The Australian prime minister, Kevin Rudd, has vowed to establish a bipartisan “war cabinet” to help tackle the stark disadvantages faced by indigenous Australians.
The promise, which has been welcomed by many in the field of indigenous peoples’ health, followed Rudd’s historic apology last week to the “stolen generations”—the tens of thousands of Aboriginal, Torres Strait Islander and mixed race children taken from their families between 1910 and 1970.
“For the pain, suffering, and hurt of these stolen generations, their descendants and for their families left behind, we say sorry,” Mr Rudd said in parliament. “To the mothers and the fathers, the brothers and the sisters, for the breaking up of families and communities, we say sorry.
“And for the indignity and degradation thus inflicted on a proud people and a proud culture, we say sorry.”
After delivering his apology, Mr Rudd called on the opposition leader Brendan Nelson to co-chair a policy commission. Although details are yet to be made public, its first business would be to implement a housing strategy for remote communities in the next five years.
These goals fit with Mr Rudd’s broader stated aims of halving the gap in infant mortality, childhood literacy, and numeracy and employment within a decade. Figures from the 2006 census show that the life expectancy of indigenous Australians is about 17 years less than the rest of the population. Infant mortality is as much as three times higher for indigenous peoples’ babies.
Dr Nelson, a GP, has said that he accepts the invitation. Yet Mr Rudd’s Labor party, which won office in November last year, has often differed from the Liberal-National coalition, which held power for the preceding decade, on how to tackle health matters for indigenous peoples.
And in the days after Mr Rudd’s announcement, signs emerged that those differences might prove a considerable hurdle in the way of true bipartisanship. The opposition indigenous affairs spokesman, Tony Abbott, for example, expressed concerns in the Australian newspaper (www.theaustralian.news.com.au, 15 Feb, “Division hits ‘war cabinet’”).
“The government will not get bipartisanship from us . . . in watering down the Northern Territory intervention,” he said, referring to a controversial initiative launched by the former government to tackle child abuse in indigenous communities (BMJ 2007;335:691; doi: 10.1136/bmj.39353.571632.DB).
So far almost 6000 children have undergone general primary care health checks as part of the intervention, but concerns have been raised about what is being done to follow up after conditions are identified.
The ophthalmologist and former president of the Australian Medical Association, Bill Glasson, told the Australian Broadcasting Corporation that not one specialist had arrived in the Northern Territory to treat patients. “Saying sorry is all very nice, but if we don’t treat these kids it means nothing,” said Dr Glasson, who chairs the Northern Territory intervention’s emergency health group.
Despite these challenges, there is optimism among those who work in the area of indigenous health about the bipartisan approach, said Mick Gooda, chief of the Cooperative Research Centre for Aboriginal Health.
“I’m fairly positive that it’s a step in the right direction,” he told the BMJ. “People I talk to are basically saying ‘Where do we sign up to this process?’ because we think it’s the best opportunity we’ve got.”