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Getting the focus back on Indigenous health

A significant amount of Government energy recently has focused on national health reform initiatives such as Medicare Locals, public hospital financing, preventative health, disability insurance, and e-health systems and shared electronic records.

07 Nov 2011

By AMA President Dr Steve Hambleton

A significant amount of Government energy recently has focused on national health reform initiatives such as Medicare Locals, public hospital financing, preventative health, disability insurance, and e-health systems and shared electronic records.

While these are important, and the AMA supports a large proportion of the direction of these reforms (while reserving the right to seek to change others), it seems that the great needs in Indigenous health have slipped down the priority list.

As Chair of the AMA’s Taskforce on Indigenous Health, it occurred to me that virtually no attention was being paid to how the health reform agenda would impact on the primary health care of Aboriginal peoples and Torres Strait Islanders and the organisations that support them.

The AMA has a strong view that Aboriginal people and Torres Strait Islanders should play a leading role in planning their own primary health care, and that the Government’s health reform agenda should be judged in terms of how well it improves their health.

Our most recent Indigenous Health Report Card highlighted the success of some service delivery models operating in different parts of Australia, including in the Kimberly region, at the Kimberley Aboriginal Medical Services Council (KAMSC).

The practical realities of health care delivery are best understood by talking with, and listening to, the doctors, health professionals and patients directly involved in it.  And this is just what I did when the Taskforce met last month in Broome, where my colleagues and I also had the chance to attend the 2011 Australian Indigenous Doctors’ Association (AIDA) conference.

We learnt a lot, especially about mental health issues in Indigenous communities.

For example, a recent report on the Northern Territory intervention revealed that suicide and self-harm rates continue to escalate in the Territory, particularly among young men.

It was of particular interest to the Taskforce whether the growing needs of Aboriginal people and Torres Strait Islanders in the Kimberley were being appropriately met in the area of mental health and social and emotional wellbeing.

After speaking with KAMSC, it became apparent that, in the Kimberley region, there are very high rates of mental health problems among Aboriginal people,  and not mostly confined to young men, or indeed males.

A significant proportion of the burden of mental illness turns out to be among Aboriginal women in the Kimberley area.

We learnt that the problems were not universal, however, and a ‘one size fits all’ solution would not be appropriate.  This is something that had come to light only recently, and it has clear impacts on how mental health and wellbeing support needs to be properly targeted with local engagement.

While the CEO acknowledged that KAMSC and the Kimberley had received improved funding for mental health support, there is a persistent problem in the region with the availability of affordable accommodation for doctors and other health professionals.

To deal with the widespread incidence of mental health problems in the region, KAMSC was developing initiatives to strengthen capacities in the region’s communities to identify mental health problems and develop management strategies until professional assistance could be sought.

The AMA supports community-based capacity building as a key to sustainable solutions in Aboriginal communities, and we have called on the Commonwealth to provide support grants to communities so they can develop local solutions to local problems.

The AIDA conference provided insights into the experiences that Indigenous doctors have in medical practice, in both Indigenous communities and mainstream settings, and the role they see themselves in as ‘healers’.

Indigenous health is very often thought of in terms of problems and setbacks.  The AIDA conference bucked this trend by showcasing a range of successful health programs in the region, and also the significant differences that Indigenous doctors were making.

The Taskforce’s visit to the Kimberley region was a success in building stronger relationships, making important contacts, and getting first-hand insights into difficulties and successes in delivering best practice primary care to Aboriginal and Torres Strait Islander peoples.


Published: 07 Nov 2011