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Sep 4, 2008

NT Intervention a lemon: 28 medical specialists give their diagnosis

We are not aware of any evidence that supports the health related components of the NTER, writes Dr Hilary Tyler.


I am writing as one of 28 medical specialists working in Central Australia, who have made a joint submission to the Review of the NT Emergency Response.

On one hand, we are pleased that there has at last been acknowledgement of the exceedingly poor socioeconomic and health status of Aboriginal people, especially in Central Australia.

However, we are concerned that the health component of the NTER has wasted large amounts of money in duplicating information that was already known.

In the year since the NTER was legislated, nearly 11,000 children have had a child health check. This has been resource intensive and disrupted existing health services. Any health benefits remain dubious as almost all health problems diagnosed were already identified.

To our knowledge, only one child in Central Australia has been identified with significant health problems that were not already known.

Many of the health practitioners involved in the screening had little or no experience in the area. Many children were referred for unnecessary investigations at great cost, causing further disruption to existing services.

We are not aware of any evidence that supports the health related components of the NTER. Specifically with respect to health checks there is no evidence that this measure increases the health of children in the long term if other factors are not also addressed.

It has also been disappointing that governments have not sought to engage our expertise and many years of experience in developing more effective long term strategies for health care delivery.

The resources available for the provision of health care in Central Australia are grossly inadequate to provide an appropriate level of care. Ongoing and increased funding are needed for existing health infrastructure, as well as funding for new, long term projects for health service delivery.

Furthermore, we believe that it is essential to respect Aboriginal cultural values and engage Aboriginal people if any long-lasting health improvements are to be realised.

Recommendations in our submission include:

  • Existing health services in Central Australia, such as primary health care, specialist outreach programmes, hospital services, aero medical services, mental health particularly child and adolescent services and alcohol rehabilitation services etc be funded appropriately so to be able to deliver an adequate service.
  • The Australian Government support the NT Government’s “Closing the Gap” plan released last year.
  • The 97 recommendations of the Ampe Akelyernemane Meke Mekarle Little Children are Sacred report be implemented.
  • A working group be immediately set up to consult with stakeholders, with an aim to facilitate resource delivery at a local level rather than to decide whether resources are required.
  • The Racial Discrimination Act (1975) needs to be reinstated. We believe that an appropriate response can be delivered without requiring the suspension of the Act.

The NTER lead to a decrease in morale of staff who had been providing services in this area for many years. We hope that future health initiatives are embarked upon only after consultation with those health experts already working in the NT. In future, short term staff should only be used when longer term staff cannot be found and must always leave the existing service in stronger shape than when they arrived and should never again be paid at significantly higher rates than the “long-termers”.

Improvements will only come with engagement and collaboration with the Indigenous community. Any improvement in health status will require a significant investment both in the social determinates of health (cultural wellbeing, housing, education, employment) and in health services.


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12 thoughts on “NT Intervention a lemon: 28 medical specialists give their diagnosis

  1. Sean

    As I said, ignorant, patronising, and pseudo-paternalistic colonialism to boot. I have ample evidence of what I have stated, having completed a major in anthropology in Australia, focusing on such peoples. Time for Avocado to have a long hard think about things and find some counter-evidence, and JamesK to stop falling for and parroting right wing discourses emanating from dubious vested interests — unless, of course, he stands to profit from the outcomes himself in a direct monetary sense. Time also to compare the rates of ‘abuse’ that JamesK is so worried about with the rates in white communities.

  2. Marion Wilson

    Social and economic disadvantage affects health throughout life. Few family assets, poor education, a dead-end job, insecure employment, living in poor housing and trying to bring up a family in difficult circumstances have cumulative effects on health. The greater the physiological wear and tear people suffer the less likely they are to enjoy a healthy old age. Welfare policies not only need to provide safety nets but also provide additional support to offset earlier disadvantage. Positive action to enable all citizens to play a useful role in the social, economic and cultural life of their society is cost effective – people would be be healthier, have greater self-esteem, would live longer, would be more productive and innovative and would commit less crime. Allowing people to fall into disadvantage is not economically sound business management.

  3. dermot mcguire

    peter throwing money into duplicating services is not ‘fixing problems’. As to cu;lturalvalues that has enormous amount to do with kids health. If you do not engage with your population whoever they are you cannot treat them effectively.

  4. Brenda Rawlins

    There always have to be raging lefties. It would absolutely kill you to admit that Mal Brough’s intervention did any good at all. I lived in Alice Springs for two years and worked at the local court. what I saw was horrific.
    Good luck w ith Mr Sheen at the helm. I am sure he will undo all Mal Brough’s good work.

  5. JamesK

    They won’t and should not be “left alone” whilst child sex, physical and emotional abuse persists on truly extraordinary scale. Those policies patently failed generations of abused children Sean.

    Grow up you twit!

  6. JamesK

    Depending on the ‘political correctness’ of the tertiary institution from which you are ‘majoring’ Sean you may even obtain an honours despite views as frankly stupid and dangerous as yours……

  7. peter cavanagh

    the system was in complete failure before intervention so knocking attempts to fix problems is particularly silly
    problems caused by 30 years of do gooders, what have cultural values got to do with kids health

  8. JamesK

    Very nice comment from Marion Wilson. Much more substantive than the ‘apple pie is good’ cry. The NTER has been largely effective and remember it is still early days…it is still an ’emergency response’.

    There is a new Aboriginal leadership who want their peoples out out of victim hood. Spending money in the past has been all too often not only counterproductive but damaging.

    Long term improvement in the Aboriginal health care statistics was not the primary focus of the NTER.

    Sadly to certain groups ‘maintaining the rage’ against all things perceived by them to have originated from John Howard is more important than outcomes

  9. Avocado

    Sean has well & truly exposed his ignorance of the matters about which he is claimimg authorative knowledge.
    “Many indigenous people still lead a simple subsistence lifestyle approximating pre-settlement conditions” he says.

    If he has any evidence to support this contention, I would be very surprised. In fact there is very unlikely to be any group of Indigenous people living that way, and the number of individuals doing so is extremely small. Just about every Indigenous individual has been caught up in the cash/welfare economy & lifestyle.

  10. Sean

    It is not a question of ‘victimhood’. It is a question of the terms of co-existence. To represent indigenous peoples as some sort of inner client state of a benevolent white invading force who ‘know better’ is insulting and disrespects a fundamental right to be left alone, or with minimal intervention and on their terms. Many indigenous people still lead a simple subsistence lifestyle approximating pre-settlement conditions. To claim ‘victimhood’ status for all indigenous peoples or to fail to respect their long-standing pattern of settlement and culture is, for want of a better word, simply ignorant and patronising.

  11. Sean

    I thought the NTER was just a thinly veiled pretext to claw back land rights and disposses indigenous peoples from areas rich in minerals like uranium or useful for dumping the world’s nuclear waste?

  12. dermot

    what good work? The staffer who lied? the duplication of services? I aint a leftie


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