Policy, Power and Politics: A Critical Analysis of NSW Aboriginal Health Plan of 2013-2023

This article critically analyzes the NSW Aboriginal Health Plan of 2013-2023, which aims to close the health gap between the Aboriginal and non-Aboriginal population in Australia. It discusses the legal, social, and cultural frameworks necessary for the development of the Aboriginal community people.

Running head: POLICY, POWER AND POLITICS
Policy, Power and Politics
Name of the student
Name of the university
Author note

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Contents
Introduction......................................................................................................................................2
Policy Analysis................................................................................................................................4
Demonstrate an understanding of policy issues...........................................................................7
Evidence of critical discussion and analysis................................................................................9
Conclusion.....................................................................................................................................11
References......................................................................................................................................13

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Introduction
One of the most ancient populations in the globe is the Aboriginal community. The
resilience of the community people develops the framework for the structure of the policies for
the effective development and improvement of the overall health of the aboriginal group of
people in Australia. The word ‘Aborigine’ is a Latin word meaning to be a native and to be
descended. Most of the aboriginal people live in the rural or remote areas (Liaw et al., 2015).
According to the surveys and the researches only a small percentage about 24.6% of the total
aboriginal people lives in the urban cities. The rest resides in the regional areas and the rural or
remote areas. Furthermore, it has been found that the life expectancy rates and the mortality rate
of the community people are lower as compared to the other populations in the country. On an
average, only 4% of the indigenous population lives more than 65 years and the research
conducted in the community revealed that most of the population aged below 15 years 9 (Gwynn
et al., 2015). The average mortality rate is generally 12 years less than the non-indigenous group
of people in the country. The higher rates of chronic diseases like mental health issues,
cardiovascular diseases, cancer, respiratory problems, diabetes and other deep injuries contribute
to the higher death rates among the community people. Furthermore, there lie multiple factors
responsible for the degrading status of the health of the aboriginal people. The data report of
2008-2009 by the Australian government stated that most of the population suffers from
disabilities and long-term health issues leading to high level of psychological distress (Lin,
Green & Bessarab, 2016). Domestic violence and sexual violence ’s, some of the basic
behavioral factors like alcohol and drug abuse, high body mass, smoking contributes to the
degrading cultural system in the aboriginal community. There lies a direct relationship among

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the health gap between the aboriginal people and the factors contributing to the socio-economic
inequalities.
The survey of 2011 by the government of Australia identified that more than 175,431
people belonging to the aboriginal community reside in New South Wales. It constitutes about
2.5% of the total population of the people living in Australia. By the year 2031, it has been
estimated by the Australian government that the rate and the number of Aboriginal people will
raise by 1 million in the continent. The number constitutes around 3.95% of the total population
of Australia (Sutherland et al., 2017). It is essential to improve and appreciate the social and
economic determinants of Aboriginal health like the factors of historical contributions,
employment, education, cultural and social capital, racism, housing, environmental factors for
the closure of the gap in health status among the aboriginal and the non-aboriginal population in
the country.
The NSW Aboriginal Health Plan of 2013-2023 aims equity of health for the aboriginal
group of people. The goal of the plan is to work in partnership with the Aboriginal community
people for the achievement of the highest level of health care required for the individuals and
families of the aboriginal community. The reason for the choice of the policy of NSW Aboriginal
Health Plan of 2013-2023 is because the plan not only constitutes measures to address the
physical wellbeing of the aboriginal population but also refers the emotional, social and cultural
wellbeing of the community people (Brown et al., 2015). The policy recognizes the importance
of the achievement of potential by the aboriginal population for the total well-being of the
community in the country. The National Aboriginal and Torres Strait Islander Health Plan of
2013-2023 was formulated to provide a dominant framework for building links with some of the
major activities related to commonwealth health. The policy furthermore identifies the areas for

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focusing to navigate the investments in the future for implementation of certain strategies that
aim to improve the health and lives of the aboriginal people. This policy framework is the result
of the parts of effort for closing the gap by the government of Australia. The 10-year health plan
has been developed in the partnership with the Australian government and the community
organizations (Durey et al., 2016). Australia’s first people’s national congress has provided a
critical role initiating insurance feedback and input in the development of this health plan. One of
the main factors which contribute to the choice of this plan includes the signal towards the
expansion of aims and focus on the health and development of the children and the persons
suffering from both mental and physical disabilities. It can thus be summarized that the policy
targets to align and implement plans and strategies for responding to the challenges the
aboriginal people are facing in their daily lives.
Policy Analysis
Policies are the principle rules that are generally adopted to achieve some targets or
goals. They are designed primarily to identify, solve and minimize the current issues. In the
current context, health related policies are being discussed (Lewis et al., 2011). These policies
are constructed to affect the organizations and the services of the organizations that are related to
the system of health care. The health care policy discussed in this assignment is about the
aboriginal people residing in Australia. The policy includes intended actions and strategies
targeting an alteration and impact on the status of health of the aboriginal population. The
procedure of the policy of the NSW government in case of the aboriginal health status is a
procedure of politics that considers the workforce availability, community and media
expectations, funds availability, epidemiology and demography, funding mechanism and the

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procedure of legislation (Ridani et al., 2015). The cycle of policy in the context of Australia can
be illustrated by the following model.

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Figure 1 Source: (Althaus, Bridgman & Davis, 2013)
The commitment between the NSW and the Aboriginal Health and Medical Research
Council (AH&MRC) contributes to their joint action towards the emission of the gap in health
care within the aboriginal community in Australia (Australian Government, 2015). The
government aims to implement a strategic solution to enhance provisions for supporting health
services of the aboriginal people of NSW. The government targets to address the social
determinants that are essential to restore and improve the health of the aboriginal population and
decrease the gap between the aboriginal and non-aboriginal people. There are various inter
connected factors which contributes towards the poor and degrading status of health in the
context of the aboriginal population. The connection and the relation between the health gap and
the factors of socio economic inequality are quite clear in this context. Some of the important
factors contributing to the socio economic inequality are education, racism, historical factors,
employment, environmental factors and more (Durey et al., 2016). The government of NSW

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hence targets to expertise for initiating support towards the provisions of the health care among
the aboriginal group of people. Thus it can be concluded that the health program and the policies
must be developed to effectively address the social and economic disadvantages of the aboriginal
group of people. There is no specific data or information regarding the amount of revenue spends
on the programs in each state of the people. The Australian Institute of Health and Welfare
(AIHW) publishes the report stating the expenditure on the community of aboriginal population
which tends to estimate the expenditure on the basis of the survey (Anderson, Ward & Card,
2015). These surveys are based on the health services and thus the estimate budgets tend to get
affected due to the sampling errors.
According to the survey reports, in the year 2006-2007, a total estimate of 80.9 billion
was being spent on the sector of health care among which $54.9 billion was being funded by the
federal governments and the state (Walls et al., 2011). The promise and the commitments for
closing the gap were reassured in the year 2010 with the support of the NSW parliament for the
achievement of health equity among the aboriginal group of people with the help of long term
comprehensive plan. The plan of NSW 2021 aims to keep the aboriginal people in a healthy
shape and out of hospital and clinics with the aim of the following strategies.
• To decrease the rate of hospitalizations which are potentially preventable by 2.5% for the
community of aboriginal people.
• To reduce the rate of smoking by 2.4% in case of aboriginal pregnant women.
• To halve the health gap between aboriginal and non aboriginal mortality rates by the
upcoming year.

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Demonstrate an understanding of policy issues
The major initiatives by the community organizations and the government focus mainly
on the gap in the health care within the Aboriginal and the non-aboriginal people. The initiatives
and the commitments for improving the health system of the aboriginal people can be achieved
by reducing the rate of risked drinking, obesity reduction and issues of overweight, improvement
of the facilities for the aboriginal people who are admitted in the health clinics, reduction rates in
unplanned re admissions and improvement in the outcomes of mental health among the
aboriginal community people (Dawson, Nkowane & Whelan, 2015). Besides these initiatives,
increasing level of satisfaction rates, decrease in the diseases related to health care among the
aboriginal patients and ensuring that all the services related to health care meet the standard and
the quality of the aboriginal patient’s safety are some of the essential factors that need to be
addressed for achieving the goal. Some of the frameworks that can be considered in the context
of the health status of the aboriginal community people are the following.
Legal framework: The lack of proper laws for the improvement of the health services of
the aboriginal people by the Australian government has negative consequences of health on the
community people. The comprehensive structure of the existing health legislation has very little
recognition of the requirements of the aboriginal people of Australia. Thus the current legal and
policy framework is faulty and states the following review. Among the 69 acts of principle by
the Department of Common wealth of Health and Aging, only three acts are referred to the
aboriginal community people though they lack the notion of responsibility for the governance
(Yi et al., 2015). Furthermore, among the 200 acts by the health authorities and the states, only
the laws introduced by the South Australia included provisions for the justification of financing
and programming decisions in the context of the health care system of the aboriginal people in

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the Australia. Lastly, there lies no strong legislative structure for securing the governance of the
health of the Aboriginal people among the principle acts administered by the State, Community
and the Commonwealth portfolios.
Social framework: In the context of the above policy, the social framework provides a
targeted focus on the emotional wellbeing and status of mental health of the aboriginal people.
The social framework develops a culturally appropriate and comprehensive model for enabling
equal access towards the health services of the aboriginal community people. The aboriginal
people have been subjected to various forms of discrimination and marginalization through the
past decades. The social health care framework thus includes some of the key principles and
strategies to emphasize on the status of the health care of the community people. It is important
to maintain harmony among certain factors such as the mental, physical, cultural and spiritual
health together with the land for persisting improvement on the health status of the aboriginal
community people. Recognition and respect towards the basic human rights of the community
people together with the abolition of the social stigma like the racism, environmental adversity,
trauma, and loss are some of the important factors that contribute to the status of the social and
health status of the aboriginal community people.
Cultural framework targets safe, responsive and accessible health care system for the aboriginal
people with the successful recognition of the cultural differences and strengths of the community
people. The cultural respect framework aims to provide support to the corporate governance
health, management of the organization and delivery of standard health care services.

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Building of strong framework for the development of the aboriginal community people
with the help of a tiered approach is thus necessary. This will furthermore initiate empowerment
of the aboriginal people together with the increasing wellbeing status.
Evidence of critical discussion and analysis
Some of the goals and objectives of the policy under discussion, NSW Aboriginal Health
Plan of 2013-2023, that can be concluded after the analysis of the frameworks includes the
closing of the health gap among the aboriginal and the non aboriginal population in Australia.
Equal access to the benefits and strategies of the policy among all the people in the country.
Halving of the gap in the rate of mortality for the children in aboriginal community under the age
group of five. Furthermore, better collaboration and levels of integration with the stakeholders
and the organizers of the policy for more funding towards the degrading group's health status.
The core indicators that need to be improved for quality health and life status of the aboriginal
people includes access to housing, clean and safe water, sanitation, electricity, emergency
management, disposal of solid wastes and more (Sibthorpe et al., 2017). The goal of the policy is
to provide efficient health care services, development, and design of an action plan for the
targeted goals.
The degrading status of health of the aboriginal people is co-related to the gap in life
expectancy among the aboriginal and the non aboriginal population in Australia. Access to
appropriate and affordable health care is thus important for the improvement of the status of
health of the aboriginal group of people. The aboriginal people of Australia are currently
experiencing the effects of health which are connected to legacies of colonial and post colonial
contexts. The community people tend to face high injury rates and higher rates of deaths caused
due to accidents as compared to the other community groups in the country (Cameron et al.,

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2014). Hence valid and proper access on affordable services of health care facilities is extremely
essential and critical for initiating improvement in the status and structure of health of the
aboriginal group of people since these serve as some of the major determinants to induce the
policies related to health care. In the above context, it can further be stated that there lie various
disparities and issues in the NSW Aboriginal Health Plan of 2013-2023. Some of the major
issues related to the policies include the negative experiences of the aboriginal people regarding
the implementation and access towards the policy. According to the community people,
aboriginal individuals are prone to discrimination, stigmatization, victims of persistent colonial
attitudes among the nation and the society. Though various measures and methods have been
initiated by the policy for making a major improvement in the health care status and the
empowerment of the aboriginal community people, there lay certain valid issues (Reeve et al.,
2015). The discussed policy has certain bureaucratic and administrative challenges which
generally operate at the community level. Issues like these generally tend to limit the space for
the aboriginal people for undertaking captivity on politics. Furthermore, there have been a very
low number of researches in this field regarding the implementation of the health policies and if
the effectiveness and targets of the policy reach the people, whether the aboriginal people get the
benefits of the NSW Aboriginal Health Plan of 2013-2023.
Some of the notable approaches by the NSW government includes the intergovernmental health
authorities and the mechanisms of cross jurisdictions in case of the NSW Aboriginal Health Plan
of 2013-2023. Besides this, this policy is often hampered by the confusion of legislation which
results in lack of proper implementation. It has furthermore been found that the policy is easily
accessible to the individuals belonging to the population of the first nations (Reeve, Humphreys
& Wakerman, 2015). The aboriginal people often lack the access to the policy. Some of the other

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notable policies for the aboriginal health care include the Koolin Balit: Strategic Directions for
Aboriginal Health 2012–2022, The WA Aboriginal Health and Wellbeing Framework 2015–
2030 and ACT Aboriginal and Torres Strait Islander Health Plan 2014–2019.
For addressing the above issues, there should lay various mechanisms and measures for
mending and bridging up the gap of jurisdictions and effective identification of the aboriginal
people towards the identification of the issues related to the health policies. Some of the decision
parameters in the context of addressing the issues related to policy includes resources,
timeframe, and priorities. Resources to address the issues of policies include a clear discussion
with the stakeholders, sufficient funding for the action plans and effective strategies to address
the issues of health care of the aboriginal group. The timeframe for the implementation of the
actions is estimated to be a 1-2 year from date (Wakerman et al., 2017). Furthermore, priorities
should be made to target the issues and the requirements of the aboriginal group of people and
their health status should be improved enabling equal access towards the policy.
Conclusion
Policy issues are complex and are generally costly to address. Effective analysis shapes
the issues with the effective establishment of the characteristics, framing of the issues and
implementing certain policy approaches. The aboriginal community people have been long
neglected throughout the years. The NSW Aboriginal Health Plan of 2013-2023 do very little to
support the provisions of the services related to appropriate health care to the Aboriginal people
of Australia. Thus it can be concluded that time has now come to consider the comprehensive
approaches of legislation for ensuring that the aboriginal people get access to appropriate
services of health. Some of the key recommendations can be the introduction of a

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commonwealth law which establishes the responsibility of the federal government for
interpretation and administration of effective services for the aboriginal people. Furthermore,
development of a model for the adoption of the strategies to address the ongoing health, physical,
social, cultural and economic issues of the aboriginal community group is an essential factor that
needs to be addressed. Introduction of child and maternal safety health services, alcohol and drug
rehabilitation services, policies for suicide preventions are some of the common
recommendations that the policy of discussion can revise. The National Aboriginal and Torres
Strait Islander Health Plan 2013-2023 must focus on both the physical and the social and the
emotional wellbeing by upgrading the frameworks to reduce and abolish the significant gap
among the aboriginal and the non- aboriginal people in the country.

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