Brisbane hospital boards lack Indigenous voices despite legal requirements

In short:

The Queensland government has failed to appoint Indigenous leaders to hospital boards, despite being legally required to do so.

Prominent health leaders have described this as a clear violation of state law.

What's next?

Health Minister Tim Nicholls says recruitment efforts are ongoing.

Prominent medical leader and former Liberal National Party candidate Bill Glasson says the Queensland government is flouting its own laws, branding the lack of Indigenous representation on Brisbane's major hospital boards a direct breach of state legislation.

For six months, the state government has failed to fill mandatory Indigenous board positions at two major Hospital and Health Services in Brisbane, despite the Hospital and Health Boards Act.

Metro South has the largest absolute Aboriginal and Torres Strait Islander population of any Hospital and Health Service in the state, serving 30,000 Indigenous Queenslanders.

Brisbane's Metro North catchment has the second-largest Indigenous population, according to Queensland Health figures.

Dr Glasson, a longtime advocate for Indigenous health and former state and federal president of the Australian Medical Association, called on Health Minister Tim Nicholls to use his powers under the act to make urgent, temporary appointments to both boards.

"Unless the boards reflect the people [they] serve, then we will get nowhere in terms of improving health outcomes," he said.

No shortage of talent

Dr Glasson, who serves on the board of the Institute for Urban Indigenous Health, said plenty of qualified candidates were available.

"I was at an [Indigenous Health] conference last week, and there was a room full of people with the credibility and experience to fill those roles and make a difference to what is happening on the ground," he said.

Mr Nicholls can make urgent temporary appointments if he "reasonably believes it is necessary" because a board lacks the "skills, knowledge or experience to perform the board's functions effectively".

The legislated Indigenous board positions at Metro North and Metro South have been vacant since March 31.

In the meantime, cabinet has appointed or reappointed 91 other board members to hospital boards across Queensland. Half of the eight board members at both Metro North and Metro South Health are new appointments.

While Mr Nicholls boasted about delivering on a key election commitment to legislate that a local clinician serve on each area hospital board, the existing legal requirement to fill the First Nations seats in Brisbane was not addressed during that wave of appointments.

Legislation mandating Indigenous board roles was designed to improve Aboriginal and Torres Strait health outcomes, following a damning 2017 report that found extreme levels of racism inside Queensland Health.

At the time, a leaked copy of the report named Brisbane's Metro South Hospital and Health Services as the worst in the state.

"I can only surmise that they are not interested in having Aboriginal and Torres Strait Islander representation," said Tom Calma, a Kungarakan and Iwaidja man, whose work highlighting deep health disparities between Indigenous and non-Indigenous Australians as social justice commissioner in 2005 laid the foundation for the Close the Gap campaign.

Professor Calma said it was "critically important" the roles be filled, given the substantial Indigenous population in South-East Queensland.

Mr Nicholls did not respond to questions about whether the government was in breach of the legislation.

However, Dr Glasson said it was.

"Absolutely, it's in breach, " he said.

Gaps left unfilled

Official Closing the Gap statistics show the rate of potentially preventable hospitalisations for First Nations peoples in Queensland remains 2.4 times higher than for other Queenslanders.

Progress on healthy birth weights has stalled. First Nations men and women die an average of 7.4 and 7.0 years younger than non-Indigenous Queenslanders.

Professor Calma said institutional racism and a lack of cultural safety routinely caused patients to avoid hospitals or abandon treatments altogether.

"We know people are discharging from hospitals against medical orders, people are not fronting up to clinics because they might have had a poor experience," Professor Calma said.

"Therefore, they're not getting the level of service every citizen is entitled to from the state.

"The board of any institution sets the tone and culture of the whole organisation. They're the safeguards at a governance level."

In a statement, Mr Nicholls said, "Recruitment and selection processes are underway to fill existing First Nations vacancies in South East Queensland."

Earlier this year, he acknowledged that efforts to recruit suitable candidates for the roles only began on March 27, just four days before the roles were to become vacant.

Metro South Indigenous director Donisha Duff was given five days' notice to vacate her role on March 31, halfway through her appointed term.

Ms Duff, who has more than 20 years' experience in health and Indigenous affairs, ran as an ALP candidate during the 2022 federal election.

Long-time Metro North Indigenous director Adrian Carson left his role to pursue private healthcare consulting.

Interviews to replace them were conducted as far back as June.

Metro North and Metro South Health did not respond to a series of questions from 612 ABC Brisbane about whether they were concerned that they were operating in breach of state law. They also did not respond to questions about whether they had followed up with the minister or urged him to make temporary Indigenous appointments.

According to Metro South's annual report, the board subcommittee advising on improving Indigenous health outcomes was inoperative.

As at August 31, the First Nations Health Equity Board Committee was currently "awaiting appointment" for both its chair and members.

However, despite the absence of an Indigenous director at Metro North, the board has appointed a guest advisor to its Aboriginal and Torres Strait Islander Peoples Equity Advisory Committee.

Both boards say they are committed to improving health outcomes for First Nations people.

The Crisafulli government has also faced criticism over a series of decisions, including scrapping the Truth Telling and Healing Inquiry, abandoning the path to treaty, and removing senior and experienced Indigenous leaders from government boards, including major cultural centre boards.