Aboriginal Health: NSB202 Assignment on Topic 1 Analysis

This assignment delves into the critical health disparities between Indigenous and non-Indigenous populations in Australia, examining governmental initiatives such as 'Close the Gap' and 'Closing the Gap.' It explores the concept of culturally competent care, emphasizing its importance in addressing the unique healthcare needs of Indigenous communities. The report analyzes the perspectives of healthcare professionals, including nurses and patient escorts, and discusses the challenges they face in providing equitable care. The role of Aboriginal Hospital Liaison Officers (AHLOs) in bridging the gap between medical teams and Indigenous families is also highlighted, emphasizing their contribution to culturally appropriate healthcare delivery. The assignment references relevant literature and case studies to support its arguments, offering a comprehensive overview of the complex issues surrounding Indigenous health and healthcare in Australia.

Running head: ASSIGNMENT ON TOPIC 1
ASSIGNMENT ON TOPIC 1
Name of the student:
Name of the university:
Author note:

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Introduction:
The health gap existing between the indigenous people and the non-indigenous people
is indeed a concerning topic of concern and government is trying its best to mitigate the gap.
Different campaigns had been initiated like the Close the Gap and Closing the Gap that had
yet not able to overcome the gap (Scott, 2015). Culturally competent care is extremely
important to make indigenous communities seek for support and receive the care that they
expect and require for better health (Cashman et al. 2016). This assignment would discuss
different aspects of the case study of Matt who had received culturally competent care.
However, some nurses still think that they have achieved more preference because of their
cultural orientation. All such factors would be analysed in the assignment.
Discussion:
Close the Gap and Closing the Gap are two similarly named programs but have
different approaches. Close the Gap is actually a public awareness campaign mainly focusing
on closing the health gap present between the indigenous people and the non-indigenous
people of the nation. This campaign is mainly run by numerous NGOs as well as different
human rights organisations, indigenous health bodies and including the Australian Human
Rights Commission (AHRC). This campaign had mainly been launched in the year 2007 after
Dr Tom Calma (Aboriginal and Torres Strait Islander social justice commissioner) released
the social justice report (Brown et al., 2015). This campaign had been found to gain support
from that of the state as well as the federal governments when COAG Council of Australian
Governments had set two important health aims and six important targets in the year 2008.
This program mainly aimed in achievement of health equality within a generation and also
focusing on having the hap in rate is mortality for children under that of five years. Following
this, the then prime minister namely Kevin Rudd along with the opposition leader namely,

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Brendan Nelson finally signed the Close the Gap statement of intent. With the intent of
establishing partnership with the aboriginal communities and leaders and apologising for
conditions faced by indigenous people, “Closing the Gap” was established in response to
“Close the Gap”. The name was mainly given to Coags’ 2008 national strategy for tackling
the indigenous inequality and was based on Indigenous Reform Agreement. The government
mainly did this with the commitment foe closing the gap between the native and the non-
native people in the nation with specific timeframes (Gannon et al., 2018). They had made up
up of a series of policies as well as programs and had established seven national targets
across various areas like health, education as well as employment. Some of the targets set in
closing the Gap policy were - closing the life expectancy gap and halving the mortality rate
for children under five. Others were ensuring access to early education for children of four
years, halving the gap in reading, wring as well as numeracy achievements in children,
halving the gap in Indigenous Year 12 achievement by 2020, halving the gap in employment
outcomes and others (Johnson et al., 2019).
The nurse who witnessed the benefits provided to the family of the patient for
accessing the treatment and conveyance stated that the aboriginals are getting additional
benefits and she thinks this to be unfair. This belief can be found to be quite similar to that of
the funding myth that had been established the the review report published about the actions
achieved by Closing the Gap. Non-native people are of the opinion that the native are
provided higher benefits in healthcare services than that of the non-natives (Georges et al.,
2017). This is evident from the spending structure of the Australian Government, which
shows expenditure of on average $2 per capita on Indigenous people for every $1 spent on
the rest of the population as well as that of the Commonwealth spends $1.20 for every
$1 spent on the rest of the population. However, it should be remembered by the critics that
burden of the disorders among the native people is also about 2.3 times higher than the rate of

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the rest of the population. Still, a surprising fact is, yet the total governmental expenditure
spent on the native communities has been found to be only meeting the 60% of the needs
based requirements. Altman et al. (2018) is of the opinion that this is indeed a massive market
failure where the health system is able to serve the needs of the bulks of the population but
still the health system has failed in meeting the needs of the indigenous people. It has been
found that the mortality of the indigenous population has been flat-lined since the time of
2008 and the result shows that the life expectancy gap in widening rather than closing. It has
been found that use of the Medical Benefits Scheme (MBS) and Pharmaceutical Benefits
Scheme (PBS) done by the commonwealth are at half and at third for the need-based
requirements of the people respectively with the number of preventable admissions for
native people are three times higher than the rest of the population. However, ot cannot be
stated that Commonwealth are deliberately funding less for the native communities.
Researchers are of the opinion from their observation over decades that demand designed
services developed for meeting the needs of the build of the population would not help in
meeting the needs of the minority of people with special needs (Parter et al., 2018). Almeida
et al. (2017) is of the opinion that Commonwealth are funding Aboriginal Community
Controlled Health Services (ACCHS) for over 40 years and this shows evidences of better
meeting those needs but still the coverage of the services had been patchy and the needs need
to be expanded. The preventable admissions and non-violent death rates can eb reduced by
the systematic application of knowledge and other evidence based funding procedures
successfully.
Patient escorts are also termed as the nursing assistants and are referred to as the
nursing aides. These individuals are seen to provide basic care for the patients in the hospitals
as well as the residents for the different long-term care facilities as in the nursing homes.
Orderlies help in transporting patients and even cleaning treatment areas. Patient escorts are

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seen to provide basic care to the patients and they help in different activities of the daily
living of the patients. They are seen to perform the roles like assisting patients with moving
about the facilities like that of pushing wheelchairs, cleaning equipments and facilities,
changing linens and working with stock supplies (Comer et al., 2017). They serve meals of
the patients, listen to, record the health concerns of the patients, and even report the
information to the nurses. They help the patients in using toilets as well as in dressing. They
also turn, reposition and transfer of the patients between the beds and the wheelchairs. They
also perform the service of transport staffs where they possess the skill for supporting patients
having a medical transition in transporting from one ward to another ward or helping them in
their journey to and from the hospital. The patient in the case study namely Matt has to be
transported to the discharge lunge first and if needed she has to arrange for services to
travelling the patient from Brisbane to Townsville. In such situation, the professional can face
a number of challenges like language barriers where she might not be able to communicate
effectively with Matt and his family who are from the indigenous background. Georges et al.,
(2017) is of the opinion that many of the words and dialects used by both natives and non-
natives are similar but can be used with different meanings and intentions. Hence, such
barriers might result in misunderstanding among the clients and the patients. Another
challenge that might be also faced by the patient escort is the cultural differences, which she
might be not aware of. Every healthcare professionals need to be well aware of the cultural
traditions, preferences, inhibitions, communication styles and others to provide culturally
competent support. This helps people to feel satisfied and respected. A patient escort might
not be well aware of the aspects and this might create challenges for patients and even in case
of Matt.
Aboriginal hospital Liasion officers are of the most responsible healthcare
professionals who act as the bridge between the medical teams and that of the patient and

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their families during the time of admission. They support the aboriginal patients, families and
well as community members and the staffs. They help in improvement of the healthcare
services as well as maintaining positive relationships within the aboriginal communities,
other service providers as well as governmental departments. They also help in the assistance
during the time of discharge for ensuring the patient and the families that are well supported
as well as understanding their future medical care. These individuals are also seen to provide
education to the healthcare professionals for increasing understanding as well as respecting
the native people and help to ensure that a culturally appropriate experience while they are in
the hospitals (Katzenellenbogen et al., 2015). During the time of their treatment in the
healthcare organisation in Brisbane, the Aboriginal Hospital Liaison Officers
(AHLOs) would be taking upon him the responsibility of making sure that Matt and his
family members get the best culturally competent care services from the healthcare
organisations. He would be educating the healthcare professionals treating Matt to understand
the cultural preferences, inhibitions as well as traditions of the indigenous people so that they
can provide care to Matt and his family as per their expectations. he would be acting as the
link between the medical healthcare teams and that of the patient and families during the time
of admission and helps in easy flow of information so that both the sides remain informed
about the actions taken, the expectation of family and Matt, different treatment and diagnostic
procedures and others. The better the flow of communication and information and better the
culturally competent services, the treatment will undertake in an unhindered manner helping
Matt and his family to feel cared and respected (McKenna et al., 2015). The professional
would also assist in the discharge process and help Matt and his family to develop a detailed
understanding about the future medical care.

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Conclusion:
From the entire discussion, it has been found that Close the Gap and Closing the Gap
are two campaigns led by non-governmental organisations and governmental organisations
respectively with aim of closing the health gap between native and non-native. However, still
there had been market failure in providing care services to native people because of the
“funding myth”. The patient escort should be culturally competent to carry on their care and
the Aboriginal Hospital Liaison Officers (AHLOs) forms a link between medical teams in
healthcare hospitals and aboriginal families nursing them that they get culturally competency
care services.

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References:
Almeida, G., Gusmão, M., Santos, C., Carvalho, T., & Amaral, T. (2017). Medical escort of
critical care patients in the pre-hospital setting.
http://repositorio.chlc.min-saude.pt/handle/10400.17/2693
Altman, J., Biddle, N., & Hunter, B. (2018). How realistic are the prospects for'closing the
gaps' in socioeconomic outcomes for Indigenous Australians?. Canberra, ACT:
Centre for Aboriginal Economic Policy Research (CAEPR), The Australian National
University. https://openresearch-repository.anu.edu.au/handle/1885/147387
Brown, A., O'Shea, R. L., Mott, K., McBride, K. F., Lawson, T., & Jennings, G. L. (2015). A
strategy for translating evidence into policy and practice to close the gap-developing
essential service standards for Aboriginal and Torres Strait Islander cardiovascular
care. Heart, Lung and Circulation, 24(2), 119-125.
https://doi.org/10.1016/j.hlc.2014.09.020
Cashman, P. M., Allan, N. A., Clark, K. K., Butler, M. T., Massey, P. D., & Durrheim, D. N.
(2016). Closing the gap in Australian Aboriginal infant immunisation rates--the
development and review of a pre-call strategy. BMC public health, 16(1), 514.
https://doi.org/10.1186/s12889-016-3086-x
Comer, D., Goldsack, J., Flaherty, J., Van Velzen, K., Caplan, R., Britt, K., ... & Corbo, T.
(2017). Impact of a discharge prescription program on hospital readmissions and
patient satisfaction. Journal of the American Pharmacists Association, 57(4), 498-
502. https://doi.org/10.1016/j.japh.2017.04.007
Gannon, M. (2018). Indigenous health: Closing the gap-10 year review. Australian
Medicine, 30(3), 25.

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https://search.informit.com.au/documentSummary;dn=480574352726957;res=IELAP
A;type=pdf
Georges, N., Guthridge, S. L., Li, S. Q., Condon, J. R., Barnes, T., & Zhao, Y. (2017).
Progress in closing the gap in life expectancy at birth for Aboriginal people in the
Northern Territory, 1967–2012. Medical Journal of Australia, 207(1), 25-30.
https://doi.org/10.5694/mja16.01138
Johnson, C. (2019). Not on track to close the gap. Australian Medicine, 31(4), 5.
https://search.informit.com.au/documentSummary;dn=288742227433654;res=IELAP
A;type=pdf
Katzenellenbogen, J. M., Miller, L. J., Somerford, P., McEvoy, S., & Bessarab, D. (2015).
Strategic information for hospital service planning: a linked data study to inform an
urban Aboriginal Health Liaison Officer program in Western Australia. Australian
Health Review, 39(4), 429-436. http://www.publish.csiro.au/AH/ah14102
McKenna, B., Fernbacher, S., Furness, T., & Hannon, M. (2015). “Cultural brokerage” and
beyond: piloting the role of an urban Aboriginal Mental Health Liaison Officer. BMC
Public Health, 15(1), 881. http://www.publish.csiro.au/AH/ah14102
Parter, C., Wilson, S., & Hartz, D. L. (2018). The Closing the Gap (CTG) Refresh: Should
Aboriginal and Torres Strait Islander culture be incorporated in the CTG framework?
How?. Australian and New Zealand journal of public health.
https://doi.org/10.1111/1753-6405.12850
Scott, G. (2015). Close the gap: Don't just do something! The Indigenous affairs budget. AQ-
Australian Quarterly, 86(1), 20.

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https://search.informit.com.au/documentSummary;dn=776086015825358;res=IELHS
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