Senate debates

Wednesday, 11 February 2015

Documents

Closing the Gap

4:26 pm

Photo of Fiona NashFiona Nash (NSW, National Party, Assistant Minister for Health) Share this | Hansard source

As minister responsible for Indigenous health, I rise to make a contribution to the tabling of the Close the Gap report. Before I do so, I would like to acknowledge the traditional owners of the land on which we meet and pay my respect to their elders past and present.

It is a very important day today in terms of the bipartisan nature of the day and of us all towards the sector—and I do indeed take Senator Siewert's point about it being multipartisan. I think we are all focused on ensuring that we get better outcomes for the Indigenous communities right across this country. It is really important that we look forward. We know where we are at this point in time, we know what has happened over time and it is really important that we focus on the future—on improvement, getting things right and, from this day onwards, making sure we do things as government better even than we have done before. I would particularly like to take the opportunity to thank all of those in the Indigenous sector who have given me such great advice over the time I have been in this role in terms of the Indigenous health policy for this government. I really do very much appreciate it.

As has been said by many today, we still have a long way to go. There is a lot yet to achieve, but I think it is really important that we acknowledge the things that have been done and the improvements that have been made. Within health, we have seen an increase in life expectancy overall, a decline in Indigenous death rates from chronic diseases, notably cardiovascular disease, and improvements in child and maternal health. We are on track to achieve the target to halve the gap in child mortality rates by 2018 and, while it has been small, there has been a reduction in the life expectancy gap between Indigenous and non-Indigenous Australians by 0.8 years for men and 0.1 years for women. The reason I make those points is to acknowledge all those people in this sector, both Indigenous and non-Indigenous, who have worked so hard for such a long period of time to make those improvements. While I know we need to focus on what still is yet to be done and what has to be done, I think it is very important for those people who have worked so hard, day in, day out, out in our communities to make things better for the lives of Indigenous people that we do acknowledge the improvements and the gains that have been made.

In health, one of the major pieces of work we are doing at the moment is working on the implementation of the health plan. I acknowledge all of the work that went into the health plan, which was done under the previous government, by those across the sector particularly in the wide consultation that took place. What we need to do now is turn that document, which is a good document and an aspirational document, into action, which is what we are doing now as government with the implementation plan. We need to turn that health plan document into tangible outcomes on the ground, through the implementation plan, that will improve health outcomes for Indigenous people. I am very pleased that there has been a lot of collaboration on that. I thank the National Health Leadership Forum for the contribution they are making in that process. I believe that at the end of this long process we are going to have an implementation plan that will truly make a difference for health outcomes for Indigenous people.

I note the work of the Aboriginal community controlled health organisations and NACCHO, their peak body, but particularly those organisations out on the ground. Comprehensive primary health care is so important if we are going to improve health outcomes for Indigenous people. Community controlled health organisations play a significant role and are going to continue to play an important role in ensuring that we close the gap. As I travel around these communities, I am continually impressed by the work of the AMSs. Some of the work they are doing is simply extraordinary. Their focus, the work they are doing and the exceptional way that they are showing leadership in their communities and delivering health services is extremely impressive. Having said that, there are organisations that can do better. My task is to work with a community to look at ways to improve those that are not doing as well as others so that across the sector we can improve the work of those organisations, ensuring that we get better health outcomes right across the board for our Indigenous communities.

The government is investing $3.1 billion in health over the forward estimates, but funding does not of itself lead to better outcomes. I think we all recognise that. No bucket of money is going to change anything in this world. It is only what you can do with that bucket of money. That is why the government is so focused on making sure that we get it right, that we have the right policies and programs in place, so that that money makes a difference and actually leads to better health outcomes for Indigenous people. That means making sure that we improve our data levels, that we improve assessment, that we look at the programs and policies that are being rolled out and that we ensure that we get the outcomes that we want. That is why the government is focused on making sure that we review some of the policies and programs that are in place and that we target better health outcomes by making sure we have the right policies and programs in place. It is about ensuring we are focused on preventive health. It is about ensuring we are focused on the management of chronic disease. It is about ensuring we are tackling smoking. It is about those issues amongst a range of other things. We have to look forward and make sure that we keep focused on doing better in the future. It is about culturally appropriate delivery of health services. It is about ensuring that we eliminate racism in the health sector for Indigenous people. Without those two things, I truly believe we will not make the progress we want. It is something that I as the minister responsible for Indigenous health am very focused on. I will continue working with the sector to ensure that we achieve both of those things.

There has been a lot of commentary about statistics. We do need to pay attention to them. Through statistics the report shows clearly where the improvements, although small, have been and what we still need to do. But it is not just about statistics. If we are going to close the gap on health we need to ensure that we focus on what is going to work. Particularly in the health area there is not necessarily a one size fits all policy. What we need when it comes to improving health outcomes of Indigenous people in Mossman Gorge is different from what we need in Sydney, from what we need in Wilcannia, from what we need in Kintore and from what we need in Fitzroy Crossing. It is really important that we have flexibility, so that communities can deliver services targeted at how they are needed in those communities.

So often Indigenous leaders and Indigenous people in the communities actually have the solutions to so many of our health problems. We need to listen to our Indigenous leaders and, indeed, all those in Indigenous communities about how they see the future being better, about how they see us being able to improve health outcomes and what they see as their contribution. This is going to be a collective. The government cannot do it on its own. We cannot do it sitting here in this chamber with the opposition and those on the crossbenches. We can do it only if we work together in this place as government, as opposition, as crossbenchers with those in the community, and we need to meet halfway. We are going to work together only if we have mutual trust. We have so many working in the health sector in our Indigenous communities. We need to trust them to deliver those health services where they can do such great improvements working with their own communities. We need to trust that they have the judgement do the right thing. I certainly do. It is very, very important that we continue to focus on the future, that we work collectively and that we work with Indigenous communities, because every single person in this place and across the communities wants to see better health outcomes for Indigenous communities and see us close the gap.

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