1967

A constitutional amendment referendum held during Liberal Prime Minister Harold Holt's term in office, gave the Commonwealth Government power to legislate for Indigenous Australians, and allowed for their inclusion in the census (1).ⁱ

1968

The Commonwealth Office of Aboriginal Affairs was established (2).

1969

The Office identified health as one of four major areas for Indigenous development and initiated specific purpose grants to the States for the development of special Aboriginal health programs (3)(4)(5). State government health authorities decided to establish Aboriginal health units to address the health needs of the Indigenous population and to administer the Commonwealth funds (2)(4).

1971

The first Aboriginal Medical Service (AMS) was initiated on a voluntary basis in Redfern, Sydney (6).

1972

The Whitlam Labor Government was elected and replaced the Office of Aboriginal Affairs with the Department of Aboriginal Affairs (DAA) (7). The DAA continued with the States grants programs initiated by the Office but also began to make direct grants to the newly-emerging AMSs (8).

The Federal Court decision in Australia's first native title case, the Gove Land Rights Case, found that traditional laws, customs and land rights were not recognised by Australian courts (9).

1973

The Commonwealth Government made a formal offer to the State Ministers to assume from them full responsibility for Indigenous affairs policy and planning. With the exception of Queensland, all the States accepted the offer and negotiations commenced for the transfer of responsibility for Indigenous policy, planning and coordination from the States to the Commonwealth. The Department of Aboriginal Affairs was given central authority for policy administration (10).

An Aboriginal Health Branch was established in the Commonwealth Department of Health to provide professional advice to the Government (11). One of its first actions was to propose a Ten Year Plan for Aboriginal Health (7).

1974

The national AMS umbrella organisation, the National Aboriginal and Islander Health Organisation (NAIHO), was formed (13).

1975

The Racial Discrimination Act was introduced, preventing governments from discriminating on the basis of race and ensuring compensation for any removal of Indigenous rights(9).

The universal health insurance system, Medibank, was introduced making mainstream health services more affordable (13).

The Liberal-National Country Coalition Government, led by Liberal Prime Minister Malcolm Fraser, was elected (14).

1976

The Report on the Delivery of Services by the Department of Aboriginal Affairs was published. It assessed the capability of the DAA to fulfil its responsibilities for Indigenous policy development and administration (10).

The Commonwealth-funded National Trachoma and Eye Health Program was launched (19).

The Commonwealth asked the House of Representatives Standing Committee on Aboriginal Affairs (HRSCAA) to conduct a review of Aboriginal health (7).

1977

The HRSCAA inquiry was initiated (15).

The Australian Parliamentary report Alcohol problems of Aboriginals was published (16).

1978

The Commonwealth Coalition Government terminated Medibank, the universal health insurance scheme (13).

1979

The HRSCAA's report Aboriginal Health was released (18).

1980

The Royal Australian College of Ophthalmologists produced The National Trachoma and Eye Health Program report(19).

The Aboriginal Development Commission was established. One of its primary functions was to provide advice to the Minister for Aboriginal Affairs on matters pertaining to Indigenous social and economic development (10).

An internal Commonwealth Government report, the Program Effectiveness Review (20), was never officially released to the public but considered, among other things, the issue of Indigenous involvement in Indigenous health policy development, the introduction of specific Indigenous health initiatives and the existing arrangements for funding and administration of Indigenous health (1).ⁱⁱ

1981

The Commonwealth Government initiated a $50 million five-year Aboriginal Public Health Improvement Program in response to recommendations outlined in the HRSCAA report (7). The program, administered by the DAA, focused on unsatisfactory environmental conditions associated with inadequate water, sewerage and power systems (3).

1983

Labor Prime Minister Bob Hawke was elected (14).

1984

Responsibility for all Commonwealth Aboriginal health programs, including the Department of Health's role in the funding of some AMSs, was consolidated within the Department of Aboriginal Affairs (4).ⁱⁱⁱ

Universal health insurance was reintroduced as Medicare (13).

A Commonwealth Task Force on Aboriginal Health Statistics was established (21).

1985

The Canberra-based Australian Institute of Health (AIH) was established within the Commonwealth Department of Health. It was given Commonwealth responsibility for the development of Indigenous health statistics (23).

1987

The Commonwealth Departments of Health and Community Services merged to form the Department of Community Services and Health (24).

The Australian Institute of Health (AIH) became an independent statistics and research agency. It continued to play an important role in the development of Indigenous health statistics (23).

A meeting of Commonwealth, State and Territory Health and Aboriginal Affairs Ministers led to the formation of a Joint Ministerial Forum on Indigenous health and the appointment of a National Aboriginal Health Strategy Working Party (NAHSWP). The NAHSWP was to develop a strategy on Indigenous health that would encompass issues pertaining to funding, Indigenous participation, intersectoral coordination and monitoring and meet with the approval of all stakeholders (1)(7).

1988

The Royal Commission into Aboriginal Deaths in Custody was initiated (32).

1989

The National Aboriginal Health Strategy Working Party (NAHSWP) final report, A National Aboriginal Health Strategy (NAHS)(26), was presented to the Joint Ministerial Forum (1).

The Ministerial Forum established the Aboriginal Health Development Group (AHDG), comprised primarily of Commonwealth, State and Territory government representatives, to assess the report and advise on its implementation (1)(7).

AMSs protested against the limited representation of Indigenous community interests on the AHDG and a community advisory group, the Aboriginal Health Advisory Group (AHAG), was subsequently established in parallel to the AHDG (1)(7).

The third national health survey (conducted by the ABS) provided, for the first time, for the identification of Indigenous people (27).

1990

The Aboriginal and Torres Strait Islander Commission (ATSIC) was established, replacing the DAA and the Aboriginal Development Commission, and assumed national responsibility for Indigenous health.

The AHDG's Report to Commonwealth, State and Territory Ministers for Aboriginal Affairs and Health was released (7).

AHDG recommendations, including the need for: a Council for Aboriginal Health; State/Territory Tripartite Forums; a specialised health branch, the Office of Aboriginal Health, within ATSIC; and a national Aboriginal community-controlled health organisation, were accepted by the Joint Ministerial Forum (28). Commonwealth Ministers within the Joint Ministerial Forum submitted the NAHS to Cabinet for a formal Commonwealth response (1).

In addition to a number of pre-existing Commonwealth-funded programs perceived to fall under the NAHS umbrella, the Commonwealth Government allocated $232.2 million (over five years) for implementation of aspects of the Strategy. Of the $232.2 million, $171 was allocated for housing and infrastructure, $47 for health services, $6.3 for ATSIC running costs, $7.3 for the National Campaign Against Drug Abuse (NCADA) projects targeting Indigenous people and $0.6 for the Australian Institute of Health (29)(34). The total allocation was far less than the $3 billion estimated as necessary for full implementation of the NAHS.^iv

1991

The Commonwealth Department of Community Services and Health was restructured and renamed the Department of Health, Housing and Community Services (24).

The extension of the Australian Institute of Health's focus to include the areas of disabilities and children's services was accompanied by a change in name to the Australian Institute of Health and Welfare (AIHW).

ATSIC produced an interim report Aboriginal and Torres Strait Islander Health Goals and Targets (31), which was proposed as a means of evaluating the effectiveness of the NAHS (6)(7).

The final report of the Royal Commission into Aboriginal Deaths in Custody (RCADC)(32) was published. The report comprehensively reviewed Indigenous health needs, government strategies addressing those needs, and the efficacy of existing programs (7). Its recommendations asserted explicit support for the implementation of the NAHS (1).

The NHMRC's Guidelines on Ethical Matters in Aboriginal and Torres Strait Islander Health Research (33) were endorsed.

Labor was returned to power under the leadership of Prime Minister Paul Keating (14).

1992

The High Court judgement in the Mabo Case, Australia's second native title case, overturned the colonial concept of terra nullius (that Australia was not recognised as belonging to anyone prior to its occupation by the British). The Federal Court's Gove decision was overruled and the High Court held that courts do recognise traditional Indigenous land and water rights (9)(35).

A number of outstanding issues in the implementation of the NAHS reached a degree of resolution. Negotiations with State and Territory governments regarding matching financial commitments ceased and Commonwealth funds were distributed through ATSIC regional councils to community controlled organisations (1). The Council for Aboriginal Health (CAH), intended to advise governments on Indigenous health policy and monitor the performance of the NAHS, met for the first time (7).

The Commonwealth Government announced a $150 million five-year funding package, principally for the establishment of Aboriginal-controlled drug and alcohol services (7).

ATSIC and the Australian Construction Services commenced a two-stage survey of Indigenous housing and community infrastructure needs (36).

The National Commitment to Improved Outcomes for Aboriginal and Torres Strait Islander People was endorsed, providing a framework for bilateral agreements between the Commonwealth and State/Territory governments to improve programs and services for Indigenous people (37).

1993

Commonwealth department restructuring resulted in the formation of the Department of Health, Housing, Local Government and Community Services (24).

The National Aboriginal Community Controlled Health Organisation (NACCHO) was established as the new national AMS umbrella organisation, replacing NAIHO which had ceased operation some 5 years earlier (38).

The Commonwealth Ministers for Health and Aboriginal Affairs initiated a review of the Council for Aboriginal Health (28).

Public calls were made for responsibility for Indigenous health to be moved from ATSIC to the Commonwealth health department (7).

The Wik peoples made a native title claim in the Federal Court (39).

The Native Title Act became law (39). The Act was intended to recognise and protect native title, and give Indigenous land rights, as stated in the Mabo Case, statutory authority (9).

1994

The Commonwealth Government announced a $500 million five-year health package, the majority of which involved a continuation of existing NAHS activities (7).

ATSIC established the Health Infrastructure Priority Projects (HIPP) scheme. The Scheme addressed environmental health issues through large-scale construction of housing and infrastructure (7).

A high-level Evaluation Committee appointed by the Commonwealth Ministers for Health and Aboriginal Affairs noted that the National Aboriginal Health Strategy had never been effectively implemented and that all governments had grossly under-funded initiatives in remote and rural areas (34).

The Australian Bureau of Statistics conducted the National Aboriginal and Torres Strait Islander Survey (40).

The NHMRC established a Research Strategy and Development Committee, which in turn set up a Working Party on Indigenous health research (34).

A Joint Health Planning Committee, comprising Commonwealth health department, ATSIC and NACCHO representatives, was established to approve funding allocations for Indigenous health projects (4).

In 1994-95, Commonwealth funding of the Aboriginal and Torres Strait Islander primary health and substance abuse services amounted to $85.4 million (4).

1995

Responsibility for Indigenous health was transferred from ATSIC to the Commonwealth health department - renamed the Department of Human Services and Health (DHSH) the year before - and the Office for Aboriginal and Torres Strait Islander Health Services (OATSIHS) was established (42).

Following the 1992 National Commitment to Improved Outcomes for Aboriginal and Torres Strait Islander People, Health Ministers agreed to a process for the development of multilateral framework agreements with States and Territories (4). The Framework Agreements provided for the establishment of consultative national and State/Territory forums to provide policy and planning advice on Indigenous health issues (43).

The DHSH and ATSIC instituted a Memorandum of Understanding defining their roles and responsibilities (42).

The Australian Bureau of Statistics conducted a National Health Survey including an enhanced sample of Aboriginal and Torres Strait Islander Australians providing national estimates on Indigenous health status.

In the 1995-96 financial year, the Commonwealth funded Aboriginal and Torres Strait Islander primary health and substance abuse services (including transfers from other programs) to the sum of $120.7 million (4).

1996

The Federal Court decided against the Wik peoples 1993 land claim on the basis that their native title rights had been extinguished by existing pastoral leases (39).

Following thirteen years of Labor rule, a Liberal-National Coalition Government, led by Liberal Prime Minister John Howard, was elected (14). The Department of Human Services and Health was renamed the Department of Health and Family Services (DHFS) (4).

The Commonwealth Minister for Health announced the establishment of the national health advisory forum proposed in the Framework Agreements, the Aboriginal and Torres Strait Islander Health Council (25).

The Aboriginal and Torres Strait Islander Health and Welfare Information Unit (ATSIHWIU) - a joint program of the AIHW and the ABS - undertook a review to develop a National Plan for Aboriginal and Torres Strait Islander Health Information (44).

Commonwealth approval was extended for all existing AMSs to bulk-bill Medicare (4).

The Commonwealth Minister for Health launched the $20 million National Aboriginal and Torres Strait Islander Emotional and Social Well Being (Mental Health) Action Plan (43).

The Commonwealth Minister for Health approved implementation of the National Aboriginal and Torres Strait Islander Hearing Strategy (43).

By the end of the year, six of the eight States and Territories had signed the Framework Agreements, agreed to by all Health Ministers in 1995 (4).

The High Court overturned the Federal Court's Wik decision. It was held that native title was not necessarily extinguished by pastoral leases, and that both native title and pastoral rights could exist over the same land (35)(45).

In the 1996-97 financial year, Commonwealth allocations to Aboriginal and Torres Strait Islander primary health and substance abuse services (including transfers from other programs) totalled $121.8 million (4).

1997

In response to the Wik decision, the Commonwealth Government presented to parliament the Native Title Amendment Bill 1997. The Bill proposed changes to the Native Title Act based on amendments made in 1996 and those derived from the Coalition's Ten Point Plan (35).

The House of Representatives Standing Committee on Family and Community Affairs initiated an Inquiry into Indigenous Health in response to a joint request from the Commonwealth Ministers responsible for health and Aboriginal and Torres Strait Islander affairs.

The NHMRC published the report Promoting the Health of Indigenous Australians: A review of infrastructure support for Aboriginal and Torres Strait Islander health advancement (25).

Development of the National Indigenous Australians' Sexual Health Strategy (1996/97 to 1998/99) was finalised and launched (46).

The national review Eye Health in Aboriginal and Torres Strait Islander Communities (47) was presented to the Minister (46).

A set of National Aboriginal and Torres Strait Islander Health Performance Indicators and Targets were endorsed by all Health Ministers (46).

The ABS and the AIHW launched the report The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples (48) which provided up-to-date statistics about Indigenous health and welfare.

Health Ministers agreed to The Aboriginal and Torres Strait Islander Health Information Plan for improving the quality of Indigenous health data (43).

The Human Rights and Equal Opportunity Commission released Bringing them home: report of the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families (49).

A Joint NACCHO/Departmental Working Group was established to review current arrangements for Indigenous access to Commonwealth health program funding (4).

Two new NHMRC sub-committees, the Research Agenda Working Group and the Strategic Health Research Working Group, were established to guide and oversee Aboriginal and Torres Strait Islander health research (43).

The National Training and Employment Strategy for Aboriginal and Torres Strait Islander Health Workers and Professionals Working in Aboriginal and Torres Strait Islander Health was released (43).

Discussions occurred between State/Territory health departments and NACCHO affiliates regarding plans for the development of a National Indigenous Australians' Health Strategy (43).

The House of Representatives Standing Committee on Family and Community Affairs released the first of a series of volumes containing submissions received in response to their Inquiry into Indigenous Health (55).

The Health Insurance Commission review Market research into Aboriginal and Torres Strait Islander access to Medicare and the Pharmaceutical Benefits Scheme was published (50).

In the 1997-98 financial year, the Commonwealth allocated $135.8 million (including transfers from other programs) to Aboriginal and Torres Strait Islander primary health and substance abuse services (4).

1998

The Australian Institute of Health and Welfare released the review Expenditures on health services for Aboriginal and Torres Strait Islander people (51).

The Health Infrastructure and Capital Replacement Program was developed to provide a strategic approach to the maintenance and upgrading of health infrastructure and the provision of accommodation for health personnel in Indigenous communities (52).

The first annual Service Activity Reporting (SAR) questionnaire was sent to all Commonwealth-funded Aboriginal primary health care services. The SAR is a joint initiative of NACCHO and OATSIH and collects data on the key activities of the services.

The Department of Health and Family Services was restructured, following John Howard's re-election as Prime Minister, and renamed the Department of Health and Aged Care to reflect its changed responsibilities and functions (4).

The Australian National Audit Office concluded its performance audit of the Department of Health and Aged Care and released its report Aboriginal and Torres Strait Islander Health Program (4).

The final two jurisdictions, Tasmania and the Northern Territory, signed Framework Agreements (4).

An estimate of Commonwealth funding for Aboriginal and Torres Strait Islander primary health and substance abuse services over the 1998-99 financial year amounted to $158.4 million (including transfers from other programs) (4).

1999

The Office for Aboriginal and Torres Strait Islander Health Services (OATSIHS) was renamed the Office for Aboriginal and Torres Strait Islander Health (OATSIH) to reflect more accurately its long term strategy and work. OATSIH continues to operate within the Commonwealth department responsible for health.

The Australian National Audit Office concluded its performance audit of the Aboriginal and Torres Strait Islander Commission and released its report National Aboriginal Health Strategy - delivery of housing and infrastructure to Aboriginal and Torres Strait Islander communities (54).

The Primary Health Care Access Program (PHCAP) was announced in the 1999-2000 Commonwealth Budget. The Program is aimed at improving access to primary health care by facilitating increased community-control, reforming existing health system structures, and increasing the available resources within selected sites.

The Commonwealth Minister for Health and Aged Care restructured the National Aboriginal and Torres Strait Islander Health Council.

The House of Representatives Standing Committee on Family and Community Affairs tabled its final report Health is life (56). The report documents the Committee's recommendations following the inquiry into the health status of Indigenous Australians.

Data on the activities of Commonwealth-funded, stand-alone Indigenous substance misuse services was collected for the 1999-2000 period. The data provides the first national statistics pertaining to the work of these services.

In February, the Australian Health Minister's Advisory Council (AHMAC) agreed to the development of an Aboriginal and Torres Strait Islander Health Workforce National Strategic Framework. The Framework objectives were endorsed by AHMAC in October. AHMAC also agreed to a consultation process for key stakeholders and the development of an implementation plan.

The Northern Territory and South Australia re-signed Framework Agreements.

Redfern Aboriginal Medical Service celebrated 30 years of health care provision to Aboriginal and Torres Strait Islander people.

The National Aboriginal and Torres Strait Islander Health Council released for discussion the draft National Aboriginal and Torres Strait Islander Health Strategy (57).

The Commonwealth Government tabled its response to the House of Representatives Standing Committee on Family and Community Affairs report Health is Life (58).

The Commonwealth Department of Health and Aged Care released The Aboriginal and Torres Strait Islander coordinated care trials national evaluation report: volume 1 - main report (59). It outlines the background, descriptions, experiences and outcomes of the four coordinated care trials conducted in Aboriginal communities between 1997 and 1999. The trials took place in Katherine (NT), the Tiwi Islands (NT), Wilcannia (NSW) and Perth/Bunbury (WA).

The report Better health care: studies in the successful delivery of primary health care services for Aboriginal and Torres Strait Islander Australians (60) was published by the Commonwealth Department of Health and Aged Care. The publication examines the concept of comprehensive primary health care, provides national and international evidence of the effectiveness of this approach in improving health outcomes of Indigenous people, and illustrates the success of this approach through a series of case studies on successful health service interventions.

The Australian Institute of Health and Welfare released the report Expenditures on health services for Aboriginal and Torres Strait Islander people 1998-1999 (61). The report provides information on the health expenditure for Indigenous Australians across the nation.

AHMAC agreed to establish the Standing Committee on Aboriginal and Torres Strait Islander Health (SCATSIH). SCATSIH supersedes the Heads of Aboriginal Health Units (HAHU) forum.

The Department of Health and Aged Care was renamed the Department of Health and Ageing.

In April, the Council of Australian Governments (COAG) agreed to commission the Steering Committee for the Review of Commonwealth/State Service Provision (SCRCSSP) to produce a regular report to COAG against key indicators of Indigenous disadvantage. The purpose of the reports is to measure the impact of policy changes on the Indigenous community.

The Aboriginal and Torres Strait Islander Health Workforce National Strategic Framework was released for endorsement by AHMAC (62).

Victoria and Western Australia re-signed their respective Framework Agreements.

Following a consultative process, the NHMRC Road Map: a strategic framework for improving Aboriginal and Torres Strait Islander health through research (63). The purpose of the consultation was to identify areas of research that would underpin better policy and practice to improve Indigenous health.

The Australian National Audit Office concluded its follow-up to the 1998 performance audit of the Department of Health and Ageing. The ANAO reviewed the extent that the Department had implemented recommendations (64).

The AIHW released the report Australia's Health 2002. The report included detail on the state of Indigenous health (65).

In October, OATSIH and the Office of Hearing Services published their report on Commonwealth funded hearing services to Aboriginal and Torres Strait Islander peoples: strategies for future action. The report outlined a set of policy principles and strategies to guide future action in addressing the continued prevalence of Otitis Media and hearing loss in Indigenous people (66).

The ABS and the AIHW published the 4th edition of the biennial report The health and welfare of Australia's Indigenous Peoples 2003 (67).

The Australian and State/Territory governments endorsed the National Strategic Framework for Aboriginal and Torres Strait Islander health: framework for action by governments. All Health Ministers signed the framework in July. The National Strategic Framework is a complementary document that builds on the 1989 National Aboriginal Health Strategy and addresses approaches to primary health care within contemporary policy environments (68).

The Office for Aboriginal and Torres Strait Islander Health began development of a national Indigenous Maternal and Child Health policy framework.

ATSIC released the Family Violence Action Plan. The Action Plan outlines policy addressing family violence in communities and has a direct focus on improving the health and social environment of individuals and communities.

The SCRCSSP released the report Overcoming Indigenous disadvantage: key indicators 2003. The report is a formally endorsed framework by COAG (69).

The Commonwealth Department of Health and Ageing published a consultation paper for The development of a national strategic framework for Aboriginal and Torres Strait Islander Mental health and Social and Emotional Wellbeing 2004-2009. The consultation was presented to a diverse audience for consideration, with the hope that the recommended actions in the paper would provide the basis for Mental Health and Social and Emotional Wellbeing over the next 5 years (70).

The HealthInfoNet is currently expanding this timeline to cover major changes that occurred in the administration of Indigenous affairs in 2004. The following paragraphs provide a very general and brief summary.

In early 2004, the Australian Government announced that it was introducing significant changes to the way policies, programs and services are developed and delivered to Aboriginal and Torres Strait Islander people and communities. The Aboriginal and Torres Strait Islander Commission (ATSIC) and its service delivery arm, the Aboriginal and Torres Strait Islander Services (ATSIS), were subsequently abolished, and the implementation of new arrangements for the administration of Indigenous affairs at the Federal level commenced 1 July 2004.

Responsibility for the delivery of all Indigenous-specific programs was transferred to mainstream agencies and a ‘whole-of-government’ approach adopted. The new approach is based on a process of negotiating agreements with Indigenous families and communities at the local level in accordance with the concepts of mutual obligation and reciprocity for service delivery.

The new arrangements have yet to be fully operationalised. At present they relate primarily to the delivery of services at the Federal level, but it is anticipated that they will form the basis for efforts by all Australian governments. To coordinate the approach at the national level, an Office of Indigenous Policy Coordination (view website) has been established within the Department of Immigration, Multicultural and Indigenous Affairs.

For an overview of key developments that lead to the introduction of new arrangements for the administration of Indigenous affairs see the summary provided in the Social justice report 2004 (view summary).