Aboriginal and Torres Strait Islander health


Preamble

The Royal Australian College of General Practitioners (RACGP) acknowledges Aboriginal and Torres Strait Islander peoples as the original custodians of Australia. Australia’s first peoples cared for this land long before European colonisation and their social and spiritual value systems are deeply connected to their “Country.”

European colonisation profoundly changed Aboriginal and Torres Strait Islander circumstances and cultures. Colonisation is not just a single past event but is a process that continues to this day. In modern society this results in the experience of racism and exclusion from social and economic opportunities.

The detrimental impacts of colonisation can still be seen today − with ongoing inequities between health outcomes for Aboriginal and Torres Strait Islander people and non-Indigenous Australians.

Background

The RACGP is committed to reconciliation with Aboriginal and Torres Strait Islander people. We acknowledge the profound social and emotional impact of discriminatory policies and practices, including the forcible removal of children from their families and the years of failure of governments and health professionals to act effectively to protect and improve the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

Over 200 years of loss and dispossession and the systematic disempowerment of Aboriginal and Torres Strait Islander people cannot be addressed without the genuine commitment of governments, nongovernment organisations and the wider Australian community.

Health and medical professionals and their representative organisations have a clear role to play in this process. Solutions must draw on the strength and resilience present in Aboriginal and Torres Strait Islander communities today, and should be developed in partnership with Aboriginal and Torres Strait Islander people and communities.

By virtue of their roles in delivering comprehensive, whole person, patient centred care, General Practitioners (GPs) are well positioned to understand the health needs of Aboriginal and Torres Strait Islander patients. Additionally, they are well positioned to positively influence local environments through the use of their advocacy and leadership skills, whether that be in the practice, community, health service, outreach clinic, hospital or political setting.

How Australia responds to the inequity and inequalities experienced by Aboriginal and Torres Strait Islander people is a mark of us as a nation. How we as health professionals work to improve the health and wellbeing of Aboriginal and Torres Strait Islander peoples will inform and strengthen all of our work in health.

Our vision is for GPs to work in partnership with Aboriginal and Torres Strait Islander people and communities, ensuring that people enjoy optimal health outcomes through the adoption of a comprehensive and holistic concept of health and wellbeing.

Position of the RACGP

The RACGP recognises that improving the health of Aboriginal and Torres Strait Islander people is one of Australia’s highest health priorities. Recognising this, the RACGP is committed to developing and supporting a culturally safe and reflective GP workforce that can work effectively with Aboriginal and Torres Strait Islander patients and communities. The RACGP is committed to advocating for culturally appropriate health delivery systems that improve health outcomes.

The RACGP:

  • supports the rights of Aboriginal and Torres Strait Islander people to enjoy ‘the highest standard of health’ iii including not just the physical wellbeing of the individual, but also the social, emotional and cultural wellbeing of the whole community, so that each individual is able to achieve their full potential and thereby contribute to the total wellbeing of their communityiv
  • deeply regrets the racism displayed towards Aboriginal and Torres Strait Islander people that occurs in individual interactions, as well as policy and institutional responses. The RACGP will challenge all forms of racism and call on all GPs to challenge racismv
  • supports self-determination of Aboriginal and Torres Strait Islander people. We acknowledge Aboriginal community controlled health services are an integral part of the Australian health system and a key means of reducing current health inequity, developing and empowering communities. The RACGP commits to working with the National Aboriginal Community Controlled Health Organisation (NACCHO), and its state affiliates, consistent with our Memorandum of Understanding
  • acknowledges there are many social and cultural determinants of health − adequate sanitation, improved housing, employment, education and access to fresh food to name a few − that influence health outcomes. The medical profession has a key role to play in improving the quality of health services and, where possible, advocating for equitable distribution of health related resources
  • reaffirms its commitment to developing culturally safe GPs and their staff to work effectively in the cross-cultural context, in partnership with Aboriginal and Torres Strait Islander people. The RACGP will support training to improve Aboriginal and Torres Strait Islander health through QI&CPD activities and rigorous assessment processes
  • recommends all GPs inform their professional practice with a competent-level understanding of Aboriginal and Torres Strait Islander culture, history and health. Aboriginal and Torres Strait Islander healthcare requires a holistic, comprehensive primary healthcare team based approach. A deeper understanding of this model is essential to improve health outcomes for Aboriginal and Torres Strait Islander people
  • commits to working with the Australian Indigenous Doctors’ Association (AIDA) and other health professional and educational organisationsvi to address the chronic shortage of Aboriginal and Torres Strait Islander people in the Australian health workforce. The RACGP actively supports Aboriginal and Torres Strait Islander doctors and registrars in achieving Fellowship
  • supports any efforts to improve medical education in Australia in a way that responds to the evolving health needs and practices, educational and scientific developments. Such as the inclusion of an Aboriginal and/or Torres Strait Islander person in assessment process as mandated by the Australian Medical Council
  • strongly supports the vital role of Aboriginal and Torres Strait Islander health practitioners, health workers, working in partnership with GPs to deliver quality comprehensive healthcare
  • supports research that makes a difference to health outcomes, policy and practice, and the capacity of general practice to engage with Aboriginal and Torres Strait Islander health issues. The RACGP particularly encourages strategic, policy driven and translational research with a focus on primary healthcare. This research must be culturally appropriate, involve Aboriginal and Torres Strait Islander people in design and implementation, and use collaborative approaches that build research capacity within Aboriginal and Torres Strait Islander communities
  • will continue to be proactive in addressing issues such as access and equity for Aboriginal and Torres Strait Islander people through the RACGP Standards for general practices. This includes active encouragement of general practices to identify their Aboriginal and Torres Strait Islander patients
  • will review the position statement every three years from the date of sign-off from RACGP Council.

Conclusion

The RACGP is committed to improving the social and emotional health and wellbeing of Aboriginal and Torres Strait Islander individuals and communities. RACGP Aboriginal and Torres Strait Islander Health will continue to reflect this commitment through maintaining appropriate RACGP representation on key national policy and program advisory groups. Our work in GP education programs, supporting effective research and advocating for Aboriginal and Torres Strait Islander self-determination on all levels will continue and expand to reflect this commitment and the ever increasing need to find effective solutions.

  1. Wilkie M. Bringing them home: Report of the national inquiry into the separation of Aboriginal and Torres Strait Islander children from their families. Human Rights and Equal Opportunity Commission; 1997.
  2. National Congress of Australia’s First Redfern Statement.
  3. Calma T. Achieving Aboriginal and Torres Strait Islander Health Equality within a Generation: A Human Rights Based Approach. Sydney (AUST): Australian Human Rights and Equal Opportunity Commission. 2005.
  4. Trewin D. National Aboriginal and Torres Strait Islander Health Survey, Australia, 2004-05. Australian Bureau of Statistics; 2006.
  5. The Royal Australian College of General Practitioners. Melbourne, VIC. Racism. It stops with me.
  6. The Australian Medical Council. Standards for Assessment and Accreditation of Specialist Medical Programs and Professional Development Programs 2015.
  7. Australian Medical Council. Procedures for Assessment and Accreditation of Medical Schools by the Australian Medical Council 2017. Available from

Download this position statement

Aboriginal and Torres Strait Islander Health (PDF 577 KB)