In West Australians Noongar language, I say “kaya wangju” – hello and welcome.
I acknowledge the traditional custodians of the land on which we’re meeting and pay my respects to Elders past and present.
I also wish to acknowledge AMA President, Dr Tony Bartone, and the work of the Australian Medical Association to improve the health of First Australians, as well as the broader population.
I thank the AMA for its 2018 Report Card on Indigenous Health – the latest in a series of respected reviews on this critical issue, that I believe is everyone’s business.
However, I would like to emphasise the progress made by communities and our Government to invest in Indigenous health, advance the Closing the Gap agenda and implement national and local policies to drive progress.
We have been working in partnership with First Australians and the states and territories to refresh the Closing the Gap targets.
Closing the Gap will be discussed at the next COAG meeting on 12 December 2018 – and I expect an agreement on targets and reporting progress to be reached.
I thank the AMA for its contribution to the Closing the Gap refresh process.
The target to halve the gap in child mortality is on track. Over the long term – from 1998 to 2016 – the Indigenous child mortality rate has declined by 35 per cent, and the gap has narrowed by 32 per cent.
While the target to close the gap in life expectancy is challenging, Indigenous mortality rates have declined by 14 per cent in the past two decades.
Mortality rates from circulatory diseases have reduced by about 45 per cent, and the gap has narrowed by 43 per cent.
Important health indicators are also showing improvements, for example, smoking rates fell nine percent between 2002 and 2014–15.
We are now building on this progress, through a record investment in proven programs, over four years, for continuity.
While the cancer mortality rate is rising, some health interventions have a long lead time before measurable impacts are seen. Reduced smoking rates may take five years to impact on heart disease and decades to reduce cancer deaths.
Other areas remain particularly concerning, especially sexually transmitted infections.
Syphilis, chlamydia and gonorrhoea are at totally unacceptable levels in our Aboriginal and Torres Strait Islander population – and we are only going to achieve better results overall, by working and walking together.
This year’s Federal Budget provides ever greater support for our effort to Close the Gap and better targets funding to improve outcomes for Aboriginal and Torres Strait Islander people, with funding for Indigenous Health of $3.9 billion from 2018-19 to 2021-22 and $10 billion over a decade.
While there is a lot of useful information in the latest AMA Report Card, unfortunately the AMA’s usually excellent quality control processes have failed at a couple of points, and the report repeats some false statements about the government’s agenda for Aboriginal Community Controlled Health Organisations.
I have asked the Department to take these issues up with the AMA.
Finding and enacting health solutions is a shared responsibility – involving parents and children, families, communities and, importantly, doctors and health professionals.
Government action alone cannot create a culturally competent and safe health system.
With around half of First Australians accessing treatment outside the Aboriginal Community Controlled Health sector, the work of the broader medical profession is critical.
It is alarming that the Victorian Aboriginal Community Controlled Health Organisation reported recently that incidents of racism within the mainstream health system often lead to our people seeking care later, or avoiding treatment all together.
The report found that of people polled, 86 per cent had experienced racism at least once, while 54 per cent said they experienced racism in hospitals every time they attended.
Respect for culture must be front and centre, with social and cultural determinants major factors influencing mortality and quality of life.
I am glad the Report Card acknowledges the role of the My Life My Lead consultations and report in informing the Closing the Gap refresh process, and developing the next Health Implementation Plan.
Respect and responsibility will underpin generational change.
Last year, the Minister for Health and I signed a Collaborative Agreement with the Council of Presidents of Medical Colleges, the Australian Indigenous Doctors Association and the National Aboriginal Community Controlled Health Organisation, to collectively improve the way the health system works with Aboriginal and Torres Strait Islander people.
There is also more that must be done to promote and improve usage of the Medicare Benefits Schedule item 715 for Aboriginal and Torres Strait Islander health assessments, to encourage First Australians to have comprehensive checks of their physical, psychological and social functioning.
Over the next four years, our Government has pledged to increase investment in First Peoples health care by around four per cent per year.
This will help drive the Closing the Gap health targets, under the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–23.
There is funding for around 130 Aboriginal Community Controlled Health Services, plus a smaller number of other providers, to deliver comprehensive and culturally appropriate primary care.
This includes a range of whole of health system programs, for example the Medicare Benefits Schedule, the Pharmaceutical Benefits Scheme, and public hospital and aged care funding.
Highlights include our Government’s Better Start to Life program, which is improving the opportunities for thousands of young children across the nation, by linking parenting, healthcare and schooling.
We are focussing on Rheumatic Heart Disease, with significant funding for new, community driven health projects, and a national roadmap underway to guide plans to end RHD.
There is a significant push to end the scourge of crusted scabies.
A renal roadmap will also show the way ahead for kidney disease reduction, building on our recent $25 million investment in the landmark Purple House project.
A new renal MBS item promises major changes, too, providing more than $34 million in support over four years for remote dialysis.
I am also heartened by the COAG Health Ministers Council making Indigenous health a standing priority from August this year.
Concurrently, the Council is preparing a national Indigenous Health and Medical Workforce Plan, to increase the numbers of Aboriginal doctors, nurses and health workers on country, and in our towns and cities – surely a positive move to put more First People’s healthcare in local hands.
While there is undoubtedly a way to go, the AMA’s annual Report Card provokes discussions that we need to have.
I look forward to continuing our shared dedication towards improving the health of our First Australians.