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Indigenous Health — Editorial

Partnerships in action: addressing the health challenge for Aboriginal and Torres Strait Islander peoples

Tamara Mackean, Mick Adams, Sally Goold, Christopher Bourke and Tom Calma
MJA 2008; 188 (10): 554-555

It’s time for genuine partnerships as all Australians strive together to Close the Gap

Ayear ago in this Journal, Indigenous health leaders outlined the emergent health equality campaign for Aboriginal and Torres Strait Islander peoples,1 now known as the Indigenous Health Campaign or “Close the Gap”. An early indicator of the depth of support for Close the Gap was the large number of health, human rights, advocacy and community organisations that enthusiastically signed up or offered support for the campaign. Since then, the Indigenous Health Campaign coalition, led by Aboriginal and Torres Strait Islander health leaders and the Aboriginal and Torres Strait Islander Social Justice Commissioner, has worked in genuine partnership with non-Indigenous organisations. Key milestones along the Close the Gap campaign journey are shown in the Box.

On 20 December 2007, the Council of Australian Governments (COAG; comprising representatives of federal, state and local governments) committed to:

  • close the life expectancy gap within a generation;

  • halve the gap in mortality rates for Indigenous children under five within a decade; and

  • halve the gap in reading, writing and numeracy achievements within a decade in a partnership between all levels of government and with Indigenous communities.

They added:

The pathway to closing the gap is inextricably linked to economic development and improved education outcomes.5

On 13 February this year, Prime Minister Rudd delivered the Apology to Australia’s Indigenous people, hopefully heralding a new and promising partnership between governments and Indigenous Australians. He stated:

We today take this first step by acknowledging the past and laying claim to a future that embraces all Australians. A future where this Parliament resolves that the injustices of the past must never, never happen again. A future where we harness the determination of all Australians, Indigenous and non-Indigenous, to close the gap that lies between us in life expectancy, educational achievement and economic opportunity. A future where we embrace the possibility of new solutions to enduring problems where old approaches have failed. A future based on mutual respect, mutual resolve and mutual responsibility. A future where all Australians, whatever their origins, are truly equal partners, with equal opportunities and with an equal stake in shaping the next chapter in the history of this great country, Australia.6

The opportunity for every government in this country to seriously tackle the entrenched disparity and unacceptable outcomes in Aboriginal and Torres Strait Islander health, through strong national leadership, should not be missed. It is time for a long-term approach that secures all of our futures — Indigenous and non-Indigenous — together, as a healed and healthy nation.

The success of the campaign for Indigenous health equality will be measured by progress towards clearly stated goals within set timeframes. It is unacceptable to continue with the current situation, in which the health outcomes and life chances of an Indigenous child are substantially worse than those of their non-Indigenous peers.

As stated in the Aboriginal and Torres Strait Islander Social Justice Commissioner’s 2005 report2 (the initial trigger for the genesis of the Close the Gap campaign), it is simply not defensible for governments and health and human services systems to argue that inadequate infrastructure, bureaucratic mechanisms or persistent complexity are justifiable speed humps to real change. It also does not hold that championing the rights of human beings is contrary to health gain.

The outcomes of the National Indigenous Health Equality Summit will be delivered by June 2008 to the Australian Government and COAG. The Summit deliberations will not only provide governments with a set of specific evidence-based targets for action and investment, but affirm the commitment to genuine partnership by signing the Statement of Intent (Box).8

A whole-of-government response across all levels of government is necessary to address the social determinants of health. COAG’s commitment to employment, education, housing and health are strong indicators of such commitment.

The time for genuine partnerships is now; that is, partnerships that strengthen us all in mutually respectful and sustaining ways. Medical bodies, including the Royal Australasian College of Physicians, Royal Australian College of General Practitioners, Australian College of Rural and Remote Medicine, Australian General Practice Network and the Australian Medical Association, have been key partners in this campaign.

We must not allow “Close the Gap” to become another shallow slogan. It is a glaring reminder of the continuing inequity in health and life outcomes within this wealthy nation of ours.

The commitment to act now — to guarantee a future where Indigenous health inequality is a thing of the past — requires concerted, tangible and immediate action. Our call is for current and future medical leaders to show their commitment by doing what they can within their area of influence and expertise.

Key milestones along the “Close the Gap” journey

Author detailsTamara Mackean, BSc (Med), MB BS, President1Mick Adams, BSocWk, MAppSci, PhD, Chairperson2Sally Goold, RN, DipNEd, MNSt, Executive Director3Christopher Bourke, BDSc, GradDipPublicHealth, GradDipClinDent, Chairperson4Tom Calma, Aboriginal and Torres Strait Islander Social Justice Commissioner5

1 Australian Indigenous Doctors’ Association, Canberra, ACT.

2 National Aboriginal Community Controlled Health Organisation, Canberra, ACT.

3 Congress of Aboriginal and Torres Strait Islander Nurses, Bribie Island, QLD.

4 Indigenous Dentists’ Association of Australia, Canberra, ACT.

5 Human Rights and Equal Opportunity Commission, Sydney, NSW.

Correspondence: romlieATaida.org.au

References
  1. Wenitong M, Mokak R, Councillor H, et al. Rising to the health challenge for Aboriginal and Torres Strait Islander peoples: what will it take [editorial]? Med J Aust 2007; 186: 491-492. <eMJA full text> <PubMed>
  2. Calma T. Aboriginal and Torres Strait Islander social justice report 2005. Report of the Aboriginal and Torres Strait Islander Social Justice Commissioner. Canberra: Human Rights and Equal Opportunity Commission, 2005. http://www.hreoc.gov.au/social_justice/sj_report/sjreport05/index.html (accessed Apr 2008).
  3. National Aboriginal Community Controlled Health Organisation, and 37 others. Open letter to the Prime Minister, State Premiers and Territory Chief Ministers, parliamentarians and Australian public. A call for health equality for Aboriginal and Torres Strait Islander peoples. The Australian 2006; 11 Dec. http://www.humanrights.gov.au/social_justice/health/health_OpenLetter.html (accessed Apr 2008).
  4. Close the Gap Campaign Launch, 4 Apr 2007, Sydney. http://www.closethegap.com.au/information.php (accessed Apr 2008).
  5. Council of Australian Governments’ Meeting, 20 December 2007. Melbourne: COAG, 2007. http://www.coag.gov.au/meetings/201207/index.htm (accessed Apr 2008).
  6. Rudd K. Apology to Australia’s Indigenous Peoples, House of Representatives, Parliament House, Canberra [transcript]. 13 Feb 2008. http://www.pm.gov.au/media/Speech/2008/speech_0073.cfm (accessed Apr 2008).
  7. National Indigenous Health Equality Summit. Fact sheet 3: progress so far. http://www.hreoc.gov.au/social_Justice/health/summit_2008_3.html (accessed Apr 2008).
  8. Close the Gap. National Indigenous Health Equality Summit statement of intent. Canberra: IHES, 2008; 20 Mar. http://www.hreoc.gov.au/social_justice/health/statement_intent.html (accessed Apr 2008).
  9. PM urged to focus on Indigenous health. Sydney Morning Herald 2008; 20 Mar. http://news.smh.com.au/pm-urged-to-focus-on-indigenous-health/20080320-20mb.html (accessed Apr 2008).
  10. Annual Prime Ministerial statement on closing the gap [media release]. Canberra: Department of the Prime Minister and Cabinet, 2008; 5 Apr. http://www.pm.gov.au/media/Release/2008/media_release_0166.cfm (accessed Apr 2008).

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