In reply: It is unclear how many mainstream general practice consultations involve Aboriginal and Torres Strait Islander patients. Of 485 300 patient encounters attributed to general practices in the BEACH study (2003–2008), 7292 were with Indigenous patients, but 2906 of these encounters took place in Aboriginal community controlled health services (ACCHSs) rather than in general practices.1 If funding to close the gap in Aboriginal disadvantage is being channelled to general practice and the Divisions of General Practice (through recent measures of the Council of Australian Governments), then the Indigenous health outcomes of mainstream services must be carefully attributed.2
The ACCHS sector agrees there is a need to make general practices culturally secure for Indigenous Australians. For example, the Aboriginal Health Council of Western Australia has developed modules for cultural safety training, which are accredited by the Royal Australian College of General Practitioners for GPs’ professional development.3 The National Health and Hospitals Reform Commission report recommends that health services be required, by accreditation processes, to meet specific standards of cultural safety for Indigenous patients to ensure high-quality care.4 Within a quality assurance framework, systematic reforms such as these can potentially improve mainstream services, while supporting Indigenous workers who face unrealistic pressures to improve their local services. As Liaw points out, these initiatives are in addition to the vital role of ACCHSs in closing the health disparity gap.
- 1. Britt H, Miller GC, editors. General practice in Australia, health priorities and policies 1998 to 2008. Canberra: Australian Institute of Health and Welfare, 2009. (AIHW Cat. No. GEP 24.) http://www.aihw.gov.au/publications/index.cfm/title/10721 (accessed Oct 2009).
- 2. Couzos S, Thiele DD. Closing the gap depends on ACCHSs [letter]. Med J Aust 2009; 190: 541. <MJA full text>
- 3. Aboriginal Health Council of Western Australia. Cultural safety training. http://culturalsafetytraining.com.au (accessed Sep 2009).
- 4. National Health and Hospitals Reform Commission. A healthier future for all Australians: final report June 2009. Canberra: Department of Health and Ageing, 2009. http://www.nhhrc.org.au/internet/nhhrc/publishing.nsf/Content/nhhrc-report (accessed Oct 2009).
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