‘First they came for the first Australians…’

Having said all that, the extra resources and the raising of the bar on expectations of delivering results does present an opportunity. most of the alcohol restrictions were not new, but the commitment to enforce them and to resource related programs was not there.

There are things about the intervention that still concern me, but the Review provides a good chance to fix many of those. A lot of the reports I hear of what’s happening match what is in the Crikey piece referred to in the post, but I do hear other much more positive reports - as shown in Crikey itself, with a different piece published on the same day giving a far more positive assessment of the impact of the Intervention in one NT community, mostly based on policing of the alcohol restrictions and the impact of quarantining.

not only where the health checks a waste of time because of the lack of follow up, some of the people doing the checks were Dr’s, but because of the tight time frames invovled, had not been registered to practice in the NT, and so could not legally provide any treatment to those they were screening.

Crikey appears to have moved the link, but here’s a report of the same thing on a doctors’ site called 6 minutes.

http://www.6minutes.com.au/articles/z1/view.asp?id=174463

(Is “6 minutes” a reference to directives from the Health dept on the proper duration of a medicare funded consultation, or something?)

A couple of paragraphs from your own link to the violence stats seem to argue against things such as the enforced income management as counter productive.

Policy Implications-What can be Done?

These figures suggest that there are fundamental issues which need to be addressed concerning excessive alcohol use amongst Indigenous people. These issues include empowerment; self-esteem and pride; meaningful occupation; and strengthening culturally-based social control mechanisms;

The prevention of intimate violence and consequent lethal violence is a problem i
However, prevention can never be imposed on a society or culture. If it is tobe successful, prevention must involve people who are willing to listen and become involved.12 It is therefore essential to provide resources for self-help, such as training for Indigenous welfare workers, to assist Indigenous Australians to help themselves. The most successful prevention has to take place within the community -it is less likely to succeed if imposed from the outside.

To back up Helen’s article this one was recently in the MJA.

http://www.mja.com.au/public/issues/188_10_190508/bai11268_fm.html

Abstract
Objectives:

To describe delivery of child health services in Australian Aboriginal communities, and to identify gaps in services required to improve the health of Aboriginal children.
Design:

Cross-sectional baseline audit for a quality improvement intervention.
Setting and participants:

297 children aged at least 3 months and under 5 years in 11 Aboriginal communities in the Northern Territory, Far West New South Wales and Western Australia in 2006.
Main outcome measures:

Adherence to guideline-scheduled services including clinical examinations, brief interventions or advice on health-related behaviour and risks, and enquiry regarding social conditions; and recorded follow-up of identified problems.
Results:

Documentation of delivery of specific clinical examinations (26%–80%) was relatively good, but was poorer for brief interventions or advice on health-related behaviour and risks (5%–36%) and enquiry regarding social conditions (3%–11%). Compared with children in Far West NSW and WA, those attending NT centres were significantly more likely to have a record of growth faltering, underweight, chronic ear disease, anaemia, or chronic respiratory disease (P < 0.005). Only 11%–13% of children with identified social problems had an assessment report on file. An action plan was documented for 22% of children with growth faltering and 13% with chronic ear disease; 43% of children with chronic respiratory disease and 31% with developmental delay had an assessment report on file.
Conclusion:

Existing systems are not providing for adequate follow-up of identified medical and social problems for children living in remote Aboriginal communities; development of systems for immediate and longer-term sustainable responses to these problems should be a priority. Without effective systems for follow-up, screening children for disease and adverse social circumstances will result in little or no benefit.

I think a large factor in the interventions failure to wedge the ALP was that the sheer cowboy nature and incompetence was obvious early on, and it is hard to whip up strong ideological support for incompetence. When a government department announces major controversial new programs, and then a few weeks later announces it won’t be doing them after all because it turned out they were illegal, that impresses no one.

The ideological back and forth is largely beside the point - whether or not you ideologically believe in the velue of various intervention measures, both sides of the ideological spectrum should agree that planning, efficiency and competence is better than rushing in and the resulting blunders, inefficiency and wasted opportunities.

we are encouraged by the current focus and commitment by Governments to improve the health of NT Aboriginal children. However, it is our very great fear that the millions of dollars spent on child health checks during phase one of the NT intervention have mostly been wasted. Time will tell, but at this stage we can see little evidence that the child health checks will make a long-term difference to improving the overall health of Aboriginal children in the NT.

It is possible that health care has been delivered to some children for ear, skin and other common problems, which may not have been delivered otherwise. But far more children could have benefited if the funds had been more wisely spent.

If the Government had paused to seek evidence for action, had sought advice and partnership with existing services and advice from health experts and Indigenous leaders with the relevant experience and expertise, a more sustainable, long-term approach to improving children’s health could have been achieved. Is there anything stopping it from doing that now?

The big problem is focusing on health checks without resourcing and developing the primary care programs needed to manage the health problems that were already well documented. Our experience is that when quality services are provided in communities, uptake from Aboriginal children and their families is actually high. Most of the health issues looked for in the checks need comprehensive continuous programs from primary health care, not once-off (or even annual) checks.

Read the whole thing.

That why the evaluation and review processes are so crucial.

Also, an older, interesting link about the rates of violence experienced by indigenous women. And, yes I note the irony of the conclusion

SIHIP is looking promising though especially if it can manage to employ local workers.

“The source told Crikey that the cost of income management alone is currently running at $3000 per person per annum — to manage average welfare payments of around $10,000 per recipient. The documents point out that there are around 10,500 people under income management.”

To get a fair comparison this would have to be contrasted with the cost/benefit to the individual, community and government for the same population when their income is not being ‘managed’.

10 500 people who have the resources to feed their families, and divert this from grog and associated violence @ $3000 each = 31.5 million.

I wonder what the associated health costs of alcohol abuse, malnutrition, alcohol related assault and violence, and child neglect actually are? I notice there has been a dramatic drop in the number of homicides since welfare restrictions have come into play. What cost is a woman’s life? Police, courts, welfare staff, and dialysis machines don’t come cheap either.

THe start up costs of any system are going to be more costly at the beginning, so this would also have to be factored into any comparision.

I’m not defending the cost btw, but merely saying these things are multi-factored.

I know the article below is merely anecdotal, but its an interesting observation nonetheless.

http://www.abc.net.au/worldtoday/content/2008/s2270349.htm

“without family support, no education system will work.”

They speak the ‘truth’. The greatest influence on an individual’s educational attainment is the family, generally speaking. All the significant Reports confirm the fundamental importance of the family.

Tis sad that this well established fact needs to be constantly restated.