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.