A damning report by the Anti-discrimination Commission Queensland (ADCQ) has found “high to extreme” levels of institutional racism within the state’s 16 public hospital and health services.
The ADCQ report titled, Addressing Institutional Barriers to Health Equity for Aboriginal and Torres Strait Islander People in Queensland's Public Hospital and Health Services, was published in March this year, but has been kept under wraps until it was leaked to the regional Queensland newspaper Torres News earlier this month, and now reported in partnership with NITV News.
While all the 16 services throughout the state are rated at least with high levels of institutional racism, 10 are rated with extreme levels. Brisbane's Metro South Hospital and Health Services have been named as the worst in the state.
The report reveals that Central Coast Hospital and Health Service has the least amount of institutional racism, followed by Townsville and the Sunshine Coast. Next up is Torres and Cape Hospital and Health Service, rated at 'very high' levels of institutional racism.
The report was produced in partnership with Queensland Aboriginal and Islander Health Council which is the peak body in Queensland that represents, advocates, and supports the state's Community Controlled Health Services sector in their delivery of primary health care to Indigenous communities.
ADCQ Commissioner Kevin Cocks AM said: "People need to understand what institutional racism is, it's about the practices and policies that are part of the institution.”
"It doesn't necessarily mean people who work there are racist, it might be unconscious bias."
The report defines institutional racism as: “a form of racism which is structured into political and social institutions. It occurs when organisations, institutions or governments discriminate, either deliberately or indirectly, against certain groups of people to limit their rights.”
One of the most damning aspects of the report was the lack of financial accountability of Closing the Gap funding, both in states and the Commonwealth, as none of the 16 Hospital and Health Services (HHS) disclosed their use of funds in the annual reports of 2014-2015.
Willie Wigness, Co-Chair of Torres Social Justice and Human Right Advocacy Group based on Thursday Island, said the report finally reveals what they have always known.
"It seems all the problems we're having on our rights, to get equity and justice for Aboriginal and Torres Strait Islander clients from [the] management of Queensland Health Services in the Torres Strait and Cape, has finally shown up in an Anti-Discrimination Commission Queensland report," Mr Wigness said.
Robert Sagigi, Co-Chair of Torres Social Justice and Human Right Advocacy Group said: "This is, after all, an indictment against Queensland Health's failed responsibilities to meet our basic human right for adequate health, given that our clientele population is mainly Aboriginal and Torres Strait Islander peoples who are copping it.
"So why do we have to wait until all our concerns are officially validated in an Anti-Discrimination report? It's a joke.”
"The report shows the failing of the whole mainstream thinking behind public health systems," Mr Sagigi said.
Mr Wigness and Mr Sagigi are both advocating for more community control of primary health care to combat institutionalised racism.
Problems 'years in the making'
ADCQ Commissioner Kevin Cocks said years and years of layering of policy and practice have created the problem, and it will take a long time to remove those layers.
"It's about dismantling those institutional policies or practices and the best way to do that is through your governance and your structures by bringing highly skilled Indigenous people into the workforce to resolve the problem," he said.
"It's very important to have the voice of lived experience of Aboriginal and Torres Strait Islanders in collaboration in the reform of what was identified within the audit and it's going to take a number of reiterations, especially when you think of how long has Queensland been a state.
"It's going to take a long time to undo the institutional racism that exists."
Michael Walsh, Director-General, Queensland Health said: “We will not tolerate any form of racism within our organisation. Where it does occur, we will take immediate action.”
He said Queensland Health has been running cultural awareness training for its staff since the 1990s, as part of educational initiatives on unlawful discrimination.
“As part of Queensland Health’s commitment to enhancing cultural capability, the Department of Health is working with Hospital and Health Service Boards to increase Aboriginal and Torres Strait Islander representation in governance and in the health workforce; improve formalised community engagement, and enhance public accountability for Aboriginal and Torres Strait Islander health outcomes.
“We are committed to ensuring Queensland Health is free from unlawful discrimination and vilification for employees, patients, clients, contractors and volunteers.
“It is important to note the ADCQ report used data dating back to 2013, is a desktop scan of documents and does not cover initiatives that Queensland Health has adopted recently.”
Commissioner Cocks believes the solution to dealing with institutional racism is through collaboration.
"We've been working with the health department to develop a strategy," he said.
"The beginning of the process is starting, but health services have a certain amount of autonomy and we are in the process of working out how all the groups can come together, how they will respond to the issues raised and then work collaboratively with local Aboriginal and Torres Strait Islander leaders in the health sector, in their respective areas to address those issues, so hopefully over time things will improve.”
The report stated that “there appears to be no dearth of good health policies to improve the health and life expectancy of Indigenous Australians... the problem appears to be more a case of the slow uptake and implementation of those policies by public hospitals and health services at a local level, and a lack of accountability mechanisms, reinforced by legislation and regulation, to make them do so.”
“The findings of this report are unacceptable for [the] contemporary health service provision in Australia.
“The lesson to be learned from this report is that if Aboriginal and Torres Strait Islander health policies are not reinforced in the relevant legislation, then those primarily charged with implementing them, namely the HHS boards and their executive management teams, as this audit demonstrates, will invariably ignore them.”
Mr Cocks said: "As far as closing the gap it needs to be an important objective of all governments and it will take courage by all parties to work collaboratively together.”
"From a human rights perspective, I think everyone in Australia understands that health issues for Aboriginal and Torres Strait Islander people are needed to be addressed to close the gap, it's a huge gap and it needs to be closed."