In most jurisdictions such assessments are considered obligatory components of the financial accountability responsibilities of agencies. Examples such as these demonstrate that MESH-type assessments are possible and can be made credible.
There is a need to decide what proportion of any overall spending that is to go to Aboriginal communities should go to MESH and what residual proportion should go to actual programs. The initial work done in Western Australia using the judgment of key Aboriginal figures suggests that in the immediate future MESH on average might account for about 40 per cent of any new spending.
Second there is a need to determine in different communities what approaches to the development of MESH are likely to prove most useful and sustainable.
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The overall spend also needs to be radically increased. In primary health care alone the increase needed, just to allow Aboriginal people given their needs and access problems, to have a just share of the primary health care budget is about five times the current level. That could be paid for by reducing the 30 per cent tax rebate on private health insurance to about 15 per cent. Surely in boom time Australia we can afford to exercise such minimal caring towards and about Aboriginal people.
Whatever is spent on Aboriginal health and their well-being more generally, the key however remains to build Aboriginal community autonomy. Abbott’s paternalism will just destroy that. Sadly, that is precisely what it is aimed to do.
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