Mr Howard, Mr Brough and Australia's Aborigines - 5: Policy and Administrative Issues

Preamble: I wrote this post over a number of days. As I did I became more depressed to the point that I thought that I had best give it away. Then yesterday (17 July) I was further depressed by a piece written by Joel Gibson in the Sydney Morning Herald in advance of the Four Corner's story on Noel Pearson and Cape York. 

I missed the Four Corner's Program, but was later able to read a transcript. I also watched on-line, transfixed, the longer segment of Mr Pearson addressing the community at Hope Vale. You can find both here. I do recommend that you watch Mr Pearson speak. He is a quite inspirational stump orator of a type no longer common in these TV dominated, short soundbite, days. Certainly he inspired me. 

I do not want to write anymore on the NT issue. It's not just depression. Watching Mr Pearson reminded me again of how little I know about the complexity of indigenous life. In the past I did read all the earlier anthropological material. as well as some of the history of Australia's northern indigenous peoples. But I simply do not understand all the complexities involved, nor do I think that I can contribute much to a public discussion where my views (at least as I see it) are too far outside the dominant mind sets. 

I do still feel that I can write on New England indigenous issues. Here I know and love the country. Here, too, I have much greater understanding of the pattern of indigenous life over geography and time. I can also put it into a historical context that I do understand. So I can do something useful by making information available (a real gap), by discussing issues, by presenting the New England story. 

So while I have let the post stand, I will come back to the NT issue if and only if I have something really useful that I can say.

While I have great respect for the views of Marcel Proust, marcellous, I greeted his post on the Commonwealth Government's intervention in Northern Territory Aboriginal communities with some concern.
As with all his pieces, it is thoughtful and well written. The quote from and link through to Jack Waterford's piece on Fred Hollows and the National Trachoma and Eye Health Program are very worthwhile. Why, then, did I read the piece with some concern? I quote:

So I have watched with dismay as Mr Howard has garnered approval for the government’s latest initiatives in relation to Aboriginal communities in the Northern Territory. My own view is that the approval which Howard has won is very much akin to the public approval for “law and order”campaigns. Part of the reason for such approval is that everybody thinks that the target of such campaign is a “them” or “other” without really contemplating the systemic harm that such campaigns do to the legal system as it operates for everybody. In the case of law and order, the them is those “crims;” in this case it is aborigines. That is why in the end I am also sorry to say that the approval is ultimately grounded in a kind of racism, because aborigines are so readily the “them” in this equation.

I agree with Marcel's general point on the law and order issue. I do not agree with the subsequent link to racism. I think that this is wrong.

To my mind, it does an injustice to the public response, including the hundreds of professionals who have volunteered support driven by motives very similar to those who supported the National Trachoma Program. It also does an injustice to Mr Brough whose personal passion for change is now, I think, well established.

The Federal Government's response is flawed, perhaps fatally so But so, too, is the reaction to it, locked into a mindset that is damaging and denigrating to all of Australia's indigenous peoples - Aboriginal and Torres Strait Islanders - and which also plays to political forces in the indigenous communities that we (the broader Australian community) have helped create.

These are strong claims, likely to raise blood pressures. In this post I want to explain the reasons for my conclusions as simply and as clearly as I can, drawing on the many posts I have written on indigenous issues to try to clarify my own thinking.

To any indigenous readers, in all my writings I have tried to be careful to make it clear that I am writing as an outsider, a non-indigenous observer.

I cannot comment on the detail of particular indigenous communities because I do not know them, just as I am careful in my comments about other communities that I do not know.

I can comment on policy issues because of my policy expertise. I can also comment on issues associated with indigenous history and culture where I have researched the matter and can give my sources.

Perhaps most importantly of all, I write from the perspective of someone who thinks that our indigenous peoples have actually done bloody well in working their way up from a position of huge social deprivation and find it sad to see this achievement tarnished, as it has been in recent years' by an overwhelming focus on failures. To my mind, we need to focus on building on successes.

Take just one measure to illustrate my point.

When I first heard Charles Perkins speak at the University of New England in 1964or 65, he was I think the first indigenous university graduate.That was only 42 years ago.

In 2004-2005, there were 9,100 indigenous people studying at university or some other form of higher educational institution. A further 20,100 were engaged in some form of post secondary study (TAFE, business college, skill center etc). In that year, 53,400 indigenous people (20.8 per cent) held a qualification at Certificate III level or higher.

For those who are interested, you can follow up these numbers and more in the June 2007 Productivity Commission Report Overcoming Indigenous Disadvantage Key Indicators 2007.

Now you can cut these numbers in two ways. You can do as I have just done and look back to see substantial progress. Or you can compare the numbers with broader Australian community averages. This shows that there is some distance still to go.

But whichever way you go, this level of educational participation is a far remove from the world that Charles Perkins described in a hot room in the UNE Union all those years ago.

Moving forward, I now want to do three things.

First, I want to outline what I see as the three core reasons for policy failure when it comes to the various initiatives that have attempted to address the needs of our indigenous people.

Secondly, I will use the eye care case as a case study to illustrate some of the points because this is an area where I have a degree of personal knowledge.

Finally, I will point to some of the problems and confusions in the Government's Northern Territory intervention, including some thinking that I have done since my last post on this topic.

Reasons for Policy Failure

Gillian Cowlishaw, to my mind the pre-eminent academic analyst of race relations in Australia, contributes "Collateral Damage in the History Wars." In this essay she examines the differing but consistently negative impacts of the debate over "Aboriginal history" on the generations, old and young, of indigenous people in rural Australia who listen to representations of these history wars in the popular media. There are two sides to the debate about Aboriginal history, but neither of them takes into account the implications of their public disputations on contemporary Aboriginal lives. The older generation sees their memories of good times working on stations (for example) discredited, and their often friendly relationships with whites in those days discredited. The younger generation absorbs a message of strife, inequality, and persecution. Neither message fosters self-respect; both contribute to an understanding of Aboriginal people as passive agents, acted upon rather than acting.

This quote, taken from an extremely good post on Aboriginal Arts & Culture: an American Eye, provides a useful entry point for my remarks.In an earlier post I mentioned an article that I read in Oceania as part of my undergraduate studies on Aboriginal life. This was around the time I first heard Charles Perkins speak, and the article had a great impact on my subsequent thinking.

The article explored the relationships between views in the broader community about the Aborigines and Aboriginal views about themselves. Its core conclusion was that negative stereotypes about Aborigines held in the broader community were in fact mirrored, reflected, in Aboriginal attitudes about themselves.

This type of mirroring, reflecting behaviour is now well known.

If you tell someone that they are a failure, if you downplay their achievements, if you tell them that they are a victim, if you invalidate aspects of their past, they will finally come to believe and act in that way. That is what we have done.

Now this is just not my view. It is also a view expressed by a number of indigenous leaders.

Note that this does not mean that problems should be ignored. Rather, it is a matter of perspective.

This brings me to my second point.

Australia's indigenous people are not and never have been a single homogeneous group. They were not at the time of the arrival of the Europeans, nor are they today. There is huge variety.

I think that we all know this. Why, then, do we persist in so much language and in policy in trying to treat our indigenous peoples as though they were a single entity instead of focusing on their varying interests and needs? Not only is this disrespectful, but it is a major cause of policy failure.

Many of those involved in indigenous development have made this point.

Our Torres Strait Islanders want individual recognition for their unique features, pointing out that they are a minority in a minority in a broader community. In Cape York, Noel Pearson's concern has been to find the best way to deal with the particular problems of his own communities. Nationally, Fred Chaney has argued the need to recognise difference, as well the reasons why particular projects or negotiations have succeeded, others failed.

Note that I am not saying that we should not address specific issues on an indigenous wide basis where that is appropriate, simply that the current approach is badly flawed.

This leads me to my last and related point, one that I have made many times before, the need to carefully distinguish between indigenous issues that should properly be dealt with through indigenous policy and those issues that affect our indigenous peoples, but which properly belong to other areas.

We have a major problem at present in that policy towards our indigenous people has not only been locked into that policy ghetto called Aboriginal policy, but is also trying to deal with issues that, while they affect indigenous people, are in fact broader.

Again, I am not alone in saying this. Recently, Fred Chaney made the point that the problems faced by our rural and remote Aborigines are in part a sub-set of problems faced by all those living in these areas and cannot be addressed without action to address the broader problem.

This led him to advocate, as I have done in the case of New England's indigenous peoples, the need for effective decentralisation and action on regional development as a necessary requirement for improvement in Aboriginal conditions.

The Eye Care Case

"It's too bureaucratic, too top down, there's no plans to advance the community, 9 out of 10 houses that get built are unsuitable because of a one size fits all approach - but the current approach means that it's just easier to spend the money than to set objectives and monitor outcomes." Stakeholder feed back May 2006, Inquiry into the Community Housing and Infrastructure Program (CHIP).
"In one Western Desert Community we had 132 consultation meetings in three months ... it's a red tape nightmare". Stakeholder interview June 2006, Inquiry into the CHIP Program.

These quotes are drawn from my post on the PriceWaterhouseCoopers Inquiry into the CHIP Program. I will refer to this a little later in this section.

Australia is the only developed country in the world where blinding trachoma still exists.
We can stop this if we as a community care. Trachoma is entirely preventable. Although it disappeared from white Australia 100 years ago, it could take another century to disappear from Indigenous Australia if we do not do something about it. We can not wait that long. All Australians have the right to sight. The time to act is now. Do we have the will?

Professor Hugh Taylor, The Medical Journal of Australia, (MJA 2001; 175: 371-372).

Trachoma, sandy blight as it has been known in Australia, is a disease of slum conditions, of poor housing and hygiene. Chronic infection with the trachoma organism, Chlamydia trachomatis, can lead to blindness.

The disease was probably brought to Australia by the European settlers. The poor housing conditions of the early settlers, and the heat, dirt and flies of Australia, meant that sandy blight became widespread and well known.

By the late 1930s sandy blight had essentially disappeared even in rural areas as most Australians moved into proper housing with separate beds, running water and adequate sewerage and rubbish removal. Despite the disappearance of trachoma from most of the Australian population, it has remained prevalent among certain groups of indigenous Australians.

The late Father Frank Flynn, an Australian-born and London-trained ophthalmologist turned Catholic priest, worked as an Army chaplain in Darwin in 1941. He was the first to recognise the frequent occurrence of trachoma among indigenous people in the Northern Territory, and their welfare became his life's work.

After World War II, Ida Mann, an English ophthalmologist who had worked with Frank Flynn in London before the war, moved to Perth. She subsequently conducted extraordinary trips throughout the outback, examining and treating indigenous people with trachoma.

In the 1960s, the late Fred Hollows took up his position as Professor of Ophthalmology at the University of New South Wales and became aware of the importance of trachoma in Australia. First working with the Gurindji people at Wave Hill in the Northern Territory and then with the people around Bourke in far western New South Wales, he cajoled the Federal Government and the Royal Australian College of Ophthalmologists into establishing the National Trachoma and Eye Health Program (the "Trachoma Program").

From 1976 to 1978, the Trachoma Program teams visited every indigenous community in Australia (including some groups in large urban centres), examining over 62 000 Indigenous people and nearly 40 000 others (consisting of whites, Asians, etc, in rural and remote areas). It gave a clear picture of the number of people affected with trachoma and its distribution. They also treated nearly 40 000 people for trachoma and set up clear guidelines and recommendations as to what needed to be done to eliminate trachoma.

Jack Waterford's article referred to earlier provides a personal and graphic picture of the Trachoma Program.

Almost twenty years later, in 1996, Professor Hugh Taylor was commissioned by the Federal Minister for Health to prepare a national report into Aboriginal eye care. As part of his work, Professor Taylor visited may of the communities covered by the earlier Trachoma Program. He said later:

It was very satisfying to go back to places like Bourke and Broome and find that trachoma had essentially disappeared over the previous 20 years. Clearly, progress was being made — at least in the towns and larger communities.

In other areas, although the amount of trachoma had decreased and fewer children were affected, their elders still had scarred eyelids and blindness from the inturned eyelashes caused by trachoma.

However, I was devastated to find that in some other communities, such as Jigalong in the Western Desert, and Amata and Fregon in the Musgrave Ranges, the rates of trachoma in children had not changed one jot over the 20-year period.

Professor Taylor handed in his report to the towards the end of 1997.

The report painted a detailed picture of Aboriginal eye care problems, including the continued incidence of trachoma as well as the increased problems posed by diabetes related eye disease. The need for improved Aboriginal housing hygiene were central to his discussion of problems. Both the then Minister for Health and the Prime Minister agreed to address the need for improved eye care.

I became CEO of the Royal Australian College of Ophthalmologists at the end of 1997. Before that, I had had no knowledge of Aboriginal eye care issues. Now the first meeting that I attended was in Canberra with health officials to discuss the Taylor Report.

The College and its Fellows were very proud of the work that ophthalmologists had done and continued to do with Aboriginal communities. The College branches set up committees to develop responses, coordinated by a central committee. Bill Glasson, now an member of the Commonwealth Government's Task Force, was a key member of this central committee.

Differences between the states and territories were quickly apparent. These differences made it hard to develop a single coordinated approach.

In Victoria, for example, we had lots of ophthalmologists but very little specifically Aboriginal needs. By contrast, in the Northern Territory we had lots of need but very few ophthalmologists, so were were dependent upon the pioneering work of a few such as Dr Nitin Verma.

As an aside, Dr Verma is, I think, now in Tasmania, but has continued his work with the East Timorese, something that began while he was in Darwin and which has involved other Australian ophthalmologists including Bill Glasson.

In NSW Rosalind Hecker was commissioned by the NSW Government to prepare a follow report about NSW conditions. Her report identified pockets of need. She advised me of proposals to establish a remote area registrar position in Sydney that might then service at least the far west on a fly-in basis.

When I looked at the detail of Rosalind's report, I took a very different view, concluding that what we had was not an Aboriginal eye care problem, but a regional eye care problem with Aboriginal aspects. Solve the regional problem, and you would benefit all, while finding it easier to meet Aboriginal needs. Leave that problem un-resolved, and you were necessarily limited to partial solutions of the Sydney based fly-in specialist type.

I put forward a number of suggestions that I thought would improve regional eye care while meeting Aboriginal needs. I also thought that the time was opportune to do this, since we might be able to get money for hospital posts, always a difficulty in expanding ophthalmic training. In this context, my view was that we faced a looming shortage of ophthalmologists, one that was going to hit regional areas especially hard because so many ophthalmologists trained in Sydney and wanted to stay in that city.

My base proposal was a simple one.

To begin with, I suggested that we put a registrar training post in Tamworth. Tamworth already had a major base hospital, while there were local Fellows who could provide training, oversight and professional support. That registrar could then service Moree, an area with a population of 15,000 including a major Aboriginal population presently serviced on a fly-basis by ophthalmologists from Maitland and the Gold Coast.

I then suggested that we put a staff specialist plus a registrar at Dubbo base hospital. Dubbo, a very major regional centre, had been unable to attract an ophthalmologist despite the size of the local market and was serviced by the big ophthalmic practices in Orange. This approach would meet an already identified area of need, while the specialists in question could also more easily meet needs in the far west tha a Sydney based service.

Finally, I suggested a registrar position at Wagga Wagga base hospital. I also suggested that we look at a training network perhaps centred on Newcastle to provide an alternative to Sydney focused training, since it was clear that Sydney trained specialists were reluctant to leave the city on a long-term basis.

I thought that this proposal would meet Aboriginal eye care needs on a far more effective basis than alternative band-aid solutions, while also building regional medical services more broadly defined.

At this distance and working from memory, I do not think it fair to discuss in detail why the proposal was rejected.

Part of the reason lay in the perceived difficulty of attracting trainees and specialists to fill the posts in the first instance. Part of the reason lay in problems in providing the required on-going training support. Part, too, lay in the presence of existing interests that would be disadvantaged.

Whatever the reasons, the rejection meant that so far as NSW was concerned, Aboriginal eye car would remain in the band-aid class for the immediate future since the underlying, broader, causes of the problem were not being addressed.

I left the College at the end of 1999. In 2001 Professor Taylor complained about the treatment of his report:

.... disappointingly little has happened. In most places, little has changed, even though the problem has been clearly identified, strategies have been carefully laid out, verbal support has been given by leaders and there has been a lot of discussion with bureaucrats.
In areas with severe trachoma, one in five of the older people have inturned lashes, and about half of these are either blind already or will eventually go blind. It is a tragedy to see their children or their grandchildren suffering from trachoma infection, because you know that they are on the same escalator and will certainly suffer the same fate if things do not improve.

Now track forward six years to 2007.

In 1997 Professor Taylor had identified poor housing and hygiene as a core problem in remote communities in improving eye care in remote communities. Almost ten years later, the PriceWaterhouseCoopers report into the Commonwealth's Community Housing and Infrastructure Program cited at the start of this section provided a devastating critique of the failure to improve indigenous housing in remote communities. Now poor Aboriginal health in general has become a national scandal.

We are all to blame. I include myself in this because, pre-occupied with other College problems, I did not push the eye care issue in the way I should have when I could do something.

The Howard/Brough Intervention

The case study I have just given bears upon both my opening remarks and the Commonwealth Government's intervention.

It is now thirty years since the Trachoma Program started.This intervention had initial good results because it targeted a specific need. However, those results were only maintained where the supporting infrastructure was in place. Outside those areas, the problem persisted until today.

In considering this, we can see the way variations across country affected on-ground delivery. We are not dealing with a single uniform problem, but one displaying considerable regional variation. We can see, too, how longer term improvements in Aboriginal eye care and health more generally can be a subset of a broader problem extending beyond the Aboriginal community.

Taking all this into account, I now want to provide a consolidated assessment of the Howard/Brough intervention.

Access to Information

I have put this one first because it is central to public credibility on what is a fairly controversial initiative. If the Government is to gain and maintain support it must provide full information to the broader community.
I give the Government a fail here. Initially a wide range of information was provided so that an interested observer such as myself could access information direct. This is no longer true in that the official sites are not being updated. Now to get information I have to dig round in the media or rely on my own contacts.

Public Trust

I have put this one next because it links to to the information issue.

Based on the public opinion polls, the majority of the Australian community supports the intervention. Those strongly opposed to the Government have, as might be expected, painted this in election terms, in many cases linking it to Tampa. Many of those who have participated in past debates on policy towards our indigenous peoples have, again as might be expected, reacted strongly because the Government has tried to change the rules of the game.

A more fundamental problem for the Government is a basic lack of trust among many observers based on past Government actions. Here I am not speaking of broad policy thrusts, mainstreaming is an example, but of the cumulative effects of a series of past decisions.

As an example, I discussed the intervention with an indigenous colleague. She was negative for very different reasons from those appearing in the media.

Commenting that the Government talked about the importance of education, she went on to detail a couple of programs that had been cancelled even though (in her view) they were very effective in keeping kids at school. I had never heard of the programs so could not comment. The point is that she judged the intervention in the context of the cancellation.

Notwithstanding general public support, I give the Government a fail in the trust area for the same reason I gave it a fail on information. It has, I think, failed to realise the scale of distrust and hence the need to manage it.

Good Intent

I give the Government a strong pass in this area. I do believe that Mr Brough in particular has a passionate desire to see conditions improved.

Focus

When this whole thing started, I thought that the exclusive focus on child abuse was a mistake because it played into what has become a national pre-occupation, the obsession with child abuse. Now here I agree with Marcel. By typing things in this way, the Government turned a complex set of social and economic problems into a law and order issue.

I held off commenting because I hoped that I was wrong. My feeling was that the actual dynamics of on-ground delivery would force changes, and indeed this has happened.

Take the question of medical examinations. Within days of the announcement, Mr Abbott was qualifying the PM's original remarks, making it clear that parental consent would be required, that examination for sexual abuse was a specialist skill, that children would be given broad health screening.

I also felt from what I knew of Mr Brough, and I have actually read every press release he has put out since becoming Minister, that he had a much broader agenda focused on Aboriginal improvement.

I will now come down from the fence and give the Government a fail in this area, too, along three critical dimensions.

First, it has given our Aboriginal peoples a huge black eye. The Government's intervention was followed by action in the states as they responded to a perceived political imperative culminating the WA Halls Creek arrests.

Note that I am not making a comment on the WA Government's actions, although I do wonder why they took so long to act. All I am saying is that the combined effect is to damage the reputation of a whole people.

I keep on saying, I have done so time and time again, that our indigenous peoples are not a single uniform lot, but a group that displays at least as much variety as the Australian community as a whole. In our desire to help, in our collective obsession with child abuse, we have done them serious damage.

This brings me to my second point.

In my first post in this series I said that things would never be the same again. I was not referring just to certain of the Northern Territories indigenous communities, nor to the indigenous population, but to the whole Australian community.

The sad fact about the Commonwealth Government, one that I have mentioned before, is that it cannot tailor responses to meet particular geographic needs, but instead is forced to respond on a national basis independent of variation.

Take this case. To avoid the tag of being racist, the Government was forced to extend measures, rhetoric, to the broader Aboriginal community and then beyond. Now we have fundamental changes to our social welfare system that affect all.

I am not saying the changes are necessarily wrong, that's another issue. I am saying that universal application of changes based on perceived needs in a particular area or areas risks being badly wrong simply because needs elsewhere are likely to be different.

This bring me to my last point in this section.

By locking itself in the way it did, the Government not only gave the indigenous community a black eye, but also severely reduced the chances of achieving long term success. Crudely, it gave its opponents the chance to link everything back the single question of the reduction of child sexual abuse.

Take the issue of the permit system.

I had not focused on this issue at all. Now, having read all the arguments for and against as presented, it would take a lot to convince me that it's a good thing. Yet when I listen ito Mr Brough present his case, I know that he is in trouble simply because arguments about the permit system extend well beyond the question of child abuse as such.

Administrative Issue

As a former Commonwealth public servant I know and am interested in the fact that that an initiative of this type has to be supported by a major administrative uinderpinning if it is to work. I was especially interested in this question because of the sudden drop in the supply of information.

My feel is that the Government is in a degree of trouble here.

One difficulty is that the intervention happened so late in the Government's term of office. In addition to fueling mistrust, this has created major time pressures at a time when the detail of decision making has become more difficult because ministers are less accessible because of election pressures including travel.

A second difficulty is that the Commonwealth Public Service itself is less able to respond quickly than in the past.

My impression is that the first meeting of the high level Inter Departmental Committee set up to progress the matter ran into a degree of problems because the required information and coordination mechanisms were simply not there any more between agencies.

Staffing the Task Force also appears to have been an issue because the thinning down of the Public Service means that the required people resources are simply not readily available.

Then, too, there are major complexity issues. As an example, in trying to draft complex legislation in a short time period, the Government is reported to have put together a team of some twenty lawyers. They have to come to grips with complex issues, create a common understanding, avoid mistakes and all in a far shorter period than would normally be the case.

These are an outsider's views. But the problems are clearly substantial
.
The Government now has a maximum of around three months left before it goes into caretaker mode. Only so much can be done in this time.

My hope, and I suspect Mr Brough's too, is that what is done during this period will have sufficient depth and substance to provide a base for the Government's successor to carry work forward. My concern is that pressure and polarised views may make this impossible.