Remedies are the things we suggested

Opinion Article

2009 July, 4

On Thursday I read a note about a young Aboriginal woman who has had to take time off work because  of heart-related medical problems. I thought about it only fleetingly. There are so many things in life  you just wish you could change, but you can’t. Thinking too much about such things just increases the sense of despair too much.  


Now that I have forced myself to think about it, the story is probably this. This young woman’s heart  problems are the consequence of her having contracted rheumatic fever sometime in her childhood.  


Rheumatic fever is caused by streptococcal throat and skin infections. It is rare in developed countries,  except in Australia among Aborigines and Torres Strait Islanders. The incidence of rheumatic fever  among children in northern regional communities is much higher than in other parts of the world. Rates of rheumatic heart fever have increased in central Australia.  


So this woman is a victim of a mundane disease directly related to poverty, overcrowding, poor  sanitation and poor hygiene.  


The progression from fever to heart disease can be avoided with proper medical attention. But there  must be early diagnosis and there is no specific laboratory test to diagnose what can be an elusive  killer.  


Even where it is diagnosed, the long treatment regimes and changes in the lifestyle and living  conditions that can stop the onset of heart disease are hard to achieve. Too many children and young  people are diagnosed too late and receive inconsistent and incomplete treatment to avoid heart  problems and early death.  


So Aboriginal communities are burying these young people in their 20s, or their 30s or their early 40s.  It is always confounding when even people who have looked after themselves, don’t drink and don’t  live destructively, are nevertheless condemned by a disease that had decided their fate when they were  only children.  


They have no choice in their fate. I fear for my young lady’s prognosis.


Then I read the communique from the Council of Australian Governments meeting in Darwin this  week, which had indigenous disadvantage as the main agenda item.  


You know that famous painting by Edvard Munch titled The Scream? Imagine a more rotund, dark  figure instead with his hands clutching his head. That’s me after reading the rubbish coming out of  Darwin.  


The Prime Minister and his colleagues across the country have little clue about what to do to achieve  their stated aim of “closing the gap” on Aboriginal wellbeing. The COAG partnership agreement gives  me no confidence that we are on the right road to turning around the plight of indigenous Australians.  Putting the words “closing the gap” in front of every policy initiative does not magically turn useless  policies into effective ones. But this is the new mantra of bureaucrats and politicians across the  country.  


The country’s most senior bureaucrats do not understand what needs to be done. Their political  masters know even less. The only politician who made any sense this week was West Australian  Premier Colin Barnett who went into the meeting declaring that the shutdown of sit-down money and a  fully concerted effort to get indigenous people into real jobs was the main agenda. Barnett said: “There  is no doubt that Australia’s greatest social challenge is the condition of the Australian indigenous  people and I think every government in Australia recognises that. I hope every person in Australia  recognizes that.”  


The rest of it was just a Groundhog Day of official consternation about the results of the Productivity  Commission’s latest biannual report on the state of indigenous Australia. The report tells us not much  progress has been made from the turn of the millennium and, indeed, there has been deterioration in  some areas. Without a doubt the most worrying statistic concerns rates of substantiated child abuse.  The rates are reported as having increased from 4 per cent in 2000 to 6 per cent today.


I expect that these increased rates are the result of more effective reporting and investigation of abuse.  Governments all across the country have been forced to overhaul their child protection regimes, driven  by The Australian’s relentless decade-long campaign to uncover the hidden abuse and force governments to take action. It is instructive that none of the momentum for the focus on child abuse  came from elected political leaders or from governments. The initiative came from the press.  


Policy formulation within the highest levels of government is extremely poor. The Department of the  Prime Minister and Cabinet has developed all sorts of facsimiles of Downing Street-style “strategic  policy”, “joined-up government” capabilities. The Blairite social policy revolutions that largely failed  are being regurgitated by a new generation of policy wonks who have no clue about how social change  happens in the real world.  


The biggest mistake made by the Rudd government is to premise indigenous policy revolution on  delegating responsibility and funding to state and territory governments.  


We are supposed to be in the era of “evidence-based policy”. Well, the present direction of indigenous  affairs policy flies in the face of at least two pieces of evidence.  


First, the Howard government undertook a trial under the aegis of COAG five years ago. One site was  selected in each of the states and territories for concerted policy and program attention. Cape York was  the Queensland site. Shepparton was the Victorian site.  


It was a failure. The government’s own evaluation of the so-called COAG trials painted a clear picture  of failure.  


So if the COAG process failed for only seven sites across the country, why do the Prime Minister and  his colleagues think it will succeed for all indigenous communities?  


Second, following his resignation, former Queensland premier Peter Beattie called for all responsibility  for indigenous affairs to be transferred from state and territory governments to the commonwealth.  


He said: “People in indigenous communities end up not being sure whether they go to the local council,  the state or the commonwealth on these matters. This is an international disgrace and we need a  national response that’s not about victimising, it’s not racist, but is actually a co-operative partnership  with indigenous communities.”  


If Beattie, having been premier for four terms, believed state governments did not have the ability to  make progress on indigenous affairs, why is present policy placing even more responsibilities on state  and territory governments?


Beattie closed his indigenous affairs department because he knew it was ineffective. Yet now we are  seeing its resurgence as the leader of new efforts aimed at “closing the gap”. By the time you get down  to state and territory government departments, and by the time you get down to indigenous affairs, the  depth of talent is so thin. It has always been the problem. Yet we are banking on this shallow pool to  make the revolution.  


Beattie was a guy whose heart was heavy with concern for indigenous suffering, but he had more  important priorities as a state leader. For his policy attention. For his political attention. For his money.  I see it time and time again: politicians and senior bureaucrats who have goodwill but for whom indigenous policy comes into view forfleeting periods and soon disappears out of sight, out of mind.  So this week the abuse of indigenous children comes fleetingly to the attention of our Prime Minister and the premiers; next week it will recede into bureaucratic oblivion.  


We are just going through another Groundhog Day.  


Queensland Premier Anna Bligh released a statement pointing out the progress being made with  welfare reform and the Family Responsibilities Commission. She cited a 44per cent decrease in the  number of Magistrates Court defendants in Aurukun community since the start of the reforms, as well  as increases in school attendance. More than 90 per cent of funds under conditional income  management is spent on food and essential items. The children in another welfare reform community,  Coen, have a school attendance rate that is higher than the Queensland average.  


“The Family Responsibilities Commission is part of the groundbreaking Cape York welfare reform  trial, which is globally unique in linking parental responsibility with government assistance,” Bligh  says. “This is about the determined joint efforts of my government and the commonwealth to improve  the prospects for all indigenous children and families living in remote communities.”


Well, actually, the Family Responsibilities Commission and the welfare reform trial is about the  determination of indigenous leaders and organisations in Cape York Peninsula. These are policies and  initiatives we designed and that we requested the commonwealth and Queensland governments to  support.  


These reforms did not come from Bligh or her government, or from the previous and incumbent federal  governments.  


As long as governments don’t recognise what lies at the heart of the Cape York reforms we will  continue to grind gears. At the heart of the Cape York reforms is not what governments say they are  going to do or say they are committed to. It is indigenous people taking responsibility for their own  future - and asking government to partner them in their own determination to achieve a better life for  their children - that lies at the heart of the Cape York reforms that are starting to show promise.

Remedies are the things we suggested