HEALTH
DEMAND 9
OVERVIEW
This overview outlines a response to some of the current Federal and NT government legislation relating to Indigenous peoples.
'Overview by Dr Hilary Tyler, Alice Springs'
The following recommendations are based on a public health approach. A public health approach looks at evidence, has an understanding of the social determinants of health (such as housing, education, and control over one’s life), and is consistent with a human rights approach. It is in this context that the following points are made.
A human rights perspective is essential. The United Nations Declaration on the Rights of Indigenous Peoples has been endorsed by the Australian government. It refers to, but is not limited to, the right of Indigenous peoples to free, prior and informed consent, self determination, autonomy, the freedom from forced assimilation including the removal of their land and that people shall not be removed from their land by force, rights to own and control their lands, a right to cultural traditions and customs, rights to education in their own language, rights under international and national labour laws, the right to their own legal systems and customs, and the rights to financial assistance from governments in order to enjoy these rights.
Current federal and NT government policies and legislation include the Northern Territory Emergency Response Act, and legislation relating to Megashires, Bilingual education, Homelands, and Community Development Employment Programme. These are discussed below from a public health and social justice approach, with recommendations.
The Northern Territory Emergency Response Act (2007) (NTER) and Social Security and Other Legislation Amendment (Welfare Payments Reform) Act 2007 (Cwlth) (No. 130, 2007) Schedule 2 (Income management regime)
1. Income Management. Compulsory Income Management was introduced to the NT as part of the legislation bundled together in the ‘Intervention’, but is strictly part of the Social Security Act.
Compulsory Income Management has proven to be expensive (approaching $500 million), disliked by many, and has not been shown to have beneficial outcomes (Brimblecombe (2010)[1], Equality Rights Alliance report[2]).
Compulsory income management does not come from an evidence base, nor a social determinants of health, nor a human rights perspective.
Recommendation: Any income management model should be voluntary, with adequate wrap-around support services such as accompanying financial literacy training.
2. Compulsory land acquisition. The NTER compulsory acquired Aboriginal land in the form of 5 year leases. Although these leases will expire in 2012, it is federal government policy that no housing or infrastructure will be provided to communities unless long-term inter-generational leases are signed. Furthermore, it is federal and NT government policy that most communities and homelands are ‘unviable’ and these communities will not be offered further housing or infrastructure independent of any leases.
All communities are in dire need of housing, further infrastructure and ongoing maintenance. Adequate housing is a core social determinant of health.
Recommendation: All homelands and communities deserve adequate resourcing including housing.
3. Customary law. The NTER has legislated that customary law is not to be taken into consideration in judicial sentencing or bail determinations. This aspect of the NTER does not have a sunset clause, and will not expire in 2012. There is good national and international evidence that respect for Indigenous culture is reflected in improved health, as well as a human rights aspect[3]. Recent conflict in Yuendumu is thought to have been prolonged because of the imposed inability to utilize customary law for conflict resolution.
Recommendation: That customary law be respected in Australian law, is facilitated in local dispute resolution, and that Western and Indigenous systems of law work beside each other.
NT Government policies
1. Megashires and community councils. In 2008 the NT government formally dismantled community councils and replaced them with ‘megashires’ with areas of governance over multiple communities. As a result of this, community members have lost access to resources and assets formerly owned by them, such as vehicles, equipment, office space and computers. There is good international evidence that community control and governance has a beneficial effect on health (Ottawa Charter (1986)[4], Barunga Statement (1987), Marmot Review (2010)[5], Chandler (1998)[6]).
Recommendation: That communities regain self governance which is accountable and transparent, funded and legislated by the NT and/or federal government.
2. Bilingual education. The NT government passed legislation restricting the teaching in language to the last hour of each day. Although indicating a partial reversal recently, there is a need to more explicitly support bilingual education, from both an evidence base[7] and human rights perspective.
Recommendation: That the NT government pass legislation to fund and support bilingual education in communities wishing to pursue this.
3. Homelands policy. Under the NT government’s Working Future policy there is a decrease in funding to support homelands and no new houses will be built on homelands. Once again, there is good evidence to support a range of benefits including improved health and wellbeing when people live on their homelands[8],[9],[10],[11].
Recommendation: That the NT and federal governments support and resource people’s rights to live on homelands.
Federal government policy
1. CDEP. Community Development Employment Program. The federal government has defunded the CDEP program which previously provided employment at a wage above the unemployment benefit, with the ability for ‘top up wages’ and time allowed off for ceremonial business. The new CDEP is now at the level of the unemployment benefit, quarantined on the basics card, with no ability for top up wages, and no time allowed for ceremonial business. This is in contrast with Marmot’s findings for the need for a fair wage for fair work[12].
Recommendation: That workers are paid award wages, and a publicly funded employment program to replace and indeed increase all jobs lost through cuts to CDEP is urgently needed.
Hurt and Suffering
Much evidence is accumulating about the experiences of shame and humiliation that Indigenous people living under the NTER and related policies are experiencing. The mental health consequences of this cannot be underestimated. The loss of personal control will have profound impacts on people’s health[13].
Recommendation: That past and future policies affecting Indigenous peoples conform to the UN DRIP, social determinants of health, respect self-determination as a foundation, and have and evidence base.
Explore the reality further: What's the next demand?
[1] “Impact of income management on store sales in the Northern Territory” Brimblecombe J et al, MJA 2010; 192: 549–554. This paper demonstrated that the introduction of IM had no beneficial effect on tobacco and cigarette sales, soft drink or fruit and vegetable sales in the communities studied. Fruit and vegetable sales did however increase with the one-off stimulus package payment. “These findings suggest that, without an actual increase in income as occurred with the government stimulus payment, income management may not affect people’s spending overall. The findings challenge a central tenet of income management — that people’s spending habits will be modified in a positive way with mandatory restrictions on expenditure alone”
[2] Women’s Experience of Income Management in the Northern Territory, Equality Rights Alliance, July 2011. Accessed at http://equalityrightsalliance.org.au/sites/equalityrightsalliance.org.au/files/docs/readings/income_management_report_v1-4_0.pdf
This report of 183 urban women on IM found that “Most women said it had had little or no effect on what they bought, and many said the card added to the difficulties and costs of paying for goods and services…Some found benefits, such as saving and budgeting, and less humbugging, but they were very much the minority. Women raised concerns about not asking for Centrelink help to exit abusive relationships because they don’t want to be referred for Income Management… Nearly three quarters of women said they do not feel safer… The perception of the majority of women was that Centrelink and others in their community do not respect them”
[3] “The Integration of Customary Law into the Australian Legal System” Speech by Tom Calma, Aboriginal and Torres Strait Islander Social Justice Commissioner at the National Indigenous Legal Conference “…the important role that Indigenous people have, to take charge of our own destinies. The maintenance and integration of Aboriginal customary law is an essential part of this.”
[4] The Ottawa Charter of 1986, recognised that “people cannot achieve their fullest health potential unless they are able to take control of those things which determine their health.” In its discussion of health promotion, it stated that “At the heart of this process is the empowerment of communities - their ownership and control of their own endeavours and destinies.”
[5] The Marmot Review (2010) lists six requirements for reducing health inequalities, one of which is healthy communities. Marmot stated in a recent MJA editorial (2011); “A fundamental theme of both the Commission on Social Determinants of Health (UK) Report and the Marmot review was the importance of creating the conditions that enable people to take control of their lives.”
[6] Chandler et al (1998) examined youth suicide in Canadian First Nation groups. Although there were six markers that were associated with protection (self-government, land control, education control, health service control, the presence of cultural facilities, and control of fire and police services), the greatest protective factor was living in a community with self-government. This has relevance for the high rates of suicide in Indigenous youth in Australia.
[7] Indigenous Languages and Culture in Northern Territory Schools Report 2004 – 2005, Department Of Employment, Education And Training, (2005) states “there is irresistible evidence to show that when the home languages and cultures of students are reflected in their learning experiences and learning environments, students achieve better levels of learning”
[9] Burgess, Johnston, et al, “Healthy country, healthy people? Exploring the health benefits of Indigenous natural resource management” Australian and New Zealand Journal of Public Health, 2005, Apr, 29(2): pp117-122
[10] McDermott, R., O’Dea, K. Rowley, K., Knight, S. and Burgess, C. 1998. ‘Beneficial impact of the homelands movement on the health outcomes in central Australian Aborigines’, Australia and New Zealand Journal of Public Health, 22 (6), pp. 653-8.
[11] Rowley et al, Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-year follow-up in a decentralised community, 2008, MJA 188 (5): 283–287
[12] Marmot, M. 2010. Fair Society, Healthy Lives. The Marmot Review (p110), states “Being in good employment is protective of health. Conversely, unemployment contributes to poor health. Getting people into work is therefore of critical importance for reducing health inequalities. However, jobs need to be sustainable and offer a minimum level of quality to include not only a decent living wage but also opportunities for in-work development, the flexibility to enable people to balance work and family life, and protection from those adverse working conditions that can damage health.”
[13] The Health Impact Assessment of the NTER by the Australian Indigenous Doctors Association in 2010 states “The impoverished notion of governance that the Intervention represented has profound, far reaching, and serious negative effects on the health (psychosocial, physical and cultural) of the people whose aspirations, knowledge, experience and skills were ignored; and it means that investments in housing or education of health ‘... are unlikely to pay off because of the lack of a capable governance system in place that can translate plans into action, priorities into concrete strategies, commitments into behaviour, and so forth’.”
