Remote Australia Online

Sexually transmissible infections (STIs) are hyperendemic in some remote Indigenous populations in Australia. Screening programs have had some success in reducing the prevalence of STIs in specific populations, but there has been little overall improvement in the past 10 years. We question the usefulness of current practice and urge consideration of a new and radical approach. Instead of a “screen, treat and contact trace” strategy, we suggest adopting the same approach as currently accepted for trachoma control: populations reaching a threshold prevalence for a set of marker STIs (identified through sentinel surveillance) should be offered a treatment program aimed at the entire sexually active population. We also recommend a parallel program of health promotion and “life skills” education and outline the arguments for such a departure from currently accepted public health policy.

The Let's Start Indigenous Preschool Programtargets Indigenous children aged 3-7 years of age who present with social-emotional and behavioural issues such as aggressive behaviour, non-compliant behaviour, withdrawn behaviour, shyness or separation anxiety. Although the program targets Indigenous children it is open to non-Indigenous families. The program aims to address and improve social-emotional learning and reduce behavioural problems, contributing to the ongoing wellbeing of children, their parents and families.

Public commentary commonly attributes blame to inadequate teaching, poor resourcing of remote schools or even lack of parental support for school attendance. In a recent review of education in the Northern Territory (NT) Dr Chris Sarra, from the Indigenous Education Leadership Institute in Queensland, accused NT educators of expecting less of their Indigenous students and inadvertently creating an underclass (ABC News April 13 2009). Why? Because the 2008 national English literacy and numeracy benchmarking tests indicated that the NT had some of the highest illiteracy rates in the country. With its singular focus on schooling, benchmark testing and attendance, the drive to increase literacy in remote Indigenous Australia tends to ignore adult literacy. Yet, Australian of the Year Mick Dodson has just declared that adult literacy is the key to closing the gap in Aboriginal life expectancy (ABC Online April 17 2009). The literacy debate rarely addresses the critical social and historical factors that also account for why literacy levels among remote Indigenous youth are lower than their mainstream, urban, English-as-a-first-language speaking counterparts. The focus on schooling obscures the less obvious fact that we must also be cognisant of the broader sociocultural factors associated with literacy acquisition, maintenance and transmission in newly-literate contexts such as those of the remote Indigenous world. There are many complex and intersecting factors that can be attributed to the lower rates of literacy, many of which actually have little to do with the quality of teaching or resources, school attendance or lower expectations of competence.

Objective: To measure changes over time in the burden of disease for Northern Territory (NT) Indigenous and non-Indigenous population. Methods: The numbers, and crude and age-adjusted rates of disability adjusted life years (DALY) were calculated for periods 1994 2013 1998 and 1999 2013 2003. A measure of information bias was developed to adjust for the tendency of years lost to disability (a component of DALY) to increase over time because of increasing data availability. The jackknife method was used for DALY uncertainty assessment. Results: The all-cause DALY rate was stable for the non-Indigenous population, but increased for the Indigenous population. For both populations, the burden of premature death decreased while the burden of disability increased. For the Indigenous population, there were substantial increases in DALY rates for type 2 diabetes, depression, nephritis/nephrosis, suicide and sense organ disorders. Conclusions: The burden of disease for Indigenous people increased over the study periods, with improvement in the burden of fatal outcomes more than offset by substantial increase in the prevalence and severity of non-fatal conditions. Implications: The paradoxical shift of living longer with a greater health burden has not been previously reported for Indigenous Australians, and highlights the critical importance of prevention for sustaining life expectancy improvement and managing escalation of health costs. This study also demonstrated the usefulness of the DALY to monitor population health.

Since 2007, Ernabella Anangu School has been looking closely at how to bring young people back into secondary classrooms, prepare them for employment opportunities, and transition into work. Initially, this was a school based focus. In 2009, a partnership was formed between the school, Dare to Lead, Dusseldorp Skills Forum and members of the community as well as builders and tradespeople in the region. The key purpose of coming together was to look at how we could develop a situation that prioritises local employment in the construction of houses and creates opportunities for young people to see an employment end point to their school based training. Housing SA (SA Govt) provided a housing contract for a local construction team to work on together. The purpose of this document is to share the principles and the learnings from this process in the hope that we can encourage others to consider new ways of looking at local employment in remote Indigenous communities. This is not about finding social benefit funds to fund ‘activity’, although it is about pursuing social justice. This is not about better ways to make money, although it is about an economic reason to work in different ways. This is not a policy position paper, although we do hope to inform, shape and encourage change in policy and practices in remote industry.

Objective: To examine trends in Northern Territory Indigenous mortality from chronic diseases other than cancer. Design: A comparison of trends in rates of mortality from six chronic diseases (ischaemic heart disease [IHD], chronic obstructive pulmonary disease [COPD], cerebrovascular disease [CVD], diabetes mellitus [DM], renal failure [RF] and rheumatic heart disease [RHD]) in the NT Indigenous population with those of the total Australian population. Participants: NT Indigenous and total Australian populations, 1977–2001. Main outcome measures: Estimated average annual change in chronic disease mortality rates and in mortality rate ratios. Results: Death rates from IHD and DM among NT Indigenous peoples increased between 1977 and 2001, but this increase slowed after 1990. Death rates from COPD rose before 1990, but fell thereafter. There were non-significant declines in death rates from CVD and RHD. Mortality rates from RF rose in those aged ≥ 50 years. The ratios of mortality rates for NT Indigenous to total Australian populations from these chronic diseases increased throughout the period. Conclusions: Mortality rates from IHD and DM in the NT Indigenous population have been increasing since 1977, but there is evidence of a slower rise (or even a fall) in death rates in the 1990s. These early small changes give reason to hope that some improvements (possibly in medical care) have been putting the brakes on chronic disease mortality among Aboriginal and Torres Strait Islander peoples.

Objective: To estimate daily cigarette consumption among residents aged 15+ in five remote central Australian predominantly Aboriginal communities. Methods: Estimation of average daily cigarette consumption derived from a 12-month (2007) complete sales audit of cigarettes in isolated communities where no other tobacco supplies are available, using two assumptions of smoking prevalence (50% and 70%). Results: Across the five communities, daily smoking consumption averaged 8.3 cigarettes per day (assuming a 50% smoking prevalence) or 5.9 cigarettes per day (assuming a 70% smoking prevalence). The corresponding amounts spent per smoker per day were $4.13 or $2.95, representing 12.7%-9.1% of the maximum $453.30 per fortnight unemployment allowance for a single person. Conclusion: While smoking prevalence may be high in these Aboriginal communities, smoking frequency is low compared to that in the wider Australian community. These results are consistent with other studies. Approaches to cessation premised on assumptions of nicotine dependence in such populations are likely to be misconceived.

Objective: To examine mortality from all causes and from cardiovascular disease (CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory. Design and participants: For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up). Main outcome measures: Mortality from all causes and CVD, and hospitalisation with CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates. Results: Mortality in the cohort was 964/100 000 person-years, significantly lower than that of the NT Indigenous population (standardised mortality ratio [SMR], 0.62; 95% CI, 0.42–0.89). CVD mortality was 358/100 000 person-years for people aged 25 years or older (SMR, 0.52; 95% CI, 0.23–1.02). Hospitalisation with CVD as a primary cause was 13/1000 person-years for the cohort, compared with 33/1000 person-years for the NT Indigenous population. Conclusion: Contributors to lower than expected morbidity and mortality are likely to include the nature of primary health care services, which provide regular outreach to outstation communities, as well as the decentralised mode of outstation living (with its attendant benefits for physical activity, diet and limited access to alcohol), and social factors, including connectedness to culture, family and land, and opportunities for self-determination.

This article, based on a Cooperative Research Centre for Remote Economic Participation (CRC-REP) research project - 'Pathways to Employment' - will canvas the proposition that mobile technology can be used as an effective vehicle for vocational learning in remote Australian communities. This proposition in itself is not new and indeed there are a number of examples in the literature that demonstrate the possibilities of mobile and emerging ICT technologies in remote Aboriginal and Torres Strait Islander communities in Australia and indigenous communities elsewhere in the world. However, the application of technologies in vocational learning is often applied to the delivery of mainstream training packages for mainstream employment outcomes. Further, the development of new technologies and 'apps' that go with them is changing at such a pace that past work in this field is fast becoming dated. The 'Pathways to Employment' research project considers pathways from a different starting point than many other research projects, which take as a given, the traditional notion of pathways to employment - typically linear, mainstream oriented and driven - with all the mainstream assumptions that go along with this notion of 'pathway'. The paper will focus on the opportunities presented by a relatively rapid uptake of mobile phone technology (in particular smartphones) and other information and communication technologies in remote communities for vocational learning that bases itself on Aboriginal and Torres Strait Islander standpoints. The challenge for VET practitioners presented in the discussion of the article is to build VET teaching and learning practice on a foundation of Aboriginal and Torres Strait Islander ways of being, knowing, valuing and doing. There is a temptation for trainers and assessors to consider pragmatic approaches of applying technologies to required competencies. Instead, the authors argue here that this should be secondary to the need for approaches using e-learning or m-learning to be grounded in learners' ontologies, epistemologies, axiologies and even cosmologies. On the surface this sounds like an academic exercise, but the authors argue that this approach is more likely to be effective, and further, it is doable for VET trainers working cross-culturally in remote parts of Australia.

The More Aboriginal and Torres Strait Islander Teachers Initiative (MATSITI) Project is a four-year national scheme to increase the number of Aboriginal and Torres Strait Islander people entering and remaining in teaching positions in Australian schools. This MATSITI Project Plan outlines the national strategy for 2012–15 and documents the scope, governance, reform priorities, project management arrangements and budget for the Initiative. The Initiative will be built on the most current qualitative and quantitative research available as the basis for developing and maintaining effective and lasting strategies to meet the objectives of the project. Developing strategies that enhance the professional and leadership capabilities of experienced Aboriginal and Torres Strait Islander teachers will form a key component of the Initiative. Key outcomes for the MATSITI project include: - comprehensive qualitative and quantitative research reports on background factors and various strategies and their effectiveness in increasing the number of Aboriginal and Torres Strait Islander teachers; - a series of partnerships and co-investment agreements with school authorities, university schools of education and other agencies to achieve lasting reform; - a national community engagement and marketing strategy to promote teaching as a career option for secondary Aboriginal and Torres Strait Islander students and adults. The MATSITI project is aligned with the COAG National Indigenous Reform Agreement and associated Closing the Gap targets to address Indigenous disadvantage. The $7.5 million MATSITI Initiative was announced by the Commonwealth Minister for Schools, Early Childhood and Youth, the Hon. Peter Garrett MP, in July 2011 and is funded by the Department of Education, Employment and Workplace Relations. The Initiative is led by senior Aboriginal and Torres Strait Islander educators, with secretariat and research support provided by the David Unaipon College of Indigenous Education and Research located within the University of South Australia.

The problem of overrepresentation of Indigenous offenders in Australian prisons highlights the need for effective tertiary intervention programs within correctional settings as a way of reducing Indigenous reincarceration. This study seeks to explore meanings of anger within an Indigenous context that might inform the development of more acceptable and potentially more effective rehabilitation programs. A methodology that acknowledges the importance of narrative, context, and culture was devised to explore how anger as an emotion is understood and experienced by a group of Indigenous men in a South Australian prison. Although some of the major themes reflected experiences of anger common to many offenders, it was evident that for these Indigenous men, anger was experienced within a broad social and political context that imbued the experience of anger with layers of culturally specific meaning. It is suggested that these layers of meaning constitute sufficient difference to warrant further exploration.

Measuring progress – providing information about whether life is getting better – is perhaps the most important task a national statistical agency undertakes. Measuring progress has been a responsibility of the Australian Bureau of Statistics (ABS) and its predecessors since colonial times. Then, the idea of progress and the measures required were somewhat simpler – wool exports and the size of the population, for instance. Over time, more complex measures were introduced, such as labour force measures and economic accounting, in response to social and economic disruption following the First and Second World Wars. More recently, global interest has focussed on measuring the social and environmental dimensions of progress; ensuring that official statistics measure what nations care about for national progress; and going beyond using Gross Domestic Product as the main indicator of progress. A decade ago the ABS made a major contribution with the release of the first issue of Measures of Australia’s Progress (ABS 2002). At that time, the Bulletin referred to Measures of Australia’s Progress (MAP) as a revolutionary set of indicators which provided great insights into how life is improving and at what rate. Ten years on, the ABS, guided by the MAP Expert Reference Group (ERG), has undertaken a national consultation to review MAP, ensuring it remains relevant to today’s society – that we are measuring what Australian society cares about. Proposing aspirations for national progress is the role of the Australian public, rather than that of the ABS. The role of the ABS has been to facilitate and synthesise the set of aspirational statements received from the consultation process. This consultation has therefore allowed the ABS to hear, listen and reflect on the aspirations that Australians hold for national progress. This publication provides an account of this consultation; how it was run and the feedback that has been received. It highlights the ABS’s use of social media to engage new audiences and provides a record of the broad consultation undertaken with individuals, organisations and governments across the nation. The publication also presents an overview of other key progress measurement initiatives, both national and international, and the aspirations that these projects articulate.

In order to systematically tailor services to meet the needs of Australians living in regional Australia, ‘remoteness’ (identified with lack of accessibility to services regarded as normal in metropolitan areas) needs to be defined. In 1996-97, the National Key Centre for Social Applications of Geographical Information Systems (GISCA) was commissioned to assist with a number of aspects of the ABS review of the Australian Standard Geographical Classification (ASGC). This review included investigating the measuring of remoteness in a more or less objective way. They recommended applying Geographic Information System (GIS) techniques to do so. ABS did not proceed with defining remoteness as suggested at that stage in the review of the ASGC. The Department of Health and Aged Care commissioned GISCA to work with them (under a steering committee of user Departments and the ABS) to develop a GIS methodology to produce a remoteness index and associated classification, along with a database of road, locality and service information. The resulting Accessibility/Remoteness Index for Australia (ARIA) was designed to be comprehensive, sufficiently detailed, as simple as possible, transparent, defensible, and stable over time - and to make sense ‘on the ground’. ARIA was also designed to be an unambiguously geographical approach to defining remoteness. That is socio-economic, urban/rural and population size factors are not considered for incorporation into the measure. ARIA calculates remoteness as accessibility to some 201 service centres based on road distances. Remoteness values for 11,340 populated localities are derived from the road distance to service centres in four categories (a weighting factor is applied for islands). Remoteness values for each populated locality are then interpolated to a 1 km grid that covers the whole of Australia and averages calculated for larger areas. To create an associated classification, ARIA values are grouped into five categories using ‘natural breaks’ in the 0 – 12 continuous variable: 1. Highly Accessible (ARIA score 0 - 1.84) - relatively unrestricted accessibility to a wide range of goods and services and opportunities for social interaction. 2. Accessible (ARIA score >1.84 - 3.51) - some restrictions to accessibility of some goods, services and opportunities for social interaction. 3. Moderately Accessible (ARIA score >3.51 -5.80) - significantly restricted accessibility of goods, services and opportunities for social interaction. 4. Remote (ARIA score >5.80 - 9.08) - very restricted accessibility of goods, services and opportunities for social interaction. 5. Very Remote (ARIA score >9.08 - 12) - very little accessibility of goods, services and opportunities for social interaction.

The concept of social and emotional wellbeing that underpins the analyses in this Report attempts to capture an Aboriginal and Torres Strait Islander holistic and whole-of-life view of health. It includes mental health, but also considers the impact of other factors on emotional well being, such as life stressors, removal from family, discrimination and cultural identification. Until recently, the majority of national data on the social and emotional wellbeing of Aboriginal and Torres Strait Islanders centred on the use of mental health services. The interim social and emotional wellbeing module was developed to collect national data on this topic in the 2004–05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS). The interim module has eight domains—psychological distress, impact of psychological distress, positive wellbeing, anger, life stressors, discrimination, cultural identification and removal from natural family. This report provides current national data on the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples, reviews the effectiveness of the interim social and emotional wellbeing module, and makes recommendations for improving measures of social and emotional wellbeing.

The purpose of this paper is to offer a counter to the argument that changes emerging from social programs are often unmeasurable. We offer a critique of the kinds of indicators used to evaluate outcomes of different types of programs and ask the question: ‘Are these indicators a true reflection of outcomes?’ The critique is based on a number of evaluations carried out by members of Charles Darwin University’s Social Partnerships in Learning consortium over recent years. These evaluations have included a range of social programs funded by several government and non-government organisations. Many of the programs were designed to address health and well-being, community safety, family function, education and community capacity issues. The paper commences with a review of relevant literature related to evaluation methodologies. It then goes on to consider traditional approaches to measurement of ‘performance’. Examples are drawn from four recent Northern Territory Government departmental annual reports. Some of SPiL’s recent evaluation work is then described as a backdrop to a discussion about the use of appropriate tools and indicators for complex evaluations. We conclude by suggesting that, provided outcomes are ascertained through culturally informed processes and correctly attributed to program activities, there is no reason why outcomes should be unmeasurable.

Models of Intervention at the Point of Crisis in Aboriginal Family Violence

This study explored the racial identity of Indigenous children and youth who attended urban, state and private primary and secondary schools in the Noongar[i] region of urban Perth in Western Australia. Thirty five Australian Indigenous children aged 8-12 were interviewed and 120 youth aged 13-17 participated in focus groups. Transcripts were analysed and common themes were identified by extracting relevant responses and their meanings. The components of racial identity for children aged 7-12 and youth were very similar such that culture, family, language and appearance featured. The most reported element of racial identity for young children was culture which comprised of eight sub-elements. Young people however, reported that a strong sense of self was the most important contributor to their racial identity and it comprised of ten sub-elements. Indigenous youth perceived that their racial identity is exposed to others' attitudes, values and behaviours because according to them 'identity is about what you look like and how others see you'. Noongar can be spelled in a number of ways and this paper has adopted the above spelling. Noongar is a collective term that denotes Aboriginal people of the south-west of Western Australia (Palmer & Collard 1993).

In Australia, injury is a leading cause of mortality and permanent disability, including the principal cause of death in people under 45 years of age. Throughout the 1990s, injury was annually responsible for more than 7000 deaths, 400,000 hospitalisations and direct medical costs of $2.6 billion according to estimates by the National Health and Medical Research Council.1 For the Northern Territory previous reports have recorded injury rates that are generally higher than those in other Australian states. The starkest indicator of injury is that of the injury death rate which for the Northern Territory (NT) has been previously reported for 1997, as 88 deaths per 100,000 of population which was more than twice the national rate of 41 deaths per 100,000. This report is the first full report on injury in the NT and provides a comprehensive summary of injury across the dimensions of mortality, public hospital admissions, presentations in Emergency Departments and importantly in the NT, interstate hospital transfers for the treatment of injury. The report also provides estimates for the health care costs of injury in the Northern Territory.

Myth of the ‘walkabout’: Movement in the Aboriginal Domain

The National Assessment Program - Literacy and Numeracy (NAPLAN) assessments are designed to assess literacy and numeracy of all Australian school children in years 3, 5, 7 and 9, and to act as diagnostics as to whether children are meeting intended educational outcomes. Tests began in May2008, and have been run annually since then. Results of the 2008 tests indicated that Indigenous children in remote communities had the lowest test scores, and results were used to make a policy decision that effectively scrapped bilingual education in the Northern Territory. In this paper, we evaluate the literacy component of the NAPLAN test for Year 3, and the language samples for each year level. Literacy components assess reading, writing and language conventions (grammar,spelling and punctuation), and we focus on the reading and language conventions components. We argue that the NAPLAN tests need to be very carefully monitored for appropriateness for the assessment of children living in remote Indigenous communities. This is because tests are standardised on groups of English language speaking children. The content of some sample tests relies on cultural knowledge which Indigenous children cannot be expected to have. Spelling tests need to be monitored to ensure that they are testing spelling rather than grammatical knowledge. Finally, it is difficult to create language convention tests which are truly diagnostic because of the mixed test population of nativeEnglish speakers, ESL learners and EFL learners in remote Indigenous communities.

1. This agreement is created subject to the provisions of the Intergovernmental Agreement on Federal Financial Relations and should be read in conjunction with that Agreement and subsidiary schedules. In particular, the schedules include direction in respect of performance reporting and payment arrangements. 2. The Parties are committed to addressing the issue of social inclusion. That commitment is embodied in the objectives and outcomes of this Agreement. However, the Parties have also agreed other objectives and outcomes which the Parties will pursue through the broadest possible spectrum of government action. Consequently, this agreement will be implemented consistently with the objectives and outcomes of all National Agreements and National Partnerships entered into by the Parties. 3. In December 2007, the Council of Australian Governments (COAG) agreed to a partnership between all levels of government to work with Indigenous communities to achieve the target of Closing the Gap in Indigenous disadvantage. 4. This National Indigenous Reform Agreement has been established to frame the task of Closing the Gap in Indigenous disadvantage. It sets out the objectives, outcomes, outputs, performance indicators and performance benchmarks agreed by COAG. It also provides links to those National Agreements and National Partnership agreements across COAG which include elements aimed at Closing the Gap in Indigenous disadvantage. 5. The National Integrated Strategy for Closing the Gap in Indigenous Disadvantage can be found at Schedule A. The foundation of the Closing the Gap Strategy is the identification of and commitment to targets addressing Indigenous disadvantage, and associated building blocks – areas for action. This Strategy acknowledges the importance of Indigenous culture, and engagement and positive relationships with Indigenous Australians. It discusses the contribution of the current COAG reform initiatives to meeting the targets, the frameworks for accountability and performance reporting, and also signals areas for future work. 6. The National Indigenous Reform Agreement, like other National Agreements, is a living document subject to enhancement over time to reflect additions and changes to existing and new National Agreements and National Partnership agreements. As COAG agrees to additional reforms to Close the Gap in Indigenous disadvantage, these will be reflected in this Agreement.

Goal To ensure that Aboriginal and Torres Strait Islander peoples enjoy a healthy life equal to that of the general population that is enriched by a strong living culture, dignity and justice. Aims To achieve this goal specific aims relating to life expectancy, morbidity, mortality and the prevalence and impact of particular health conditions need to be achieved. The aims listed below relate to already agreed national performance indicators (NPI -indicated by number in brackets and specified at Appendix Five of the Context document) and provide the basis for measuring the impact of this National Strategic Framework on some significant indicators of health outcomes. 1. Increase life expectancy to a level comparable with non-Indigenous Australians. (NPI #5) 2. Decrease mortality rates in the first year of life and decrease infant morbidity by: _ Reducing relative deprivation; and _ Improving well being and quality of life. (NPI #6-10, 26, 28, 32,48) 3. Decrease all-causes mortality rates across all ages. (NPI #50-56) 4. Strengthen the service infrastructure essential to improving access by Aboriginal and Torres Strait Islander peoples to health services (NPI #15-24) and responding to: _ Chronic disease, particularly cardiovascular disease, renal disease, diseases of the endocrine system (such as diabetes), respiratory disease and cancers; (NPI #41, 43, 44, 54, 55, 56) _ Communicable disease, particularly infections in children and the elderly, sexually transmissible infections and blood borne diseases (including Hepatitis C); (NPI #37, 38, 39) _ Substance misuse, mental disorder, stress, trauma and suicide; (NPI #30, 32-36, 46, 53) _ Injury and poisoning; (NPI #35, 42, 53) _ Family Violence, including child abuse and sexual assault; (NPI #32, 35, 42, 53) and _ Child and maternal health and male health. (NPI #5-10, 25-32, 47-49)

Research in Aboriginal health may be hampered by a lack of experience with the process of collaboration with Aboriginal communities, and additional ethics approval requirements. Awareness of resources and advice from Aboriginal mentors with in-depth knowledge of clinical and research issues can greatly assist researchers. A collaborative approach between researchers and Aboriginal communities is pivotal to developing a research project consistent with Indigenous cultural values and health concepts, with the potential to improve services and outcomes for Aboriginal peoples. Planning and broad consultation can ensure that research is feasible, ethical, culturally sensitive and beneficial. This article outlines lessons learned from personal experience of developing a project in Aboriginal health, which we hope may serve as a practical guide for others.

A New Deal for Aborigines: Private property rights, educational reform, health care privatisation, and the application of the rule of law are urgently needed in Australia’s remote communities if Aborigines and Torres Strait Islanders are to move out of the Third World squalor in which they are currently trapped. Since the 1970s Australia has been conducting a socialist experiment in remote communities with the lives of Aborigines and Torres Strait Islanders. Coombs, Brandl and Snowdon provided the blueprint in A Certain Heritage, advocating communal land ownership, supported by substantial welfare transfers, to create an Aboriginal and Torres Strait Islander hunter-gatherer utopia that would culminate in a nation independent from the rest of Australia. The Mabo and subsequent judgments that transferred large areas of land to Aborigines and Torres Strait Islanders made a substantial contribution to the implementation of the Coombs experiment. But nowhere in the world has communal land ownership ever led to economic development. Attempting to replicate hunter-gatherer groups in fixed locations created remote, fragmented communities that cannot support jobs and incomes. Education, health, life expectancy, housing, employment and income gaps between the remote community dwellers and other Australians have widened. Alcoholism and other substance abuse and crime, particularly against women, have escalated. Any group, regardless of ethnic origin, subjected to this experiment, with all energies deflected from economic to cultural activities, would have been condemned to the same fate. Lack of funding is not the problem. Household incomes in remote communities, largely consisting of welfare payments, average $14,000 a year to which must be added expenditure on education, health and housing. But Commonwealth funding alone is some $70,000 per household, and there is additional State and Northern Territory funding. A very considerable share of public expenditure clearly does not reach its targets. Notionally, Aborigines and Torres Strait Islanders in remote communities would be better off if they were paid the amounts spent by the Commonwealth, States and Northern Territory in cash and were free to buy their own education, health, housing and other services. The deprivation resulting from welfare dependence has been hidden by policies that prevented contact between the Aboriginal and Torres Strait Islander ‘living museums’ and all other Australians, except for their ‘curators’, until courageous Aborigines, led by Noel Pearson, began to speak out for an end to welfare dependence. The deprivation and misery of remote Aboriginal and Torres Strait Islander communities can no longer be tolerated. ‘Mutual obligation’ cannot reduce dependence on welfare while failing education denies Aborigines and Torres Strait Islanders jobs. A new deal must replace the utopian experiment with policies that ensure that Aborigines and Torres Strait Islanders have equal opportunities to other Australians. The following areas require urgent reform: - An individual property rights land ownership framework must be established to enable Aborigines and Torres Strait Islanders to develop enterprises and attract investment to create jobs and incomes. Ninety-nine year leases are essential to facilitate individually owned private housing. - A volunteer ‘literacy corps’ campaign in school and university vacations should introduce literacy in English and basic numeracy to all communities that desire it within three years. ‘Internet cafes’ should stimulate and maintain literacy. - The health care bureaucracy should give way to clinical solutions to stem appalling health conditions. A census of children’s and young people’s health should provide the basis for the immediate improvement of clinical health care. - To reduce violence and end the exploitation of remote communities by ‘payback’, State, Territory and Federal laws must apply to all Australians, regardless of ethnicity.

On 19 July 2007, the then Minister for Family and Community Services, Ms Delia Lawrie, announced an Independent Audit of Clients at Risk to cover high risk clients within her portfolio of Community Services. This followed the deaths of two people for whom the Department had some level of statutory responsibility - a twelve year-old girl in foster care, and a seventeen year-old boy who allegedly stabbed and killed his carer, who was also his uncle. The Minister announced that the audit would involve ‘A risk assessment of all potentially at risk clients across the Territory’ and would ‘look at clients across the agency’s divisions of Alcohol and other Drugs, Family and Children’s Services, Aged and Disability and Mental Health.’ Terms of Reference for the project were developed which provided more detail of the project parameters. The central objective of the audit was: To assess whether current risk management strategies for client care in the Community Services Division reflect appropriate professional practice and models of care. A set of processes and tasks were defined as the parameters of the project were negotiated in discussion with Departmental management. These included the appointment of a Departmental Project Manager and initial workshops conducted with senior personnel from the four Community Services Programs. As the concept of client risk is complex and multi-faceted, it was determined that the focus of the audit would be on the nature of the concerns expressed by Minister Lawrie – risk to the welfare of clients of the various Community Services Programs, and that posed by the clients themselves to others. Many aspects of good case work and clinical practice could broadly be understood as approaches to manage risk, but an exploration of good practice in the many professional domains represented in Community Services was beyond the scope of the audit. The focus of the audit was therefore placed on those approaches and interventions that were specifically designed or described as being for risk assessment and/or management. There was also a focus on those areas of practice where specific tools, processes or services were needed but not available or not being used. Given that Family and Community Services (FACS) and Aged and Disability (A&D) had a statutory role in the cases that triggered this audit, they are the Programs that have been examined in greater depth.