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Tuesday, 14 February 2017
Page: 1047


Ms CATHERINE KING (Ballarat) (17:42): I too rise, today, to join with many colleagues on the 2017 Closing the Gap statement. I will begin by acknowledging the traditional custodians of the land, the Ngunnawal and Ngambri peoples, and I pay respect to their elders both past and present. I also acknowledge the Wathaurong people, who are the traditional custodians of the land surrounding my electorate in parts of Ballarat. I also want to thank Congress this morning for their terrific presentation of the Redfern Statement. It was a very powerful message, bringing that statement here into this place to tell us as community leaders what they expect and what they demand of us if we are to close the gap.

This year's Closing the gap is released at a time of positive progress in Indigenous representation in our parliament. In our shadow ministry in this place and in the other place, Labor is proud to have taken steps to increase the voices of Indigenous people in this parliament, a platform which we look forward to building into the future and it is already making a significant difference. The appointment of the member for Hasluck as the Minister for Indigenous Health should also be recognised and commended.

While we celebrate progress within parliament, the stark reality is that closing the gap in Aboriginal and Torres Strait Islander health and equality, unfortunately, remains a persistent challenge for us and is, sadly, still a distant goal. The Closing the gap report released today is a sobering reminder of the substantial work needed to address the Closing the Gap health targets. The target to halve the gap in child mortality by 2018 is not on track this year. The target to close the gap in life expectancy by 2031 is not on track this year. The Indigenous mortality rate from cancer, which is the second-leading cause of death, is rising and the gap is widening. Cancer, in particular, and the low survival rates of Aboriginal and Torres Strait Islanders is something that needs much more investigation and much more understanding. When I have spoken to services providers, for example, in the Northern Territory—in particular, in the cancer centre there—there is a huge amount of work that needs to be done to not only provide access to services but also it is about the treatment methods that are being made available for Aboriginal and Torres Strait Islanders.

We are doing very well, and I recognise the government's commitment in terms of eye health. I think there is further work that needs to be done in terms of ear health, particularly otitis media.

There are some positives to note. There has been a nine percentage point decline in Indigenous smoking rates for those aged 15 years and over between 2002 and 2014-15. Smoking cessation programs in Aboriginal and Torres Strait Islander communities do make a difference, and funding for them matters. This will, of course, contribute to improvements in health outcomes into the future. The total Indigenous mortality rate declined by 15 per cent between 1998 and 2015, with the largest decline being from circulatory diseases. Tracking progress, of course, is critical to knowing what strategies to close the gap are actually working and where we need to do more, but if we are not actually achieving progress, if we are simply tracking the contribution of underlying problems, policymakers cannot expect meaningful change.

There is a road map on how to proceed, and that is the National Aboriginal and Torres Strait Islander Health Plan. The plan, developed in true partnership between Aboriginal and Torres Strait Islander peoples, articulates a vision for closing the gap in Aboriginal and Torres Strait Islander health inequality. It outlines a life course approach to developing health policy, and targets the social determinants of health. It addresses the important issues of chronic diseases so prevalent in Aboriginal and Torres Strait Islander communities across this country. And, very importantly, it prioritises the fundamental importance of Aboriginal community controlled health organisations in providing comprehensive primary health care and preventative health programs.

I note the government is pursuing patient-centred medical homes. We already have an example of that in this country, and they are called Aboriginal medical services. They have been doing comprehensive medical care for quite some time and they are the best in the country at it. I recognise in particular my own Aboriginal medical service, the Ballarat and District Aboriginal Co-operative, who, again, do terrific work throughout my own community.

I think it is critically important that Primary Health Networks, as they are working through competitive tendering, have formal MOUs with Aboriginal community controlled health organisations and that they do not throw out programs that have been working or organisations that have been working in the health space purely because of the motive of competitive tendering. It is critical that Aboriginal community health organisations are central to the work of improving health and life expectancy for Aboriginal and Torres Strait Islanders. If the PHNs do not go down that path, I think that would be a very serious mistake.

Unfortunately, whilst we do have a national plan, we have yet to see any funding attached to that plan. It is all very well to have a plan. It is all very well to have developed an implementation plan. But, without the funding to actually do the work, it remains a document that will be testament in the years to come to why we have failed to close the gap in Aboriginal and Torres Strait Islander health. In order to make substantial inroads to meet the Closing the Gap targets in health, the government needs to commit to properly funding ACCHOs as well as the National Aboriginal and Torres Strait Islander Health Plan.

As noted during the election campaign, one program that I would commend to the government is Deadly Choices. If you want a preventative health program that is in fact working in terms of getting smoking rates down and making sure that there are comprehensive health checks undertaken and follow-up work, it is one of the few programs that has seen significant success across this field. I note that in the election campaign we committed to fund it further and roll it out across the country, and I hope very much that the government follows suit.

Future budgets must adequately resource the implementation of the National Aboriginal and Torres Strait Islander Health Plan if it is to have any success. Labor will always support a bipartisan approach to this issue, and the implementation plan in particular is essential for driving progress towards the provision of the best possible outcomes for investment in health and related services. As we heard today, the Redfern Statement grants us an opportunity to refocus and recommit to working with the Aboriginal and Torres Strait Islander community to improve participation in and delivery of health services.

While measures of inequality are a sharp reminder of how far there is to go, they should drive us to be more determined than ever to enact change. The Closing the gap report is a reminder that supporting treatment models driven by Aboriginal and Torres Strait Islander peoples that are culturally appropriate from their inception has to be at the core of health policy.

Today we have united as a parliament to reflect on our progress towards meeting the Closing the Gap targets, but this is only one part of the picture. We need to unite to enact change, not just share words, in this place. Rhetoric is just that. It needs to be matched by action. It does matter when you cut funding programs for Aboriginal and Torres Strait Islander health programs, in particular in areas of prevention but in broader areas as well. It does matter when you make changes to tendering processes where Aboriginal and Torres Strait Islander peoples and organisations do not have a seat at the table. Addressing the disparity in health outcomes for Australia's first people must be a priority of this parliament. I do not want to be here again next year and the year after and the year after, again despairing that we have been unable to meet or see improvement in those targets.

I was encouraged to hear the Prime Minister say that he has asked his Minister for Indigenous Health to look in particular at the area of cancer survival rates. There is more that can be done and more that should be done, but it will require the will of the government to invest more comprehensively in cancer services that are available for Aboriginal and Torres Strait Islander peoples, understanding that treatment closer to where people live is critical. That is not always easy to deliver, nor is it cheap to deliver, but it is something that the government needs to do if it is going to have a serious impact on cancer survival rates.

Again I say that the area of ear health is really critical. We are seeing children who have already had substantial damage done to their ears who are finding it very difficult to learn in a challenging learning environment. It certainly sets back their education, their employment and their life opportunities substantially if we are not tackling that area. There is work being undertaken and, again, I commend that work to the government and suggest that, if we do want to continue to close the gap, those are two areas that we could do some easy and early work in.