Abstract
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
"policy imagination" 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.