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

Moving Forward TogetherJanet KellyThe existing health system was to be maintained while reforms were developedand implemented. Health practitioners and consumers were to have increasedinvolvement in health planning and policy decisions. An emphasis onimproving health services for the most vulnerable populations, includingAboriginal people, children, young people, the frail aged and those with amental illness was highlighted (Government of South Australia 2003). Healthservices across Adelaide were rearranged into two major regions withcommunity based primary health care services and tertiary services broughttogether under a single administration and management (Government of SouthAustralia 2003b). The combination of national selective health care policieswith state health reform and increased focus on comprehensive primary healthcare created complex policy, program and financial dynamics. SomeAboriginal and non-Aboriginal community health professional positions arejointly state/national funded and health professionals discussed their confusionin trying to meet the directives of both national (selective), and state(collaborative) health policies (Discussion with Aboriginal and communityhealth managers, Gilles Plains, February 7, 2005). At the time of writing(November 2008), there has been little action by the state government toseriously implement comprehensive primary health care.Aboriginal healthPrior to the 1970s, public health was delivered mainly in hospitals in line withthe biomedical model with an emphasis on infectious diseases, medicaltherapies and surgical advancements (Baum 2008; McMurray 1999). Asdiscussed in the last chapter, many Aboriginal peoples experienced substandard care within hospitals, with health services and health professionalscontinuing the colonising practices, exclusion and discrimination thatAboriginal people experienced in the wider community. There were of courseexceptions to this, but many Aboriginal women clearly remember times whenthey were refused entry to hospitals or were housed in annexes rather than themain building (Community consultations 2005; Eckermann et al. 2006;McMurray 1999). These experiences continue to impact on their health seekingdecisions today.75