Many Indigenous health positions have been axed in a cost-cutting campaign which will see an end to 4,000 Queensland Health jobs and many services.
The state government says federal funding cuts, little evidence of outcomes, and duplication of services, meant many Indigenous health programs programs had to go.
Now Queensland is now turning to Indigenous community-controlled health services to deliver where Queensland Health once used to.
Stefan Armbruster reports.
“To save money it’s going to cost lives and in our communities we are very concerned because our workers are part of these communities, and when the Queensland government is slashing and saving pennies, I think it’s going to cause more deaths in our communities.”
A grim forecast from Clarke Scott, CEO of the National Aboriginal and Torres Strait islander Health Worker Association.
It’s a sentiment echoing through many parts the Indigenous health sector in Queensland.
From the Torres Strait to Brisbane the list of job cuts is extensive.
Beth Mohle from the Queensland Nurses Union has been compiling the numbers from Queensland Health’s own figures.
“Alcohol and drug services, things like diabetes education, renal services, heart disease, deadly ears, mental health services, you name it. Wherever there is Indigenous social disadvantage, there’s been services that have been cut.”
The federal government is unimpressed.
Warren Snowdon is the federal minister for Indigenous health.
“Ultimately, the delivery of primary healthcare is the responsibility of the Queensland government. We want to make sure no actions by any government lead to a worse health outcome for Aboriginal and Torres Strait Islander people. That’s what I’m concerned about, and if drawing away staff from preventative health or public health means people get a poorer health outcome, that’s a grave concern to me and should be a grave concern for the whole Queensland community.”
The Close The Gap target for health is to reach parity in life expectancy of Indigenous and non-Indigenous people by 2033, and halving of infant mortality for under-fives by 2018.
Queensland’s health minister, Lawrence Springborg, says the government is committed but needs to radically overhaul the health system.
“When it came to Closing the Gap, the thing that disturbed me the most when I became minister was the lack of real proper indicators with real-time information around the programs that Queensland Health had been funding and we’re going to change that. And the other thing is there’s been enormous duplication, which the Indigenous organisations themselves agree, where we have Queensland Health going in and doing a similar thing that a funded indigenous health organisation will do and probably resulting in hundreds of millions of dollars of wasted resources.”
Lawrence Springborg also blames shortfalls in federal funding.
“The other big impact that our hospital and health services are suffering from is Mr Snowdon and Wayne Swan cutting $103 million out of our health budget in December last year.”
Federal Indigenous health minister Warren Snowdon believes that’s not a legitimate excuse.
“No, I don’t think it is. Frankly it’s about their obligation to their own community, and to understand they are the primary driver and deliverer of health services, not the Commonwealth government.”
Figures available from five of seventeen Queensland health regions show at least 80 jobs are gone that deal specifically with Indigenous health, are filled by Indigenous people or dealing mainly with Indigenous patients.
The Nurse’s Union’s Beth Mohle says if the numbers for the other 12 regions are similar, then the indigenous health sector is carrying a larger proportion of the 4000 Queensland Health job cuts than their share of the state’s population.
“So it’s disproportionately falling on Indigenous health workers in local communities, and some communities are being devastated by it, like Cape York and Torres Strait.”
Many Indigenous Queensland Health employees are classified as health workers and play a vital role in communities, as Clarke Scott explains.
“There’s been research done that health outcomes for Aboriginal and Torres Strait islander people are better when there’s the involvement of an Aboriginal or Torres Strait islander health worker. It’s that connection to the community, no-one else can provide that.”
Most of their jobs are gone.
Also cut is training for Queensland Health’s Indigenous workers.
Suzanne Plater is the coordinator of Indigenous Health Promotion at Sydney University’s School of Public Health.
Almost two-thirds of the course was until recently filled with Queenslanders; now there are almost none.
“We still have a full cohort, so it’s not about our course numbers, it’s just such a shame that such a vigorous building of the workforce in Queensland has been stopped dead in its tracks, and I believe quite a few of our graduates have also lost their jobs. So they put all this into coming to university, put their lives on hold for a year and worked really hard, did what they were asked to do by their workplaces, and have now lost their jobs.”
It’s not all negative.
Last year, the Indigenous community-controlled sector lost millions in funding for preventative health, mental health and drug and alcohol-related services.
The Queensland Aboriginal and Islander Health Council accused the government of turning its back on indigenous health.
The Council’s CEO, Selwyn Button, says that’s changed.
“Yes we do have a different view now and the different view has been as a result of the investment we have been able to get out of Queensland government to support the growth strategies in community-controlled services.”
The 23-year-old organisation represents 26 community-controlled health services and there has been a big expansion, particularly in south-east Queensland.
“It is at the expense of Queensland Health and at the expense of government-run services, and from the community-controlled perspective, because we’ve got the evidence, because we’ve got the data, because we can show the improvement. Essentially what it does do, and it isn’t spoken about a great deal, it significantly drives that whole notion of self-determination, because it’s about giving responsibility, ownership and accountability to Aboriginal and Torres Strait islander people to make a difference for their own mob.”
Health minister Lawrence Springborg says Close The Gap in Queensland is coming from a very low base.
“It’s been probably a D minus. We need to be lifting the results and getting better outcomes for our investment and if a community-controlled organisation can provide guidance and make things work, then we should be doing more of it and we’ll be doing that.”
Queensland Nurses Union’s Beth Mohle says it’s not a new policy.
“It’s a very complex process to move towards that, it’s not an easy thing to do. We were working collaboratively with the previous government to do that, and if they think it’s going to be a quick and easy solution, it’s not. The cuts are being made far too fast with no thought.”
But National Aboriginal and Torres Strait Islander Health Worker Association CEO, Clarke Scott, has little faith in Queensland’s approach to Close The Gap.
“I don’t think there is a commitment there at all.”
Selwyn Button says there’s a lot of work to be done.
“I think at this point there is willingness to want to contribute, there is willingness to want to work together and partner, so at the moment out of 10, we’re at a 6 and I think it can improve.”