Issue 44 / 24 November 2014

RESIDENTS, law enforcers and koalas in the greater Brisbane area were breathing deep sighs of relief last week as some of the world’s most powerful leaders departed following the successful passage of the G20 summit.

According to a brief report about the summit there were some important agreements and resolutions made, although there were inevitable murmurings that the report contained few surprises.

Health leaders were among those who pointed out gaps in the G20’s packed agenda, specifically the failure to include anything related to health. To bring health to the fore, the World Medical Association (WMA) joined with the AMA to arrange their own summit just before the G20, to encourage international discussion and collaboration on shared health issues.

MJA Editor-in-Chief, Professor Stephen Leeder, contributed to the H20 meeting and has written a brief report for this week’s MJA InSight, which touches on three major themes that emerged from the meeting: health inequality, climate change and the growing threat of non-communicable diseases.

The need for the G20 to tackle growing inequality — both within and between countries — has resonance for Australia where yet another report was released last week about Indigenous disadvantage.

The Productivity Commission’s 2014 Overcoming Indigenous Disadvantage found that, while there have been improvements for Aboriginal and Torres Strait Islander people in infant and child mortality, life expectancy and some measures of education, employment and income, the rates of incarceration, mental health problems, self-harm, suicide, chronic illness and child removal have stagnated or worsened.

In response, the Minister for Indigenous Affairs, Nigel Scullion, said the findings pointed to ongoing disadvantage and a gap in “opportunities” for Indigenous and non-Indigenous Australians but that the government’s policies were focused on the right areas.

A statement from the National Aboriginal Community Controlled Health Organisation (NACCHO) expressed a different view. New NACCHO chair Matthew Cooke warned that policies such as the GP copayment and closure of remote communities, coupled with uncertainties arising from the lapse of National Partnership Agreements were not conducive to overcoming Indigenous disadvantage, and would lead to worse outcomes.

In health, striving for better outcomes should always be the ultimate goal, as it is in many other facets of life including education, and reports should be an aid to making change.

Those of us with children at school are currently waiting on a much-anticipated report. While writing this InSight column I took comfort from the thought of teachers all over Australia collating information and carefully wording their comments to produce a document that probably won’t deliver many surprises to parents.

Yet careful documentation is needed to highlight strengths, priority areas for action and strategies for remediation, with the knowledge that progress will be monitored in further reports.

In the case of the Productivity Commission’s reports on Indigenous disadvantage, such ongoing monitoring will be particularly important in view of the misgivings of Indigenous leaders about recent and proposed changes to funding for health, legal and social services.

Soon after the report’s release, Aboriginal union organiser Celeste Liddle articulated a concern about cuts to counselling services and women’s shelters that is likely to be shared by many — “… are we likely to see the next report highlighting similar stasis or decline? What about the one after that?”


Dr Ruth Armstrong is the medical editor of MJA InSight. Find her on Twitter: @DrRuthInSight

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