GEORGIA ROBERTS:You're on a bit of a listening tour at the moment. I mean what have you heard on the ground so far?

DEBORAH ONEILL, SENATOR FOR NSW: Well I think that any time I come to Broken Hill I'm always sort of overwhelmed by the positive nature of the community and we've heard from people who are really delighting in the opportunity to work in health in this community. But we've also heard that the critical issue that constantly faces the community is drawing that workforce to come and do the work that is needed here. So I think that tension remains. I have been out here many times in the last few years and attracting and retaining a high quality workforce is something that I always hear when I come out.

ROBERTS: And Senator do you think that stands with education being a problem and that we're not providing enough money into rural education so to speak to keep people here working in health?

ONEILL: Well I have to say that you know that has popped up in the conversation many times and the reality is the further you are from a city the more the need exists for real investment in local schools and you know Labor certainly had a very big plan to do that before the election. Sadly we are not the Government but the cost is not just to the Labor Party who arent in government but the cost is to a community that lost really significant funding that would have made a big difference. I mean on previous visits I've been here and I've seen the amazing work that actually happens in schools with the provision of speech pathology placements from the Sydney University through the hospital here feeding into your local schools and that is transformative in terms of kids ability to learn. If you imagine that program being properly funded in each school to put in the real needs meeting by providing the proper professional responses thats a transformation for a community. So yeah I think education standards are built on the provision of great education. It's a shame that the resources I think that need to go into this community for it to be its very best are just not going to come from this Government.

ROBERTS: Mr Bowen, I mean you're out here on the ground checking out some of the Broken Hill, in particular, youve been to Broken Hill hospital today. Do you feel as though we as a rural community or rural communities sometimes do come up second best in terms of health care they can receive? Do you think that they're at the maximum of the amount they can provide in comparison to capital cities?

CHRIS BOWEN, SHADOW MINISTER FOR HEALTH: Well I think it's not just about health care Georgia, you make a valid point there, but it is about health more broadly. When I think of health I think from beginning to end. I think prevention, I think primary health care, chronic disease and one of the things which I do intend to concentrate on in my time in the health portfolio is the disparity between health outcomes in rural Australia and metropolitan Australia. And they are very substantial as you know. Life expectancy, incidence of disease and then that is compounded by health care itself. The system sometimes tries very hard, theres work force shortages sometimes which the systems, and Im not here to score political points, federal and state struggle to deal with. But clearly we need to think more about how we can get more resources into rural areas for health care but also how we can make health more broadly more equal between cities and rural and regional Australia because there is a massive disparity at the moment and it is one of the things I've been concentrating on in my time in the portfolio so far and will continue to do so.

ROBERTS: What are some ways in which you think you've I mean as you've just mentioned there is a recent portfolio for you. What are some ways in which you think we can bridge this gap between capital cities and regional areas?

BOWEN: Well I think one we can talk more about it. We go through a whole health care debate sometimes we don't mention, we collectively don't mention the fact that we have a disparity between cities and the regions or a disparity between Indigenous and non-Indigenous Australians. Now that's something that I will certainly be putting into every time I debate health care with the Minister or contribute to a health care discussion, saying well you know, how do we deal with regions?.

I'll give you one example, the week before last I gave a speech about stillbirth. Now our stillbirth rates in Australia are roughly comparable to our rates of suicide and we're talking a lot about suicide, were doing a lot on mental health and that's as it should be but our stillbirth rate has been the same for about 20 years. It's greater than the road toll. We're not talking about it at all. We're doing very little as a country about stillbirth and the disparity between the cities and the regions is massive. You are much more likely to have a stillbirth if you live in remote Australia, rural Australia. That's not acceptable.

ROBERTS: No.

BOWEN: That's not good enough but unless we recognise the challenge, recognise the problem. So therefore as I said I gave that speech about stillbirth and talked about the issue generally and my family's experience with it and talked about how there is a disparity between rural Australia and metropolitan Australia and we need to do better. So if we're putting these issues on the agenda and when we're tackling a particular health issue we are also tackling the issue of real disparity then at least we're going to make a start.

ROBERTS: You touched on a little earlier there the life expectancy in regional areas and the life time expectancy for Indigenous people in this area in particular is incredibly low for in comparison to their white counterparts. I mean you said you've been to Broken Hill hospital today. Do you have plans to visit Maari Ma, the Aboriginal Health Corporation here in Broken Hill?

BOWEN: We've been trying to line it up but unfortunately so far the timings haven't worked but certainly whenever I go to any area I always make a priority of seeing the Indigenous community, Indigenous healthcare providers. On our tours today so far we've been asking questions about how the service providers interact with the Indigenous community. My first trip as Shadow Health Minister, my first visit was to the Institute of Urban Indigenous health in Brisbane which is a fine organisation, they do very good healthcare for the Indigenous people of south east Queensland. I have since been on a tour of the Northern Territory and when I go to the Northern Territory and I'm not talking about Darwin, Im talking about Ive been to Kintore which is 600 kilometres west of Alice Springs which builds on my previous trips to Docker River and Papunya which are all in that region and that is all about Indigenous health.

So you're right lifting again as well as lifting the prominence of rural health in the national debate I'm very keen to see Indigenous health lifted up. In Parliament we talk about it one day a year, we do the annual Closing the Gap report and we sit around and tut-tuts that we haven't made enough progress over the last twelve years since the apology or the last twelve months and some of the stats have gone backwards, there's been some forward movement but not enough has happened. You know its to Kevin Rudd's credit that we have that one day of reflection on how we're going with Indigenous health and then we move on. The Parliament moves on, the media moves on, everyone moves on. Well we cant move on.

ONEILL: One of the great things I think that the Labor Party is benefiting from now is the fine representation of the First Nations leaders in our own caucus who like First Nations leaders right across the country are using their cultural knowledge and experience to educate all of us alongside us. So they do their job as Senators and Members and then they further educate us about the reality of their community. So Linda Burney, great New South Wales woman former Deputy Leader of Labor in New South Wales, now a member, a Minister as well in the Labor team.

They are powerful advocates within our political structures to tell the story of what is going on. Certainly in my previous visits out here I have met with Maari Ma and they are doing an amazing job and I think that they are remarkable champions for the real and pressing needs that are in this community and with deep respect for the traditions and the understandings of their own community but also very articulate in finding pathways through the established health system to find points of access for the people who need the care that they need.

ROBERTS: Do you think we need more health providers completely dedicated to Indigenous health needs, population permitting?

ONEILL: Well one of the interesting things that I found when I've been in Alice Springs trying to find out about this is where Aboriginal led health solutions occur in a community and they become well established and they create communities of care and professional care, draw great expertise and stability, the community around it actually starts to seek out care through the Aboriginal Health controlled organisation. So I don't think one size is going tofit everywhere but I found that a fascinating study in how Aboriginal people leading health care were providing into their community a quality of care that was seen by everybody as the very best and the community is seeking it out and dealing with the reality of how they manage that in terms of funding lines et cetera. And that's quite a complex conversation. But great health care can come in a whole variety of ways. It needs to respond to the community

ROBERTS: And I guess this can be quite a reductive statement but do you think we keep having these conversations and talking about how we need more than one day and we need more First Nations people in Parliament. Rather than having these conversations do you think they should be more put in place to make sure these things happen rather than just the conversation?

BOWEN: Well I guess that's one of the reasons why we support an Indigenous voice to Parliament. Because an Indigenous voice to Parliament is permanent, theyre there every time. Its not a third chamber you know as some would have us believe, that is a complete fabrication. It is about saying Indigenous people deserve a voice on the issues which affect them. Now let's be frank. Some people say Oh well we should all be treated equally. You know we don't need an Indigenous voice to Parliament. My answer to that is Yes sure we should all be treated equally. We should all have the same life expectancy. We should all have the same maternal success rates. We should all have the same education achievement attainment. We dont. Indigenous people, First Nations people do worse than non-Indigenous people across the board on all those measures and many more. So until and unless that is fixed clearly we're getting something wrong. And clearly we're not hearing what we need to get right. So that's why we think a constitutionally enshrined Voice to Parliament on those issues is just the right thing to do for our times. So we can work with Indigenous communities, First Nations communities to tackle these issues instead of coming in for one day a year thinking about them and then moving on. Now Deb is of course 100 per cent right. It's changed even in my time in Parliament fifteen years when I came there were no Indigenous members of the Labor caucus. It's a revolution now to think it was 15 years ago. We now have a number of very senior colleagues who are there talking to us every day about these issues and of course we all think deeply about these issues. But having that Indigenous voice of accountability and us being accountable to that voice and listening to the voice I think would be a very significant and important step forward for our country.

ROBERTS: If you are just joining us, I am speaking with Chris Bowen, the Shadow Minister of Health and Deborah ONeill, the Australian Labor Party Senator. Senator you are a former Shadow Mental Health Minister. You are on a bit of a listening tour at the moment both of you. I do want to ask and I do want to touch on mental health because it is something that is so important to regional Australia. People are in quite bad condition mentally out here, the drought seems to be ongoing. There is, no one can see an end pretty much. You know we hear a lot of these stories here on ABC Broken Hill and they are incredibly hard to hear. Have you had a chance to chat with anybody yet who has been affected in a very negative way by the drought in terms of their mental health?

BOWEN: Well Deb can answer in a second. Look today so far we've been to the hospital and the community health centre. Obviously at the hospital were respectful of the patients and respecting their privacy but we talked to the service providers both in the hospital itself and the associated respite facility or out-patients facility. You're 100 percent right of course; mental health is an issue across the country. What Im meant to say at this point, what the talking points would say is that it is good that we're talking about mental health. Well that only gets us so far. Okay yeah, it is good were talking about it but that doesn't actually achieve very much. Yes it helps get rid of some of the stigma but talk is not gonna fix this problem. I welcome the Government's efforts so far. I give them a tick for putting these issues more on the agenda but I also hold them to account. I mean having a target of zero suicides is great, its fine but our suicide rates are going up. Again I don't hold the Government responsible for all that but I hold them responsible for matching their good intentions and they are no doubt sincere intentions and their rhetoric with real policy action. We haven't seen that yet. And we cant just saywere going to Headspace next and we are all supporters of Headspace and that's great. We cant just say weve got Headspace and that fixes it for young people. One, that is only young people and its not just young people who have mental health challenges. Two, it is a certain type of mental health problem that Headspace can deal with. They can only deal with so much, theres much more in the community. And two, its dealing with the symptoms to a very large degree.

We've also got to deal with the social determinants of health what causes mental health as well as other health challenges which will be another focus of mine. So it's a big part of the reason we're here. I'm here at Debs suggestion, it was Deb who suggested for us to come out which I thought was excellent. We arranged it on short notice but dealing with mental health must be seen, again it's like where we started the conversation, through a rural prism as well as a national prism.

ONEILL: One of the things that has really impressed me in my previous visits here and I look forward to going to Headspace again which I understand is celebrating their second birthday tomorrow, so congratulations to Headspace. The hope that such surfaces give to communities like that that gathers around here in Broken Hill can't be underestimated and the relief that happens to families who access that service for the first time who are just about at their wits end. That is a very powerful thing but as Chris said it is the whole milieu in which people grow up. It's all those social determinants of health that create either a person who feels particularly well physically and mentally or somebody who might not be in such good shape. And I think that there is still a significant piece of work for us to do across the nation in terms of the sense of being on a continuum of health like we know physically I'm feeling really fit at the moment I'm in great shape or all I'm a little bit out of shape and I should really start to look at a few things in my life. We understand that continuum in terms of physical health but in terms of mental health that sense of Hey it's a green light. I'm in great shape things in my life. I'm feeling the control. I'm feeling a sense of ownership I've got a stable job with secure employment I feel connected to my community. All those sorts of things.

ROBERTS: So rather than treating it when it happens, work towards creating a prevention plan almost.

ONEILL: Well an awareness of, Hey I'm not feeling so well mentally and maybe that's something I need to do something about early. But you spoke about how is mental health right now in this community when the entire community is under the physical and mental stress of drought and when that is exacerbated by the debate that's going on around the Murray-Darling Basin and particularly the operation or the lack of operational control of that water flow here in the Northern Basin and how that affects every community down this enormous river of which you know we as New South Welsh people are profoundly proud. That that kind of an environmental stressor on an entire community is going to manifest itself in mental ill-health. Now the questions have to be asked is the provision of service adequate for when things get really bad? But what's being done to take that pressure cooker off the entire community. And I think that the community would absolutely say that that need is not being met as well as it might be. And I think the reality here in Broken Hill is the service providers are doing everything they can with the resources that they have at hand

ROBERTS: $736 million dollars is what I believe the Federal Government has allotted to mental health at the moment. Actually tonight so it is quite ironic that both of you are in town there's going to be a town hall on health at the Civic Centre here in the city centre of Broken Hill where that is Federal Government funded and Christine Morgan the CEO of this Mental Health Commission so to speak will be there hearing peoples submissions and hearing their thoughts. Are either of you considering attending that?

BOWEN: Well we actually saw Christine on the plane, we were on the same flight so we had a good chat at the airport on the way in.

ROBERTS: At Broken Hilll.

BOWEN: That's right. As it happens we have another event but we're big supporters of her being out here and elsewhere. She's been through the top end for example. We arebig supporters of that, that's showing that she's listening. So the Mental Health Commission is a bipartisan thing and they're doing good work and with our support and I look forward to seeing what they have to say resulting in those consultations. There's a lot of things under way in mental health at the moment and the jury's out to be honest. We've got the Productivity Commission inquiry into mental health. The Victorian Labor Government has held a Royal Commission into Mental Health which has not yet reported. The Premier has said it is not working. You know he has what my Government is doing on mental health is not working and that's why he's held a Royal Commission and is a very good thing for him to have been done. And weve got this work by the Mental Health Commission. Now that all needs to be brought together. None of those have yet reported. We know that when the three of them report, the Government of the day will need to synthesize that and bring them together in one coherent mental health response together with all the other things which are being said to us politicians directly.

ROBERTS: Do you sometimes feel as though it's a matter of throwing money at a wall and expecting it to stick?

BOWEN: It can be.

ROBERTS: We aren't taking these recommendations by these separate commissions and inquires.

BOWEN: It can be if we're not careful. You're right. I mean if money is important but the money is just the start. You know you can spend billions on mental health and make no progress unless you do it right. So we need to make sure that it gets done right. Which is why its not a bad thing that there's sort of three things are under way parallel but as I said the Government's going to bring them together in one coherent response. If they do that's great. If they dont, thats a failure.

ONEILL: And evidence informed practice. I mean sometimes that sort of evidence based. Well, evidence that's based in a particular community and you know in North Western Queensland might not be exactly the same shape as the community that exists here in Broken Hill as opposed to Fairfield where Chris comes from or the Central Coast where I live. So I think great evidence-based, evidence-informed practice is going to be really important and even this morning just speaking with some of the key health professionals here in the local community asking about the dual diagnosis of drug and alcohol with mental health, the conversation about what's changed even in the last four or five years in this local community where it was predominantly people presenting simply with a mental health challenge. Now the figures have reversed. It was sort of 80/20 drug and alcohol plus mental health and the comorbidities shape of that has changed in the last five years. So if that's the case what you did five years ago you can't do now. So good practice in healthcare has to be responding to the reality of people's needs that are in front of them at that time.

ROBERTS: As they grow adapting to that and lets hope rural areas can keep up.

BOWEN: Absolutely.

ONEILL: I'm sure that they can, they are amazingly innovative resilient places and I think the community support that I hear about when I come out here and just you know visiting here at the ABC and talking to the local presenters and producers. This is a community that cares for its own. It's one of those great Australian characteristics. I mean this is just a remarkable town. I love coming here and you know I just want to give all your listeners encouragement to continue the great work that they're doing looking after one another but also encourage them to notice if you're not in great shape mentally don't wait. You know seek help contact Lifeline.

ROBERTS: 13 11 14.

ONEILL: That's it.

ROBERTS: All right. Thank you so much for your time this morning. I know you have to head off and onto Walgett was it next?

ONEILL: No, Cobar, then Bourke, Brewarrina, Walgett.

ROBERTS: And then Walgett.

ONEILL: Dubbo.

ROBERTS: Enjoy your tour of the far west. Thank you for your time.

BOWEN: Thanks for having us. It was great.

ENDS

*For 24/7 crisis support and suicide prevention services call Lifeline on 13 11 14. Other services include Suicide Call Back Service: 1300 659 467, Beyondblue: 1300 22 4636, Kids Helpline: 1800 551 800, MensLine Australia: 1300 789 978*