The following represents a synopsis of a lengthy report upon health administration and associated problems in Northern Australia. Statements made positively in this synopsis without discussion or qualification can be supported by reference to the more detailed report.
The situation confronting the Commonwealth in tropical Australia may be outlined as follows:
- Three factors which have in the past materially assisted the Commonwealth Department of Health in excluding quarantinable disease from Australia are in large measure now no longer operative –
- The highly efficient health and medical services formerly maintained by European administration to control and notify disease in adjacent parts of Asia have been impaired by recent political changes.
- The long time interval between infected overseas ports and Australian ports of debarkation associated with maritime transport by sail or steam has been eliminated by the development of air transport.
- The narrow selection of airborne passengers amongst the well to do and less unhygienic classes no longer obtains – air transport now extends to categories of immigrant definitely at risk.
- The security of Australia from imported communicable disease, quarantinable and other, must now depend largely upon improving and maintaining Australian health and medical services at such as standard that the unsuspected introduction of infection to any locality will not endanger it – normal conditions must be such that the risk of dissemination is negligible.
- The responsibility for so ordering local health services as to avert the possibility of epidemics is in the hands of State and local health authorities who, collectively and individually, have little experience in, or consciousness of, quarantinable disease – such having always been the Commonwealth’s responsibility.
- A considerable area of Australian continent lies within the tropics and provides environmental conditions eminently adapted to the epidemicity and endemicity of dangerous communicable disease likely to frustrate the white settlement or involve considerable expense in control.
- This area is parsley populated by a small while population of a low natural increase rate, a large and rapidly increasing hybrid population and a larger but diminishing native population. This community cannot maintain the standard of health and medical service necessary to ensure its own security.
- Plans are being made for the development of parts of this region by the introduction of relatively large numbers of immigrants likely to be carriers of diseases dangerous to the area. The incidence of typhoid fever, trachoma, dysentery, syphilis and tuberculosis amongst Displaced Persons in Western Germany particularly amongst Poles who predominate amongst proposed migrates to this area, is so great that the introduction of multiple sources of infection must be expected.
- Meantime, the white and native communities in this area exist under deplorable conditions of squalor and insanitation.
Conditions of housing, water supply, waste disposal and insect control are such as to foster the uncontrollable dissemination of imported infections –
- Natives in contact with white communities habitually indulge in practices inconsistent with the maintenance of community health and serve as dangerous reservoir of, and transport agency for, imported infections.
- Hybrids concentrating in and about white communities set a standard of living approximating to that of the full blood native rather than to that of the white person.
- The white population is becoming accustomed to life under conditions normal only to less civilised races.
- These circumstances demand an efficient health and medial organisation throughout the area but the distribution nature and economic circumstances of the population will not permit its organisation upon the conventional local authority lines. An efficient corps or service provides the only agency.
- A present insuperable obstacle to efficient hygiene administration is the de factor exclusion of the hybrid and the native from the white social structure and our failure to integrate the coloured population into the white community and to raise the coloured standard of living. Under these circumstances no prospect of permanent or secure protection from epidemicity and endemicity of communicable disease will offer until the constituted health of authority can effectively exercise over all sections of the population those educative, admonitory, supervisory and directive powers which are vested in local and central health authorities in settled communities. For this purpose the health authority must be vested with all the powers and functions of the Native Affairs authority and must enjoy the powers of initiation and veto in the policies of that authority.
- Failure of the Native Protection organisations in the north to orientate either the mass or the individual native or hybrid into the white community has exposed large number of detribalised full bloods ad outcast hybrids to seditious indoctrination by Communist agents who are all too ready to exploit towards Communist ideology the inherent, traditional native lack of property sense. So has developed in a section of the population, which promises in numbers shortly to dominate most of the north, a socio political problem of the first magnitude.
Ingeniously presented, or misrepresented, Communist ideology must have a deep appeal to a people whose economic background is one in which all property is communal and the accumulation of private or community wealth is incompatible with human existence and to whom the foreign mode of life, now thrusting inexorably upon them, offers no present security or promise of future dignified survival.
- The health problem confronting the Commonwealth in this area, which extends beyond State boundaries is a national one. It is of sufficient gravity to Australia at large to demand that it be vigorously met and countered wherever it exists. This means and the method of combating it must be devised on a national plan financed by national funds.
- (12)The importunity of Communist agents in Australia and in adjoining States of Asia bring to the problem an international flavour which imposes on the national Government the exclusive duty and responsibility of coping with it. This problem of the coloured component of the northern population must be resolved to a plan directed by the national interest as determined by the Government concerned with Australian international relations. The national policy must not be subject in execution to prejudice or impairment by caprice or political expediency by any local, State or Territory authority. Native administration must be brought under the National Government.
- (13)The basic factor emerges that the Commonwealth Department of Health in pursuance of its function to prevent the introduction of imported communicable disease and the interstate dissemination of such disease if inadvertently introduced, must in the national interest be vested with the following executive powers:-
- Supervisory and directive authority over State, Territory and local authorities;
- Initiation and imposition of policy in its general particular details and the framing of national health standards;
- Control of Native Administration throughout the Commonwealth;
- An effective voice in the disposal of immigrants and the plans for development of backward areas.
- (14)In the Northern Territory the Northern Territory Medical Service is already in the hand of the Department and provides the necessary machinery for health and medical work but increasing attention must be given to prevention. It remains but to integrate native affairs into the Northern Territory Medical Service.
- (15)In respect of the States, the Commonwealth may agree with each to provide the necessary State organisation to implement national policy providing the necessary funds as an inducement and as a measure of control.
(a) National policy should be formulated by the Commonwealth on the advice of the Director-General of Health.
(b) The States should agree to implement national policy and, in particular, to subordinate native administration to the health authority at least at Ministerial level. Subordination however achieved must be adequate for the purpose of defining native administration within the policy determined by the Federal Minister for health –
- In Western Australia the Northern Medical Services are constituted on similar lines to those of Northern Territory Medical Service. There is already close liaison between the Commissioner of Native Affairs and the Commissioner of Public Health.
- In Queensland, both Health and Native Affairs administrations are under the name Minister and co-operation should offer no difficulty.
- In other States some major readjustment would probably be necessary as Native Affairs Administration is usually vested in a Board of laymen with or without Health Department representation.
(c) The Director-General of Health could supervise the expenditure of funds and the development of policy by the States.
(C. E. COOK)
7th February 1950