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The “Stronger Futures” legislation will weaken health

More than 400 submissions have been made to the Senate committee that is due to report next week on the Federal Government’s Stronger Futures in the Northern Territory Bill 2011 and two related bills.

One submission was from the Public Health Association of Australia, whose representatives Vanessa Lee, Gabriel Moore and Melanie Walker also presented to a committee hearing this week.

In the article below, Lee and Moore cite a wealth of public health evidence that the legislation will undermine health and wellbeing. (And at the bottom of the post is a link to a new campaign opposing the legislation).

***

Self-determination and health are at risk

Vanessa Lee and Gabriel Moore write:

The Senate’s Community Affairs Legislation Committee is conducting hearings this month on amendments to the Stronger Futures in the Northern Territory Bill of 2007 and two related bills, prior to their roll out in 5 new sites around Australia.

The original Northern Territory Emergency Response (NTER) Bill of 2007 involved the suspension of the Racial Discrimination Act making it fundamentally discriminatory to Aboriginal people.

Although the PHAA welcomed the reinstatement of the Racial Discrimination Act in 2010, remaining discriminatory aspects to the new Bills may entrench further discrimination and undermine the self-determination that so many Aboriginal people have struggled to achieve and that solid research evidence suggests is vital to good health (Anderson et al 2007; AHRC 2003; Reading, Wien 2009). All forms of racial discrimination undermine the health of populations (UN Economic and Social Council 2009).

The greatest criticism arising out of the NTER intervention is the failure of the former Federal Government to engage and negotiate with Aboriginal communities to whom the NTER measures were to be applied.  This approach exacerbated mistrust towards government services, undermined community leadership and ownership, and created a sense of disempowerment (ACOSS 2008:4; AIDA 2010i).

While the PHAA acknowledges that the Government has engaged with Aboriginal leaders, Aboriginal organisations and Aboriginal communities as part of developing the Stronger Futures Bills, the widespread criticism from Aboriginal leaders and organisations in the Northern Territory suggests that the time frame for consultations was too short and that there was insufficient negotiation about the new Bills.

Consequentially, aspects of the Bills remain of critical concern including: the lack of community ownership of and responsibility for the implementation of the measures; the lack of flexibility to respond to local needs; the absence of mechanisms for ongoing discussion and negotiation with individuals as their circumstances change.

For the Government and their institutions to work effectively with Aboriginal people, a form of governance is required that involves positive relationship building between communities and government institutions and how they operate within the laws of the nation, rather than just how the Commonwealth Constitution implements a formal framework to implement their own laws (Reilly 2006; Sullivan 2007; Hunt & Smith 2007).

With little or no consultation between government and the affected communities, the health and wellbeing of the communities will continue to be adversely affected.

Under the amendments currently proposed in the Social Security Legislation Amendment Bill 2011, income management may be entered into on a voluntary basis, or be triggered by referrals from State and Territory agencies, such as child protection authorities, Centrelink social workers and other statutory authorities such as the Alcohol and other Drug Tribunal in the Northern Territory, who would determine the terms of the income quarantined and the amount of income deducted.

In spite of the Government’s attempts, the new Bill does not repeal the current NTER model whereby universal and compulsory income management is implemented across prescribed communities.

In our view, there is never a case for universal, compulsory income management, for moral, ethical, and legal reasons and for reasons of cost (particularly, social and health costs).  Further, as well as undermining autonomy and self-determination, universal compulsory income management violates Australia’s human rights commitments and the principles of citizenship.

Voluntary income management, with informed consent and on an opt-in basis, emphasises the importance of control over one’s life circumstances as crucial to good health (Marmot 2005; Wilkinson, Pickett 2009).

For Aboriginal and/or Torres Strait Islander People, voluntary schemes need to be governed by Aboriginal community controlled organisations – and by community organisations in the five new sites – with agreed entry and exit criteria, clearly specified processes and with the terms of the scheme negotiated and agreed according to individual circumstances.

In addition, the efficacy and the effectiveness of voluntary income management measures, including its cost effectiveness, should be evaluated rigorously. The question of opportunity cost must also be addressed.

The evidence clearly suggests without substantial investment in comprehensive interventions to reduce the prevalence of problems such as alcohol abuse and child neglect, or to improve education, housing and employment opportunities, by strengthening of partnerships with communities, there is no rationale for expecting long term improvement in their health and wellbeing.

However, other questions remain unanswered including whether people have opted to discontinue income management as their circumstances change; and whether income management has increased peoples’ capacity to take control of their own lives.

The PHAA acknowledges that there may be a case, in some limited instances, for compulsory income management for targeted individuals, where transparent, priority criteria have been established, such as child abuse or neglect, or alcohol-related violence.  If compulsion is to be applied, there should be legal and ethical criteria to govern the process, including transparent methods of decision making, defined criteria to determine ‘entry’ and enable ‘exit’ from the scheme, and the right to appeal and review.

Compulsory income management should only be implemented as a last resort and as part of a case management program, implemented by a properly consisted non-government organisation, with safeguards against arbitrary decision-making.

• Vanessa Lee is Vice-President (Aboriginal and Torres Strait Islander Health) of the PHAA and Gabriel Moore is NSW Branch President.

***

Stand for Freedom

Earlier this week, Our Generation Media, in partnership with ANTaR, launched an online campaign, Stand For Freedom, to demand the withdrawal of the Stronger Futures legislation.

[youtube]http://www.youtube.com/watch?v=zGQyinbxQXQ[/youtube]

 

 

 

 

 

 

 

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#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
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