Achieving best practice in primary health care for Aboriginal Peoples and Torres Strait Islanders

The AMA Indigenous Health Report Card 2010-11 was launched in Melbourne today.

The Report Card – the ninth in a respected and authoritative series dating back to 2002 – examines models of best practice in primary care for Aboriginal peoples and Torres Strait Islanders and makes a number of strong recommendations to governments to greatly improve Indigenous health outcomes.

AMA Vice President and Chair of the AMA Indigenous Health Taskforce, Dr Steve Hambleton, said that more needs to be done in a practical way to build on the momentum of significant Government investment of more than $1.6 billion to Close the Gap in Indigenous Health.

Dr Hambleton said the gap in life expectancy would not close unless all Aboriginal and Torres Strait Islander peoples have full access to high quality primary health care.

“Aboriginal and Torres Strait Islander peoples do not currently have a level of access to health care that matches their greater need.  They experience a range of barriers in accessing the appropriate care in a timely way.  Any reform of Australia’s primary health care system must place a greater priority on improving access to the right model of care in the right place at the right time for Indigenous Australians,” Dr Hambleton said.

“The first step is to be clear about what is involved in providing ‘best practice’ high quality and accessible primary health care for Aboriginal and Torres Strait Islander peoples.

“The AMA Report Card identifies some of the more successful primary health care models that reduce barriers to access and promote high quality health and clinical outcomes for Indigenous patients.

“The challenge is to ensure continuity of care through collaboration and integration between services and sectors, and the sharing of cultural understanding, resources, expertise, and geographical availability,” Dr Hambleton said.

According to the most recent available data, there is significant unmet need in Aboriginal and Torres Strait Islander peoples’ access to primary care.

In 2008-09, just over half (54.5 per cent) of Aboriginal and Torres Strait Islander peoples accessed Australian Government-funded Aboriginal and Torres Strait Islander-specific primary care services in major cities.

In 2008, only 13 per cent of these services were located in major cities.  This equates to approximately 6,700 Aboriginal and Torres Strait Islander people for every Australian Government-funded Aboriginal and Torres Strait Islander–specific primary care service in major cities.

The AMA Report Card makes the following recommendations to governments to ensure best practice in primary health care for Aboriginal and Torres Strait Islander peoples.

• Aboriginal and Torres Strait Islander peoples must play a leading role in planning their primary health care;

• Aboriginal medical services must not be disadvantaged in any changes to primary care funding arrangements between the Commonwealth and the States and Territories;

• Governments must ensure:

• ongoing monitoring of service capacity needs;
• continuity between primary care and acute care for Aboriginal and Torres Strait Islander peoples;
• Lead Clinician Groups include doctors involved in the care of Aboriginal and Torres Strait Islander peoples;
• systematic, rather than piecemeal, access to specialist services for Aboriginal and Torres Strait Islander peoples, and
• e-health systems within regions to underpin continuity of care for Aboriginal and Torres Strait Islander peoples.

• Priority must be given to building the capacity of Aboriginal community-controlled primary care services, so they can maximise their high potential for best practice;

• Private general practices and community health centres must be further empowered to provide accessible and high quality primary care to Aboriginal and Torres Strait Islander peoples.  This could involve:

• support to routinely record Aboriginal and Torres Strait Islander status in patient records;
• incentives to allow routine bulk-billing of Aboriginal and Torres Strait Islander patients;
• support for the completion of cultural safety training;
• development of Registrar training in core competencies in Aboriginal and Torres Strait Islander health; and
• incentives to train and employ Aboriginal Health Workers.

• Collaboration and integration should be supported, where appropriate, between private general practices or community health centres and Aboriginal community-controlled services to enable the sharing of cultural advice and clinical expertise.

• Stronger support must be provided for Aboriginal Health Workers, including a commitment that some training takes place in local communities to encourage local recruitment; and

• A network of Teaching Health Centres of Excellence should be established across Australia to act as practical training and research hubs in Aboriginal and Torres Strait Islander health.

The AMA Indigenous Health Report Card 2010-11 is on the AMA website at:

Long version:                http://ama.com.au/aboriginal-reportcard2010-11

Summary:                     http://ama.com.au/aboriginal-reportcard2010-11-summary

13 May 2011

CONTACT:         John Flannery                       02 6270 5477 / 0419 494 761

                       Geraldine Kurukchi                 02 6270 5467 / 0427 209 753

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