Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Hansard source

I acknowledge the traditional owners, the Ngunnawal and Ngambri peoples, and I pay my respects to their elders, both past and present. There has been no greater failure in public life than the failure of governments—state and federal, Labor and Liberal—to ensure our first Australians enjoy the same quality of life as all other Australians. Lives are being ended far too soon and parents are not living long enough to see their grandchildren—due, more often than not, to health outcomes we would not tolerate in our wider community. That is why it is so important that until the gap is eliminated all of us here in this place are reminded every single year by this report of what we have achieved, where we have fallen short, what is working and where we need to do better. As the Leader of the Opposition said, it is about telling the truth, being honest about where we are and making sure that we continue to do that each year.

Again, this year we as a nation are falling short, with just two of the seven targets on track to be met, according to the 'closing the gap' report delivered to the parliament. There is just one target that Australians can be confident is on track to be met, and it is a very important target that we can be proud of: progress is being made in reducing infant mortality rates by more than 33 per cent. Long-term progress has also been made in narrowing the gap in year 12 attainment, with a significant boost in the rate of Aboriginal and Torres Strait Islander students completing secondary education, although it is less clear whether Australia remains on track to halve the gap in year 12 attainment.

But on the remaining targets the news is far from good. Aboriginal and Torres Strait Islander kids have lower rates of literacy and numeracy, greater rates of truancy, lower readings skills and are going to high school without the minimum requirements. The overall employment rate for Indigenous Australians actually fell between 2008 and 2013, with fewer than half of 15-to-64-year-olds holding down some form of job. Most shamefully of all, Indigenous adults are likely to die 10 years earlier than other Australians. If we are ever to close this gap it will require the best efforts of all of us, working with Aboriginal communities, to ensure all Australians enjoy the same quality of life and health care most of us take for granted.

We need to ensure that every child is given the best educational opportunities to succeed in later life. It is why the Gonski reforms are so critically important to not only this population group but other population groups. It is a matter of equity. We need to develop a justice target to prevent crime, improve community safety and tackle the unacceptably high levels of Indigenous incarceration and victimisation rates. And we need to tackle health outcomes that should be considered unacceptable in a First World nation for any of its people—outcomes such as the wholly preventable eye disease trachoma, which is still rife in Indigenous communities.

It is why I and my colleague the member for Blair were very proud to hear the Leader of the Opposition commit to investing an additional $9.5 million for additional optometry and ophthalmology services and prevention activities to close the gap in eye health and to eliminate trachoma and other eye diseases. Shockingly, Aboriginal and Torres Strait Islander adults are six times more likely to suffer from blindness. However, 94 per cent of this vision loss is either preventable or treatable. Addressing vision loss alone will account for around 11 per cent of the gap in health outcomes between Aboriginal and Torres Strait Islander people and other Australians.

Australia is the only developed nation where the infectious and wholly preventable eye disease trachoma still exists at endemic levels, and it only exists among Aboriginal and Torres Strait Islander peoples, where it is endemic in two out of three remote communities. Leaders such as the Vision 2020 alliance of health organisations, including the Fred Hollows Foundation and the Indigenous Eye Health Unit at the University of Melbourne, are making great progress in improving Indigenous eye health. However, there is a significant unmet need. Around 35 per cent of Aboriginal and Torres Strait Islander adults have never had an eye exam. Labor will deliver additional funding to increase visiting optometry services for Aboriginal and Torres Strait Islander people to address this gap in general eye health. We will also increase funding for ophthalmology services for Aboriginal and Torres Strait Islander people to address the gap in specialist eye healthcare service delivery. To continue to drive progress towards the elimination of trachoma in Australia, Labor will invest in trachoma prevention activities recommended by the World Health Organization. This is sensible reform. It is not a huge amount of money. I call on the government to match this funding and ensure that we eliminate trachoma from Australia by 2020 and we begin to turn the tide on this endemic health problem both with trachoma and, more broadly, with those preventable eye health issues that so deeply affect our Aboriginal and Torres Strait Islander communities.

I also call on the government to abandon its repeated attempts to make health care more expensive and its attack on bulk-billing through its four-year freeze on Medicare rebates and its move to scrap bulk-billing for pathology and to change it for diagnostic imaging. These attacks have one aim in mind: to make patients pay more for those services. For Aboriginal and Torres Strait Islander people, who already suffer far worse health outcomes than is acceptable in any First World nation, the consequences of that attack are disastrous. As the report of the Close the Gap Campaign Steering Committee—a report that is released prior to the parliamentary report each year and one which I think provides very important and challenging reading for all of us—said:

A further factor that could negatively impact the services offered by ACCHOs—

Aboriginal community controlled health organisations—

is the … freeze on GP and non-GP Medicare rebates continuing until July 2018, announced by the Australian Government … The freeze is continuing despite the fact health care costs continue to rise above the rate of inflation … A recent study has estimated that by 2017-18, the freeze would amount to a 7.1% reduction in GP rebate income compared with 2014-15. It is generally expected that GPs will pass increased costs onto patients, as many do already. But ACCHOs don't pass on such costs—to ensure their services remain affordable (and therefore economically accessible) to Aboriginal and Torres Strait Islander people. At worst then the freeze could result in staff or service cuts. Whatever its impact, it will be a disproportionate one on ACCHOs and the users of ACCHOs, who are predominantly Aboriginal and Torres Strait Islander people, over other primary health services and their clients.

It is an important point that they are making and one, I have to say, that the government has refused to deal with or respond to appropriately.

We already know that cost is a big barrier to health access for Aboriginal and Torres Strait Islander people, especially in remote areas. We know that one of the COAG Reform Council's later reports showed that cost is already a barrier to one in eight Indigenous people seeing a GP, for one in five visiting a dentist and for one-third filling a prescription. This situation will become worse as this freeze bites and the attack on bulk-billing takes hold. The COAG Reform Council also says that Aboriginal and Torres Strait Islander Australians are three times more likely to die of an avoidable cause, meaning that three-quarters of deaths of Indigenous people under 75 could have been avoided through early prevention or treatment. The cuts to Indigenous health and the Medicare freeze make early prevention and treatment a lot less likely. One of the most pernicious and short-sighted cuts, frankly, was the cut to smoking cessation programs that were beginning to work. It absolutely astounds me that the government would think a program that was working towards prevention on the ground should be cut in the way that it was.

The gap is already far too large and our efforts to close the gap are too slow for us, with these health cuts, to threaten the progress we have made. For the sake of the health of all Australians, and especially our First Australians, the government must abandon its attacks on Medicare and bulk-billing and instead commit to ensuring all Australians, not just those who can afford it, have the right to live a long and healthy life. In particular, I commend the work done by my predecessors on the national Indigenous health plan. I note that the government has since, after much time, worked on the national Indigenous health implementation plan. An implementation plan is only as good as the resources that you put into it to make it happen. We look forward to, and we will certainly be looking in the budget for, a very sound commitment to the Indigenous health implementation plan, because you cannot, as many have said in this place, cut your way to closing the gap. This is what the government has done. There are consequences for that. The Indigenous health implementation plan will need to be resourced seriously, and we will certainly be looking at the government to do so.

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