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An essential service to be de-funded. And yes, it’s an Aboriginal service

Kate Conigrave writes:

On the Thursday of Reconciliation Week this year (June 2) the Aboriginal Drug and Alcohol Council South Australia (ADAC) received a letter from the Office of Prime Minister and Cabinet. This stated that their core funding would stop at the end of 2018. This was to end ADAC’s 25 years of continuous funding by the Commonwealth, since its formation in response to the Royal Commission to Aboriginal Deaths in Custody.

Professor Kate Conigrave

For a quarter of a century, ADAC has provided services to Aboriginal peoples and communities in SA and nationally to help reduce alcohol and drug problems. Their services include a residential rehabilitation in Port Augusta, two drug and alcohol day centres (in Port Augusta and Ceduna); a prevention and support program to communities across South Australia (‘Makin’ Tracks); and services to reduce harms and prevent uptake of alcohol and drug misuse. ADAC also creates culturally appropriate resources that have been requested by more than 2000 services Australia-wide. Federal and state governments, academics and clinicians regularly call on ADAC for expert advice.

In a move reminiscent of ‘Yes Minister’, the Office of Prime Minister and Cabinet plans to continue to fund the key services that ADAC provides, but without funding ADAC itself. This is despite the fact that none of these services are themselves legal entities, which are able to receive the government funding directly. This is almost a mirror image of the 1981 episode of Yes Minister, where the Minister for Health, Jim Hacker (played by Paul Eddington) is advised that a new hospital, St Edwards, has 500 staff but no patients. Hacker is indignant, but is reassured by his permanent secretary that: ‘First of all, you have to sort out the smooth running of the hospital. Having patients around would be no help at all’. In ADACs case, the services are to stay – which is great – but the body responsible for running them is to go.

Real life challenge

Paul Eddington by Rama – Own work, CC BY-SA 2.0

Unlike the fictional St Edwards Hospital, ADAC has very much taken up the challenge of serving real-life people. Indeed, ADAC serve some of the most marginalised and vulnerable individuals of our society. These include Aboriginal men and women from remote communities who speak limited English, and who have become stranded in towns or cities because of alcohol or drug problems. For many of these people, their alcohol or drug use occurs on a background of trauma, repeated grief and loss, and sometimes, erosion of their connection to culture and country. Add to that mix the lack of employment opportunities in regional towns (let alone in remote communities) with resulting boredom and lack of meaningful activity. This combination can provide a powerful incentive to drink.

ADAC goes to meet the people where they are, and on their terms. This work demands sensitivity and flexibility.

I have observed firsthand ADAC’s drug and alcohol day centre in remote Ceduna. Many of the people who seek help come from more remote communities, then become stuck in town ‘on the grog’. Each morning, drinkers drop in in for a meal. This can help prevent brain damage from thiamine deficiency. Food also provides a precious opportunity for engagement. Showers and clothes-washing facilities are available. This not only supports dignity but helps stave off skin infections which can lead to heart and kidney disease. First aid and linkage to medical care is provided when needed. And staff provide activities to act as constructive alternatives to alcohol. When people are open to it, staff gently encourage them to consider transport home to their community or to ADAC’s residential rehab.

I have a clear image from my visit to ADAC’s day centre in Ceduna. A traditional Aboriginal woman was carving up her bush meat while sitting on a lounge. She was clearly worse-for-wear through alcohol. The Aboriginal staff member on duty respectfully and gently engaged her, speaking in a mix of English and her language, and started to understand her needs. Another client was using traditional sign language to communicate – the staff member immediately understood. Such a service, where attendees feel respected and understood, is something that is possible through Aboriginal leadership. For a non-Indigenous body, the best intentions and best bureaucracy in the world are not enough.

Expert opinion

ADAC has been able to recruit and support their Aboriginal staff – with five Aboriginal staff members having completed university qualifications in recent years. Because of their wealth of experience, ADAC’s staff, and in particular its CEO, Adjunct Associate Professor Scott Wilson, are regularly sought after by federal government, health services and universities for their expert opinion on issues relation to alcohol, ‘ice’ or other drug use.

Despite this reliance on ADAC for both service delivery and advice, when the Office of Prime Minister and Cabinet wrote to ADAC to advise of their loss of funding, the only reason provided was that ADAC was a peak body. Indeed, ADAC has representation from over 30 Aboriginal community agencies on its board. This strength helps ADAC to respond to community needs. But 90% of ADAC’s effort is spent on service delivery, and only 10% on its peak body role.

We urge the Minister for Indigenous Affairs, Nigel Scullion, and the Prime Minister, Scott Morrison, to reverse this decision and restore ADAC’s core funding ($700,000 per year) before key staff and hence key ADAC services are lost.

Readers, please write to your local federal member, to the Minister and to the Prime Minister urging them to continue ADAC’s core funding. ADAC is a precious resource and is not replaceable.

You can search for your local member’s contact details. And write to:

Senator the Hon Nigel Scullion
Minister for Indigenous Affairs
PO Box 6100
Senate, Parliament House
Canberra ACT 2600
E: nigel.scullion@ia.pm.gov.au
T: (02) 6277 7780

And

Hon Scott Morrison MP
Prime Minister
Parliament House
CANBERRA ACT 2600

Or you can write direct to the PM through this website, and his Twitter handle is @ScottMorrisonMP.

Professor Kate Conigrave is an addiction medicine specialist, a public health physician and Director of the NHMRC Centre of Research Excellence: Indigenous Health and Alcohol. This article was prepared with editorial assistance from Kylie Lee PhD.

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National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018 <