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Culturally respectful health services

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Whole of organisation approach

Tasmanian Government health leaders, have committed to making our health system culturally respectful for Aboriginal people. This means ensuring all Aboriginal people are treated respectfully at all points of interaction with Tasmania’s health system.

Policies and frameworks

Racism and health

Racism is not rare or harmless in the Tasmanian health system.  In 2018 we asked Tasmanian Aboriginal people about their experience when visiting a government or mainstream health service. Over one in four (29 per cent) survey participants had experienced racism or discrimination in the preceding three years.

"You are not going to Close the Gap around Aboriginal health until we genuinely talk about racism."

Parter C, Murray D, Mohamed J, Rambaldini B, Calma T, Wilson S, Hartz D, Gwynn J, Skinner J. Talking about the ‘r’ word: a right to a health system that is free of racism. Public Health Res Pract. 2021;31(1):e3112102).

There are three types of racism:

  • Personal racism: a person’s beliefs, attitudes and actions because of biases, stereotypes or prejudices.
  • Interpersonal racism: which is between individuals, e.g. denial of existence, racial jokes.
  • Institutional racism: reflected in the systems and policies of institutions, organisations or governments. This may be deliberate, or accidental.

Together we can improve our cultural competence and reflective practice. It is important to critically reflect to understand racism.

Useful resources

Asking the question "Are you of Aboriginal or Torres Strait Islander origin?"

In 2018, Tasmanian Aboriginal people were asked about their experiences in accessing Tasmanian health services.

  • Many participants said they had never been asked if they were Aboriginal when accessing services;
  • Few participants were asked if they were Aboriginal and felt they were asked in a respectful way.
  • Like many health workers, many Aboriginal participants did not understand the rationale for being asked the standard Aboriginal Identifier Question.

A top priority identified by Tasmanian Aboriginal people was improved recording of Aboriginal identity. This requires staff training and improved processes in asking and recording Aboriginal identity.

Why valid data is important

Aboriginal and Torres Strait Islander people are under-identified in many health-related data collections. Self reporting Aboriginal identity is the only way to accurately record data and identify a clients status.

‘Our trauma is compounded by having to convince people we still exist.’ 

Quote from the Community Consultation Report 2018

It is important to ask all patients and clients if they are of Aboriginal or Torres Strait Islander origin. Recording Aboriginal status when collecting information is important because it:

  • enables referrals to the Aboriginal Health Liaison Officer at the major hospitals
  • helps us provide culturally respectful care, bearing in mind Aboriginal risk factors
  • supports patient-centred care, discharge planning and referral to Aboriginal Community-Controlled organisations.
  • helps measure progress in improving health outcomes and supports service planning.
  • it is required under national accreditation standards.

How to improve recording Aboriginal origin when collecting information

Asking the Question Resources

All healthcare services need to ask the question “Are you (or is the person) of Aboriginal and/or Torres Strait Islander origin?”. This video supports all staff to have the confidence they need to ask all those accessing their service.

Closing the gap

This site is the home of the National Agreement on Closing the Gap, and has a suite of data and resources.

Go to the Closing the Gap website

Everyone has a role to play in Closing the Gap . This video explains the importance of Closing the Gap for the health and wellbeing of Australia's First Nations people.

Data

Overview of Aboriginal and Torres Strait Islander health status 2020

The most recent indicators of the health of Aboriginal and Torres Strait Islander people are documented in the Australian Indigenous Health InfoNet’s authoritative publication.

Tasmanian Department of Health

State-wide data

National data

Consumer participation and engagement

Aboriginal people are more likely to access health services and have better health outcomes when service providers are culturally respectful.

To provide culturally respectful care it is important to:

  • build good relationships
  • communicate respectfully
  • have an awareness of underlying social issues and intergenerational trauma
  • have some understanding of history and culture ( you don’t need to be experts); AND
  • include Aboriginal people in the healthcare team.

Effective partnerships between Aboriginal and Torres Strait Islander people, governments, primary health care networks, and service providers underpin the development and delivery of culturally respectful services. See the The Cultural Respect Framework for Aboriginal and Torres Strait Islander Health 2016-2026 for more information.

Partnerships with Aboriginal Community Controlled Organisations

Building partnerships between Aboriginal community-controlled organisations (ACCO's) and mainstream health services is important. To improve these partnerships, Tasmanian Aboriginal people suggested:

  • a “how to” guide for building relationships with ACCO’s
  • clearer processes for referral pathways
  • rotate mainstream health service staff through Aboriginal community-controlled health services
  • better understanding of the roles of Aboriginal Health Liaison Officers, Aboriginal Health Workers and Aboriginal Support Workers.

See our Key contacts page to know which ACCO’s are available in your area.

ACCO's improve the health and wellbeing of Aboriginal people. They lead the way in providing culturally respectful primary health care. ACCOs are critical in Australia’s health system for better patient journeys.

Developing effective partnerships between ACCOs and mainstream health organisations is critical. This relationship is important to make healthcare:

  • accessible
  • responsive
  • culturally safe.

Key strategies to improve relationships:

  • know which ACCO’s are available within the community.
  • connect with key contacts from the ACCO’s, including healthcare providers, elders and health leaders.
  • learn about the roles of the Tasmanian Aboriginal Health Forum and the Tasmanian Aboriginal Health Reference Group.
  • understand the way the department consults with ACCO’s.
  • ask the Aboriginal Health Policy Officer and/or the Aboriginal Health Liaison Officers how to respectfully build working relationships with key contacts in local Aboriginal organisations.
  • ask an experienced work colleague, existing networks, other business units or community organisations how they engage with ACCOs.
  • develop clear referral pathways.
  • rotate mainstream health service staff through ACCOs.
  • build relationships with Aboriginal Health Liaison Officers, Aboriginal Health Workers and Aboriginal Support Workers.

Useful links:

Community consultation

‘Listen to our people. Just Listen.’ 

Rosie Smith, Tasmanian Aboriginal Elder.

In 2018, we asked Tasmanian Aboriginal people about their experience in Tasmanian health care services. Many participants emphasised they had positive experiences.

Their top concerns were:

  • acceptance of the ongoing presence of Aboriginal people in Tasmania
  • data collection
  • visibility of Aboriginal culture
  • racism
  • complaints management
  • lack of partnerships between health services and Aboriginal organisations.

Their top priorities for improving cultural respect in Tasmanian healthcare services were:

  • cultural awareness training for all staff
  • improved recording of Aboriginal identity
  • more welcoming environments and cultural visibility
  • better access to Aboriginal Health Liaison Officers
  • more Aboriginal health workers in mainstream services
  • better complaints management
  • improved partnerships between mainstream health services and Aboriginal organisations
  • better understanding of the role of Aboriginal Support Workers and Aboriginal Health Workers

Deadly Questions

Learn from Aboriginal Victorians about the oldest continuous cultures on earth. Here you can explore Aboriginal cultures, histories, ideas and opinions.

Go to the Deadly Questions – Victoria site

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