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Legislative Assembly for the ACT: 2003 Week 3 Hansard (13 March) . . Page.. 1021 ..

MS TUCKER

Aboriginal life expectancy still tends to be 20 years less than that of other Australians. This was once due to high infant mortality, but it is now due to high rates of adult mortality. The reason why Aboriginal people are sick are numerous, and they are linked to processes that have been repeated through the history of white domination of Aboriginal peoples. The reasons include fragmented families, contributing to grief, stress and powerlessness; marginalisation; low levels of education, which contribute to marginalisation; poor access to services, including preventative health care; poor access to appropriate and consistent housing; and social exclusion.

Aboriginal people can also be trapped in a grief/anger/despair cycle that is perpetuated from the histories of massacres, infectious diseases, dispossession, forced settlement and having their children taken away. Just providing basic medical care is not going to break this cycle.

Health care for all people, but particularly Aboriginal people, needs to be approached in a holistic fashion. The World Health Organisation recognises this by defining health as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.

Winnunga Nimmityjah also recognises this and treats not only the patient and the disease but the whole family and also addresses housing, education, transport and income through support in dealings with Centrelink, support in the criminal justice system and health care beyond the mainstream model in spiritual and emotional healing.

It is particularly important to address the social determinants of health. It is agreed that the following are critical determinants of health: education, particularly of women; autonomy of women; effects of early life impacting on health in adulthood; employment or economic activity; access to food; physical environment (housing, water, waste); access to health services; social networks/social exclusion; addictions; chronic stress; and social gradient (where one sits in the social hierarchy).

Winnunga already goes a long way to meeting these needs, but needs additional support. Existing staff have extraordinary commitment to the service. However, as Winnunga has over 5,100 clients who are mostly marginalised and have complex needs, the government needs to recognise the service given by Winnunga and fund it adequately.

An example was given to the committee of Winnunga clients being unable to enter Centrelink so Winnunga staff would drive to the Centrelink office with the client and go into the office so a Centrelink staff member could come out and attend to the client. Surely all the services will operate more efficiently if mainstream services can go to Winnunga on a regular basis.

Winnunga also reports clients trying to access mainstream services and these services automatically referring them on to Winnunga because they are Aboriginal. One client called a telephone counselling service and was referred to Winnunga, but this posed some difficulty, given that the client was sitting in the Winnunga offices making the call and in need of immediate counselling.

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