The Royal Australian College of General Practitioners (RACGP) is Australia’s largest professional general practice organisation, representing over 18,000 urban and rural general practitioners across Australia.
Recognising that improving the health of Aboriginal and Torres Strait Islander people is one of Australia’s highest health priorities, the RACGP established the National Faculty of Aboriginal and Torres Strait Islander Health (‘the Faculty’) in February 2010. The Faculty now has 800 members and six staff. Faculty Board members comprise GPs (including an International Medical Graduate and a Torres Strait Islander GP), and a representative from the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Australian Indigenous Doctors Association (AIDA). The Board Chair is Dr Brad Murphy, a remote area solo GP in Queensland and an Aboriginal man from the Kamilaroi people of northwest NSW.
The objectives of the National Faculty of Aboriginal and Torres Strait Islander Health are to:
- advocate widely for improvement in Aboriginal and Torres Strait Islander health
- model and advocate for best practice in community engagement
- develop and promote education that improves engagement in Aboriginal and Torres Strait Islander health
- support all of those working to improve the health of Aboriginal and Torres Strait Islander communities
- advise and assist the RACGP to become culturally safe and effective in its work in Aboriginal and Torres Strait Islander health
While the Faculty is responsible for leading initiatives to improve health outcomes for Aboriginal and Torres Strait Islander people, the RACGP commitment is that improvements are achieved through all of its activities, as outlined in its Position Statement on Aboriginal and Torres Strait Islander Health.
Consistent with findings in Australia and overseas, the RACGP believes that accessible, high quality primary health care is essential for the improvement in life expectancy and health for Australia’s first people. It recognises that general practices, in addition to Aboriginal Community Controlled Health Services (ACCHSs), play a vital role in providing these services to Aboriginal and Torres Strait Islander communities across Australia. A number of recent Faculty initiatives support general practices to provide accessible, high quality health care. Several are briefly described below.
Online cultural awareness activity and criteria for cultural awareness education and cultural safety training
A major opportunity for general practices to improve accessibility for Aboriginal and Torres Strait Islander people in their community, is to provide a more culturally safe practice environment. The National Faculty of Aboriginal and Torres Strait Islander Health has developed and released an online activity: Introduction to Aboriginal and Torres Strait Islander Cultural Awareness in General Practice, to enhance awareness of this and other access barriers and to consider positive changes that could be made to improve health care access and delivery.
Participation in the online activity is seen by the Faculty as a valuable first step for general practices to enhance their provision of clinically and culturally appropriate health care for Aboriginal and Torres Strait Islander people. The 6 hour educational activity focuses on providing a historical and contemporary context for current health and wellbeing inequities experienced by Aboriginal and Torres Strait Islander people. It was funded by the Department of Health and Ageing, to be available by the College free of charge to general practices wishing to meet the cultural awareness training requirements of the Indigenous Health Incentive.
The Faculty believes that this online activity is of a purely introductory nature, and urges general practice teams who complete it to go on to participate in locally delivered, face-to-face cultural safety training. To ensure that cultural awareness education and cultural safety training programs offered to RACGP members are of high quality, educational criteria have also been developed, to adjudicate applications by training providers for endorsement through the Quality Improvement & Continuing Professional Development Program
Position paper: The identification of Aboriginal and Torres Strait Islander people in Australian general practice
The 2007 Council of Australian Governments National Indigenous Reform Agreement requires improvements in the data used to measure progress towards ‘Closing the Gap’ in health outcomes for Aboriginal and Torres Strait Islander people. It is expected that all jurisdictions in the health sector will have implemented the Australian Institute of Health and Welfare report National Best Practice Guidelines for Collecting Indigenous Status in Health Data Sets by December 2012.
Also, at general practice level, identifying Aboriginal and Torres Strait Islander status is a necessary precondition for participation in the Closing the Gap initiative. Without practice awareness, a patient who is of Aboriginal or Torres Strait Islander origin cannot benefit from various measures in the Australian Government’s Indigenous Chronic Disease Package. However, the recording of Aboriginal and Torres Strait Islander status in patient health records in general practices is low. Research has identified a number of concerns about, and barriers to, introducing routine collection of Indigenous status in general practices.
The RACGP has begun to address this issue by introducing a new indicator in the RACGP Standards for general practices (4th edition): Our practice can demonstrate that we routinely record Aboriginal and Torres Strait Islander status in our active patient health records. A RACGP position statement, the identification of Aboriginal and Torres Strait Islander people in Australian general practice has also been released. Further activities will be undertaken during 2011 to support general practices to implement appropriate identification processes.
Aboriginal and Torres Strait Islander Health Curriculum Statement
The RACGP acknowledges that a major pathway to the participation of general practitioners in improving Aboriginal and Torres Strait Islander health starts with medical students and GP registrars. Their education should encompass culture, history, and a holistic view of health and well-being, in addition to awareness of the factors related to the disproportionate percentage of Aboriginal people with poor health and increased mortality.
A RACGP curriculum statement for Aboriginal and Torres Strait Islander health has been developed, identifying the relevant knowledge, skills and attitudes necessary for general practice. It is hoped that institutions responsible for undergraduate and postgraduate medical, nursing and paramedical courses will include the compulsory study of Aboriginal culture, history, and health issues as part of formal course work, drawing from this curriculum statement.
For more information about the above Faculty initiatives, and to learn about others visit the Faculty websitehttp://www.racgp.org.au/Aboriginalhealth