Transcript - Dr Michael Gannon - National Close the Gap Day

MICHAEL GANNON: It's a great pleasure to be here today at Winnunga Aboriginal Health Service, and I'd like to thank Julie [Tongs] and the other staff for inviting not only myself, but eight state and territory AMA Presidents.

It's important that the AMA acknowledges the importance of National Close the Gap Day. The AMA has been a champion of improving Aboriginal and Torres Strait Islander health services for many years now. We look at things that directly relate to health, like child mortality rates, like life expectancy - but it's so important to see how things relate to health from the other metrics in the Close the Gap target; things like employment, things like life expectancy, things like Year 12 attainment are key social determinants of health.

So it's a good opportunity today to recognise the advances that have been made, but sadly to realise that there is still so much work to do to close the gap. We need to find a way to celebrate the improvements in things like child mortality, but the AMA is determined to help lead the debate on social determinants of health, and to lead the changes. It's fabulous that we have bipartisan support in Australia for Indigenous advancement, but we need to do so much better. It's important that the words match the action.

The AMA is a strong supporter of Aboriginal-controlled health organisations like Winnunga. We think that bringing the services close to people, close to patients, responding to the needs of the community, is the best way of making these advances, so that we can one day talk about Close the Gap and why we no longer need it. That has to be the aspiration for all of us assembled here today.

Very happy to take questions.

JOURNALIST: Dr Gannon, one of the recommendations of today's report is an inquiry into racism and institutionalised racism in the healthcare setting. What do you make of that recommendation?

MICHAEL GANNON: Well, one of the areas where the AMA has very clear direction is that we need to support Aboriginal-controlled health organisations like this one for primary care. But it's not realistic to have secondary and tertiary care that is exclusively provided for Aboriginal and Torres Strait Islander Australians. So it's so important that patients feel safe in the hospital setting, whether that's the tertiary hospital setting or in secondary hospitals.

If patients don't feel safe, if they don't feel secure, if they feel they're exposed to racism, well, that's simply not good enough. So we support that call for that inquiry. It's so important that primary healthcare services are very much driven and delivered by Indigenous communities, but we need to do better when, inevitably, like all other Australians, Aboriginal and Torres Strait Islanders end up in hospital.

JOURNALIST: You've just heard Julie say that she would recommend six to eight week stints for doctors here. There's still a lot of distrust of medical services among Indigenous communities. What are you doing to try and rebuild that trust?

MICHAEL GANNON: Well, I think it's a constant challenge to make sure that medical curricula are responding to the needs of the community. So we talk a lot about the importance of positive experiences at medical student level, junior doctor level, into specialist training level in rural areas, and the same should apply when it comes to Aboriginal and Torres Strait Islander health. So I would hope that it's a key part of the curriculum of medical schools across Australia to provide that experience; this is important to break down the barriers.

It does vary a lot. If I reflect on my training as a medical student, seeing Aboriginal patients in Perth was, well, in many ways sadly commonplace. But it's so important that we give medical students across Australia – whether that's in the rural clinical schools or in the middle of our big cities – exposure to Aboriginal and Torres Strait Islander patients and their wants and needs.

JOURNALIST: What stuck out to you the most with this report, what alarmed you the most?

MICHAEL GANNON: Well, every time we open up a Close the Gap report, we unfortunately have to acknowledge what's gone before. There are definitely positive moves in this report. We can reflect today on the fact that, every year that goes by, it's more and more likely that a doctor of Aboriginal and Torres Strait Islander heritage is going to be working in an organisation like this. So we are seeing things move forward. Every year there's more and more Indigenous medical students; every year there's more and more completing their internship, getting access to specialist training.

So it's going to take time. When we look at the metrics – whether they're in the area of health, whether they're in the area of employment or education – it is going to take time. But I think that it's important that at least once a year on National Close the Gap Day, we reflect on how far we've come, and hopefully, as every year goes by, we talk about the gap shrinking in whichever target we're talking about.

JOURNALIST: Obviously it's not going in that direction. You said in the 2016 Report Card on Indigenous Health, successive governments have failed to deliver on policies to address major issues. Do you think governments are just paying lip-service to this issue?

MICHAEL GANNON: I think they need to do better. I'm glad that Indigenous affairs has been one area where overwhelmingly there's been bipartisan cooperation over the years, but simply both side of politics need to do better.

It's not just about money. It's easy to call for greater investment, but we need them to continue to see what works in terms of Aboriginal-controlled health organisations, and they need to come down and look at places like Winnunga and look at similar models around Australia that are working, see what works in one place and see whether that can be expanded and delivered in a similar way in another part of Australia.

But, put simply, the best politics is local politics. The organisations must maintain the flexibility to look at what might work in one place and not in the other. What works in Darwin might not work in Cairns, might not work in Redfern, might not work in the middle of Adelaide. Responding to local community needs is important.

JOURNALIST: How important are Indigenous-led solutions in health services like Winnunga here today to resolving some of these issues?

MICHAEL GANNON: Well, Aboriginal and Torres Strait Islander-led services are absolutely essential so that the community is getting the care that they want, and you get smart in terms of delivering the care that is directed at the needs of patients.

I was interested today to hear at Winnunga there's no strict appointment schedule; the doctors here are paid salaries, they don't rely on the fee-for service Medicare arrangements that primary care uses in many other parts of the country. That means there's local smarts, local flexibility.

The area where we have to get better is making sure that our big tertiary hospital sector is also responsive to the social, cultural and health needs of Aboriginal and Torres Strait Islanders when they're admitted to hospital.

16 March 2017

CONTACT: John Flannery                            02 6270 5477 / 0419 494 761
                 Maria Hawthorne                           02 6270 5478 / 0427 209 753

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