As a founding member of the Close the Gap campaign and a public supporter of the Uluru Statement from the Heart since 2018 we recognise that truth-telling and sovereignty* are crucial in overcoming health inequalities and are pathways to implement principles of self-determination and community control in practice.
2.1 RACGP’s ongoing commitment to the Uluru Statement from the Heart
In 2018, the RACGP endorsed support for the implementation of the Uluru Statement from the Heart, the result of a 2017 constitutional convention held at Uluru, which brought together over 250 leaders from Aboriginal and Torres Strait Islander communities. In 2023 the RACGP reaffirmed our support for a Voice to Parliament ahead of the 2023 referendum.4
The RACGP is a member of the Close the Gap Alliance. We continue to advocate for self-determination and for meaningful representation of Aboriginal and Torres Strait Islander peoples solution and decision-making processes at all levels of government.
RACGP submissions
2.2 The importance of Aboriginal and Torres Strait Islander justice and self determination
Health outcomes are far greater when Aboriginal and Torres Strait Islander peoples take control over their communities’ health and wellbeing.5,6
The United Nations Declaration on the Rights of Indigenous Peoples7 highlights the right of Indigenous peoples to participate in decision-making in matters affecting their rights, and to be consulted prior to any implementation of strategies and initiatives. This international standard is understood and accepted by most Australians in the community, who agree it is important that Aboriginal and Torres Strait Islander peoples have a say in matters affecting them.8 Aboriginal and Torres Strait Islander peoples have a deep and long-standing appreciation of the issues and solutions related to their own health and wellbeing. The strength of community governance and leadership, essential to longevity and community buy-in, is demonstrated in ACCHOs.
The RACGP has long-term relationships with NACCHO, embodied in our Memorandum of Understanding, and with the Australian Indigenous Doctors’ Association and the Indigenous General Practice Trainee Network. The RACGP is also committed to supporting the growth and leadership of Aboriginal and Torres Strait Islander GPs. The governing Council of RACGP Aboriginal and Torres Strait Islander Health has majority Aboriginal and/or Torres Strait Islander membership and is uniquely positioned to influence through a permanent identified position for the Council Chair on the RACGP Board.
2.3. The role of general practitioners
As outlined by AIDA, a culturally safe health practice requires ongoing critical reflection of health practitioners’ knowledge, skills, attitudes and practising behaviours, and an awareness of existing power differentials.9 The RACGP is committed to developing and supporting a culturally safe and reflective general practitioner workforce.
To support this commitment the RACGP has an Aboriginal and Torres Strait Islander Cultural and Health Training Framework which is a commitment to comprehensive and system-wide action to ensure the rights and sovereignty of Aboriginal and Torres Strait Islander peoples are visible and active within our GP training system.
The primary healthcare sector is well positioned to support good health for individuals, families and communities through the provision of high-quality healthcare, including through health promotion and disease prevention activities and reducing the impact of structural disadvantage.6
Guided by Aboriginal and Torres Strait Islander leaders, the RACGP worked in partnership with NACCHO to develop the National guide to preventive healthcare for Aboriginal and Torres Strait Islander people. The guide is a key source of evidence for culturally and clinically safe healthcare, providing guidance for GPs and primary healthcare teams on health issues that are preventable, are a priority for Aboriginal and Torres Strait Islander communities and are actionable in primary healthcare settings.
2.4 The role of governments
Aboriginal and Torres Strait Islander peoples have consistently communicated their expectations and priorities based on their first-hand experience and knowledge. The Partnership Agreement on Closing the Gap commits governments to . With governments and peak organisations working together, a strong mandate for effective and lasting change can be achieved. The ongoing collaboration to deliver the is another opportunity to expand this commitment.
The noted that the Gap stems from a disregard of Aboriginal and Torres Strait Islander knowledge and solutions, and that business as usual is not going to support governments to deliver on their commitments. The commission have noted that power sharing requires more than consultation and partnerships. Self-determination is recommended as the basis of shared decision making for Aboriginal and Torres Strait Islander peoples and organisations, recognising that (as demonstrated through the actions and outcomes of the COVID-19 pandemic) Aboriginal and Torres Strait Islander peoples know what their communities need and a relinquishing of control by governments is required for progress to be made under Aboriginal and Torres Strait Islander leadership.
Collectively, there must be a stronger commitment to work alongside communities and their representatives and be guided by lived expertise on health and wellbeing matters.
All governments have a critical role to play as primary funders and in maintaining a supportive policy environment. It is the particular responsibility of the Australian Government to ensure this commitment is sustained, with effective, collaborative leadership and coordination with state and territory governments.
The RACGP acknowledges the significant work being undertaken by the First Peoples’s Assembly of Victoria with the Victorian Government.
Historically, government engagement with Aboriginal and Torres Strait Islander peoples has been inconsistent and often disrespectful. All too often, communities have been subject to policy decisions and changes, without consultation, participation or reliance on evidence of what is effective.10
Remaining committed to the Uluru Statement from the Heart increases real opportunities for Government to support self-determination, implement priority reform areas and achieve targets under the National Closing the Gap agreement.
‘When we talk about progressing Voice, Treaty, Truth we build a broader understanding of how history, activism, leadership and compassion are inextricably linked and necessary to building socio-economic and political equity’.
Close the Gap Co-Chair Karl Briscoe
*Sovereignty is one of the guiding principles in the RACGP Aboriginal and Torres Strait Islander cultural and health training framework. It is defined as follows:
“Sovereignty is exercising autonomy, both at an individual level and as a ‘People’. It acknowledges Aboriginal and Torres Strait Islander rights, ownership and authority in Australia which was never ceded in terms of land, law and its People. This recognises that Aboriginal and Torres Strait Islander governance and participation is inherent to the effectiveness and success of programs.
By foregrounding the principle of sovereignty, RACGP are choosing to pay particular attention to the historical and political factors that have shaped the lives and health of Aboriginal and Torres Strait Islander peoples.
This principle is necessary for the RACGP Aboriginal and Torres Strait Islander Cultural and Health Training Framework to embody the kind of systemic and structural change required to improve health outcomes, also aligning with the Uluru Statement from the Heart.”