State of general practice for Aboriginal and Torres Strait Islanders

Royal Australian College of GPs

The Royal Australian College of General Practitioners (RACGP) has released its General Practice: Health of the Nation report, an annual health check-up on general practice in Australia.

Chair of RACGP Aboriginal and Torres Strait Islander Health, Professor Peter O’Mara, said that report contained many positive signs for Aboriginal and Torres Strait Islander health.

“It is important not to just dwell on the problems confronting healthcare for Aboriginal and Torres Strait Islander people,” he said.

“On the workforce, education and training front there is very good news. In 2018, there were 74 Aboriginal and Torres Strait Islander GPs registered and employed – an increase from 50 in 2015.

“In 2020, there are 404 Aboriginal and Torres Strait Islander medical students – this has increased from 265 in 2014. This year 121 Aboriginal and Torres Strait Islander students started studying medicine, which is a 55% increase over the past three years.

“Nearly 11,000 members have joined the RACGP’s National Faculty of Aboriginal and Torres Strait Islander Health, which to me shows real interest and engagement.

“The report also notes that almost one in five Australian General Practice Training registrars report they were currently training or had already completed a training post in an Aboriginal Medical Service or Aboriginal Community Controlled Health Service.

“If we keep all that up, the sky is the limit. The report states that more Indigenous medical graduates choose general practice compared to other specialities too. That is very welcome news because GPs are the ones who need to understand a person’s life story in order to provide comprehensive, holistic primary health care.

“GPs working in Aboriginal Medical Services more commonly report seeing patients about the effects of non-medical issues on health than GPs working in all types of practices.”

Professor O’Mara said, however, that more needed to be done to improve Indigenous health outcomes.

“Four in 10 Indigenous Australians have at least one chronic condition which poses a significant health problem,” Professor O’Mara said.

“When you consider that high rates of chronic health issues are a risk factor for COVID-19 mortality it is even more concerning. Indigenous Australians are also 16 times more likely to be living in an overcrowded house than non-Indigenous Australians, so physical distancing is basically impossible.

“We need to dramatically improve the health and wellbeing of Aboriginal and Torres Strait Islander peoples and be proactive, rather than just reactively fixing health problems when they emerge.

“A few months ago, an impressive doctor in Sydney, Dr Josie Guyer, won the RACGP New South Wales GP in Training of the Year award. A proud Wiradjuri woman, Dr Guyer said that a key focus of hers was preventative healthcare.

“She is absolutely spot on in saying that when working within Aboriginal and Torres Strait Islander communities it is about empowering people and supporting them with the education and tools to improve their health.”

Professor O’Mara said that mental health must be a key focus in the care of Aboriginal and Torres Strait Islander patients.

“The summer’s bushfires and the COVID-19 pandemic have placed the spotlight squarely on the mental health of patients across Australia,” he said.

“Many people are doing it tough and I fear we are going to see a stark increase in people presenting with mental health issues in the months and years ahead.

“That is potentially very troubling for Aboriginal and Torres Strait Islander patients. Even prior to the pandemic, suicide rates among Aboriginal and Torres Strait Islander peoples were double those of other Australians.

“General practices and Aboriginal Community Controlled Health Services must be adequately resourced to continue to provide timely, accessible and culturally appropriate mental health care for these patients.

“Something that would make a real difference is having new Medicare subsidies allowing much longer consultations for patients with mental health concerns. That way a GP like me could spend more time with a patient and really get the bottom of what is going on and the best ways to help.

“We are not out of the woods yet but the decisive 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 and should be applauded.

“That includes remote community closures and designated biosecurity areas across Australia. The report also details how Aboriginal-led health services ensured that public health messages were shared with communities in their local languages and in a culturally appropriate way.”

Peter O’Mara, who recently became a Professor in the school of Medicine and Public Health at Newcastle University, is Director of the Thurru Indigenous Health Unit and a practicing GP in an Aboriginal community controlled health service.

He is a key leader in the Raise the Age campaign, which has been established to lobby all state, territory and Commonwealth governments to raise the minimum age of criminal responsibility in Australia to 14. This issue disproportionately affects Aboriginal and Torres Islander children, who made up more than 60% of the 600 children aged 10 to 13 in detention from 2018-19.

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