As Australia approaches the next federal election, the political landscape regarding the health of Aboriginal and Torres Strait Islander communities is at a crossroads.
Following the failure of the Voice to Parliament referendum in October 2023, and the subsequent abandonment of the treaty pathway by Queensland, as well as a slowdown or halting of treaty processes in other states, Aboriginal and Torres Strait Islander Australians are left questioning: what now?
What do political parties intend to do for the future health of Aboriginal and Torres Strait Islander communities if they reject a Voice and treaty frameworks? How will they address systemic inequalities and achieve meaningful change?
QAIHC is calling for genuine, tangible commitments from political parties to address these questions.
QAIHC Chairman Matthew Cooke believes ACCHOs must be recognised and funded as integral participants in our federated health system. This recognition requires action, not rhetoric.
“We need fair and transparent funding arrangements based on clear evidence of need, and governance structures that grant the ACCHO sector a substantial role in shaping health service planning, funding, and delivery,” Mr Cooke said.
Mr Cooke highlighted the pressing need to address medication shortages and improve access to pharmacists within ACCHOs, stating, “Urgent action is needed to ensure Indigenous communities have the same access to essential medications and pharmacy services as other Australians.
“There is a lot of chronic disease in our communities and there is more difficulty for our patients to access medicines than other Australians.”
While governments often cite commitments to improving Indigenous health outcomes, the reality has fallen short. The National Agreement on Closing the Gap, signed in July 2020, outlined four priority reforms:
- establishing formal partnerships and shared decision-making;
- strengthening the community-controlled sector;
- transforming government organisations to better serve Indigenous communities; and
- sharing access to data and information at a regional level.
However, the Productivity Commission reported in February 2024 that governments have failed to adequately progress these commitments. Despite “pockets of good practice,” progress against the priority reforms had been “weak.” The absence of robust mechanisms to measure progress against these reforms highlights a persistent gap between policy intention and implementation.
Additionally, the failure of the Voice referendum has left governments wary of prioritising Aboriginal affairs, viewing it as a politically sensitive issue that does not win votes. This fear has led to a retreat from commitments like Path to Treaty, with Queensland repealing its legislation and other states slowing their efforts. This reluctance has created a general malaise among political parties in addressing Indigenous issues, including much-needed health reforms.
“These varying approaches highlight the lack of a cohesive national strategy to address Indigenous self-determination,” said Mr Cooke.
“Without clear commitments, governments risk deepening divisions and perpetuating inequities.
“Aboriginal and Torres Strait Islander communities have made it clear: they want practical, community-driven solutions over inappropriate and often tokenistic strategies.
“Investments must empower Aboriginal and Torres Strait Islander communities through local and regional place-based solutions, and promote shared decision-making that allows communities to identify their own priorities and solutions.”
Mr Cooke emphasised the need for equitable investment guided by evidence.
“We need publicly accessible data dashboards and mechanisms to ensure investments are targeted where they’re needed most. This is how we create real change,” he added.
Such measures would enable Indigenous communities to take control of their own futures, fostering practical solutions that are culturally appropriate and locally relevant.
Australia’s National Health Reform Agenda provides an opportunity to incentivise partnerships between hospitals and ACCHOs. Some hospital-delivered services — whether in the community or at home — could be transitioned to ACCHOs to ensure culturally appropriate care is prioritised. This approach would strengthen local expertise as well as address workforce capability gaps in Hospital and Health Services.
“We need to see direct investment in ACCHOs. This will better meet community needs rather than relying solely on hospital systems that have historically struggled to deliver culturally safe care,” said Mr Cooke.
As we move closer to the federal election, QAIHC is asking political parties to clarify their plans for Indigenous Australians. If they reject a Voice to Parliament and treaty pathways, what alternative frameworks will they propose? How will they:
- Close the gap in health and socioeconomic outcomes?
- Empower Aboriginal and Torres Strait Islander communities to lead decision-making processes?
- Ensure sustained investments that deliver measurable, effective outcomes?
The National Agreement on Closing the Gap has been in place for over three years, yet progress remains elusive. Achieving the 17 socio-economic targets under the agreement requires urgent action and rigorous measurement (please see pages 10-20 for detailed analysis). Without genuine commitment to shared decision-making and practical reforms, governments risk continuing to make investments that fail to deliver effective outcomes for Aboriginal and Torres Strait Islander communities.
Mr Cooke urged Members to advocate for their local communities and highlight the needs of Indigenous communities in the lead-up to the election, so their voices were heard.
He said this would be important for governments developing practical, actionable plans.
“Aboriginal and Torres Strait Islander peoples deserve more than symbolic gestures,” he said.
“They deserve meaningful action that respects their autonomy, acknowledges their expertise and invests in their futures.
“Leading up to the election, political leaders must provide detailed, actionable plans for addressing the systemic challenges faced by Aboriginal and Torres Strait Islander communities.”
For Aboriginal and Torres Strait Islander peoples, the question remains: who will step up and deliver the change they need and deserve?
Sector Leader asked our Member CEOs, as leaders in the ACCHO sector, what issues were most important to them in the upcoming federal election.
Ailsa Lively
Proud Gunggandji woman, CEO of Gindaja Treatment and Healing Indigenous Corporation, Yarrabah.
As the CEO of an Indigenous-run, community-controlled Alcohol and Other Drugs rehabilitation, treatment and healing service, the most important issue in the upcoming federal election is support for culturally safe, locally-led services for Aboriginal and Torres Strait Islander communities.
We need increased funding for programs designed, delivered, and governed by Indigenous people to ensure culturally appropriate care for those battling alcohol and drug dependence, particularly in remote areas.
We call for greater investment in holistic rehabilitation that respects traditional knowledge, empowers community leaders, and addresses the root causes of substance misuse.
Our services are designed to meet the unique challenges of remote Indigenous communities, and we urge the government to work with us to sustain community-led, evidence-based programs.
There must also be urgent action to close the gap in health outcomes, especially regarding the overrepresentation of Indigenous Australians in substance misuse statistics. Government policies should focus on long-term, community-driven solutions that ensure Indigenous voices are central to decision-making.
Manjit Sekhon
Acting CEO of Gidgee Healing, Mount Isa.
Current health systems fail to meet the needs of health care providers in creating a conducive environment for effectiveness and growth. These systems promote a reactive approach, responding to events by working towards solutions for specific problems rather than fostering long-term, sustainable change.
For instance, if a patient experiences a heart attack, the system focuses on reducing the risk of further heart attacks and preventing early death. While this response is critical, it highlights a broader issue: the lack of emphasis on proactive, preventative measures that could stop the heart attack from occurring in the first place.
However, the challenge extends beyond primary and secondary health care measures — it lies in the systems that underpin them.
Without structural support that enables preventative and community-driven health care, Australia struggles to become a major player in the field of effective and successful primary health care models, despite access to a competent, economical health care environment and a highly trained workforce.
What is QAIHC advocating for?
ACCHOs must be recognised and funded as integral participants in our complex federated system. This requires:
- Fair and transparent funding arrangements that respond to evidence of need.
- Governance arrangements that give the ACCHO sector a seat at the table and a substantial role in shaping health service planning, funding and provision.
- Direct actions to address medication shortages and improve access to pharmacists in ACCHOs.
