This thesis concerns the relationship between ideology, values, beliefs, politics, language, discourses, public policy and health outcomes. By examining the origins of federal health policy concerning Aboriginal and Torres Strait Islander Peoples 1972-2001 I have explored the idea that the way a problem is constructed through language determines solutions enacted to solve that problem, and subsequent outcomes. Despite three decades of federal policy activity Aboriginal and Torres Strait Islander children born at the start of the 21st Century could expect to live almost 20 years less than non-Indigenous Australians. Explanations for the gap include that the colonial legacy of dispossession and disease continues to wreak social havoc and that both health policy and structures for health services have been fundamentally flawed. The research described in this thesis focuses on the role of senior Federal politicians in the health policy process. The research is grounded in theory which suggests that the values and beliefs of decision makers are perpetuated through language. Using critical discourse analysis the following hypotheses were tested: 1. That an examination of the language of Federal politicians responsible for the health of Aboriginal and Torres Strait Islander Peoples over three decades would reveal their beliefs, values and discourses concerning Aboriginal and Torres Strait Islander Peoples and their health 2. That the discourses of the Federal politicians contributed to policy discourses and frames in the Aboriginal and Torres Strait Islander health policy environment, and 3. That there is a relationship between the policy discourses of the Aboriginal and Torres Strait Islander health policy environment and health outcomes for Aboriginal and Torres Strait Islander Peoples. The hypotheses were proven. I concluded that there was a relationship between the publicly-expressed values and beliefs of politicians responsible for health, subsequent health policy and resulting health outcomes. However, a model in which theories of discourse, social constructions of people and problems, policy development and organisational decision-making were integrated did not adequately explain the findings. I developed the concept of &quotpolicy imagination&quot to explain the discrete mechanism by which ideology, politics, policy and health were related. My research suggests that the ideology and values which drove decision-making by Federal politicians responsible for the health of all Australians contributed to the lack of population-wide improvement in health outcomes for Aboriginal and Torres Strait Islander Peoples in the late 20th Century.

During 1996 and 1997 an Australian parliamentary committee conducted an inquiry into greater autonomy for Torres Strait Islanders, but by 2000 the future of the issue seemed unclear. This thesis explores what the notion of autonomy has meant for Torres Strait and for Torres Strait Islanders in the past, and what it might mean in the future. The thesis uses material from the period before European contact to just after the end of the parliamentary inquiry. ¶ Several analytical tools were utilised to explore the concept of autonomy. Major among these to propose and then analyse the relationship between autonomy’s economic and political components. The thesis also introduces the paired concepts of negative and positive autonomy to provide a counterpoint to ideas of welfare colonialism. Cross cutting these economic and political elements is a consideration of both regional and corporate forms of autonomy. The thesis argues that it is necessary to consider the factors which people can use to legitimise a case for autonomy and these are identified and discussed. ¶ Although previous research and historical material are utilised, unique parts of the thesis include an analysis of: the formal submissions and hearings associated with the parliamentary inquiry; the Torres Strait’s location between Australia and Papua New Guinea; and the Strait’s small-island make-up. In this latter regard, comparisons are made with models and examples of autonomy found in small island states and territories in the Pacific. ¶ The findings include that we must consider two groups of Torres Strait Islanders, those in Torres Strait and those on mainland Australia. Whereas those in the Strait have been able to legitimise a case for a form of autonomy those on the mainland have not. Islanders in the Strait have achieved a degree of regional autonomy; those on the mainland are unable to make a case to be part of this regional autonomy, or to achieve a form of corporate autonomy. The status of Islanders in the Strait is influenced by several factors including the Strait’s location on the border with Papua New Guinea, the associated Treaty with that country, and the nature and the accessibility of the in-shore fishery. A major finding however is that although Islanders have achieved a degree of regional political autonomy, which may be progressed yet further, they have been unable to embrace non-Indigenous people within this. Their present aspiration for regional political autonomy therefore is limited to one that would apply only to Indigenous-specific affairs. This stands in some conflict with their aspiration for regional economic autonomy which would include their control over the entire regional fishery which they presently share with non-Islanders. ¶ Though Islanders have achieved some degree of political autonomy, they depend on substantial government financial transfers to the region. Despite this they have also achieved some economic autonomy, particularly through being involved in the region’s fishery. Juxtaposing negative and positive autonomy with political and economic autonomy shows that a dependence on government economic transfers does not preclude gains in political autonomy. This can be contrasted with the notion of welfare colonialism.