Contemporary Issues facing Indigenous Australians Institute of Governance Canada 4 November 2011 CLOSETHEGAP Dr Tom CalmaNational Coordinator Tackling Indigenous Smoking and Founder, Close the Gap Campaign
Outline of presentation• Theme: Contemporary Issues facing Indigenous Australians Background to: – Indigenous Australia – Issues affecting Indigenous peoples – Social Justice Commissioner – Close the Gap Campaign – Tackling Indigenous Smoking – Key Challenges and Initiatives CLOSETHEGAP
National Coordinator, Tackling Indigenous Smoking 16 February 2010 to 31 July 2013• National Patron – Poche Centres for Indigenous Health Network• Patron, Rural Health Education Foundation• Member, Close The Gap on Indigenous Health Equality Steering Committee• Member, National Congress of Australia’s First Peoples interim Ethics Council• Chair, Indigenous Suicide Prevention Advisory Group• Member, National Indigenous Mental Health Advisory Group• Deputy Chair, Cooperative Research Centre - Remote Economic Participation (CRC REP)• Ambassador, Constitution Reform to recognise First Australians• Co-Chair, Reconciliation Australia
Demographics• At 30 June 2006, the Indigenous estimated resident population of Australia was 517,200 or 2.5% of the total pop• Just over 50% are female• Just over 50% under 30 years old• 194,000 Indigenous children aged 14 years (38 %, compared with 19 % for the non-Indigenous pop)• Fastest growing population group in Australia• 75% live in urban and regional environments• Is likely to reach between 713,300 and 721,100 by 2021 - about the same as estimated population at the time of colonisation in 1788
IndigenousLanguage Map250 languagesat colonisation100 languages still spoken80 languages under threat18 languagesspoken by all age groups within a community
Discussion paper Measuring progress in closing the gapChart 1Sources:Australian Institute of Health and Welfare, 2006Hill, Barker, Vos, 2007Statistics New ZealandHealth CanadaGrim, 2005United States Census BureauUnited States Department of Health and Human ServicesN.B. Australian data using methodology applied prior to May 2009.In a report entitled ‘What makes First Nations communities successful’ HealthCanada (Driscoll, Jackson, 2007) reports that health practitioners and First Nationscommunity leaders believe the positive progress in Canada is the direct result of
Aboriginal and Torres Strait Islander Social Justice Commissioner
The campaign for healthequalityOVERALL TARGET:HEALTH STATUS EQUALITYWITHIN 25 YEARSTargets and benchmarks asappropriate.FOUNDATION TARGET:EQUALITY OF OPPORTUNITY TOBE HEALTHY WITHIN 10 YEARSSub-target 1:Equality of access to primary healthcare within 10 years. Sub-target 2:Equal standard of healthinfrastructure within 10 years
A human rights based approach• All policies and programs relating to indigenous peoples must be based on the principles of non- discrimination and equality, which recognize the cultural distinctiveness and diversity of indigenous peoples.• Indigenous peoples have the right to full and effective participation in decisions which directly or indirectly affect their lives.• Such participation shall be based on the principle of free, prior and informed consent.
A human rights based approach (cont)• Capacity building always needs to be considered and resources made available to facilitate meaningful participation by indigenous peoples as equal partners in planning, design, negotiation, implementation, monitoring and evaluation of policies that affect them.• Independent dispute resolution mechanisms should be put in place for the parties.
Principle of Progressive Realisation• Create a plan – ‘ambitious yet realistic time frame’, – set equality as a target, – set a time frame;• Commit sufficient resources; and• Be accountable to the plan by setting benchmarks
Campaign Origins• 2005 Social Justice Report to the Australian Parliament• CTG Campaign Steering Committee formed March 2006• CTG launched on 4 April 2007
What is the Close the Gap Campaign?- A movement that is growing- Lead by Indigenous people- Embraced by the Australian population- Bi-partisan political agreements signed or pledged at federal level and in all mainland states and territories- Supported by over 80 non-Indigenous health peak bodies and affiliates and human rights advocacy groups and organisations- Non government funded campaign
Steering Committee membersIndigenous Leadership• Mick Gooda, Co-chair, Aboriginal and Torres Strait Islander SocialJustice Commissioner, Australian Human Rights Commission• Jodie Braun, Co-chair, and also Co-chair National Congress• Australian Indigenous Doctors Association• Australian Indigenous Psychologists Association• Congress of Aboriginal and Torres Strait Islander Nurses• Indigenous Allied Health Australia Inc.• Indigenous Dentists Association of Australia• National Aboriginal Community Controlled Health Organisation• National Aboriginal and Torres Strait Islander Health Workers Assoc.• National Indigenous Drug and Alcohol Committee• National Aboriginal and Torres Strait Islander Health WorkersAssociation• National Coordinator, Tackling Indigenous Smoking
Steering Committee members cont.Building partnerships• Oxfam Australia• Australian General Practice Network• Aboriginal Health and Medical Research Council• Australian Human Rights Commission (Secretariat)• Australian Medical Association• Australians for Native Title and Reconciliation• Australian Peak Nursing and Midwifery Forum• Bullana - the Poche Centre for Indigenous Health• The Fred Hollows Foundation• Heart Foundation Australia• Menzies School of Health Research• Palliative Care Australia• Royal Australasian College of Physicians• Royal Australian College of General Practitioners• Professor Ian Ring, Wollongong University (expert adviser)
The truth is, a business as usual approach towardsIndigenous Australians is not working. Most oldapproaches are not working. We need a new beginning— a new beginning which contains real measures ofpolicy success or policy failure; a new beginning, a newpartnership, on closing the gap with sufficient flexibilitynot to insist on a one-size-fits-all approach for each ofthe hundreds of remote and regional Indigenouscommunities across the country but instead allowingflexible, tailored, local approaches to achieve commonly-agreed national objectives that lie at the core of ourproposed new partnership; a new beginning that drawsintelligently on the experiences of new policy settingsacross the nation.Prime Minister Kevin Rudd, Apology to Australia’s Indigenous Peoples, 13 Feb 2008[i]
Statement of Intent• Prime Minister 20 March 2008• Minister of Health and Minister of Indigenous Affairs• Opposition Leader• Every major Indigenous and non Indigenous peak health and human rights body• First and only bipartisan agreement
Statement of Intent “……commits the Government of Australia, Indigenous Australians, supported by non-Indigenous Australians and non-Indigenous health organisations to work together to achieve equality in health status and life expectancy between Indigenous and non-Indigenous Australians by the year 2030.”• To developing a comprehensive, long-term plan of action, that is targeted to need, evidence-based and capable of addressing the existing inequalities in health services, in order to achieve equality … by 2030• To ensure the full participation of Aboriginal and Torres Strait Islander peoples and their representative bodies in all aspects of addressing their health needs.
People MovementNational Close The Gap Day – 25 March – 840 events
Community Involvement RAPs Philanthropy Reconciliation Australia is dedicated to closing theunacceptable life expectancygap between Indigenous and non-Indigenous children.One of our key strategies in Greg Poche - Health care achieving that ambition is to philanthropy. Poche Centre for support and encourage skin care research and treatment in Sydney organisations to sign up to their own tailored (Melanoma Institute) and Reconciliation Action Plan Poche Centres for Indigenous Health in Sydney and Adelaide (RAP).
Council of Australian GovernmentsDecember 2007All Australian Governments have agreed to close theinequality gap in Indigenous health outcomes in ageneration Council of Australian Governments 29 November 2008 All Australian Governments have agreed to a $1.6 billion investment in Indigenous health over four years – $805.5 million Commonwealth commitment – $771.5 million State and Territory contributionIn excess of $ 8 billion of new money pledged for Indigenous affairs since November 2008
!"#$%&()*%(+ !"#$%&()*+)"#,-./("0/"&1#2(-,(/&&#-3)(4*-&+",# 6/#,)2#+"#*+7/#/82/5)"59#:/3//"#;"4+,/"-%&#)"4# "-"<;"4+,/"-%&#$%&()*+)"& 1. Principles to underpin a national effort 2. A partnership 3. A health equality plan,-%.)+")/#*,#0*#123!+))(132,%001++))4)5(6#(789::
CLOSETHEGAP STORY• Social Justice Report 2005• March 2006 – CTG Coalition formed• July 2006 – RAP scheme launched• April 2007 – National Launch of CTG• December 2007 – COAG commitment• May 2008 – SOI signing• November 2008 – COAG $1.6 billion ($8 bil pledged)• February – NRL All Stars match• March – Opening of Parliament – PM s Report• 24 or 25 March – National CTG Day• August – NRL CTG Round• All state and territory governments signing SOI• 2011 – Development of a comprehensive national plan announced by Ministers on 3 November. 39
UN Declara*on on the Rights of Indigenous Peoples Articles 24.2 and 23, United NationsDeclaration on the Rights of IndigenousPeoples state:• Indigenous individuals have an equal right to the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view to achieving progressively the full realization of this right.• Indigenous peoples have the right to determine and develop priorities and strategies for exercising their right to development. In particular, indigenous peoples have the right to be actively involved in developing and determining health, housing and other economic and social programmes affecting them and, as far as possible, to administer such programmes through their own institutions.
Breaking News – 3 November 2011Thursday 3 November 2011NEW NATIONAL ABORIGINAL AND TORRES STRAIT ISLANDER HEALTHPLANThe Minister for Health, Nicola Roxon and Minister for Indigenous Health,Warren Snowdon, today announced the development of a new healthplan for Aboriginal and Torres Strait Islander Australians.The National Aboriginal and Torres Strait Islander Health Plan will beestablished by the Australian Government working in partnership withAboriginal and Torres Strait Islander peoples and organisations, and stateand territory governments will be invited to be participate."The plan is an important step in providing a road map for actionacross Australia," Ms Roxon said.“It is important this plan is thorough and inclusive, covering not onlyhealth but also factors which impact on health, such as education,housing, employment and early childhood development,” Mr Snowdonsaid.
Chronic Disease Funding• $805.5 million will be committed over four years, and will focus on three priority areas: - $161 million to tackle chronic disease risk factors. - $474 million to improve chronic disease management and follow up. - $171 million over four years for workforce expansion, training and support. 44
• National Coordinator, Tackling Indigenous Smoking• Tobacco Action Workers and Healthy Lifestyle workforce of 340 over 4 years• Community educators and facilitators not clinicians• Targeted social marketing messaging• Prevention, reduction and cessation• Training existing workforce 45
Key elements of the TIS initiative:• Equitable distribution and access;• Changing norms;• Engaging community leaders, health workers andparents who can really make a difference,particularly in influencing young people andchildren;• Flexibility and support for innovation; and• Tailoring a range of mechanisms to meet theneeds of local communities. 48
Host Organisation Responsibilities – all Aboriginal Medical Services• data collection• development and implementation of appropriate smoke free work place policies and support staff who wish to cease smoking• consideration of potential interactions with other Closing the Gap measures and to utilise established or common resources & infrastructure 49
Localised messaging for a remote environment 53
Locally developed health messages foran urban environment 54 http://www.iuih.org.au/
Major policies in Indigenous affairs > Referendum (1967)• CDEP (1977) > AEDP (mid 80’s),• ATSIC (1990 – 2005)• Native Title (1993) > Australia Colonised (1788)• New Arrangements in Indigenous Affairs (2005) (2005)• NTER & Welfare Reform (2007) (2007)• UN Declaration on the Rights of Indigenous Peoples (2007)• National Apology (2008)• National Congress of Australia’s First Peoples (2010)• Constitutional change to recognise First Australians (2013)
Constitution Reform to recognise Indigenous Australians• To pass a referendum, a double majority must be achieved: that is, a majority of those voting throughout the country must vote in favour, as well as separate majorities in each of a majority of states. This means that the majority of people in 4 of 6 states must also vote in favour of the proposed Bill.• Since 1906 only 8 of 44 referendums have been carried, including the 1967 referendum - 90.77% of the nation came together in support of Indigenous rights.• Aboriginal and Torres Strait Islander peoples are ‘the oldest continuing cultures in human history’ yet the nation’s founding document, the Constitution, does not mention Australia’s Indigenous peoples.• It was only in 1992 with the Mabo Judgment that the Doctrine of Terra Nullius, meaning a Land that belongs to no-one, was overruled.
National Representative • Recommended in SJR Body • SJC presents Govt with options paper that identifies key considerations • National workshops and consultations • Steering Committee formed and Chaired by SJC • Report presented to Govt • Govt adopts report • Interim Board appointed April 2010 • Elected Board 8 July 2011
• The Congress was incorporated as a Company Limited by Guarantee in April 2010. As a company the Congress is owned and controlled by its membership and independent of Government.• Two full time Co-Chairs and six part time directors• 120 members of Congress
A National Board of Directors led by elected male and female Co-Chairsand six Directors who are responsible for the Chambers of the annualCongress meetingThe Board is supported by an Ethics Council – a special body of experts whoprovide independent advice on standards and guidelines.Congress staff, headed by the Chief Executive Officer, assist with operations,policy advice, membership, promotion and education.