Northern Territory Emergency Response - PHM Standpoint Analysis

Overview

The NT Emergency Intervention premised on The Little Children are Sacred report of child abuse in NT Aboriginal communities is directed toward the inhabitants of 73 remote NT Aboriginal communities.

The elements of the intervention include:

• bans on alcohol use;
• bans on access to pornography;
• mobilisation of the army into Aboriginal communities;
• increased police presence;
• scrapping the Comunity Development Employment Program;
• voluntary health checks (initially designated compulsory) for Aboriginal children;
• compulsory acquisition of Aboriginal land;
• scrapping the permit system through which Aboriginal people controlled access to their communities;
• suspending the right of Aboriginal people to make claims under the Native Title Act;
• quarantining 50% of social security payments paid to Aboriginal recipients for food and rental payments;
• exempting provisions of the legislation from the Racial Discrimination Act;
• loss of the right to appeal to the Administrative Appeals Tribunal;

An analysis of this intervention from a health perspective necessitates consideration of the complex array of factors impacting on the lives and health of ordinary Aboriginal people. The well known statistical fact that life expectancy of Aboriginal men and women is seventeen years less then their non-Aboriginal counterparts in Australia somewhat masks the massive amount of injury, illness, grief and suffering that is a constant of everyday Aboriginal life. Furthermore, this suffering is contextualised in impoverished environments of poor quality housing, poor access to health services, limited effective schooling and negligible employment opportunities. And, it has been this way for decades. The legacy of colonisation impacts the lives of most Aboriginal people.

Moreover, Aboriginal health policy and program development requires, at the least, consideration of the diversity of Aboriginal peoples, their diversity of geographical locations, the diversity and size of Aboriginal communities, diversity of histories, evidence from previous and existing programs and services, assessment of ongoing workforce capacity for implementing programs, and potential for engagement by Aboriginal leaders and their constituents. In a nutshell, policy and program development in this arena is complex with the potential to be viewed from a broad range of standpoints.

Similarly, the NT Emergency Intervention has numerous strategies targeted at a plethora of Aboriginal individual and communal lives and can be viewed from a broad range of standpoints. Attempting an analysis of the NT Emergency Intervention as a whole, is a salient example of engaging the complexity inherent in Aboriginal issues. The signature statement of all Aboriginal health problems and solutions is complexity. Problems and potential portrayed simply as "black vs white", "left vs right" or "practical vs symbolic" trivialise and mask significant complexity in this work. Below, we examine the NT Intervention from a range of standpoints.

A Law and Order Standpoint

Consistent reports of family violence and child abuse in Aboriginal communities over the past decade have prompted numerous inquiries and more than one national summit on Indigenous Family Violence. Many of these reports link alcohol and drug abuse to family violence. There can be no doubt that the wellbeing of some mothers and their children are at high levels of risk. The extent to which this is an "Emergency" justifying actions exempt from the Racial Discrimination Act and true everywhere in the NT, as portrayed by Mal Brough, the Minister of Indigenous Affairs, is certainly questionable. The Little Children are Sacred Report contained many shocking descriptive qualitative accounts of instances of child sexual abuse in Aboriginal communities. It also employed some highly evocative language describing "rivers of grog." However, the NT is one jurisdiction that does have good population health data on Aboriginal Australians and report provided no information regarding the incidence or prevalence of notifications of child abuse on a population basis. Nevertheless, where mothers and children are known to be at risk, the deployment of the police and the army to establish "stability' in these areas may be reasonable. Still, given the history of the relationships between Aboriginal people and police in this country, there is a question concerning the ability of police with limited training to undertake the duties assigned them.

A Pragmatic Standpoint

Marcia Langton makes the point that the recommendations of the Little Children are Sacred Report in large part repeat the recommendations of the 1991 Royal Commission into Aboriginal Deaths in Custody (RCIADIC) regarding the "Underlying Issues." However, very little funding or resources were forthcoming for addressing these recommendations of the RCIADIC over the next decade. Therefore, the NT Intervention with a funding appropriation of over $540m to address issues of housing, education, employment, access to health services, policing and infrastructure development represents a rare opportunity for substantial development to occur.

An Economic Standpoint

The cost of the NT Intervention is another angle from which to view it. The intervention is focused upon just 10% of the Australian Aboriginal population. All the data suggests that Aboriginal people in urban and rural areas suffer the same hardships as Aboriginal people in more remote parts of Australia. The Australian Medical Association suggests that $450m targeted on health service provision to all Aboriginal Australians would go a substantial way towards reducing health inequalities nationally between Indigenous and non-Indigenous Australians. Is the $540m appropriated to the NT Intervention to be mirrored elsewhere for the benefit of Aboriginal people? To what extent are the issues in other jurisdictions to be addressed?

Of equal concern from an economic standpoint is the opportunity cost of this intervention should it fail? To allocate $540m to an intervention that may people see as inappropriate, disrespectful, wrongly formulated and lacking on-the-ground support highlights the possibility that few sustainable changes will result from the intervention (link to more information). Should this be the case who will shoulder the blame and to what extent will the Australian Government be likely to make such a commitment to ending Aboriginal disadvantage in the future.

Human Rights Standpoint

A key component of the Northern Territory National Emergency Response Bill is its exemption from the Racial Discrimination Act. Under this exemption, the legislation authorises the quarantining of 50% of the social security payments to all Aboriginal people in the Northern Territory. This is not the case for non-Aboriginal recipients of social security payments. Whereas non-Aboriginal people can appeal decisions made by Centrelink about apportioning their social security payments in particular ways, Aboriginal Australians covered by the NT Intervention legislation have no such rights. The Aboriginal Torres Strait Islander Social Justice opposes the exemption from the Racial Discrimination Act (see here).

Political Economy Standpoint

The impacts of the global economy can be factored into an analysis of the NT Intervention. The impact of "peak oil" and global warning means that alternative forms of carbon-neutral energy are required, with nuclear energy receiving considerable press as a carbon neutral option. Australia holds an estimated 45% of the world known uranium reserves and a substantial portion of these are on land held by Aboriginal groups under the NT Land Rights Act. Furthermore, the storage of nuclear waste in the remote Northern Territory on Aboriginal land is proposed. The historical context includes a sustained twenty-five year history of pressure by mining companies and their peak industry councils to open up Aboriginal land to uranium mining. In this context, the compulsory acquisition of Aboriginal land and the scrapping of the permit system as key plank of an intervention supposedly directed towards overcoming child sexual abuse cannot help to raise eyebrows. Helen Caldicott raises the kinds o questions on her website. Likewise the Greens in their dissenting report on the land provisions in the legislation described the powers ascribed to the Minister as unprecedented and an undermining of parliamentary oversight.

A Public Health Practitioner Standpoint

Fran Baum describes Pat Anderson and Rex Wild the authors of The Little are Children are Sacred report as recommending "a thoughtful consultative process that stands some chance of achieving meaningful change. [The report] recognised that there has to be change but that this was likely only if Aboriginal people are listened to and respected — the basis of any functional relationship". She goes further to suggest that "the intervention stands a very good chance of being detrimental to the health of Aboriginal people and their communities... A consistent message from the evidence is that when you rob people of control over their lives, it is uniformly bad for their health, whether they be British civil servants or Indian women living in slums." (Baum's article). Fran and other like-minded observers suggest that it is impossible to implement any meaningful intervention that has a chance of success unless the people for whom the intervention is supposed to benefit are engaged in the development of the project.

An Indigenous Health Practitioner Standpoint

The Australian Indigenous Doctors Association (AIDA) makes the point in their submission to the Senate Inquiry into the legislation that much wisdom has been gained over the past thirty years about effective and appropriate health interventions that work in Aboriginal communities. AIDA suggests that the NT Intervention seems to be ignoring the knowledge and skills that already exist in the Indigenous health workforce (see here for more information).

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