Question

Scenario: You are a registered nurse working at a hospital in Brisbane. Matt is a 24 year old Aboriginal and Torres Strait Islander man from Palm Island, he is currently an inpatient, but is awaiting transfer to the discharge lounge. He will be traveling back to Townsville today where he will continue his care from his mothers home in Kirwan, Townsville. He experienced some challenges while admitted to your ward, however thanks to your confident and informed patient advocacy and culturally safe care, he was able to be empowered to complete his care.

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Answer 1

1. Close the gap is a public awareness campaign focused on closing the health gap. It’s run by numerous NGOs, Indigenous health bodies and human rights organisations, including the Australian Human Rights Commission (AHRC). The campaign was formally launched in 2007, after the release of the social justice report by the Aboriginal and Torres Strait Islander social justice commissioner, Dr Tom Calma.

Close the Gap gained support from state and federal governments when the Council of Australian Governments (Coag) set two health aims among their six targets in 2008: achieving health equality within a generation and halving the gap in mortality rates for children under five within a decade.

Closing the Gap :-

Closing the Gap is the name given to Coag’s 2008 national strategy to tackle Indigenous inequality, which includes the Indigenous Reform Agreement, a commitment to closing the gap between Indigenous and non-Indigenous Australians within a specific timeframe, with six key targets :-

- To close the life-expectancy gap within a generation

- To halve the gap in mortality rates for Indigenous children under five within a decade

- To ensure access to early childhood education for all Indigenous four-year-olds in remote communities within five years

- To halve the gap in reading, writing and numeracy achievements for children within a decade

- To halve the gap in Indigenous Year 12 achievement by 2020

- To halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade.

2. There is a ‘funding myth’ about Aboriginal and Torres Strait Islander health – indeed in many Indigenous Affairs areas – that must be confronted as it impedes progress. That is the idea of dedicated health expenditure being a waste of taxpayer funds. Yet, if Australian governments are serious about achieving Aboriginal and Torres Strait Islander health equality within a generation, a refreshed Closing the Gap Strategy must include commitments to realistic and equitable levels of investment (indexed according to need). Higher spending on Aboriginal and Torres Strait Islander health should hardly be a surprise. Spending on the elderly, for example, is higher than on the young because everyone understands the elderly have greater health needs. Likewise, the Aboriginal and Torres Strait Islander population have, on average, 2.3 times the disease burden of non-Indigenous people. Yet on a per person basis, Australian government health expenditure was $1.38 per Aboriginal and Torres Strait Islander person for every $1.00 spent per non-Indigenous person in 2013-14.3 So, for the duration of the Closing the Gap Strategy Australian government expenditure was not commensurate with these substantially greater and more complex health needs. This remains the case. Because non-Indigenous Australians rely significantly on private health insurance and private health providers to meet much of their health needs, in addition to government support, the overall situation for Aboriginal and Torres Strait Islander health can be characterised as ‘systemic’ or ‘market failure’. Private sources will not make up the shortfall. Australian government ‘market intervention’ – increased expenditure directed as indicated in the recommendations below – is required to address this. The Close the Gap Campaign believes no Australian government can preside over widening mortality and life expectancy gaps and, yet, maintain targets to close these gaps without additional funding. Indeed, the Campaign believes the position of Australian governments is absolutely untenable in that regard.