-----Original Message----- From: Webcentral <[EMAIL PROTECTED]> >Speech by >ATSIC Commissioner Jenny Pryor >Yarrabah Health Planning Workshop >[Tuesday 28 March 2000] >Policy Environment and Strategic Directions in Indigenous Health: ATSIC > > (Opening remarks) >Let me say from the outset, what you are doing here in Yarrabah, and the way >you have done this, is the cutting edge of where public policy and >indigenous affairs is finally showing some signs of going, and ought to be >going. > >The start to meaningful solutions, not just in indigenous health, but across >all-indigenous concerns and issues is at the community level. > >It is called community control. > >Community control is the way forward. > >It is, in my view, the only way forward. > >The answers to the issues we face do not reside in governments and their >agencies. > >I think we are seeing governments and their bureaucrats finally beginning to >admit that their way has failed - and that includes ATSIC. > >It has - and the evidence is clear. > >So what we're seeing happening here today, is a new direction emerging. > >One that holds some hope of getting some sorely needed changes in the >shockingly disadvantaged circumstances that the indigenous people of this >country live under. > >A direction which is seeing agencies, including ATSIC, no longer telling you >what you need. > >Where it is the community telling them not just what the issues and our >needs are - but also what the priorities are and how they should be dealt >with, and done in a user-friendly way in our own communities. > >This is not a new idea, this is self- determination. > >Self-determination is very basic proposition: > >What it means is, that it is you, the community who know best what your >needs are. > >I t means that we as indigenous people know what's best for us. > >That we do know better than government, better than their department's, the >ministers and their bureaucrats. >It means that Yarrabah has a far better idea of what the issues and problems >are. > >It means that the people, the organisations and the community of Yarrabah >have a much better chance of getting the answers and solutions under way >than bureaucracies in Brisbane, in Canberra or in Cairns. > >Community control is self-determination in action. > >Not only is it important. We are actually doing it here now in Yarrabah. >Today. > >Putting self-determination, putting community control into practice. > >By actioning a process where policy, program and service delivery responses >can be ' built up' from the community level. > >A process which you drive, from here in Yarrabah, and which should be >accountable to you. > >A process which puts government and its agencies on notice that these >community responses can help identify and outline the real needs here. > >One which puts forward locally developed solutions,. > >Solutions which will require some real control in place on the ground in >Yarrabah. > >If things are to become really different from the stop start, band-aid >approach of the past. > >So, to put these comments so far into the context of this session, ATSIC has >two principal concerns in Indigenous health. > >The first is community control. > >As the world health organisation has recognised, communities must take >responsibility for their own health. > >ATSIC strongly supports the concept of community-controlled Aboriginal >health organisations. > >And to be fair, it must be noted at a time when other health and welfare >expenditure is being restricted, the current federal government has still >provided funding to expand the number of Aboriginal Medical Services. > >ATSIC is also a partner under the Memorandum of Understanding on Aboriginal >Health, which is currently being renegotiated and is about to happen. > >ATSIC has a unique role in Indigenous health. It is the elected voice of >the Indigenous community, and its representative nature ensures that it can >speak for all the community. > >ATSIC also supports the role of NACCHO. > > NACCHO is also a partner under the MOU. NACCHO is the peak body >representing individual medical services, and able to speak for Indigenous >health professionals. > >ATSIC believes also that improvements in indigenous health must be linked to >improvements in living standards generally. > >It is beyond dispute that without clean water, good housing, employment, >education etc health outcomes will not occur. > >While ATSIC does not -and has not had funding or program responsibility for >primary health care since 1995 - the Commission has a continuing role in >coordinating, monitoring and pushing for many of these key services - >including environmental health services. > >There must be close collaboration across all these other sectors, such as >education, housing, employment, between state, federal and local government- >if health outcomes are to be improved. > >This is, in my view, an area of great concern. > >ATSIC'S Role in Indigenous Health > >Responsibility for health programs for Aboriginal and Torres Strait Islander >people rests with the Office for Aboriginal and Torres Strait Islander >Health Services. > >Which is part of the Federal Department of Health and Family Services. > >ATSIC has taken very seriously - at both the elected Commissioner level and >by its Officers - its ongoing role in the provision of advice and the >determination of priorities. > >Framework Agreements have been signed in relation to the health services in >every State and Territory. >These Framework Agreements are all different - reflecting differences in >Indigenous consultative arrangements as well as State government agencies in >every State and Territory. > >The Australian Health Ministers' Advisory Council recently reviewed these >Framework Agreements. >As I said, earlier Queensland remains a problem. > >ATSIC will continue to concentrate on ensuring that these Framework >Agreements translate into better primary health care. > >An important part of this is ensuring that the Framework Agreements are >complemented by Regional Health Agreements. > >Agreements which recognise elected Regional Councils and which will enable >our regional councils to a have an effective contribution to health planning >at the local level. > >Indigenous Health Disadvantage > >Despite all this, by almost every measure, Indigenous people have the >poorest health status of any group in Australia. > >Aboriginal and Torres Strait Islander people die at three times the rate of >other Australians. > >Tragically, in some age groups our people such in their late 30's and early >40's are dying at rates that are 6 to 8 times higher than non-Aboriginal >Australians. > >An Aboriginal person is 10 times more likely to suffer from blindness, >especially from Trachoma and blindness as a complication of diabetes. > >Both these conditions are preventable. > >Life expectancy for Aboriginal and Torres Strait Islander men is about 17 >years less than for other Australian males and the difference is slightly >more for women. > >Health is clearly a life and death matter for us. > >Indigenous health expenditure: > >It remains so, despite increases to the commonwealth health funding, said to >be a 70 percent increase in the last four years, according to the federal >Minister, Dr Wooldridge. > >Yet despite the increase, measured against the burden of disease in the >Indigenous community, there remains a clear case of under-expenditure on >Aboriginal and Torres Strait Islander health services. > >This under expenditure is well documented by research. > >The so called Deeble Report, Expenditure on Health Services for Aboriginal >and Torres Strait Islander People, by Professor John Deeble, found that >expenditure on Aboriginal health for all services and from all sources of >funding - was $853 million. > >Only 8 per cent higher than for all other Australians on a per capita basis. > > >Despite our death rates being least three times higher. > >Despite our health indicators being dramatically worse across almost any >indicator you care to name. >The research also shows Medicare benefits paid on behalf of Indigenous >people are on average only 27 per cent of those paid to other Australians. > >Payment levels for treatment of our people by prescribed drugs under the >Pharmaceutical Benefits Scheme is only 22 per cent. > >Earlier this month, the AMA in a submission to the federal government, >pointed out that health funding for indigenous Australians was running at >only 50 cents per person. > >Whilst funding for non indigenous Australians was 400 percent higher - at $2 >per person. And called for a massive boost in funding. > >In any assessment of what needs to be done to redress this tragedy, the need >for a substantial and sustained increase in funding is surely obvious. > >Regrettably, it has not been forthcoming, despite the obvious need, and >despite the efforts of the current federal minister. > >It says a lot about a federal government that claims great credit for the >record sustained boom in the Australian economy. > >Yet it cannot find, nor deliver a similar commitment or result for >indigenous health. > >One wonders what the funding equation might become if the economic boom >disappears. > >Aboriginal Medical Services > >Let me turn to the positives. > >Primary health care is provided through about 250 community-controlled >Aboriginal Medical Services (AMS). >These medical services are in my view one of the bright spots in the overall >indigenous health picture. > >Independent research has established that they are cost-effective. > >They are also popular with Indigenous people. > >Importantly, they allow Aboriginals and Torres Strait Islanders to take >control over their own health care. > >Something which is recognised by the World Health Organisation as important >in raising health care standards. >ATSIC strongly supports the extension of the Aboriginal Medical Services, >and commends the expansion we have seen over the past four years. > >We also strongly support the role played by their peak body, NACCHO. > >ATSIC and Environmental Health > >Improved Indigenous health outcomes require environmental health issues to >be addressed. > >It is in this area that ATSIC still remains responsible and has the ability >to provide funds for environmental health programs. > >Without clean water, sewerage systems, proper waste disposal, adequate >housing, washing facilities for people and cloths, dust control, properly >maintained roads, airstrips for transport and emergency medical evacuation, >Aboriginal people will remain sick. > >ATSIC is committed to a substantial housing and infrastructure program. > >And to monitoring the result of that program closely against improvement in >primary health outcomes. > >ATSIC is also working with the army to use army personnel and equipment in >the provision of infrastructure, especially clean water, to selected remote >communities > >Although the ATSIC/Army Community Assistance Program (AACAP) provides only a >small fraction of the assistance provided to remote communities by ATSIC, it >has proven popular with Aboriginal communities, and has gained a great deal >of positive media attention. > >In closing, I will finish by giving a brief outline of what ATSIC's funding >levels and commitments to Yarrabah currently are: > >There are 2 large projects here in Yarrabah - one started, one in planning > >We have a major environmental health project worth $4.8 m under way. > >Providing Yarrabah with new housing, house renovations, and redevelopment of >the hostel and to help upgrade water supply. > >The project is well under way and in the construction phase. > >ATSIC is also looking at funding a second a major project here, worth around >$2.75 m, which will be used to give major renovations to around 45 houses. > >It is also worth pointing out that ATSIC is also providing more than $12m >this financial year to this community to fund the two CDEP programs, run by >the Council and Bama Ngappi Ngappi, the legal service and a range of other >programs run by the Council. > >So that's the picture from ATSIC's perspective. > >I will finish by returning to where I started. > >This workshop, is community control and direction. > >Community control, or self-determination, is I believe, part of the way >forward. > >Not just in terms of health, as important as that is. > >It is about the future of Yarrabah. It is the future in Indigenous affairs. > >But I want to remind the bureaucrats here of this: you are on notice that >indigenous people want to start seeing results. > >We want to see you listen to our suggestions and ideas, and do something >with them. We want to see you help us put them into action, help us make a >difference to our lives. > >To how long we live and how we live. > >I look forward to seeing what comes out of the next three days. > >But we will all be looking to see what happens after the meeting finishes. > >That will be the test of whether this is the old 'consultation' we are used >to. > >Or whether this is a new partnership and new relationship with ongoing >community involvement. > >Thankyou. > > > > ------------------------------------------------------ RecOzNet2 has a page @ http://www.green.net.au/recoznet2 and is archived at http://www.mail-archive.com/ To unsubscribe from this list, mail [EMAIL PROTECTED], and in the body of the message, include the words: unsubscribe announce or click here mailto:[EMAIL PROTECTED]?Body=unsubscribe%20announce This posting is provided to the individual members of this group without permission from the copyright owner for purposes of criticism, comment, scholarship and research under the "fair use" provisions of the Federal copyright laws and it may not be distributed further without permission of the copyright owner, except for "fair use." RecOzNet2 is archived for members @ http://www.mail-archive.com/recoznet2%40paradigm4.com.au/
