Policy futures: A reform agenda

By Winston Churchill Trust

November 9, 2022

The Policy Impact Program is a partnership between The Winston Churchill Trust and The University of Queensland. It aims to help Churchill Fellows draw upon the international knowledge they gain on their Fellowships to best inform policy reform in Australia.

Policy Futures: A Reform Agenda is the Program’s flagship publication which combines some of the best of the Churchill Fellows’ insights with the policy and governance expertise of The University of Queensland’s Centre for Policy Futures.

Professor Thomas Edwin Calma, AO, co-Patron of The Winston Churchill Trust, said:

“Policy Futures second issue includes four Churchill Fellow-developed reform agendas that have the potential to not only transform many Indigenous peoples’ lives for the better, but also support Australian Governments to achieve the 2020 National Agreement on Closing the Gap targets.”

This article introduces the work of four Fellows who explored key Indigenous Closing the Gap issues, demonstrating that a focus on health, housing, criminal justice and entrepreneurial policy change can deliver a multi-pronged solution.


It’s time to treat sick kids, not punish them

By Clement Ng

Almost 95% of children in Northern Territory detention are Indigenous, and research suggests that effective strategies that improve the mental health of First Nations young people will reduce their criminalisation and in turn, their over-representation.

The Royal Commission and Board of Inquiry into the Protection and Detention of Children in the Northern Territory (Royal Commission) found 56% of children who gave evidence about their experience in youth detention had a history of self-harm and/or suicidal ideation.

Further, justice-involved children are more likely to receive more than one mental health diagnosis or suffer from a dual diagnosis of mental health and substance misuse.

Unfortunately, the current funding the NT receives for mental health services per capita is the lowest in the country and none of the community mental health services at present have capacity to meet demand.

Policy recommendations:

  • Pilot a youth mental health diversion list in the Northern Territory.
  • Involve Aboriginal Community-Controlled Health Organisations (ACCHOs) to co-design and deliver holistic community mental health services.

First Nations First: Targeted investment to grow a dynamic and sustainable First Nations fashion sector

By Belinda Cook

There are increasing numbers of First Nations-owned fashion brands and related businesses developing a First Nations fashion sector within the broader fashion industry.

Evidence shows participation in arts and culture supports outcomes across the Closing the Gap framework. Fashion is a highly visible platform for young First Nations people to see First Nations role models and the celebration of culture.

However, broader industry funding is not reaching the First Nations fashion sector, despite its potential value of over $800 million. This is a growth sector lacking recognition on a policy level, needing government investment directed specifically to First Nations programs.

Australia Council created the Flourish Fund, a First Nations fashion specific funding program in 2022. A sum of $500,000 was distributed to 21 successful applicants. This national funding approach should be permanently established with increased investment and replicated at State level.

Policy recommendations:

  • Recognise the First Nations fashion sector’s value and strategically invest in its future.
  • Invest in a federally funded First Nations fashion sector grant scheme.
  • Commit to First Nations culture and leadership and action recommendations to recognise ICIP in law.
  • Increase First Nations Australians’ access to education and training, manufacturing, and fashion business development.

Safe, healthy and thriving

By Niroshini Kennedy

Aboriginal children represent one third of children in out-of-home care (OoHC), even though they account for only 5.9% of Australia’s children. They are more than ten times more likely to be in care than non-Aboriginal children, and numbers are rising.

The paediatric clinic at the Victorian Aboriginal Health Service where I have worked for more than eight years, has functioned as a defacto OoHC clinic despite limited funding. More than half of our patients are in OoHC. This is because it is seen as a culturally safe service.

However, a recent Victorian study found that less than one per cent of children in state care received health care in accordance with national guidelines.

Children with undiagnosed health and neuro-developmental problems remain in the system. An inquiry found that two-thirds of Aboriginal children in Victoria’s youth justice system had been in OoHC. Late intervention in the OoHC sector is estimated to cost Australia $5.9 billion annually.

Early intervention saves lives and money. The current system is failing these children by not identifying their needs early and not providing multidisciplinary and integrated health and wellbeing services that wrap around the child and family.

Policy recommendations:

  • The Australian Government should develop a national health and wellbeing action plan for children in out-of-home care to mandate health assessments and accompany Safe and Supported: The National Framework for Protecting Australia’s Children 2021-2031.
  • The Australian Government should develop specialised multidisciplinary Integrated Care hubs for vulnerable children to deliver integrated, culturally safe health and wrap-around services.

Healthy housing programs

By Maida Stewart

Australia has one of the highest rates of acute rheumatic fever (ARF) in the world – a condition almost exclusively seen in its First Nations people. ARF is caused by Streptococcal A (Strep A) throat and skin infections that can trigger an autoimmune response, leading to an episode of ARF.

Strep A infections are more common in crowded environments with limited access to health hardware. Recurring Strep A infections and episodes of ARF can lead to valvular damage of the heart known as rheumatic heart disease (RHD). RHD causes heart failure and premature death.

The Australian Institute of Health and Welfare reports that the number and rate of notifications increased from 424 (60 per 100,000) in 2016, to 521 (69 per 100,000) in 2020. If no action is taken to eliminate ARF and RHD, more than 8,000 more people will develop RHD by 2031, accruing at least $344 million in direct health care costs.

New Zealand Government’s Healthy Homes Initiative has been credited with around 1,533 prevented hospital admissions, 9,443 fewer GP visits, 6,101 hospitalisations of reduced severity, and 8,764 less pharmaceuticals dispensed.

Policy recommendations:

  • The National Indigenous Australians Agency (NIAA) and the Department of Health and Aged Care (DoHAC) should lead the development of a National Aboriginal and Torres Strait Islander Housing and environmental health strategy, in partnership with First Nations communities and peak Aboriginal health and housing organisations, that focuses on place-based housing solutions.
  • The NIAA and DoHAC should work in partnership with peak Aboriginal and Torres Strait Islander health and housing organisations, and communities with high rates of ARF, to develop and implement sustainable healthy housing programs.

The full policy articles for these Churchill Fellows along with others will feature in Policy Futures: A Reform Agenda Issue 2, launching on November 30. Learn more, receive a copy or request a policy presentation by our Fellows.

https://www.youtube.com/watch?v=lB6NFLlS4lY

 

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