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Close the Gap - Part 1 Background

Close the Gap - Part 1
Background

The Close the Gap Campaign for Indigenous Health
Equality

In my 2005 Social Justice Report1, I argued that it was unacceptable for a country as rich as ours, and one based on the notion of the ‘fair go’ and the ‘level playing field’, to tolerate the gross health inequality that has existed between Indigenous and non-Indigenous Australians for at long as records have been kept. I called for action, and I made recommendations that set out a broad path to bring it to an end as soon as practicable.

In particular, I recommended that the following targets be adopted by Australian governments:

  • 25 years to achieve equality in health status and life expectation
  • 10 years to achieve equality of opportunity in relation to access to primary health care and in relation to infrastructure that supports health (such as housing, food supplies, water, and etc.).

A further recommendation was that a number of detailed Indigenous health status and other health related sub-targets (hereon referred to as the Close the Gap National Indigenous Health Equality Targets) be developed.

My recommendations, reproduced in full on page 9, encapsulated a human rights based approach to ending the Indigenous health crisis – one that utilises targets and benchmarks to not only provide an end in sight, but also to ensure accountability for achieving the goal of health equality. I did this not just because the right to health equality and equality of opportunity is a legally recognised right of Indigenous Australians, but also because the right incorporates sound principles whose value and utility are recognised: the need for a holistic approach to Indigenous health, for example.

Following the release of my report in March 2006, the National Aboriginal Community Controlled Health Organisation, the Australian Indigenous Doctors’ Association, the Congress of Aboriginal and Torres Strait Islander Nurses, the Indigenous Dentists’ Association of Australia, and Oxfam Australia, Australians for Native Title and Reconciliation and I led the National Indigenous Health Equality Campaign based on the recommendations I had made. To that end we founded a Steering Committee to guide the development of the Campaign and worked with a coalition of 40 or so organisations all committed to bringing Indigenous health inequality to an end.

‘Close the Gap’ was the public face of the Campaign, organised with great impact by the National Aboriginal Community Controlled Health Organisation, Australians for Native Title and Reconciliation and Oxfam Australia. On 4 April 2007, the campaign was formally launched at Telstra Stadium by Catherine Freeman, Ian Thorpe, Henry Councillor, Chair of the National Aboriginal Community Controlled Health Organisation, and myself.

A full-page open letter, reproduced on page 11, was also published in The Australian calling for Australian governments to support the campaign.

The two main goals of the Campaign were:

  • First, to provide impetus for Australian governments to revitalise their existing commitments to ending Indigenous health inequality, but also – significantly – to place a time frame on these commitments, and to be accountable to them, by adopting the targets I had recommended.
  • Second, to generate a range of Close the Gap Indigenous Health Equality Targets. As it eventuated, these targets were developed by 3 targets working groups of the Steering Committee for Indigenous Health Equality. Each was led by a notable Indigenous person with extensive health experience. The targets working groups drew on the experience of
    acknowledged health experts (and particularly Indigenous health experts) to create the
    targets. A full list of those involved is included in this publication at page 75.

This and other activities had real impact: notably, the ALP in Opposition – and now in Government – had adopted much of the language and the approach of the Campaign in its Indigenous affairs policy by the time of the 2007 federal election.

The Campaign culminated in the National Indigenous Health Equality Summit held in Canberra over 18 – 20 March, 2008. There were two streams of activity that took place at the Summit:

  • First, the draft Close the Gap Indigenous Health Equality Targets were presented to a range of invited delegates, including Australian government representatives, for comments and feedback.
  • Second, the Commonwealth government and the Opposition re-committed to achieving Indigenous health equality within a generation through signing a Close the Gap Statement of Intent (reproduced on page 15). It was signed by the Prime Minister, the Ministers for Health and Indigenous Affairs, the Opposition leader, Ian Thorpe, Catherine Freeman, and every major Indigenous and non-Indigenous health peak body.

After the Summit, the work of the 3 target working groups was integrated into a single table of
targets and a summary outline. This has now been presented to the Commonwealth Government for integration into the COAG Working Group processes and is reproduced in this publication.

An important announcement made by the Prime Minister at the Summit was that that the National Aboriginal and Torres Strait Islander Health Council will be reformulated as an Indigenous Health Equality Council, with a primary role around the implementation of targets and benchmarks. This provides an opportunity to embed the targets into policy and practice nationally.

The Steering Committee continues to work with COAG and Australian governments to progress the adoption of the targets, and their integration with a variety of monitoring frameworks. A non-exhaustive list might include:

  • the National Strategic Framework for Aboriginal and Torres Strait Islander Health and the Aboriginal and Torres Strait Islander Health Performance Framework;
  • the Productivity Commission’s Overcoming Indigenous Disadvantage framework, which measures the total impact of Australian government activities on a range of Indigenous socio-economic indicators, including health;
  • the targets developed by the Building the Evidence sub-group of the COAG Working Group on Indigenous Reform;
  • the social inclusion performance framework developed by the COAG Health and Ageing Working Group and the National Health and Hospital Reform Commission in relation to the Australian Health Care Agreements; and
  • the Prime Minister’s annual report to Parliament on closing the gap, announced at the National Apology to Australia’s Indigenous Peoples.

It is hoped that in the near future these and other policy frameworks and indicators will be linked to benchmarks and targets to the end of achieving Indigenous health equality by 2030 or earlier.

What follows are a number of extracts and summary documents pertinent to the right to health, the Campaign for Indigenous Health Equality and the Close the Gap National Indigenous Health Equality Targets.

Endnotes

[1] See Aboriginal and Torres Strait Islander Social Justice Commissioner, Social Justice Report 2005, Human Rights and Equal Opportunity Commission, Sydney, 2006, pp 9 – 97. This was printed as a stand alone publication: Aboriginal and Torres Strait Islander Social Justice Commissioner, Achieving Aboriginal and Torres Strait Islander health equality within a generation, Human Rights and Equal Opportunity Commission, Sydney, 2007 and is also available online at: www.humanrights.gov.au/social_justice/health/health_summary.html.