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‘You’ve got to look back before you can move forward’
Truth-telling and sovereignty are vital to overcoming Indigenous health inequalities, according to a new RACGP submission.
The college has applied principles that come from a place of ‘humility, acknowledgement and commitment’ to its submission.
The RACGP has welcomed the opportunity to contribute to the Yoorrook Justice Commission – the
first formal truth-telling process into historic and ongoing injustice experienced by Aboriginal people in Victoria since colonisation.
In the joint submission between RACGP Aboriginal and Torres Strait Islander Health and RACGP Victoria, the college identifies the importance of acknowledging the root causes of health inequities for Aboriginal people, recognising the health benefits of ‘truth-telling, sovereignty and self-determination’.
RACGP Aboriginal and Torres Strait Islander Health Chair Dr Karen Nicholls told newsGP that truth-telling is important because people and communities can heal from trauma.
‘The first step is acknowledging the trauma and that those events leading to it occurred. You have got to look back before you can move forward,’ she said.
‘This is not about reliving, it’s about acknowledging that events occurred … [as] a foundation to be able to move forward.
‘Truth-telling is not about blame. It is about hearing a person’s story of their lived experience.’
The Commission called for input from organisations with lived experience and expertise in healthcare, and the college’s submission highlights the importance of primary healthcare and its link to many themes in the Commission’s enquiries, including justice.
‘As a founding member of the Close the Gap campaign and a public supporter of the Uluru Statement from the Heart since 2018, we recognise that truth-telling and sovereignty are crucial in overcoming health inequalities,’ the college states.
The submission’s themes include:
- past and present injustices within the health and healthcare sector
- challenges and barriers to accessing healthcare
- health equity – investment in early intervention and preventive healthcare
- support for increased investment in Aboriginal community controlled health organisations (ACCHOs)
- increasing the number of Aboriginal healthcare professionals
- healthcare in custodial settings
- cultural safety for Aboriginal people in mainstream health services
- racism in healthcare settings
- climate change and health.
The
RACGP’s commitment to improving health inequities for Aboriginal and Torres Strait Islander people in Victoria, and nationally, is reaffirmed in the submission, according to Dr Nicholls.
‘It [also] acknowledges that colonisation has an ongoing impact on the health and wellbeing of Aboriginal and Torres Strait Islander people,’ she said.
‘As GPs who have an understanding of the complexity of the experiences of our patients, we are really well placed to see what these look like in our everyday interactions with patients and communities.’
Comprehensive, patient-centred, trauma informed, culturally safe, accessible and equitable healthcare, supported by a multidisciplinary healthcare team are ‘core to effective, high-quality primary healthcare’, the RACGP states.
A key enabler for this is a stronger Aboriginal and Torres Strait Islander health workforce, and recent
trends show these numbers are growing.
The RACGP is calling for a strategic focus on attracting, training and retaining Aboriginal and Torres Strait Islander doctors, as well as advocating for greater investment in the growth and sustainability of the Indigenous health workforce across a range of professions.
Part of this is through supporting Aboriginal and Torres Strait Islander GPs in training through its
Joint Colleges Training Services (JCTS) and
Yagila Wadamba Program, as well as continuing to
celebrate their
achievements.
The RACGP also called for a stronger primary healthcare system and accepted the right of Aboriginal patients to access culturally safe healthcare that meets their needs, wherever they might seek care.
‘It’s really important for us to ensure that we are really clear that cultural safety in healthcare is one issue that we can strongly advocate for and change, through increasing investment in services that have demonstrated cultural safety and positive outcomes for Aboriginal people, such as ACCHOs,’ Dr Nicholls, who is also the JCTS Board Director, said.
‘Increasing the number of Aboriginal and Torres Strait Islander healthcare professionals in the healthcare sector and supporting and growing general practice registrars [would also help].
‘Our zero-tolerance position on racism in healthcare is extremely important for the college to have.
‘We are committed to fostering anti-racist practice and supporting patients who experience racism.’
The soon-to-be-released next edition of the NACCHO–RACGP
National guide to preventive healthcare for Aboriginal and Torres Strait Islander people will include a new topic on the health impacts of racism.
Dr Nicholls said the submission to the Yoorrook Justice Commission, which was offered ‘with humility and a commitment to listen and learn from the truth-telling process’, signifies further progress.
‘We are looking well forward. We acknowledge that this is a long road but if we can set the groundwork right now, we can have a positive impact,’ she said.
‘We can get it right for the next seven generations, it’s what we do now that will have that flow on effect.’
The RACGP will share further details on the significance of this submission and the final outcomes of the Yoorrook Justice Commission once available.
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Aboriginal and Torres Strait Islander health truth-telling Victoria Yoorrook Justice Commission
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