“If we are committed to Black lives, we should be committed to diagnosing the problem properly. We have the wrong diagnosis here, so of course, we are giving the wrong treatment. If it worked, we would have seen changes.”

ASSOCIATE Professor Chelsea Bond, Munanjahli and South Sea Islander woman and a Principal Research Fellow at the University of Queensland, says in an exclusive InSight+ podcast that racial violence within the Australian health system is at the heart of the continued health inequities experienced by Aboriginal and Torres Strait Islander peoples.

And, she said, the latest iteration of the Closing the Gap policy, which came into effect on 30 July this year, was unlikely to change the course of Aboriginal and Torres Strait Islander health in Australia.

“We have an agreement that we have signed up to, apparently, and all it does differently from the last decade or so of failure is that it enables the government to blame Indigenous peoples – both the [Coalition of the Peaks] and the Blacks on the streets – that the failure and the ongoing problems are because Aboriginal people are the problem,” she said.

In a Perspective in the MJA, Associate Professor Bond and colleagues wrote that despite the “parlous state of Indigenous health” in Australia, the Black Lives Matter movement had failed to ignite the kind of urgency that the global movement had sparked elsewhere.

“What we have been presented with, aside from the Health Minister admonishing Black Lives Matter protestors for putting the health of the public at risk, has been the triumphal announcement of ‘research projects’, the release of a ‘landmark report’, and a drafting of ‘refreshed’ and ‘historic targets’. All of these supposedly fresh responses were on track before the Black Lives Matter movement hit our shore,” they wrote.

“The Australian health system’s Black Lives Matter moment is best characterised as indifferent; a ‘business as usual’ approach that we know from experience betokens failure.”

In the podcast, Associate Professor Bond said the latest Closing the Gap agreement did not offer “real, substantive change for Indigenous people”, and, coming as it did amid the Black Lives Matter moment, was an “insult”.

“When we look at the detail, what we see is not an ambitious plan for Closing the Gap, in fact we see an abandonment of parity in this new agreement,” she said.

Bond and her co-authors proposed abandoning the “failed” Indigenous health policy of Closing the Gap in favour of a health justice framework. The proposed framework has six elements:

  • Foregrounding Indigenous sovereignty in all processes of health policy formation.
  • Government commitment to the recommendations of coronial inquiries into the deaths of Aboriginal and Torres Strait Islander peoples who have died of preventable or avoidable conditions.
  • An explicit commitment to fund research that attends to the nature and function of race in producing the conditions that allow racialised health inequities to persist.
  • Raising awareness of the ways in which Aboriginal and Torres Strait Islander peoples may seek justice when experiencing discrimination within the health system.
  • The introduction of publication guidelines for health and medical journals requiring research relating to racialised health disparities to foreground institutionalised racism in its analysis, rather than socio-economic disadvantage and other social and cultural factors.
  • The introduction of an interdisciplinary Indigenous health workforce agenda that centres the care of Indigenous people beyond capacity building to include attending to racial violence within workplaces across the Australian health system.

Associate Professor Lilon Bandler, Principal Research Fellow for the Leaders in Indigenous Medical Education Network, agreed that Closing the Gap had failed.

“Year after year the data is provided to the Australian Parliament, and the gaps are clearly not closed, let alone aspiring to more than just closing the gap,” Associate Professor Bandler said.

“Yes, we can revitalise or review or revise, whatever you like to do with that policy, but as is highlighted in this article, it is fundamentally flawed in its ideas.”

Professor Bandler liked the “how-to” approach of the proposed six-step health justice framework.

“I like the clarity of those statements,” she said. “They make clear what needs to happen. And certainly, what we are doing at the moment, however it’s rephrased, isn’t working. So, here is a set of six things to do and we should get on with it.”

Associate Professor Bandler also welcomed the amplification of Indigenous voices in the MJA article, which begins with the words of Kevin Yow Yeh, whose grandfather, Kevin Yow Yeh Sr, “apparently had a heart attack at the Mackay watch house” and died at the age of 34 years.

“So many articles start by outlining the disparities in Indigenous health, but this article … begins with and continues with an Indigenous voice and that’s really critical,” she said.

“It is about giving voice to voices that are not usually heard, and I think that that is part of our responsibility as health care workers. We have status and credibility, and the MJA as a journal has status and credibility, and it behoves us then to insist on that voice being heard and, more importantly, actually be listened to.”

Dr Summer May Finlay, a Yorta Yorta woman, public health professional, lecturer at the University of Wollongong, and Postdoctoral fellow at the University of Canberra, said the Black Lives Matter movement had made a “significant impact” at the community level, but had been “dismissed” at the political level.

“Black Lives Matter has certainly had an impact at a grassroots level – we are seeing community coming together in a way that they haven’t before and people who probably haven’t been across Aboriginal and Torres Strait Islander issues or issues for people of colour are starting to learn and to self-educate,” she said.

“But what we haven’t seen is significant involvement or attention to the Black Lives Matter movement from the political parties, particularly, and politicians individually.”

And while Dr Finlay agreed with the health justice strategies outlined by the MJA authors, she said such an approach could be adopted under the Closing the Gap framework.

“Ultimately, it doesn’t matter what the name is; what matters is what’s in the framework and its implementation,” she said. “There is no reason why these strategies cannot be adopted under the Closing the Gap framework.”

Dr Finlay said acknowledging and addressing systemic racism and encouraging self-reflection and self-education among health care professionals were critical steps in making the substantive changes required to improve the health and wellbeing of Aboriginal and Torres Strait Islander people.

“A lot of it goes to unconscious bias. If you ask most health professionals about how they treat a black life or a white life, they will just say they treat people equally. But we know that doesn’t happen in practice,” she said. “So, it will require people to do a fair bit of self-reflection and a fair bit of self-education to address this.”

This was a hurdle for many, she said, because generally people did not want to feel bad about themselves or acknowledge a need to change.

“They don’t want to get uncomfortable because it’s all too hard,” she said. “But a mother dying; that’s harder than being self-reflective.”

Dr Finlay said she was “slightly more optimistic” about the future, but said change was far too slow.

“My grandmother died at 49, and my uncle, my cousin and aunt all died. They formed the statistics that we are actually looking to address,” she said. “I think there has been significant improvement in the health and wellbeing of Aboriginal and Torres Strait Islander people but the gap is staying the same because the health and wellbeing of non-Aboriginal and Torres Strait Islander people are improving at the same rate or greater.”

A spokesperson for the Minister for Indigenous Affairs Ken Wyatt said the new National Agreement on Closing the Gap was a marked shift in the Closing the Gap framework.

“This historic Agreement is the culmination of a significant amount of work undertaken by the Joint Council on Closing the Gap and developed in genuine partnership between all Australian governments and the Coalition of Aboriginal and Torres Strait Islander Peak Organisations,” they said.

“It is the first time an Agreement designed to improve life outcomes for Aboriginal and Torres Strait Islander people has been developed with Aboriginal and Torres Strait Islander people.”

The spokesperson noted that the Agreement was centred on four priority reforms:

  • Strengthening and establishing formal partnerships and shared decision making.
  • Building the Aboriginal and Torres Strait Islander community controlled sector.
  • Transforming government organisations so they work better for Aboriginal and Torres Strait Islander people.
  • Improving and sharing access to data and information to enable Aboriginal and Torres Strait Islander communities make informed decisions.

“There are 16 national socio-economic targets that will track progress in improving life outcomes,” they said.

The MJA authors wrote that what was needed was “an Australian health system that has steadfast commitment to Black lives; not as in need of saving, but as deserving of care”.

Associate Professor Bond said if we shifted the focus to Aboriginal and Torres Strait Islanders being deserving of care, then we would consider different measures and use different language.

“The system is happy to talk about ‘discharge against medical advice’, ‘non-compliance’ and ‘health literacy’,” she said. “But the system refuses to look at itself … and diagnose how the system is working to produce these racialised outcomes.”

InSight+ sought comment from the National Aboriginal Community Controlled Health Organisation and from the National Indigenous Australians Agency, but those bodies chose not to comment.


Poll

It is time to call time on Closing the Gap
  • Strongly agree (42%, 27 Votes)
  • Strongly disagree (20%, 13 Votes)
  • Neutral (14%, 9 Votes)
  • Agree (12%, 8 Votes)
  • Disagree (12%, 8 Votes)

Total Voters: 65

Loading ... Loading ...

9 thoughts on “Racial violence: new Closing the Gap policy “an insult”

  1. Cate Swannell says:

    Note from the editor: David you complained that it was derogatory. So I removed it.

  2. Dr De Leacy says:

    Would the editor of this page please explain to me and their readers why the final comment directed at me by ‘anonymous’ has subsequently been edited with the sentence deleted?
    Exactly where has the AMA arrived at?

  3. Dr De Leacy says:

    Anonymous (whoever you are), this is an extremely poorly written opinion piece for nowhere does it define exactly what ‘violence’ is occurring for the non-anonymous non-woke readership it apparently is trying to reach.
    You miss my point entirely. This ‘messenger’ piece has no insight into the human psyche whatsoever when attempting to influence people’s opinion in the hope of leading to action.
    A valid opinion will be accepted only when supported by the presentation of facts.
    Emotive opinions, poorly presented and without facts, as this article exemplifies, do more to damage to it’s stated aims than any civil disobedience in the streets.
    I’m afraid your derogatory insult addressed to me says far more about you ‘anonymous’ than about me.
    You know absolutely nothing about me or my personal philosophies.

  4. Dr. Rolf Tsui says:

    To anonymous – put a name to yourself to have debate, I welcome it.

    I believe the shoe is on the other foot. Look at the mirror yourself. There has been a blatant dismissal of my efforts, as I can only speak for myself. How are you supposed to form a dialogue or lasting trust when one opinion should override the other? There should be acknowledgement of each other’s opinions and not make conclusions like the person I quoted from.

    Health is a two way street. We can help only when the help is wanted and develop a mutual respectful relationship, regardless of race, sex, gender or culture.

    So, who needs to look at the mirror – I believe that is you. Not only that, it needs polishing since you’re not very tolerant of listening to others either.

  5. Anonymous says:

    To Dr Leacy. Try listening to the podcast, and you’ll find out exactly what “violence” means in this context.

  6. Anonymous says:

    To Dr Rolf. Wow, way to try and silence black voices, doc. “defamatory”, “inflammatory”, “arrogant”, “soap box”, “discarded”, “achieves nothing” … can you not hear yourself dismissing black opinion? Can you not see how you’re trying to make black experience invisible? Take a long hard look in the mirror.

  7. Dr. Rolf Tsui says:

    “A lot of it goes to unconscious bias. If you ask most health professionals about how they treat a black life or a white life, they will just say they treat people equally. But we know that doesn’t happen in practice,” she said. “So, it will require people to do a fair bit of self-reflection and a fair bit of self-education to address this.”

    This was a hurdle for many, she said, because generally people did not want to feel bad about themselves or acknowledge a need to change

    This is defamatory. This is the type of broad brush stroke labelling of the masses which infuriates and diminishes our efforts. Every individual efforts matter, from here 2 people, then 4 and so on. It is a cultural shift and it takes time to produce a sustained response. Being inflammatory and standing on the soap box rhetoric will be regarded just as that and discarded. It achieves nothing except proves the arrogance of this person.

    The solution lies with working together and not causing divisions. I seriously doubt the major contributors to this article have done that.

  8. Dr De Leacy. says:

    “centring care .. beyond capacity building to include attending to racial violence within workplaces of the Australian Health Care System”? Exactly what violence does the author accuse the healthcare sector of?
    Provide hard fact evidence of ‘violence’ in health care systems to support this totally assumed and emotive statement of ‘fact’.
    This ‘social science’ fact free article’s constant blame apportioning hyperbole exemplifies the reasons that readers just turnoff this verbiage.. Don Watson needs to dissect this exercise in biased opinion.

  9. Anonymous says:

    Where is the “violence”?

Comments are closed.