There are many aspects of the Prime Minister’s report on closing the gap that we and many Australians, Aboriginal and non-Aboriginal, will welcome. With respect to health, which is our prime concern, the downward trend in infant mortality among Aboriginal kids is especially welcome. We also accept that it will take time to eat into the gap more generally and that, even if we are currently doing so, that is difficult to measure. It is a big report and we recommend to Crikey readers to try to digest it for yourselves.

We want to focus on just five issues. First, we are surprised and disappointed that there is so little attention seemingly being paid to the social determinants of health in seeking to close the gap. They get a mention but a fleeting one and then there is no analysis and no indication that the government really believes that these not only do have major negative effects on Aboriginal health but that actively pursuing policies to address these negative effects might well yield dividends.

We know, for example, that for people living on the homelands or outstations, their health is better — yet the federal government, in tow with the NT government, continues its policy of seeking to centralise services. During this next year Prime Minister can we please see more action on the social determinants of health?

Secondly, AHCWA and its members are much interested in primary health care which is so important for the health of Aboriginal people. AHCWA has devoted much energy to attempting to have a say in the policy developments around Medicare Locals. To that end, in response to requests they received, AHCWA submitted two papers with its ideas to minister Roxon’s department at the end of September last year and again in December. Feedback has been minimal. Why?

Thirdly, in her speech in parliament on Wednesday, the Prime Minister suggested that just as “Closing the Gap demands that the Australian government meets our responsibility … [so it] also demands personal responsibility” from Aboriginal people as if this was some sort of “equality of effort” between equals.

Did the Prime Minister ever read the Sacred Children Report?  Has she any understanding of the impact on the Stolen Generations of being taken from their families? Surely a role of government is to be understanding of and compassionate towards disadvantaged people? Treating Aboriginal people as equals is a bit much given how lacking in resources in the broadest sense they are as compared with the federal government! Tch! Tch! Naughty irresponsible Aboriginal people.

Fourthly, in her speech she said, as “an activist” with respect to Aboriginal disadvantage. We would also consider ourselves to be activists in this context. So we seem to share her stance but, given her position of power, why as just indicated above does she not arrange that her Health Minister at least responds to the AHCWA “activists”?

Lastly and most fundamentally and perhaps in many ways summing up what we have said, in her report there is all too little recognition of the need to listen, to consult and to negotiate with those she wishes to help. Aboriginal people have some very good ideas about what is wrong and some very good ideas on how to make it if not right at least “righter”. It is also the case that — going back to where we started in this piece — as the literature on the social determinants of health tells us taking away people’s self-respect and autonomy does not do their health any good.

Next year in the Closing the Gap Report, we want to learn about what the government has been doing to show respect for Aboriginal people and their views and values.

Peter Fray

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Peter Fray
Editor-in-chief of Crikey