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

Moving Forward TogetherJanet KellyThese three comments highlight the very different approaches and perceptionsof staff members.With rapid changes of management staff members felt they were always beingtold what to do with very little two-way conversation or negotiation, oropportunity to use their own ideas and abilities.One staff member reflected;Here at the Aboriginal Neighbourhood House the managers dictate whereworkers work, people get put in and pulled out constantly. It feels veryreactionary rather than planned. It is not participatory, not a bottom upapproach, we don’t have a say in how we want to work. Management geta good idea and impose it, then we have to do it and then if it doesn’twork they say’ look what you have done’, and blame us. Staff membersneed to be involved in solving problems as well, everyone needs to belistened to. You can’t expect people to be autonomous thinkers if whatever they are doing is controlled by someone else. When everything hasalready been sorted and decreed by a higher level. It is a very old way ofworking, it is about control (AH Hp Int.1).These comments reflect a trend of prioritising policy and external knowledgeover health professional knowledge, an issue also raised by Kirkham et al(2007). They recognised that unmodified and unquestioned Western scientificevidence based knowledge (and in this case management and policyknowledge) can limit health professionals’ ability to meet individual clientsneeds, particularly Aboriginal people with ongoing health disparities.Changes in all health staff positions led to further confusion, instability andfrustration. Reasons for staff changes were short term contracts, beingreallocated to other sites, or leaving the organisation altogether (AOHS FG5).Only two employees remained from mid 2005 until 2007. These constantchanges in the first eighteen months of the newly establishing multi-agencyhealth service were very unsettling for staff, community members and otheragencies. The employment structure for staff added another level ofcomplexity. Some were employed by either or both the Aboriginal CommunityControlled Nunkuwarrin Yunti Health Service (nationally funded) and the state221