Extract from a Speech
to the National Press Club, on July 18th 2001, by the
Federal President of the Australian Medical Association, Dr Kerryn Phelps
Indigenous health is another area of desperate need.
In the past year, I have had the privilege of visiting a number of remote Aboriginal communities.
Like others before me, I was shocked at the appalling lack of basic services other Australians take for granted.
It is a national tragedy that needs a more dignified response than the argy-bargy of party politics.
Indigenous Australians have the worst health of any group in Australia, with lower life expectancy at birth. Indigenous parents can expect to lose their babies at a rate 2 to 4 times higher than the national average, and indigenous men and women can expect to live twenty years less than non-indigenous Australians.
Chronic diseases are the leading cause of premature death.
Together with injuries, they are responsible for rates of hospitalisation that are two and a half times that seen in non-Indigenous Australians.
Other countries have bitten the bullet and significantly improved the health of their indigenous populations. Australia has not.
The improvement in the health of Indigenous communities in countries such as Canada, the United States and New Zealand wipes out our excuses. Progress is achievable
It is unacceptable that Australia lags behind in ensuring the health of Indigenous people.
It is particularly damning because the priorities are obvious.
The message received by the AMA Taskforce in Indigenous Health is that there needs to be a quantum leap in funding for Indigenous Health if progress is to be achieved and the cycle of ill health broken.
It is not acceptable for the Commonwealth to spend less on health services for those whose health is the worst in the nation. This is what happens at present.
AMA-commissioned research by Professor John Deeble shows the inadequacy of Commonwealth funding, particularly through services rebated by Medicare and through the PBS.
At least an extra $245 million per year is necessary to fund Indigenous health services.
Such an increase was not forthcoming in the recent Federal budget.
There needs to be a major emphasis on primary health care (or out of hospital) services, adequately funded, and delivered by skilled staff as a basic human right.
It is essential that the Commonwealth backs and funds Aboriginal community controlled health services ensuring that these have national representation in policy matters through an adequately resourced National Aboriginal Community Controlled Health Organisation (NACCHO).
Aboriginal and Torres Strait Islander communities must be in a position to shape their health services so that they address local priorities and are culturally appropriate.
It is also essential that the basic infrastructure such as clean water, sanitation, appropriate housing and transport - taken for granted by other Australians - is available to all Aboriginal and Torres Strait Islander communities irrespective of where the communities live.
Underlying all these matters, however, is the fundamental matter of the relationship between Indigenous and non-Indigenous Australians.
The issue of a treaty is being taken forward by ATSIC and by Aboriginal Land Councils.
Today I announce the AMA's support of their efforts.
In other countries, such as New Zealand, the signing of a treaty has facilitated progress that has flowed on to many other areas.
A treaty is able to acknowledge and help resolve historical issues that are currently outstanding, ensure the rights of Indigenous Australians, and make a binding contract as to what should happen next.
There has been some talk of the need for "practical reconciliation".
But there cannot be practical reconciliation without a binding contract or, in other words, a "treaty".
We have reports up to our eyeballs but words and paper are cheap.
It is time to begin the process of ensuring that the rights of Indigenous Australians are securely protected.
A treaty is necessary to ensure accountability from State and Federal Governments to achieve measurable quality of life and health outcomes.
Such an undertaking would involve a mutual agreement between indigenous people and governments which would underpin any national Aboriginal and Torres Strait Islander health strategy, specifying what needs to occur, who is responsible for what strategies, and in what time frame.
Until there is an unassailable commitment in the form of a contract to overcome the poverty and desperation of our most disadvantaged citizens, we are not taking the issue seriously enough.
The recently released draft of the new Aboriginal and Torres Strait Islander health strategy lacks the specificity and clear direction necessary to achieve real progress.
The AMA is not entering this debate cold or uninformed.
Indigenous Health is an area in which the AMA has a long history of advocacy.
The AMA National Conference in 2000 passed a resolution reaffirming the need for an apology to Aboriginal and Torres Strait Islander people and support for the reconciliation process.
In my first year in office, I established the Taskforce in Indigenous Health.
This has representation from NACCHO, the Australian Indigenous Doctors' Association and ATSIC, as well as from AMA Federal Councillors and others with particular experience in this area.
It is essential to move beyond a piecemeal and incremental approach and show the world that Australia is, at last, able to bring about real progress in the health of Aboriginal and Torres Strait Islander communities.
Until then, Australia will maintain the shame.
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