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Aboriginal treatment is racism: Professor Stanley

By Kate Gauntlett

22 March 2003 - The appalling health and living conditions endured by many indigenous Australians was a denial of their human rights, says Australian of the Year Fiona Stanley.

Professor Stanley, who gave the Vice-Chancellors' Oration last night at Edith Cowan University, said the nation's tolerance and acceptance of the worsening gap between indigenous and other Australians was racism.

"At a time when many of us are consumed by anguish and uncertainty as our nation commits to war, we also need to consider this very confronting battle on our own homefront," she said.

The speech marked the close of WA Harmony Week and the United Nations Day for the Elimination of Racial Discrimination.

Professor Stanley, who is director of WA's Telethon Institute for Child Health Research, said there was overwhelming evidence that health - declared a human right by the United Nations - was not enjoyed by many Aboriginals.

"That some of us, in the name of equality, are calling for the cessation of special indigenous services, smacks of ignorance of both the causes and the solutions to indigenous disadvantage," she said.

Research showed Aboriginal children experienced higher infant mortality, lower birth weight, high incidence of birth defects, diabetes, cot deaths and respiratory illness.

A number of social indicators of wellbeing, such as level of education, economic and employment status, representation in the justice system and rates of suicide, were several times higher in indigenous young people than in the non-indigenous population.

Professor Stanley said the inequality between indigenous and other Australians affected everyone through escalating health and welfare budgets, rising crime rates and loss of human potential.

Communities needed a holistic approach, taking into account spiritual, cultural and physical environments.

"Focusing on treatment is too costly and too late - if mainstream health systems and services continue to focus on treatment of problems rather than prevention, they will never break the cycle of poor outcomes," she said.

Services that used a holistic model, such as the Kalgoorlie-based Ngunytj Tjitji Pirni, had an enormous impact.

"Indigenous people often feel alienated from mainstream services, but their brokering system was incredibly successful - for example, the use of antenatal services increased from 20 per cent to over 100 per cent as women came in from outside the area," she said.

Professor Stanley said early poor health, growth, nutrition and social conditions had lifelong impacts.

"A child growing up in a healthy family and community, in which people work towards common goals and provide one another support, is more likely to seek positive outcomes for itself throughout the child's life," she said.

Nelson Mandela's wisdom was clear when he said there was no keener revelation of a society's soul than the way it treated its children, Professor Stanley said.

She also flagged her intentions to raise awareness and funding of child health issues during her tenure as Australian of the Year at her first official address in the role.

Source: The West Australian

STATEMENT BY PROFESSOR FIONA STANLEY, A.C, AUSTRALIAN OF THE YEAR

Sorry Day, May 26 2003 - The appalling health and living conditions endured today by many Indigenous Australians is a denial of their human rights.

What outrages me is that Australians are not more outraged.

What concerns me most is that the gap between Aboriginal people and other Australians is worsening.

That as a nation we appear to tolerate and accept the current situation is actually racism.

For our nation to say Sorry would be an important step towards reconciliation.

We should not only acknowledge the impact of the removal of children from their families but should implement policies and programs which use the new knowledge about the importance of infancy and early childhood to enable Indigenous children to thrive and prosper.

It would seem to me that the statistics that need to be debated with this issue are not those around assessments of how many children were taken, but what the impact has been on the communities and 'generations' of people affected by the policies.

There is no doubt that we are seeing the effects of the removal of indigenous children into the third and fourth generations.

It is very apparent when looking at the dismal state of Aboriginal health.

Aboriginal children experience higher infant mortality, lower birth weight, more birth defects, diabetes, cot death and respiratory illness.

A number of social indicators of well-being such as level of education, economic and employment status, representation in the justice system and rates of suicide are several times higher in indigenous young people than the non-indigenous population.

Inequality affects everyone in the community.

We pay for it with escalating health and welfare budgets.

Even worse is the loss of human potential.

I think Nelson Mandela's wisdom is clear when he says that there can be no keener revelation of a societys soul than the way it treats its children.

How is Australia treating its indigenous children and what does it say about our values as a nation?

There are plenty of medical problems, but only one real crisis

20 March 2003 - Fixing the disgraceful state of indigenous health conditions would benefit us all in the long-term, writes Jim Hyde.

The Herald's Blueprint for Health has rightly nominated a number of areas where reform must be undertaken. But first we must know why we want to change the health system.

After all, as recent OECD figures show, Australia has one of the best life expectancy rates in the world and an efficient system measured in the cost of health as a percentage of our GDP.

Australia ranks 19th among the OECD countries in pharmaceutical costs - hardly the crisis the Federal Government would have us believe. And we have some remarkably good public health outcomes, especially in the area of HIV/AIDS prevention. So given these successes, why change? There are many reasons and the blueprint alludes to some of them while not mentioning perhaps the most important.

Technology and pharmaceutical costs will continue to rise; inefficiencies in the system will be maintained by the divide in health funding between the Commonwealth and the states, and between public and private providers; concentration on acute care services means that more care is being pushed into the community and on to families; there is a significant workforce shortfall that is not being addressed innovatively or with a long-term view; and health consumers feel alienated from the system.

These are the obvious day-to-day matters that clinicians, health policy-makers and administrators grapple with. But there are more fundamental problems that face us.

The health crisis exists in only one area - indigenous health outcomes remain on par with those in many developing countries. The resources devoted to Aboriginal and Torres Strait Islander Australians are paltry when assessed against need.

Their health outcomes can only be described as disgraceful with the average life expectancy 20 years below that of other Australians.

Gavin Mooney and Shane Houston from Curtin University have estimated we need to spend in the ratio of 5:1 in favour of indigenous Australians if we are to bring direct health outcomes up to scratch.

But more importantly, the things that give the rest of us good health are also missing from the equation for indigenous Australians. About 70 per cent of health outcomes are determined by our socio-economic status. That means a job, good housing, a good education, opportunities for advancement, strong families and strong communities.

That is where we have failed in health and that is why we have to reassess why we need reform.

Reform here would be good for the rest of us. It would promote an explicit debate about equity and health inequalities. It would crystallise our focus on access to services and health outcomes. It would make us recognise the importance of healthy communities - employed, educated, well-housed - and lead to reforms in broader areas of government policy to achieve better health outcomes.

So how would I change the health system? The blueprint gives us the direct areas of focus.

We need a major health inquiry that develops a blueprint for our nation.

Canada has just completed one from which we could learn. Sweden goes even further and looks forward 50 years in health planning. Why is it that in Australia, meetings of health ministers are really about short-term resources and funding and rarely about long-term health outcomes? We also need to agree on the principles that underpin our health system.

Universality of access to services is a key around the world to better health outcomes. The recent attacks on Medicare should stop.

Equity of health outcomes (this does not mean equality) must be a key principle. The 30 per cent private health rebate should be scrapped and reinvested wisely.

Quality of clinical services must be enhanced with support for clinicians, be they doctors, nurses or allied health professionals. More resources must be given to sustainable workforce development and training.

Equity and efficiency in health financing must become a priority. This means a single funder (or pooled funds at least), an increase in investment, reallocation to community-based services, a fair go for service providers and an equitable investment according to disadvantage, on top of universal services.

A focus on population health outcomes means more investment in public health, health promotion and the community sector and the building of partnerships with other sectors which more directly influence the 70 per cent of health outcomes for which the health system cannot and should not be held accountable.

The most important thing, however, that we must do is to change community attitudes and to do that politicians and health leaders must show a good deal more leadership than has been demonstrated to date in Australia.

Professor Jim Hyde is president of the Public Health Association of Australia (NSW branch), and director, Health Policy Unit of the Royal Australasian College of Physicians. The opinions expressed are his own.

Source: The Sydney Morning Herald

ATSIC Chairman urges action on indigenous health

ATSIC
Media Release

Geoff Clark, ATSIC Chairman

30 March 2003 - The devastatingly high rates of kidney failure in remote Indigenous communities should be a cause for alarm by all Australians.

As reported in The Weekend Australian the poor living conditions suffered by Indigenous peoples in communities in the Northern Territory and elsewhere are a key factor in the rapid growth of kidney disease and renal failure.

A disease which was virtually unheard of 30 years ago is now doubling every four years and Indigenous people in remote communities are suffering kidney failure at a rate of up to 30 times higher than in mainstream Australia.

NT medical authorities say it is becoming clearer that socioeconomic disadvantage is fuelling the spread of the disease and that there needs to be better educational and economic outcomes for our people to address this serious health issue.

Welfare is not working, so we also need to look at ways of developing the economic empowerment of communities so that they can buy better services.

The rejection of native title is also leading to disillusionment and the breaking of spirits in our communities and I urge the Federal Government to revisit these important issues.

This health crisis again underlines the need by governments at all levels to address the continuing failure of mainstream services to meet the needs of Indigenous people in key areas such as health, education, employment and housing.

ATSIC is working with governments at all levels to address the problems but there is a need for greater urgency in our work and a much stronger focus on the reasons why mainstream services designed to help all Australians are not meeting Indigenous needs.

ATSIC recognises these problems are very complex and not easily solved. Their resolution requires renewed efforts by all parties including the communities.

If we are serious - governments, service providers and Indigenous leaders and organisations - then we urgently need to put together a co-ordinated strategy and the resources needed to implement it to attack this scourge.

As a first step, I invite relevant Federal Ministers to come with me to areas such as Yuendumu in the Northern Territory or Doomagee in Queensland to see at first-hand how poor are the living conditions of our people and how pressing is the need for action.

Source: ATSIC

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