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Health strategies and policies

Don’t underestimate the power that governments - their policies, practices and officials - can have on the lives of Australia’s First Peoples.
Closing the Gap, for me, is all about family. I lost my father when he was 52. And both my aunties didn’t make 60 either. They all died in their 50s. It’s just about getting better health outcomes. I’ve got young kids– I don’t want them growing up thinking this is sort of acceptable. I think Close the Gap is important because we need to recognise the injustices to Aboriginal people in Australia. We need to step forward together, and I think that something that really is central to the issues with Aboriginal people is health. I think Close the Gap is important for everyone because there’s a massive disparity between Aboriginal employment, health.
The life expectancy difference is 17 years at the moment, which is– it’s too much. It’s ridiculous. I’m working as a midwife at the moment, working to improve child mortality, morbidity rates, like recognising the issues in maternal health and women’s health. We as Indigenous people in working in health care can actively take control of our own future to better provide services for our own people and better health outcomes for our own people, as well as educating non-Indigenous people to the processes and policies of doing that and coming alongside us as well. We can’t make a difference to health care unless we have the funding. And we can’t make a difference unless we have nurses and midwives.
And we can’t make a difference unless everybody in Australia agrees that indigenous health is something that we, as a whole nation, needs to look at. It’s great to hear about the research going on in, particularly, in remote communities and the empowerment of people in those communities to identify what areas need to be prioritised and do it in a way that the whole community is involved, so that they’re setting the agenda, not someone from the city. Close the Gap means to me that my children and my grandchildren will have a better life. I’m a midwife and we have less than 200 midwives across the country, so I’m a very passionate advocate to increase our midwifery workforce.
I find that I have an Indigenous centre, support centre, at my university. I’m in my first year and if I didn’t have that there would be nowhere – I wouldn’t be doing as well as I am today. I think it’s very important. A lot of people don’t know about Closing the Gap. And the more we spread that Closing the Gap is there to help our people, the more we will close the gap. And eventually one day there will be no gap. When we sit down and we talk together, I think that this is the germination and the seeding ground for a lot of activity and a lot of positive activity coming out of gatherings like this, like the CATSINaM Conference.
I think education is another one, education that enables people to move from one point from early years through to tertiary education to move into the professions like midwifery and nursing. And then the flow-on effects from that– to be able to enjoy your rights all the way through without discrimination along the way and to be able to be valued for your contribution, not just to your own peoples, but to all peoples, but also contribute to the better health of all Australians because you’re in the profession. If we’re to seriously do something about closing the gap, what we need is the right types of health workforce, the right numbers with the right skills.
Nurses and midwives, as the largest component of the health workforce in this country, are critical in playing a role in closing the gap.

Don’t underestimate the power that governments – their policies, practices and officials – can have on the lives of Australia’s First Peoples.

Consider what A.O. Neville, a man who held roles as ‘Chief Protector of Aborigines’ and ‘Commissioner for Native Affairs’ had to say in his 1937 address to the Initial Conference of Commonwealth and State Aboriginal Authorities.

Are we to have one million blacks in the Commonwealth or are we going to merge them into our white community and eventually forget that there were any Aborigines in Australia?…[W]e have power under the Act to take away any child from its mother at any stage of life…’

Neville’s goal was to ‘eliminate’ the Aboriginal ‘race’ through government policy and assimilate First Peoples into the white population. He was responsible for shaping official policy towards Aboriginal people during much of the period from 1915 until his retirement in 1940. You can appreciate how Australia’s First Peoples may still feel wary about government initiatives.

That was then, what about now?

Much of the Australian Government policy relating to Australia’s First Peoples dates from the 1967 referendum, which gave the Australian Government powers to legislate for Aboriginal and Torres Strait Islander peoples. Up until then, all services for Aboriginal and Torres Strait Islander peoples, including health, were a state responsibility – not delivered within a national policy framework.

Watch this video to learn about significant steps forward in recognising Australia’s First Peoples’ rights, but also the setbacks in the past three decades.

This is an additional video, hosted on YouTube.

Many of the gains made in health for Australia’s First Peoples have been lead by Aboriginal and Torres Strait Islander peoples through the process of self-determination.

Here is a list of key Indigenous health policies, plans and initiatives you may be interested to learn more about.

National Aboriginal and Torres Strait Islander Health Plan (2013-2023)

This sets out a 10 year plan for the direction of Indigenous health policy. It was developed by the Australian Government in partnership with Aboriginal and Torres Strait Islander people, community organisations and their peak bodies.

Learn more about the plan

Closing the Gap

Established in 2008, this framework is one of the more recent Commonwealth government policy initiatives aimed to close the gap that exists between Indigenous and non-Indigenous Australians. Under this initiative, targets are set each year to achieve improvement in specific areas relating to health, education, employment and community safety.

The two targets relating to health are:

  • close the gap in life expectancy by 2031 and
  • halve the gap in child mortality by 2018.

After ten years, only two out of the seven targets are on track to be met. These two targets are centre on early childhood education and Year 12 attainment. Remember: bad statistics aren’t caused by Indigeneity but by systemic barriers.

Closing the Gap Report

You will also have heard in the video at the start of this step, from various nurses and midwives about why closing the gap is so important and that funding is needed to make a difference. As the largest component of the health workforce in this country, nurses and midwives are critical in playing a role in closing the gap.

Closing the Gap Refresh

With four of the seven targets expiring in 2018, the Council of Australian Governments (COAG) has refreshed the Closing the Gap agenda.

Learn more about the refresh program.

The Close the Gap campaign

A very similar title, however this national campaign focuses purely on achieving Indigenous health equality. Established in response to the 2005 Social Justice Report, it aims to close the health gap by way of a human rights approach. The campaign is operated by Australia’s peak health bodies (both Aboriginal and Torres Strait Islander and non-Indigenous) and human rights organisations.

Learn more about Close the Gap campaign.

If you are interested in seeing how the Close the Gap campaign operates within a community then you may wish to view the following example of Palm Island. You will see the commitment and hard work that is dedicated to addressing the specific health needs of this community.

Learn more about Oxfam Australia’s Close the Gap campaign on Palm Island.

National Aboriginal Community Controlled Health Organisation (NACCHO)

NACCHO is the national peak body. It represents 143 Aboriginal Community Controlled Health Services (ACCHSs) across Australia on Aboriginal health and wellbeing issues. It advocates on behalf of their member services at the national policy level.

Learn more about NACCHO.

Your task

Share with the group which of these initiatives (if any) you were aware of and comment on the value of Australia-wide policy informing best practice for First Peoples health.

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Safer Healthcare for Australia's First Peoples

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