Minister for Health and Aged Care – press conference in Adelaide – 27 September 2023

Read the transcript of Minister Butler's press conference about a Voice to Parliament, funding for Australian Indigenous Doctors Association, Australia’s health system; Qatar; Timor Leste and China; South Australian Voice to Parliament.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MINISTER FOR FOREIGN AFFAIRS, SENATOR PENNY WONG: Thanks for being here. It's great to be here at the Aboriginal Health Service Hillcrest. And I want to thank staff for hosting us today and for talking to us about the work that they do. I'm here with Tony Zappia, the Member for Makin; with Mark Butler, the Federal Minister for Health and; with Kyam Maher, relevantly, Minister for Aboriginal Affairs. And we're here to – Mark will be making an announcement shortly – but we're here to talk to people who work here about why this service matters and why consultation matters.

We know that Aboriginal Torres Strait Islander Australians have far worse outcomes than non-Aboriginal Australians. We know that an Aboriginal kid in this country is more likely to die before their second birthday. We know that suicide rates are almost twice as high. And we know that Aboriginal and Torres Strait Islander Australians don’t live as long. This is one of the disadvantages that we are trying to address, not just through the programs that we put in place, but through the Voice to the Parliament and to the Government.

The Voice is ultimately about listening. And one of the things that I spoke with a couple of the workers about today was how they construct their programs so that they deliver. What they were speaking to me about is: it's about consultation, it's about engagement. They try to design their programs and deliver their programs in consultation with community. That's what we need more broadly across this country. But we need to try and close the gap so that we don't have Aboriginal children more likely to die before their second birthday.

I know this is a very loud campaign at times. I know that Australians have got a lot of politics being played out. What I'd say is, open your hearts and listen. Listen to what Aboriginal and Torres Strait Islander Australians are saying. They're asking to be listened to. They’re asking for recognition and respect. They want the opportunity to try and improve the lives of their children.

MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thank you Penny. And I want to echo Penny's thank you to the staff at Maringga Turtpandi here, which is one of the four clinics that Watto Purrunna run, a state government Aboriginal Health Service here in Adelaide. And I'm delighted to call them out as the 2023 College of General Practice ‘General Practice of the Year,’ which I think gives you a sense of the quality of the service that they provide to around 12,000 Aboriginal South Australians who live in the north-eastern suburbs of Adelaide. As Penny says, there is no area of policy where a Voice from Aboriginal and Torres Strait Islander people would be more valuable than in health. Because we know, year after year, the reports are provided to Parliament since 2008 spell out in awful detail the yawning gap in health outcomes and life expectancy between Indigenous Australians and non-Indigenous Australians.

And with the best of intentions from governments of both political persuasions at state and federal level, with enormous investment and with the terrific work of Community Controlled Aboriginal medical services and government funded Aboriginal services like this one, here. We have to admit the current approach just isn't working. Because not only is the gap not closing, in some very important areas that gap is actually getting wider – the health gap between Indigenous and non-Indigenous Australians.

That is why on Monday, more than 125 health organisations – pretty much every serious health organisation in the country – signed their name to an open letter expressing their support for the referendum on the 14th of October. Because they work on the frontline, and they know the appalling gap between health outcomes and life expectancy between Indigenous and non-Indigenous Australians. They also know as health professionals, that as doctors, as health professionals, you listen carefully to your patient. You listen carefully to what they're describing, as you think about the best possible course of treatment. And just as a good doctor listens to their patient, a good government, a wise Parliament, should be listening to the voice of Aboriginal and Torres Strait Islander people more closely, more comprehensively than we've been doing to date - if we are going to make real inroads into closing the gap, particularly in health, but in other areas of policy, as well.

Now, there is a range of very good measures in Aboriginal health that our government has been funding and have been going for some years that are making some inroads. And I want to announce today that our government will be providing $900,000 in funding to the Indigenous Doctors Association, to continue their terrific program to provide cultural support to Indigenous doctors doing their specialist training – their non-GP specialist training. This will continue to build the Indigenous health workforce – Indigenous doctors, Indigenous nurses and midwives, Aboriginal Health Workers and Aboriginal health practitioners and many other disciplines besides – are building the Aboriginal health capacity that we see at this terrific practice here. Which is exactly why every Aboriginal Medical Service I go to around the country is reporting a very fast increase in their patient numbers, because they know that they are providing the culturally safe or culturally sensitive health care that Aboriginal and Torres Strait Islander people need. But we need to learn from examples like this one – a ‘General Practice of the Year’ here in South Australia and mainstream it and scale it up across the country. And the only way we're going to be able to do that is to have a Voice to Parliament, constitutionally enshrined, where the government and the Parliament listen carefully to that Voice, in the same way a good doctor listens carefully to their patients. Really glad to be here with the State Attorney General and Minister for Aboriginal Affairs. And we’ll ask Kyam to say a few words before we take your questions.

SOUTH AUSTRALIAN MINISTER FOR ABORIGINAL AFFAIRS KYAM MAHER: Thank you. And it's a pleasure to be here today on a sunny day on Kaurna Yerta and Maringga Turtpandi. And being here today reminds us of the importance of the vote that we as a country are facing in just over two weeks’ time. In just over two weeks, we collectively will get to shape the future of our nation, we will decide whether we recognise the oldest living culture and its people in the birth certificate of our country, the Constitution, and whether we create a body that allows Aboriginal and Torres Strait Islander people to have more of a say in the decisions that affect their lives. And there couldn't be a more appropriate place than an Aboriginal Health Service to be talking about that today.

As Mark Butler outlined, the life outcomes for Aboriginal and Torres Strait Islander Australians fall well below, I think, what we expect. A statistic I saw published a few years ago, had the average life expectancy of a man born on the APY Lands in South Australia at 48 years. In a state, in a nation as prosperous as this, we know something's going wrong when you see those statistics. For the history of this nation, for 235 years, governments and the colonial institutions that preceded it, have struggled to listen to Aboriginal people. Struggled to listen to Aboriginal people and to make effective change. We see this manifested in the closing the gap reports that are handed down every single year. And as more than 125 medical and health organisations – who understand the need to listen to people who you're providing services for – have said 'a Yes vote will create a Voice that will help governments do better'.

It will have governments do better, not just in health outcomes, but in in a whole range of outcomes: in educational outcomes, in job outcomes, in child protection and criminal justice outcomes. Before coming here today, I spent some time with a whole lot of leaders from different Native Title bodies right around South Australia. And universally, these leaders talked about the benefits a Yes vote will bring. It will help governments to make decisions so that they don't do things to Aboriginal people, but with Aboriginal people, to make better decisions. A Yes vote will help governments do better.

JOURNALIST: Can you describe how some of this funding will be used?

BUTLER: This will be a grant provided to the Indigenous Doctors Association. They've already been providing this culturally safe mentoring support to Indigenous doctors then wanting to do their non-GP specialist training. We know that providing that additional cultural and mentoring support vastly improves retention and completion rates. Based on the work that the Indigenous Doctors Association has been already doing in this area, we've decided to extend that funding arrangement.

JOURNALIST: Minister, we know earlier in the year that National Cabinet flagged the intention of holding a specialist meeting with regards to health in the second half of 2023. How significant is that particular gathering of national leaders going to be for the future Australia's health system, and can we look forward to any serious structural reforms off the back of that gathering?

BUTLER: That's obviously a matter for the Prime Minister, Premiers, and Chief Ministers. I know the Prime Minister has reiterated a number of times that his intention that the last National Cabinet meeting of this year, which I think is still to be scheduled, but likely in November, will be devoted, in large part, to health reform. There has been substantial work that state governments, territory governments and the Commonwealth have been doing over the course of this year, to find areas of common agreement that we can work on together. I think what's been really refreshing about debate at government level around health this year has been governments coming out of their traditional trenches: where state governments ask the Commonwealth for more money for hospital funding, and the Commonwealth expect states do A, B and C in hospital performance. Instead, we've seen an identification of areas where we can work together, particularly the areas of interface between traditional funding for Commonwealth like aged care and disabilities, primary care, which have been areas of Commonwealth responsibility for a long time. And the hospital system, which despite it being co-funded by the Commonwealth, is obviously operated by states. There's a lot of work happening behind the scenes by all levels of government to make sure that the meeting towards the end of the year of National Cabinet is a productive one. As the Federal Health Minister, and I think my state and territory colleagues share this view, we've been enormously gratified by the level of interest taken by First Ministers in the important area of health.

JOURNALIST: Do you also think it speaks to governments around the country acknowledging the size, the challenge, that lays before them and the need for some serious change to be rolled out?BUTLER: Every health system around the world, particular

ly in developed economies to which we'd usually compare ourselves, are under enormous strain after three and a half years of a once-in-a-century pandemic. There's obviously the direct impact of the pandemic, which has exhausted and in some areas, literally traumatised the health workforce, working in the health system. We also know that as a result of the pandemic, and responses like lockdowns and such, a lot of people deferred the care that they should have been getting for their non-COVID conditions. We've seen a rise in acuity for a whole range of physical conditions, not just here in Australia, but right around the world. We've seen a long tail in mental health impacts from COVID. All levels of government recognise our health system is under enormous strain. We're seeing that right around the world. It's going to take a while to get through the legacy of COVID, even though the emergency phase of the pandemic is behind us, and governments have learned through the COVID pandemic, of the need to work together. So to get out of the trenches, which has been a hallmark in many years past of health discussions, and recognise the need and the value of working together. I think you'll see that at the National Cabinet meeting later this yea

JOURNALIST: Minister, have you had any approaches from Qatar?

WONG: I think everybody knows that Qatar Airways has a strong commercial interest in increasing the number of slots – as every airline has an interest in increasing their number of slots. Obviously, I've engaged with Qatar as has been made public on a number of issues. I don’t think it's a secret that they obviously would prefer to have the commercial benefit of more services.

JOURNALIST: Can I get you to turn your attention to Timor Leste and China. When did the Australian Government learn of Timor Leste’s decision to sign a strategic partnership with Beijing? Was it before or after it was announced?

WONG: I’ll make a couple of comments about that. I saw Senator Birmingham's criticism of this and I have to say I thought was pretty amazing, from a government that barely engaged with Timor Leste, to have a go at this government. I've been to Timor Leste twice. I've appointed Steve Bracks as a Special Envoy to try and unlock the Greater Sunrise project, which is their key project. I've met last week with my counterpart. I would make the point that we have a comprehensive strategic partnership with China. Australia has a comprehensive strategic partnership with China. Senator Birmingham should actually perhaps look at the years of neglect and disrespect of production and development, which his party presided over, which left a vacuum and obviously others have filled it. We are in an era now with much more intense competition in the Pacific. I’ve made that very clear. We are engaging. I would note that President Horta, who I've had a number of engagements with, but also briefly caught up with in New York, just a few days ago, has made clear that Timor Leste is not seeking to align with China.

JOURNALIST: Prime Minister Gusmao has invited Chinese investment in infrastructure resources and food security, as well as more regular military contact and this agreement make a semi-permanent Chinese military presence in the country?

WONG: That’s a big leap. I understand Timor Leste’s desire for development. And if any of the politicians throwing criticism have been there, they would know the level of development in that country is unacceptable. Their leaders desperately want to improve the lives and health outcomes of their people. We want to work with them to do that.

JOURNALIST: You mentioned the Greater Sunrise project, considering this agreement between Timor Leste and China, should that process be expedited?

WONG: That's what we've been doing for about a year. This project has been stuck for nine years under the previous government. I said about a year ago that I want the project unstuck. I appointed Steve Bracks, who is a very long-standing supporter of Timor Leste. He has very strong relationships with those who are Members of Parliament now, particularly Prime Minister Gusmao. He’s engaged in a discussion about how we proceed with that project.

JOURNALIST: You mentioned obviously Pacific Island nations, has Australia lodged any complaints with regards to the Solomon Islands address to the UN last week?

WONG: No, that's a matter for Prime Minister Sogavare what he wishes to say to the United Nations. What Australia says to the UN General Assembly is contained in my speech and I'm very happy for you to take the time to have a read of it.

JOURNALIST: Attorney General have you read the Auditor-General's report that was tabled in Parliament yesterday with regards to his desire to access cabinet documents and have that privilege legislated?

MAHER: Yeah, I hadn't seen it before. But obviously when it was tabled and distributed to parliamentarians, I saw it.

JOURNALIST: What's your take?


MAHER: the Auditor-General has views that are often well known and much of what's in the report has been previously ventilated by the Auditor-General.

JOURNALIST: Does the state government have a problem with transparency?

MAHER: Absolutely not. The state government is doing what governments of all persuasions have done in the past, particularly with things like when there's a request for cabinet documents, it’s considered on a case-by-case basis. That's what previous governments have done. That's what this government has done.

JOURNALIST: And previous governments of both persuasions have given the Auditor-General access to cabinet documents in the past. So why hasn’t this government?

MAHER: We will consider it, as other governments have done on a case-by-case basis.

JOURNALIST: But it's the problem here that the Auditor-General has flagged he hasn't been able to see documents relating to more than $18 billion worth of state and federal government funding for projects – two projects in particular – should he be granted access to see those documents as he has previously?

MAHER: As I've said, Rory, previous governments have done what we're doing on a case-by-case basis, they will decide what to do when the Auditor-General requests cabinet documents, previous governments have done that, Liberal governments and Labor governments. And that's what we will continue to do.

JOURNALIST: Attorney General, the Greens are set to move a motion in the upper house today to disallow regulations that would have young people detained in adult facilities, what’s the government’s take on that?

MAHER: We will have a look at that. And we're always open in a dialogue with the Greens to looking how we improve the criminal justice system as it pertains to young people. One of the Greens have also moved amendments to raise the minimum age of criminal responsibility. And that's something that as a government, we are seriously considering. We're doing the last body of work in relation to if there was the raising of the age of criminal responsibility, if it wasn't a criminal justice intervention, what sort of intervention – a therapeutic, a family support intervention – and that work in South Australia continues.

JOURNALIST: A lot of Aboriginal organisations and leaders have been calling for the criminal age to be lifted for some time. With the Voice to Parliament referendum coming up. Do you see that pressure growing for governments to act?

MAHER: I've had representations from many organisations, and many organisations that represent the interests of Aboriginal peoples, families and children. And that is why we are doing that body of work in South Australia.

JOURNALIST: Just on the South Australian Voice to Parliament, can you provide an update on where things are headed – the election still planned to be in March and what work is underway to prepare for that?

MAHER: Yeah, absolutely. So, our South Australian First Nations Voice to Parliament legislation passed earlier this year in March, the first elections for that body are scheduled for Saturday the 16th of March, next year. The Electoral Commissioner in conjunction with the Commissioner for First Nations Voice, Dale Agius has already done a significant amount of work in preparation for those elections. And once we pass this referendum, that work will intensify. There'll be education and publicity campaigns ahead of nominations and those first elections in March next year.

JOURNALIST: Can I just get you on ICAC, we obviously saw Ann Vanstone’s response to Philip Strickland's review tabled in parliament yesterday. Strickland is set to hand down his annual report in coming days. Has your department done any preliminary works as to potential changes legislative wise for the ICAC Act that might be required?

MAHER: We've had representations from a number of integrity agencies, certainly from the ICAC Commissioner, previously from the ombudsman, from the Office of Public Integrity, and we're expecting now some thoughts to be put forward by Phil Strickland in his first annual report that is expected in the coming weeks. We will consider all those once we have them and see if any changes are needed. But of course, there were comprehensive changes made a couple of years ago, so we will see.

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