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

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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. 50 ANZCA Bulletin June 2011
Support clinicians working in indigenous health • Facilitate the production of hardcopy and electronic resources to improve understanding of anaesthesia and pain medicine for indigenous health workers. • Advocate for an increase in indigenous health workers in theatre environments. • Establish an ongoing committee of council to support indigenous health initiatives and practitioners. • Promote a shift in thinking – a period of time spent working in a rural/remote area should be viewed favourably when a Fellow is seeking to re-establish practice in a major centre. • Advocate for “partnering” large urban and small rural/remote hospitals. Advocacy • Establish and maintain dialogue with key stakeholders. • Advocate on matters related to indigenous health, specifically workforce and training issues. • Work with partners to promote a clear message. Support for the initiatives has been strong with the Australian Indigenous Doctors’ Association (AIDA) and the Honourable Warren Snowdon, Minister for Indigenous Health, amongst others, providing positive feedback. The inter- College ‘Indigenous Health and Cultural Competency Online Portal’ project has begun to take shape and will provide specialists, trainees and IMGS, with a focus on those in Australia’s rural and remote areas, with access to resources relevant to medical specialists. As a part of the project ANZCA/FPM have applied for funding to develop anaesthesia and pain specific resources for the portal and have been approached to provide a representative for the project’s steering committee. Currently all of the members of the working party will be continuing to work as part of the new Indigenous Health Committee. Fellows, IMGS and trainees interested in additional information, working with the committee, or available to assist with specific initiatives are encouraged to contact Paul Cargill, Policy Officer, at pcargill@anzca.edu.au or +61 3 8517 5393. Paul Cargill Policy Officer, ANZCA (on behalf of the Indigenous Health Committee) ANZCA Bulletin June 2011 51
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