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Tuesday, 14 February 2017
Page: 1042

Mr SNOWDON (Lingiari) (17:21): Can I firstly acknowledge the traditional owners of this great land that we are on, the Ngunawal and the Ngambri people, and acknowledge the traditional owners of all Aboriginal lands—all Aboriginal nations—right around this country, most particularly in my own electorate of Lingiari, which traverses 1.34 million square kilometres, one-sixth of Australia's landmass, and has a sizeable proportion of the remote Aboriginal population.

I thank the member for Riverina for his contribution. I will come to a couple of points that he made shortly. I also acknowledge the member for Blair's contribution.

I will say at the outset that I watched both the Prime Minister and the Leader of the Opposition today and I thought they both spoke well. I was particularly impressed by the Leader of the Opposition's commitment to two new Closing the Gap targets. The first was the justice target, which I think was long overdue. The second was the issue to do with out-of-home care, which is a vexed issue but something that we must confront as a nation and something that is long overdue.

I do, however, want to concentrate most particularly on two elements of the Closing the gap report, which I commend the government on. It is, as the member for Blair said, actually a good report because it lays down, in a very bare way and a very straight way, the issues that are confronting us in our attainment of these targets that are before us. I want to talk in particular about the life expectancy target and the halving the gap in child mortality in 2018 target. I just make this observation about the child mortality target: this is the first year that we have gone backwards. In the nine years, this is the first year that we have gone backwards. The key point that the report points out is:

The target to halve the gap in child mortality by 2018 is not on track this year.

As I say, this is the first time. We know that they have declined. On the surface, we seem to be doing well, but, if we are actually going to meet these targets, we need to do a damn lot more. It is of particular interest that many people now have started to twig that, if we really want to have an outcome here, we have to actually invest in what works.

The report itself talks about the need to focus on preconception and maternity-care services through to early childhood services for children up to eight years of age. I agree with that, and it is something I know is at the forefront of Labor policy. We have taken a decision to take this early childhood area very seriously and support the First 1000 Days proposals, which are now well and truly within the lexicon of the health debate and something we should be supporting.

If we are ever going to close the gap in this infant mortality space, and more importantly close the life expectancy gap in the longer term, then we must make sure all children get the best start in life. This means starting to communicate with parents-to-be prior to conception, working with them for the first thousand days and looking at opportunities that exist—as has been happening in the congress, the Aboriginal health service in Alice Springs—using the Abecedarian model of education opportunity for kids 18 months and older. We must actually channel kids so they get the health care they require and, at the same time, the education opportunities that will benefit them and make sure they grow up into healthy adolescents and then adults.

That is of primary importance, but what goes with it is a whole lot of other things. We need to make sure that housing is being properly addressed and that there is food security. But all the wraparound things that go to making sure a young child is in a safe, caring environment, can live a productive life, learn well, be healthy at the end of their adolescence and enter adulthood with the opportunity for further education are fundamentally very important. If we do that properly then closing the gap will be something we can achieve.

Whether we hit it in 2031, however, is a very different question, because that is probably the most difficult target for us to achieve. This report outlines, in particular, that if we want to close the Indigenous life expectancy gap:

… Indigenous life expectancy would need to increase by 16 years and 21 years for females and males respectively, with average annual life expectancy gains for Indigenous Australians of between 0.6 and 0.8 years required.

That is a really difficult task, but it is not beyond us to address it. It requires us to take seriously the addressing of the continuing issues of chronic disease and further addressing the issue of tobacco consumption, which is highlighted in this report.

I will just add, as an aside—it is not my desire to politicise this debate—that the Labor government, and I as the minister, introduced anti-smoking measures which measures were pilloried by the then shadow Treasurer, now ambassador to Washington, who did not believe we should be funding these programs. How short-sighted he was, because what this report points out, very starkly, is that these programs and other preventative health measures are the things we should be investing in if we want to make sure that the diseases which are now so apparent amongst Aboriginal and Torres Strait Islander people are to be addressed.

I want to quote from Dr Fadwa Al-Yaman, an Indigenous health expert at the ANU and also with the Australian Institute of Health and Welfare. She said, referring to tobacco and, most importantly, to higher cancer mortality rates that they:

… were largely a result of more prevalent risk factors such as smoking, cancer not being detected until later stages, inadequate education about health risks and issues with access to healthcare.

Unfortunately, time is too short for this discussion because there are many components for us to get to the nub of this to address it properly. But what we must do is what the Leader of the Opposition said today, which is that we need to work with those things that actually are working themselves and that are getting the better outcomes.

He point to the National Aboriginal Community Controlled Health Organisations around this country and the magnificent work they are doing to improve the health outcomes for Aboriginal and Torres Strait Islander people right around this country. They are the best examples of comprehensive primary health care in the nation. What we do not want is for them to be white-anted by some competitive-funding model, which has the potential to happen. So I say to the government: invest in what we know works. I am sure that if we do that, we can get better outcomes all round.

I note also—and the Leader of the Opposition spoke about this today—that there are programs that actually do work well.

The Deadly Choices program through the Institute of Urban Indigenous Health, which the member for Blair referred to—a highly progressive organisation—started with four health clinics in Brisbane and now has 18, delivering comprehensive primary health care across the urban population of Brisbane for Aboriginal and Torres Strait Islander people—some 50,000 to 60,000 people. The number of health checks is increasing. I note that one of the very positive signs that come out of this report today—something which I think we all should take note of—is that Aboriginal and Torres Strait Islander one- to five-year-olds have the highest immunisation rate of any group nationally, and that has a lot to do with the work which is being done by these health organisations, and we need to commend them for it.

As I said, there is a lot more we could say about this, but one of the things we on this side of the chamber are determined to do is to try not to politicise this debate. We will be critical of the government for bad policy and, we will say, poor decisions, but it is my intention to work as closely as I possibly can as the shadow minister who is responsible for Aboriginal and Torres Strait Islander health. We have had discussions about working together to try to get the best outcomes we possibly can across this parliament. That is not to say we will agree with everything and it is not to say we will not be critical, but we can attempt to work together in a constructive way for the benefit of the nation, and that is something this parliament should be doing in any event. Similarly, we have started discussions with the minister who is responsible for Aboriginal and Torres Strait Islander affairs, Senator Scullion, about having a similar approach, trying to make sure that, where there are points of difference, we put them aside and try to do the things we can agree upon so the benefit goes to the whole community.

I say again that we have a lot to do in this country if we want to achieve the objectives that are set out in the Closing the Gap targets. I commend this report, but most importantly I commend the new targets, which have been stressed by the Leader of the Opposition—that is, new targets for justice, hearing and out-of-home care. We can do this, but we have to be listening and working with Aboriginal people, not telling them what is important. They know what is good for them. We need to work with them to get the best possible outcomes that we can.