National Indigenous health equality summit 2008
Fact Sheet 1
Who is the Aboriginal and Torres Strait Islander Social Justice Commissioner?
The Aboriginal and Torres Strait Islander Social Justice Commissioner is a position created by the federal parliament in December 1992 – a response to the findings of the Royal Commission into Aboriginal Deaths in Custody and the National Inquiry into Racist Violence. It was also a response to the extreme social and economic disadvantage faced by Indigenous Australians.
Social justice is about making sure that every Australian – Indigenous and non-Indigenous – has choices about how they live and the means to make those choices. It also means recognising the distinctive rights that Indigenous Australians hold as the original peoples of this land.
What is the Social Justice Report?
The Aboriginal and Torres Strait Islander Social Justice Commissioner monitors the enjoyment and exercise of human rights for Indigenous Australians.
The HREOC Act and the Native Title Act 1993 (Cth) require that the Aboriginal and Torres Strait Islander Social Justice Commissioner produces an annual Social Justice and a Native Title Report. These reports are tabled in Parliament.
A summary of Chapter 2 of the Aboriginal and Torres Strait Island Social Justice Commissioner’s Social Justice Report 2005 on Indigenous health.
- There is a well known health inequality gap between
Indigenous and non-Indigenous Australians. Notably there is a 17-year life
expectation gap. But significant inequality exists across a range of health
indicators – from life expectation to chronic and communicable diseases,
and across all age groups.
- The Social Justice Commissioner argued that underlying
the inequality statistics was an underlying inequality of opportunity to be
healthy. Indigenous Australians, in other words, simply did not have the same
chances to be as healthy as other Australians. This, he argued, was a human
rights issue that went to the core of our national character as the country that
offered the ‘fair go’ to all, and the ‘level playing
field’.
- It has long been recognised that to ensure equal health
status between population groups, they must enjoy the same opportunities to be
healthy.
- That means Indigenous and non-Indigenous Australians
should enjoy a similarly healthy standard of drinking water, can access roughly
the same standard of fresh vegetables, fruits and meat, and have their sewerage
and garbage removed. It also means that they enjoy a similar standard of housing
– from a health perspective. And it means that we should
all be able to take a shower, wash our clothes, keep our food refrigerated, and
not live with five or 10 people to a room - conditions where diseases can spread
rapidly. These things are referred to as health infrastructure or health
hardware.
- Further, it means that all people and communities
should have equal access to health services, particularly primary health care
services. Access means:
- physically accessible or reachable services;
- affordable services;
- culturally accessible services, for example, in the language spoken; and
- non-discriminatory
services.
- The Social Justice Commissioner set out data which
showed that Indigenous peoples in Australia do not enjoy the same
opportunities to be as healthy as the non-Indigenous population in relation to
primary health care, medicines and health infrastructure. This was data drawn
from Australian Bureau of Statistics (ABS) and other reliable
sources.
- Following human rights principles, the Commissioner
argued that what was necessary was to link existing strategies, such as the National Strategic Framework for Aboriginal and Torres Strait Islander
Health, to equality and equality of opportunity targets within a set time
frame. The Commissioner felt it was unacceptable to continually state - as
happens in Australia - that poorer Indigenous health is tragic and ought to be
treated with urgency, and then fail to put into place bold targets to focus
policy making over the short, medium and longer term, or to fund programs so
they are capable of meeting these targets.
- He also argued for the proper resourcing of these
strategies, stating that a plan that is not adequately funded to meet its
outcomes cannot be considered an effective plan. The history of approaches
to Aboriginal and Torres Strait Islander health reflect this: Australian
governments have proved unwilling to fund programs based on need and, as a
result, plans have failed or had limited success.
- The Commissioner also recommended that Australian
governments ensure that Indigenous peoples have the opportunity to participate
effectively in all aspects of policy development and service delivery that
impact upon their communities.
- In part, the failure of the existing commitments and
strategies to address Indigenous health is because of the failure of Australian
governments to engage appropriately with Indigenous peoples and develop
strategies and programs with the full participation of Indigenous communities.
- He argued it was simply a matter of common sense that
governments risk failure if they develop and implement policies about Indigenous
issues without engaging with the intended recipients of those services.
Bureaucrats and governments can have the best intentions in the world, but if
their ideas have not been subject to the ‘reality test’ of the life
experience of the local Indigenous peoples who are intended to benefit from
this, then government efforts will fail in the medium to long term.
- He also argued for the rolling out of community
controlled primary health care services wherever possible that are culturally,
physically, and economically accessible. Crucially, they empower Indigenous
communities and people to look after their own health. They literally speak the
language of the community, know the communities problems and are best placed to
work out solutions – for example, choosing to invest more of its funds
into integrating drug and alcohol counselling or mental health programs into its
practice.
Recommendations from the Aboriginal and Torres Strait Island Social Justice Commissioner’s Social Justice Report 2005
Recommendation 1 – A commitment to achieve Aboriginal and Torres Strait Islander health equality
That the governments of Australia commit to achieving equality of health status and life expectation between Aboriginal and Torres Strait Islander and non-Indigenous people within 25 years.
Recommendation 2 – Supporting commitments and processes to achieve equality of health status
a) That the governments of Australia commit to achieving equality of access to primary health care and health infrastructure within 10 years for Aboriginal and Torres Strait Islander peoples.
b) That benchmarks and targets for achieving equality of health status and life expectation be negotiated, with the full participation of Aboriginal and Torres Strait Islander peoples, and committed to by all Australian governments.
