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AMA backs call for inquiry into institutionalised racism

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The gap between health outcomes for Indigenous and non-Indigenous Australians will not be closed until systemic racism is rooted out of the health system, the Close the Gap Campaign says.

Releasing its 2017 Progress and Priorities Report on National Close the Gap Day on 16 March, the Campaign Steering Committee called for a national inquiry into institutionalised racism in hospitals and other healthcare settings.

“The reality for Aboriginal and Torres Strait Islander peoples is that we have a life expectancy at least 10 years shorter than non-Indigenous Australians. We need urgent action,” Close the Gap Campaign co-chair Jackie Huggins said.

The report found that four interacting factors within Australia’s health system continue to be ‘potentially lethal’ for many Indigenous people:

  • limited Indigenous-specific primary health care services;
  • Indigenous peoples’ under-utilisation of many mainstream health services and limited access to government health subsidies;
  • Increasing price signals in the public health system and low Indigenous private health insurance rates;  and
  • Failure to maintain real expenditure levels over time.

“The persistence of these factors reflects systemic racism; that is, racism that is ‘encoded in the policies and funding regimes, healthcare practices and prejudices that affect Aboriginal and Torres Strait Islander people’s access to good care differentially,” the report said.

“Failure to engage effectively with Aboriginal and Torres Strait Islander people through their elected peak organisations allows such racism to continue.

“The progress of the headline targets in the Closing the Gap strategy will continue to be disappointing until these issues are properly addressed.”

The AMA supported the call for the inquiry, and for knowledge of Indigenous culture to be built into medical school curricula.

AMA President Dr Michael Gannon, AMA Vice President Dr Tony Bartone, and all eight State and Territory AMA Presidents toured the Winnunga Nimmitjah Aboriginal Health Service in Canberra on Close the Gap Day.

Dr Gannon said that while Aboriginal community-controlled health centres like Winnunga Nimmitjah were vital for primary care, it was not realistic to have hospitals dedicated to treating Indigenous patients only.

“It’s so important that patients feel safe in the hospital setting, whether that’s the tertiary hospital setting or in secondary hospitals,” Dr Gannon told reporters.

“If patients don’t feel safe, if they don’t feel secure, if they’re exposed to racism, well that’s simply not good enough.

“So we support that call for the inquiry. It’s so important that primary health care services are very much driven and delivered by Indigenous communities, but we need to do better when, inevitably, like all other Australians, Aborigines and Torres Strait Islanders end up in hospital.”

Keeping medical curricula up to date with community needs was a constant challenge, but more needed to be done to teach medical students about Indigenous culture, he said.

“We talk a lot about the importance of positive experiences at medical student level, at junior doctor level, into specialist training level in rural areas, and the same should apply when it comes to Aboriginal and Torres Strait Islander health,” Dr Gannon said.

“If I reflect on my training as a medical student in Perth, seeing Aboriginal patients was in many ways sadly commonplace.

“But it’s so important that we give medical students across Australia, whether that’s in the rural clinical schools or in the middle of our big cities, exposure to Aboriginal and Torres Strait Islander patients and their wants and needs.”

Dr Gannon said that days like Close the Gap Day were a good opportunity to recognise the advances that have been made, but to realise that there is still so much work to do.

“It’s going to take time, when we look at the metrics, whether they’re in the area of health, whether they’re in the area of employment or education, it is going to take time,” he said.

“But I think that it’s important that at least once a year on National Close the Gap Day, that we reflect on how far we’ve come, and hopefully as every year goes by, we talk about the gap shrinking in whichever target we’re talking about.”

Maria Hawthorne