Key Messages and Recommendations
- It is imperative to ensure that the AG CHC initiative and other NTER measures ultimately result in long-term, sustainable improvements in those areas that contribute to child safety and protection and the general health and well-being of Aboriginal children and families in the Northern Territory. Achieving sustainable improvement in these areas requires maintaining increased levels of investment by the Australian Government in services and programs in comprehensive Primary Health Care (PHC) and addressing the social determinants of health. It is essential that funding is provided commensurate with need via coordinated delivery processes based on comprehensive planning.
- Both in terms of achieving legitimacy among Aboriginal people and meeting Australia's human rights obligations, effective reform of the NTER cannot be achieved without removing the racially-discriminatory aspects of the NTER measures, and reinstating the protections of the Racial Discrimination Act 1975 (Cmth).
- Many of the NTER measures do not address the issues that provided the Australian Government's justification for its intervention; lack an evidence-base that they are effective or appropriate responses; and have resulted in considerable and unnecessary negative impacts on affected individuals and communities. These deficiencies should be rectified as a consequence of the current review.
- Addressing the health, wellbeing and protection of Aboriginal children and families requires an approach that: builds on existing services, capacities and strengths in communities; addresses immediate needs as well as long-term community development; and provides for Aboriginal engagement, participation and control in the design and implementation of solutions.
- The centralised decision making processes, poor strategic prioritisation and flawed processes of implementation adopted by NTER have resulted in the considerable unnecessary expenditure of public money that could have been better-utilised towards achieving more effective and sustainable outcomes.
[Recommendation 1] AMSANT urges the Review Panel to give consideration to, and provide findings with respect to the flawed foundations of the Australian Government's Northern Territory Emergency Response.
[Recommendation 2] AMSANT urges that the Review Panel recommends that detailed plans be developed for each NTER measure for the linking and transition of each measure to an appropriate, long-term, sustainable service delivery strategy.
[Recommendation 3] AMSANT urges the Review Panel to recommend that appropriate ongoing monitoring and evaluation of all NTER measures are put in place so that it can be determined if the measures are achieving effective outcomes.
[Recommendation 4] AMSANT supports the Social Justice Commissioner's action plan and recommendations on modifying the NTER measures to comply with human rights standards and urges the Review Panel to strongly recommend that the Australian Government implements them in full.
Child Health Checks
[Recommendation 5] AMSANT urges the Review Panel to investigate and compare the total cost of the AG CHCs, including administrative and data collection costs, with the alternative of using local health services to do the checks; and to consider the opportunity cost of not using these funds towards increased recurrent investment in primary health care.
[Recommendation 6] AMSANT urges the Review panel to recommend that the Australian Government commits to extending the timeframe and funding for Phase 2 primary health care, specialist and hospital follow up to ensure that all follow-up work is completed, and to provide clear advice to health services on the matter.
Comprehensive Primary Health Care reform
- Governance arrangements of Phase 3 via the Expanding Health Service Delivery Initiative (EHSDI) need to be urgently reviewed and agreed to by the three partners of the NTAHF (OATSIH/DoHA, AMSANT and DHF).
- The two-year time frame for the EHSDI should commence from when services and regions receive funding.
- Phase 2 follow up should not be funded through the EHSDI.
- The evaluation of the EHSDI should be governed from within the NTAHF and should be based around the agreed core primary health care indicators.
- The Commonwealth commits to maintaining increased levels of funding for
Aboriginal comprehensive Primary Health Care beyond the present two year
timeframe of the EHSDI.
- New resources are used to fund the agreed core primary health care services and are focused on closing the gap in Aboriginal life expectancy.
Alcohol and other drug measures
- Changes that have occurred in alcohol consumption and in alcohol-related assaults and arrests as a result of the NTER alcohol measures, and;
- The effect non-NTER-related alcohol control measures, such as the pre-NTER Alice Springs Alcohol restrictions, have had over the past 12 months.
[Recommendation 9] AMSANT urges the Review Panel to recommend the coordinated reform of the NTER alcohol measures and NT alcohol policy to achieve an evidenced-based alcohol policy framework in the NT that includes supply reduction, demand reduction and harm minimisation measures, including a minimum price benchmark and reduced take-away trading hours.
[Recommendation 10] AMSANT urges the Review Panel to recommend that ongoing funding be provided for AOD services in PHC and that these services be expanded to cover all indigenous PHC services in the NT after suitable consultation and evaluation of the existing services. AMSANT also recommends that these services should broaden in scope so that they have the capacity to treat both AOD and mental health problems as outlined in AMSANT's policy paper on integrating AOD, mental health and PHC services.
- Establish and clarify the prevalence and context of sexual abuse in Aboriginal
- Adjust its responses to include appropriate evidence-based measures to address the issue of consensual sexual behaviour between adolescents;
- Foster a balanced view of the roles and responsibilities of Aboriginal men;
- Strengthen the capacity of PHC to offer family support services to all families with a particular focus on families of vulnerable children; and
- Improve the social determinants which are related to high rates of neglect and abuse including poverty, alcohol and other drug abuse, poor education and unemployment.
- Addresses the issue of the appropriate placement of Aboriginal children removed from their families through supporting the establishment of an Aboriginal Child Placement Authority.
- Acts on the recommendations of the Little Children are Sacred report in relation to child protection needs.
[Recommendation 12] AMSANT urges the Review Panel to recommend an immediate halt to the further roll-out of compulsory blanket income quarantining and that its replacement with an alternative targeted scheme should only occur where there is community support for the measure or where the targeted scheme is applied to all welfare recipients on a non-discriminatory basis. Compulsory blanket income quarantining should be removed from those communities already subject to it and substituted with the targeted scheme subject to the conditions outlined above.
- Whether and to what degree income quarantining has resulted in the increased purchasing of healthy foods and reduced spending on alcohol and drugs;
- The full cost of implementing and maintaining the income quarantining regime and whether the high administrative costs of the blanket management of individual incomes by bureaucrats is justified in terms of the identified benefits and the negative impacts experienced by those subject to it; and,
- What alternative measures are available that are based on voluntary participation or targeted strategies. For example, Centrepay is an existing successful, voluntary system that has been used widely in the NT to enable individuals and families to manage their welfare income. The system currently being trialed in Cape York also warrants further examination.
[Recommendation 14] AMSANT urges the Review Panel to recommend that the Australian Government commits sufficient additional funds to address the unmet housing needs in all Aboriginal communities and that its strategy addresses the needs of smaller remote communities according to need within the same timeframe as that proposed for addressing housing needs in larger communities.
[Recommendation 15] AMSANT urges that the Review Panel recommends that the issue of staff accommodation for service delivery organisations be given a higher priority than it currently has and that additional resources be allocated for new staff accommodation.
- Increased funding for schools, teachers and infrastructure to meet current unmet need;
- Increased training of Aboriginal teachers and teacher aides;
- Effective Adult literacy programs to assist adults to become more employable and to help develop better understanding and commitment around the need for their children to attend school;
- Pre-schools in all Aboriginal communities to ensure that all 3 year old Aboriginal children can attend pre-school;
- Supervised boarding hostels for young people who want to go to high school in regional centres;
- Programs bringing members of the Aboriginal community, particularly elders, into schools;
- Developing a culturally-appropriate curriculum that engages Aboriginal children;
- Programs, such as that developed by Aboriginal educationalist, Chris Sara,55 that combine building confidence and self-esteem through cultural programs and sport, with programs focusing on attaining academic excellence.
Government Business Managers
[Recommendation 18] AMSANT strongly recommends that, if GBMs are to be retained, that the relevant legislation is amended to remove the current delegable powers in relation to ‘government business areas' and that these be replaced with the requirement for GBMs to undertake appropriate consultation and provide for genuine participation of communities and community-based service organisations in the planning and development of services and infrastructure.
55. From the Indigenous Education Leadership Institute.