First off, I note the distinction between the Close the Gap community campaign, which marks its fifth anniversary next month, and the government program Closing the Gap, which has been extended to cover the Northern Territory emergency response. This is very important, because we actually have two campaigns. We have the Close the Gap community work and the work that the government is doing.
The original Close the Gap statement of intent, which was signed by the government, the opposition and the Greens in March 2008, signalled a commitment to a list of very important measures. Two of these commitments have not yet been met and seem to have been missing from the programs and funding of the government’s Closing the Gap measures. In fact, this year’s Shadow report draws particular attention to them, as did last year’s report.
The first of these two issues is to develop a comprehensive, long-term plan of action that is targeted to need, evidence based and capable of addressing the existing inequities in health services in order to achieve equity of health status and life expectancy between Aboriginal and Torres Strait Islander people and non-Indigenous Australians by 2030.
The second one is to ensure the full participation of Aboriginal and Torres Strait Islander peoples and their representative bodies in all aspects of addressing their health needs.
It is the issue of participation that I would particularly like to draw to the Senate’s attention today. It is about much more than consultation, especially the narrow way that consultation is often interpreted by the government and public servants. It is about real partnerships in all aspects of health, life and community.
The Prime Minister in her statement today spoke of increased investment, changing behaviours and working together with respect. While we welcome, of course, the continued investment in Indigenous health at a time when government is cutting funding in other areas, I am disappointed to see that there seems to date to have been little to indicate a change in behaviour by the government. I believe that this is required if we are really going to begin working together with respect and to make real progress on closing the gap.
The Prime Minister spent a lot of time today talking about and focusing on the fact that with opportunity comes responsibility, which continues the dialogue of the previous government on mutual responsibility. I was disappointed to hear that the focus really was only on the need for individuals, families and communities to change their behaviour, and not on how governments— not only the federal government but also state and territory governments—need to change their behaviours to give and take: to take on a little bit more responsibility on their part and to show a little bit more respect for the needs of real partnerships.
There needs to be a change in the way they are addressing some of the issues. In other words, responsibility goes both ways.
As today’s Shadow report says in the statement of intent:
In making these commitments the Australian government demonstrated that it recognised a sound policy foundation was needed if the COAG targets were to be met. It acknowledged that a haphazard, unplanned effort will not deliver health equality within a generation and that Australian governments must work with Aboriginal and Torres Strait Islander peoples and their representatives if the targets are to be achieved.
In other words, a health partnership between Aboriginal and Torres Strait Islander peoples, their representatives and Australian governments was needed.
The report goes on to say:
That was three years ago. Since then, there have been significant investments in Aboriginal and Torres Strait Islander health as well as other positive developments, such as the appointment of a Minister for Indigenous Health. However, there has been no sign of a plan or partnership. In fact, policy is still not being developed with the adequate participation of Aboriginal and Torres Strait Islander peoples and their representatives.
It went on to say:
Broken promises litter politics, but there is more at stake here than just the Australian government’s credibility. Without a plan or a partnership, there is a risk that the significant investments made in health since 2008 will be wasted. It should not be forgotten that planning and partnership are efficiency measures too, helping to secure the best bang for the buck in a time of limited resources.
But, more importantly, they said:
… it is the ongoing, unnecessary and preventable fatal impact on Aboriginal and Torres Strait Islander lives and the suffering that will result if the national effort to secure health equality does not proceed on a firm policy footing.
I draw the Senate’s attention specifically to the ongoing problems with the funding and administration of Aboriginal health services, funding that is often fragmentary, short term, over-specific and accompanied by unduly onerous and inappropriate reporting requirements.
These problems have been documented and pointed out to the government on many occasions, but specifically in 2009 in the Overburden report by the Cooperative Research Centre for Aboriginal Health.
We have yet to see the planned and comprehensive approach to delivering primary healthcare services to Aboriginal Australians that is needed. We are yet to see the investment in building the capacity of Aboriginal controlled health organisations to deliver and support Aboriginal health workers and managers of the future.
We have yet to see from the government the type of mutual respect that is needed if we are to form real partnerships and if we are to turn rhetoric into reality. The bulk of the funding for the Closing the Gap measures continues to be delivered through mainstream health organisations, which do not reach out to many of the people in greatest need. Not enough is being done to invest in and build the capacity of Aboriginal community controlled health services, despite their strong record of reaching those most in need and delivering good outcomes to Aboriginal Australians.
Having said that, although it was not addressed in the Prime Minister’s speech I note from the media today that apparently representatives of Aboriginal and Torres Strait Islander peak health organisations have been meeting with the Prime Minister, the Minister for Health and Ageing, Ms Roxon, and the Minister for Indigenous Health, Mr Snowdon. I understand that there has been a commitment to start to work together in partnership to follow up on the commitment that I have been talking about—in other words, the development of a more comprehensive plan. I read that in the media just today.
We believe this is an important development, and I urge the government to take seriously its new commitment to work in partnership with these and other key organisations.
We believe the government needs to ensure that the substance of that partnership and the results that it produces are fed through effectively to COAG, to encourage COAG members to also commit to the development of such partnerships so that all levels of government are committed to full participation and partnership in the ongoing campaign to close the gap.
The reason I believe this is important is that we need to change from the government’s rhetoric to reality. In other words, the government’s actions need to match what it says it is doing. The government says it is committed to closing the gap. The government says it is committed to delivering on the commitments that it has signed up to. Yet it continues to undermine the rights of Aboriginal people. It talks about addressing the issues of disadvantage, but it fails to make the link between Aboriginal and Torres Strait Islanders’ rights and disadvantage.
This was highlighted just 10 days ago with the UN Human Rights Committee report on its Universal Periodic Review. There were 145 recommendations made. I admit they were not just on Aboriginal and Torres Strait Islander issues, but many of them addressed the ongoing issues of disadvantage and the undermining of people’s rights. The report asked for the full—I emphasise the word ‘full’—restoration of the application of the Racial Discrimination Act in the Northern Territory. It commented on issues around native title, income quarantining and the implementation of the Declaration on the Rights of Indigenous Peoples.
All these issues need to be fundamentally addressed if we are truly going to close the gap for Aboriginal and Torres Strait Islanders in the time frame that the government, the opposition and the Greens have committed to.