The Royal Australian College of General Practitioners (RACGP) General Practice: Health of the Nation report shows promise for the future of Aboriginal and Torres Strait Islander health – but adequate funding for GPs and Aboriginal health services is critical.
An annual health check-up on general practice in Australia, the Health of the Nation report draws on publicly available data, as well as the Health of the Nation survey of RACGP Fellows from across Australia. This year’s survey was undertaken by EY Sweeney during April-May 2021, with 1386 respondents.
This year’s findings show there is strong and growing interest among GPs to work in Aboriginal and Torres Strait Islander health.
The report found:
· 56% of GPs in training surveyed agreed or strongly agreed with the statement “I have an interest in Aboriginal and Torres Strait Islander health/healthcare”, compared to 44% among other specialty trainees
· general practice is the most common specialty of choice for Aboriginal and Torres Strait Islander medical graduates
· organisations providing Aboriginal and Torres Strait Islander primary health services employ about 4,300 full time equivalent health staff, nearly half (48%) of whom identify as Aboriginal and/or Torres Strait Islander
· the number of full-time equivalent GPs employed in Aboriginal and Torres Strait Islander primary healthcare services increased from 568 in 2018-19 to 596 in 2019-20.
RACGP Aboriginal and Torres Strait Islander Health Chair, Professor Peter O’Mara, said the report included many positive signs for Aboriginal and Torres Strait Islander health.
“While we cannot ignore the gap in health outcomes between non-Indigenous people and Aboriginal and Torres Strait Islander people, this year’s Health of the Nation report offers us hope for the future,” he said.
“On the workforce front, we continue to see growth in Aboriginal and Torres Strait Islander GPs, as well as interest in Aboriginal health among GPs in training – 16% of trainees taking part in the Australian General Practice Training program surveyed said they would like to work as a GP in Aboriginal and Torres Strait Islander health in future.
“This is positive step forward because we know that more GPs providing high-quality, culturally appropriate and accessible healthcare is key to closing the gap.
“Aboriginal and Torres Strait Islanders face considerable health inequities driven by the circumstances in which people live, such as their housing, food security or experience of racism. Improving the patient’s experience of health services, as well as increasing ease of access to services, will contribute to better health outcomes.
“The report shows both Aboriginal Medical Services and GPs are valued by Aboriginal and Torres Strait Islander people – 43% prefer to see a GP for medical help, while 48% prefer to go to a GP or other health provider at an AMS or community clinic.
“AMS provide specially tailored care to the community and are an important source of healthcare in remote areas. Of those living in remote areas, almost seven-in-10 report they usually see a GP who is part of an AMS or community clinic, compared with less than three-in-10 or 29% in non-remote areas.
“The good news is that nine in 10 Aboriginal and Torres Strait Islanders reported seeing a GP or other medical specialist in the last 12 months. Aboriginal and Torres Strait Islander people use GP services at rates that are slightly higher than those for non-Indigenous people.
“However, challenges in terms of access remain, particularly since there is a higher level of need for general practice care among Aboriginal and Torres Strait Islander people.
“More than one in 10 Aboriginal and Torres Strait Islanders say they had needed to see a GP in the last 12 months but had not gone to one on at least one occasion, with the most common reason being they were too busy.
“Aboriginal and Torres Strait Islander people tend to have more complex medical needs and need culturally safe care for this to be successful. However, Medicare doesn’t adequately fund the longer consultations, non-face to face care, co-ordination and flexibility required.
“Adequate resourcing is crucial in order for general practices and Aboriginal Community Controlled Health Services to continue to provide high quality care to Aboriginal and Torres Strait Islander people.”
Professor O’Mara also warned of the impact of the COVID-19 pandemic on Aboriginal and Torres Strait Islander people.
“We have seen some devastating outbreaks in Aboriginal and Torres Strait Islander communities, despite the considerable work that went into ensuring these vulnerable communities were isolated from the virus,” he said.
“Now we have COVID-19 vaccines, it is critical that more is done to ensure high rates of vaccination among Aboriginal and Torres Strait Islanders. This is essential to ensure the protection of our most vulnerable communities.
“We urgently need to tackle the scourge of health misinformation and work together with communities and leaders to ensure messages about the importance of vaccination and COVIDSafe practices reach everyone. We cannot leave anyone behind.
“Aboriginal and Torres Strait Islander communities have not only been affected by outbreaks, but the pandemic has also impacted access to general healthcare.
“In 2019-20, Aboriginal and Torres Strait Islander primary health services saw around 469,000 patients and provided 3.5 million episodes of care – a decrease from 500,000 patients and 3.7 million episodes of care in the previous year. This likely reflects the impacts of the pandemic, such as people delaying or avoiding consultations, restrictions on travel, reluctance of patients to travel to see a GP, and barriers to use of telehealth, particularly video technology.
“The swift action taken in Australia to reduce the impact of the COVID-19 pandemic on Aboriginal communities was informed and led by Aboriginal and Torres Strait Islander leaders and communities. This ongoing work is a remarkable achievement and has no doubt saved lives.
“However, we are not out of the woods. We must continue working together to tackle the impact of the pandemic on Aboriginal and Torres Strait Islander communities – improving access to care for appointments missed, boosting vaccination rates and measures to ensure the protection and health of our communities.”