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Indigenous representatives to guide vital health regulation process

Giovanni Torre -

First Nations representatives will be central to regulatory decisions about medical practitioners, nurses and midwives where Aboriginal and/or Torres Strait Islander Peoples are involved under a new process being rolled out.

Details about a new culturally safe process being implemented to consider such matters are being released as part of the Australian Health Practitioner Regulation Agency (Ahpra) and the National Board's commitment to eliminating racism from healthcare.

A minimum of two Aboriginal and Torres Strait Islander representatives, plus practitioners from each of the relevant profession and community members, will together make decisions about matters concerning culturally safe health care and racism in line with the legislation governing health practitioners in Australia.

The Indigenous experts will make decisions with other Board representatives about any notification involving Aboriginal and/or Torres Strait Islander Peoples. In the most serious matters, this will include the decisions about whether to refer a practitioner to an independent Tribunal.

A proud descendent of the Darumbal and Juru clans of the Birra Gubba Nation with South Sea Islander heritage, Associate Professor Carmen Parter, is an Ahpra Board member. As co-Founder and Director at the Learning Centre for Systemic Change and Research and the inaugural Co-chair of the Indigenous Working Group of the World Federation of Public Health Association, A/Prof Parter said elevating Indigenous involvement in the consideration of matters concerning race was "real and significant action".

"Racism is the biggest public health issue that Australia faces today and no-one wants to talk about it or do anything about it," A/Prof Parter said.

"When we move forward to looking at these cases it is so critical to have Indigenous voices brought into the process because we'll bring that cultural lens on race and how it plays out.

"We bring a different lens to the process - a lens of lived experience - to uncover things that people aren't necessarily aware of because we know that racism is a difficult subject to talk about."

A/Prof Parter said has been talking about cultural safety and eliminating racism for a few years, "but this is the action, this is going to be visible".

The arrangements come after Ahpra, the National Boards and the Aboriginal and Torres Strait Islander Health Strategy Group advocated to enshrine cultural safety as a guiding principle and objective for the National Scheme, which was adopted as legislative amendments to the Health Practitioner Regulation National Law last October.

The changes could prove crucial to ensuring appropriate medical attention is provided to Indigenous people in custody, an issue brought to national attention repeatedly in recent years with the deaths in custody of Indigenous people who asked for medical attention and did not receive appropriate care.

A/Prof Parter said establishing culturally safe notification processes, led by Aboriginal and Torres Strait Islander Peoples, was vital in sending a message through the entire health system "as well as building confidence among Indigenous communities".

"Cultural safety being legislated is such a big move. But the solutions are held with those that experience racism, so that's why it's important that we have a voice at those tables and to bring that experience into addressing racism in healthcare practice,' A/Prof Parter said.

"This is where Ahpra can play a critical role in terms of how we eliminate racism in the health professions that we regulate.

"It's critical to get that communication out there because communities are going to feel much more confident that services are going to really do something. I want to end up one day where my grandkids and future generations will actually enjoy the same level of healthcare as others would expect."

Chair of the National Health Leadership Forum Ms Fiona Cornforth said cultural safety is "very much a prerequisite for health service delivery" in providing an environment free of racism that ensures better health outcomes are achieved for First Nations people.

"The vision for both the 2021-2031 National Aboriginal and Torres Strait Islander Health Plan and the 2021-2031 National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan is for a health care system to be free of racism; to achieve this we must address the discriminatory policies and practices that exist, instituting culturally safe care is intrinsic to this aim," she said.

"The NHLF welcomes and supports Ahpra's work in establishing a culturally safe notification process, and the message it sends that racism and the poor care delivery that stems from racism will not be tolerated."

Fiona Cornforth. Photo supplied.

The creation of a culturally safe notification process, led by Aboriginal and Torres Strait Islander Peoples, is considered a major milestone in the implementation of the National Scheme's Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025.

Ahpra and National Boards said they will continue to work closely with Indigenous health leaders to implement the five-year strategy, which has seen the organisation's Culturally Safe Notifications Working Group lead reform in the way notifications involving Aboriginal and Torres Strait Islander Peoples will be considered.

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