Sep 4 2019

NACCHO Aboriginal #MentalHealth and #SuicidePrevention : Read and Watch @beyondblue Chair The Hon Julia Gillard AC speech @UniofAdelaide Truth-telling and reconciliation will enhance the social and emotional wellbeing of Indigenous Australians.

” Suicide in our Indigenous communities is one of the greatest challenges of our times and its causes are complex.

Beyond Blue cannot claim or seek to be a specialist or comprehensive provider of social and emotional wellbeing or suicide prevention services for Aboriginal and Torres Strait Islander people.

That is a role which is more appropriately the domain of Aboriginal-led and community-controlled organisations.

But we can apply what we have learnt so far through our Reconciliation Action Plan, our growing cultural competencies, and strong relationships with Aboriginal and Torres Strait Islander peoples, leaders and organisations.

We can complement the work of the Aboriginal organisations and others by ensuring our major interventions are suitable for, and accessible to, Aboriginal and Torres Strait Islander people wherever possible, and use our well-known brand and strength in communications to fight racism and discrimination.

We will recognise those inherent protective factors of Indigenous cultures and communities – those powerful forces of resilience, humour, spirituality and connectedness – that can and should be utilised as sources of strength and healing.

We are ready to work alongside Indigenous people and communities in co-designing solutions to provide better outcomes for health and wellbeing.

We intend to be the best ally we can be, lend our voice when required and listen to learn.

We need to educate ourselves and ask questions when we need to; to commit, to support, to ally.

We pledge to be a positive force for change as the nation addresses the issue of constitutional recognition of Aboriginal and Torres Strait Islander peoples.

Aboriginal and Torres Strait Islander peoples have always resisted actions designed to destroy their culture, disperse their families and sever their connections to Country.

The day will come when we look with pride upon that determination, and indeed celebrate it as a complete history.

The Hon Julia Gillard AC University of Adelaide public lecture 2019 3 September 2019

Yellaka Dance Group

Read over 230 Aboriginal Mental Health articles published by NACCHO in past 7 years

Read over 150 Aboriginal Suicide Prevention articles published by NACCHO in Past 7 years

I acknowledge the traditional owners of the land on which we meet and in the spirit of reconciliation, pay my respects to Elders past and present. Yellaka, thank you for your warm Greeting to Country.

Introduction

The is the second time I have had the privilege of being so welcomed by Yellaka. The first time was at the recent South Australian State dinner to celebrate 125 years of women’s suffrage in our State – a milestone to be inspired by.

In fact, that dinner was very important for me in preparing for this lecture.

It caused to me to reflect on the complexity of history; on our achievements and failings. In that speech I spoke about the need to erect a permanent monument to celebrate the fight for women’s suffrage and all that was gained here in South Australia in 1894.

But in doing so, I said care must be taken to tell the whole story, not part of it.

Despite Aboriginal men and, as a result of women’s suffrage, Aboriginal women having the right to vote, it was common for them neither be told about it nor supported to enrol. Sometimes this oppressive neglect morphed into a more active discouragement from participating.

This pernicious repudiation of a human right was compounded by a direct legal bar, when in the 1902 Commonwealth Franchise Act, Aboriginal and Torres Strait Islander people were excluded from voting in federal elections. It was not until 1962 that Indigenous Australians could have a say in who governed our nation.

We cannot tell the history of how our democracy developed without looking squarely at how equality was denied for so long.

This is just one example of the need to tell the deeper truths that lie beyond the surface.

To quote the words of Labor Prime Minister Paul Keating in his famed Redfern Speech, we need:

‘Recognition that it was we who did the dispossessing.

We took the traditional lands and smashed the traditional way of life. We brought the diseases. The alcohol.

We committed the murders.

We took the children from their mothers.

We practised discrimination and exclusion.

It was our ignorance and our prejudice.

And our failure to imagine these things being done to us.

With some noble exceptions, we failed to make the most basic human response and enter into their hearts and minds.

We failed to ask – how would I feel if this were done to me?’

Friends, this question is as profoundly challenging today as it was when Paul spoke those words almost thirty years ago. Trying to answer it requires honesty, empathy, intellectual understanding, spiritual depth.

Today, I am asking you to bring those characteristics with you as we discuss the tragic topic of suicide and Indigenous Australians.

Honesty

First, with honesty, let’s confront the facts.

Since 2012, suicide has been the leading cause of death among young Aboriginal and Torres Strait Islander people aged 15 to 34.

The suicide rate for Aboriginal and Torres Strait Islander teenagers aged 15 to 19 of both genders is around four times that of their non-Indigenous peers.

Despite Aboriginal and Torres Strait Islander people comprising around three per cent of the Australian population, they account for thirty per cent of the suicide deaths among those under 18 years of age.

There are significant suicide or self-harming clusters that can occur within a single community or locale over a period of weeks or months.

For example, In February, Western Australia’s State Coroner handed down her report on a cluster of 13 deaths that occurred in less than four years in the Kimberley region and included five children aged 10 to 13.

The Coroner spoke of the deaths as profoundly tragic, individually and collectively, of dysfunction, alcohol, domestic violence and grief.

But she added:

‘to focus only upon the individual events that occurred shortly before their deaths would not adequately address the circumstances attending the deaths. These tragic individual events were shaped by the crushing effects of inter-generational trauma and poverty upon entire communities. That community-wide trauma, generated multiple and prolonged exposures to individual traumatic events for these children and young persons.’

Watch video

Please note : Julia Gillard starts her talk at about 27 minutes into the 1hr 10 min event, and talks for just under 30 minutes. It finishes with a Q&A session (of about 20 minutes).

Empathy

The Coroner here is calling to our ability to show empathy. To walk alongside our First Peoples and try to understand how history and lived reality come together and can create circumstances of despair.

Great damage has been done to our Aboriginal and Torres Strait Islander communities through two centuries of discrimination, dislocation and cultural disruption.

Culture is a word that is often tangled up with nationality, but it entails much more.

Our culture determines so much of our identity; our values, the way we view the world, the way we interact with others, our sense of belonging.

And if the foundations of culture are systemically disrupted – connection to land, traditional places and practices, languages, spirituality, family and kinship ties – it causes devastation across generations.

But honesty also requires us to recognise that there is both deep lingering pain from our history, and new pain that arises in the present.

Imagine not getting the job you’re qualified for because of the colour of your skin; to know you are being followed by a store detective just for being you; to feel the stranger sitting beside you slip sideways to create greater distance.

These are everyday situations – the constant but subtle cues of difference – and where being racially different is nearly always positioned as a liability.

Put simply, racism, including these kinds of behaviours, is not only bad for mental health and wellbeing – it both causes and perpetuates high levels of social and emotional distress for Aboriginal and Torres Strait Islanders. In addition, there is a ‘dose’ effect for psychological distress caused by racism: the more a person is exposed to it, the greater the impact.

That was why Beyond Blue launched its Stop, Think, Respect invisible discriminator campaign in 2014 with a repeat run in 2016.

The campaign – the most viewed and shared in Beyond Blue’s history – highlights the routine everyday impact of subtle racism on the social and emotional wellbeing of Aboriginal and Torres Strait Islander people.

The campaign aimed to change behaviour by encouraging non-Indigenous Australians to think about their often, unconscious behaviours and to think again before they act.

To think before they laughed along – even uncomfortably – at a racist joke in the pub.
To challenge why they may not sit beside an Aboriginal person on a crowded bus.

But it was the reaction from Indigenous people that was most revealing.

They told us they loved the campaign because finally somebody had noticed that, for them, every day could be a little tougher than it should be.

Over half of Aboriginal and Torres Strait Islander people who experience racial discrimination report feelings of psychological distress, meaning they are at elevated risk of anxiety and depression, substance use and contemplating or attempting suicide.

Empathy requires us to recognise that the threads of the past and the attitudes shown in the present day are woven together. For non-Indigenous Australians, our collective failure to face up to all of the brutal truth of our history and its ongoing effects holds us back from full understanding today.

For Indigenous Australians, the interconnected issues of cultural dislocation, personal trauma and the ongoing stresses of disadvantage, racism and exclusion are absolutely contributing to the heightened risk of mental health problems, substance misuse and suicide.

All this was acknowledged by the Royal Commission Into Aboriginal Deaths In Custody. That report was tabled in 1991.

Intellectual understanding

Driven by empathy, we also need to engage intellectually on the best ways to provide culturally appropriate services and supports to prevent Indigenous suicide.

Nothing less than profound systemic reform is needed to improve social and emotion wellbeing.

Such major change must be culturally informed and co-designed. As many Aboriginal and Torres Strait Islander people continue to remind us, Indigenous policies and responses must be led by Indigenous people, which might mean solutions that look different to anything that has been implemented before.

Innovation and new efforts are needed nationally and locally.

In 2009 the Rudd Government launched the ‘Closing the Gap’ response as a measurable account of Indigenous disadvantage that would be reported to parliament annually on progress.

In the 10 years since launch most of the indicators of disadvantaged have remained stubbornly unmoved. Aboriginal and Torres Strait Islander people can expect to live 10 to 17 years less than other Australians.

While there have been some improvements against some performance indicators, these have been small and incremental.

And babies born to Indigenous mothers still die at more than twice the rate of other Australian babies.

Aboriginal and Torres Strait Islander people experience higher rates of preventable illness such as heart disease, kidney disease and diabetes.

And a major contributing factor to the life expectancy gap is suicide.

There are no mental health or suicide prevention targets in Australia’s Closing the Gap strategy despite the alarming statistics on Indigenous suicide and psychological distress, but as a member of the steering committee, Beyond Blue is adding our voice to rectifying this.

At the same time, we are calling for this act of national leadership, as an organisation we are trying to be a good partner in locally led change models.

In November 2018, Beyond Blue launched Be You: a Commonwealth-funded national initiative that aims to strengthen the mental health literacy, resilience, self-care and help-seeking of every member of Australia’s school communities and early childhood settings.

In January, Minister Wyatt announced $2.3 million over two years to pilot and evaluate a culturally appropriate, place-based adaptation of Be You for schools in the Kimberley and Pilbara regions of WA, in partnership with Aboriginal communities.

That work is now underway. And we are taking a very different approach to this work than what we would normally.

Local stakeholder engagement has confirmed that we must be guided by local communities to genuinely co-design the project; to employ people with community relationships and credibility; and to engage Aboriginal community-controlled organisations to support implementation and delivery of the program.

It’s still very early days, but we are gaining much from partnering with Indigenous communities.

Spiritual depth – Uluru Statement from the Heart

Honesty, empathy, intellectual understanding, all are necessary in the cause of tackling the rate of Indigenous suicide.

But so is spiritual depth, the ability to transcend a divided past, address the dispiriting inequalities of the present and embrace a united future.

Just over two years ago, 250 Aboriginal and Torres Strait Islander leaders endorsed by standing ovation the Uluru Statement from the Heart.

In burning prose it describes that the sovereignty of this nation’s First peoples is ‘a spiritual notion: the ancestral tie between the land, or ‘mother nature’, and the Aboriginal and Torres Strait Islander peoples who were born therefrom, remain attached thereto, and must one day return thither to be united with our ancestors. This link is the basis of the ownership of the soil, or better, of sovereignty.’

It goes on to say:

‘Proportionally, we are the most incarcerated people on the planet. We are not an innately criminal people. Our children are aliened from their families at unprecedented rates. This cannot be because we have no love for them. And our youth languish in detention in obscene numbers. They should be our hope for the future.

These dimensions of our crisis tell plainly the structural nature of our problem. This is the torment of our powerlessness.

We seek constitutional reforms to empower our people and take a rightful place in our own country. When we have power over our destiny our children will flourish. They will walk in two worlds and their culture will be a gift to their country.

We call for the establishment of a First Nations Voice enshrined in the Constitution.’

As we all know, changing our constitution is difficult in every sense. Conducting and carrying a referendum by a special majority is hard to do. Our history books are littered with the stories of failed referendums. Nineteen referendums proposing 44 changes to the Constitution have been held since Federation but the Australian people have agreed to only eight changes with the last ‘yes’ vote occurring in 1977.

Of course, the Indigenous leaders who gave us the Uluru statement from the heart know this history. They neither underestimate how hard it is to have voters accept change, nor the joy that can come when they do. Many of them were alive when more than 90 percent of Australians voted in the 1967 referendum to allow First Nations people to be included in the census and for the Federal Parliament to have the power to legislate for an improved future.

In the Uluru statement, Indigenous leaders are specifically calling for a comparable act of national unity. There is some reason to believe that voting Australians in their millions are prepared to answer that call.

The Australian Reconciliation Barometer is a national research study conducted every two years to measure and compare attitudes and perceptions towards reconciliation.

In 2018 the Barometer found:

90 per cent of Australians believe the relationship between Aboriginal and Torres Strait Islander people is important;
95 per cent believe that it is important for our First Peoples to have a say in matters that affect them;
and 80 per cent support a formal truth telling process.

That there is a public mood for change is further confirmed by the Australian Constitutional Values Survey of 2017 released by the Centre for Governance and Public Policy at Griffith University.

It found 61 per cent of respondents would vote “yes” in a referendum to add an Indigenous voice to Parliament.

So, we increasingly desire a richer understanding of our shared history and some form of national reconciliation, but change can be hard to achieve, even when the majority is willing.

Successive Prime Ministers and governments, Indigenous leaders and organisations have tried to advance this cause.

The government I led set out to bring a referendum on constitutional recognition to the people by the 2013 election. I appointed an Expert Panel on Constitutional Recognition of Indigenous Australians to advise on the wording.

On that panel were some of our most persuasive and respected Indigenous leaders, including The Hon. Ken Wyatt AM, the first Indigenous Australian to serve in the House of Representatives.

The panel’s recommendations were sensible and smart.

But before we could proceed, we needed to diagnose the prospects of success at a referendum. The very worst thing we could do would be to put a referendum proposal forward only to have it fail.

The consensus was we did not have time to build momentum for change ahead of a 2013 election.

That need for certainty remains a critical issue for today’s leaders as they move towards a proposal to put to the people.

But much has changed since 2013 and we can all be heartened by that. I am especially heartened that we have, for the first time, extremely talented and respected Aboriginal people from both sides of politics leading Indigenous policy and discussion on this issue.

With bi-partisan support, shared commitment and collaboration, change is achievable.

We know wellbeing is intrinsically linked to a strong sense of self, connections to community, and recognition of culture.

That is why I and my Beyond Blue Board colleagues recently approved a comprehensive Aboriginal and Torres Strait Islander Strategy to guide our contribution for the next five years. Through the Strategy, we have resolved to continue to advocate on national issues of importance to Aboriginal and Torres Strait Islander people.

We are particularly determined to raise our voice in support of an openhearted and respectful response to the Uluru Statement from the Heart.

Beyond Blue acknowledges that there are still community and political discussions occurring about constitutional change and recognition. As that conversation continues, Beyond Blue advocacy will be aimed at our nation adopting the kind of far-sighted change that can bring a new era of healing and unity.

This isn’t a mental health organisation dabbling in politics. We do it because structural discrimination has a profound and proven negative impact on individual and community wellbeing and mental health.

This is absolutely about ‘sticking to our knitting’.

This is about the Board of Beyond Blue supporting action on the basis there will be significant benefit to a population group at higher risk of mental health conditions and suicide, and who experience discrimination and disadvantage.

The Board of Beyond Blue also accepts the invitation issued in the Uluru Statement from the Heart to walk with you in ‘a movement of the Australian people for a better future’.

To our federal parliamentarians who are working through how best to respond to the Uluru statement my personal message is this; I know what it is like to be beset with doubts about the best way to respond to a call to address trauma and despair. To worry about making the wrong decision, one that risks more damage.

I went through every painful permutation of that in my head when I worked through whether to call a Royal Commission into Child Sexual Abuse in Institutional Settings. I am not ashamed to say here that in the face of such a major decision, I was afraid.

Specifically, I was afraid that holding a Royal Commission would retraumatise, rather than heal.

As history records, I worked through those fears and called the Commission. I know now from my own observations of the impact of the Royal Commission that great healing can come from heeding the call, truth-telling and acknowledgement of past trauma.

I ask our current leaders on all sides of the parliamentary chamber to work through their fears and concerns. I ask our current leaders to heed the call of the Uluru Statement from the Heart.

Conclusion

Suicide in our Indigenous communities is one of the greatest challenges of our times and its causes are complex.

Beyond Blue cannot claim or seek to be a specialist or comprehensive provider of social and emotional wellbeing or suicide prevention services for Aboriginal and Torres Strait Islander people.

That is a role which is more appropriately the domain of Aboriginal-led and community-controlled organisations.

We are ready to work alongside Indigenous people and communities in co-designing solutions to provide better outcomes for health and wellbeing.

We intend to be the best ally we can be, lend our voice when required and listen to learn.

We need to educate ourselves and ask questions when we need to; to commit, to support, to ally.

We pledge to be a positive force for change as the nation addresses the issue of constitutional recognition of Aboriginal and Torres Strait Islander peoples.

Aboriginal and Torres Strait Islander peoples have always resisted actions designed to destroy their culture, disperse their families and sever their connections to Country.

The day will come when we look with pride upon that determination, and indeed celebrate it as a complete history.

I look forward with hope to that day and I thank you.

Dec 11 2013

NACCHO Aboriginal eye health : Small victories add up to gap closure for Aboriginal health

With a team at the University of Melbourne, we have researched and consulted widely over the past five years to come up with a plan to “Close the Gap” in Indigenous eye health. ‘The Roadmap to Close the Gap for Vision’ presents an opportunity for another ‘small victory’ by eliminating preventable vision loss for Indigenous people over the next five years

Professor Hugh Taylor (pictured centre above)

Early this year, then Prime Minister Julia Gillard spoke to Parliament about some of the positive trends that are emerging in the long-term goal of the Government to “Close the Gap” for Australian Indigenous disadvantage.

From The AGE

She described Closing the Gap as ‘an accumulation of small victories’ which can provide ‘the basic public services…delivered at the standard that every Australian expects’.

The general theme is that some things are improving, albeit slowly, and others need to get a wriggle on.

This is the first time Indigenous eye health has been comprehensively researched to identify the problems, needs and solutions.

Previous reports on Indigenous eye care have been limited to reviews and the findings have been implemented incompletely at best. ‘The Roadmap to Close the Gap for Vision’ has drawn on successful examples and practices from around the country and extensive community and stakeholder consultation. Best of all, it is feasible and doable, but each component is essential for success.

The key to the Roadmap is the comprehensive approach that will improve the provision and utilisation of eye services by the application of additional resources to increase the availability of eye care and provide good co-ordination and case management of patients.

Indigenous Australians experience six times the rate of blindness compared with the rest of Australia. Vision loss causes 11 per cent of the Gap in health – it is equal third with trauma, following heart disease and diabetes but ahead of stroke and alcoholism. The provision of good quality eye care is fundamental to improving the health of Indigenous Australians and unlike many other conditions, most vision loss can be eliminated overnight.

The Roadmap provides policy recommendations to eliminate unnecessary vision loss through 42 interlocking strategies. The recommendations build on previous reports from the Indigenous Eye Health Unit at the University of Melbourne and an extensive consultation process with the community-controlled sector, eye health professionals, governments and other stakeholders.

The Roadmap addresses primary eye care, refractive services, cataract, diabetic eye disease and trachoma. It includes cost estimates for the Commonwealth, state and territory governments. It builds on community consultation and control, the regional delivery of services and the National Health Reforms. It stresses the assessment of population-based needs, strong co-ordination, monitoring of performance and national accountability.

A recent Victorian initiative is one example of the difference a co-ordinated approach that involves all the key partners and addresses one of the concerns raised as a barrier can make. The Victorian Eyecare Service was augmented in 2010 by the Victorian Government with funds to allow Aboriginal Victorians access to a specifically designed pair of spectacles for $10. The scheme is available from optometrists working in Aboriginal Health Services and through a network of private optometrists in rural Victoria.

There is no requirement for a health care card or pensioner status to be eligible for access to the scheme. The introduction of this scheme in 2010 has been followed by a more than twofold increase in demand. Cost is identified as the most common reason Indigenous people do not go to a health professional when needed. However, rather than cost, we found that cost-certainty was the more important issue. Cost-uncertainty for spectacles was commonly reported to the research team as the reason for not visiting the optometrist and not having eyes tested. The Victorian scheme demonstrates that when good quality spectacles are provided at a low and certain cost, the service is rapidly accepted and taken up.

All Australians reasonably expect to see clearly and comfortably and to have healthy eyes. We all fear vision loss and blindness given its considerable potential impact on the quality of our lives. The Roadmap to Close the Gap for Vision provides opportunity to accumulate yet another small victory to reduce Indigenous disadvantage. We have the evidence, the strategy and the capacity to close the gap for vision – the time is right to take this next “small step”.

The Indigenous Eye Health Unit would like to acknowledge support from the following donors; The Harold Mitchell Foundation, The Ian Potter Foundation, Mr Greg Poche AO, the University of Melbourne, Dr David Middleton, Mr Peter Anastasiou, Mr Rob Bowen, Dr Vera Bowen, Mr Noel Andresen, Dr Mark & Alla Medownick, Gandel Philanthropy, CBM Australia, The Cybec Foundation, The Aspen Foundation and “K” Line Logistics. Funding for work on the Implementation of the Roadmap to Close the Gap for Vision has been provided by the Department of Health for 2013 – 2014.

Read more about Hugh Taylor at: www.medicine150.mdhs.unimelb.edu.au/taylor

NACCHO AGM Perth 2013 health news: Aboriginal life expectancy increases to Close the Gap (nacchocommunique.com)
NACCHO AMA Aboriginal health news : Action needed to give Aboriginal children a healthier start to life ; Download report (nacchocommunique.com)
NACCHO Aboriginal Health News:PM appoints Professor Ngiare Brown to advisory council (nacchocommunique.com)
NACCHO Aboriginal health news :Leading organisations rally: Food security the missing link in ‘closing the gap’ (nacchocommunique.com)
NACCHO political news: Tony Abbott picks leaders for ‘the Indigenous dozen’ council (nacchocommunique.com)
NACCHO Aboriginal health news: Smoking fall a win for Aboriginal health, but many problems remain: ABS report (nacchocommunique.com)

Aug 11 2013

NACCHO political debate alert :Aboriginal policy- check out where the parties stand

According to the latest census figures from 2011, there are 548,370 people in Australia who identify as Aboriginal or Torres Strait Islander.

From the ABC website Anna Henderson CLICK here for page

NOTE: Provided for the information of NACCHO members and stakeholders but not endorsed in anyway

In the Northern Territory just under 27 per cent of the population identified as Indigenous.

Across the rest of the country, the proportion of the state or territory population who identified as Indigenous was 4 per cent or less.

But Aboriginal and Torres Strait Islander people remain over-represented in prison system, have lower average life expectancy, higher child mortality rates and a higher likelihood of living in poverty.

Earlier this year, then prime minister Julia Gillard delivered the latest report card on the Government’s efforts to close the Indigenous disadvantage gap. She said the Federal Government’s investment in the portfolio has been unprecedented but she noted eliminating disadvantage would take a sustained commitment over many years from all governments, the business sector, non-government organisations, Indigenous people and the wider community.

What aspects of Indigenous Affairs policy do the major parties agree on?

Constitutional Recognition of Indigenous People

The major parties have given in principle backing for this goal. Former prime minister Julia Gillard originally agreed to hold a referendum by the 2013 election but shelved that plan because of a lack of public awareness about the issue. Instead an Act of Recognition was passed in Federal Parliament in February 2013 on the anniversary of the national apology with a two-year sunset clause for holding a referendum. The Coalition has also committed to put forward a draft amendment to the Constitution within 12 months of winning government and establish a bipartisan process to assess its success. There are some differences of opinion between the parties about the exact wording that should be used to make the constitutional amendment. Federal Parliament has established a Joint Select Committee on Constitutional Recognition of Aboriginal and Torres Strait Islander Peoples. They are working with the funded group Recognise.

Despite the bipartisan agreement to hold a referendum, the issue became political divisive in July when Kevin Rudd announced his intention to hold a referendum within two years and asked the Opposition Leader Tony Abbott to “join that journey”. Mr Abbott reacted by pointing out the Coalition’s one-year timeframe for an amendment means an Abbott government would act more quickly on the issue than a re-elected Labor government.

Closing the Gap

The major parties have backed Labor’s 2008 targets:

Close the life expectancy gap within a generation.
Halve the gap in mortality rates for Indigenous children under five within a decade.
Ensure access to early childhood education for all Indigenous four-year-olds in remote communities within five years. The Government says this will be met this year.
Halve the gap in reading, writing and numeracy achievements for children within a decade
Halve the gap for Indigenous students to stay on for Year 12 or equivalent attainment rates by 2020
Halve the gap in employment outcomes between Indigenous and non-indigenous Australians within a decade

Indigenous representation in Federal Parliament

All parties have expressed interest in ensuring there are Aboriginal and Torres Strait representatives holding seats in Federal Parliament. The Coalition welcomed the first Indigenous Lower House MP, the member for the WA seat of Hasluck Ken Wyatt at the last election. The former prime minister Julia Gillard intervened in local preselections in the Northern Territory this year to appoint a “captain’s pick” for the top spot on Labor’s NT Senate seat, Nova Peris. She will be the first Aboriginal woman to represent the party in the Federal Parliament if successful. The Greens have a policy aim to ensure Aboriginal people have political representation, and the party has recruited a number of Aboriginal candidates for this year’s election.

Economy and jobs

The major parties have all promoted the idea of ensuring Aboriginal people living in remote communities have access to a job. The high unemployment rates in the communities are partially due to the lack of economically viable industry in those areas. Labor has been promoting private investment to create jobs. The Coalition is also focused on the need for economic investment and has flagged the prospect of flying workers in and out of nearby resources projects so they remain connected to their home country but are also earning money to support their families. The Greens policy emphasises the importance of Aboriginal communities determining the kinds of economic projects they have in and around their communities.

What are the key differences between the major parties?

Video: Tony Abbott promises a new engagement with indigenous Australians (Lateline)

The Indigenous Affairs portfolio

Under Labor the portfolio has been held by Minister Jenny Macklin. The Coalition has appointed NT Senator Nigel Scullion as its spokesman. Opposition Leader Tony Abbott has announced that if elected, the portfolio would become part of Prime Minister and Cabinet. Senator Scullion would remain as spokesman but Mr Abbott says he would also effectively be the Prime Minister for Indigenous Affairs. The Greens have also had a spokeswoman Rachel Siewert appointed to oversee the portfolio.

The Northern Territory Intervention

The Coalition announced an Intervention into the Northern Territory under former Prime Minister John Howard. Labor changed some elements of it when it implemented the Stronger Futures legislation. The Greens want to rescind those laws.

Homelands (also known as outstations)

In the 1970s, family groups in the Northern Territory, Queensland, Western Australia and South Australia began to reject the mission and settlement communities where they had been relocated, and wanted to move back to their traditional and ancestral lands. The remote Homelands have been an ongoing political issue because it is expensive and inefficient to provide services to them. It is estimated that thousands of people are continuing to live in the Homeland environment, particularly in the Northern Territory. The Federal Government was responsible for Homelands until the former Liberal prime minister John Howard handed responsibility to the NT government as part of the Northern Territory Emergency Response in 2007.

As part of Labor’s 2012 Stronger Futures package, the Federal Government has committed $206 million for basic services in the NT, including water, power, roads, sewerage and other infrastructure. The Coalition’s Indigenous Affairs spokesman Nigel Scullion has criticised the Government for not providing enough funding for adequate service provision. He has also stated the Government should not be funding the services and they should be paid for with council rates. The Greens have a strong view that Aboriginal people should have government support to maintain a connection with their traditional lands.

Education

Labor is hoping to seal a deal with all the states and territories, along with the Catholic and independent sectors on its Better Schools package as recommended in an expert report conducted by David Gonski. The report outlines a funding formula with a base figure for all students and extra loadings. Some of those loadings are specific to remote areas and Indigenous students. The Coalition has sent mixed messages about whether it would honour the deal in government but it is unlikely unless most, or even all, schools sign up. The Coalition is more likely to extend the existing funding model if elected. The Greens say remote communities should have access to government services and the party advocates for culturally appropriate education incorporating language and culture.

What we know

ALP

Want to see parliament revisit a referendum on recognition of Indigenous people in the constitution within two years
Close the Gap targets, agreed to by COAG in 2008. Results collated and presented in parliament each year by the PM
Funding through national partnerships agreements for health, education and housing
Stronger Futures package of measures in the NT
Cape York welfare reform trial
Constitutional recognition of Aboriginal people – latest progress report
Funding land and sea ranger programs

Coalition

The Indigenous Affairs portfolio would be move into the Department of Prime Minister and Cabinet
Changing the constitution to acknowledge Aboriginal people – draft amendment would be put forward within 12 months
If elected Tony Abbott would spend a week each year in Aboriginal communities and take senior decision makers with him
Consideration of tailored governance processes for different communities
Concentration on creating economic opportunities
Look at fly in, fly out job prospects for Indigenous people in remote communities to work in the mining industry
Attendance data for all schools would be published (not just Indigenous schools, to avoid stigma)
Income quarantining- supported but not linked to school attendance. Instead it is proposed there would be on-the-spot fines for parents.
Encourage longer term postings at remote schools and clinics and aim to attract high quality teachers and health professionals
All larger Indigenous communities would have a permanent police presence

Greens

Compensation for the Stolen Generation
End the NT Intervention
Close the Gap targets
Recognise Aboriginal and Torres Strait Islander people in the Constitution
Respect the link between Indigenous people and the land
Comply with international agreements on Indigenous rights including he Declaration on the Rights of Indigenous Peoples
Aboriginal people have the right to self determination and political representation and must partner in programs and services that affect them
Aboriginal people should benefit financially from their cultural heritage and the biodiversity of their lands and waterways
Dispossessed Aboriginal people have a right to be assisted to acquire or manage land and waterways that belong to them
All Australians including those living in remote communities have the equal right to essential government services
Protection of Aboriginal cultural traditions
Culturally appropriate health, housing and infrastructure
Culturally appropriate education incorporating language and culture
Allowing Aboriginal people to control their own education system when they want to
Qualified interpreters at hospitals, courts and government meetings
Rescind Stronger Futures legislation
Full implementation of recommendations from key Indigenous Affairs reports
Strategies to deal with impacts of climate change on indigenous communities
Food security for Aboriginal people in remote areas
Long term sustainable funding for land and sea ranger programs

What don’t we know about the major parties’ policies?

Policy release

The major parties had not released their full Indigenous Affairs election policies by the middle of the year, though Mr Abbott and Ms Macklin have delivered key speeches outlining their vision for the portfolio this year. The Greens have a policy document on their website and have flagged the prospect of some further announcements before the election is held.

What we don’t know

Whether the Coalition would be open to changing the structure of the powerful land councils
How the Greens would fund the full suite of policies that have been put forward

Key reports on Indigenous Affairs

Bringing Them Home

The Royal Commission into Aboriginal Deaths in Custody

NT, WA and SA Coroner’s recommendations on petrol sniffing

The Little Children are Sacred report

HREOC reports on petrol sniffing, suicide

The Evatt Review

NACCHO political alert: What is the future of Aboriginal leadership and activism ? (nacchocommunique.com)
NACCHO NASTIHP health plan news: Racism a driver of Aboriginal ill health (nacchocommunique.com)
NACCHO OCHRE DAY:The new generation of Aboriginal males is making generational changes (nacchocommunique.com)
NACCHO Aboriginal health alert:All Northern Territory prisons will be totally smokefree from Monday 1 July (nacchocommunique.com)
NACCHO male health news alert – NACCHO calls for male-only Aboriginal health clinics (nacchocommunique.com)
NACCHO NATSIHP news: $12 billion Aboriginal health plan to be launched today (nacchocommunique.com)
NACCHO launches Aboriginal Male Health 10 point Blueprint 2013-2030 (nacchocommunique.com)
NACCHO NATSIHP News:What a report about Aboriginal health can teach journalism (nacchocommunique.com)

Aug 3 2013

Ten great reasons why you should not miss the NACCHO Aboriginal health summit In Adelaide

Inaugural Aboriginal health summit: why Aboriginal community control works

The National Aboriginal Community Controlled Health Organisation (NACCHO) will hold their first ever National Aboriginal Primary Health Care Summit in Adelaide later this month.

NACCHO Primary Health Care Summit

20th-22nd August 2013

Adelaide Convention Centre

The inaugural summit, which goes for three days, will bring health service professionals from around the country together to discuss national, state and local best practice in health management, and focus on three key themes: primary health care, governance, and workforce.

10 great reasons why you should not miss the NACCHO summit In Adelaide

Inspiring speakers
Opportunities to meet old friends and make new ones
Practical take-home ideas
Entertainment
Resources to equip you
What about ‘Three streams of break-out sessions each day’
Social events
Opportunities to partner with other organisations and people from inside and beyond the ACCH sector
Delicious food (health of course)
and Aboriginal community control according to Justin Mohamed

For more information and to register visit http://www.naccho.org.au

NACCHO Chair, Justin Mohamed (pictured above left with Megan Davis and Deputy Matthew Cooke) said the Health Summit was a great opportunity to showcase the incredible contribution Aboriginal Community Controlled Health Organisations are making in their communities.

“We have concrete evidence that Aboriginal health in Aboriginal hands is what is really making the difference in achieving health outcomes for our people,” Mr Mohamed said.

“We are seeing big improvements in child birth weights, maternal health and management of chronic diseases like diabetes, highlighted recently in a report by the Australian Institute of Health and Welfare (AIHW) Healthy for Life Report Card.

“The Aboriginal community controlled health model has been working well for 40 years, and it is important that we get together to share best practice and discuss issues and areas where we can make improvements.

“Over the three days, summit participants will hear from Aboriginal leaders who are making a real difference in their communities.

“Our culturally appropriate health providers with majority Aboriginal governance are not only providing comprehensive primary health care to just under half of Australia’s total Aboriginal and Torres Strait Islander population, but are one of the largest employers of Aboriginal people as well.

“There is still a long way to go to Close the Gap and to build a healthy future for all Aboriginal and Torres Strait Islander people. Aboriginal Community Controlled Health Organisations are part of this picture and achieving targets to deliver better health outcomes.

NACCHO Primary Health Care Summit

20th-22nd August 2013

Adelaide Convention Centre

For more information and to register visit http://www.naccho.org.au

Media contact: Colin Cowell 0401 331 251, Anaya Latter 0432 121 636

NACCHO OCHRE DAY:The new generation of Aboriginal males is making generational changes (nacchocommunique.com)
NACCHO media release: Aboriginal health gap in danger of blowing out (nacchocommunique.com)
NACCHO NATSIHP news: $12 billion Aboriginal health plan to be launched today (nacchocommunique.com)
NACCHO NASTIHP health plan news: Racism a driver of Aboriginal ill health (nacchocommunique.com)
NACCHO download and updated press release: National Aboriginal heath plan will help close the gap (nacchocommunique.com)
NACCHO launches new 2013-2030 Healthy Futures 10 point and AIHW report card (nacchocommunique.com)

Jun 11 2013

NACCHO political news alert:Tony Abbott says there is no “one size fits all” solution to Aboriginal policy but new engagement is a must

A NEW engagement with Aboriginal people should be one of the hallmarks of an incoming Coalition government.

From Tony Abbott Federal Opposition Leader

Opinion article News limited

While our forefathers created a country we can be proud of – perhaps the most magnificent country on earth – there is no escaping the fact that the dispossession and marginalisation of Aboriginal people is by far the most troubling feature of our national story so far. News Limited is right to revisit this essential national issue.

As Paul Keating put it so eloquently over two decades ago, chronic indigenous disadvantage constitutes a stain on our nation’s soul. Until the first Australians can fully participate in the life of our country, we are diminished as a nation and as a people.

Of course, progress has occurred, but there is still much to do. There is a new spirit in this land that reaches out to embrace the indigenous people of our country, so different from the prejudice that prevailed when I was young. Still goodwill hardly matters, if adults aren’t going to work and children aren’t going to school.

Of course, the knowledge, understanding and identification of culture is a rich foundation for the emotional and spiritual growth of indigenous children but equally, if it’s not accompanied by a decent education in English and a secure home life then their growth and emergence as strong, well adjusted and healthy young adults will not occur.

There can’t be one standard for the Australian community at large and a different one for Aboriginal people. Adults have to go to work (or work programs) and kids have to go to school.

That is not to say there is a single mechanism or structure that will suit every community. As Ken Wyatt, the House of Representative’s first indigenous member has cautioned, there are no “one size fits all” solutions here.

In this area, more than most, policy makers’ over-riding instinct should be: “first, do no harm”. Nevertheless, if elected, a Coalition government will co-operatively work with the states and territories, and offer the communities ready to try it, a different, less prescriptive type of governance structure.

To give an example of how it could work, as part of welfare reform in Cape York, the Family Responsibilities Commission, which is guided by magistrates, local elders and community leaders, has been working with local and national agencies to help deal with family dysfunction.

The success of this model has seen dramatic improvements in school attendance rates and some improvement in the “tone” of several Cape York communities. There may be other regions that would benefit from their own fit-for-purpose arrangements.

Idleness and boredom in any community leads to dysfunction, that’s why getting adults to work and kids to school is so important.

Idleness is never healthy and, inevitably, eats away at self-esteem. It harms the soul. Idleness, substance abuse and a breakdown in social norms are inevitably linked.

That’s why we’ll work in the Northern Territory and elsewhere with local authorities and communities to best determine how we can create safer communities and help local people access jobs and education opportunities – because education and jobs are antidotes to idleness.

Making indigenous communities safer and stronger has to start at the top of government. That’s why, if elected, a Coalition government will see indigenous affairs handled within the Department of Prime Minister and Cabinet. This means that along with Nigel Scullion as minister, there will be, in effect, a Prime Minister for Aboriginal Affairs.

It’s also why I have pledged, should I become prime minister, to spend at least a week every year in a remote indigenous community. If these places are good enough for Australians to live in they should be good enough for a prime minister and senior officials to stay on.

I do however want to add a few words of caution. It would be presumptuous, even arrogant to thank that any incoming government could swiftly overcome two centuries of comparative failure.

If elected, it would be equally complacent, even neglectful, for a new government not to commit from day one, to redressing the most intractable difficulty our country has ever faced.

A flurry of activity from any new government lapsing into business-more-or-less-as-usual won’t be good enough. A new cycle of enthusiasm-turning-into cynicism will not do.

We must steadfastly address this urgent national challenge, so that indigenous Australians fully share in the bounty of being part of one of the most free, fair, and prosperous countries on earth.

Tony Abbott is Federal Opposition Leader

Jun 5 2013

NACCHO press release :Download the Closing the Gap progress report: small steps make ongoing commitment vital

Closing the Gap on track: but more to be done

The National Community Controlled Health Organisation (NACCHO) today welcomed the Closing the Gap Progress Report findings as confirmation that the program is working, but that there is still more to be done to ensure that the gap between Aboriginal and Torres Strait Islanders and other Australians does not widen.

DOWNLOAD the COAG reform Council report here

Included below Close the Gap and AAP news press release

Download NACCHO Media Release here

NACCHO Chair, Justin Mohamed (pictured above) , said that it was imperative to continue the good progress made in halving the gap in child death rates, improving early childhood education and year 12 or equivalent attainment.

“The Close The Gap programs are working towards achieving their goal, and improving the health and life expectancy of Aboriginal Australians,” said Mr Mohamed.

“The 150 Aboriginal community controlled health organisations (ACCHOs) that NACCHO represents continue to work to improve Aboriginal health and wellbeing across the board at a local community level, providing over 75 per cent of the work on-the-ground to Close The Gap.

“While we have seen vast improvement in child death rates, more must be done to address the overall mortality rates.

“The death rates of Aboriginal Australians have seen little change. The main cause of deaths for Aboriginal Australians is circulatory disease – attributed to the high level of tobacco usage, poor diet, physical inactivity and hypertension.

“It’s imperative that Close The Gap gets long term investment from governments, rather than just three or four year funding phases, to ensure that they have resources to deliver these vital services.

“The National Partnership Agreement hangs in the balance – which means some of these programs are on a precipice – whilst the Federal Government has renewed its commitment, States and Territories are lagging behind.

“We need Aboriginal health and Close The Gap to be a priority for all governments that goes beyond party politics. These programs which have taken a foothold must be allowed to continue to grow and build momentum so that Close The Gap can continue to improve Aboriginal peoples’ health and chances in life.

“Aboriginal ill-health and mortality rates present a grim picture – one that is out of step comparative to other Australians.

“Close The Gap is about improving outcomes for Aboriginal people, but unless these vital programs get ongoing funding, our chance at increasing life expectancy and health for Aboriginal people narrows.

“Aboriginal comprehensive primary health care provided by Aboriginal communities is the key to making a difference to Aboriginal health outcomes,” said Mr Mohamed.

Closing the Gap progress report: small steps make ongoing commitment vital

Australia is on track to halve the gap in child death rates between Aboriginal and Torres Strait Islander people and other Australians but a much greater effort is needed to achieve equality in life expectancy by 2030, an independent report has found.

Close the Gap campaign co-chairs Mick Gooda and Jody Broun welcome the positive results in relation to lowering the child mortality gap

Mr Gooda said addressing child mortality is critical in efforts to close the gap and will help drive improvements in life expectancy for Aboriginal and Torres Strait Islander people.

However, Mr Gooda said more needs to be done because Aboriginal and Torres Strait Islander people are still dying at nearly twice the rate of other Australians.

“The reduction in the death rate for Aboriginal and Torres Strait Islander children is a real step forward, but there is long way to go to improve child health outcomes more broadly.

“The good news is that 91% of Aboriginal and Torres Strait Islander children in remote communities are enrolled in a preschool program and the new attendance target is welcomed.

“We believe the improvements outlined in this report point to what’s possible when we have co-ordinated and long term action from all governments,” Mr Gooda said.

The findings, released today, are part of a report prepared for the Council of Australian Governments (COAG) on behalf of the COAG Reform Council. The report assesses the progress of Australian governments against the Closing the Gap targets on education, employment and health.

Ms Broun said it is essential that all governments recommit to the National Partnership Agreement (NPA) on Closing the Gap in Indigenous Health Outcomes as a matter of urgency.

“We call on all Australian Governments to put greater effort into closing the life expectancy gap by 2030,” said Ms Broun.

“So far, the Federal and Victorian governments have renewed their funding commitment to the NPA. We urge all other Australian governments to commit to the future health of our people through a renewed NPA.

“In this federal election year, it’s important to remember that the Closing the Gap agenda is a truly multi-partisan national project which must be backed by multi-decade commitments spanning policy cycles, funding agreements and governments”, she said.

National AAP news coverage

MORE action is needed to close the life expectancy gap between indigenous and non-indigenous Australians to meet the 2031 target, a national report warns.

The life expectancy gap is 11.5 years for men and 9.7 years for women.

In 2008, federal, state and territory governments agreed on six targets to tackle indigenous disadvantage in life expectancy, health, education and employment.

Only the Northern Territory is on track to close the life expectancy gap, according to the Council of Australian Governments (COAG) Reform Council report released on Wednesday.

Heart attacks and strokes were the most common cause of Aboriginal deaths.

Death rates had declined in Queensland, but not at the needed pace, while NSW and South Australia were not on track to achieve the target, the COAG report said.

Western Australia’s indigenous death rates had also dipped, but the state had not set a target.

The report noted progress in reducing the death rates of Aboriginal children aged under five.

But it found half of indigenous mothers were still smoking during pregnancy.

Literacy and numeracy skills of indigenous children were also lagging behind, the report said.

On efforts to increase indigenous employment, it said only NSW had seen some improvement.

The early childhood education target to improve access to preschool for all indigenous four-year-olds in remote communities is expected to be achieved this year.

The federal government accepted the COAG report’s recommendation to set a new target to boost attendance levels in preschool programs.

Year 12 completion rates for indigenous children had improved, and WA, SA, NT and ACT were on track to meet the 2020 target, the report said.

National Congress of Australia’s First People spokesman Les Malezer said the small improvements in the report were welcome, but it also came as a warning that more work was needed.

He reiterated a call for a justice target, to reduce the high representation of Aboriginal people in Australian j

May 31 2013

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

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:

May 29 2013

NACCHO health news:Healing the Fault Lines: uniting politicians, bureaucrats and NGOs for improved outcomes in Aboriginal Health.

Prominent Aboriginal Territorian and the current CEO of Danila Dilba Health Service Olga Havnen argues that the “fault lines” between politicians, bureaucrats and NGOs and the Aboriginal Community Controlled Health sector must unite to make a real difference.

A little known positive aspect of the Northern Territory Intervention was a significant increase in resources to Aboriginal Comprehensive Primary Health Care.

This, along with parallel initiatives under Closing the Gap, gave some hope that the decades long demands from our sector for substantial extra resources in primary health care was at last being heard.

However, while we have been making some advances in the Northern Territory, we face the potential for a “race to the bottom” in Aboriginal health where the interests of politicians, bureaucrats and NGOs potentially outweigh the evidence of Aboriginal community control.

Prominent Aboriginal Territorian and the current CEO of Danila Dilba Health Service Olga Havnen argues that the “fault lines” between these groups and the Aboriginal Community Controlled Health sector must unite to make a real difference.

Extract from the 16 pages speech which can now be download from NACCHO

I am currently the CEO of Danila Dilba Health Service in Darwin, which has not long ago celebrated its 20th anniversary. We are an Aboriginal Community Controlled Health Service—and part of a broader, national movement of community controlled comprehensive primary health care that has its origins in Redfern some 42 years ago.

At the core of what we have achieved over those many years has been an aggressive approach to basing our work on evidence. Our accumulated achievements have always been based on what works—in clinical as well as social practice.

At the heart of what we have strived to achieve is the development of a practice—both clinical and social—that displays our strong and central commitment to comprehensive primary health care.

This model was codified at an international level at Alma Ata in 1978, and subsequently endorsed by the World Health Organisation (WHO) and the United Nations:

Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.

Primary health care is socially and culturally appropriate, universally accessible, scientifically sound, first level care.

You can download Olga Havnen full speech 16 pages here

PRESS Coverage below and picture from the Australian May 29

REMOTE indigenous communities are suffering from a government culture of “risk intolerance” which has diverted funding from community-led organisations, a leading Aboriginal figure has said.

Olga Havnen, the Northern Territory’s former co-ordinator general for remote services, last night attacked successive governments for choosing large non-government organisations for service delivery ahead of smaller indigenous-led organisations.

Ms Havnen said many community-led service delivery organisations had “disappeared” since the Northern Territory Emergency Response in 2007.

“Aboriginal control of service delivery in many areas has withered on the vine,” she said in the Lowitja O’Donoghue Oration at the University of Adelaide.

“Despite jurisdictional, national and international evidence that community control over service delivery achieves better results, with control being a key element in the social determinants of health, for example, we have gone backwards.”

Ms Havnen, whose position in the Territory was abolished by the new Country Liberal Party government in October, said there had been a “massive expansion” of NGO involvement in service delivery with “many millions of dollars” flowing to non-indigenous NGOs and multinational NGOs, regardless of their effectiveness.

She said in the past decade, only one new community controlled health service had been established in the Territory and only two remote health clinics handed across to community control.

“It is a process which has allowed government agencies to quarantine themselves from what they too often ascribe as risk in funding Aboriginal organisations,” she said.

“By this I mean that nothing is done, or can be done, that might in any way shape or form come back to haunt politicians or bureaucrats at a Senate estimates hearing or their state and territory equivalents.”

Ms Havnen, who is now chief executive of the Danila Dilba Health Service in Darwin, an Aboriginal community controlled health service, said that there needed to be a fundamental change in the relationship between Aboriginal service delivery in the Territory and elsewhere, and politicians, bureaucrats and NGOs who were involved in the process.

“The politicians and public servants can be agents of innovation and change if they abandon risk intolerance,” she said.

“Similarly, the response of NGOs to the last decade or so of reaping the benefits of government funding into Aboriginal service delivery must also change.

“Risk intolerance cannot be part of Closing the Gap.”

Ms Havnen said she remained concerned about many elements of the 2007 intervention into Northern Territory communities, which would continue to have a psychological impact “for many years”.

May 29 2013

NACCHO social policy news:Indigenous Australians a quarter of Australia’s prisoner population. It’s a social policy disaster.But could there be solution!

Firstly though, politicians and the public alike need to understand and admit that the current policy ethos, and its reliance of incarceration, is a failure, both socially and economically.

Australia spends $2.6 billion a year incarcerating adults

But could there be solution!

We invite our members to make comment see below

Reproduced from the DRUM : Paul Simpson and Michael Doyle

The continual rise in incarceration rates of Indigenous Australians represents nothing short of social policy disaster.

If reducing the numbers of those in prison is to be achieved, then we need to end the reliance on incarceration and invest more into new thinking and rigorous research on non-incarceration alternatives.

Marking 20 years of monitoring since the Royal Commission into Aboriginal Deaths in Custody, the Australian Institute of Criminology finally released its ‘deaths in custody‘ report last Friday and the figures reaffirm the increasing over-representation of Indigenous persons in custody.

In 20 years rates have gone from one Indigenous person in seven incarcerated to one in four.

Indigenous persons make up 26 per cent of the prisoner population yet only constitute 2.5 per cent of the Australian population.

The over-representation of Indigenous persons in Western Australian prisons is the highest of any Indigenous group in the OECD.

Addressing Indigenous over-representation in custody requires new thinking and tested approaches to the offender population.

Firstly though, politicians and the public alike need to understand and admit that the current policy ethos, and its reliance of incarceration, is a failure, both socially and economically.

Australia spends $2.6 billion a year incarcerating adults. Punitive penal policies cost Australia big time.

While happy to scrutinise the effectiveness and efficiencies of all other sectors and services, political authorities seem quite content to overlook the billions poured into the prison system.

The return on this ‘investment’ amounts to very little. It simply does not prevent re-offending.

Longitudinal studies show that two-in-five people are re-imprisoned within two-to-five years of release.

Those who advocate for new thinking beyond the current social policy failures have hailed Justice Reinvestment (JR) as one new approach.

Justice Reinvestment was introduced to the US in 2003 by the Open Society Institute and has subsequently been adopted in eleven US states.

It involves identifying geographic areas from where significant numbers of the incarcerated population emanate and investing in services in these areas.

Importantly, at the policy level JR aims to divert funds that would be spent on criminal justice matters (primarily incarceration) back into local communities to fund services that are said to address the underlying causes of crime, thus preventing people from engaging with the criminal justice system.

Detention under this model is seen as a last resort – for only the most dangerous and serious offenders.

The goal is to shift the culture away from imprisonment and to restoration within the community through restorative health, social welfare services, education-employment programs and programs to prevent offending.

The effectiveness of JR was reported on at the First National Summit on JR in Washington in 2010, where lawmakers from several American states discussed how they had enacted policies to avert projected prison growth, saving several hundred million dollars, while decreasing prisoner numbers and recidivism rates.

Australian scholars have reservations about the type of JR model adopted in some US states, specifically querying who controls and receives the funding. Is it the community-sector or another state agency?

Former Aboriginal and Torres Strait Islander Social Justice Commissioner Dr Tom Calma commended JR as a possible solution to Indigenous over-representation in Australia’s criminal justice system. Several other Australian commentators have followed suit.

Despite the increasing popularity of JR, Australia so far lacks evidence to support it beyond its appealing rhetoric and, some might argue, simplistic notion as a viable policy alternative.

Members of the Indigenous Offender Health Research Capacity Building Group (IOHR-CBG) and the Australian Justice Reinvestment Project based at the University of NSW have begun research efforts to address this paucity of information, .

Following two national Justice Reinvestment forums convened by IOHR-CBG member Dr Jill Guthrie, a three-year JR research project has begun at National Centre for Indigenous Studies.

Using a case study approach, the research explores the conditions, governance and cultural appropriateness of reinvesting resources otherwise spent on incarceration, into services to enhance juvenile offenders’ ability to remain in their community.

The Australian Justice Reinvestment Project is currently is examining JR models from overseas in order to provide a sound theoretical and practical foundation for the future development of JR strategies in Australia.\

There is also a Citizens’ Jury research project being run this year by IOHR-CBG researchers aimed at eliciting the values and priorities of a critically informed Australian community with respect to JR.

Citizens’ Juries have been used in various policy fields internationally, including in health in Australia. They involve bringing together group of randomly selected citizens, giving them a variety of evidence-based information on the issues to hand and asking them, as representatives of the community, about their preferences for certain policy options or priorities for resource allocation.

The project also assesses how the results of the Citizens’ Juries might influence the decision making of government policy makers.

Research of this nature is critical in order to imagine and test new and viable alternatives to incarceration. Unfortunately, the current amount invested in such research is minute.

As the recently-emerged adage says, a ‘tough on crime’ approach needs to be replaced by a ‘smart on crime’ approach. A new policy platform to justice is well overdue.

This platform must be informed by evidence and not the tired political populism that exploits the fears of the electorate if we are to ever make inroads in reducing the hugely disproportionate Indigenous incarceration rate in Australia.

Paul Simpson and Michael Doyle are research fellows with the Justice Health Research Program at the Kirby Institute, University of NSW, and are also members of the Indigenous Offender Health Research Capacity Building Group.

May 29 2013

NACCHO workforce news : Download the Independent Review of Health Workforce Programs Released

Minister for Health Tanya Plibersek today released the final report of the independent review into Australian Government’s health workforce programs.

The report makes 87 recommendations covering Commonwealth programs that target the medical, dental, allied health, nursing and midwifery and Aboriginal and Torres Strait Islander health workforces.

If you would like to make comment about this report there is a feedback section at ther bottom of this page

Download Mason Review of Australian Government Health Workforce Programs

NACCHO comments

Upon reading chapter 5, NACCHO has noted that it contains much information provided to the various contributors of this review, from our sector.

NACCHO has participated in various degrees with some of the contributors: for example but not limited to:

National Health and Hospital Reform
The Workforce Roundtable consultation
The Aboriginal and Torres Strait Islander Health Worker Project
CS&HISC environmental Scan
The Battye Review (subsequent report)
National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2011-15
Lowitja Report

It was pleasing to see that these consultations had value.

The chapter highlights achievements but also addresses many of the challenges that still need to be addressed and recommendations that cannot be ignored if the Australian government are to significantly increase the Aboriginal and Torres Strait Islander Health workforce.

It addresses pay equity and funding of RTO’s. It promotes the continued funding of peak Aboriginal bodies.

The Review identifies the Blueprint for Action (the Pathways Paper) and some of the key recommendations within the Pathways Paper namely;

The need to provide training in career guidance to Aboriginal and Torres Strait Islander education workers and roles to supplement those of existing careers advisors;
Education institutions and Aboriginal and Torres Strait Islander health personal and communities should work in partnership to develop a culturally–inclusive Aboriginal and Torres Strait Islander Health curriculum in a multidisciplinary manner; and
Tertiary education providers should consult with Aboriginal and Torres Strait Islander communities on a whole-of-institution strategy to increase the number of Aboriginal and Torres Strait Islander students in health courses. Strategies should include student support and curriculum matters.

The recommendations at the conclusion of chapter 5, if taken up by Government (namely the Commonwealth), will be the some key steps in building the workforce within our sector: i.e. (abbreviated recommendations)

Recommendation 5.1: must be coordination of activities aimed at building the capacity of theAboriginal and Torres Strait Islander health workforce..

Recommendation 5.2: continuation of funding to peak Aboriginal and Torres Strait Islander bodies/networks…

Recommendation 5.3: continue consultation with National Congress of Australia’s First people’s National Health Leadership Forum….

Recommendation 5.4:build on the success of LIME by reconfiguring this group to include support and mentoring for all Aboriginal and Torres Strait Islander tertiary level health professions including nurses, midwives, dentists and allied health professions….

Recommendation 5.5: develop and implement a new program aimed at; increasing Aboriginal and Torres Strait Islander health student enrolment and graduate numbers, and pursuing the development of culturally appropriate curriculum into all health courses…

Recommendation 5.6: compliment 5.5 by the development of Aboriginal and Torres Strait Islander academic leaders/champions and Aboriginal and Torres Strait Islander student support networks that would provide culturally appropriate mentoring, counselling….

Recommendation 5.7: take action to implement those recommendations directed to the RTO as outlined in the Battye Review……

Recommendation 5.8: consider options for the establishment of an Aboriginal and Torres Strait Islander Nursing and Midwifery Policy Adviser role…

Recommendation 5.9: the NT Medical Program Indigenous Transitions Pathway program to be evaluated to assess outcomes

Recommendation 5.10: is a DWEER program responsibility re investigating the connectivity of education and training sectors from school through the VET sector and onto undergraduate studies, with multiple entry points for younger and mature students

Minister for Health Tanya Plibersek

“I commissioned this review of our health workforce programs to ensure that Australian communities have access to a highly qualified health workforce now and into the future,” Ms Plibersek said.

“As a first step in responding to the review, I have accepted the report’s recommendations to provide a more advanced system for classifying rural locations and areas of workforce need to determine eligibility for support and funding through many Commonwealth workforce programs.

“This will build on and update the Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) system, providing customised enhancements to current methods of determining eligibility for program support.

“I have announced the formation of the Rural Classification Technical Working Group to guide the implementation of the improved classification system that will deliver a fairer and more sustainable method of determining the level of support doctors in each community receives. We will also consider the recommended reforms to the Districts of Workforce Shortage system as part of this process.”

Ms Plibersek said the Government will also develop a model for a new and more integrated rural training pathway for medical graduates, with the potential to extend this approach to other health disciplines.

“This model will be designed to build on the Government’s existing rural health training initiatives so that students who are interested in a career in rural health have a more seamless transition between their education, training and employment.

“The training model will be designed to improve the distribution of health professionals to rural areas, and if successful it will help deliver new doctors to areas of significant workforce shortages.”

The report was led by former Director General of the NSW Departments of Human Services and Community Services, Ms Jennifer Mason, and was informed through an extensive consultation process.

“I’d like to thank Ms Mason for delivering this important report, and for the health community’s involvement to help guide its development,” Ms Plibersek said.

“The report has raised a number of critical issues covering our health workforce programs and key reform areas. We will now carefully consider all the recommendations and any potential implications they may have,” she said.

The Australian Government has invested more than $5.6 billion into training the nation’s health workforce to deliver more doctors, nurses and other health professionals to where they are needed.

Download Mason Review of Australian Government Health Workforce Programs

Share this:

Like this:

Related articles

Share this:

Like this:

What aspects of Indigenous Affairs policy do the major parties agree on?

Constitutional Recognition of Indigenous People

Closing the Gap

Indigenous representation in Federal Parliament

Economy and jobs

What are the key differences between the major parties?

The Indigenous Affairs portfolio

The Northern Territory Intervention

Homelands (also known as outstations)

Education

What we know

ALP

Coalition

Greens

What don’t we know about the major parties’ policies?

Policy release

What we don’t know

Key reports on Indigenous Affairs

Related articles

Share this:

Like this:

Related articles

Share this:

Like this:

Share this:

Like this:

Closing the Gap on track: but more to be done

Closing the Gap progress report: small steps make ongoing commitment vital

National AAP news coverage

Share this:

Like this:

Report summary

Share this:

Like this:

Prominent Aboriginal Territorian and the current CEO of Danila Dilba Health Service Olga Havnen argues that the “fault lines” between politicians, bureaucrats and NGOs and the Aboriginal Community Controlled Health sector must unite to make a real difference.

Extract from the 16 pages speech which can now be download from NACCHO

Share this:

Like this:

Share this:

Like this:

NACCHO comments

Minister for Health Tanya Plibersek

Share this:

Like this: