Introduction by Croakey: The mainstream health sector should speak up to counter the growing tide of misinformation and disinformation being spread by the far right, according to a senior Indigenous health leader.
They also should be helping to amplify news about the good work being done in Aboriginal and Torres Strait Islander health and social programs, to counter dangerous and harmful narratives being propagated by far right politicians and groups, says Dr Peter Malouf.
Malouf, a proud Wakka Wakka and Wuli Wuli descendant from Central Queensland, is chief executive officer of the Australian Indigenous Doctors Association (AIDA), and chair of the National Indigenous Health Leadership Alliance.
His call comes as polling reported today shows One Nation as the most popular political party in Victoria, ahead of Labor and the Coalition, less than five months out from the state election on 28 November.
Peter Malouf writes:
There is a pendulum shift towards the far right in Australia, which is a significant and growing area of concern, whether it comes through the Liberal and National Parties or One Nation.
It is manifesting in political racism that is an escalation of what Aboriginal and Torres Strait Islander people experienced through the Voice referendum campaign and in the result.
Political racism is not only expressed through individual prejudice, but is embedded into the public debate, into the public agenda, and particularly in institutional decision making and systems of authority.
It is seen, for example, in the recent Ministerial decision in Aotearoa/New Zealand not to reappoint the first wahine Māori chair of the Medical Council of New Zealand (MCNZ), head and neck surgeon Dr Rachelle Love, and deputy chair Simon Watt.
As Croakey has previously reported, Health Minister Simeon Brown said the regulator had become distracted by politics and an “ideological agenda”.
The decision raises serious concerns about the politicisation of independent health regulation, particularly where the Minister’s concerns appear to relate to the Council’s work on cultural competence, cultural safety and hauora Māori.
It’s a shift towards thinking that cultural safety is not a valid or a clinical practice.
As AIDA said in a statement in response to the decision: “This position reflects a lack of understanding and knowledge of the evidence base. Evidence based medicine is core to ensuring appropriate standards and safety and quality in healthcare.”
Systemic change
My concern is that we will see such a scenario soon play out here in Australia, exacerbating the current problem of racism operating in health policy and healthcare at a systemic level (policies, funding, access barriers); and an interpersonal level (stereotyping, misdiagnosis, dismissal of symptoms).
What do we need to do to head off those risks, to challenge those narratives?
We’re yet to see the new Australian Health Practitioner Regulation Agency’s (Ahpra) Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy, which is due to be published later this year.
But the key is in how these commitments are being applied and managed in the workforce at a time when Aboriginal Torres Strait Islander medical trainees continue to be exposed to high levels of racism and discrimination in their training pipeline.
Our latest Medical Training Survey results show that more than half (56 percent) of Aboriginal and Torres Strait Islander trainees have experienced bullying, discrimination, harassment (including sexual harassment) and racism, almost double the national average of 30 percent.
The persistence and, in some cases escalation, of these harmful behaviours underscore the urgent need for systemic change.
It raises concerns that political racism is also playing out within institutions and health settings that are not seeing racism as a priority to be addressed.
It’s all well and good to have formal commitments and statements addressing cultural safety, anti-racism, and public accountability, but they can be performative instead of transformative.
The weakness or strength is in the governance: who actually governs these commitments.
So I hope there is a mechanism that shows Ahpra is fair dinkum in terms of implementation of the Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy.
The integration of Schedule B: Better Outcomes for Aboriginal and Torres Strait Islander peoples addendum into the National Health Reform Agreement (NHRA) is an important step in embedding responsibility for Aboriginal and Torres Strait Islander health outcomes within Australia’s core health funding and governance arrangements.
But again I am a little nervous about who is actually driving the accountability.
As we said in our statement at the time it was adopted, Schedule B provides the foundation, but it is not the end point. The true measure of success will be improvements in health outcomes, workforce experiences and accountability across the system.
Work together
In thinking about other ways to address the threats to our people from the rise of populism, I agree with Scott Wilson, in his recent article at Croakey, about the benefits of holding a summit, bringing together health, medical and social policy organisations to try and combat the misinformation and messaging that’s part of the far right agenda.
At this moment, governing boards of national organisations, including their board chairs, must stand up and show visible national leadership in responding to misinformation, racism, and harmful public narratives, because silence from national bodies risks normalising the very forces that undermine Aboriginal and Torres Strait Islander health, human rights and self-determination.
Because if we don’t do something, if we don’t publicly come together as a collective or coalition, then the sector is at risk of losing public trust.
I also want to see health and medical allies, such as the Australian Medical Association, the Royal Australian College of GPs, the Royal Australasian College of Physicians – organisations that have signed up to Reconciliation Action Plans – stand up and speak up in that space, in this moment, to show how they are protecting the health, safety and wellbeing of our mob.
They have a commitment to addressing racism and discrimination, and understand the complex capability structures needed be able to address those issues.
We want them collectively to come out to combat the mis-messaging that’s out there, to explain how evidence-based programs, particularly in health, are actually having a huge impact and changing the lives of Aboriginal and Torres Strait Islander people.
We need to have our non-Indigenous colleagues talk about how these programs are contributing to creating thriving communities by delivering high quality healthcare.
Similarly, we want to hear from the social sector on the social determinants of health and the power of incorporating that holistic view of healthcare that our communities have.
To have One Nation calling for the abolition of the Closing the Gap program is harmful and uses harmful language — the language, unfortunately, of Donald Trump.
Focus on strengths
Medical and health allies play an important role in changing the narrative. So too does the media.
I live in Townsville, where there is significant investment by communities and allies in the youth justice space, and significant evidence about what works. Yet the headlines don’t show that, and any wrong step made is taken to cast the view that Aboriginal and Torres Strait Islander organisations don’t know what we’re doing.
That’s where allies like the medical colleges can speak up about the positive work they are doing too and the evidence of success that is creating thriving communities.
We always get to see the deficits. There needs to be a balance of reporting, where we also see the positives in communities and organisations.
For the media that could involve making sure we are not invisible in these stories, recognising and valuing Aboriginal and Torres Strait Islander leadership and leaders, who are actually doing the work.
We have Aboriginal and Torres Strait Islander people on health boards, Aboriginal and Torres Strait Islander senior leaders within hospital systems, who are driving local change through local solutions and decisions, and these need to be reported.
There is a lot happening on the ground in communities, and I think the media need to actually do a bit of a deep dive, to understand what’s happening locally before they generalise, before they just lump everyone together and say that nothing positive is happening.
I agree also with Scott Wilson that the Coalition of Peaks and the National Aboriginal Community Controlled Health Organisation (NACCHO) need to come out more and talk about the positive work they’re doing with and for communities, and to fight the tide of misinformation.
There are high stakes in this, and significant health impacts. Racism is a disease and it impacts people and communities, their social and emotional wellbeing and their physical health.
We saw this very starkly during and after the referendum campaign, in the significant increase in calls to our helplines of people experiencing anxiety and depression.
Misinformation and disinformation about Aboriginal and Torres Strait Islander affairs cause harm, and health and medical organisations and leaders have an important role in tackling this scourge.
Previously at Croakey
- Health sector urged to collectively address threats of populism
- Why a public health response is needed to address the harms of populism
- Health leaders respond to Pauline Hanson and the rise of populism
- Following the bulldozer stunt, health advocate issues a call for action
- How should health organisations and advocates respond to One Nation?
See Croakey’s archive of articles on the Trump Administration and health
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