ANZCA Bulletin June 2011 - Australian and New Zealand College of ...

Indigenous Health
Committee
ANZCA’s Indigenous Health
Committee was established
at the April 16, 2011 ANZCA
Council meeting. The
committee was established
on the recommendation
of the Indigenous Health
Working Party as part of a
detailed series of proposals
to improve diverse health
issues faced by indigenous
peoples in urban, rural
and remote locations in
anaesthesia, pain medicine
and intensive care.
The poorer health of indigenous
peoples of Australia and New Zealand
relative to non-indigenous people is
well recognised (for the purpose of
this article the term indigenous is used
inclusively when referring to Australian
Aboriginal people, Torres Strait
Islanders, Māori and Pacific Islanders).
Furthermore, indigenous people are
under-represented in the healthcare
professions, especially in medicine, and
in particular the medical specialties.
Fellows of ANZCA and FPM contribute
individually to improved health for
indigenous communities but until now
the College overall has not had specific
programs that support indigenous health.
There is a 10-12 year gap in life
expectancy separating Aboriginal
and Torres Strait Islander Australians
from the wider population. That only
0.2 per cent of Australian doctors
claim indigenous heritage while
indigenous people make up 2.3 per
cent of the population highlights the
need to encourage more indigenous
doctors and medical specialists. New
Zealand provides a brighter picture,
however, Māori are still highly underrepresented
making up only 1.9 per
cent of medical specialists as opposed
to 15 per cent of the population. The
Australian Committee of Presidents of
Medical Colleges (CPMC) is focused on
encouraging more indigenous doctors to
specialise and ANZCA/FPM have been
looking at ways to support increasing
numbers of indigenous specialists.
In July 2010, an Indigenous Health
Working Party was established to
assess how ANZCA/FPM could support
programs for indigenous health in
Australia and New Zealand. Members
were Dr Rod Mitchell (Chair, SA), Dr
Penny Stewart (Alice Springs), Dr Jenny
Stedman (WA), Dr Jack Hill (NZ), and
Dr Ted Hughes (NZ). Recognising the
limitations of one organisation’s ability
to address all facets of indigenous
health, the working party focused on
ANZCA/FPM’s strengths, concentrating
on building partnerships and
contributing to existing programs where
possible. The working party met on four
occasions and submitted its proposal to
support indigenous health in Australia
and New Zealand to council in April 2011.
The diversity of health issues
facing indigenous peoples in rural/
remote and urban locations as well
as across Australia and New Zealand
make it challenging to arrive at single
initiatives that address differences
and meet ANZCA’s strategic priority
to ‘Provide support for indigenous
health’. The initiatives took into
account these differences in an attempt
to develop an equal commitment
in each area. Considered input of
indigenous organisations from each
country assisted in the development
of this proposal. The working group
sought input from interested Fellows,
and where possible supported CPMC
Indigenous Health Subcommittee
proposals.
The working party identified three
broad positive outcomes that ANZCA/
FPM could contribute to within
anaesthesia, pain medicine and
intensive care medicine, these being:
1. Improved access to services.
2. Improved safety within these
services.
3. Facilitation of indigenous role
models.
To achieve these outcomes the working
party suggested 16 tangible actions
that, in the coming years, ANZCA
could undertake in areas of cultural
competency, encouraging indigenous
trainees/supporting indigenous Fellows,
supporting clinicians working in
indigenous health and advocacy. The
working party endeavoured to produce
targeted strategies with measurable
outcomes. Some measures, such as
advocating for workforce reform, whilst
less tangible and difficult to measure,
were also regarded as highly important.
Cultural competence for trainees,
international medical graduate
specialists (IMGS) and Fellows
• Incorporate indigenous health and
culture into the ANZCA revised (2013)
training curriculum.
• Collaborate with the Royal
Australasian College of Surgeons on
the development of content for the
‘Indigenous Health and Cultural
Competency Online Portal’.
• Investigate the possibility of shortterm
training opportunities for ANZCA
trainees in hospitals with a high
concentration of indigenous peoples.
• Include a dedicated session on
indigenous health and culture at
selected future ANZCA annual
scientific meetings.
Encouraging indigenous trainees/
Supporting indigenous Fellows
• Engage with medical students/interns
to promote an increase in indigenous
trainees.
• Provide funding for an anaesthesia
training scholarship with research
into issues surrounding indigenous
anaesthesia.
• Establish a register of Fellows
prepared to mentor indigenous
students/trainees/Fellows.
• Monitor the number of indigenous
trainees, against an agreed target
benchmark.
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ANZCA Bulletin June 2011