Tuesday, 29 October 2024

First Nations health care

Sarah MANSFIELD (Western Victoria) (22:06): (1209) My adjournment matter is for the Minister for Health, and the action I am seeking is that her department works with Aboriginal community controlled health organisations to overhaul the current funding model and establish a long-term block funding mechanism. Last week delegates from across Victoria’s ACCHOs came to Parliament to launch their model of health care. I was honoured to sit amongst these community champions and yarn about the important work that they do, their successes and the difficulties they face in maintaining these services. ACCHOs take a truly integrated and holistic approach to health and wellbeing. Our First Peoples understood the so-called ‘social determinants of health’ tens of thousands of years before they were coined by colonial academics. ACCHOs approach to health care reflects First People’s understanding of health and wellbeing as not only a physical state but one of emotional safety, spiritual strength and connection to place and to community.

But overwhelmingly, I heard of a funding model that is not fit for purpose because each person’s needs are different; they need different supports to be well. Perhaps they need housing support, mental health care, vaccinations and dietitian support. Perhaps they need midwifery, dental care and transport. But the siloed nature of government departments and funding does not recognise a whole person with complex needs. Some ACCHO delegates described having over a thousand touchpoints to government across various departments. Others spoke of the struggle to reconcile the government’s professed commitment to self-determination for First Peoples with the on-ground reality of imposed top-down structures and arduous, regular and often pointless performance meetings and reporting requirements.

But perhaps what stood out the most was a reflection that this government does not fund a wellness model; they fund a sickness model. While not an entirely new concept to me, it was powerfully put. Community health organisations, public health officials and many others are constantly stressing to me that when it comes to public health policy, investing resources into prevention and social wellbeing must be our primary focus. Yet this government seems hell-bent on funnelling millions of dollars into shiny new big hospitals at the expense of preventative health – a sickness model. The idea that we will care for you when you develop heart disease and get so unwell that you need emergency care, when your teeth have decayed to the point that they have become necrotic and infected you can jump the queue to get emergency oral surgery and when you are so distressed that you develop severe depression and can no longer function – a sickness model, not a wellness model. This has to change.