Professor Owler, Launch of 2015 AMA Indigenous Health Report Card

Closing the gap on Indigenous incarceration rates

Good morning, and welcome to the launch of the 2015 AMA Indigenous Health Report Card.

I acknowledge and pay respect to the traditional owners of the land on which we meet – the Ngunnawal Peoples.

On behalf of the AMA, I thank Senator Fiona Nash, the Minister for Rural Health – and Minister responsible for Indigenous Health – for accepting our invitation to launch the Report Card. She also launched our 2013 Report Card.

We are pleased to welcome:

• Assistant Minister for Health, The Hon Ken Wyatt MP;
• Shadow Health Minister, the Hon Catherine King MP;
• Shadow Minister for Indigenous Affairs, the Hon Shayne Neumann MP;
• Shadow Parliamentary Secretary for Indigenous Affairs, the Hon Warren Snowdon MP;
• Labor Senator for the Northern Territory, Senator Nova Peris; and
• Greens Senator for Western Australia, Senator Rachel Siewert.

We are also honoured to have with us today:

• Professor Tom Calma AO, Co-Chair of Reconciliation Australia;
• Mr Duncan McConnel, President of the Law Council of Australia;
• Mr Rod Little, Co-Chair of the National Congress of Australia’s First Peoples; Mr Craig Ritchie, Chairperson of the Winnunga Nimmityjah Aboriginal Health Service;
• My colleague, AMA Vice President, Dr Stephen Parnis; and
• AMA Secretary General, Anne Trimmer.

Welcome to representatives of Minister Scullion, Oxfam, ACT Legal Aid, the Law Council, the Australian Indigenous Doctors’ Association, the National Aboriginal Community Controlled Health Organisation – NACCHO, political advisers, and members of the media.

The AMA wishes to acknowledge the outstanding contribution of Chris Holland, the author of the Report Card. Unfortunately, Chris cannot be with us today.

Before we launch the Report Card, I would like to note that today is White Ribbon Day.

The AMA supports White Ribbon Day, and earlier this year we launched our GP Domestic Violence Tool Kit, in partnership with the Law Council of Australia.

We welcome the efforts of the Government and the Opposition in addressing this important social issue.

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By introducing its Indigenous Health Report Cards in 2002, the AMA wanted to increase awareness of the health inequalities between Indigenous and non-Indigenous Australians and to show how governments have responded to these problems.

That first report was titled ‘No More Excuses’. Regrettably, over a decade on, we are still hearing all the excuses.

Today, we are launching the AMA’s 2015 Report Card on Indigenous Health, which focuses on the impacts on incarceration on the health of Aboriginal and Torres Strait Islander people.

The 2015 Report Card is the AMA’s longest and most comprehensive Report Card to date, which is evidence enough that Aboriginal and Torres Strait Islander people continue to be failed by both the health and justice systems.

Aboriginal and Torres Strait Islander people continue to experience a life expectancy of around 10 years less than non-Indigenous people, and are significantly over-represented in custodial settings.

This year, Aboriginal and Torres Strait Islander people comprise 27 per cent of all sentenced prisoners, and 29 per cent of people awaiting sentencing.

They are 13 times more likely to be imprisoned than their non-Indigenous peers.

In 2006 - when the AMA released its Indigenous Health Report Card, Undue Punishment? Aboriginal and Torres Strait Islander People in Prison: An Unacceptable Reality - Aboriginal and Torres Strait Islander people comprised 22 per cent of the prison population, and were 12 times more likely to be in prison than a non-Indigenous peer.

As the data demonstrates, the imprisonment of Aboriginal and Torres Strait Islander people is rising - and the situation is only going to get worse unless we take immediate action.

Next year will mark a grim milestone in the numbers of Aboriginal and Torres Strait Islander peoples being held in custody.

Under current projections, for the first time, more than 10,000 Indigenous people - which includes over 1000 Aboriginal and Torres Strait Islander women - will be in custody on the night of the annual prison census on 30 June 2016.

As our Report Card points out so starkly, in one year alone, there was a dramatic increase in the rate of Aboriginal and Torres Strait Islander people in custody.

There was a 10 per cent increase in the imprisonment rate of Aboriginal and Torres Strait Islander people from 2013 to 2014.  That means the number of prisoners rose from 8,430 prisoners to 9,264.

The situation for young Indigenous people is even more distressing.

In 2012-13, Aboriginal and Torres Strait Islander 10 to 17 year-olds were 17 times more likely to have been under youth supervision than their non-Indigenous peers. This is truly unacceptable.

In our Report Card, there is one sentence that more than any captures the situation for Aboriginal and Torres Strait Islander people:

“It is not credible to suggest that Australia, one of the world’s wealthiest nations, cannot solve a health and justice crisis affecting three per cent of its citizens.”

It is not credible to keep hearing the excuses and well-meaning but unsupported words of successive Federal and State and Territory governments.

It is not credible that, here in Canberra, the national capital, we can travel just a few kilometres from Parliament House and find Aboriginal and Torres Strait Islander people with vastly inferior health care and health outcomes than non-Indigenous people.

The high rates of health problems among, and the imprisonment of, Aboriginal and Torres Strait Islander people should be a priority social justice and human rights issue in this context.

The AMA Report Card recognises that life expectancy and overall health are most definitely linked to prison and incarceration.

We understand the complex drivers of imprisonment in any individual’s case.

But we also understand that the ‘imprisonment gap’ is symptomatic of the health gap.

We believe that it’s possible to isolate particular health issues – notably mental health conditions, alcohol and other drug use, substance abuse disorders and cognitive disabilities – as among the most significant drivers of the imprisonment of Aboriginal and Torres Strait Islander peoples.

These health issues must be targeted as a part of an integrated effort to reduce imprisonment rates.

Because Aboriginal and Torres Strait Islander peoples are coming into contact with the criminal justice system at younger ages than their non-Indigenous peers, a major focus of the integrated approach in the AMA report is on health, wellbeing, and diversion.

Despite significant improvements over past decades, it remains a fact that, in many critical areas, neither the health nor the prison health system is able to respond appropriately to the needs of Aboriginal and Torres Strait Islander prisoners.

We have identified culturally-based approaches as being effective in working with Aboriginal and Torres Strait Islander children and adolescents in areas such as suicide prevention.

The AMA’s 2006 Report Card called on the Australian Government to:

• keep those out of prison who should not be there, principally those with mental health and substance abuse problems; and
• ensure that health service provision in prisons is the best it can be – in particular, supporting inmates to take control of their health and the determinants of their health.

Our 2015 Report Card builds on these calls by recommending:

• setting a national target for ‘closing the gap’ in the rates of imprisonment of Aboriginal and Torres Strait Islander peoples (that is, bringing it down to at least the rates among non-Indigenous Australians); and

• adopting a justice reinvestment approach to fund services that will divert individuals from prison as a major focus.

It is the AMA’s hope that this Report Card will help build momentum for a national integrated approach to reducing both the Aboriginal and Torres Strait Islander health and imprisonment gaps – an approach that understands both as aspects of each other.

We do not pretend to have all the solutions to the many health problems that confront Aboriginal and Torres Strait Islander people.

Nor do we have all the answers to addressing the disproportionately high rates of incarceration.

But the AMA recognises and acknowledges these problems, and we want to help fix them.

Our Report Card is a work of outstanding research and exposes a problem that must be fixed, and provides some recommendations and examples of models that work.

The AMA wants to improve the health and wellbeing of Aboriginal and Torres Strait Islander people, especially children and adolescents.

Prevent interaction with prisons and criminal justice systems is one way we can help achieve this goal.

It is my great pleasure to ask Senator Nash to make some comments and officially launch the 2015 AMA Report Card on Indigenous Health.

25 November 2015

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