Are Shared Responsibility Agreements Truly Mutual?
The Federal Government's "shared responsibility agreements" with Indigenous communities smack of paternalism and lack the principles of respect and equality.
In an article in the latest issue of the Medical Journal of Australia, authors from the Social and Public Health Economics Research Group from Curtin University express concern about whether mutual obligation arrangements respect the autonomy of the Indigenous communities involved.
The Mulan Aboriginal Community in Western Australia has entered into a shared responsibility agreement whereby they will receive a petrol bowser for their community on the proviso that the residents adhere to certain standards of personal and community hygiene.
The authors are concerned about the narrowness of the choices the communities have been offered.
Further, they argue that the agreements may be contrary to human rights law; they may also be discriminatory if they only provide infrastructure that other Australians expect or take for granted (such as petrol bowsers).
According to the authors there is little evidence for the effectiveness of mutual obligation schemes in the context of improving health. In addition, the agreements do not appear to comply with many of the principles for interaction with Aboriginal and Torres Strait Islander communities that were adopted by the National Health and Medical Research Council in their guidelines for ethical conduct of research in these communities.
There is a need for research to establish whether shared responsibility agreements work and to what extent, say the authors.
The authors propose alternative strategies for improving health in Indigenous communities, including building up management, economic, social and human infrastructure in the communities and respecting the preferences of Aboriginal and Torres Strait Islander peoples.
The nature and extent of choice in shared responsibility agreements need to be established to ensure that they are truly mutual.
The Medical Journal of Australia is a publication of the Australian Medical Association.
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Judith TOKLEY, AMA Public Affairs, 0408 824 306 / 02 6270 5471