriginal and Torres Strait Islander peoples”.
As a leading Aboriginal community controlled health service with over forty years of experience in delivering improvements in services and outcomes for Aboriginal people1 in Central Australia, Congress is submitting this paper to the Taskforce that has been established in the Department of the Prime Minister and Cabinet to progress this important work.
The paper is framed around five key structural reforms to the CtG process and on eight specific social and cultural determinants of health and well being
The February 2018 issue was released today. It focuses on ‘Close the Gap’ and features articles including:
Better Indigenous health—Ken Wyatt see in full below
Aboriginal patient journey mapping tools—Flinders University, University of Adelaide, Port Augusta Hospital and Regional Health Unit, Royal Adelaide Hospital
Walk with us—Janine Mohamed, CATSINaM
Nutrition from first foods—Dympna Leonard
Check today, see tomorrow—Hugh Taylor and Mitchell Anjou, University of Melbourne
Understanding and respecting Aboriginal and Torres Strait Islander cultures—our strengths, traditions and our family, kinship, values and knowledge—is a fundamental foundation for better Indigenous health.
The Turnbull Government understands that significant factors contributing to higher rates of premature death and chronic illnesses among our people lie largely outside the traditional health system.
Consideration of the social and cultural determinants of health is vital, because a strong connection to culture correlates with good health, through strengthened identity, resilience and social and physical wellbeing.
We know that over one-third of the average health gap between Indigenous and non- Indigenous people is the result of social determinants—the implications of housing, employment, justice and education.
This rises to over 50% when combined with risky behaviours such as tobacco and alcohol use, poor diet and physical inactivity.
In 2017, the Government led the My Life My Lead consultations across the nation,listening to people, and government andnon-Government agencies, sharing theirexperiences around the social and culturaldeterminants of health, with around 600attending 13 forums.
We heard that to make significant overall improvements in Indigenous lives, including their health, we need to:
• recognise the importance of culture, family and country;
• partner with communities to build capacity;
• recognise and address the impacts of underlying trauma; and
• lift access to health, education, employment and social services.
There is a need to address systemic racism and enhance cultural competency.
The 2017 Aboriginal and Torres Strait Islander Health Performance Framework highlighted some areas of success: There has been a 44% decline in Aboriginal circulatory disease death rates between 1998 and 2015, and a 47% decline in kidney deaths; there has been a longer term 33% decline (1998–2015) in child mortality and a recent 9% drop in smoking rates.
However, we can, and must, do better.
Among my Aboriginal and Torres Strait Islander health priorities are:
• Renal health—reducing the incidence of kidney disease, with a strong focus on early intervention.
• Maternal and child health—making sure we give babies through to teenagers the best possible start in life by developing a 0–17 years approach to social, physical and emotional wellbeing.
• Men’s health—considering more of the social and cultural determinants of health.
• Eye and ear health—working on the causes of preventable blindness and hearing loss, including tackling otitis media.
• Preventable hospital admissions—with a strong focus on early intervention to keep people out of hospital.
Aboriginal and Torres Strait Islander men’s life expectancy is 10 years shorter than non- Indigenous males.
While smoking rates have improved significantly, they remain high and contribute to the largest burden of Indigenous ill health.
The $116.8 million (2015–16 to 2017–18) Tackling Indigenous Smoking program aims to further reduce these rates.
The gap in the blindness rate in Aboriginal and Torres Strait Islander people over 40, compared to non-Indigenous Australians, has halved between 2008 and 2016. The Australian Government is investing $76 million from 2013 – 14 to 2020–21 to build on this improvement.
A comprehensive approach to childhood hearing loss is combining prevention, early treatment and management of ear infections, supported by an investment of $76.4 million from 2012–13 to 2021–22.
In addition, providing a culturally safe and respectful environment within mainstream health services can help improve access to health care, as well as the effectiveness of that care.
Between July 2013 and June 2015, Aboriginal and Torres Strait Islander peoples were discharged from hospital against medical advice at seven times the rate of non-Indigenous people and were more likely to leave the emergency department without waiting to be seen.
I am pleased to be partnering with organisations including the National Aboriginal Community Controlled Health Organisation, the Australian Indigenous Doctor’s Association and the Council of Presidents of Medical Colleges to help reduce the barriers to accessing health care.
The initial focus includes improving how the health system works with Aboriginal and Torres Strait Islander peoples, ranging from enhanced cultural awareness and training for staff, through to reducing any forms of institutionalised racism.
The Cultural Respect Framework for Aboriginal and Torres Strait Islander Health 2016–2026, sponsored by the Australian Health Ministers’ Advisory Council, commits all state and territory governments to embedding the principles of cultural respect into the health system.
The next Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan, due in 2018, will recognise the importance of culture in finding solutions, and focus on the factors that promote resilience, foster a sense of identity and support good mental and physical health and wellbeing for individuals, families and communities.
In the words of the Prime Minister, we are committed to doing things with Aboriginal and Torres Strait Islander people, not to them, empowering local community solutions and better personal choices.
This will require the involvement of individuals, families, communities and Aboriginal organisations at all levels, in shaping the future and achieving improved health.
The Closing the Gap refresh and the next Implementation Plan will be important opportunities to build on what we have learned, and help ensure our people live better, longer and healthier lives and are able to achieve their full potential.
