Improvements in Aboriginal and Torres Strait Islander Healthcare in Australia

This article discusses the improvements in healthcare for Aboriginal and Torres Strait Islander populations in Australia, including government investments and community-controlled health services. It also covers the impact of migration on immigrant health, traditional Vietnamese medicine, and the Australian healthcare system.

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Scenario 1
1. There has been a progressive change in the healthcare system of Australia with evidences
that reflect that there have been government investments especially in the field of primary
care. This has made changes in the life expectancy in the Aboriginal people along with
the Torres Strait Islander populations. Improvements have been brought about in the
ambulatory care that is sensitive to the process of hospitalization. There have been
successful campaigning by the Aboriginal community-controlled health sector and other
such organizations demanding the responsibility to fund the Aboriginal primary health
care. This was transferred from the Aboriginal and Torres Strait Islander Commission to the
Commonwealth Health Department in the year of 1995, which made way for the increase
in the funds contributed towards Aboriginal and Torres Strait Islander primary health care
(Gubhaju et al., 2013). This also took steps to include new programs like the Primary
Health Care Access Program. The data received showed that the funds for the Aboriginal
community that was controlled by the health services increased from $233 per Indigenous
person in 1998-99 to $426 per person in 2004-05 (Jongen et al., 2014).
2. Most of the Indigenous Australians tend to experience poorer health conditions as
compared to the Australians who are non-indigenous (Duckett & Willcox, 2015). Apart
from obesity, some of the common health issues they face include heart diseases along
with respiratory problems, kidney diseases and more importantly mental health issues.
This population of people belonging to the aboriginal Australians and Torres Strait
Islanders are considered being socially, economically, culturally and politically
challenged or disadvantaged (Thomas, Bainbridge & Tsey, 2014). Therefore factors like

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the cultural barriers and social determinants should be addressed in order to provide
health equity to them. Some of the social determinants that impacts their health involves
the socio-economic status, chronic stress and historical treatment especially in terms of
racism.
3. The Commonwealth government along with the Queensland Government and other
Australian States and Territories, in the year of 2003 projected a policy framework that
was a National Strategic Framework for Aboriginal and Torres Strait Islander Health
(Thomas, Bainbridge & Tsey, 2014). This policy was committed to provision of
community control in terms of primary health care services. In the year 2010, the
Queensland Government took steps to make tracks towards “closing the gap in health
outcomes for Indigenous Queenslanders by 2033” through the Policy and Accountability
Framework (Gubhaju et al., 2013).
4. In the aboriginal communities with populations which are greater than 5000, the health
service model includes discrete services from local services and diagnostic services. For
small or defined population, the model involves integrated services and comprehensive
primary care services (Sherwood, 2013). Finally for small rural or remote areas, it
includes outreach or telemedicine services.
Scenario 2
1. The health of the immigrants like Vinh is majorly impacted due to the adoption of the
different eating habits or physical activities including smoking and alcohol consumption,
especially in the long run (Tsai & Lee, 2016). The stress of migration along with the
stress of adjustment to a new culture and problems of discrimination play a role in the
impact of the deteriorating health of the immigrants. Several studies have identified these

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as barriers to the effective use of the health services. Chronic diseases are the major
causes of the mortality and morbidity of the immigrant population apart from the mental
health problems arising due to the cultural barriers (Kennedy et al., 2015).
2. A private health insurance plan is provided to the migrants who hold a 457 asylum visa.
Vinh has been living in Australia for the past two years therefore he will be entitled to
this healthcare plan. He is also entitled to the public healthcare service that is provided
under the Reciprocal Health Care Agreements framework (Minas et al., 2013). Under this
policy, immigrants from various countries receive opportunities of essential medical
treatment and some subsidized medicines and health services in Australia. Another such
policy that is being used by the Australian government is the Significant Cost Threshold
(Claxton et al., 2015). Utilization of this has increased significantly in the recent years.
The immigrants learn about this healthcare policies through the humanitarian programs.
Inquiries can be carried out through the Human Rights and Equal Opportunity
Commission (HREOC) (Green, 2016).
3. Several studies have suggested that in the 17th century, many Vietnamese and Chinese
healthcare practitioners had started identifying their colonial medicine as the Dong Y
(Nguyen et al., 2016). Their aim was to distinguish their traditional medicine with that of
the western medicines. Vinh belonging to the Vietnamese origin can therefore use the
traditional Vietnamese Medicine (TVM) for his general healthcare and wellbeing. This
TVM is different from that of the western medicines in terms that it puts emphasis on the
nourishment of the vital energy and blood (Loue, 2013). Unlike western medicine is does
not focus only on the specific symptoms. Another traditional method can be use of

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acupuncture. This implements the use of needles to the specific points on the body that
are believed to channel the energy to the mind and the body.
4. The nursing profession perspectives that are important in influencing the people’s
perspective of the nursing profession includes aspects such as the cultural competence.
Implementation of cultural competence in nursing profession has succeeded in gaining
importance in providing improved quality of care. This has also led to the reduction in the
disparities which mainly arise due to the racial and the ethnic causes (Mayo et al., 2015).
Scenario 3
1. A model of “Genuine Caring in Caring for the Genuine” has been proposed for provision
of care to the patients having high risk pregnancy. There are three aspects of this model
which includes a relationship of dignity and protectiveness, embodied knowledge along
with the prevalence of a balance between the perspective of nature and medicine. The
aspects includes the factors like mutuality, trust, shared responsibility and endurance of
presence in case of the dignity-protection relationship (Hod et al., 2016). In terms of
embodied knowledge, the factors include genuineness towards oneself, along with
presence of theoretical, practical, intuitive and lastly reflective knowledge (Tsai & Lee,
2016). Lastly the factors of balance between the perspective of nature and medicine
involves supporting of normalcy and sensitivity exhibition in case of the genuine.
2. Pregnant patients suffering from type 2 diabetes have seen to experience much elevated
rates of problems like preeclampsia, cesarean delivery and shoulder dystocia in the baby
(Gubhaju et al., 2013). Additional conditions involves preterm delivery, large-for-

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gestational-age infant and fetal anomaly. Some studies view the impact of the diabetic
pregnancy as a vicious cycle (Hod et al., 2016). The consequences of this for the
offspring extends beyond the stage of neonatal. It also suggests that young woman whose
mother also had suffered diabetes during pregnancy are at elevated risks of perpetuating
the cycle. This increases the chances of diabetes development in years of childbearing.
3. There are several differences between the public and the private healthcare system in
terms of provision of maternal health. The differences can be in terms of care providers,
choosing of the appropriate place of birth and the cost (Gubhaju et al., 2013). In case of
the care providers, the public hospitals tend to provide one-to-one options of midwifery
along with the center of birth or homebirth. On the other hand in case of private care,
there is an option of provision of a private obstetrician and midwife. In such cases the
providers also engaged in providing care in their personal clinics. In terms of choosing
the right place of birth, the public hospitals generally provides private or most of the
times shared rooms (Hod et al., 2016). The private hospitals also provides both private
and shared rooms. However in private hospitals there is an option to appoint a private
obstetrician (Buchmueller et al., 2013). The hospital takes initiative to provide the patient
with a list of obstetricians who are available in that respective facility. The cost of birth in
public hospitals can be entirely covered by Medicare however if the patient chooses
private facility then the Medicare will only cover parts of the entire cost (O'Keefe &
Kushelew, 2016).
Scenario 4

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1. In Australia, healthcare and medical treatment is covered by the system of public health
and Medicare along with a few for- profit and not-for organizations which provide
private health funds (Buchmueller et al., 2013). These private health funds tend to
compliment the Medicare by the process of paying benefits for treatment procedures that
are beyond the coverage scope of the public health systems. These might include dental
and optical treatments. Coverage is available in terms of hospital cover, extra cover like
dental and physiotherapy along with the combined covers of hospitals and the extras
(Loue, 2013). In addition to this, ambulance coverage is also received. Whereas there are
disadvantages like all conditions are not covered. Sometimes it is difficult to recognize
which PMI will be suitable (Tracy et al., 2014). Additionally premium costs are rising
above the level of inflation which poses a limitation.
2. The Australian healthcare system has several pros and cons. The advantages of the
system involves the fact that it is financially supported by the federal government. The
Medicare system involves the insurance program that consists of facilities of physicians,
hospitals and the medications that is provided in the prescriptions. Studies have reported
that the death rate is the lowest in the medical care provided by Australia. Inspite of the
several advantages, there are limitations of the system which involve the complaints of
waiting in long queues for attending any medical procedures or to receive any
appointment (Duckett & Willcox, 2015). There are additional problems of workforce
supply and distribution in Australia which effects the quality of the healthcare services.
There is still an existence of inequality in health between Australia’s most advantaged
and least advantaged population.

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3. For the provision of healthcare services in the rural areas, the government-funded groups,
several local organizations and healthcare professionals tend to work together with the
aim to provide the community with healthcare options that are easily available (Hall &
Christian, 2017). These regional hospital services consists of resources that provide a
broad range of health care which includes emergency care and mental health services
along with intensive care, paediatrics and rehabilitation (Tracy et al., 2014). The
Australian Health Ministers’ Advisory Council (AHMAC) engaged the Rural Health
Standing Committee (RHSC) to take steps for the development of a National Strategic
Framework for Rural and Remote Health. This would help to define vision and for rural
health and to define an agreed set of priorities of national rural health. This reflects the
common issues and challenges across jurisdictions (O'Keefe & Kushelew, 2016).
4. The constraint factors includes regional health care models, matching capacity and
demand, economies and diseconomies of scale and scope and the capital investment
dimension (Jongen et al., 2014). The financial factors effects the care, the findings and
also the profits. In absence of funding, resources will not be present therefore economic
efficiency should be increased (Duckett & Willcox, 2015).

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