Rachel Siewert (WA, Australian Greens) Share this | Hansard source

I move:

That, in the opinion of the Senate, the following is a matter of urgency:The need to act to ‘close the gap’ to achieve health equality for Aboriginal and Torres Strait Islanders within a generation.

Tomorrow is National Close the Gap Day, a day on which Australians across the nation will come together at a range of events and forums to show their support for closing the 17-year life expectancy gap between Aboriginal and Torres Strait Islanders and other Australians. They are calling for all Australian governments to take action to achieve health equality for Aboriginal and Torres Strait Islanders within 25 years through: increasing annual Indigenous health funding by $450 million to enable equal access for Aboriginal people to health services; increasing Indigenous control and participation in the delivery of health services; and addressing critical social issues, such as housing, education and self-determination, which contribute to the Indigenous health crisis.

The gap in life expectancy in health outcomes between Indigenous and non-Indigenous Australians is an international embarrassment. We are the only First World country that has failed to make progress on the health and life expectancy of our first peoples. In fact, most developing and so-called Third World nations have made better progress with population health, despite the chronic hardships they face. On average, a person from Bangladesh, for example, can now expect to live for 10 years longer than an Indigenous Australian. As the Aboriginal and Torres Strait Islander Social Justice Commissioner, Tom Calma, pointed out at the release of his Social justice report 2006, the fact that a wealthy country like Australia cannot fix a health crisis that affects only three per cent of our citizens is simply not credible. The greatest threat to Indigenous Australians is disease, and many of the diseases they face are easily preventable and have long since been eradicated from our non-Indigenous population.

Australia has the dubious distinction of being the only developed country that has not yet eradicated trachoma. Other First World nations have, within the last decade or two, managed to significantly reduce the gap for their first peoples. Canada, New Zealand and the US have all reduced their life expectancy gaps down to between five to eight years, as opposed to our outrageous 17 years. Infant mortality rates for Indigenous Australians are now almost twice as high as those in New Zealand and the US. Indigenous babies in Australia are 2½ times more likely to die before the age of one than their non-Indigenous counterparts. If they are in the NT or WA, they are three times more likely to die. They are also twice as likely to have low birth weight, which places additional stress on their development and makes them more vulnerable to poor health in later life. The WA Aboriginal child health survey reported very high rates of recurring ear infections, recurring chest infections, recurring skin infections and recurring gastrointestinal infection in Aboriginal kids in the west. A comprehensive study would, we believe, likely reflect similarly high rates across the country.

Recent research into the rates of ear infections in the NT carried out by the Menzies School of Health Research showed that 80 to 90 per cent of Aboriginal children have persistent ear infections within the first three years of their lives. Hearing problems as a result of easily prevented and treated ear infections, especially otitis media, are a major factor in poor educational outcomes for Aboriginal kids who simply cannot hear or understand what the teacher is saying.

Let me touch for a brief minute on the Northern Territory intervention. The government, I have no doubt, will come in here and argue that it is their contribution to closing the gap. Let us have a look at some of the material that has come out just today. Today we had a leaked briefing from the Aboriginal Medical Service Alliance of the Northern Territory, on Crikey.com, that suggested that medical checks are failing to reach more than 10 per cent of the at-risk population. They claim that the health check component of the intervention is largely incompetent, probably unethical, underfunded and absolutely ignores the long term. They claim that the intervention is in breach of the National Health and Medical Research Council guidelines, the Medicare guidelines and the health screening guidelines issued by the Royal Australian College of General Practice.

It is estimated that, as a consequence of the lack of experience and training in Aboriginal child health of the medical task force, they have a diagnosis rate of about 50 per cent below known disease and illness rates. The rate of diagnosis of ear infections is a whopping 77 per cent below that which would be expected on the basis of expert research. The diagnosis of otitis media, a middle ear infection where kids have fluid behind their eardrums and hence experience significant hearing loss, is particularly difficult, especially if you are not experienced in working with young children, let alone with Aboriginal children.

If you were going into communities where there were known to be high rates of this disease, surely you would ensure that you knew what you were looking for and would be taking along the right equipment. However, this latest report from the NT found that, for 10 per cent of children referred to the ENT surgeon, that had in fact not been done. The level of hype around the NT intervention raises some serious ethical issues because of the manner in which it is raising false expectations within the community without having in place the resources to follow it up. This is hype; it is not actually dealing with the issue. Can you please remember these facts when you hear the government argue that they are doing something about closing the gap because we have this wonderful medical task force in the NT? Now we are starting to hear on the ground what is really happening.

A recent report by the World Health Organisation found that the health of Aboriginal Australians is lagging a century behind the rest of the population. Per capita, access to primary health care remains at 40 per cent of that enjoyed by other Australians. Half of the Aboriginal population over the age of 15 already show signs of chronic disease. Despite the fact that they are three times as sick as other Australians, their access to primary health care, as measured by the Medical Benefits Scheme and the Pharmaceutical Benefits Scheme, is only 40 per cent of that of the general population. That is despite claims by the government that they are spending a large amount of money on Indigenous health. For every $1 spent through the PBS and MBS on a non-Aboriginal Australian, only 40c is spent on an Aboriginal Australian. The work done by Access Economics for the AMA estimates that an additional $460 million a year is needed simply to bridge the existing gap between the health needs of Indigenous Australians and the current spending.

I seek leave to table a report by the National Aboriginal Community Controlled Health Organisation, or NACCHO, and Oxfam titled Close the gap: solutions to the Indigenous health crisis facing Australia. I have contacted all whips about this and I understand that leave will be granted.

Leave granted.

The Australian Greens believe that this report provides us with a strong basis on which to proceed. I commend this report to the chamber and urge all parties to take on board its recommendations, which relate to access to primary health care, the number of health practitioners working within the Aboriginal Health Service, the responsiveness of mainstream services, greater targeting of maternal and child health, increased funding and support and actually setting national targets and benchmarks towards achieving health equity for Aboriginal Australians. The AMA put out a very good report in May that provided a long list of successful Indigenous health programs. We recently helped co-host an exhibition in Parliament House of photos by Oxfam which documented some of the successes in Aboriginal health.

The central point here is that the positive outcomes of these successful initiatives show that this is not an intractable problem. It is not a case of not knowing what to do but is simply a matter of scale. The reach of these programs and the level of resources and infrastructure behind them are simply inadequate, given the extent of the problem and the levels of chronic illness that need to be tackled. What we need is a pure and simple commitment to better primary health care on the basis of need; more resources which tackle the issues are essential.

We also need to put more effort into tackling the social determinants of poor health so that we can reduce the level of chronic disease and the massive demands that chronically ill people place on our medical health system. We need to tackle this through prevention, through healthier living, through better homes, through better environments in which people live and also to ensure that people have a sense of control over their lives. We need to set ourselves clear targets that we can measure and be accountable for our progress against. That is why I also believe that the report and the recommendations put forward by Tom Calma, our Aboriginal and Torres Strait Islander Social Justice Commissioner, are essential in helping us to close the 17-year age gap in life expectancy between Aboriginal and non-Aboriginal Australians.

Closing the gap is absolutely essential within the next generation. People are not saying this can be done overnight. What is being said is that we need to do it within a generation and that there needs to be a clear plan for doing that. We urge—beg, in fact—the government to target the resources that are needed to address these issues. As I said, we know that we can do these successful programs; there are successful programs on the ground. We need a commitment to start addressing them properly and to not taking the funding away from groups that are implementing them. (Time expired)