Advancing Aboriginal health

It is also the case that we have racism at an institutional level in the Australian health care system. Different performance criteria are applied to Aboriginal and non-Aboriginal health care, both in funding and in treatment. Here is just one example:

The Derbarl Yerrigan Aboriginal Medical Service in Perth was forced to close its services at a then recently opened clinic at Midland, on the outskirts of Perth, when an “overspend” of $800,000 arose. That overspend occurred because of the success of Midland in attracting new clients. At the very same time the Perth teaching hospitals overspent their budget by $100 million, 120 times as great as that at Derbarl Yerrigan. The teaching hospitals were given an extra $100 million. They were bailed out. I have it on good authority that some of the money from that bailout was taken from the budget of the WA Health Department’s Office of Aboriginal Health.

The Federal Minister of Health Tony Abbott has argued (PDF 45KB): “Australians’ sense of guilt about the past and naïve idealisation of communal life may now be the biggest single obstacle to the betterment of Aboriginal people.” No, the biggest single obstacle is the lack of compassion in federal and state governments and health departments - and in the AMA.

How to advance Aboriginal health?

If we are to have rational priority setting in Australian health care - and we desperately need that - we need values and principles to underpin these priorities. Whose values can we use? The doctors’ and the AMA’s with all their vested interests? Other health care professionals with similar biases? The politicians who have failed us up to now? The consumers who inevitably and rightly want what is best for them when they are sick?

No, the only place to go for the values is to the citizen! They also seem to be the ones who are prepared to show the caring and compassion that we need in this society and in our health services.

In all the five citizens’ juries with which I have been involved, greater equity has been identified as a priority. The citizens consistently want a better deal for the disadvantaged, and especially for Aboriginal people. They also appear to want what might best be described as the moral responsibility for setting the principles for health care. People like being asked to act responsibly on behalf of their community!

Thus to get beyond institutional racism and build compassion into the health care system, let us shift the power base in health care away from the institution and back to the people.

The neglect of Aboriginal health in Australian health care is deeply disturbing. It arises from not just apathy but institutional racism. Fortunately there is evidence that the Australian people when given good information and asked to act as responsible citizens show much more compassion for those less fortunate in this society - certainly much more compassion than our “leaders”.