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‘Heartbreaking’ outcomes amid mixed Closing the Gap progress

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The first Closing the Gap annual report since the National Agreement between Australia’s governments and Coalition of Peaks has delivered mixed results.
 
The goal of having 91% of Aboriginal and Torres Strait Islander babies with a healthy birthweight by 2031 is ‘on track’, with 89.5% meeting this mark in 2019 – up from 88.1% in 2017. Likewise, far more children are enrolled in preschool (96.7%) than there were in 2016 (76.7%), already exceeding the target of 95% enrolment by 2025.
 
However, none of the 16 other socio-economic targets are on track to be met and some are going backwards.
 
Aboriginal and Torres Strait Islanders are being imprisoned at a higher rate (2222 per 100,000) than two years ago, while only 34.3% of children commencing school were deemed ‘on track’ across all five Australian Early Development Census (AEDC) domains, a decrease from 35.2% in 2018.
 
Additionally, more children are in out-of-home care (57.6 per 1000) than there were in 2019, and deaths by suicide have also increased, from 25 per 100,000 in 2018 to 27.9 per 100,000 in March 2022.
 
RACGP Aboriginal and Torres Strait Islander Health Medical Advisor Dr Tim Senior described the latter two statistics as ‘heartbreaking’, but also told newsGP there is room for optimism around some of the report’s findings.
 
‘The headline figures will be the outcomes that are not being met or regressing … [and] I’ve heard many Aboriginal and Torres Strait Islander people refer to [the increase in out-of-home care] as a new Stolen Generation,’ he said.
 
‘However, the improvement in the proportion of babies born with a healthy birth weight will likely show itself in improved health outcomes over the next generation.
 
‘The most significant part of the report is not in the headline figures, but in setting the ways of working in partnership between levels of government and Aboriginal and Torres Strait Islander communities.
 
‘If these partnerships can work well long-term, then that is the basis – indeed the only basis – on which we will see improvements in these outcomes in future reports.’
 
It is a message echoed by Wiradjuri woman and Indigenous Australians Minister Linda Burney, who said the annual report tells a story of mixed progress.
 
‘The Closing the Gap architecture can only work when all parties are invested and there is a coordinated effort from all jurisdictions in partnership with First Nations peoples,’ she said.
 
‘We have to work more closely with Aboriginal and Torres Strait Islander people to make real and much needed progress.’
 
According to the Coalition of Peaks annual report, released last week, ‘significant’ advances have been made against commitments in its implementation plan, in particular: 

• progress on the establishment of five policy partnerships and five place-based partnerships
• the development of a number of sector-strengthening plans
• the establishment of three Community Data Project sites, and progress on another one
• agreement on the Data Development Plan
• growth in Coalition of Peaks membership
• case studies highlighting the successful implementation of the National Agreement across the country, leading to better outcomes for Aboriginal and Torres Strait Islander people.

But it also revealed that progress on Priority Reform Three – transforming mainstream organisations – remains slow, and that more needs to be done.
 
‘Priority Reform Three is an opportunity to identify, call out, and then address, the institutionalised racism in our mainstream agencies and services’, the Coalition’s Acting Lead Convener Scott Wilson said.
 
‘All governments have committed to establish an independent mechanism that is able to review, report on, and make recommendations for how mainstream services should be transforming to be more responsive and accountable to the needs of our people.
 
‘While this commitment is not due to be implemented until 2024, the racism we experience, and the poor health outcomes of our people, demand urgent action.’
 
Mr Wilson said the Coalition could ‘only do so much’ and pointed out that the success of the National Agreement will depend on the responses of governments.
 
‘Work needs to accelerate beyond commissioning research papers,’ he said.
 
‘Our government partners need to be bold and break down the systems, structures, and beliefs of the past to implement and achieve Priority Reform Three.
 
‘If we get it right, Priority Reform Three can support the transformation of the mainstream agencies and services to reduce the occurrences of racism we experience and the corresponding impact on our health and life outcomes.’
 
Dr Senior said GPs can be key contributors to Closing the Gap, but also warned that the steady erosion of general practice funding needs to be reversed if healthcare targets are to be met.
 
‘From a GP point of view, we have a role in working closely with our Aboriginal and Torres Strait Islander patients to get better health outcomes, and the college needs to continue its excellent working relationship with NACCHO that results in resources such as the National Guide to a Preventive Health Assessment,’ he said.
 
‘I hold out hope for optimism if we can work in real partnership over the long-term, and we should certainly hold governments accountable for that.
 
‘Of course, the funding and recruitment crisis in general practice at the moment will have a disproportionate impact on Aboriginal and Torres Strait Islander health, and the Government will need to fix this if they are to succeed on the health outcomes related to Closing the Gap.’
 
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Aboriginal and Torres Strait Islander health Closing the Gap Coalition of Peaks

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