Aboriginal and Torres Strait Islanders must exercise agency – and government must let go: Romlie Mokak
Delivering the 2016 Medicine & Society Oration, Lowitja Institute CEO Romlie Mokak laid out the case for reassessing the relationship between money and outcomes in health policy and the steps required to do so.
In the speech at Cranlana on 10 August 2016, Romlie touched on the way power is wielded through health policy for Australia’s First Peoples:
Power in the policy world sits with others, not with Aboriginal and Torres Strait Islander peoples. It resides outside of the domain of Aboriginal and Torres Strait Islander peoples. We must redress the power imbalance.
The state uses a range of instruments on Aboriginal and Torres Strait Islander peoples — legislation, policy, guidelines, contracts, funding agreements. I have seen these used to the utter detriment of our people. Funding, for example.
We have too many examples of the heavy transactional costs on services simply in doing their business to improve the lives of our people.
The Overburden Report — published by the Lowitja Institute — analysed the complex contractual environment for the Aboriginal community controlled health sector. It found that highly fragmented funding from multiple sources imposed a heavy burden of reporting and acquittal. In effect, Overburden concluded that the funding of the sector imposed barriers to care, impeded efficiency and diverted vital resources away from the ultimate goal of improving health outcomes for clients.
The research found that equivalent mainstream metropolitan health providers do not generally face the same onerous level of reporting requirements – hence the name of this study, the Overburden Project.
And the need for a transfer of control:
In order to be able to prescribe and act upon the solutions that are needed to improve health and wellbeing outcomes, Aboriginal and Torres Strait Islander peoples — organisations, communities, individuals — must exercise agency, take control, and government at all levels must let go.
One of the first priorities must be to build on our existing strengths to represent the interests of Australia’s First Peoples and negotiate on our terms.