The final report card of the COAG Reform Council also reveals that more than two out of five indigenous people delayed, or did not see, a dental professional due to cost, and one-third delayed, or did not fill, a prescription for the same reason.

In a blunt warning, the council chairman, John Brumby, has observed that much of the good work to close the gap on health outcomes could be undone if barriers are put up to healthcare access for indigenous people.

In a speech launching the report at an indigenous health summit in Melbourne on Thursday, Mr Brumby says when people start to avoid going to their primary or community care provider because of cost they often end up in hospital.

“And, what we found was that rates of potentially preventable hospitalisations for indigenous people were already three to four times higher than rates for other Australians,” he says.

Mr Brumby makes only an indirect reference to the changes in the federal budget in the address, noting that healthcare is “very topical at the moment”, with Australians being asked to consider what they would pay for access to a primary care physician.

The report finds that indigenous people are three times as likely to die of an avoidable cause as non-indigenous people and that three quarters of deaths of indigenous people under 75 were avoidable through early prevention or treatment.

While reporting progress in closing the gap between indigenous and non-indigenous child deaths, it concludes the target of closing the gap on life expectancy by 2031 is unlikely to be met.

In what may be his final address as chairman of the council, which will be wound up next week, Mr Brumby also warns that progress towards closing the gap could be put at risk unless it is measured and reported by someone independent of government.

After informing those at the summit that the council will no longer be reporting on outcomes, he asked who would assume the council’s role of holding governments to account on the promises they have made to close the gap.

While Mr Brumby says he respects the Prime Minister’s department, which appears likely to assume the role, he says what made the Reform Council special was that it acted independently of government.

“We report independently on the progress of all nine of Australia’s governments — the Commonwealth, the States and the Territories — in closing the gap,” he says in a speech to be delivered to an indigenous health summit on Thursday. “Who will do this in future?”

“We need to consider how to increase the effectiveness of our independent public reporting on government progress, such as improving the quality of indicators, and accessing better data,” he says.

“It is important in the future that someone, or some organisation, will be there to properly measure what governments are achieving with the billions of dollars in taxpayers’ money they are spending.

“Crucially, it is important that any future design of performance reporting frameworks and targets must involve indigenous stakeholders as equal partners.”

Mr Brumby says the council’s reports have not only enabled governments to monitor their performance, but equipped the public and indigenous health organisations “with the information they need to hold governments to account for promises they have made in regards to indigenous Australians”.

“And after five years of reporting on governments’ performance, our reports have shown that we are still only at the beginning of the change required over a generation to close the gap.”