QUESTION:      What are your [inaudible] of healthcare?

GLASSON:       Well look, as I said when I came up here, we had raised concerns obviously about the statistics around Indigenous health, both around the, I suppose, the longevity of the Indigenous population. 

But, I suppose, the message I'm getting more and more over the last five days is really around trying to get some solution to this overall problem.  I'd rather concentrate on the solutions rather than the problems because we all know the statistics.  And, I suppose the message I want to get very clearly out there, is that we have to really try and retarget or redirect our resources. 

Now, where should they be redirected?  Essentially, at our children - this is our children who are at conception, so as the pregnant mother is identified, I do believe that those mothers have to be absolutely supported through their pregnancy.  And what do I mean by support?  Support in the way of education, support in the way of ensuring they have appropriate nutrition so that baby grows in an environment so when it's born it's not underweight and that it's healthy. 

Paediatricians are telling me that the health of the kids in this state is worse now than it was 20 years ago, and that's a pretty frightening statistic, given what's happening around the world.  So we have to turn that around.

And so it's really trying to target education, and health, and housing.  Removing all those silos and treating it in the holistic manner.  If we can do that and making sure that our children are fed properly, making sure that our children are educated properly, then essentially we've got some future for our Indigenous population. 

If we continue to go down this road, we will become the eye of the world where we have, as I said, some of the worst statistics in the world.  Something that every Australian is not proud of and I want to make it very clear to every Australian out there that I want to make - we want to make, the AMA want to make this one of our major issues in the next Federal Election.

QUESTION:      So the commitment from AMA is to try and put it on the cards for the next election, is that what you...?

GLASSON:       Very much so.  We want to see this on the - more than just on the radar screen, we want to see this profiled and I'll be asking both sides, all sides of politics what are they going to do about Indigenous health?  Where are they going to target the resources?  And I suppose what sort of I suppose funding model they're going to use to make sure that the sufficient resources are to meet the needs, and not just saying here's a certain amount of money and trying to make that fit the needs. 

And re-identify what strategies are going to work as far as delivering long-term outcomes, as far as better health outcomes, better education outcomes and better employment outcomes, because these people have not got - when they wake up in the morning - they haven't got the self-esteem to say listen I am worth something, I can deliver something back to society.  We ought to give them that self-esteem, and the best way to do that, is to have them healthy, educated and give them a job.

QUESTION:      Would you class it as one of the top priorities in your push at the next election?

GLASSON:       Absolutely, I make it very clear today that the AMA federally, and at a state level with my colleague here, Dr David Meadows, who will be making this a major issue that we're going to target at the Federal Election. 

I've already spoken with both sides of the major parties about this issue.  But I reiterate that again I think it's something that every Australian wants something done about it.  They've got their hearts on their sleeves on one side and I think they've got the red and the black flag on one side and probably the green flag environment on the other. 

But we tell you, on the issue of Indigenous health we're going to be very strong, very vocal.  Make sure that we can take the [inaudible] for all Indigenous Australians.

QUESTION:      ...[inaudible]...?

MEADOWS:     Well, I mean it's quite a very big problem with - around Australia in terms of workforce, doctors, nurses, Aboriginal health workers.  And what we're finding as we've been going around and what we've known for a while is that there's not enough training going on to actually [inaudible] the workforce.  That's actually needed to actually get the health right to start with. 

And the silos that Bill was talking about have been going for some time.  Well, [inaudible] doesn't help education, and education doesn't [inaudible] health.  Bob Collins has been trying to get [inaudible] for many years to get [inaudible] message that we need to actually get all departments of Government across the country speaking to each other and working out [inaudible]. 

And the other problem is that the funding that we seem to have at the moment by the Federal Government, and that doesn't allow any flexibility to be able to deliver these services as the community [inaudible] what to do it.

QUESTION:      [inaudible]...?

GLASSON:       Why where we are?  Why is something just being done?  Well I think at the end of the day, [inaudible] that the solution must come from the bottom up.  Too long we've been depending on sort of Governments, Commonwealth Governments, whatever's thrown to provide the solutions.  They have to provide the funds, don't get me wrong, but it seems the solution has to come from the community. 

And I think it's very important that we identify those people in the community - we call them social entrepreneurs - that actually can make a difference. Part of our strategy is to work out who those people are - and a few of them were clearly [inaudible] yesterday - who've actually got the energy, the drive, to actually make a difference.  And we have to get behind those people and support them to make a difference.

And as I said, I think we've got to look at issues around substance abuse, and it's a real issue with alcohol and substance abuse.  It is in fact we clean [inaudible] ... not only Indigenous but our non-Indigenous communities.

We have to get strong about these issues, and I ask for leadership from our Indigenous community on this particular issue, because it has to - they have to stand up and make it very clear that they will not tolerate the communities being torn apart by alcohol and substance abuse. 

And who does it impact on?  I'll tell you who it impacts on, it impacts on the future generation of Indigenous people in this country, and that's our children because they do not get fed, they don't get bathed and they don't have the proper social structure or family structure in to which to grow up. 

And so that's why we have a vicious cycle, because if you never learnt, you've never known something, how can you as a parent deliver those sort of - those values back to your children, if you've never been taught them yourselves?  So we have to get the new generation and work on them.  And if we do that I think we've got a future. 

Pretending to concentrate on the chronic diseases - which is important don't get me wrong, the diabetes, the lung disease and the heart disease - we have to make sure those patients get appropriate treatment.  But really the reality of the future is in our younger generation.

QUESTION:      Certainly alcohol and...

GLASSON:       Could I just get you to take a step froward for us?

QUESTION:      Certainly alcohol abuse petrol sniffing has been a major problem that's been identified in the Northern Territory for a long while.  What sort of leadership do you think the AMA can provide in trying to - I guess, you mentioned community leaders to get people [inaudible]...?

GLASSON:       I think that's right.  I think the AMA haven't really - we're just an advocacy organisation, we can advocate on behalf of our community on a whole range of issues.  But on this one particularly, we know what its doing tot he communities.  We know what petrol sniffing and drugs are doing. 

We have to really develop strategies with the communities to work out how this can be addressed.  Now that might be some simple things as far as removing sort of petrol off - accessed petrol off some of these smaller communities full stop but in the larger communities that would be more difficult. 

But it's all about education, it's all about really asking yourself, why do these children actually petrol sniff and why do they sort of do all these extraneous activities?  It's often because they're bored, it's often because they've got no purpose in life.

So we actually have to give these kids activities.  And that might be first of all making sure they're fed, and they're feeling strong, and they're feeling educated, but give them some educational activities to do.  That might be bike riding, it might be a BMX bike ride, it might be a motorbike, whatever it might be, get them involved. 

Who can actually lead that?  It's the social entrepreneurs in those communities, but for them to lead, they need funds to provide the resources to actually get these kids involved and give them some purpose in life.  So when they wake up in the morning they say I've got something to deliver to life, I feel good about myself, I'm educated and I can compete with my non-Indigenous counterparts on equal basis.

But when you wake up and say listen, I'm uneducated, I can't read and write, I'm malnourished, I'm full of chronic disease, well it doesn't give you a great start to the day.  And so we have to turn that around, the best way of turning it round as I say is addressing it at the grassroots, and that's from the time that baby's conceived.

QUESTION:      In your press release you talk about Government agencies have to speak together or communicate better, what agencies in Government are you specifically talking about?

GLASSON:       Well it really is three obviously.  Obviously, health, education, and certainly anybody who provides environmental issues around housing, water, sanitation.  But finance, obviously all those silos within Government, which tend to sort of sit out there on their own. 

If you're going to treat Indigenous health holistically, those silos have to be broken down, and all those groups have t work together to try and deliver the outcome. Otherwise - you know, one can't do it on their own, and certainly that goes from the Chief Minister through to the Treasury, through to the education department particularly.  Because really, if we put more and more resources in education, and we simply fed people, I reckon that would solve 90% of the problem. 

And seeing what I saw at Tiwi Island yesterday, seeing these kids with stomachs full of food, happy, sitting them down watching a video and making that an educational video about the importance of cleaning your teeth and washing your skin etcetera, etcetera, that'll make a difference.  And those kids will start to feel good about themselves, rather than going down to the canteen, eating all the rubbishy food and basically going to sleep that night feeling hungry.  So we've got to keep them fed.

QUESTION:      The future Government's launched a number of initiatives over the last two years.  are you saying that they're not working?

GLASSON:       Well I think, what I've seen here so far, I think the Government's starting to sort of take hold of the problem.  It's not easy, don't get me wrong, but I think some of the solutions are actually quite simple to be honest with you and I think we've got to look at some complex solutions for this. 

I don't think the solution is complex.  If you get rid of the drugs and all those issues - but I don't think we'll have such a problem with drugs and the petrol sniffing.  If we actually take these kids at an early age, feed them, educate them and their health status will automatically improve, and so will their self-esteem status. 

So I don't think there'll be a need to go and do that.  But also give them a job; give them something to do.  And there's lots of initiatives that I've seen in the Tiwi that Indigenous people could be working on as far as restoring their self-esteem.

QUESTION:      Can I ask you about Darwin Hospital?

GLASSON:       Yes.

QUESTION:      You were there, what do you think?

GLASSON:       Well look, I saw the new facility and the new accident-emergency department and the primary care - state of the art, world class.  Wouldn't get any better in the world I can reassure you of that. 

The issues - and I saw in the paper this morning the issues about bed block [inaudible]... But the reasons about this issue is not about GP patients, a lot of the Government officials to stand up and say we'll get rid of the GP part time patients and all the this problem is solved. 

It's not that, this access block relates to the fact you've patients sitting in the ward, you cannot get hem out because they can't find an aged care facility, and therefore you can't get the patients out of the A and E department.  It's all about chronic disease, it's all about trying to develop different [inaudible] for addressing these patients.  And the [inaudible] facility often is not the way to go. 

So we need to enhance our community support in this area, so general practitioners might be able [inaudible] here, respect community nurses, allied health people.  They can actually provide a lot of that service and overcome the GP-type patients. 

But the David Meadows of the world are going to have no - make no difference to the fact that people are sitting on trolleys trying to get into the A and E department because the people in the A and E department can't get upstairs to a bed because there are no beds.  And because there's no aged care facilities to get them out too, or rehabilitation centres.

So it's a vicious cycle that we have to try and address in a sort of again, get away from silo mentality - what's Commonwealth, what's state - and say that we've got a simple sort of funding model so to speak on pooling funds.  So that we can actually make sure that you seamlessly can move from the acute, to the semi-acute to the chronic system without any major impositions.

QUESTION:      [inaudible]... what sort of feedback are you taking from both major parties [inaudible]...?

GLASSON:       Well I think, I mean there's votes in it, we make it an issue.  We - the AMA sits back, David Meadows and I sit back and don't say a word about it, it will just sit in the back blocks and we'll talk about other issues that they think they can win the election on.  But if the David Meadows' and Bill Glasson's' who'll get up there and be half of the AMA and all doctors and all the patients in Australia and say this is a national disgrace. 

But having said that, this is what we can do to make a difference and say to the parties, well what are you going to do?  And say to the electorates when you go to put your tick on the box, I want you to think about what's your party - what's the person you're going to vote for - what they have done for Indigenous health in this country. 

Now if they put their hand on their heart and say they've done a great job, or they've got initiatives in place that will make a difference, then I think you should give them a tick.  But I want both parties to say, to come out and make it very clear what their strategies are, and how they're going to address this problem across the board.

QUESTION:      What kept you on the [inaudible]...? 

GLASSON:       I mean, my feeling is that ATSIC was probably dead, and John Howard came along and simply chopped its head off.  But I think that the basic structure as far as the funding that [inaudible] ATSIC it will continue.  I'd like to see more at a state level to be honest, because I think the state-based organisations do, do a good job. 

I think the trouble is that the federal body, what it - it started to lose relevance, unfortunately because the grassroots felt they weren't sort of necessarily being represented and they forgot why they were there.  And they were there to represent Indigenous people, and not to represent themselves. 

And like David and I in our organisation are very careful that when you speak, you speak on behalf of your members and you're not speaking on behalf of David Meadows or Bill Glasson. That you speak on behalf of what is right for your members and in the case of ATSIC they lost the plot a bit unfortunately.

But as I say, I think that a new structure will be put in place, again both parties will come forward no doubt the election saying what they're going to do about this structure.  And it needs to be done with consultation with Indigenous leaders around this country to what they think is the most appropriate structure to deliver Indigenous services throughout Australia.

QUESTION:      Do you think it's important that Aborigines have an [inaudible]...?

GLASSON:       Oh very much so.  I mean, I think that there has to be a system by which Indigenous people in this country - their voices are heard.  And more importantly, they're often heard, but they're acted upon.  Because there's no point in implementing policies that don't reflect the views of the people you're trying to serve. 

And it's the really the Indigenous leaders probably have to go and sell those to the community, rather than some bureaucrat in Canberra sitting behind a desk developing a policy that has no relevance to this.  Particularly rural and remote areas of the Northern Territory it will be impossible to say how it works.  So the Indigenous leaders have to take ownership of the solution, of the problem, and then ownership of the solution for it to be delivered the outcome that we will like.

QUESTION:      So what do you think of programs like the Fred Hollows Foundation, who are actually doing working in Katherine at the moment to start up a breakfast program for children down there?

GLASSON:       Yes, I mean there are lots of similar agencies that feel that because of the situation in Northern Territory they need to come and develop these programs.  Well I think that any initiative that is about feeding people, whether it be for breakfast, lunch or dinner which they all need, needs to be congratulated. 

So why should the Fred Hollows Foundation feel the need to do that?  Because they can see what the problem is, they can see the fact that if treating all this diabetic eye disease and all the diabetes because of the fact that the whole nutrition from a child through to adulthood is insufficient and they're eating the wrong foods.  And hence the vision issues, hence the diabetes issues and the consequences of that. 

So I think it's just a reflection of what simple things need to be done to actually make a difference.  And that's actually putting some food in somebody's mouth and actually sitting down with them and talking with these children the importance about basic health needs etcetera and then to educate them.

By the way, how can you educate someone when they're deaf?  How can you - David Meadows, you've got some figures on deafness you told me before?

MEADOWS:     That's 79 per cent of all Indigenous kids suffer from ear disease, 50 per cent of them go on to long-term deafness of one form or another.  So that makes it particularly difficult to actually learn anything when you're doing education. 

So, the other thing that's just on that point about programs - it's great when people do these things and they usually work very well.  There's been a lot of good programs that have actually been developed but they're not sustainable or recurrently funded, and so even the good programs that we all hear about actually fall down because funding runs out and there's nothing in its place any more. 

So it's - this, a series of these sorts of things we keep hearing is - Fred Hollows can't feed the whole of the Territory.  It will do a program in Katherine and that will be fine for that, which proves that it works.  But it never gets expanded.  And they don't have the wherewithal to - it's really the Government's responsibility to be able to do that. 

What we would like is the Federal Government to be able to be able to build on those initiatives that people have already shown to work, like the Wendy Boyd* program and the renal disease on Tiwi Island.  And to actually keep the funding going on that, rather than actually see it fall down.

QUESTION:      Just in regards to Darwin Hospital as well, one of your members was making [inaudible]...?

MEADOWS:     Look, it's a difficult thing in the territory because of the numbers up here.  We don't have an after-hours service that's particularly easy to access for the people who don't have money.  I mean the only after-hours things are open till 10 o'clock at night and require some money to sort of do, so that is a real problem.  And therefore you might say that some of those after-hours will actually go up to the hospital. 

But I agree with Bill, and that it's not just access blocking it up, it's access blocked because people are in the hospital way to long.  And we don't have a psycho-geriatric unit up here so anybody who's brain damaged through car accidents or alcohol damage, petrol sniffing, gets clogged up in the major hospital, instead of going to a unit which actually is out in the community which can care for them appropriately.

QUESTION:      So therefore the blame shouldn't be laid squarely with the Territory Government, it should be not there...

MEADOWS:     Well, the whole problem with the health system is that the Territory Government doesn't - they say they don't get enough funds from the Feds to be able to run the hospital system.  So, and then the Commonwealth Government says yes, you've got plenty of money, you're just not running it very efficiently.  And this argument's been going on forever and it's one argument maybe to do with things rising in health. 

So maybe if the Northern Territory Government had enough money like on the [inaudible] rollouts that are going out, on the rollouts, we are arguing that that's probably a good funding model.  But if you start capping it as they are doing and saying it's 2,000 people and that's it, what about a community of 2,500, or 3,000 people?  Are you going to just suddenly be deflated by that amount? 

It's got to be flexible and allow the people on the ground to be able to administer it, because they're the ones who know the problems.  Again, you can't get a bureaucrat in Canberra actually saying how it should be run in the community.  So it's a matter of allowing that flexibility and if that happens and the funding is adequate then things will start to...

QUESTION:      But there is a problem though?

MEADOWS:     Oh, there's definitely a problem.

Ends