Generation to Close the Gap?

At the heart of this nation, there is a fundamental wrong in the relationship between the First Peoples and non-Indigenous people.

We are divided between those who celebrate Australia Day without any thought of the implications of that day, and those who mourn Invasion Day and mark it as Survival Day, those for whom racism is an abstract noun, and those for whom racism is a concrete daily reality.

There is yet another division.

It's the entrenched Indigenous health crisis that separates those who can enjoy good health in their golden years from those who die 10 to 17 years younger.

The denial of these basic human rights to equality and dignity were why we heard a rallying cry 10 years ago from the then Aboriginal and Torres Strait Islander social justice commissioner Tom Calma to achieve Aboriginal and Torres Strait Islander health equality within a generation.

He said in 2005, when launching his Social Justice Report, that "it is not credible to suggest that one of the wealthiest nations in the world cannot solve a health crisis affecting less than 3 per cent of its citizens". This call to action led to the establishment of the close the gap Campaign.

Next month marks the 10-year anniversary of our campaign.

Made up of more than 20 Indigenous and non-Indigenous organisations, and supported by more than 200,000 Australians, the goal is to achieve Aboriginal and Torres Strait Islander health equality by 2030. In other words, to "close the gap" within a generation.

So what has been achieved in a decade? We had a major breakthrough in 2008 when all sides of politics came together to sign the close the gap Statement of Intent, a commitment by all governments through COAG to achieving Aboriginal and Torres Strait Islander health equality.

This was followed by funding of $1.6 billion committed over four years to tackle the crisis.

Since 2009, we have seen improvements in infant and child health outcomes, a gradual closing of the gap in smoking rates, significant increases to the number of health checks and increased access to medicines due to higher levels of resourcing to the Aboriginal and Torres Strait Islander health sector.

But the long-term impact of such improvements on adult health and life expectancy is yet to be seen, with a life expectancy of 69.1 years for Indigenous men being nearly 10 years lower than for non-Indigenous men, and a life expectancy of 73.7 years for Indigenous women being nearly 9.4 years lower than for nonindigenous women. We know that it takes time to design, deliver and evaluate health programs.

Similarly, it will take time for health improvements to become evident. TS Eliot once said that "between the idea and the reality . falls the shadow". For Aboriginal and Torres Strait Islander peoples, that shadow too often takes the form of a cloudy spot on an X-ray, a diabetes diagnosis or a disrespectful or racist encounter at a hospital reception desk.

It is the shadow that falls between a handshake or the signing of a statement, and a budgeting decision by a treasurer.
Closing the Gap and moving out of the shadow require long-term, concerted efforts and respectful relationships between government and our people. It requires strong leadership from Aboriginal and Torres Strait Islander people, and buy-in from our communities.

This has been exemplified by the nation's high-level body for Aboriginal and Torres Strait Islander peak health organisations, the National Health Leadership Forum, which has pushed for action on health inequality and worked with government to guide future directions.

Their hard work in partnership with the Australian government led to last year's launch of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan (2013-2023). The implementation plan will reinvigorate efforts to close the health gap through identifying core service models and service gaps, workforce requirements and funding mechanisms, reducing racism and highlighting the importance of culture to improved health outcomes. But a plan without appropriate resourcing cannot address the appalling life expectancy gap.

It is imperative the government provides appropriate funding for the implementation plan in the 2016 budget.

Specifically, there needs to be an overall increase in resources directed towards Aboriginal and Torres Strait Islander health - in proportion to population size, service need and demand. This is vital, given the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes expired in 2014, and funding under that agreement has finished.

What's heartening is that Australians are, in ever increasing numbers, demanding decisive action to support achieving Aboriginal and Torres Strait Islander health equality by 2030. It is clear this generation of Australians wants to see their governments make good on the commitments made back in 2008.

Health inequality has been described as a stain on our nation.

This generation knows it has the opportunity, and responsibility, to remove it. The message is clear.

We must be the generation that closes the gap.

This opinon piece is co-written by the Aboriginal and Torres Strait Islander Social Justice Commissioner, Mick Gooda, who is also co-chair of the close the gap Campaign; and Dr Jackie Huggins, who is is co-chair of the National Congress of Australia's First Peoples and co-chair of the close the gap Campaign.