Warren Snowdon (Lingiari, Australian Labor Party, Shadow Parliamentary Secretary for External Territories) Share this | Hansard source

Yesterday we heard two fine speeches, one by the Prime Minister and one by the Leader of the Opposition, at the Closing the Gap breakfast. I have been attending these Closing the Gap breakfasts since the Closing the Gap campaign started—of course, I was the Minister for Indigenous Health for a number of years until the last election. I am cognisant of the targets that have been set and our obligations to try and meet them.

I want to go briefly, if I may, to the target to close the life expectancy gap within a generation—by 2031. We learn from the current report that in 2010-12 Indigenous life expectancy was estimated to be 69.1 years for males and 73.7 years for females. The life expectancy gap has been reduced between non-Aboriginals and Aboriginals and Torres Strait Islanders in the community, but the reduction is only small and we need to understand why this challenge is so significant. As you would be aware, Mr Deputy Speaker, in the context of our own population—that is, the non-Aboriginal and non-Torres Strait Islander population—we are all living longer. In fact, we are not all living longer—obviously some people have their lives shortened for various reasons—but the bottom line is that, as a generalisation, life expectancy for non-Aboriginal and non-Torres Strait Islander people is increasing, just as it is for Aboriginal and Torres Strait Islander people. So the relevant gap is what is important.

Whilst we may be making significant advances in addressing chronic disease in Aboriginal and Torres Strait Islander communities, we may not be addressing them fast enough to get that relative gap closed. So it is very important that we understand the magnitude of this challenge, and why it is so important that governments, led by the federal government in partnership with the state and territory governments, renew their commitment to the national partnership agreements on Aboriginal and Torres Strait Islander health.

Let us just remind ourselves of what that commitment has been. In 2008, COAG agreed to a historic $1.6 billion reform package. Last year, under Labor, there was a commitment for a further $777 million for the three years from 1 July 2013 to 30 June 2016 as its share of the renewed national partnership agreement. When the estimates for the MBS and PBS are included, the Commonwealth contribution over those three years would be about $992 million—a significant amount of money.

What we say is that if we are actually going to continue this work of improving the outcomes for Aboriginal and Torres Strait Islander people in health then we need to renew that investment commitment. Unfortunately and sadly, it appears that the Commonwealth government has taken this national partnership agreement off the table. If that is the case, and if the present Commonwealth government is not prepared to live up to the commitment made by the previous government by renewing their commitment to the states and territories, then it is very unlikely that we will ever have the capacity to meet the close the gap target of life expectancy. It is very important to appreciate that under Labor there was a continuing proposal to implement the Indigenous Chronic Disease Package. It is also important to appreciate what the outcomes of that proposal have been. If we can understand why these outcomes are important then it does make a difference.

As of 30 June 2013, 795 full-time equivalent positions were funded under the Indigenous Chronic Disease Package. More than 204,000 Aboriginal and Torres Strait Islander patients have been helped by PBS copayment measures as at 30 April last year. If we do not continue this work, and if we do not continue in an ongoing fashion the $100 million investment made by Labor on tobacco action, then we will not see a continuing reduction in tobacco consumption rates amongst Aboriginal and Torres Strait Islander people. So if we are deadly serious about this—and I take the Prime Minister at his word that he sees this as an absolute top priority of the government—then I say to the government: 'Stop pussyfooting around. I understand you've got this commission of audit, but this has got to be above that.' We need the government to recommit its resources—the resources committed by Labor—over the next period for the national partnership agreements. We need the Commonwealth government to get up and sign the agreements and Minister Dutton to go out there and work with the state and territory governments to get agreement on the national partnership arrangements, so that we have got these agreements signed and the money committed and the work ongoing. If we do not provide ongoing resources, we will not get the outcomes.

Unfortunately and sadly, it appears that Aboriginal and Torres Strait Islander health may be confused and mixed up with the desire by the government to cut expenditure in all areas of the government. If that is the case then these targets are going to be harder to meet.

I want now to make an observation on the aim of halving the gap in mortality rates for Indigenous children under five within a decade. We are on target to achieve this aim not just because of commitments made by government but also because of commitments made by Aboriginal and Torres Strait Islander communities right across this country, including their commitment to work with government to make sure that they have got the best primary health care services available for their communities. This has ongoing impacts. If we address and meet the target of halving the gap—as we will—then, in the longer term, it means we will have healthy kids growing into healthy adolescents and then healthy adults with, we expect, longer life expectancy. That is a very, very good thing. But it will not happen in a vacuum. It will only happen by working in partnership with Aboriginal and Torres Strait Islander communities right across this country and by governments understanding that they have to stump up the resources, as I said before when I talked about the life expectancy gap.

Last year I had the privilege of launching the National Aboriginal and Torres Strait Islander Health Plan along with Aboriginal and Torres Strait Islander people. This is a framework for improving Aboriginal and Torres Strait Islander health outcomes for the next decade.

What is required now is for this government to work on an implementation plan working with the state and territory governments and the community control sector—Aboriginal and Torres Strait Islander communities right across this country—to implement this plan. If we do implement this plan—the first of its kind—then it will change dramatically not only the way in which we deliver health services but our understanding of how health services impact upon Aboriginal and Torres Strait Islander communities.

It is important to appreciate that this plan actually thinks about and talks about issues to do with racism—understanding how racism is an inhibitor to people accessing and having a long and happy life, and the cultural dimensions of working with Aboriginal and Torres Strait Islander people. These are very important things: looking at the social determinants of health, being culturally respectful, and making sure we have a non-discriminatory health system, making sure that the health system is effective and that there is clinically appropriate care, making sure there is evidence based practice, making sure mental health and social and emotional wellbeing are addressed, and making sure there is human community capability.

We need to do these things together with Aboriginal and Torres Strait Islander people. And a reminder: this plan did not come out of the top of my head or anywhere else in my body; this actually came from a long period of consultations with Aboriginal and Torres Strait Islander people right around this country, in partnership with the National Congress of Australia's First Peoples and also NACCHO, the National Aboriginal Community Controlled Health Organisation. We went around Australia talking to Aboriginal and Torres Strait Islander communities to establish their priorities and to work with state and territory governments to come up with this document. It is a very, very important document.

I say to the government—and, again, I applaud the Prime Minister's words yesterday—that if we are going to make it a reality to improve life expectancy and address these issues with Aboriginal and Torres Strait Islander health, then it is absolutely imperative that the government work with the state and territory governments and Aboriginal and Torres Strait Islander people right around this country to develop an implementation plan and put that plan into practice.

There are a whole range of other matters I would love to talk about, including education; unfortunately, time will not permit. But it is important to appreciate that whilst the Prime Minister has said he wants to make a new target of five years for getting school attendance up, he will not do it just by having truancy officers. He has to make sure state and territory governments stump up to the mark and make sure there are teachers and other support workers in schools—unlike the Northern Territory government, which has reduced expenditure on education and taken teachers and support staff out of schools.

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