Moving Forward Together in Aboriginal Women's Health: - Theses ...

Moving Forward TogetherJanet KellyAlongside these frameworks was the South Australian Health Reform thatpromoted greater opportunities for inclusion and community participation,strengthening and reorienting services towards improving quality and safety ofservices, prevention and primary health care, developing service integrationand co operation and developing whole of government approaches to advanceand improve health status (Government of South Australia 2003b). Staffmembers and managers discussed that the changes in the health system linkedto restructuring were unsettling while they were occurring.High turn over of management and staffThe first eighteen months of the Aboriginal health service development atGilles Plains involved rapid changes of staff. In 2006 alone there were fivedifferent managers at the Gilles Plains Aboriginal NeighbourhoodHouse/Aboriginal Outreach Health Service. While this sounds unbelievable,the changes occurred due to severe illness and extended sick leave, relocated toother sites, caring for family members, moving interstate and the tragic illnessand then death of one of the managers. In early 2007 there was no onsitemanager for five months. One of the staff members assumed the managementrole unofficially, leading to increased work loads for the rest of the team, andcomplexities associate with having a team member performing a managementrole but being given no official authority.The impact of five differing management styles in one yearWith each new manager came a new management style, interpretation ofpolicies and priorities and this affected both staff and community members.The first manager had been involved in developing the original vision of anAboriginal Neighbourhood House and supported collaborative communitydevelopment programs with comprehensive primary health care. Unfortunatelyshe became ill and had to take extended leave. Incoming managers were givena different mandate that led the service in other directions. One of thefollowing managers described service provision as;…a mixture of community development and clinical approach, butpredominantly clinical. Increased access to GP services and chronicdisease services is the push because the need is so high. It is not enough219