Health Minister Tony Abbott said the figures showed that dramatic action was needed. He advocated the use of administrators and a return to "paternalism" to improve what he described as the "gothic horror" of life in some remote settlements.

In 2004-05, 29 per cent of indigenous Australians reported their health as fair or poor, almost double the rate for the rest of the population.

Cardiovascular disease, diabetes, respiratory problems, injury and cancer are the five leading causes of death among indigenous people, representing almost three-quarters of fatalities.

Smoking levels have also remained high, with one in two indigenous people addicted, compared with one in four other Australians. And one in six indigenous people aged over 18 have a "risky" level of alcohol consumption.

Rates for hospital admissions for indigenous people are higher than for other Australians. Aboriginal people need treatment involving dialysis at 17 times the rate of other Australians.

For endocrine, nutritional and metabolic diseases, which includes diabetes, the rate is four times higher.

The figures came amid tension within the federal cabinet, with Indigenous Affairs Minister Mal Brough slapping down Mr Abbott for describing the Government's plans to intervene in dysfunctional communities as a new "paternalism".

Mr Brough said that while Mr Abbott supported the Government's resolve to break the cycles of violence and poverty by appointing administrators in failed communities, it should be seen as "good governance".

Labor said Mr Abbott's approach was similar to that which led to the stolen generation.

Mr Abbott said successive governments had failed indigenous Australians and it was time for a new form of "paternalism" in dysfunctional communities. The culture within Aboriginal communities had to change.