1st January 2019

Institutional Racism – A Sickness in Queensland’s Health System

By DrMJLock
  • A report on institutional racism in Queensland hospitals was completed in early 2017 but suppressed until late 2018. The Marrie Report revealed a strain of institutional racism in the Queensland Health System – dubbed the IRQldHS strain.
  • The Bukal Institutional Racism Matrix (BIRM) is at the heart of the Marrie Report and provides an innovative way to measure, monitor, and evaluate institutional racism.
  • Mr Adrian Marrie and Ms Henrietta Marrie, from Cairns, developed the BIRM after reports of overt racism in 2014 in the Cairns Hospital and Hinterland Health Service (CHHHS).
  • Dr Mark J Lock, a Ngiyampaa academic, led an advocacy campaign to have the Marrie Report made public in the face opposition from high-powered executives in publicly funded organisations.
  • This post is the launch of a 2019 campaign to blog weekly about the BIRM and institutional racism in the Australian health system.

IRQldHS – A Virulent Strain of Institutional Racism

Queensland, Australia’s second largest state with a land area of 1.85 million square kilometres and a population of 5 million people (May 2018), has a history of overt racism against Aboriginal and Torres Strait Islander peoples. Read Prof Andrew Jakubowicz’s short commentary on ‘combating racism in Queensland’.

But Queensland racism extended to incredible depths in the governance of the lives of Aboriginal and Torres Strait Islander peoples, documented in Rosalind Kidd’s (1997) ‘The Way We Civilise“. This book had a profound effect on me as young man seeking answers to Australia’s history of treatment of my ancestors. And it was just last year (2018) that I came across the work of Carl Adolf Feilberg on racism in Queensland and title of one of his newspaper articles is ‘The Way We Civilise’ (1880). Shocking, appalling, saddening – that’s the history of Queensland racism.

I do see many efforts to promote anti-racism in Australia and Queensland. They include the specific websites: Racism No Way, Racism – It Stops with Me, Australians Against Racism, and All Together Now. Also, there are many organisations with anti-racism policies. However, it feels as though these efforts about awareness, reporting, and education of racism have little impact because of the lack of a tool to measure, monitor, and evaluate their effectiveness within the complexity of social policy generally.

Unable to see the Beach for the Sand

All the minute efforts to address racism are like single grains of sand seeking a beach to land on, but at the moment I can’t see all the sand let alone a beach! The BIRM is an extraordinary matrix that captures lots of grains of information and places them into a framework of meaning – where the grains of sand cohere into a beachhead against institutional racism.

Perhaps that’s why high-powered public health professionals didn’t want Aboriginal citizens to know the power of the BIRM – because it caught them in a lie about what they said they were doing and what the measurements showed about their inactions. Lots of sand thrown around by executives to spruke about addressing the health inequity of Aboriginal and Torres Strait Islander peoples, but the BIRM showed that there is no institutional beachhead to serve as a solid platform of trust that healthcare consumers could stand on. 

All the inactions are revealed in the report ‘Addressing Institutional Barriers to Health Equity for Aboriginal and Torres Strait Islander People in Queensland’s Public Hospital and Health Services’. It was funded by the Queensland Aboriginal and Islander Health Council and the Anti-Discrimination Commission Queensland (ADCQ) and it was the leaders of these organisations that suppressed the report.

A Citizen’s Right to Information Demeaned

The Marrie Report was completed in March 2017 and was suppressed because of the embarrassing results for all Queensland’s Hospital and Health Services. This was brought to my attention in this National Indigenous News news link ‘Leaked report reveals ‘extreme’ levels of racism in Queensland public health system‘ written by Aaron Smith.

Subsequently, I contacted the ADCQ in July 2018 to ask about the Marrie Report and find out what actions were occurring as a result. A high-powered executive (hereafter, HPE) called to explain why the organisations were taking a ‘quiet’ (that is, non-public) approach, and could I also be quiet about it because I would be kept in-the-loop? But I was kept out of-the-loop and on 30 October 2018, I applied for a Right to Information to the Anti Discrimination Commission Queensland (ADCQ) to release the Marrie Report into the public domain.

I found it strange that both the Queensland Government (Queensland Health) and the ADCQ promote openness, transparency, and accountability but the Marrie Report remained hidden. From March 2017 to December 2018 (21 months) the respective organisations had remained silent on the Marrie Report. But I was not silent – as the Australian Human Rights Commission campaign encourages in their campaign “Racism. It Stops With Me” and to #StandUp to Racism @AusHumanRights.

Campaign met with Derision

My twitter campaign to have the Marrie Report brought into the light was met with derision, silence, and profanity from stakeholders – however, nothing that was written but only what was reported to have been said. I was told that “not being from Queensland” meant I was excluded from being privy to what the organisational responses were to the Marrie Report. I telephoned the high-powered executives of the ADCQ and QAIHF – and these were left unanswered. And then, I was reportedly called a disgusting insult by one of the high powered executives. Not the responses I was seeking when standing up for my citizen rights.


It’s about time for action on institutional racism in the Australian health system. And after a week-long twitter campaign (see image, left) and a post on Facebook, a media statement was released ‘Working in Partnership to address institutional barriers to Aboriginal and Torres Strait Islander health equity‘. However, my phone calls to the Deputy Commissioner of the ADCQ, the Commissioner of the ADCQ, and the CEO of the Queensland Aboriginal and Islander Health Council, have gone unanswered. And it’s pretty clear why…

The Extent of IRQldHS is Embarrassing!

The Marrie Report shows the sheer embarrasing depth of Institutional Racism in Queensland Hospital and Health Services (HHS):

Institutional Racism Matrix 2017

Based on the audit results across the five key indicators (participation in governance, policy implementation, service delivery, recruitment and employment, and financial accountability and reporting), 10 of the 16 HHSs rated within the extreme range of institutional racism (that is scoring less than 20 points out of the possible 140), with the remaining six in the very high range (20-39 points out of 140). Thus, all of the 16 HHSs rated in the very high to extremely high levels of institutional racism.

‘The lesson to be learned from this report is that if Aboriginal and Torres Strait Islander health policies are not reinforced in the relevant legislation, then those primarily charged with implementing them, namely the HHS boards and their executive management teams, as this audit demonstrates, will invariably ignore them’. (Adrian Marrie, 2017)

Call to Action – #CallOutIRAustralia

  1. This campaign encourages you to share your stories about institutional racism in Australia using the above hashtag that I will track that and post the commentaries on this website.
  2. The campaign raises awareness about the Marrie Report and the Bukal Institutional Racism Matrix. The work of Adrian and Henrietta Marrie should be applauded, awarded, and lauded for the incredible work that it is!
  3. The campaign calls on Governments, Academics, Professionals, and Citizens to support my call for an Anti-Racism Institute to be funded to develop and apply the Bukal Institutional Racism Matrix to all areas of Australian civil service.