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Richard's Closing The Gap Statement

Firstly, let me acknowledge the traditional owners, the Ngunnawal people. I want to pay my respect to their elders, past and present. The official Closing the Gap report and the civil society reports are very clear-we have a long way to go when it comes to achieving equal health, social and economic outcomes for Aboriginal and Torres Strait Islander peoples. Of course, the statistics tell the story-they are damning-but there is no substitute for seeing and experiencing.

Let the say a few words about my own experience of working in an Aboriginal community controlled health clinic. For young graduates coming out of medical school, there is no need to travel overseas to experience the health conditions that we see in developing countries. Indeed, conditions that have effectively been eliminated in most wealthy nations exist right here in Australia. We see diseases like trachoma-a disease which causes blindness and is entirely preventable but which is prevalent within Indigenous communities-and rheumatic heart disease, which was wiped out generations ago for non-Indigenous people. We see the scourge of hearing loss and the impact it has on young children's ability to learn language skills and to develop and thrive at school. Then there is kidney disease. I have had the experience of a young boy who came to see me at the age of 10 because he was failing to thrive-his kidneys had stopped working. We did not have haemodialysis and we had to set up a system basically to try to keep him alive in the community in which he lived. The incidence of diabetes and the many complications that flow from that-poor eye health, peripheral vascular disease, kidney disease and so on. And then there are the problems with grog-alcohol fuelled violence, domestic violence and the issues that stem from that.

There is no substitute for seeing and for experiencing those conditions. It is true that we have made some gains in the area of maternal and child health, for example, but, gee this, we have a long way to go. It is one thing to see it and experience it from the perspective of privilege, which was the perspective I had as a young graduate in my late 20s, thinking I had all the answers and knowing what needed to be done. I have come to learn that what is absolutely critical here is that we listen-that we listen to the voices of Aboriginal people if we are to make progress on this issue.

We had an intervention from one of those Aboriginal voices today-Stan Grant at the National Press Club.

He said:
For so many of my people, Aboriginal people, this is true, there is a deep, deep wound that comes from the time of dispossession, scarred by the generations of injustice and suffering that have followed. And this wound sits at the heart of the malaise that grips Indigenous Australia.
What he is saying is that we have to come to terms with our past if we are to make progress.

We must come to terms with our past. It is true that we now have a national debate around constitutional recognition-one small step forward-but if we are really and truly to come to terms with our past we have to do much more than that. We have to truly reconcile and we have to ensure a treaty with our Aboriginal brothers and sisters. At the heart of what needs to be done is understanding that solutions must be owned by Aboriginal people. I know there are many good people who think they know what needs to be done, and some of the interventions in this space have been guided by goodwill, not malice, but they have failed and they have been counterproductive. The Healthy Welfare Card, for example, aimed to stabilise communities and to move people away from the use of welfare cash to buy grog and to get people off welfare and into work. We know that in the communities where that has been tried, it has failed and it is failed badly.
We know that the most detailed investigation, according to Nicolas Rothwell in the Australian, who made a very insightful contribution to this debate on the weekend. He talked about the Northern Territory Emergency Response, the intervention, and all of the downstream programs that came with it and about the devastating conclusions that the intervention report revealed in 2014. There was no improvement in community wellbeing, no financial autonomy for people-and indeed an increased sense of dependence on welfare-and a complete failure to meet the stated objectives of the intervention.

The report itself says:
The tools envisaged as providing welfare recipients with the skills to manage have rather become instruments which relieve them of the burden of management.

We saw too the former head of the Department of Prime Minister and Cabinet, Michael Thawley, who said with laser-like precision that the effect 'has probably been to increase the sense of dependence in the Indigenous community, whereas we actually have wanted to try to build their capacity to manage themselves'. So what can we do? Let us start by funding the implementation plan for the National Aboriginal and Torres Strait Islander Health Plan, which is critical given that the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes expired in 2014 and the funding under that agreement has been discontinued. I know what people will say-money alone will not solve the problem. That is true, and some money in this area has not been spent as effectively as it could have been-but the health dollar has been underutilised because Indigenous people simply are not afforded the same level of access. Of course, there is the other retort that we cannot afford it. While this government might be locked into the notion that we need to reduce spending and lower income tax, we think that in a decent society we can raise revenue to pay for the sorts of things that we value-that we can pay for health, education, infrastructure; that we can address growing income inequality and contribute to improved productivity simply by ensuring that we have a fairer tax system.

We need to ensure that, rather than seeing this area as a drain on the budget, spending in health for our Aboriginal brothers and sisters is an expression of the value that we place on health. If we are going to extend the improvements we need more consistent quality primary health care that is delivered in culturally appropriate settings. We need more Aboriginal health workers, Aboriginal nurses and Aboriginal physiotherapists and doctors, and thankfully we are starting to see some change. We need to provide basic essential primary health care to prevent disease and to diagnose it early and treat it when it is picked up. We need to address the social determinants of health. That means addressing, again, the huge disparities that exist when it comes to income.
If we are going to do that, we need to have effective strategies to create jobs for Aboriginal people. We know that employment for Aboriginal and Torres Strait Islander people is linked to completion rates at school and higher education-vocational education and university. That means we need more effective education strategies. We need to support role models, those people who are doing incredible work in this space, not just the sporting heroes-the Adam Goodeses and Cathy Freemans-of the world but the workers who are caring for country through their terrific ranger program, and people who are coaching sporting teams and the like. Role models are critical. The story of Adam Goodes is significant. He is a proud Aboriginal man, a leader in his field, and through the embrace of his culture he has brought to the surface some of the issues that we as a nation need to tackle. He has shown that racism does need to be addressed, that much more work needs to be done, and that as part of our education response and employment response tackling racism is critical. It needs to be called out and addressed wherever it is. We have to encourage more innovation in the health space-new ideas; something that we know can be driven by Aboriginal and Torres Strait Islander people.
In the end, this is a question of will. As a parliament we can do something about this-I just hope that this Prime Minister is not going to join the long line of Prime Ministers who finish their term and say, 'I wish I could have done more.'

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