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					                    Australia’s compliance with the ICESCR
                         Fact Sheet: Access to Health
Current Australian laws and policies do not adequately protect the right to health, raising concerns in regards
to Australia's obligations under the International Covenant on Economic, Social and Cultural Rights. While
Australian government spending for health services is relatively high, at around 30 percent of the total
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budget, there are concerns that this money is being used inefficiently.

Public Health
Provision of public health care in Australia is suffering from chronic underfunding, a decaying public hospital
system, rising medical costs, inadequate coverage and inaccessibility, particularly for marginalised and
disadvantaged people. Recent cases show problems associated with public funding of hospitals in rural
areas and also mismanagement of patients.

Indigenous Health

The state of Indigenous health in Australia continues to result from and present serious human rights
breaches. Indigenous Australians, and in particular Indigenous women, continue to experience much higher
levels of ill-health, disease and death than non-Indigenous Australians. The average life expectancy for
Indigenous male Australians is 56.3 years and 62.8 years for females, compared to 77 years for males and
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82.4 years for females in the general Australian population.

In November 2008, the Federal Government and State governments committed a joint $1.6 billion to improve
Indigenous health. This constitutes the biggest single injection of new funding by an Australian government
to improve Indigenous health outcomes. Whilst the significant commitment of funding is to be welcomed,
reports suggests that Indigenous children continue to be subject to extreme disadvantage compared with the
non-indigenous population in many health statistics, including the number of stillborn babies, pre-term births,
low birth weights, infant mortality rates, deaths from respiratory problems, infectious and parasitic diseases
and many other significant health problems.
Whilst the Australian Government’s commitment to further funding is to be commended, the Government
should ensure that it implements the range of strategies suggested by the Australian Medical Association’s
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2008 report card on Indigenous health.

Mental Health
Mental health inpatient and crisis services are significantly under-resourced in Australia and there are
widespread problems with access to care, quality of care and adequate accommodation for people requiring
mental health services. People with mental illness are significantly over-represented in key measures of
disadvantage such as homelessness, unemployment, poverty, substance abuse, and incarceration rates.
Furthermore, within mental health services, there is still too great a use of aversive treatments with harmful
side effects and reliance on involuntary treatment regimes. These factors jeopardise the adequacy of mental
health treatment for consumers.

The Government should take immediate action to ensure that mental health services are adequately funded
and that consumers have appropriate input into their own treatment.




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Asylum Seekers

Many asylum seekers who have been detained for long periods have developed mental health problems, or
have had their mental health problems become worse because of their time in detention. Given the
increased risks of distress and vulnerability to mental illness, there have been particular concerns about the
suicide and self-harm observation rooms at Villawood Immigration Detention Centre: where detainees should
receive adequate psychiatric care, individuals requiring mental health care are placed in what amounts to
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solitary confinement. This has been labelled a ‘disgrace’ by the Australian Human Rights Commission.

On 9 August 2008 the Australian Government abolished temporary protection visas for refugees. This is a
welcome improvement to the right of many asylum seekers in the community to access appropriate
healthcare. People engaging the protection obligations of Australia are now placed on either permanent
protection visas or Resolution of Status visas, both of which provide immediate access to health care
benefits, among other things.
Despite the welcome reforms, further changes are needed to ensure that all asylum seekers in the
community receive adequate nutrition and healthcare while their immigration status is waiting to be resolved.
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Many asylum seekers on bridging visas still cannot access work, welfare benefits or healthcare. Bridging
visa holders who are not allowed to work are also ineligible for Medicare and the Pharmaceuticals Benefits
Scheme; they are without the support of the Australian public health system.

Homeless People
In December 2008, a White Paper on homelessness was released by the Australian Government, detailing
its commitment to provide $800 million over five years to fund mental health services to all Australians,
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including those who are homeless.

The links between poor health and homelessness are well-established. A recent report on mental health
issues of homeless people in NSW found that of the homeless population living in Inner Sydney: 75 per cent
of people had a mental health issue; 23 per cent of men and 46 per cent of women had schizophrenia; and
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33 per cent of people had depression.

Prisoners

Prisoners face major health issues, including high rates of injecting drug use and high rates of sexually
transmitted diseases. Despite this, most Australian prisons have not developed adequate harm minimisation
strategies, including the provision of free condoms, and needle and syringe exchange programs.

There is also substantial evidence that mental health care in Australian prisons is manifestly inadequate and
constitutes a severe level of neglect. The number of forensic patients and mentally ill inmates housed in
Australian prisons has steadily increased, but without a proportionate increase in mental health resources.
Recent research indicates that of a total Australian prison population of around 25,000 people, approximately
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5,000 inmates suffer from serious mental illness. In some jurisdictions, such as the Northern Territory,
people with mental health issues who have committed minor offences are often placed in jail due to
insufficient mental health housing facilities.

Access to IVF
There is not currently equal access to in vitro fertilisation (IVF) and Assisted Reproductive Technology (ART)
in Australia. As the laws are state-based, there is no uniform position across Australia. All states and
territories except South Australia and Victoria currently allow lesbian couples access to IVF and ART,
although access in Victoria will be effective from January 2010. Only the ACT and Western Australia allow
access to IVF by surrogates of gay male couples, while Victoria will allow it from January 2010.




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The right to access IVF and ART, are important aspects of the right to health, and should be protected by
federal legislation in Australia. Equitable access to IVF and ART also raise concerns under Article 15.



TABLE OF CROSS-REFERENCES
    Issue                                    Covenant         Reference to issue in NGO Submissions
                                              Rights

    Public Health                                12           FREDA NGO Report Part N.1 (pages 116-118)
                                                              FREDA Addendum Part N.1 (page 64)

    Indigenous Health                            12           FREDA NGO Report Part N.2 (pages 118-120)
                                                              FREDA Addendum Part N.2 (pages 65-66)

    Mental Health                                12           FREDA NGO Report Part N.3 (pages 120-121)
                                                              FREDA Addendum Part N.3 (pages 66-67)

    Asylum Seekers                               12           FREDA NGO Report Part N.4 (pages 121-122)
                                                              FREDA Addendum Part N.4 (pages 67-69)

    Homeless People                              12           FREDA NGO Report Part N.6 (pages 123-124)
                                                              FREDA Addendum Part N.6 (pages 69-70)

    Prisoners                                    12           FREDA NGO Report Part N.7 (pages 124-126)
                                                              FREDA Addendum Part N.7 (pages 70-73)

    Access to IVF                                12           FREDA NGO Report Part N.8 (page 127)
                                                              FREDA Addendum Part N.8 (page 73)



Endnotes

1
    Australian Institute of Health and Welfare, National Public Health Expenditure Report 2004-05 (2007), x.
2
 Australian Institution of Health and Welfare, The Health and Welfare of Australia’s Indigenous and Torres Strait Islander
Peoples 2003 (2003).
3
  Australian Medical Association, AMA Report Card Series 2008 – Indigenous and Torres Strait Islander Health, Ending
the Cycle of Vulnerability: The Health of Indigenous Children (2008), available at
http://www.ama.com.au/system/files/node/4335/AMA+Indigenous+Health+Report+Card+2008.pdf.
4
  Human Rights and Equal Opportunity Commission, ‘Immigration Detention Centres: Improvements, But Still More Work
to Do’ (Media Release, 9 January 2008) available at http://www.hreoc.gov.au/about/media_releases/2008/1_08.html.
5
 Department of Immigration and Citizenship, ‘Fact Sheet 68 – Abolition of Temporary Protection Visas (TPVs) and
Temporary Humanitarian visa (THVs), and the Resolution of Status (subclass 851) visa’ (2008), available at
http://www.immi.gov.au/media/fact-sheet/68tpv_further.htm; Senator Evans, ‘Budget 2008-09 – Rudd Government
scraps Temporary Protection Visas’ (Press Release, 31 May 2008), available at
http://www.minister.immi.gov.au/media/media-releases/2008/ce05-buget-08.htm.
6
 Commonwealth of Australia, The Road Home (2008), available at
http://www.facs.gov.au/housing/homelessness_white_paper/the_road_home.pdf.
7
 T Hodder, M Teeson and N Buhrich ‘Down and Out in Sydney – Prevalence of Mental Disorders in Sydney’, in St.
Vincent De Paul (ACT/NSW) A Long Road to Recovery (2001).
8
 J P R Ogloff et al., Australian Institute of Criminology, The Identification of Mental Disorders in the Criminal Justice
System (2007).




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