Transcript: Dr Hambleton, Press Conference, Melbourne, 13 May 2011

                Minister for Indigenous Health, Mr Warren Snowdon

                Australian Indigenous Doctors’ Association CEO, Mr Romlie Mokak

                National Community Controlled Health Organisation, Acting CEO, Ms Kate Kelleher

                Friday 13 May 2011

Subject:    Launch of AMA Aboriginal and Torres Strait Islander Health Report Card 2010-11

STEVE HAMBLETON: Thank you all for coming today to the launch of this important Report Card. The first thing I’d like to do is acknowledge the traditional owners of the land, the Wurundjeri people, and acknowledge their elders, past and present.

And special thanks to the Indigenous Health Minister, Warren Snowdon, for launching the Report Card. Thanks also to the CEO of the Australian Indigenous Doctors Association, Romlie Mokak, and the Acting CEO of the National Aboriginal Community Controlled Health Organisation, NACCHO, Kate Kelleher, who will symbolically receive the Report Card and respond.

The health of Aboriginal and Torres Strait Islanders is a national concern and a national priority. We must close the gap – the mortality gap between Indigenous and non-Indigenous Australians. There’s a lot being done, but a lot is never enough until it’s finally done.

Nobody knows more than the Minister. He lives in the Northern Territory and has been a frequent visitor to Indigenous communities – remote, rural and urban – for many years. He knows the problems and he’s always willing to hear advice and ideas about solutions.

Minister Snowdon actually launched our last Report Card and took our advice to government. He’s working on solutions. We invited him here today to launch our Report Card and take on board our next round of recommendations. He does that a lot in his job.

Aboriginal and Torres Strait Islander people do not currently have a level of access that matches their greater need. They experience a large range of barriers in accessing appropriate care in a timely way. Any reform of the primary health care system must place a greater priority on improving access to the right model of care in the right place, at the right time for Indigenous people.

The first step is to be clear about what’s involved in providing best practice in high quality and accessible primary health care for Aboriginal and Torres Strait Islander people. The AMA Report Card identifies some of the more successful primary health care models that reduce barriers to access and promote high quality health and clinical outcomes for Indigenous patients.

The challenge is to ensure the continuity of care through collaboration and integration between services and sectors and sharing of cultural understanding, resources, expertise and geographic availability. The Report Card contains practical and achievable recommendations to make a big difference in Indigenous health.

I know Minister Snowdon will give them serious consideration and take them to his colleagues in government. I’ll now ask the Minister to say a few words and launch the Report Card.

WARREN SNOWDON: Well, firstly, can I thank Steve for that introduction and thank also the AMA for inviting me to be here today to launch this Report Card. Can I acknowledge the Wurundjeri traditional owners of this country. Can I thank my colleagues over here. It’s great to see Kate here from NACCHO and Rom. Well, he’s just a bloke from Darwin really, so.  I think it’s just talking about the populations living in urban areas now.

Obviously we understand when there’s more barriers to accessing health care in remote areas so why, obviously, are we - do you think there’d be better access in urban areas?

KATE KELLEHER: You naturally would. The question was about access in urban areas. You would think that that would be much easier. But what happens is that we don’t have as great a presence in the urban areas to service the population that’s there.

I think it’s quite a myth that, you know, we have this picture of Aboriginal people living out in the remote areas but the statistics tell us that, you know, I think it’s 60 per cent of the population live in urban areas. And so people don’t identify, necessarily, when they go into medical services and often – I just think of an example with my own cousin going in to register for PIP, which is a concession for Aboriginal people – didn’t know anything about it. She was in a particular area of Sydney, affluent area, but even so. So there needs to be a change of perception, as is recognised in the report.

WARREN SNOWDON: Can I just make one point? We understand this, which is why we’ve provided outreach workers and project officers to divisions of general practice and Aboriginal medical services across the country. Because we believe it’s very important that we try and promote the idea that people need to go out and find people who currently aren’t getting access to services. So by working with the divisions of general practice through the private practices and working with the Aboriginal medical services, we hope we can make contact with those people who are currently not getting services and induce them in. I’ve been here in Victoria and spoken to a couple of people who are working in Fitzroy as outreach workers, and they’ve changed – 150-odd clients they’ve brought in who would otherwise not have accessed the services.

So we think we’re on the right path in terms of doing this, but it’s an educative function because there are clearly people who are reticent about going to a medical service. They’re reticent about going to a local doctor who may not bulk bill, for example. Those sorts of things are barriers, and we need to try and overcome them. We can only overcome them by talking to people, communicating with people and working with those people who are delivering the services now, and that is through the College of General Practice, and the general practices themselves.

The AMA obviously is an advocacy organisation. And NACCHO, as well as the doctors – all the organisations. If we actually have a common objective and we’re prepared to distribute the information – and cultural safety is really very important. I mean, people have got to feel confident and safe, and when they go to a practice they’ve got to know that that person who’s going to see them will understand the issues which might – they might be confronted with but also, importantly, understand who they are. And understanding who they are and what their demands are is a very, very difficult thing at times.

But again, the AMA, the divisions of general practice, and NACCHO have all got things happening to break down those barriers and give people an educative opportunity – that is the doctors, the medical profession – to learn, acquire those skills that they need in the areas in which they live.

QUESTION: Romlie, you said you needed 1000 extra doctors right now. Can you just expand on that? I’m sorry, I wasn't sure if you were talking about – were you talking about Indigenous doctors?

ROMLIE MOKAK: Indigenous, yeah. So if we look at the numbers, essentially the proportion of non-Indigenous doctors, so the total population of doctors to total population, if we were to look at parity – so we’ve got about 500,000 Aboriginal people. If we were to look at parity, we would need 1000 Indigenous doctors now, right now. So that’s basically the point.

Now we know that we’re not going to reach that target immediately, so what we need to do is to really have government and systems, education and training systems, working together with communities so that we’re identifying – you know, the Minister talked about kids born healthy remain healthy, ultimately to be healthy adults.

Now that’s the game that’s in town but what it requires is a whole of system response – whole of government, whole of system response. So we’ve got to get identifying those kids much earlier. We’ve got to keep Aboriginal kids at school. We’ve got to make the school experience a strengthening, positive, empowering experience, not an experience which typically is the case for Indigenous kids, where teachers make decisions about what the capabilities are, their future capabilities, and often will, you know, encourage them to take the soft option which might be – I mean, it sounds very judgmental, but it might be a trade or a VET sector option rather than a higher education professional option.

We need our kids to have strong maths and science literacy so that they’re much better prepared to, you know, propel themselves into the professions. We need a whole bunch of things happening with universities sort of doing outreach to communities, universities knowing what their population is, their Aboriginal population. It’s not good enough for, you know, people to stand behind their sandstone barricades any longer and to think that they don’t need to do stuff with Aboriginal communities. So there’s all of that as well as the profession itself, in the case of medicine, ensuring that every medical student in this country has Aboriginal content in the curriculum.

KATE KELLEHER: Absolutely.

ROMLIE MOKAK: So that they, whether they’re black or white, are better placed to service Aboriginal people in the future. Not only curriculum, but rotations through Aboriginal medical services, for example.

And that doesn’t come easy, you know. We can’t just expect health services to open the doors up and invite all of these medical students in. There’s a whole set of things around infrastructure, capability of health services, proper relationships between training and education providers and community services. And all the way through – you know, all the way through the specialties. So in medicine you could be on that trajectory for, you know, a dozen or more years before you become a surgeon, you know.

So we need to indigenise that continuum all the way along and our organisation is doing work right along that continuum. What’s really limited though, I think, is the conversations and, more than the conversations, the action that needs to happen between the school sector and the higher ed. sector. And that’s really where we’ve got to do a hell of a lot more work – as well as the VET sector. Sorry, that’s a long response.

STEVE HAMBLETON: All right. Well, look - I think I’d very much like to thank all of our speakers today and thank everyone for turning up, and it’s our great pleasure to have this launched. And we hope that it does instruct government or assist government and our medical community to actually improve the health of the Aboriginal community and actually close the gap. So thank you very much everyone.

16 May 2011

CONTACT:               John Flannery                           02 6270 5477 / 0419 494 761

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