Assistant Minister For Indigenous Health, Speech

Department of Health

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bajinda yamaluyinda ngarna Yanyuwa wuka lianthawiriyarra.

As a Saltwater woman from Borroloola, the Yanyuwa Garrawa people, I pay my respects to the Cammeraygal people, their ancestors, past, present and emerging.

I also want to acknowledge our young people. It's really good to see the students here from St Vincent's. You remind me of when I used to go to events, in year 11 and year 12. I hope tonight will be a really important night for you. You are our future and our next generation of young Australians that I look to wherever I travel around the country with the roles and responsibilities that I have.

Thank you to the Mary Aikenhead Ministries for the opportunity to speak to you tonight.

I acknowledge the Trustees, Chair Richard Haddock and the members Penny Wright, Margaret McKenna, Gary Humphrys and Deirdre O'Donnell.

Ministry Leaders Paul McClintock AO and Professor Marie Emmitt.

Thank you everyone for coming out on a Sydney winter evening.

And hello to the many people joining us online - from as far away as Nigeria and Kenya!

And before I go any further tonight, I'd like to say some words about someone quite extraordinary.

My friend and mentor and parliamentary colleague Linda Burney.

It's been a mixed day of emotions no doubt for Linda, but certainly for those of us who worked very closely beside her. I've had the honour of working with her in the Federal Labor Caucus for the past 8 years. Both her and Senator Pat Dodson, we came in together in 2016 and it's been an extraordinary journey and wonderful privilege to walk beside her and today has been a sad day. But at the same time, incredibly proud to see the work that she's done recognised and I know in the days to come she will certainly feel the love and warmth from Australians around the country.

She has fought the fight with grace and dignity. As the first Indigenous woman to enter NSW parliament and then Federal parliament. She has blazed such a trail. And we all share the responsibility to keep blazing it.

Tonight, as we look ahead, I also want to talk a little about the trail that has led me to this point in life. I want to share with you my story and my kujika - my songline that weaves its way from the Gulf Country across Australia.

The old people would sing the kujika, now the young people sing the kujika, the songline - following the path of many kujika, like the brolga story, the kurdarraku, of my grandmother's country - the beautiful brolga country, where my spirit always returns to.

They would sing of the shark dreaming, and how it travelled from Queensland all the way down the coast to the Gulf Country and out to the islands of my families.

And like the old people before us, we dance the dance of the mermaids, the ngardiji, the ngardiji kujika of the Gulf and Barkly country, linking so many of our First Nations people.

It was my father, a school teacher from Sydney, who inspired my educational upbringing, both in the Western ways and in maintaining a strong understanding of Borroloola families.

It was my mother, bless her soul, who taught me the Yanyuwa and Garrawa ways of our families.

Our McCarthy ancestor came to Australia in 1842, sailing across the seas from Ireland aboard the ship Palestine.

Unlike so many before him, he came not as a convict but as a free man.

He chose to make this country his home, not just for him but for his young family. To live in Australia, to build his future and his dream, in an unknown land.

The deep Catholic faith of the McCarthy clan has passed down the generations.

My dad, John McCarthy baptised me at birth as a Catholic thinking I may not survive as a baby, whilst my mother taught me the spirituality of Yanyuwa culture.

We are known as li-anthawirriyarra, a people whose spiritual origin comes from the sea country.

So my kujika has allowed me to see both worlds - through the eyes of the Western world view, and through the eyes of the Yanyuwa/Garrawa.

And I'm really pleased to be able to share some of this with you this evening.

There are four beautiful reasons to why creating a better way of life in Australia, deeply matters. They are:

Hadassah

Ebony

Indianna

And Nevaeh

Our four beautiful girls. These young women are a daily reminder of why I do the work I do, in service to the people of the Northern Territory, and indeed all Australians.

My husband Richard, a school teacher dedicated to educating and expanding the young minds of the next generation, walks with me in our journey.

A journey to provide a safe, loving and stable home for our daughters, and to encourage opportunities that open their minds and their hearts to achieving whatever they strive for in life.

Why does this matter?

It matters because we made the decision to care for these young women, or perhaps they made the decision to come and care for us.

Either way, our family and work life is enriched by their presence.

As a Yanyuwa Garrawa woman, one of the very familiar responsibilities in First Nations families in particular, is kinship.

Hadassah and Nevaeh are the daughters of my cousin - sister.

Ebony and Indianna are the daughters of my cousin-brother.

In our way there is no difference.

Richard and I are just their parents, or in Yanyuwa language for mum and dad, it is Bunanana and Ardie.

For the twins, Ebony and Indiana, we are their Aunt and Uncle.

And then there are my two eldest sons, CJ and Grayson.

Together, the six children, Richard and I are just family.

Kinship for us, is to care for others.

I see grandmothers across the country caring for so many grandchildren when their own children are unable to do the job of parenting.

Some cannot raise their children because they are still children themselves. Others are captured by the lure of substance abuse with alcohol and drugs. And some are in the revolving door of incarceration.

In many cases, poverty is a deep cause of the situation these grandmothers find themselves in, raising grandchildren and sometimes great-grandchildren.

Throughout my life, what I have observed among First Nations families is the instinct to care for others is an instinct that never ceases.

It is an instinct felt strongly even by families who already have more than enough people to care for, more than enough mouths to feed.

What drives these families to take on the responsibility of caring for more children is the deeply rooted desire to never again see another generation removed - and robbed of ever knowing their kin and culture.

But the grandmothers who are on the frontline of the care do all this even when they are coping with their own health issues, including diabetes,chronic kidney disease, and high blood pressure, along with other challenges such as overcrowded homes, and money that keeps running out before the hunger does.

Yet what they have in such abundance is love - and they want to give it.

Love is why we took on the care of our four nieces from Borroloola. We wanted to give the girls the good education they could access if they lived with us in our home in Darwin. And we wanted to give their grandmother, Nana Jeanette, support to deal with her own health challenges.

And we wanted to her have some peace. I can tell you she has earnt it.

Yet an essential part of the girls' upbringing is returning home to Yanyuwa country during school holidays. This ensures they know who they are, where they come from, who their families are in the kinship structure. It means they know the cultural stories, song, dances and bush foods on country - all of which is their birthright.

And of course, returning home means spending time with Nana Jeanette.

Indigenous children are almost eleven times more likely to be in out-of-home care than non-Indigenous children.

And 29 times more likely to be in juvenile detention.

This gross over-representation is a national shame.

But it is not enough to sit by and acknowledge that these statistics are unacceptable. That is why our government has taken bold action.

Earlier this year, the Prime Minister announced a National Commissioner for Aboriginal and Torres Strait Islander Children and Young People.

This is something Aboriginal and Torres Strait Islander leaders in the space have been calling for - for decades.

The National Commissioner will focus on working with First Nations people on evidence-based programs and policies to turn around the cruel reality that those figures represent.

Nearly a quarter of the way into the 21st century, the tired old policies of the assimilationist era have no place when we're talking about our young ones.

We know the trauma and harm caused by forced removal polices of the past - they have had a long lasting and inter-generational impact.

We simply cannot repeat those mistakes of the past.

That's why we're taking a new approach.

Because we have to grow our communities and our kids to be strong in culture, strong in identity. And we want our children to live in safe and loving homes.

What it adds up to are the foundations of a good life - nothing more, nothing less.

We've seen recently the experiences of First Nations children and young people in places like Alice Springs and Townsville making media headlines about youth crime.

But why is it that young people are walking the streets all night and in the early hours of the morning?

Why is it that social media often fuels crime and violence?

As I speak with with organisations, teachers and families across the country and in Alice Springs in particular, much of the discussion about young people lands on causes such as poverty, unsafe and overcrowded homes, boredom, and, heartbreakingly, a lack of hope for the future.

Our role as parents, guardians, teachers, and politicians, is to create a pathway that substantially improves lives for the better. To give the next generation cause to hope.

The Prime Minister knows this. The Federal Cabinet knows this.

That's why a commitment of $250 million has been invested in Alice Springs over four years. Our plan for a Better, Safer Future for Central Australia is seeing increased funding for police, domestic violence services and youth services.

We're improving access to preventative health services f or children and families with early intervention, Foetal Alcohol Spectrum Disorder and Autism diagnosis and support.

And we're supporting more alcohol and other drugs treatment and rehabilitation services.

These are long term solutions to long standing issues.

A major part of our work in Alice Springs involves a new approach - and a commitment to self-determination.

We have set up an Aboriginal Leadership Group, empowering community leaders a say in the priorities and where we're investing money.

Safe communities and safe homes for First Nations families are paramount, as they are for everyone.

And again, we must work with communities on solutions.

We know that First Nations women and children are disproportionately affected by violence.

Indigenous women are 18 times more likely to be the victims of domestic and sexual violence. We are also 34 times more likely to end up in hospital as a result of that violence.

In 2009 when I was in the Northern Territory Labor Cabinet, I travelled the length and breadth of the Northern Territory talking with women shelters and medical and legal experts on an amendment we wanted to make to the NT Family and Domestic Violence Act.

We would become the first jurisdiction in the country to make it mandatory to report family and domestic violence.

I would like to read to you some paragraphs from my speech to the NT Assembly on this most reformative piece of legislation at the time.

"I know their trepidation and I know they are anxious. I know they wonder where this could lead them. But not one of them said to me: do not do this, do not go down this path, do not pursue the mandatory reporting of domestic violence. Not one person said that. Every person who works with any victim of domestic violence, or any of the perpetrators for that matter, recognises that this is important. There has to be attitudinal change in the Northern Territory. We cannot have half the population being assaulted - being victims in such a way - and not care about what is going on.

I have to tell the story of Rosie; we are probably around the same age. I remember getting a phone call one night saying that she had been flown in on the doctor plane from a community, and she was unconscious. I had to get all the family who were in Darwin prepared to think that this is it. She had obviously been caught up with drinking and fighting with her partner and she had picked up an infection from the violence that she had received over so many months or years - I do not know.

When I got the phone call that she was being flown in, we expected the worst and we went into the intensive care unit at Royal Darwin Hospital. How many times have I gone into that hospital visiting mainly women who had experienced some form of violence? And now I was going to visit someone very special to me. When the nurses said: 'Look, you all better get ready'. We prayed, we really prayed; we were praying for a miracle, wondering how much chance she had.

No one actually knows what happened because she had not been able to tell anyone. The only thing people knew was that she had tried to get to the clinic, and when she got to the clinic she collapsed. People were trying to piece together her movements. Someone had seen her down by the river; someone else had seen her drinking with a group of people at a house; someone else had seen her trying to walk up to another house somewhere.

So while family members were trying to piece together who she was with and where had she been, we stood around the bed and we prayed. Her daughters were with me, and over the next days, she hung in there. The nurses and doctors were starting to think that she was fighting. She ended up staying in hospital for one year. Rosie survived - she survived - and it was an absolute miracle. However, her left arm had been broken, many of her toes were cut off and some of her fingers. She had not only to recover physically, from what had been a major physical attack on her; she also had the mental and emotional recovery to make.

I used to jokingly say to her: 'I need your autograph. I do not think I have known anyone who has been in RDH this long'. Many of the doctors and nurses got to know and love her, and helped her in her recovery. The medical staff were tremendous, knowing they were flying a person out and thinking that she was gone. Her will to survive was astounding.

What happened to Rosie over so many years, everyone new about. People in the community knew and no one did anything because they thought: 'That is their business. Whatever happens is between them'. That is what we have to change. That is what this legislation is about. It is about the care and compassion that is required for others in our community, who may or may not belong to us. It is about the courage to speak up and say: 'No. Enough is enough. We are not going to do that'. That is my call, in particular, to the men of the Northern Territory, this is about all of us.

That was in 2009.

Today it's organisations like the Arrernte Boxing group in Alice Springs that have helped turn around the lives of so many young people in Central Australia.

The Kings Narrative and the Tangentyere Women's Family Safety Group are other organisations in Central Australia doing incredible work - working with men, women and families on these difficult issues of family and domestic violence.

Whether its young people affected by family and domestic violence, or adults themselves wanting to better their lives, these organisations need support. We've still go to a long way to go, but we are trying.

At the heart of our approach to Closing the Gap is strengthening Aboriginal Community Controlled Organisations.

As the Prime Minister said in his annual Closing the Gap address earlier this year:

"If we want to close the gap, we have to listen to people who live on the other side of it. Canberra must be willing to share power with communities. To offer responsibility and ownership and self-determination. To let local knowledge design programs, to trust locals to deliver them and to listen to locals when they tell us what's working and what isn't."

Across my portfolios as Assistant Minister for Indigenous Australians and Assistant Minister for Indigenous Health - my focus is on improving the lives of Aboriginal and Torres Strait Islander Australians.

And one important part of that is deepening the understanding among non-Indigenous Australians about the history we share. A history that includes the oldest continuing culture on the planet.

We are making some progress on Closing the Gap.

More Indigenous babies are being born at a healthy birth weight.

We're seeing improvements in employment.

And we're narrowing the divide in early childhood enrolment.

But there are still too many targets that aren't budging.

Too many Aboriginal and Torres Strait Islander people are in custody

Too many of our kids are in out of home care.

And tragically, too many of our people are taking their own lives.

The question we need to keep asking and exploring is: How do we improve things? How do we bring about positive change? There's more than one answer, of course. The foundations of a better, healthier life need to be broad and made up of many elements.

One of the ways we're trying to improve health outcomes is by growing the First Nations workforce.

We've made great progress in our commitment to see 500 First Nations trainees to get their qualifications as Aboriginal Health Workers or Aboriginal Health Practitioners. So far more than 300 people are enrolled.

The importance of having Aboriginal and Torres Strait Islander people working in the health system cannot be under-estimated.

I recently visited the Torres Strait for a gathering of Torres Strait doctors.

In the local language Igilyawa means Custodians of Life, which is such a beautiful translation about what being a doctor is all about.

The doctors had come together on Thursday Island with the Australian Indigenous Doctors Association and Elders of the Torres Strait.

It was such an important gathering - for connection and strengthening cultural ties.

It was a celebration - of the great progress that's been made.

20 years ago there was one Torres Strait doctor in Australia.

Now there are around 130 across the country.

And we have over 800 Indigenous doctors.

First Nations doctors are crucial because they make our health system better reflect the reality of our community.

They make our health system more inclusive

And importantly, improving cultural safety will help improve the health and life outcomes of First Nations people.

Another priority on our health agenda is strengthening Medicare and making it easier for all Australians to access healthcare.

Medicare Urgent Care Clinics have been one of our most successful initiatives, since coming to government.

Since the centres were first opened in June last year, there have been more than 580,000 visits across Australia.

Earlier this week we announced 6 new Urgent Care Clinics in remote communities of the Northern Territory.

In places you probably haven't heard of:

  • Alyangula (Groote Eylandt)
  • Wurrumiyanga (Tiwi Islands)
  • Maningrida
  • Galiwinku (Elcho Island)
  • Lajamanu (Big Rivers Region)
  • Ali-Curung (Barkly Region)

We believe you should have the access to good quality and affordable health care for all Australians, no matter where you live.

I'd like to take a moment now to tell you about the work we're doing on renal dialysis.

Chronic kidney disease casts a terrible shadow across Indigenous Australia. We are twice as likely as non-Indigenous Australians to have chronic kidney disease. And almost 4 times as likely to die from chronic kidney disease.

Wherever I travel right across the country in my role as Assistant Indigenous Health Minister, this is an issue that troubles me deeply.

I see our people on dialysis chairs, in hospitals, in units across the country, and patients are getting younger.

Dialysis is an essential, lifesaving treatment for patients with end stage kidney disease, which can otherwise only be treated by a kidney transplant.

We are all acutely aware of the need for more kidney dialysis units for First Nations communities.

The paradox of dialysis units is that they save lives - but are a dreadful experience for those who need them, usually 3 days a week for the rest of their life - which is why we're also focused on the need for prevention.

But right now, we have to do both.

Last month I travelled to Coober Pedy in the South Australian outback to open a new dialysis clinic.

It was an emotional day for local families who have lost loved ones to kidney disease.

But there was a genuine sense of relief for those in Coober Pedy, who will no longer have to uproot their lives and relocate to places like Adelaide and Alice Springs.

Many hundreds of kilometres away from family, community and country, to get the life-saving treatment they need.

The new chairs are part of our election commitment to improve access to renal dialysis services.

In Coober Pedy I got to meet Tommy - who has been living in Adelaide for two years.

And Raelene, who packed up her life in Coober Pedy three years ago to get dialysis.

As she put it, "I'm just glad to be home"

As well as Coober Pedy, we've committed to building new dialysis units in Yalata in South Australia, Balgo in Western Australia, and Atitjere (Harts Range), Borroloola, and Ti-Tree in the Northern Territory.

And we've just announced another three locations in:

1. Badu Island in the Torres Strait Islands

2. Tom Price in the Pilbara region of Western Australia.

3. Wiluna in the Western Desert region of WA.

This news has been welcomed by a group of Elders from Badu Island who I met with on Thursday Island in April.

Uncle Bongo, who is on dialysis himself, told me that people on Badu Island say farewell to their loved ones leaving the island for dialysis - and their loved ones expect them to return home in a coffin.

It's stories like that I carry all the way to Canberra - to make sure we do make the changes we need to make.

There are many reasons why these stories are so close to my heart.

One is that I had to care for my mum for the 10 years she was on renal dialysis.

She had to move from Borroloola for dialysis.

She always wanted to go home on Country. But she passed away in Darwin, never having that opportunity to return home permanently.

So to some people, these chairs might not sound like a big deal.

But for people like Tommy and Raelene and Uncle Bongo, they are life changing.

Because we know that providing dialysis treatment closer to a patient's home increases the likelihood of regular treatment, continued support and care, while remaining on Country, deep in the embrace of connection to community and family.

We are also working hard to improve maternal health outcomes and give our babies the best start in life.

When I was 3 months pregnant with my first son I was out on the islands, the sea country, where I was fishing with my family.

A sharp oyster cut my right foot and for a week I could barely walk. I spoke with my mother. We knew something was not right with my unborn child, but the peace of the waters told us he would be okay. And the spirits of my ancestors quietly reassured me.

My son CJ was born with a fibular limb deficiency. It meant his feet did not form properly nor his legs. His birth was a challenging experience, but he was a fighter, striving to live.

He has grown into a determined young man keen to help others overcome their difficulties and disabilities. CJ continues to inspire me three decades, as does his brother Grayson. CJ pursues his passion for wheelchair basketball, and working with young people - especially those in our schools and in the justice system in institutions like Don Dale.

Birthing on Country is a ceremony close to the heart of First Nations women. The chance to birth the way women would like to give birth, matters.

I recently visited the remote community of Galiwin'ku in North East Arnhem Land to learn more about the Djäkamirr project.

The Djakamirrs are birth companions. They accompany women during their birth journey and watch over them during this sacred time.

They help ensure that Yolŋu knowledge and ways are passed to the next generation and babies are born healthy and safe.

First Nations women and their babies experience poorer health outcomes compared to non-Indigenous mothers and their babies.

The rate of preterm birth experienced by First Nations mothers is almost double that of non-Indigenous mothers.

The evidence is there, wherever it has been trialled, Birthing on Country models of care lead to better health outcomes for First Nations mothers and babies.

The Djäkamirr model of care is an exceptional example of Birthing on Country. It is a great example of a program that will help improve First Nations women and babies' health outcomes.

As Associate Professor Lawurrpa Maypilama said while I was there:

"When children come to the world, they need to feel the land, they need to know who they are, they need to know what their identity is".

But not all families have the joys of bringing home a baby.

One of our stranger traditions in Australia is the lack of discussion on stillbirth, in particular with First Nations families. A silent stigma that I believed needed revealing.

In 2018 I chaired the Senate Select committee on Stillbirth and the personal grief filled stories of families across the country, finally echoed loudly in the halls of Australia's parliament.

As parents, doctors, nurses and midwives came forward to give evidence, the Senate committee listened deeply to their voices and sought to recommend ways to reduce the number of stillbirths in Australia.

Two of my Senate colleagues, Senator Kristina Keneally and Senator Catryna Bilyk shared their own journey of loss. Senator Keneally was a firm and passionate advocate for more understanding about stillbirth.

Senators from across the divide, including the late Liberal Senator Jim Molan told the story of the loss of his grandchild, and former Greens Senator Janet Rice, joined me in ensuring Australian families were better informed during pregnancy and had the support services required when grieving the loss of a baby.

The committee heard disturbing evidence about six Aboriginal babies who were stillborn who had remained in the morgue at the Katherine Hospital. Some for well over 3-4 years.

Ms Sara Potter, Clinical Nursing Midwife at the Katherine Hospital, highlighted the lack of resources available for locating and working with bereaved Aboriginal and Torres Strait Islander parents. She told us that many parents didn't have the money to bury their babies and carry out Sorry Business.

The work of our Select Senate committee and the nature of collegiality on a subject that no one wanted, or should ever politicise, meant we could move the many unnecessary roadblocks for families and the medical profession in the area of stillbirth. And most importantly try reduce the high rates across Australia especially in First Nations communities.

This work showed me that working together - across the political divide - can deliver better outcomes for this country.

When I say the Albanese Labor Government is working with First Nations people, it's not just words. Words are important, but they can only be a beginning.

Our Remote Jobs program will replace the failed Community Development Program or CDP with real jobs, proper wages, and decent conditions.

We're doing this in partnership with First Nations people.

And this will be life-changing for many people in remote communities.

The old CDP program was a failure. It failed individuals and failed communities.

The remote jobs program is about self-determination through economic and community development.

Jobs that local communities want, and need, to grow remote economies. Because we believe people in remote communities deserve access to the benefits and dignity of work.

Self-determination is also at the heart of our remote housing program.

We've signed a landmark $4 billion 10-year joint investment with the NT Government to improve housing in remote NT, which has the worst overcrowding rates in the country.

With up to 270 houses built in remote communities each year.

This will ease severe overcrowding, experienced by too many families in remote communities.

I want to turn now to the heartbreaking result of last year's referendum and importantly where we go from now.

There is still deep hurt and disappointment in the community about the result.

Especially when we look at places like the NT, and northern Australia where we saw such a strong 'Yes' vote in remote communities like:

• Wadeye, with a 92% 'Yes' vote.

• The Tiwi Islands an 84% 'Yes' vote

• And Maningrida an 88% 'Yes' vote.

Not enough though to turn the country around. But what it was, was an absolute affirmation, that all of these communities, of First Nations people, wanted what we were trying to get. Wanted what we were pushing for at the Federal level, a Voice to parliament.

The rejection felt by so many First Nations people is still a difficult thing to swallow.

But while we may not have won the referendum, we did not lose our courage. And we did not lose our resilience.

We did lose our determination to keep going as a people in this country. To keep finding better ways to improve the lives of Indigenous people. And I can tell you - that determination to drive change has not wavered.

We have to redouble our efforts.

And I take great heart in the fact that so many Australians walked the journey with us last year.

More than 6 million Australians shared the vision for a better future.

And the only way we're going to make change is by working with Aboriginal and Torres Strait Islander people in genuine partnership and supporting self- determination.

Because First Nations communities already know the issues.

They already know the challenges. And they certainly know what solutions will work and what won't.

The Albanese Government remains committed to the principles of treaty and truth-telling.

Already, important treaty and truth-telling work is underway at the state and territory level.

In Victoria, we are seeing the progress being made by the First Peoples Assembly and the important work of the Yoorook Justice Commission.

Work is underway too in South Australia - with the historic SA Voice to parliament

This is important work.

It is how we deal with the injustices of the past and move forward together, united.

As I travel this country and talk to Aboriginal and Torres Strait Islander Australians - I am humbled that despite everything we've been through - both historically and more recently - there is a great determination to keep going.

We are a resilient people and there is great generosity to share our culture.

I can tell you, it was one of the hardest things I've ever had to do - to look my girls in the eye - aged 16, 10 and the twins 9, when they asked me why Australia said no in the referendum. Why would they say no?

They had campaigned with me, wearing their yes shirts, knowing that what we were asking Australians for, wasn't much.

As hard as it was to do, we accept and respect the result.

And what did I say to my kids? I saw we just dust ourselves off, there's always another sunrise. Let's keep going. And we move forward.

And in our family, the very next day, we did that in our own way.

My husband Richard, declared that Sunday was going to be a yes day

Everything the girls asked for ice-cream, swimming at the beach, hot chips at the club, the answer was yes.

And I have to say, by sunset we were laughing again. Just as a family, it was really important for us, in holding our girls and our sons, to say, it's ok, we'll get through this. And there's a lot of love here.

And now, nine months on from then, I tell my girls as often as I can, to be proud of who they are, be proud of where they are from. Be proud of their culture

And I tell them that my hope for the future is one that brings us as Australians together, to celebrate our diversity our differences.

Bauji Barra. Thank you.

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