1. Contemporary Issues facing Indigenous
Australians
Institute of Governance Canada
4 November 2011
CLOSETHEGAP
Dr Tom Calma
National Coordinator Tackling Indigenous Smoking
and
Founder, Close the Gap Campaign
2. 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
3. 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
4. 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
5. Indigenous
Language Map
250 languages
at colonisation
100 languages
still spoken
80 languages
under threat
18 languages
spoken by all
age groups
within a
community
11. Discussion paper Measuring progress in closing the gap
Chart 1
Sources:
Australian Institute of Health and Welfare, 2006
Hill, Barker, Vos, 2007
Statistics New Zealand
Health Canada
Grim, 2005
United States Census Bureau
United States Department of Health and Human Services
N.B. Australian data using methodology applied prior to May 2009.
In a report entitled ‘What makes First Nations communities successful’ Health
Canada (Driscoll, Jackson, 2007) reports that health practitioners and First Nations
community leaders believe the positive progress in Canada is the direct result of
17. The campaign for health
equality
OVERALL TARGET:
HEALTH STATUS EQUALITY
WITHIN 25 YEARS
Targets and benchmarks as
appropriate.
FOUNDATION TARGET:
EQUALITY OF OPPORTUNITY TO
BE HEALTHY WITHIN 10 YEARS
Sub-target 1:
Equality of access to primary health
care within 10 years.
Sub-target 2:
Equal standard of health
infrastructure within 10 years
18. 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.
19. 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.
20. 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
21. Campaign Origins
• 2005 Social Justice Report
to the Australian Parliament
• CTG Campaign Steering
Committee formed March
2006
• CTG launched on 4 April
2007
22.
23. 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
24. Steering Committee members
Indigenous Leadership
• Mick Gooda, Co-chair, Aboriginal and Torres Strait Islander Social
Justice 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 Workers
Association
• National Coordinator, Tackling Indigenous Smoking
25. 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)
26. The truth is, a business as usual approach towards
Indigenous Australians is not working. Most old
approaches are not working. We need a new beginning
— a new beginning which contains real measures of
policy success or policy failure; a new beginning, a new
partnership, on closing the gap with sufficient flexibility
not to insist on a one-size-fits-all approach for each of
the hundreds of remote and regional Indigenous
communities across the country but instead allowing
flexible, tailored, local approaches to achieve commonly-
agreed national objectives that lie at the core of our
proposed new partnership; a new beginning that draws
intelligently on the experiences of new policy settings
across the nation.
Prime Minister Kevin Rudd, Apology to Australia’s Indigenous Peoples, 13 Feb 2008[i]
27. 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
29. 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.
33. Community Involvement
RAPs Philanthropy
Reconciliation Australia is
dedicated to closing the
unacceptable life expectancy
gap 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).
34. Council of Australian Governments
December 2007
All Australian Governments have agreed to close the
inequality gap in Indigenous health outcomes in a
generation
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 contribution
In excess of $ 8 billion of new money pledged
for Indigenous affairs since November 2008
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1. Principles to underpin
a national effort
2. A partnership
3. A health equality plan
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39. 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
40. UN
Declara*on
on
the
Rights
of
Indigenous
Peoples
Articles 24.2 and 23, United Nations
Declaration on the Rights of Indigenous
Peoples 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.
41. Breaking News – 3 November 2011
Thursday 3 November 2011
NEW NATIONAL ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH
PLAN
The Minister for Health, Nicola Roxon and Minister for Indigenous Health,
Warren Snowdon, today announced the development of a new health
plan for Aboriginal and Torres Strait Islander Australians.
The National Aboriginal and Torres Strait Islander Health Plan will be
established by the Australian Government working in partnership with
Aboriginal and Torres Strait Islander peoples and organisations, and state
and territory governments will be invited to be participate.
"The plan is an important step in providing a road map for action
across Australia," Ms Roxon said.
“It is important this plan is thorough and inclusive, covering not only
health but also factors which impact on health, such as education,
housing, employment and early childhood development,” Mr Snowdon
said.
44. 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
45. • 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
48. Key elements of the TIS initiative:
• Equitable distribution and access;
• Changing norms;
• Engaging community leaders, health workers and
parents who can really make a difference,
particularly in influencing young people and
children;
• Flexibility and support for innovation; and
• Tailoring a range of mechanisms to meet the
needs of local communities. 48
49. 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
55. 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)
56. 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.
57. 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
58. • 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
59. A National Board of Directors led by elected male and female Co-Chairs
and six Directors who are responsible for the Chambers of the annual
Congress meeting
The Board is supported by an Ethics Council – a special body of experts who
provide independent advice on standards and guidelines.
Congress staff, headed by the Chief Executive Officer, assist with operations,
policy advice, membership, promotion and education.
63. Questions?
Further information can be found at:
www.health.gov.au/tackling-chronic-
disease
www.aihw.gov.au/
www.pc.gov.au/gsp/reports/
indigenous
www.ceitc.org.au/
63