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‘Building a culturally safe workforce will go a long way’
On National Close the Gap Day, leaders reflect on work to address the barriers to health equity for Aboriginal and Torres Strait Islander people.
Only four of 19 targets are on track to be met by 2031, a recent Closing the Gap update reveals.
‘Every day, I reflect on how lucky I am to have this opportunity.’
That is Anthony Paulson, the General Manager of the Joint Colleges Training Services (JCTS) speaking on National Close the Gap Day, 20 March 2025.
An Aboriginal man whose people are from the Worimi and Mununjali nations, Mr Paulson is passionate about the mission of the organisation he leads.
Created as a joint venture of RACGP and the Australian College of Rural and Remote Medicine in response to general practice training returning to the colleges in 2023, the JCTS provides cultural education equipping GPs to deliver culturally safe healthcare for Aboriginal and Torres Strait Islander people.
Asked to lead JCTS in 2022 after previously working in GP Training in the registered training organisation in New South Wales, and extensive work with Aboriginal community controlled health services, Mr Paulson believes in its power to contribute to closing the gap.
Once again, the National Agreement has shown slow progress this year.
A recent Productivity Commission update shows only four of 19 Closing the Gap targets are on track, and while there have been improvements in 11 areas, including health, it is falling short of the trajectory for goals set for 2031.
‘The cultural component is a big one – and that’s sometimes not at the heart of the strategy to address that gap,’ Mr Paulson told newsGP.
‘Increasing access to services and building a culturally safe workforce will go a long way to closing the gap in life expectancy strategies, as well as in early childhood, educational services, and psychological services to support reducing the suicide rate.’
While the JCTS operates nationwide, Mr Paulson is very conscious of the need to adapt general practice training according to regional variations.
‘Obviously, the localised content is really important, understanding the local culture, people and local community that the registrars are working in,’ he said.
JCTS says it is committed to closing the gap by training a culturally safe GP workforce, that, in partnership with the Aboriginal and Community Controlled Health Service sector, supports GP registrars in delivering high-quality, culturally responsive care to Aboriginal and Torres Strait Islander communities.
A little more than two and a half years on from the formation of JCTS, Mr Paulson acknowledges the scale of the task ahead for the gap to close.
‘We’re a newly formed organisation, and there’s a lot of opportunities for us to make a difference,’ he said.
The RACGP is ultimately aiming for 100% participation in cultural and health education among GPs in training, as well as encouraging more practising GPs to undertake training.
It also aims to increase the Aboriginal and Torres Strait Islander workforce – goals expressed in the new Aboriginal and Torres Strait Islander Cultural and Health Training Framework which launched at GP24 last November.
Dr Olivia O’Donoghue, the RACGP National Clinical Head of Aboriginal and Torres Strait Islander Training, was a driving force behind the first-of-its-kind framework.
A descendant of the Yankunytjatjara people and the Narungga Nations people, she said that while there have been closing the gap healthcare improvements, there remain ‘significant inequities … and persisting barriers’ to culturally safe care.
Dr O’Donoghue hopes the framework will help drive transformational change.
‘Through incorporating the 12 guiding principles outlined in this framework, the RACGP will actively embed Aboriginal and Torres Strait Islander values and ways of knowing, being and doing within the education and training program, as well as the systems and policies that support it,’ she told newsGP.
‘Fundamentally we need a healthcare system that allows self-determination, true co-designed programs, listens to Aboriginal and Torres Strait Islander health experts and communities, is trauma-informed and utilises strengths-based approaches.’
Dr O’Donoghue also emphasises the work with partner organisations such as JCTS, the National Aboriginal Community Controlled Health Organisation (NACCHO), Australian Indigenous Doctors’ Association, and the Indigenous General Practice Trainee Network.
She says the framework’s principles align with the 2025 theme of ‘Agency, leadership, and reform’ adopted by the Close the Gap Campaign Alliance Group, an independent, Aboriginal and Torres Strait Islander-led organisation of which the RACGP is a founding member and on the steering committee.
Formed in 2007 to push governments to bring about health equality within a generation, it helped influence the formation of the National Agreement in 2020.
However, its latest report launched on Close the Gap Day notes that ‘very little meaningful reform has been implemented’.
‘For almost two decades some iteration for the Closing the Gap strategy has been in place and yet comprehensive departmental and agency reform is seriously lacking,’ it states.
It called for a renewed focus on the four areas of priority reform:
- Shared decision-making
- Strengthening and building the community-controlled sector
- Transforming government organisations
- Shared access to data
RACGP President Dr Michael Wright also describes the lack of progress on Closing the Gap targets as ‘deeply disappointing’.
‘It shows how much work there is still to do,’ he told
newsGP.
‘The college and GPs have an important role to play, and I am proud that the RACGP was a founding member of the Close the Gap Campaign.
‘The college will keep jointly advocating for the health of Aboriginal and Torres Strait Islander people in collaboration with partners such as the campaign and NACCHO, among others, for many years to come.
‘Our work will continue to be based on the principles of respect, equity, shared decision making and self-determination for Aboriginal and Torres Strait Islander people and organisations.’
The RACGP is now calling on governments to fully implement each of the four priority reform areas.
For Mr Paulson, that journey towards a culturally safe workforce is essential, however can sometimes be hard to measure immediately, but he sees the difference JCTS makes.
‘GP registrars really see the value in understanding more around Aboriginal and Torres Strait Islander health and their role in closing the gap and supporting communities.’
An RACGP National Close the Gap Day Members’ Webinar will be held on 20 March from 7.00 pm (AEDT).
Register online.
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