The Observatory

Budget a missed opportunity to close the gap on health

When tabling the 2017 Closing the Gap report in February this year, Prime Minister Malcolm Turnbull said that despite having successive jurisdictional and Commonwealth governments committed to closing the gaps faced by Aboriginal and Torres Strait Islander people, there was much more work to do – “we have not come far enough”.

Why then, were Aboriginal and Torres Strait Islander people not more of a focus in last week’s Federal Budget?

The Australian Government has rightly pointed out that many of the budget health measures for all Australians will also impact on Aboriginal and Torres Strait Islander health, such as unfreezing Medicare rebates, and the sector has acknowledged positive measures which were announced, including the:

  • Ongoing development of the revised Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan (2018–2023) to be released in 2018
  • Investment of $50 million over four years to establish an Indigenous Research Fund
  • Strengthened evaluation of the Indigenous Advancement Strategy
  • Inclusion of Aboriginal Community Controlled Health Services in the Health Care Home trials
  • Appointment of a Productivity Commissioner dedicated to Aboriginal and Torres Strait Islander services.

However, in the days following the handing down of the 2017-18 Federal Budget, Vision 2020 Australia and other peak health organisations, including the National Aboriginal Community Controlled Health Organisation (NACCHO), have called out the Australian Government for neglecting to place a spotlight on specific measures to address the health gap for Aboriginal and Torres Strait Islander people.

Three Indigenous children. Credit: Yarralin Creative

Photo caption: Three Indigenous children. Credit: Yarralin Creative

Speaking to Aboriginal and Torres Strait Islander health representatives in Canberra last week, Pat Turner, Co-Chair of the Close the Gap Campaign and CEO of NACCHO, said: A nation as wealthy as ours should fund the critical health care of less than three per cent of its entire population.

The Commonwealth must work in full partnership with the state and territory governments to address all Aboriginal health needs. We especially need to agree on a national strategy to address the social and cultural determinants of health.

Every child under four must have ready access to early childhood education; every family should be able to live in decent social housing which is not over-crowded; and every working age person should be able to be gainfully employed.

These are immediate priorities because the social determinants of health account for more than 30 per cent of the burden of disease that affects our people. There is no other sector of Australian society that would tolerate the conditions our people live in and the lack of opportunity we have to improve these conditions.

For the eye health and vision care sector, investing in Aboriginal and Torres Strait Islander eye health and vision care is a no-brainer when around 90 per cent of vision impairment and blindness is preventable or treatable. However, despite significant progress over recent years, the prevalence of vision impairment and blindness among Aboriginal and Torres Strait Islanders remains three times that of non-Indigenous Australians.

Uncorrected refractive error causes almost two-thirds of vision impairment among Aboriginal and Torres Strait Islander people and although spectacles are the easiest and most cost-effective solution, Australia does not have nationally consistent subsidised spectacles schemes.

Cataract is the leading cause of blindness for Aboriginal and Torres Strait Islander people, yet waitlists and backlogs prevent access to surgery that could allow people to instantly see.

Investment in effective coordination at all levels is critical to make sure the right services are provided where they are needed to the people who need them, particularly those in regional and remote areas.

Without consistent and ongoing targeted investment, the health of Aboriginal and Torres Strait Islander people, and particularly eye health and vision care, will continue to lag behind non-Indigenous Australians. The eye health and vision care sector has a long history of collaborating to utilise its collective expertise to identify the investments and policy changes required, but without the targeted and focused support of the Australian Government, we will never close the gap.

See Vision 2020 Australia’s full 2017-18 Federal Budget analysis and commentary