Close the Gap rebuild must ‘put Aboriginal health in Aboriginal hands’: AMA

The Australian Medical Association President says governments must look to community-controlled health organisations if they want to close the health gap by 2031.

Indigenous-led organisations hold the key to closing the health gap, says a new Australian Medical Association report. Source: Supplied

The Closing the Gap strategy has "all but unravelled" and needs a complete rebuild to meet its health targets by 2031, according to the Australian Medical Association (AMA) Indigenous Health Report Card 2018.

"It really is unfathomable that in such a resource-rich country as well-off as Australia, we’re still having these conversations today," AMA President Dr Tony Bartone told NITV News. 

"We need to ensure that closing the gap becomes more than just a strategy, it becomes an actual measure of outcomes which we deliver by 2031."

This year marks a decade since the Close the Gap strategy was launched, with the aim of closing the gap in health, economic and employment outcomes between Indigenous Australia and the wider population. 

But in 2018, it was revealed that only three out of seven targets were on track, prompting calls for a refresh. 

In terms of life expectancy, Aboriginal and Torres Strait Islander men are still dying 10.6 years earlier than their non-Indigenous counterparts, while life expectancy for Indigenous women is 9.5 years lower.

The AMA Indigenous Health Report Card, released on Thursday, provides a roadmap to get the health targets back on track. 

"We need to be serious, we need to refresh, we need to stop the unravelling of that strategy and build it from the ground up in order to meet that 2031 target," says Dr Bartone. 

The report makes several recommendations to federal, state and territory governments, including:

• Allocate spending to match the disproportionate burden of disease - which is 2.3 times higher for Indigenous people;
• Prioritise mental health;
• Invest in primary healthcare, especially Aboriginal Community Controlled Health Services;
• Restore funding for remote housing;
• Address socio-economic factors, such as income, education and institutionalised racism, and;
• Put Aboriginal health in Aboriginal hands. 

Dr Bartone, who toured several community-controlled health organisations in Brisbane on Wednesday - including the Salisbury Mums n Bubs Hub - said local Indigenous health programs would be key to a revamped strategy. 

"In this community environment here in Salisbury, we’re already seeing significant improvements, and those are the outcomes that we could see replicated right across the whole of the Aboriginal and Torres Strait Islander population throughout our country," he said.

Busting the myth that Indigenous-led organisations 'don't deliver'

Adrian Carson, CEO of the Urban Institute of Indigenous Health, said while national outcomes lagged behind, he had seen "significant" health improvements at a local level in south-east Queensland.

He urged governments to place more trust in Indigenous-led organisations to deliver services.

"This country’s still got a crisis in terms of its relationship with the First People," Mr Carson told NITV News.

"The narrative’s a negative one, it’s always deficit-based, but we turn around and look at what parts of our sector are doing… we’re actually coming up with improved health outcomes within our community – they’re actually solutions that could benefit the whole country.

So this whole idea that somehow our communities can’t be trusted, or that we don’t have the capacity to deliver, is a myth."

Mr Carson said while he welcomed the AMA's report, it was important to take a proactive approach rather than dwelling on negative statistics.

"It doesn’t mean that things aren’t improving, because health outcomes for our people are improving," he said. 

"The challenge is that we’re trying to actually improve the pace of that improvement faster than some of the healthiest people in the world, which is what Australians enjoy – one of the healthiest countries on the globe.

"So you’re trying to actually close the gap between some of the sickest people in the world to some of the healthiest people in the world – it was always an ambitious target."