2024 Menzies School of Health research oration - Darwin

Release Date:
Speech
Check against delivery

Thank you to the Youth Mill Performing Arts Company for the wonderful Welcome to Country.

And thank you Professor Cass for the warm introduction and the invitation to speak today.

As a Saltwater woman from the Yanyuwa Garrawa people, I pay my respects to the Larrakia people.

It was just 3 months ago that I was sworn in as the Minister for Indigenous Australians - an incredible honour.

My priority, as part of the Albanese Labor Government, is on Closing the Gap between Aboriginal and Torres Strait Islander people and our fellow Australians.

And putting Indigenous Affairs above politics - with respect, sincerity, and a focus to improve the lives of First Nations people in this country.

Today, I would like to share part of my journey − one that is deeply personal but familiar to so many. ­

My mother’s battle with kidney disease required us to move her over 1,000 kilometres from her home in Borroloola to Darwin, so she could access dialysis treatment.

This is my family’s experience.

Sadly, we are not alone.

It is the experience of many First Nations families in remote regions of Australia.

Kidney disease is all too common among First Nations people, placing enormous stress on families and communities.

The people of the Northern Territory, and their needs and aspirations, are very close to my heart.

Finding genuine solutions so quality health care is accessible to everyone, no matter where they live, is one of my key priorities.

The Menzies Institute is a great public and civic institution with a strong record of making a real difference to the lives of Aboriginal and Torres Strait Islander people.

I’m enormously proud to work beside people like Luke Gosling, the Member for Solomon, and also Marion Scrymgour, the Member for Lingiari, equally passionate in our moves, not only as the three federal Labor representatives, to improve the lives of First Nations people, but indeed our Caucus and our Cabinet.

First Nations people have absolutely borne the brunt of the damage government policies can do, and have done, to our people and our communities.

Truth-telling processes are shining a light on the pain caused by some of those policies.

The purpose is to acknowledge and to heal.

To learn and to avoid making the same mistakes.

It is precisely these traumatic experiences that point to the opportunity for governments to make a positive difference, in partnership with community.

When we govern well and in partnership with the people that our decisions affect, there are so many opportunities for good.

I remain optimistic that good people, working in partnership and in good spirit can make a very real difference.

Much of that work is not headline grabbing.

It is people rolling up their sleeves and doing the work of engaging, persisting and building relationships, not destroying them.

Relationships of trust and connection that lay the foundations for more and better progress.

Aboriginal and Torres Strait Islander people have been doing this for centuries.

And we will keep doing it. We are not going anywhere.

That is why I have been serving the people of the Territory at various levels for over two decades, and more recently as Assistant Minister for Indigenous Health and Assistant Minister for Indigenous Australians.

And of course, now as the Federal Minister for Indigenous Australians – my priorities are clear:

To improve social, health, justice and economic outcomes for First Nations people by working in partnership across all levels of government and with the Coalition of Peaks.

To base everything we do, and every decision we make, on Closing the Gap.

I am more determined than ever to make sure our future is one where First Nations people have the same opportunities for a happy, healthy life as our fellow Australians.

The statistics are stark and a reminder of where our focus needs to be: health, justice, wellbeing, housing, education and employment.

The health inequities between Indigenous and non-Indigenous Australians are significant.

We know Iife expectancy is much shorter.

We face far worse health conditions and outcomes, with higher rates of chronic disease and poor mental health, including higher rates of suicide.

Fewer than one in three First Nations people aged 18-64 are considered in ‘good health.’

Just have a think about that, fewer than one in three.

First Nations people are:

55 times more likely to die in their youth from rheumatic heart disease.

More than three times more likely to have kidney disease, diabetes, and die from suicide.

They’re more likely to have a child that dies in infancy, have a disability and die from cancer.

There are three Closing the Gap outcomes specifically related to Aboriginal and Torres Strait Islander health.

They are:

Children are born healthy and strong.

People enjoy high levels of social and emotional wellbeing.

Everyone enjoys long and healthy lives.

The Productivity Commission’s latest Closing the Gap data makes it clear that we’ve still got a long way to go.

Life expectancy is not on track.

Social and emotional wellbeing is getting worse, and we can see this reflected in the increasing number of First Nations people dying by suicide.

One health related target is on track:

89.6 per cent of First Nations babies were born with a healthy birthweight in 2021.

That’s wonderful news, and well on the way to the target of 91% healthy birthweights by 2031.

We know that Closing the Gap on health requires more than just a health response.

All targets impact health outcomes in one way or another.

Housing, education and employment are all tied to better health and wellbeing.

And all governments need to do more to accelerate progress.

I am working closely with my colleagues in the National Parliament, with ministerial colleagues in state and territory governments, and partnering with First Nations people and the Coalition of Peaks to bring about positive change.

One of the things that I said I would do when I took on this role was to reach out across the parliament, across the party aisles, to the opposition, to the crossbenches, to the Greens.

I figured that we all had to have a sense of wanting to improve the lives of First Nations people.

That we had to get away from the language of the parliament, the weaponisation of Indigenous issues, of Indigenous people.

Talking down everything black.

And I see that as something that crept in way before the referendum and became highlighted throughout the referendum.

As a result, I’m determined to make sure that I do reach out across the aisle, and I’ll continue to do so.

I’m not going to give up.

I still believe in the goodness of this country, I still believe that even though we may all think all sorts of things, we still have to strive to find the common thing that keeps us together in our humanity.

My agency – the National Indigenous Australians Agency – is participating in and supporting Closing the Gap Policy Partnerships.

These partnerships are critical to guiding the Government’s focus to what matters for First Nations people to close the gap.

They are partnerships that are co-led by preeminent First Nations people and organisations who bring expertise, wisdom and lived experience to the table.

This includes:

The Social and Emotional Wellbeing Policy Partnership which is co-led by Coalition of Peaks and the Department of Health and Aged Care. The partnership focuses on reducing suicide rates and improving the social and emotional wellbeing of First Nations people.

Two key priorities are refreshing the National Strategic Framework for Mental Health and developing a First Nations-led framework to guide how we invest in mental health and suicide prevention.

The Justice Partnership brings together the Coalition of Peaks and the Attorney-General’s Department. This is addressing the over-representation of Aboriginal and Torres Strait Islander adults and children in prison and youth detention.

They are taking a joint approach and are guided by the recommendations of the Royal Commission into Aboriginal Deaths in Custody.

The Early Childhood Care and Development Policy Partnership, co-led by Coalition of Peaks and the Department of Education. It is focused on ensuring Aboriginal and Torres Strait Islander children have the best start to life. That means looking at early years reforms that support children and their families, so they can thrive long term.

These Policy Partnerships complement work ongoing across Government to close the health and wellbeing gap for First Nations people.

Importantly, we must continue to connect and listen to First Nations people and communities.

This is at the heart of Priority Reform 1 in the Closing the Gap Agreement: formal partnerships and shared decision making.

We are taking a strengths-based approach, ensuring respect for culture is at the centre of how we shape our policies and programs, which include:

The Closing the Gap framework and the National Agreement on Closing the Gap.

The Indigenous Australians’ Health Programme which funds high-quality health care for Aboriginal and Torres Strait Islander people.

The National Aboriginal and Torres Strait Islander Health Plan which guides all action to improve health and wellbeing outcomes.

Each and every day the work I do with my colleagues is with the aim to close the gap.

And we continue to work in partnership with the Aboriginal Community Controlled Health sector, and state and territory governments, to improve First Nations’ health and wellbeing.

To support these efforts, the Government is providing record investment in First Nations health measures aimed at Closing the Gap, including:

$300 million for Indigenous health infrastructure projects, training First Nations health workers, boosting renal services and water infrastructure projects.

This includes our commitment to deliver 30 dialysis units for First Nations peoples in regional and remote Australia with end stage kidney disease. It was wonderful to be home on Country in Borroloola last week to talk to the community about one of these clinics.

But I’m ever so mindful that so many younger First Nations people are going onto renal dialysis. So, we have to also look at the other end of this and that is prevention.

Food security, cost of living, the ability to be able to have fresh food and vegetables at reasonable prices.

So, ours is not just a health response.

It’s also about housing initiatives.

Too many First Nations people live in overcrowded and run-down houses – that’s why reducing overcrowding is one of our Closing the Gap targets.

These living conditions negatively affect health, education, economic and social outcomes. Something we all know.

Overcrowding leads to higher rates of infectious diseases.

That’s why we’re investing $4 billion over 10 years with the NT Government to address overcrowding and improve housing in remote communities and also homelands.

The agreement will deliver 270 houses each year for 10 years, with the aim of halving over-crowding.

We’re working with First Nations partners, and states and territories and to get the best outcomes, including by funding $200 million over 5 years for maintenance and improvements of housing in remote Indigenous communities in Western Australia, South Australia, Queensland and the Northern Territory.

Our School Nutrition Program provides practical support for families and children in remote communities, who often go without a nutritious meal due to a lack of access to healthy and affordable food.

Providing healthy meals reduces rates of nutrition-related illnesses and diseases.

We are also developing a National Food Security Strategy, in partnership with state and territory governments and First Nations people.

And next week, I’m bringing together representatives from the food manufacturing and producing industry, as well as experts in Indigenous health, to look at what we can do to make food and vegetables in remote communities more affordable.

While all of this hard work is promising, one area of First Nations health that especially needs our attention is the impact of incarceration on First Nations adults and children, who are vastly over-represented in the justice system.

The Northern Territory and Queensland have the highest rates of incarcerated First Nations children.

Our landmark justice reinvestment initiatives are designed to reduce the number of people incarcerated.

In my previous role as Assistant Minister for Indigenous Health, I pushed hard to see Aboriginal medical centres more involved with corrections and justice systems across the country.

A high proportion of First Nations people have underlying health issues and when they enter these facilities, it's critical that they're getting the appropriate care they need.

Another area where progress is urgently needed is out of home care.

In 2022 there were more than 22,000 Aboriginal and Torres Strait Islander children in out-of-home care in Australia, the highest number ever recorded.

Indigenous children are almost eleven times more likely to be in out-of-home care than non-Indigenous children and 29 times more likely to be in youth detention.

Our government is committed to achieving better outcomes for First Nations children and young people.

I’m extremely proud that we’re establishing a National Commissioner for Aboriginal and Torres Strait Islander Children and Young People.

The Commissioner will be dedicated to protecting and promoting the rights, interests and wellbeing of First Nations children and young people across a range of issues, including the over representation of Indigenous children in out-of-home care.

I can’t emphasise enough how important partnerships are to achieving results.

For too long governments have done things to First Nations people, rather than with First Nations people.

Working in genuine partnership is not just the right thing to do – it works.

People know their own lives and giving people agency is itself a positive.

That’s why we know that for improved First Nations health outcomes, we must continue to support Aboriginal controlled organisations to deliver culturally appropriate care and services.

I am often asked, what is the best way to close the gap and get the best outcomes for First Nations people and communities?

The answer is always the same and very simple.

Community ownership of policies and programs is essential to success.

This means listening to communities and facilitating community decision making and empowerment.

When decisions are made in consultation with communities – and implemented in genuine partnership, the potential to make a real impact on the lives of First Nations people increases dramatically.

Our partner organisations play a crucial role in the decision-making process through their relationships on the ground, their expertise and their advocacy for communities.

The National Agreement on Closing the Gap is a common accord between us all.

The Commonwealth Government working with state and territory governments and the Coalition of the Peaks to create lasting change for First Nations people.

The National Agreement sets out four Priority Reforms that were directly informed by First Nations people and agreed by nine governments.

Everyone has signed up to this.

There is no party, Labor or Liberal, who can say they were not party to this agreement.

Those priority reform areas are:

  • Formal partnerships and shared decision making
  • Building the community-controlled sector
  • Transforming government organisations
  • Shared access to data and information at a regional level.

This is about embarking on systemic change, where First Nations people have a say in the decisions that affect them.

It ensures that decision-making is shared between governments and Aboriginal and Torres Strait Islander people – with accountability locked in.

From a government perspective, this means:

Taking the time to genuinely listen to communities about their priorities – rather than coming to communities with predetermined outcomes.

Engaging earlier and more often.

Recognising the value Aboriginal and Torres Strait Islander people bring to policy development and service delivery.

Investing in genuine partnerships with adequate time and funding.

And transforming processes and systems to become better, more credible partners.

If we do these things well, we can improve life outcomes for First Nations people.

The future of health in the Territory, and across Australia is being shaped by all of us.

Our strength is in our partnerships, our respect for First Nations knowledge and our collective desire to make a difference.

That’s why I’m optimistic.

As I travel the country I see more and more good people, working in partnership and in good spirit, making a difference.

Let’s keep working together to create a better, healthier future for Aboriginal and Torres Strait Islander people.

Thankyou.