Ken Wyatt: Kaya wangu
I acknowledge the traditional custodians of the land on which we’re meeting, the Whadjuk people of the Noongar nation, and pay my respects to the Elders past, present and future.
I also want to acknowledge, even though he’s not here today, the Honourable Warren Snowden who I meet with on a fortnightly basis because I want to make sure we had a bi-partisan approach And also with Patrick Dodson.
I also acknowledge the Honourable Roger Cook, MLA Deputy Premier and Minister for Health who has been a great support and a colleague in some of the things we’re doing nationally.
Pat Turner who I know is not with us because she is about to attend the inaugural Joint Council on Closing the Gap which she will co-chair.; distinguished guests and delegates.
It’s good to be with you once again, especially at at a gathering tasked to lead the way, to challenge the possibilities and imagine the future.
Its interesting thinking about those three sets of actions because the challenge is how do we turn them into reality? How do we make sure that every person within our communities has access to the whole gamut of healthcare and the range of healthcare services that are available to every Australian?
Because I certainly don’t see the figures showing the number of our people accessing specialists for the next step into some of the significant pathways increasing.
I am responsible for the Organ and Tissue Authority.
There are 14,000 people on renal dialysis but only 13 per cent of people on the transplant list are Indigenous. It’s a low figure. It’s one which means that they’ll never have the opportunity of having a transplant.
It means they’re married to a machine for the rest of their lives. So there are areas that we talk about key themes, but how do we turn that into reality for all those who need the gamut and range of services.
What I like about being back here with you is I’m seeing leadership, innovation and imagination at work in Western Australia during what is a critical time for the health of our people. Good health is a foundation of a fulfilling life because it supports greater opportunities.
Good health is about overall wellbeing – how we feel physically, emotionally, mentally and spiritually. It’s about how we face both daily and lifelong challenges, a strong sense of worth and wellbeing is an element that helps us fulfil our potential – and yet I don’t see it in the young people who’ve committed suicide.
It’s the incredible gap in some communities and yet we talk holistic health approaches. If we are serious then we should be focussing on those elements that go to what I saw described by a young man in the Northern Territory who said: our lives are like a fire.
When we are born the fires burn strongly, we are nurtured. We nurture that fire and we keep that fire – giving heat, warmth, light and smoke for healing. But if we don’t nurture that fire it wanes and at some point it goes out.
And the point he was making is sometimes there are young people who don’t nurture the fire. And so we see the challenge is, how do we turn our minds as adults to focus on our views?
As the young Kimberley youth said to me - we don’t suicide between nine and five, we take our lives outside of those hours. Maybe we need to think about the hours we offer services if we are thinking about a future.
Having pride and self-worth means we can bring others along on the journey and in this context I’m reminded of the words of Dr Martin Luther King, he said: life’s most persistent and burgeoning question is, what are we doing for others?
The aim of our nations’ network of Aboriginal Community Controlled Health Services is to respond to this question every day. Your work helps others to grasp their potential from the very beginning of life to our most senior elders, working together through continuous care.
Looking after new mums and dads, supporting them to bring bright and happy babies into this world – nurture them as children. We know a healthy child learns more quickly and finds it easier to engage at school.
Those who’ve completed secondary school are more likely to be employed. People who are employed have a regular range of options and better choices in life.
Conversely, poor health can complicate lives when they have barely begun. I heard from a community at Maningrida about a seven year old who was walking to school, collapsed on the side of the road and died.
They tried to revive him but what they discovered was that he had renal heart disease, undiagnosed. And so the community have taken control.
What they’ve done is they’ve had meetings with key people; the whole community came together and they had a discussion. They then asked the school to teach what strep A was – it was good to hear you make reference to strep A and what it means in understanding how it works on the body.
So what the school did is they developed an app, a program that showed the white cells as Aboriginal warriors attacking bacteria in their body.
But it also showed them how the bacteria got in through cuts and sores on their skin. The kids now take care of what it is that protects them and if they have skin sores or cuts they self-refer to the clinic and they go and see the Community Controlled Health Organisation – they no longer ignore it.
Just a simple action by a community, not by governments, not by organisations but a whole of community. So if we’re thinking about the future, we have to think about a whole community involvement as well.
This is why the work that Australia’s Aboriginal Community Controlled Health sector is crucial to the health and wellbeing of hundreds and thousands of our people.
You aim to deliver holistic, culturally appropriate and safe health services to nurture better lives. Since last year’s AHCWA Conference there have been major health milestones I believe that will have long term positive impacts.
At July’s COAG health meeting in Alice Springs Indigenous health leaders convinced COAG, the Health Ministers Council to make Indigenous health a standing priority on their agenda, and that the Indigenous Health Minister, or the Minister responsible for Indigenous Health at the national level would also sit on that Council as an ex officio Member – it’s a significant decision by them, it’s a decision that should have taken a long time ago.
Development of the Indigenous Health Workforce Plan was also prioritised to rapidly grow the number of Aboriginal and Torres Islander health professionals and we’re working with all of our peak organisations who are responsible to the work force.
This month’s COAG health meeting then pushed forward with a raft of new national measures aimed at Closing the Gap. The Health Ministers Council has ordered the Draft Medical Workforce Strategy to be finalised by July this year but to work and include Aboriginal peak organisations in that work.
And now the Council in all states and territories are progressing four critical roadmaps that are being drawn up through national consultation over the past 15 months that has involved NACCHO and some of the ACCHO’s depending on where they were done.
They are kidney health, avoidable blindness, avoidable deafness and rheumatic heart disease. At the same time the Morrison Government has created the $160 million Indigenous Health Research Fund which will be co-chaired by Alex Brown with another co-chair.
And they have three flagship priorities - ending avoidable blindness, ending avoidable deafness which includes otitis media and ending rheumatic heart disease.
$35 million from the fund is to develop a vaccine to eliminate rheumatic heart disease and a WA telethon’s kids institute is leading that project. They’re on the verge of potentially four vaccines that will vaccinate against strep A.
If they can do that, that will save our children having to have every 28 days, an injection of penicillin in their buttocks which is painful, for the next ten years of their life.
And potentially reducing the number of open heart surgeries that are required to fix the valves that are damaged by strep A. It’s totally unacceptable that each year nearly 250 children are identified with acute rheumatic heart fever, with up to 6000 living with rheumatic heart fever in our community and 150 people are lost every year.
In the Kimberley people die at the age of 41, they very rarely see beyond that point.
Our focus on renal health is also intense with major investments in community driven prevention and treatment projects, including $25 million to the central Australia’s Purple House organisation.
This month, I committed $2.3 million to drive a national project to increase the low rates of Indigenous and Torres Strait Islander people, receiving donor kidneys.
As I’ve said before, it’s untenable that our people in dire need are having kidney and organ transplants at a low rate compared to that of non-Indigenous Australians.
Changes will include a National Indigenous Kidney Transplantation task force to consult and advocate for Aboriginal and Torres Strait Islander patients.
An Indigenous reference group in every transplant unit with the initial trailing of patient navigators and programs targeting cultural bias in health services and enhance transplant data for lection and reporting.
In October, at the very well attended NACCHO national conference in Brisbane, I launched the Australia Institute of Health and Welfare’s report - Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing.
This told us 63 per cent of Aboriginal and Torres Strait Islander people aged 10 to 24 rated their health as either excellent or very good. We also learned that the proportion of 15 to 24 year olds who had health checks rose from 6 per cent in 2010, to 22 per cent in 2016.
These are encouraging results and we need to build on this progress. I also want to announce today that the Morrison Government will proved more than one million dollars over three years to the Aboriginal Health Council of Western Australia.
The funding will help the health council to continue to develop and support its ‘Youth Project Two’, and to implement the WA Aboriginal and Torres Strait Islander Youth Health Strategy 2018 to 2023, to grow leadership and resilience, help tackle suicide and continue vital work supporting our young people.
This includes engaging with counterparts in other states and territories to drive youth health improvements.
While respect for our culture and our elders is fundamental, young people are our future. According to the most recent census, 42 per cent of Aboriginal and Torres Strait Islander people are aged between 5 and 24, so the impact will be profound.
So it’s critical we support and listen to and take the lead from our young people and encourage them to take responsibility for their wellbeing and future. As you may recall, the youth strategy identifies five key domains to support long and healthy lives: strength in culture; being capable and confident; strength in family and relationships; educated to employ empowering future leaders, and healthy now, healthy future.
It includes the rollout of a family wellbeing program and an Aboriginal youth mental health first aid course. The strategy supports expansion of the Aboriginal and Torres Strait Islander health workforce specifically to improve youth health.
I’m pleased to see that AHCWA has released an Aboriginal Workforce Engagement and Development Strategy 2018 to 2020 that is available for everyone to access on your website.
I want to commend you on your leadership in these areas which compliments national moves through the COAG Health Minister’s Council to grow the Indigenous workforce. I say that on this basis, not only in health will we need a workforce; in aged care by 2050, I need a million people working in aged care in a range of health positions.
That’s on top of the 366,000 we currently have. In NDIS they need 1.4 million workers, in early childhood services they need 940,000.
That’s just in three key areas over the next 20 to 30 years. Our kids can become the workforce of those three key areas because they care. And the nurturing that I’ve seen in aged care has been exemplary.
Its simple implementation will involve consultation with communities and families with the cooperation of NACCHO and its affiliates. The aim is to share good practice and grow national capacity in our youth health and wellbeing.
These are important steps on the journey to reform. One of the first projects supported by funding was yesterday’s AHCWA Health Youth Committee Conference, where almost three dozen delegates come together from cross WA and South Australia to discuss youth issues with suicide prevention a priority.
The West Australian coroner Ros Fogliani’s report paints a tragic picture. She details the suffering endured by 13 young people how took their own lives between November 2012 and March 2016 in the Kimberley.
Young people who felt they had nothing to live for. The coroner’s report is a wake up call for our nation; we have to do things differently. As challenging as it is to read, it demands we rethink how we do things, walking and working together with local people who truly understand what’s happening on the ground.
The report’s recommendations highlight the need for suicide prevention programs to grow from the ground up and to be respectful of culture. These were critical elements of success that she highlighted.
She stressed we must work with local communities, understand their particular needs and support their activities which go directly to the heart of the problems that must be solved. And you’ll be aware the coroner made 42 recommendations.
When you read- and I would recommend that as many of you as possible read that report – it goes to a lot of health issues and other underlying challenges that those young people faced. But it also goes to appalling treatment of young individuals who are in circumstances beyond their control that were abused by adults.
This includes better coordination between government agencies responsible for suicide prevention and the establishment of a Commissioner of Aboriginal children and young people.
The Office of Prime Minister is leading the government’s response and are carefully considering the reports and recommendations. Meanwhile our work to save lives at full pace is important after a tragic start to the year.
In January I brought together a group of people with elders, experts, and young people to discuss what they were doing in the community effort and resources to the Kimberley region.
What came through clearly is the importance of communities wrapping themselves around our young people. They said they need to feel loved, with a sense of belonging and purpose. Since then, I’ve announced an extra $7.46 million in funding for six locally focused programs to reduce the incidence of suicide.
These include fast tracking the roll out of ‘Be You’ school based support in the Kimberley and Pilbara. Delivering targeted social media campaigns, expanding the Young Ambassadors for Mental Health project to include a special focus on Aboriginal and Torres Strait Islander youth, and that includes employing young Aboriginal men and women.
As we’ve done in the Kimberley, and Jacob and Montana who have been brilliant in the work that they’re doing connecting.
Funding for the important work of Dumbartung here in Perth for families dealing with grief. Expansion of the Red Dust Role Models in mental health and wellbeing and working in the Northern Territory.
Respect for, listening to, and learning from local cultures and traditions always- already underpins the Indigenous Suicide Prevention Trials in the Kimberley and Darwin.
And may I compliment the Aboriginal Community control organisations and communities who sit at the roundtable in the Kimberley. You have been outstanding in moving forward the reforms in connecting with your community to tackle these issues in a very real way.
Respect for our people is critical. The Kimberley also have appointed nine community liaison officers, who work very closely within their community, with vulnerable young people and families.
Local leaders, elders, and families are deeply involved to establish programs that provide the tools and systems needed to address mental health and suicide in the region. So the communities have now finalised their own action plans, with another $130,000 to roll out to each one, reflecting and responding to local issues.
Many of the plans have a common thread - it is centred on country, there’s a series of camps involving high risk groups. The camps and the providers support around suicide including healing and sharing, and respecting our culture and traditions.
Our national plan is to learn from the approaches that have worked in the Kimberley and Darwin trials, and they can provide a blueprint for low-key driven engagement that will lead to effective suicide reduction in communities across the nation.
And one of the key themes that is coming through as I indicated from the young people was open outside of the 9-5 hours. We want somebody we can come to. They talk about mentors; they talk about role models all being critical in their lives.
Our families and community networks need to find ways of being there for our young people at all time. Education and teachers also provide a critical support, highlighted by the number of recent losses that occurred during school holidays. And I've seen that in other states as well.
I have no doubt the Aboriginal Health Council of WA’s youth strategy of strong engagement with our young people will also play a significant role in reducing the toll. We must continue to work closely with families, communities, elders and young people, and local services to tackle the web of challenges that impact on our health, our lives and our wellbeing.
Our focus and resolve is clear. We want our young people, our mothers and fathers, and our uncles and aunties, the elders, to be the champions of live participation, echoing the positive words of the Kimberley youth ambassador Jacob Corpus, who said we need champions; champions who will be there for us.
I know that working and walking together collectively as a community as we are equipped to tackle these complex and heartbreaking situations that we see. It’s fundamental to leading the way, challenging the possibilities, and imagining and achieving a better future.
When I look at the Closing the Gap data, I wonder why it is that we have so much bleakness across the whole continuum, even in ageing.
The challenge that many of us will have to grapple with are those senior Indigenous Australians, who have told me very openly in meetings I’ve had with them that they would take their own lives before they got into an aged care facility because they started life in an institution.
And they said we do not want to go back to an institutionalised lifestyle. I have community groups around the country to give me some advice and direction on what they think might be a model for work within their region, for their elders and their settings. And how we can have access to primary health care through ACCHOs.
How do we make sure that older Australians are getting access to reading glasses, to having their sight restored through access to clinicians. Over the years, we have funded organisations to fly in and fly out; Vision 2020 does a brilliant job.
But in respect to that question Dr Kelvin Kong in a meeting recently, he said – so how do you equip and empower the people on the ground to sustain the work that you flying in to do? And one of the response was we give them pamphlets and brochures.
And I asked the question of how do you engage with the Aboriginal health workers? How do you inform a community of the rights, the choices they have to make? In aged care, I’ve just announced a charter of rights that anybody going into aged care should expect of their provider will deliver to them to make a difference to their frail years, as they move forward to eventually leaving us.
And it sets out obligations and it is co-signed for both recipient of the aged care service and the provider.
Pushing for reform is never easy and I was pleased to see the announcement by the Prime Minister and Nigel Scullion and Pat, that an alliance will focus on some national priorities.
Those national priorities will have to deliver real outcomes, not be about the three things that are identified in the media release. It has to go to many other critical issues. But the most important and critical one is how do we involve every community member in our communities in shaping some of the decisions of the services that we deliver.
Not just the Indigenous leadership but every family because every family that I meet have a range of complex health conditions as they get older. We have a moment in this country’s history to leave a mark in the sand in a different way.
And I spoke to the health ministers; I had something like nine items on the COAG Health Ministers meeting agenda which is highly unusual. But let me tell you that Indigenous health is now at the forefront of the Australian health ministers in a way that we’ve not had before.
Not because I pushed them, but because the leaders who came to Alice Springs and spoke to health ministers in a forum before COAG health ministers met, said very clearly things are not working.
The level of gap persists since 1972, if we take the first drop of money that was poured into the buckets by Gough Whitlam through DAA state grants.
So I like your theme. I think your theme is great – lead the way, challenge the possibilities, imagine the future, but we have to apply it to each and every one of us in this room as well.
I said to a group recently in Darwin, you’re sitting here at the roundtable, but what do you do, when you are away from the table? Do you pay attention to the detail that has been placed on the table in your wake? Or do you wait till the next meeting so that you turn up and say we’re progressing?
So this time I’ve said to them that at the next meeting, I want a two pager from all of you on what you’ve done to implement what the elders said to us this morning.
So my challenge is to all of us, including me, what are we going to do between now and the next time you meet in your conference next year about leading the way, challenging the possibilities and imagining the future that is stronger and better from where we’ve got to at the moment?
I thank you.