Wednesday, 11 February 2015

February 2015 progress report on the 'Prime Minister for Indigenous Australia'

In 2008, led by the first Rudd Federal Labor Government, the Council of Australian Governments (COAG) committed to six targets to reduce and/or eliminate the disadvantage faced by Indigenous Australians in life expectancy, child mortality, education and employment.

These were:

Prime Minister Tony Abbott entered the Australian Parliament in a 1994 by-election -becoming the Member for Warringah, an affluent electorate on Sydney’s North Shore. By 1996 he was part of the first Howard Government and by 1998 he was a minister.

In December 2007 he became an Opposition MP when the Coalition lost government. Two years after that he became Leader of the Opposition and in 2013 he returned to the government benches as prime minister.

To his credit he probably has had more contact with remote area indigenous communities than many other metropolitan-based parliamentarians.

However, despite his political self-promotion on the subject, his time ‘living’ in these remote communities by his own admission barely makes 42 days in 21 years.

Four out of five of these short living and working in community experiences occurred during the six years he spent on the Opposition benches between 2007 and 2013.

Once Abbott became prime minister he declared himself to be “Prime Minister for Indigenous Australia”.

On 12 February 2014 he released his first Closing The Gap: Prime Minister’s Report and stood in the House of Representatives and pledged a fair go for Aboriginal people during his first Closing The  Gap Statement.

The Australian Human Rights Commission’s own Progress and priorities report 2014: Closing The Gap ended with a clear call to the Abbott Government in this Conclusion:

The commitment to close the Aboriginal and Torres Strait Islander health and life expectancy gap by 2030 was a watershed moment for the nation. Politicians, the Aboriginal and Torres Strait Islander and non-Indigenous health sector, and human rights organisations, made a public stand in committing to this agenda. As did the Australian public. To date almost 200,000 Australians have signed the close the gap pledge and approximately 140,000 Australians participated in last year’s National Close the Gap Day. This is the generation who has taken on the responsibility to end Aboriginal and Torres Strait Islander health inequality.

Because of this leadership, and the willingness to ‘draw a line in the sand’, we are seeing reductions in smoking rates and improvements in maternal and childhood health that will eventually flow into significant increases in life expectancy. This provides early positive signs that people on the ground are responding to the initiatives and demonstrates that Aboriginal and Torres Strait Islander communities are taking responsibility for their health as they are being provided with increasing opportunities to do so.

Achieving health equality by 2030 is an ambitious yet achievable task. It is an agreed national priority and it is clear that the Australian public demand that government, in partnership with Aboriginal and Torres Strait Islander peoples and their representatives, build on the close the gap platform to meet this challenge.

For this reason, the Close the Gap Campaign has stressed the need for the new Australian Government to stay the course, to ensure policy continuity and to strengthen the national effort. This term of government will be critical to achieving the 2030 goal and we call on the new Australian Government to not only ensure policy continuity in critical areas of the national effort to close the gap, but to take further steps in building on and strengthening the existing platform.

Since Tony Abbott's first report and statement a marked change has occurred and, thus far, he has overseen a $534 million funding cut to indigenous programs administered by the Prime Minister and Cabinet and Health portfolios budgeted over five years; more than $160 million of the cuts will come out of Indigenous health programs. The health savings will be redirected to the Medical Research Future Fund.

The Human Rights Commission Progress and priorities report 2015: Closing The Gap states:

The Campaign Steering Committee is also concerned that hard won Aboriginal and Torres Strait Islander health gains could be negatively impacted by proposed measures contained in the 2014–15 Budget. Potential cuts to the Tackling Indigenous Smoking programme are of particular concern and could hinder the significant progress made in reducing Aboriginal and Torres Strait Islander smoking rates in recent years. Investment in early prevention activities saves on the provision of complex care into the future. These programmes also address and have started to make inroads into primary prevention, particularly in healthy eating, nutrition and physical activity.

This report recommended:

1. That the findings of the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS) are used to better target chronic conditions that are undetected in the Aboriginal and Torres Strait Islander population. In particular, access to appropriate primary health care services to detect, treat and manage these conditions should be increased.
Aboriginal Community Controlled Health Services should be the preferred services for this enhanced, targeted response.

2. That the Australian Government should continue to lead the COAG Closing the Gap Strategy.

3. That the Australian Government revisit its decision to discontinue the National Indigenous Drug and Alcohol Committee.

4. That connections between the Indigenous Advancement Strategy and the Closing the Gap Strategy are clearly articulated and developed in recognition of their capacity to mutually support the other’s priorities, including closing the health and life expectancy gap.

5. That the Tackling Indigenous Smoking programme is retained and funding is increased above current levels to enable consolidation, improvement and expansion of activities until the gap in the rates of smoking between Aboriginal and Torres Strait Islander and non-Indigenous people closes.

6. That proxy indicators are developed to provide insights into the use and availability of health services on Aboriginal and Torres Strait Islander health and life expectancy outcomes.

7. The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing provides the basis for a dedicated Aboriginal and Torres Strait Islander mental health and social and emotional wellbeing plan. This is developed and implemented with the National Aboriginal and Torres Strait Islander Health Plan, the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy 2013 and the National Aboriginal and Torres Strait Islander Peoples’ Drug Strategy implementation processes in order to avoid duplication, be more efficient, and maximise opportunities in this critical field.

8. That Closing the Gap Targets to reduce imprisonment and violence rates are developed, and activity towards reaching the Targets is funded through justice reinvestment measures.

9. That the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan include the essential elements:
* Set targets to measure progress and outcomes;
* Develop a model of comprehensive core services across a person’s whole of life;
* Develop workforce, infrastructure, information management and funding strategies based on the core services model;
* A mapping of regions with relatively poor health outcomes and inadequate services. This will enable the identification of services gaps and the development of capacity building plans;
* Identify and eradicate systemic racism within the health system and improve access to and outcomes across primary, secondary and tertiary health care;
*Ensure that culture is reflected in practical ways throughout Implementation Plan actions as it is central to the health and wellbeing of Aboriginal and Torres Strait Islander people;
* Include a comprehensive address of the social and cultural determinants of health; and
* Establish partnership arrangements between the Australian Government and state and territory governments and between ACCHS and mainstream services providers at the regional level for the delivery of appropriate health services.

Abbott’s second prime ministerial report and statement to the Parliament will be of considerable interest and this morning (11 February 2015) The Australian published an article in which he attempts to soften the public reaction to this year’s report which covers his term as prime minister to date:

TONY Abbott will today declare “profound” disappointment with the nation’s efforts to lift indige­nous Australians out of disadvantage as his centrepiece Closing the Gap report shows stalled progress on half its indicators.

This article also reported:

Gap steering committee co-chair Mick Gooda will hand his own report to the Prime Minister…. It implores the government to maintain momentum on health targets.

Mr Gooda said ­budget decisions — such as cutting smoking programs and a possible GP co-payment — threatened hard-won gains. He also said discussions about federation reform were ­ominous and “could potentially signal a break with the spirit of the 1967 referendum” that had ­addressed the unsuitability of state and territory efforts to reduce indigenous disadvantage.

“It is right that these targets have a long timetable because they won’t be achieved in a year. But we risk going backward if programs that work are sent packing,” he said.

Health targets, he argued, were the base from which all other improvements sprang. They were also linked to the large prevalence of disability in the community.

“Alice Springs Hospital is like a war hospital with the number of amputations they are doing,” he said. “That comes from diabetes and chronic disease. You fix that, you stop contributing to another problem as well.”


Progress against the targets Key findings:

* While there has been a small improvement in Indigenous life expectancy, progress will need to accelerate considerably if the gap is to be closed by 2031.
*  The target to halve the gap in child mortality within a decade is on track to be met.
*  In 2012, 88 per cent of Indigenous children in remote areas were enrolled in a pre-school programme. Data for 2013, to show whether the 95 per cent benchmark for this target has been met, will be available later this year.
*New data on whether enrolled children are actually attending school should also be available later this year.
* Progress against the target to halve the gap in reading, writing and numeracy within a decade has been disappointing. Only two out of eight areas have shown a significant improvement since 2008.
* The target to halve the gap for Indigenous people aged 20–24 in Year 12 or equivalent attainment rates by 2020 is on track to be met.
* No progress has been made against the target to halve the employment gap within a decade.

Based on the last three Closing The Gap prime minister’s reports the following is evident:

Between 1998 and 2013 the gap between mortality rates indigenous children under five and non-indigenous children in this same peer group has narrowed by 35 per cent. Unfortunately there is no data for 2014 in Abbott’s second prime minister’s report.

Indigenous mortality rates dropped by 12% between 1998 and 2011 with the gap between indigenous and non- indigenous mortality staying the same by 2011. Indigenous life expectancy data is drawn from the national census and is only published every five years by the Australian Bureau of Statistics, so the 2013, 2014, and 2015 prime minister’s reports appear to all rely on the same figures.
Reliable up-to-date data on population numbers and life expectancy will not be available until around 2018. 
However, the rate at which indigenous life expectancy is growing is stated to be very slow. National indigenous mortality rates are not included in Abbott’s first prime minister’s report and only go up to 2006 in his second, even though more recent mortality rates are available at Australian Indigenous HealthInfoNet : There were 2,620 deaths in Australia in 2012 where the deceased person was identified as Indigenous [4]. For NSW, Qld, WA, SA and the NT, the only jurisdictions with adequate identification of Indigenous status, the age-standardised death rate of 1,128 per 100,000 population for Indigenous people was 2.0 times the rate for their non-Indigenous counterparts.
More detailed information about death rates is available for the five-year period 2006-2010 for people living in NSW, Vic, Qld, WA, SA and the NT [5]. After age-adjustment, the death rate for Indigenous people living in those jurisdictions was 1.9 times the rate for non-Indigenous people (Table 1) [5]. The rates for Indigenous people were highest in the NT (1,541 per 100,000) and WA (1,431 per 100,000).

Pre-school enrolment in 2011 was 91%. Preschool enrolment had fallen by 2% since 2012 and was at 85% in 2013. 
It appears to have remained stagnant at that rate since Tony Abbott became prime minister and moved Aboriginal and Torres Strait Islander focused programs into the Dept. of Prime Minister and Cabinet. The enrolment target is not being met and, the overall government strategy appears to be failing.

The new baseline for the 2018 indigenous school attendance target appears to be based on data released in December 2014 which shows that; the Indigenous attendance rate was already 90 per cent or above in 2,046 (44 per cent) of the 4,605 schools for which an Indigenous attendance rate was published. The proportion of schools achieving the 90 per cent benchmark for Indigenous attendance in 2014 varies sharply by remoteness: 48 per cent of schools in metropolitan areas, 44 per cent in provincial; 21 per cent in remote and only 14 per cent in very remote areas.

There is still no progress in raising indigenous literacy and numeracy levels above those recorded in 1988 according to Abbott’s 2015 prime minister’s report.
The last three prime minister’s reports rely on NAPLAN data. For example, in the 2014 NAPLAN national report the gap between indigenous and non-indigenous Year 3 students achieving at or above minimum national standards in reading was 20 per cent, for persuasive writing the gap was 19.1 per cent and, the numeracy gap for this same student group was 17.5 per cent. 
However, between 2009 and 2013 across all student bands included in NAPLAN data there have been literacy and numeracy gains for indigenous students.

The Gillard 2013 prime minister’s report stated that; In 2011, the proportion of Indigenous 20-to-24-year-olds with at least Year 12 or Certificate II was 53.9% which was a 6.5 percentage point increase on 2006 figures. 
According to the Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) quoted in Abbott’s first prime minister’s report; 59.1 per cent of Indigenous 20–24 year olds had a Year 12 or equivalent qualification in 2012–13, which represents a rise of 13.7 percentage points from 45.4 per cent in 2008
His second report indicates that the gap narrowed to 28 percentage points in 2012-13. There appears to be no data for his term in office.

Comparing both of Abbott’s prime minister’s reports it appears that his 2015 report contains no new data for the 2013-14 financial year, so the decline in the indigenous employment rate may possibly have deepened since September 2013.

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