Introduction by Croakey: Democracy in Australia is “fraying at the edges”, former ABC broadcaster Kerry O’Brien observed recently – as we’ve seen in recent days with the United Australia Party advertising campaign promoting disinformation in newspaper advertisements across Australia.
It is beyond unfortunate that media companies have been complicit in these attacks on democracy by being willing to take these advertising dollars. Meanwhile, the role of the media industry and journalists’ practices have been widely critiqued for undermining public and policy discourse at this critical election.
Also undermining democracy has been the failure to ensure that all people eligible to vote have the opportunity. Despite last minute efforts to ensure people recently diagnosed with COVID are able to vote by phone, concerns have been raised about people in hospitals, aged care and other institutions being unable to vote.
Democracy is also undermined when the diverse voices of minority groups are not heard or amplified to ensure their needs are centred and responded to. While important determinants of health, like housing and financial stress, have been prominent during the election campaign, the perspectives of priority populations on these issues has not often been central. The focus has so often been on home ownership, for example, rather than housing security, social housing, and rental options.
In the spirit of contributing to democracy, Alison Barrett has asked some organisations that are often missed from election discussions in mainstream media about their key election priorities and calls for action to the incoming government.
Plug these important funding gaps
Aboriginal Drug and Alcohol Council South Australia
Scott Wilson, CEO of the Aboriginal Drug and Alcohol Council South Australia, told Croakey said his key federal election priorities are:
• Hold the Referendum on having Aboriginal and Torres Strait Islander people included in the Constitution ASAP. “Australians aren’t stupid and if the question was put to them, I think the majority would say YES”, Wilson said.
• A massive injection into public housing Australia-wide, in particular for Aboriginal housing and not just in remote communities.
• Fund the National Indigenous Drug and Alcohol Conference which is the only workforce development opportunity for Aboriginal workers in the alcohol and other drugs (AOD) field.
• Fund the Centre for Research Excellence (CRE) in Indigenous Health and Alcohol which has so far helped nine Aboriginal people gain a PhD, as current funding ceases 30 June 2022.
• Provide funding to Aboriginal Alcohol and Other Drug (AOD) Services to employ mental health practitioners rather than have services stand alone. For example, more than 100 people in the Ceduna region in South Australia have to wait until the psychiatrist/psychologist flies in for visits, but “who looks after the clients while they are waiting?” Wilson asked.
• Increase investment in AOD services. For example, in SA with a population of 1.5 million residents, there is approximately 40 rehabilitation beds, of which the Commonwealth Government funds approximately 20 of. “There needs to be funding made available for that to double,” Wilson told Croakey. Most people struggling with AOD issues need residential rehabilitation not telehealth counselling.
• All state Attorney Generals need to agree to Raise the Age of criminal responsibility to 14 years. This would also help with the Close the Gap Partnership Agreement to halve the rates of Juvenile detention by 50 percent overnight. He recommends that the Federal Government then invest in diversionary programs to consider that kids will no longer be incarcerated but will have social and support needs.
• Commit to funding the Close the Gap and the National Agreement that was signed by the Prime Ministers and all State and Territory Premiers and Chief Ministers which goes until 2033.
Key workforce matters
Network of Alcohol and other Drugs Agencies
Robert Stirling, CEO of Network of Alcohol and other Drugs Agencies, told Croakey that stigma and discrimination towards people who use drugs is impacting policy and funding decisions, which is then impacting the people who work in the alcohol and drug sector.
Stirling said that since the Council of Australian Governments (COAG) ceased, there has been no governance structures in place to monitor the performance of alcohol and other drugs sector.
“This means there is limited opportunities for transparency and accountability between the Australian Government and the States and Territory’s health departments,” Stirling told Croakey.
Stirling said the alcohol and other drug sector is seriously underfunded and needs long term investment. “We know that we don’t have the workforce to immediately establish services.”
“COVID-19 has placed extraordinary demands on the alcohol and other drug sector. While the sector has shown considerable resilience, the impacts of the pandemic continue to be felt. To say we are in a workforce crisis in the sector would be an understatement. I have services telling me that they are unable to recruit to positions,” Stirling said.
NADA’s key election priorities and calls to action for the incoming government are:
• Invest in strategies that actively reduce stigma and marginalisation and prioritise the voices of people with lived experience.
• Establish governance structures that include the NGO sector, who provide 70 percent of all episodes of care in Australia.
• We need a commitment to incremental increases in treatment and harm reduction funding over the next 10 years to ensure a skilled workforce can be attracted, developed and retained.
• Whilst the above actions will support responses, we need a workforce strategy with an implementation plan that includes investment to offer to incentives for people to work in the alcohol and other drugs sector.
Fixing housing provides so many health solutions
Northern Territory Shelter
Peter McMillan, Executive Officer of NT Shelter, told Croakey that their key election priorities are:
• Increased funding for public housing
• Short-stay accommodation facility in Katherine, a region with 31 times the national average of homelessness
• Policies to improve rental accommodation availability and affordability.
“In terms of housing, one of the things that we really need to see regardless of which major party forms government, is a continued investment in remote overcrowded housing,” he said.
In the Territory, 50 percent of housing in remote or very remote communities is severely overcrowded, typically having 20 or more people in a house, McMillan told Croakey, which contributes to disproportionate rates of acute rheumatic fever and rheumatic heart disease.
“We need to keep getting housing done until we eliminate overcrowding so that everybody in the Northern Territory has the same opportunities for health and prosperous life,” McMillan said.
Other determinants of health, such as educational opportunities, employment and mental health, will be improved with improved housing.
The “Federal government can play an integral role” in improving the housing situation in Katherine with “funding for the construction of short stay visitor accommodation” similar to short-term accommodation in Darwin, McMillan told Croakey.
Katherine is a major service hub for the region, where people from “outlying communities” come for medical treatment, among other services.
McMillan said that a survey by the Salvation Army estimated that 90 percent of people visiting Katherine for medical treatment are sleeping rough and short stay accommodation would help minimise that.
There is also an “estimated shortfall of around 12,000 homes in the Northern Territory” McMillan told Croakey.
They are calling on the Federal government to establish a National Housing and Homeless strategy that develops a plan to build more social affordable housing, that will obviously have a positive impact on people’s health and mental health and wellbeing.
More about the short stay visitor accommodation campaign for Katherine is here.
More funding for housing
Australian Alliance to End Homelessness
David Pearson, CEO of Australian Alliance to End Homelessness, shared their election priorities:
• We want to see housing recognised an essential element of healthcare, as the pandemic has demonstrated how interconnected these things are.
• We want to see that as part of a commitment to develop a national housing and homelessness strategy, which from a health perspective we think needs to include a commitment to:
• implementing a ‘no exits into homelessness’ policy for people all people who are discharged from institutional care, including hospitals and prisons, but specifically for people with mental illness, as recommended by the Productivity Commission report into mental health.
• Introducing a mandatory requirement for all hospitals to record housing status/residential address.
• Developing a national homelessness deaths reporting framework as we don’t currently measure how many people die whilst experiencing homelessness in Australia, the AAEH has estimated that it is approximately 424 people who died whilst experiencing rough sleeping alone each year.
Finally, and most importantly, we need greater investment in housing, social housing generally and permanent supportive housing specifically (such as permanent housing with wrap around support).
Value young people’s mental health
Youth Focus Western Australia
Youth Focus WA welcomed last week’s announcement by the WA state government for increased funding in mental health, particularly “further investment in peer support workers, reducing unnecessary hospital admissions and the resourcing of more frontline staff in regional areas to address some long-term issues.”
However, they acknowledged “the mental health issues Youth Focus is presented with daily are simply too much for the current system to handle.”
Arthur Papakotsias, CEO of Youth Focus WA told Croakey their key federal election priorities are:
• Increased funding for headspace services
• Funding for young people who present with more complex needs and co-occurring issues
• Suicide prevention strategies and resources
• Greater support for carers and families in helping young people.
Youth Focus calls for greater integration of mental health services to support young people with a broader range of services catering for a wider range of needs. Mental health services should be easier to navigate and have a ‘no wrong door’ approach, Papakotsias said.
Nine key priorities
LGBTIQ+ Health Australia
James Zanotto, LGBTIQ+ Health Australia’s Policy and Research Manager told Croakey that “current systems are failing LGBTIQ+ communities. Disparities will remain if LGBTIQ+ health and wellbeing continue to be sidelined and under-resourced in policy and service planning.”
“The 2021-2030 National Preventive Health Strategy highlighted health and wellbeing disparities for LGBTIQ+ people, particularly in cancer rates, tobacco and alcohol use, and mental health and suicide.
Compared with the general population, LGBTIQ+ people are more likely to have depression, anxiety, be diagnosed with a mental health disorder, have suicidal ideation, engaged in self-harm and/or have attempted suicide in their lifetime.
Older LGBTIQ+ people desperately need improvements to every aspect of aged care.
The poorer health outcomes can primarily be attributed to the impact of minority stress—the chronic stressors to which LGBTIQ+ people are uniquely exposed because of sexuality, gender and bodily diversity being socially stigmatised.
This includes discrimination, social exclusion, harassment and physical violence.
For LGBTIQ+ people who live at the intersections of additional marginalised identities and experiences, these health inequities can be compounded by racism, ableism, and other forms of discrimination.”
LGBTIQ+ Health Australia’s top calls for action
LGBTIQ+ Health Australia has identified nine priority action areas that focus on changing systems and targeted supports to address health and wellbeing disparities amongst LGBTIQ+ communities. These are:
- Complete a 10-year National LGBTIQ+ Health and Wellbeing Action Plan from existing national strategies and deliver it.
- Count LGBTIQ+ people and communities in data collection for health planning, especially the next national Census.
- Invest in LGBTIQ+ community-controlled health and wellbeing organisations.
- Prioritise the mental health and wellbeing of LGBTIQ+ communities.
- Protect the human rights of people with innate variations in sex characteristics.
- Ensure the rights and needs of LGBTIQ+ people in the next national plan to prevent all forms of family, domestic and sexual violence.
- Deliver gender affirming care in the public health system.
- Provide equality and opportunity for LGBTIQ+ people with disability.
- Ensure safe and culturally appropriate aged care services.
Additionally, Zanotto told Croakey:
“LGBTIQ+ people are rightly identified as a priority population in a range of existing national health and wellbeing strategies, but there is currently a lack of national coordination of goals and targets.
Despite evidence of best practice showing that many health interventions and programs are best delivered by people and communities with lived experience, investment in LGBTIQ+ people’s health is often funnelled into larger mainstream organisations at the cost of community-controlled health organisations that are best placed to deliver inclusive and culturally safe care to LGBTIQ+ people and work with insufficient resourcing.
Fundamental change is needed to include LGBTIQ+ people and communities in national structures and systems. Inclusion would see progress towards addressing the disparities and inequities experienced by LGBTIQ+ people and communities.
Our central priority is a 10-year National LGBTIQ+ Health and Wellbeing Action Plan drawing on existing national strategies. This requires a dedicated Office within the Department of Health to oversee development, implementation and monitoring of the plan, with resourcing to place lived experience at the centre of implementation, especially community-controlled health services.”
Further details about LGBTIQ+ Health Australia’s election priorities are included in this report.
Nicky Bath, CEO of LGBTIQ+ Health Australia wrote for Croakey about an election forum for lesbian, gay, bisexual, trans/transgender, intersex, queer and other sexuality, gender, and bodily diverse (LGBTIQ+) people, where they heard from representatives of the Liberal, Labor and Greens parties.
Calling for diversity in policy, practice and workforce
Federation of Ethnic Communities’ Councils of Australia (FECCA)
Romel Lalata, communications officer for the Federation of Ethnic Communities’ Councils of Australia told Croakey that the biggest issues facing the FECCA community are COVID-19, culturally appropriate aged care, and lack of research and data covering health and culturally and linguistically diverse communities.
Lalata said that FECCA is part of the National CALD COVID-19 Health Advisory Group and that they also administer the CALD COVID-19 Health Small Grants Fund (from the Federal Department of Health).
These grants are aimed at helping “multicultural community groups to lead grassroots communication activities around COVID-19,” of which the first round has been successful.
Additional funding has been received for a second round, applications close November 2022 (or until funds depleted).
Lalata told Croakey that FECCA advocate for culturally appropriate aged care and a less complex and more accessible pathways to aged care services.
“We are in the process of developing EnCOMPASS: Multicultural Aged Care Connector Program which has received funding from the Commonwealth Government until 2023,” Lalata said.
They also advocate for a multicultural workforce who should be compensated for labour that is highly skilled and demanding.
Acknowledging an increase in research covering health and culturally and linguistically diverse communities, “there are still huge gaps in data about health when it comes to our communities. The data is not simply there,” Lalata said.
Lalata told Croakey that FECCA’s main election priority is for the establishment of an “an Office for Multicultural Australia, elevated in the Department of Prime Minister and Cabinet, which will ensure a renewed focus and the continued success of multiculturalism in Australia.”
Among other functions, an Office for Multicultural Australia would:
- embed diversity reflective of Australian society in the foundation of policy making
- ensure consistency and coherence of Australia’s multiculturalism framework through co-ordination across relevant programs, laws, regulations, and policies across all government departments and agencies
- design and implement consistent and accurate measures of cultural, ethnic and linguistic diversity across government data collection
- strengthen the Multicultural Access and Equity Policy and ensure mandatory implementation throughout service delivery across all departments and agencies
- embed coordinated impact assessment of decision making across Departments
- ensure all people in Australia feel safe and live without fear of discrimination or violence
- establish diversity targets in the Australian Public Service.