Skip to 0 minutes and 14 secondsSo my name is Renee Blackman. So I'm a Gubbi Gubbi woman. So I'm now Director of Health Services for ATSICHS Brisbane. ATSICHS Brisbane is the oldest Aboriginal medical service in Queensland. We've been in operation for 44 years. Definitely privileged to be part of a very long legacy and want to contribute to moving that even further forward for our people in the way that they access health services here in Brissy. You connect with people in health in a certain way, where you actually create-- it's very relationship based. You create a certain type of relationship very much based on trust. And if you can't do that, all is lost actually.

Skip to 0 minutes and 52 secondsNo one's going to listen to you if people don't trust you, especially when you ask them to change something they've done for the last 20 years. The health service management theoretical underpinnings include the provision of safe quality systems and governance. Partnering with health professionals and other health services is also an important element of contemporary Health Service Managers. First Peoples Health Service Managers are guided by Western health service management theories further enhanced by First Peoples knowledges, ensuring culturally safe health care.

Skip to 1 minute and 23 secondsBut also liaising with a lot of our partners to make sure that we've got the allied health running the way we need it to run, any of the maternal and infant health partners, so the major hospitals where our mothers may birth, those sorts of places. I think once they step out of that area and step into either a community service, like a community health service or a community-controlled environment, where actually you need the human being to come out and the connections and the relationships to come out, people start to realise that that's a whole other skill set. It's a whole other way of looking at the world and a whole other way of delivering service.

Skip to 2 minutes and 1 secondWhen they start to realise that if you have a certain skill in that area, or you are an Aboriginal Torres Strait Islander person who can communicate well with your community, you have an advantage. And people do learn from each other. And that's not to say that we-- we don't have all Aboriginal Torres Strait Islander staff in Aboriginal medical services. We have a lot of non-Indigenous people with us, working alongside us, with us, to deliver the best service we can to the community that access the service. So to answer the question about non-Indigenous people understanding and realising the value of an Indigenous workforce, absolutely in the AMS sector.

Skip to 2 minutes and 37 secondsIf they want to see it in action, and in action people working together to get a really good outcome for the community that's very vulnerable, come work in an Aboriginal medical service. You'll see it.

Skip to 2 minutes and 52 secondsSo my name is Leeona West. First and foremost I'm a proud Kalkadoon woman, born in Cloncurry, raised in Mount Isa. Secondly, I'm a registered nurse. I've been working in our services for about 16 years, probably 10 of those years in leadership positions. Whether you're working at service delivery or whether you're in a senior management position, welcoming your community to your service is your typical day. So you know you're in your waiting room, you're making sure your staff are OK. Just because we're in a position, we don't go from what our cultural responsibilities are outside our positions to not embedding that into our positions. So our mother brings us back down to level all the time.

Skip to 3 minutes and 38 secondsYou know, don't think too deadly to go out there and see Auntie that's sitting in the waiting room and offer her a cup of tea. So that's an everyday job for us, no matter what position you're in, we're all -- we maintain our respect for our people. We maintain the importance of building relationships. And we maintain the importance of building connections with our mob. Majority of the time, we leave it up to the Health Workers because we like the non-Indigenous health professionals to go with our Health Workers into the community. But it's role modelling, letting them see how important it is for us to connect with our mob. Where are you from, Auntie? And just how we address our people.

Skip to 4 minutes and 19 secondsWe always call them Auntie or Uncle, or Mr. or Mrs. We never address people who are older than us by their first name. But we always try and connect. I think that the role modelling is the best way to do it with our non-Indigenous health professionals.

Building respectful relationships and partnerships

When Aboriginal and Torres Strait Islander peoples aren’t included in decision making, the results are poor and precious resources are usually wasted in the process.

An understanding of culture, effective communication and a commitment to working in partnership is key to your success in working with First Peoples. Lilla Watson (N.D.), Aboriginal elder, activist and educator once wisely said: ‘If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together.’

Research shows Indigenous clients in Australia are a third less likely to receive appropriate medical care across all conditions, compared to non-Indigenous patients (Paradies, Harris & Anderson, 2008). Ensuring access to culturally and clinically safe healthcare must be our focus.

A smiling doctor bends down to be at eye level with her client in a wheelchair © Shutterstock

‘Access’ does not just refer to physical access

It also includes:

  • providing care and services that are culturally safe, where clients and families are free from discrimination and judgement
  • affordable health care and services
  • making available health information that is both culturally responsive and easily understood.

What else can you and your team do to make a difference?

Small steps can make big inroads toward change. For example, it’s important to remember First Peoples are more likely to access health services where service providers:

  • communicate respectfully
  • have an understanding of First Peoples’ culture
  • take time to build good relationships with First Peoples, and
  • include Aboriginal or Torres Strait Islander health workers as part of the healthcare team (Durey, Thompson & Wood 2011; Shahid, Finn & Thompson, 2009; Taylor et al., 2009).

In the next few steps we focus on supporting you to embrace each of these strategies.

Your task

What strategies does your workplace implement to support culturally safe communication and better access to health services? Also share ideas of what you think could work well. Use the comments link further below to post your responses.

References

Durey, A., Thompson., S.C. (2012) Reducing the health disparities of Indigenous Australians: time to change focus, BMC Health Services Research, vol.12, p.151.

Paradise, Y., Harris, R. & Anderson, I. (2008). The impact of Racism on Indigenous Health in Australia and Aotearoa: Towards a Research Agenda. Cooperative Research Centre for Aboriginal Health. Discussion Paper Series: No. 4

Shahid, S., Finn, L. & Thompson, S.C. (2009) Barriers to participation of Aboriginal people in cancer care: communication in the hospital setting, Medical Journal of Australia, Vol. 190, pp. 574-579.

Taylor, K., Thompson, S., Smith, J., Dimer, L., Ali, M. & Wood, M. (2009). Exploring the impact of an Aboriginal health worker on hospitalised Aboriginal experiences: lessons from cardiology, Australian Health Review, 33 (4), 549-557

Watson, L. (ND). Lilla: International Women’s Network.

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This video is from the free online course:

Safer Healthcare for Australia's First Peoples

Griffith University