Indigenous health a casualty of federal budget

The standard of health of Aborigines lags almost 100 years behind that of other Australians, according to the World Health Organisation. Some Indigenous people still suffer from leprosy, rheumatic heart disease and tuberculosis. A similar survey from Oxfam and the National Aboriginal Community Controlled Health Organisation reported that Australia ranked last for health among rich countries with Indigenous populations. (International edition The Guardian Weekly, London, May 11, 2007).

You might think the Australian Government’s Federal Budget would be the ideal place to start setting this right. Especially when the previous week The Australian reported “The Treasurer will unveil a significant funding boost for Aboriginal health programs”, and The Sunday Age predicted “Indigenous Australians will be among the biggest winners in Treasurer Peter Costello's 12th budget on Tuesday”.

But no. Costello made clear in his Budget address Australia is cashed up to the tune of a $10.6 billion surplus, GDP growth of 3.75 per cent, wage growth of 4.25 per cent, and absolutely no debt, so all pensioners could have a $500 gift and many others tax cuts. But in his hour-long spiel the health of Indigenous people received not one mention, even in his section on Healthcare. Not one.

Nor did Indigenous disadvantage make an appearance in Opposition Leader Kevin Rudd’s Budget reply two days later. Nothing.

Further, there were no comments or questions on Indigenous health by political affairs journalists on ABC television immediately after Costello’s speech, or on ABC Radio National’s Breakfast, including AM, the next morning.

Chris Richardson of Access Economics reiterated the government is “rolling in money”, but representatives of welfare organisations commented the poor in general are still left behind, the housing rental crisis not addressed, and there were references by the St Vincent de Paul Society to the “growing cohort of working poor” not affected by the budget. Australian Council of Social Service President Lynne Hatfield-Dodds said there was little relief for those on low incomes, those paying rent, and no real measures to help the jobless.

There were brief mentions of Indigenous needs in newspaper back pages. The Australian’s Caroline Overington had a story about Indigenous ear, nose and throat surgeon Kelvin Kong, who said it’s embarrassing in 2007 to be the nation’s first Aboriginal surgeon “because I’d rather be the 100th”. On Indigenous health “we’re in an emergency situation and it’s not being addressed”, he said. Hatfield-Dodds referred to “looking for the Government to invest … greater resources to tackle Indigenous disadvantage”.

The front page of The Courier-Mail: “Whether you are a pensioner, a student, an apprentice, a working mum or a high-income earner, there was something substantial announced last night just for you. And invariably, the substance is in the form of cold, hard cash … and a stack of giveaways for everyone from parents to pensioners.” Well, not quite everyone.

In the Australian Financial Review’s budget supplement John Breusch commented Australia’s health system ranked among the world’s best, although its flaws include “the appalling state of Indigenous health”.

The National Indigenous Times had a different take: “The area that is most disappointing is health. Despite under-funding to the tune of about half a billion dollars a year, the federal government has announced additional Indigenous health funding of just $90 million, and two quarters of that will be spent on drug initiatives and capital works programs.

“At the same time, Australian taxpayers get a surplus of almost $11 billion, plus tax cuts worth three times that amount yet they still wonder why Indigenous Australia is in such a mess … The tragedy is that the government is likely to be applauded for it, because mainstream media analysis of the Indigenous affairs budget has been almost zero.”

Professor Jon Altman of Australian National University’s Centre for Aboriginal Economic Policy was scathing in his budget review. On SBS TV’s Living Black he said the budget was simply more of the same, “enormously disappointing … turning a blind eye” to the need for massively increased expenditure on community based housing, health services and jobs. There was too little recognition that 75 per cent of Indigenous people live in urban areas. Budgeting only $37 million for health was “enormous under-expenditure” considering the Australian Medical Association called for $460 million.

There were proposals to send children to exclusive schools in the cities but there is a great need for improved basic education in home communities. Community Development Employment Program (work for the dole) is to disappear but real jobs available are “a drop in the ocean”. The government has missed an opportunity to create new infrastructures to break into the cycle of poverty in health, housing, and education, he said.

After a few days to think about it journalistic luminaries Barry Cassidy, ABC; Misha Schubert, The Age; George Megalogenis, The Australian; and Piers Akerman, Daily Telegraph, met for an hour on ABC’s Sunday morning Insiders, with Paul Kelly of The Australian also calling in. They talked about Howard, Costello, Rudd, Zimbabwe, Murdoch, Blair, Keating, refugees and Indigenous people on AWAs in north Queensland. But no mention of Indigenous health.

Oxfam Australia Executive Director Andrew Hewett said the Budget “delivered less than one-tenth of what’s needed to make the slightest impact on the health and well-being of Aboriginal and Torres Strait Islanders”.

According to The Australian, at Wudapuli, 380km southwest of Darwin, an Aboriginal family who signed up for an eight-bedroomed $420,000 house will receive special government funding. Four families in the scheme will become eligible to buy the properties after two years if their rental record is strong and the children are sent regularly to school. Reporter Patricia Karvelas referred to giving children in remote communities scholarships “to attend the nation’s wealthiest schools”, youth leadership scholarships to attend high-performing schools and university, and the plan to convert CDEP jobs into “real jobs”, in environmental and heritage protection, childcare, night patrols, community care.

“The budget signalled Indigenous Affairs Minister Mal Brough’s focus on remote communities, with urban Aboriginal people being forced to use mainstream services.” But National Indigenous Council member Wesley Aird said much of the $3.5 billion committed to Aborigines in the budget will be wasted because “Indigenous people still want to go to Indigenous organisations”.

Brough said the lack of any real economy in remote communities could be overcome because “this is great cattle country”, there are opportunities in crocodile farming, and market gardens could supply produce to communities. “You can make your own jobs and your own destiny”, he said. The Courier-Mail reported scholarships will be offered to encourage Indigenous people to study dental health.

But it seems no-one has the courage, even when Australian money-bags are overflowing, to create the grand plan for comprehensive economic, social and culturally appropriate structures likely to overcome poor health in a rich country.

Around the world the worst health profiles are in places where “poverty” does not refer to too little cash in the wallet, but describes the total social infrastructure in which people exist day to day. Where drinking water carries disease, waste disposal spreads disease, the diet is inadequate for healthy growth and resistance to infection, housing overcrowded (and often without necessary mosquito nets), there are no means of earning income, little or no education is available, health services non-existent or inaccessible.

These daily conditions all too easily produce violent competition for resources, hopelessness, bewilderment, despair and early death. Such scenes have been described in very moving terms by United Nations special envoy Stephen Lewis in his book Race Against Time - searching for hope in AIDS-ravaged Africa.

Overcoming destructive infrastructures requires long-term investment of funds, effort, radical ingenuity, imagination, determination and co-operation. At present in Australia there seems little government interest in this kind of commitment, only little projects here and there, some of them controversial, and judging by experts’ reactions under-funded. Australia, one of the richest countries in the world, could do much better, given the will.