| Project Objectives / Summary:
This project targeted the urban indigenous population of Macarthur that is thought to be similar to other urban indigenous communities in major cities, particularly those residents on the city fringes. The Macarthur community is made up of Aboriginals from diverse geographical regions that have moved to the city fringes seeking employment and cheap housing. Problems that have been anecdotally identified include unemployment, transport and friction between Aboriginals from different regions.
This project intended to address these issues in partnership with Tharawal Aboriginal Corporation (TAC) and Macarthur Health Service by integrating primary health services, while continuing to support the Aboriginal Medical Service (AMS).
It seeks to provide more culturally appropriate primary health care services, with a focus on GP services, that integrate with the AMS and other local health services such as ambulatory care program at Campbelltown Hospital. The latter would include care by GPs as an alternative to hospital admission.
The project had three phases.
Phase 1 - the role of the GP Receptionists in ensuring access of Aboriginal people to GP services.
Phase 2 - the views of Aboriginal people on their access to health care.
(MDGP had previously prepared reports on these two phases of the project. They are available on request from MDGP.)
Phase 3 - implications for GP services and moving forward.
Project Outcomes:
- A demographic profile of the indigenous population of SWSAHS.
The data extrapolated from the ABS was seen as a true indication of the number and age, with given socio demographic characteristics for the Aboriginal community in Macarthur. The comparative data on service utilisation for health services was inadequate, GPs and TAC were not presented in this data.
- A map of existing programs and services to indigenous people. Identify the gaps and links between the services.
At the conclusion of this mapping exercise the bulk of services and programs were for child and youth health, mental health and D&A services, infectious diseases with a few for diabetes, oral health and CVD. This is a limited review given that only one area health service was contacted as the visit to Daruk has not yet taken place.
- A report on services and strategies provided by selected other Aboriginal Medical Services (AMS).
Services and strategies provided in other areas by Divisions of General Practice, Area Health Services and Aboriginal Medical Services were considered and the findings disseminated. Findings included, a friendly environment that is culturally inclusive, friendly people that are sensitive and aware of cultural issues, employment of Aboriginal people in key positions including reception staff, and DGP providing information on how to contact AHWs.
- A list of DGPs involved in indigenous health and nature of involvement.
A number of DGPs were identified from the National Directory for Divisions of General Practice. Contact was made with them and nature of their involvement defined. This varied from formal partnerships to initiatives which individual practices could introduce on their own. All require consultation with and consideration of the local Aboriginal community.
- A user-friendly reference on available educational resources on indigenous health in print and electronic format.
The package has been developed by Dennis McDermott and will be trialed by a group of interested GPs. This is being supervised by MDGP and data will be released when completed.
- Hold a forum including MDGP, TAC, Aboriginal Health Workers in SWS, MHS.
The forum is to be jointly hosted by MDGP & CHETRE in early 2003.
The project met all of its aims and they are outlined more specifically in the final report.
Recommendations:
- A survey of the prevalence of disease conditions and risk factors be considered as the data produced would be highly advantageous in the planning of appropriate primary health care services.
- The MDGP arrange cultural awareness training for GPs to consider ways of working better with their Aboriginal clients.
- General practice receptionists be encouraged to attend cultural awareness training together with training on why and how to ask a question on Aboriginal status.
- On a practical front, employing an Aboriginal receptionist where the practice has a significant Aboriginal population, similar to the role of the Aboriginal Liaison Officer.
- A meeting is held under the auspices of the Education Committee of the MDGP to present the Package of Educational Resources on Indigenous Health to a small number of interested GPs; and that these GPs be asked to trial it in their practices.
- Tharawal Aboriginal Corporation, Macarthur Health Service and MDGP meet in the near future to begin working together to develop strategies to address the two priority areas selected at the forum. These being:
- Child and youth health services
- Diabetes
Lessons / Assessment:
The project recognised that access of the indigenous populations into local primary health care services in Macarthur was not simply a problem of physical access, but one of providing high quality care appropriate to the needs of the population. This project highlighted the need for attitudinal and behavioural change to occur to ensure access and equity to GP and allied health services. |
