NACCHO Aboriginal health and our political future : So which side of politics will end Aboriginal disadvantage

Kev and Tony

Article by Amanda Cavill

While Indigenous Australians make up a small percentage of Australia’s population, they are vastly over-represented in a number of alarming ways.

WATCH NACCHO chair  Justin Mohamed and National Congress Kirstie Parker on SKYNEWS

Aboriginal and Torres Strait Islander people have a lower average life expectancy, higher child mortality rates and a higher likelihood of living in poverty, according to FaHCSIA.

In the lead up to this year’s election, Prime Minister Kevin Rudd has said he wanted to see Parliament revisit a referendum on recognition of Indigenous people in Australia’s constitution within two years.

Labor has also pledged funding through national partnerships agreements for health, education and housing, committed to a Cape York welfare reform trial and funded a series of land and sea ranger programs to boost jobs.

Federal Indigenous Affairs Minister Jenny Macklin has also announced new targets to help close the gap between Indigenous and non-Indigenous Australians.

“One: to make sure that we get more Aboriginal and Torres Strait Islander people into higher education. Two: that we will set ourselves a new closing the gap justice target, because incarceration rates are too high, and thirdly: we’ve announced disability targets making sure that Indigenous people get the access they need to Disability Care Australia”, Ms Macklin said.

The Coalition supports many of the government’s policy initiatives.

VIEW the Coalition policy released yesterday

It too has pledged to changing the constitution to acknowledge Aboriginal people, with a draft amendment to be put forward within 12 months.

However, if elected, the Coalition says it would elevate Indigenous affairs by moving the portfolio into the Department of Prime Minister and Cabinet.

Coalition leader Tony Abbott has also promised to set up an Indigenous Advisory Council, headed by former ALP president Warren Mundine.

The council would be made up of Indigenous and non-Indigenous representatives and would meet with the government three times a year, while Mr Mundine would meet the prime minister and Indigenous affairs minister every month.

Mr Abbott said the disadvantage faced by Indigenous people is the result of a flawed system.

“What we’ve got to do is develop new governance arrangements where things happen a lot more quickly than they seem to at the moment.  Now I don’t want to underestimate the difficulties of this, but I think that we start getting places more quickly if it’s not just the government dictating to Aboriginal people, but the government, allied with people like Warren Mundine, making it happen”, Mr Abbott said.

And, if elected, Tony Abbott said he would spend a week each year in Aboriginal communities – as he has been doing for years already – but as prime minister would take senior decision-makers with him.

Income quarantining would remain but, unlike Labor’s policy, would not be linked to school attendance.

He has promised on-the-spot fines for truancy, job training trials based on mining billionaire Andrew “Twiggy” Forrest’s model, and greater help for Indigenous people to develop businesses and own homes.

Katter’s Australia Party, which is expected to retain leader Bob Katter’s lower house seat and win at least one senate seat, is highly critical of the major parties’ plans.

Bob Katter said they are policies that won’t work.

“They believe that whitefellas should go in there and build all these houses for them, and fix everything up for them.  You know, I have the exact opposite position.  Mahatma Gandhi had it right; ‘Even though we may not be able to run India as well as the British Raj, it is infinitely more important that Indians run India, even though we may not be able to run it as well'”, he said.

Meanwhile The Greens said they will use their expected balance-of-power position in the Senate to pursue compensation for the Stolen Generation and recognise Aboriginal and Torres Strait Islander people in the constitution.

The party opposes income management, welfare quarantining, and Labor’s scheme to link welfare payments to school attendance.

The party wants a justice target in the Closing the Gap program and action to reduce alcohol supply, for example through a minimum price or fewer liquor licences and stronger measures to boost Indigenous health.

Greens Senator and former GP Richard Di Natale says the first step to improving health in remote Indigenous communities is training more Aboriginal health workers.

“We’ve got a huge investment in infrastructure that would ensure that we get more people from an Indigenous background trained and becoming health professionals.  I worked for two years at an Aboriginal health service in the Northern Territory and one of the best things about that service was that Aboriginal people were coming into a place where they were getting care from their Indigenous brothers and sisters. That’s so critical”, Di Natale says.

NACCHO political download alert: Tony Abbott and Warren Mundine puts land rights at heart of Aboriginal policy approach

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NACCHO Chair Justin Mohamed (left) and Deputy Chair Matthew Cooke (right)  were at Garma Festival with Warren Mundine (Centre)

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WARREN Mundine has thrust an overhaul of land rights at the centre of his call for a new approach to indigenous policy.

The former ALP national president has been hand-picked by Tony Abbott to chair a new advisory body on Aboriginal policy if the Coalition wins the September 7 election.

He gave a keynote address at the Garma Festival 10 August 2013

“The bureaucracy encasing indigenous people is complex, inefficient and unwieldy.

We have seen through the years examples of corruption taking hold in indigenous governance bodies — I do not believe this is the norm but the perceived lack of transparency makes these bodies more vulnerable to it.”

DOWNLOAD Warren Mundine’s full speech here

VIEW Tony Abbott speech to Garma

Mr Mundine, who travelled with Mr Abbott to the Garma festival in Arnhem Land today, said his appointment to lead the Prime Minister’s Indigenous Advisory Council under a Coalition government would no doubt come as “a bit of a surprise for a lot of people”.

But he said indigenous Australians were not making progress on a number of key targets under the Closing the Gap initiative and more needed to be done, particularly in the areas of land rights and economic development.

Echoing the words of Galarrwuy Yunupingu, who made a plea this morning for political leaders to “wake up” land rights, Mr Mundine said: “It is our soul, it is our economic future, it is the way our children need to move forward.”

Mr Abbott praised Mr Mundine, declaring him a friend who shared his vision for indigenous reform

You can download Warren Mundine’s full speech here

Below

MORE than 40 years ago, Australia embarked on a strategy for bringing indigenous people to full and equal participation in society. That has had significant successes.

Indigenous people do not suffer anything like the discrimination they suffered 50 years ago and have achieved things they could never have achieved in the past. Community attitudes have changed radically. There has been real reform in land rights and anti-discrimination laws, access to university and professions, and access to employment

But if someone had told me in the 1970s that during the following four decades Australia would spend billions and still have a vast gap between indigenous and non-indigenous Australians in areas such as health, education and employment, I would have been shocked. If someone had told me that by 2013 indigenous people would actually have gone backwards in some areas, I simply would not have believed them.

Yet that is the reality. I’ve visited communities where the reading level of younger people is worse than that of their grandparents, where the last group of people who learned how to read were the ones educated by the mission schools. Indigenous incarceration and alcohol abuse have increased in the past 40 years.

The Closing the Gap initiative, introduced by the Labor government and its Indigenous Affairs Minister Jenny Macklin in 2008, was a transformative reform in indigenous affairs. The initiative focuses on six specific indicators in health, education and employment, sets empirical targets based around the gap between indigenous and non-indigenous people in those metrics, regularly measures achievements against the targets and publishes those results.

We know from the most recent report that the gap is not closing. This year marked the halfway point for the Closing the Gap targets and so far the outcomes have fallen short on health targets, moved backwards in some education targets and shown minimal improvement in employment figures.

I believe we will go another 40 years with no change unless we have a new strategy built on four fundamental principles: governance, land ownership, social stability and openness.

GOVERNANCE:

INDIGENOUS people are the most highly governed people in Australia. At every level of government there are additional structures for indigenous people on top of those that exist for the rest of Australia. Over-governance stifles autonomy and entrepreneurship and makes it nearly impossible to get anything done.

The present system is crippled by over-regulation and does not meet the criteria for good governance. Most statutory indigenous governance bodies are not truly representative and many are not transparent. The bureaucracy encasing indigenous people is complex, inefficient and unwieldy. We have seen through the years examples of corruption taking hold in indigenous governance bodies — I do not believe this is the norm but the perceived lack of transparency makes these bodies more vulnerable to it. In indigenous communities there are too many examples of a complete failure of the rule of law: with alcohol abuse, violence, sexual abuse of children, property crime and systemic truancy.

When I talk about transparent and representative governance here I don’t mean voting. I mean that many of the special bodies created to represent indigenous people are not reflective of the indigenous nations.

There are many statutory bodies with levels of authority in indigenous communities, such as land councils, regional councils, homeland councils, Aboriginal corporations and indigenous shire councils.

These bodies are not always transparent, with meetings and records open to the public or even their members. Many of these statutory bodies have substantial gatekeeper power over traditional lands or the exercise of native title. They may also hold royalties generated from land use by mining companies or from government compensation for dispossession. There are bodies with custody of hundreds of millions in funds held and collected on behalf of traditional owners, but the structure does not contemplate funds being distributed directly to the traditional owners. It has to be asked what the benefits are for indigenous people from these funds.

When Europeans came to Australia, indigenous people were grouped in nations, each with a distinct geography, language and culture. The identity of indigenous people was tied to the culture and language of their own nation, not to the Australian land mass as a whole.

Most statutory bodies created to govern indigenous people are not aligned to indigenous nations. In NSW there are twice as many land councils as nations, and land council members do not need to be descended from a nation that the land council services. In the Northern Territory there are four land councils and dozens of nations.

Many indigenous statutory bodies are expected to be all things to all people, carrying out normal municipal functions as well as running commercial operations and owning all the land and housing. Seeking permission from the council may mean seeking permission from the local government authority and the landowner and the monopoly service provider all in one. If they say no, there is practically nowhere to go for review.

We don’t need special indigenous bodies to handle things such as municipal services, commerce and service delivery. A local shire council that is part of the regular local government system can perform municipal functions just as effectively, if not more so, as an agency established under some special statute.

Where special governance is relevant is for matters uniquely relevant to the indigenous nation, such as the use of traditional lands, native title rights, community assets, culture, heritage and language. For this there should be one governance body representing each indigenous nation. One governance body to represent that nation on land and native title; hold land and other assets; collect royalties for use of the land or compensation for loss of land and use that for the benefit of the people of that nation; and preserve its culture, heritage and language. One governance body that companies that want to invest in an area can deal with on development and use of traditional lands.

I’m not talking about independent national sovereignty or suggesting that indigenous nations cede from the rest of Australia. I am talking about establishing a governance system that reflects the identity that indigenous people have to their own nations, governs the matters and decisions that are distinctive to those nations and provides certainty to those who want to engage with that nation.

In the next term of federal parliament, Australians will be asked to pass a referendum that formally recognises indigenous people in the Australian Constitution. Wouldn’t it be fitting if we also implement a system of governance that recognises the indigenous nations and gives members of those nations the ability to govern matters concerning their traditional lands, assets, culture, language and heritage?

NACCHO health news: Aboriginal Australians more likely to be seriously or fatally injured in land transport accidents

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Aboriginal and Torres Strait Islander Australians are more likely to be injured in land transport accidents than other Australians, according to a report released Friday 26 July 2013 by the Australian Institute of Health and Welfare (AIHW).

PURCHASE THE REPORT HERE

The report, Injury of Aboriginal and Torres Strait Islander people due to transport: 2005-06 to 2009-10, looks at death and serious injury of Aboriginal and Torres Strait Islander people in Australia due to land transport accidents over the five-year period 2005-06 to 2009-10.

It shows that Indigenous Australians were 2.8 times more likely to be fatally injured due to land transport accidents, and 1.3 times more likely to be seriously injured compared with other Australians.

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‘One of the main reasons for this finding is that a much larger proportion of Indigenous people live in remote regions, where rates of land transport injury were highest overall’, said AIHW spokesperson Professor James Harrison.

‘But, even after taking the remoteness factor into account, Indigenous land transport fatalities were higher than expected.’

‘The good news is that fatal injury rates among Aboriginal and Torres Strait Islander people, as well as non-Indigenous Australians dropped over the five years from 2005–06 to 2009-10—by about 8% and 6% per year respectively,’ Professor Harrison said.

‘However, serious injury rates for Indigenous Australians rose by about 2% per year over the five-year period, while serious injury rates for other Australians dropped by about 1% per year.’

Indigenous Australians who were fatally or seriously injured in land transport accidents were less likely to have been drivers and more likely to have been passengers than other Australians.

‘Among Indigenous Australians, drivers made up 27% of all fatal injuries due to land transport accidents while passengers made up 32%. Among other Australians these figures were 36% and 14% respectively,’ Professor Harrison said.

‘For serious injuries among Indigenous Australians, 15% of those injured were drivers and 19% were passengers. Among other Australians, the figures were 21% and 9% respectively.’

Due to issues with data, Tasmania and the Australian Capital Territory were not included in the report.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.

Further information: Professor James Harrison, tel. (08) 8201 7620, mob 0405 031 467
For media copies of the report: 02 6249 5048/02 6249 5033 or email

NACCHO award winning member news: Carbal Medical Centre QLD takes top gong at awards

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Article by: Adam Davies, The Chronicle

Justin Mohamed chair of NACCHO congratulates another award winning NACCHO member .

CARBAL Medical Centre CEO Dr Harry Randhawa was still on cloud nine yesterday, days after learning the organisation had won a prestigious award as part of NAIDOC week celebrations.

The organisation was named indigenous business of the year at a gala dinner held at the Cathedral Centre at the weekend.

Dr Randhawa said the award came as a big surprise to the organisation and its 33 employees.

“It is a huge boost for the centre,” Dr Randhawa said.

“It is recognition of all the hard work we have done over the past year.

“It came as a very big surprise really,” he said.

Dr Randhawa said Carbal Medical Centre, which was established in 2006, provided culturally safe and secure health service to the city’s indigenous population.

“The centre is an extremely important part of the local community,” he said.

“We provide GP and nursing services for indigenous people.

“However, we also have access to a number of different health services for indigenous people.”

Dr Randhawa said thousands of indigenous people accessed the organisation’s services each year.

“We have more than 4500 clients registered on our books,” he said.

“Last year alone 2723 people accessed the services we provide.

“I am still gob smacked at winning the award. It is just fantastic news for the centre and the staff.”

NACCHO health news:There is a way forward if government would only listen to NACCHO

There is a way forward if government would only listen to NACCHO

Two reports released last week, one relating to health delivery services and the other on Justice reinvestment program to cut the appalling rate of imprisonment of Indigenous Australians are perfect examples of how government at all levels can deliver meaningful outcomes in addressing the disparity facing our First Nations people.

DOWNLOAD BOTH NACCHO PLAN and AIHW REPORT CARD HERE

First health ,The National Indigenous Times has long supported the National Community Controlled Health Organisation or NACCHO as it is more commonly known.

The reason we have long acknowledged the incredible work this organisation performs and the strong fearless leadership with Chair, Justin Mohamed at the front is because what NACCHO has been calling for to improve the standard of health delivery services to Indigenous Australians makes absolute sense.

Even more so because what Mr Mohamed and NACCHO have demonstrated is a way to deliver health service without the terrible waste in funds and therefore outcomes we have all witnessed in the methods used currently.

NACCHO’s approach can be simplified to this : Let Aboriginal Health delivery services control and manage the service to Aboriginal communities and we will all see improvements in outcomes.

Billions have been spent by all levels of government claiming it has evidence of their genuine attempts to address the health issues communities have faced for generations. Despite the enormous sums of money spent there has been little improvement in outcomes.

The myriad of programs launched have largely been driven by governments handing out money to public service bureaucrats to administer the disbursement of funds. There has generally been little interaction with the communities affected and worse still, no acknowledgment or meaningful attempts to provide what the Indigenous communities themselves say is required.

Like so many of the processes government adopts when it comes to Indigenous affairs the outcome ends up with the communities watching on as these government initiatives fail.

Some believe the approach by government is just” the government way” of doing things. Others believe it is a deliberate policy position of government designed to ensure communities are not empowered to achieve the desired outcome. The National Indigenous Times leans toward the latter rather than the former.

But NACCHO has resisted this policy approach and has continued to fight for an approach which empowers community based Indigenous health organisations to take responsibility for delivery of the program.

As Mr Mohamed said last week this is all about delivery of health services “by Aboriginal People for the Aboriginal people”. He is absolutely on the money. We couldn’t agree more with him. We believe the more empowerment given to the reputable and responsible Aboriginal organisations, the more we will see improvements in the Closing the Gap targets.

NACCHO’s position has been further strengthened now with the release of a report by the Institute of Health and Welfare which has found significant improvement in the quality and outcomes of health delivery services when those services are delivered by Aboriginal community based organisations.

This is the salient lesson for all governments if government genuinely wants to see improvements for Indigenous Australians then the best way, the most effective way, the “biggest bang for the buck” way is to empower Indigenous organisations to take responsibility and let them make it happen.

What NACCHO has demonstrated can be achieved also tells us if it can work for NACCHO it can work across the entire spectrum of health services and also for education, housing, employment, and the list goes on.

What NACCHO has said is the way forward and which has been endorsed by this Institute of Health and Welfare report now emerge as the true test of Federal State and Territory governments. NACCHO has shown us all a way forward and how it can work. All it requires is a commitment from government to change its approach on how funding is controlled and delivered across all Indigenous programs.

The report by the Senate committee inquiring into the benefits of Justice Reinvestment is another example. This committee has found the system of jailing Indigenous Australians at an ever increasing rate simply does not work.

All governments are spending billions locking up Indigenous Australians only to find they are more than likely to re-offend after they have been released. It should not take a Rhodes scholar to work out his was always a recipe for the outcomes we are now seeing. Indigenous Australians are more likely to be jailed than any other race of people anywhere in the world. And as the rate keeps increasing so does the rate of re-offending. It is a vicious cycle with no end.

What the Senate committee has found is it would be far more effective to invest in the communities and end the poverty. If that was done then the number of people ending up in jail would decrease.

Justice Re-investment has been shown to work in various countries around the world including of all places in the United States. If it can work there you would have to think it could work anywhere, including Australia.

But Justice Re-investment is what the name implies. It requires a re-investment by government into the communities, a willingness to empower the communities, a desire to provide meaningful outcomes on core issues such as housing, employment and education. If government committed to this there would be genuine and meaningful savings in the cost currently borne to lock these people up.

The reason is simple. If people are provided meaningful employment. If they can see they can own their own home and their children provided with a decent education then less will have any desire to commit a crime.

As it stands today many communities are being left to rot and die because of government inaction. If there are no jobs, no houses, no education, what is there ?. Well one alternative is crime and little wonder under those circumstances.

Both these initiatives, NACCHO’s demand for empowerment in the delivery of health services and re-direction of focus toward building and supporting communities so people are not left drifting aimlessly through life and crime are real outcomes. They are meaningful and they can make a difference to what faces so many Indigenous Australians today.

All it requires is government to commit to this change in approach. It seems crazy to even have to contemplate why government wouldn’t change. If delivery of health services can be more effective, therefore saving on the money wasted to date and if we can cut the number of people being jailed, again saving a great deal of money why wouldn’t you ?.

NACCHO health news: Not under the influence of evidence: A sober critique of the NT Alcohol Mandatory Treatment Bill

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Picture:John Paterson-CEO of NACCHO affiliate Aboriginal Medical Services Alliance NT (AMSANT),one of the driving forces behind the APO NT (full details of APO below)

APO NT does not support passage of the Alcohol Mandatory Treatment Bill (the Bill). Our organisations do not agree with key assumptions which underpin the Bill. We do not agree that mandatory treatment as provided for in this bill is an effective way to assist in reducing alcohol related harm in the NT.

Download APO NT submission

Download APO NT submission Appendix A

The mandatory rehabilitation scheme outlined in the Bill is not based on the best available evidence about what is effective to address alcohol dependence. The measures contained in the Bill will not be cost-effective and will not work.

The Bill in its current form would be a de facto re-criminalisation of public drunkenness which is contrary to the recommendations of the Royal Commission into Aboriginal Deaths in Custody. APO NT believes detaining problems drinks will lead to unnecessary tensions between Aboriginal people and police and is likely to result in more Aboriginal people entering the criminal justice system. Prisons in the NT are already overflowing with Aboriginal people.

We also believe that the Bill indirectly discriminates against Aboriginal people in the NT, particularly those Aboriginal people living remotely who are often more likely to drink in public places when they visit centres or towns.

APO NT believes that there may be a limited role for involuntary treatment in extreme circumstances where individuals are at very high risk of harm and unable to manage their circumstances, where clinically effective and culturally appropriate methods of engaging the patient into treatment have been tried and failed, and where strong safeguards and protections are in place, including that it does not criminalise, either directly, the behaviours it seeks to address.

The NT is a small jurisdiction with a finite amount of resources for programs and services. The budget allocation for the mandatory rehabilitation scheme is $45 million to set up and run the scheme for a year, which works out to an average spending of approximately $80,000 per problem drinker. APO NT believes that the NT, by investing in existing voluntary rehabilitation and other alcohol treatment programs including AOD treatment provided in Aboriginal primary health care, as part of a holistic suite of reforms which includes population supply reduction measures.

About APO NT

Aboriginal Peak Organisations of the Northern Territory – APO NT – is an alliance comprising the Central Land Council (CLC), Northern Land Council (NLC), Aboriginal Medical Services Alliance NT (AMSANT), North Australian Aboriginal Justice Agency (NAAJA) and Central Australian Aboriginal Legal Aid Service (CAALAS).

The alliance was created to provide a more effective response to key issues of joint interest and concern affecting Aboriginal people in the Northern Territory, including through advocating practical policy solutions to government. APO NT is committed to increasing Aboriginal involvement in policy development and implementation, and to expanding opportunities for Aboriginal community control. APO NT also seeks to strengthen networks between peak Aboriginal organisations and smaller regional Aboriginal organisations in the NT.

Introduction

NACCHO United Nations report:Indigenous heath, education and culture a focus in New York

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The United Nations Permanent Forum on Indigenous Issues (UNPFII) held at UN headquarters in New York has throughout the duration of the forum focused on areas including previous forum recommendations relating to Aboriginal and Torres Strait Islander Peoples health, education and culture.

Picture above of Kirsten Gray, Brian Wyatt (co-chair) Tjanara Goreng Goreng (FIRDA- Culture) and Amala Groom (FIRDA – Culture) at the UNPFII.

NACCHO was represented by Deputy chair Matthew Cooke,CEO Lisa Briggs and Professor Ngiare Brown

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 Brian Wyatt, Co-Chair of the Indigenous People’s Organisation (IPO) Network Australia welcomed the opportunity for Australia’s indigenous issues to be raised on the international stage.

 Mr Wyatt said nine recommendations had been made to the Forum relating to Indigenous health with a strong focus on the need for Indigenous Peoples to have control over health service delivery.

 “All over the world we see evidence that the biggest improvements in Indigenous health is where those people have control over the services provided to them.

 “This is because we understand our own communities and their needs and can deliver culturally appropriate care. Australia’s own Aboriginal Community Controlled health sector has been proven to be the most effective in closing the health gap.

 “We need to ensure measures to promote health equality are consistent with the rights, principles and standards contained in the UN Declaration on the Rights of Indigenous Peoples and particularly the right to Self Determination.”

 Mr Wyatt said the IPO had also made an intervention on education, urging members to ensure knowledge and contemporary social circumstances of Indigenous Peoples are embedded in the curricula of education systems.

 “In the face of global challenges to the self-determining interests of Indigenous Peoples, it is urgent that action be taken by the UN to protect and promote the sovereign rights of Indigenous Peoples to systems of education that embeds the scholarship of their cultural knowledge in the development of curriculum and research.

 “It is imperative that western education systems commit to working with Indigenous Peoples at the local level, demonstrate respect for the cultural rights of Indigenous Peoples and profile and promulgate these rights as determined by the UN Declaration of Human Rights and the UN Declaration on the Rights of Indigenous Peoples.”

 Mr Wyatt said the IPO had also put forward four recommendations in relation to culture acknowledging the need of Indigenous Peoples to retain control over their genetic resources, intellectual property and traditional cultural expressions.

The 12th Session of the United Nations Permanent Forum on Indigenous Issues is being held at the United Nations in New York from 20-31 May 2013.

The IPO is a broad affiliation of Aboriginal and Torres Strait Islander organisations and individuals, who engage with United Nations mechanisms and frameworks to advocate for the implementation of the Declaration.

First Peoples Disability Network Australia – Foundation for Aboriginal and Islander Research Action (FAIRA) – Foundation for Indigenous Recovery and Development, Australia (FIRDA) – National Aboriginal Cultural Community Health Organisation (NACCHO) – National Congress of Australia’s First People’s – National Aboriginal Torres Strait Islander Legal Services (NATSILS) – National Indigenous Higher Education Network (NIHEN) – National Aboriginal and Torres Strait Islander Women’s Alliance Corporation (NATSIWAC) – National Native Title Council (NNTC) – New South Wales Aboriginal Land Council (NSWALC) – Office of the Social Justice Commissioner.

NACCHO Closing the Gap report: Analysis of provisions in the 2013-14 budget of the Indigenous Chronic Disease Package

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Total government expenditure on Indigenous health has risen significantly since the commencement of the National Partnership Agreement (NPA) on Closing the Gap in Indigenous Health Outcomes in 2009-10 and now represents about 5.1% of total government health expenditure.

DOWNLOAD THE CLOSING THE GAP ON INDIGENOUS DISADVANTAGE:

An analysis of provisions in the 2013‐14 Budget and implementation of the Indigenous Chronic Disease Package

Russell, Lesley
Menzies Centre for Health Policy

ABSTRACT and LINK

This paper presents the author’s analysis of the Indigenous provisions in the Australian Government’s 2013-14 Budget in the context of current and past strategies, policies, programs and funding support. It also looks at the implementation and impact of the Commonwealth’s Indigenous Chronic Disease Package. This work has been done using only materials and data that are publicly available. The opinions expressed are solely those of the author who takes responsibility for them and for any inadvertent errors. This work does not represent the official views of the Menzies Centre for Health Policy, the Australian Primary Health Care Research Institute (APHCRI) or the Commonwealth Department of Health and Ageing which funds APHCRI.

Report summary

This amounted to $4.7 billion in 2010-11; of this, the Commonwealth provided about one-third ($1.6 billion).

However while there is a significant effort underway to close the gap in Indigenous disadvantage and life expectancy, in most areas this effort has yet to show real returns on the investments. The disadvantages that have built up over more than 200 years will not disappear overnight, and sustained and concerted efforts are needed to redress them.

Chronicdiseases, which account for a major part of the life expectancy gap, take time to develop, and equally, it will take time to halt their progress and even longer to prevent their advent in the first place. Programs will need to be sustained over decades if they are to have an impact on improving health outcomes.

On this basis, it is worrying to see that continued funding for the NPA on Closing the Gap in Indigenous Health Outcomes, as announced in April, will be less over each of the next three years than in 2012-13.

At the same time, the Budget Papers show that expenses in the Aboriginal and Torres Strait Islander health sub-function will decline by 2.7% in real terms.

This comes as states such as Queensland and New South Wales have made damaging cuts to health services and Closing the Gap programs.

Education is a significant determinant of health status so it is also concerning to see a reduced level of funding provided for Indigenous education over the next six years, especiallywhen efforts to close the gap in education for indigenous students have stalled. These cuts inhealth and educations commitments cannot be justified by saying that Indigenous Australianscan access mainstream programs. In many cases these are absent, inappropriate, or perceived as culturally insensitive, despite recent efforts to improve these deficits.

It is a strength of the COAG commitment to close the gap on Indigenous disadvantage that it recognises that a whole-of-government approach is needed to deliver improvements in the lives of Indigenous Australians.

However tackling disadvantage is about more than building houses, providing job training, implementing welfare reform, community policing andincreasing access to health services; it requires that governments recognise and respect the complex social and cultural relationships that underlie the housing, economic, health and societal issues present in many Aboriginal

DOWNLOAD THE CLOSING THE GAP ON INDIGENOUS DISADVANTAGE:

NACCHO health and racism:Goodes’ racism ordeal is only the tip of the health iceberg

Adam Goodes talks to the press

“In the contest of societies with dominant and minority cultures, such as Australia, the widespread and persistent suppression of minority cultural practices causes severe disruption, making our communities susceptible to trauma, collective helplessness and endemic maladaptive coping practices,”

CEO of Danila Dilba Health Service Olga Havnen (NACCHO member)

• This article first appeared on The Global Mail, part of our Guardian Comment Network

So, after this week we’re all clear: it’s not acceptable to call an Aboriginal an ape.

As the footballer Adam Goodes said, “it hurts”. Quite rightly, Eddie McGuire and a 13-year-old girl have had to hang their heads and publicly apologise for doing just that.

But who is going to apologise for Australia’s covert racism? That’s the racism that Northern Territory Aboriginal activist Olga Havnen described in her Lowitja O’Donoghue oration on Tuesday night in Adelaide.

YOU CAN DOWNLOAD Olga Havnen FULL SPEECH HERE

While McGuire should have tucked himself up in bed, getting the brain-refreshing sleep which would possibly have averted his gaffe in suggesting Goodes might promote King Kong, Havnen was showing us what covert racism looks like.

She spoke of how misguided politicians and public servants have used the Ginger Bread Men, also known as Geckos, and the NINGOs and the BINGOs to wrest control from Indigenous organisations in the Northern Territory.

“Ginger Bread Men” and “Geckos” are the names Aboriginal wits gave managers sent in to communities by the government as part of the federal Intervention — a package of policing and welfare measures introduced in 2007 to deal with enduring problems of child abuse and alcoholism in Indigenous communities.

Many millions of dollars have gone into resourcing the NINGOs (non-Indigenous government organisations) and BINGOS (Big International NGOs), delivering services to Aborigines, Havnen said. Aboriginal control of these services has withered, as the NGOs’ involvement has grown, she said.

It’s been six years next month since the Intervention began and the army rolled in, sending some people fleeing into the bush. In this time, it has “had profound psychological impacts on our people,” said Havnen. These impacts have gone almost completely unnoticed by policy-makers.

Health services, land managers and art centres have survived, but “Aboriginal community-driven service delivery has, in many parts of the Northern Territory, simply disappeared,” she said.

The link between action and psychological hurt may not seem as clear as in the case of McGuire’s suggestion that Goodes be used to publicise the musical King Kong. But Havnen, a descendant of the Western Arrernte people of Central Australia, argued that the “misguided, coercive approaches” of the Intervention are causing harm because lack of control over their own lives can virtually kill and maim her people.

It’s about who makes the decisions; who’s the boss.

“In the contest of societies with dominant and minority cultures, such as Australia, the widespread and persistent suppression of minority cultural practices causes severe disruption, making our communities susceptible to trauma, collective helplessness and endemic maladaptive coping practices,” she said.

She counted the ways in which the dominant culture’s decision-makers had taken power. First the soldiers had arrived. Then, Aboriginal-run organisations and community government councils were rapidly dismantled.

The Aboriginal “work-for-the-dole” CDEP program was “allowed to wither away”. (The CDEP was criticised as being merely a “make-work” program, leading to pointless paid activities such as painting rocks. However, it did have uses, including paying artists to paint.)

“Fourth, the introduction of mandatory, universal income control and the introduction of the Basic Card, although welcomed by some welfare recipients, has nevertheless had a major impact on the ways people use and control their money,” Havnen said.

Fifth, the “emergency response” introduced in the name of child protection “universally painted men as violent drunks, paedophiles and consumers of pornography, and women as passive, helpless victims,” she said.

While the introduction of alcohol controls across all Northern Territory “prescribed areas” was welcomed in some areas, it played havoc in others.

It’s about who makes the decisions; who’s the boss.

“Many communities had voluntary alcohol restrictions in place for years prior to the Intervention. The hundred or so locally initiated ‘dry areas’ were abolished in favour of blanket restrictions that have driven drinkers into unsafe drinking behaviours in towns and drinking camps,” she said.

And when the Intervention brought doctors and nurses from interstate to provide child health checks, the message was that Aboriginal health workers and nurses, who had been struggling in tough conditions with inadequate resources, had failed.

“In effect, they were being told that their careers had been rubbish,” she said.

Havnen, who was giving her oration for the Don Dunstan Foundation in Adelaide, knows as well as McGuire how quickly a public figure’s own words can rebound on them.

Late last year, the conservative Northern Territory government sacked her as its coordinator general for Remote Services following the tabling of her comprehensive report in which she criticised its Indigenous affairs expenditure.

McGuire, in defence of the comments he made on Melbourne radio, said he was tired and that his King Kong comment was “a slip of the tongue”.

He knew you were not allowed to say that sort of stuff any more. He probably doesn’t know that the idea of Indigenous people being close to the apes is a hangover from 19th century “scientific racism”, which devised a hierarchy of races by skin colour and put those of paler hue (including to the “scientists” who devised the system) up the top, near the angels.

Some ideas hang about for an awfully long time.

The Intervention is likely to stay. Federal opposition Leader Tony Abbott has said he would consider extending it – after he has consulted with Aboriginal leaders.

But perhaps he should first read the scores of reports compiled over the past three or so decades which say that the answer to addressing Indigenous disadvantage is to hand over increased Indigenous control of decision-making and service delivery.

Havnen is asking for a fundamental change. She wants leaders to show more daring, to give up what she calls “risk intolerance” in Indigenous affairs.

It’s worth considering. But, hey, everyone has been mesmerised by McGuire’s bungle, while out in the desert, the emergency continues.

NACCHO political news:Report finds need for more effective leadership across government to tackle critical issues in Aboriginal affairs

 

Rob Oakey

Committee chair Rob Oakeshott MP said the need for more effective leadership across government to tackle critical issues in Aboriginal and Torres Strait Islander affairs was clear.

A parliamentary committee has recommended a high level review of leadership in Indigenous Affairs

The report, by parliament’s joint Public Accounts and Audit Committee, supports recommendations from the Auditor-General for a ‘refresh’ of the lead agency role for Indigenous affairs, and calls for particular attention to be given to strengthening the authority of the agency to better drive changes across government departments.

DOWNLOAD REPORT HERE

Committee chair Rob Oakeshott MP said the need for more effective leadership across government to tackle critical issues in Aboriginal and Torres Strait Islander affairs was clear.

“The Government needs a lead agency with authority and a clear mandate to oversee expenditure, monitor outcomes, define priorities and drive actions at whole-of-government level,” Mr Oakeshott said.

“We live in a time where the want to reconcile is high”, he added. “FaHCSIA has made commendable progress in improving coordination between government agencies, but the committee was not convinced that the current arrangements provide FaHCSIA with the authority needed to drive outcomes as effectively as possible.”

The committee’s report also recommended:

  • the development of an explicit whole-of-government strategy for capacity development —both within government and for not-for-profit Indigenous organisations;
  • improvements to the availability of location-based data on Indigenous expenditure and outcomes;
  • an update to be provided on efforts to measure outcomes in ‘priority’ remote service delivery communities; and
  • options to be examined for improving Aboriginal and Torres Strait Islander representation and involvement in decision-making processes.

The committee came to its conclusions upon reviewing three reports published by the Auditor-General in 2012 focusing on government coordination arrangements for Indigenous programs.

The committee held three public hearings related to its review of the reports, and received written submissions from the National Congress of Australia’s First Peoples and the Social Justice Commissioner for Aboriginal and Torres Strait Islander Affairs.

An electronic copy of the report can be downloaded

For media comment: please contact Committee Chair, Rob Oakeshott MP, on
(02) 6584 2911.

 For information about the report:

please contact the committee secretariat by telephone (02) 6277 4615, e-mail jcpaa@aph.gov.au,