‘Duty of care’ to help Close the Gap: RACGP leaders

Anastasia Tsirtsakis

1/06/2023 4:16:58 PM

The college hosted a webinar to mark National Reconciliation Week and explore this year’s theme: ‘Be a Voice for Generations’.

 RACGP Reconciliation panel
The panel featured Chair of the RACGP Aboriginal and Torres Strait Islander Health Faculty, Dr Karen Nicholls; Faculty Manager, Leanne Bird; and RACGP CEO, Paul Wappett.

With this year’s National Reconciliation Week theme a nod to the Voice to Parliament, which Australians are expected to go to the polls on later this year, the RACGP took the opportunity to host a Q&A event to answer any questions staff may have.
Facilitated by the college’s Senior Reconciliation Action Plan Advisor, Christine Dernee, the panel featured the Chair of the RACGP Aboriginal and Torres Strait Islander Health Faculty, Dr Karen Nicholls; Faculty Manager, Leanne Bird; and RACGP CEO, Paul Wappett.
Ms Bird, who is a Yorta Yorta and Taungurung woman, said the Voice for Parliament is a chance to acknowledge those who have stood up and fought for Aboriginal and Torres Strait Islander rights, as well as being an opportunity for greater self-determination.
She reflected back, prior to the 1967 referendum, when she and her mother were not counted in the Australian census.
‘We asked to be counted at that time and, overwhelmingly, Australians said yes, we should be, Aboriginal and Torres Strait Islanders should be counted,’ she said.
‘But now it’s time for all for us to really be heard.
‘This is a great opportunity for our allies who are also always [saying] “What can we do? What can we do to help?” – this is one of the biggest things you can do to support our cause.’
As an ally, Mr Wappett reflected on the importance of personal responsibility when it comes to reconciliation.
He revealed that early in his career as a lawyer, he worked for a large commercial firm that, following the Mabo decision in 1992, financially benefitted from giving advice to corporate clients on how to avoid native title claims.
‘I feel shame about that,’ he admitted.
‘When I think about reconciliation, I come at it from the proposition that says I think there are fundamental truths that I want to make sure that I’m always acknowledging – firstly that there is a … gap between Indigenous and non-Indigenous Australia and, for me, that’s shameful.
‘If we accept that the system has done that, then I think that we have to also accept that those of us who are beneficiaries of that same system have an important job to do in making sure that we’re helping to close that gap, to tear down those systems, to tear down that lack of meritocracy that has existed.
‘And, so, what I’m really looking for is … how I as an individual, how all of us as individuals, how we as institutions, can actually just accept some of those fundamental indisputable truths, that we can absorb the lessons of them, that we can actually make meaningful change to close the gap because it’s fundamentally unjust that the gap should exist.’
Dr Nicholls, who is a Torres Strait Islander woman descending from Boigu Island, agreed.
She said Aboriginal and Torres Strait Islander people should have a direct role to play in helping to close the gap, noting that there are many examples where, when directly involved, communities are able to provide their own appropriate solutions – and that a Voice to Parliament would be a direct opportunity for that.
‘It will give a permanent seat at the table, a seat that cannot be taken away by the Government and the decision makers at whichever time,’ she said.
‘Self-determination is really, really important and sometimes decisions can be made on issues that people don’t understand actually closely relate to health.
‘In the Aboriginal and Torres Strait Islander health setting, we do take a really holistic view of health, it is not about the absence of disease … and the way in which we deliver health messages are not always just in the consultation room. That’s why having many Aboriginal and Torres Strait Islander people at the table looking at these things, providing an opinion, [is important].
‘You won’t get consensus on everything, but you will understand that what might work for one area is definitely not going to work somewhere else, [and] they will come up with a model that will work for their area. It’s understanding that local knowledge that community has and understanding their context in providing solutions.’


Ms Bird shared the view and reflected on past experiences where government agencies or other mechanisms have been employed to provide a voice for Aboriginal and Torres Strait Islander people, but that with a change in government and new direction previous efforts have been suddenly ended.
‘In terms of the Aboriginal voices working to achieve and improve our outcomes, the Aboriginal community control sector does a great job in that,’ she said.
‘It’s owned and operated by community and community providing solutions to their own healthcare and their own destiny if you like. And they’re a great model in grassroots Aboriginal and Torres Strait Islander solutions to Aboriginal and Torres Strait Islander issues.’
Voice to Parliament
The panellists highlighted that the concept of a Voice for Parliament is not new. Dr Nicholls said that various Aboriginal and Torres Strait Islander communities – both urban and rural – have been advocating for a seat at the table since the early 1900s.
However, it was in 2017 at the National Constitutional Convention, which resulted in the Uluru Statement from the Heart – which the RACGP has supported from the outset – that a Voice to Parliament gained prominence.
Mr Wappett said the Voice to Parliament is also an opportunity to bring Australia into step with the rest of the world.
‘If you look at models like New Zealand, you look at models like Scandinavian countries, and what they’ve been able to do in terms of having meaningful approaches around self-governance and self-determination around making sure that there’s opportunities for tangible, real reconciliation and understanding of the past – those are models that have brought about a more cohesive, unified society in each of those areas and led to many goods for the society as a whole,’ he said.
‘What we’re trying to do here is to establish a really unified approach that recognises that Aboriginal and Torres Strait Islander people have been here for millennia and that they need to be recognised as such, and that they need to have the opportunity to have representation on matters that affect them.’
If Australians vote in favour of a Voice to Parliament, it will see the Constitution changed to include a requirement for a First Nations’ voice. The legislation by which the voice will operate, however, will be left to Parliament.
Ms Bird said it is important for people to remember this. She noted that there appear to be tensions – both from Indigenous and non-Indigenous Australians – about this and concerns as to whether it will be another ‘tick the box’ exercise.
‘I think people have been getting wound up in exactly what the mechanism is going to look like and at this point in time that is not decided,’ she said.
‘[But it’s] really important, I think, to understand that the model doesn’t exist yet. And if we don’t capture this opportunity and embrace this opportunity, then we miss a big opportunity to ensure that our mob can speak for us in the Parliament setting and make laws and recommendations for us.
‘It’s a real opportunity for a self-determined approach, in my mind. I can’t believe we’re in 2023 and other people are speaking for us … at the government level and across the board.’
Dr Nicholls acknowledged that it would be ‘naïve and unfair’ to expect there not to be any teething problems in its development, but that it would be a chance for increased accountability – both for communities and government.
What was clear, however, is the important role that organisations such as the RACGP will have to play moving forward.
Mr Wappett said that in his opinion, organisations cannot maintain neutrality when it comes to issues of fundamental human rights.
‘And this is what we’re talking about,’ he said.
‘We have to accept that there is an enormous gap between the health outcomes for Indigenous and non-Indigenous Australians. If we don’t want that to be the case, if we don’t want to accept that as being okay, then who is better placed than the RACGP to actually be a strong voice for saying, “Well, we have to change that”?
‘And one of the ways that we change that is through these mechanisms that allows self-determination, that allows the Parliament to actually have an understanding of the impact of laws that it’s making, of the fiscal decisions that it’s making.
‘Certainly, I want to lead an RACGP that is always going to try to do what’s right, even when that’s difficult.’
Ms Bird wholeheartedly agreed, and said that as an organisation, the RACGP has a ‘duty of care’ to do its bit to improve close the gap and improve health outcomes for Aboriginal and Torres Strait Islander people.
‘This is a really good way for us to be public about the fact that we’re not tolerating this gap and that we need to do something about that – and we have 40,000-odd members who we hope would support us in that,’ she said.
‘But, at the same time, we also recognise that not everyone will be of the same view. We will get some opposition potentially for our stance on this. But our role is to say we stand firm on this, for those reasons, but also for us to provide information and resources for people to help make up their own minds as well.’
However, as Australia moves closer to the referendum and the debate heats up, Dr Nicholls urged people to keep perspective.
‘I do worry about people’s wellbeing through all of this. [We need to be] making sure that discussions remain respectful, not personal, and understand that there’s diversity of opinion and that that is good,’ she said.
‘But also take the time to care for ourselves and the people we care for.’
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