Essay: Closing The Gap Policy's Impacts On Indigenous Australians' Healthcare.

1.You are to write a brief explanation of what “Closing the Gap” (CTG) policy is including the history and data that influenced the policy’s creation. You are then to discuss the significance of this policy on Aboriginal & Torres Strait Islander People’s health outcomes using relevant literature and statistics. Please include any challenges and/ or barriers which may have affected the changes.

2.You will then analyse the impact of Judy’s Diabetes and how it is addressed within CTG including the long-term consequences to health and social determinants.

3.Discuss the benefits of Judy being registered on CTG, and how this may have an impact on her social determinants.

4.Why would the AMS and ALO be referring Judy? What services do they provide; including an explanation about the relationship between the health systems?

Background of Australia’s Racial-based Policies

Australia has its history surrounded by racial-based policies and that made the relation between European origin people and that of Indigenous Australians both complex and controversial for unambiguous and straightforward interpretations. Such policies obscured the essence of equality in regard to social welfare and hence creating the disparity which has been perceived for decades in regard to the health status of Indigenous Australians and non-Indigenous Australians (Pruett and DiFonzo, 2014, p.155). This paper scrutinizes “Closing the Gap” policy which was enforced to counter the inequality in healthcare sector which faced the non-indigenous Australians, the impacts of the policy on the health sector of the country, the policy benefits and its relationship with other programs like the Aboriginal Medical Services and the Aboriginal Liaison Officer.

In its launch, “Closing the Gap” policy was a government scheme whose main aim was to take care of the disadvantaged among the Aboriginal and Torres Strait Islander people in respect to access to quality healthcare, educational and employment opportunities (House et al, 2016). It was launched as a formal commitment in Australia to ensure equality in healthcare distribution regardless of whether a person was an Aboriginal or a Torres Strait Islander. “Closing the Gap” policy was put in place in response the social justice report of 2005 to close the gap on health injustices which were rampant among the Aboriginals at the time. It’s however not until March 2008 when all the governments in Australia collaborated with the Aboriginal and Torres Strait Islander people to work together in order to ensure there was equality in matters concerning health care between both in Aboriginal and Torres Strait Islander peoples and the non-Indigenous Australians in future (Dyer et al, 2017, p.1365).). To support the policy, Council of Australian Governments (COAG) set some targets which were aimed at seeing improvement in health and wellbeing among the Aboriginal and Torres Strait Islander population. Among those targets were ensuring 95% of the Aboriginal and Torres Strait Islander young ones were enrolled in school by 2025, closing the gap in life expectancy by 2031 and halving the gap in mortality by 2018 (Hartog, 2016).

Closing the Gap policy has its history from the social justice report by Tom Calma who was then a social justice commissioner representing the Aboriginal and Torres Strait Islander community. The report required the Australian governments to work together to achieve healthcare equality among the Aboriginal and Torres Strait Islander community (Krause et al, 2015, p.50). This report was furthered under the “Close the Gap campaign” whose main aim was to ensure equality in healthcare among all the Australians. The campaign had begun as a National Indigenous Health Equality Campaign in 2006 steered by organizations such as the Human Rights and Equal Opportunity Commission, Australian Indigenous Doctor’s Association and the Indigenous Dentist’s Association of Australia.

Closing the Gap Policy and Its Objectives

Closing the Gap policy has contributed much in ensuring equality in matters of health among all the Australians. Initially, the Aboriginal and Torres Strait Islander population in Australia could not access quality healthcare like the rest of the Australians and that implied suffering among the group (Douglas et al, 2016, p.100). However, with the launch of Close the Gap initiative under Closing the Gap policy, Australia’s NGO’s, peak non-indigenous and indigenous health bodies, as well as human rights organizations, have realized a uniting factor in their efforts for health equality among all the Australians and especially among the  Aboriginal and Torres Strait Islander people. Close the Gap campaign goals have clearly shown the superb contribution of Close the Gap policy especially among the poor population which could not afford quality healthcare.

Although the policy has indicated its positive progress in the fight against inequality among the Aboriginal or Torres Strait Islander population, challenges have been rampant in the course of its efforts. The ongoing challenges which have been identified regard the actual identification of Indigenous patients. This is because differentiating the patients who are in a similar condition becomes hard and it may end up helping some people who don’t necessarily require the help and leaving out the genuine victims (Kassam, 2016, p.20). Also, as a form of campaign, the program faces direct costs in terms of travel, medication and other expenses which need financial support. Lack of adequate financial support has therefore limited the efforts of the program and made the stakeholders strain beyond the expected limits in order to meet their objectives.

The case of Judy, a 57-year-old Aboriginal woman who has been suffering from type 2 diabetes is a perfect example to show how “Closing the Gap” policy has worked to ensure equal distribution of quality healthcare among the Australians. From the information presented in the case study, we get to know that Judy is a widow and this implies that her financial ability won't enable her to receive the required treatment for diabetes which is highly expensive. Apart from financial inability, Judy also lacks the necessary attention from the family because she doesn’t have a husband and his two grown-up children are busy and only affords to assist her when they can. Patients especially those under critical conditions like Judy requires a high level of attention as well as quality treatment failure to which suffering and agony easily succumbs them to death. Judy under these conditions is likely to die earlier than expected because first of all the quality of treatment she is receiving is not a quality one and secondly, she lacks someone close who can take good care of her in the condition she is.

Targets set by Council of Australian Governments (COAG)

Under the CTG policy, cases like the one for Judy are considered first and given the necessary attention. For instance, with the policy’s objective to improve life expectancy old people like Judy are given the first priority and will be sponsored for quality treatments and given the necessary attention which makes them live longer. For that matter, registering with CTG will be of much benefit to Judy (Hayes et al, 2015). First, the case study has presented Judy as an Aboriginal citizen who in addition is a widow and that indirectly presents her inability to cater to her treatment for diabetes. Also, as an aged person requires attention in matters concerning her health status and we get to know that she lacks the close attention of her two children. The two factors if not taken care of would see her die quickly. However, under the CTG plan, the two would be taken care of by professionals and that would see Judy receive the necessary treatment regardless of her financial status.

Apart from the CTG, the case of Judy has presents another two organizations working closely to the CTG to ensure quality healthcare for Aboriginal or Torres Strait Islander population. The two organizations are the Aboriginal Medical Service (AMS) and the An Aboriginal Liaison Officer (ALO) (Sims et al, 2017). AMS was formed in July 1971 with an aim of providing free medical support to the Aboriginal people who were living in Sydney at the time. It had been launched as an Aboriginal community-controlled medical service with a holistic approach to health problems which were facing the Aboriginals from the outset (Kelly et al, 2015). Its foundation acted as a response to the health issues among the Aboriginal people who had migrated from NSW region, the majority of whom lived in poor and overcrowded conditions where accessing quality healthcare was a challenge (Glenister and Prewer, 2018, p.630).

The Aboriginal Liaison Officer (ALO) on the other hand gives confidence and trust to the Aboriginal community to engage with the council. Employment of these officers also helps in stimulating the consideration of local Aboriginal community needs by the staff across all the areas of the council (Carriage, Akers and Payne, 2017, p.32). The Aboriginal Liaison Officers help local Aboriginal population talk to health professionals and help them understand the medical procedures as well as routines that help them participate in the decisions about their healthcare status. Additionally, they provide support information to the GV Health staffs to help them deliver culturally sensitive health services (Jennings, Spurling and Askew, 2014, p.155). ALOs can helps the local Aboriginals make arrangements for their admissions in hospitals as well as after being discharged. Finally, they help link patients to the appropriate community support agencies, programs, and services.

Benefits of Closing the Gap Policy in Healthcare Distribution Among Australians

Conclusion

In summary, it has come out clearly that the CTG program has played a great role in ensuring equality in healthcare among the Australians. As it has been seen from the history of this policy, the Aboriginals in Australia faced the healthcare challenges which led to low life expectancy cases and high mortality rates. However, with the launch of this policy, this has changed because the Aboriginals began to enjoy the same opportunities as the indigenous people. This has not been fully achieved because of the various challenges which have been outlined above like the lack of enough resources to meet the costs of implementing the policy. Lastly, other programs which have facilitated the success of this policy have also been revealed as well as their major roles. The two subordinate programs are the Aboriginal Medical Service (AMS) and the Aboriginal Liaison Officer (ALO).

References

Carriage, C., Akers, J. and Payne, K., 2017. Immersion as a pedagogical approach to indigenous health curriculum: An immersive model of learning in Aboriginal community control services for MBBS students. LIME Good Practice Case Studies Volume 4, p.32.

Dyer, S.M., Gomersall, J.S., Smithers, L.G., Davy, C., Coleman, D.T. and Street, J.M., 2017. Prevalence and characteristics of overweight and obesity in indigenous Australian children: a systematic review. Critical reviews in food science and nutrition, 57(7), pp.1365-1376.

Douglas, E., Waller, J., Duffy, S.W. and Wardle, J., 2016. Socioeconomic inequalities in breast and cervical screening coverage in England: are we closing the gap?. Journal of medical screening, 23(2), pp.98-103.

Glenister, D. and Prewer, M., 2018. Capturing religious identity during hospital admission: a valid practice in our increasingly secular society?. Australian Health Review, 41(6), pp.626-631.

Hartog, J., 2016. Safeguarding Quality of Higher Education in the Netherlands. Closing the Gap between Policy and Research.

Hayes, S.L., Riley, P., Radley, D.C. and McCarthy, D., 2015. Closing the gap: past performance of health insurance in reducing racial and ethnic disparities in access to care could be an indication of future results. New York, NY: Commonwealth Fund.

House, R., Moth, R., Porteous, D. and Jamieson, G., 2016. ‘Closing the Gap’TUC conference, Salford, 29 April 2016: Mental health beyond austerity: a ‘mental health approach to post-austerity policy-making.

Jennings, W., Spurling, G.K. and Askew, D.A., 2014. Yarning about health checks: barriers and enablers in an urban Aboriginal medical service. Australian journal of primary health, 20(2), pp.151-157.

Krause, G., Brugere, C., Diedrich, A., Ebeling, M.W., Ferse, S.C., Mikkelsen, E., Agúndez, J.A.P., Stead, S.M., Stybel, N. and Troell, M., 2015. A revolution without people? Closing the people–policy gap in aquaculture development. Aquaculture, 447, pp.44-55.

Kassam, R., 2016. Closing the Gap between Policy and Practice of Childhood Malaria Management in Uganda: a Need to Reach beyond the Formal Health System. Malar Cont Elimination, 5(136), pp.20-25.

Kelly, J., Ramage, M., Perry, D., Tinsley, J., Auckram, H., Corkhill, W., Wyatt, S. and McCabe, N., 2015. Managing Two Worlds Together: Stage 3: Improving Aboriginal Patient Journeys-Cardiac Case Studies. Managing Two Worlds Together: Stage 3: Improving Aboriginal Patient Journeys-Cardiac Case Studies, p.vi.

Pruett, M.K. and DiFonzo, J.H., 2014. Closing the gap: Research, policy, practice, and shared parenting. Family Court Review, 52(2), pp.152-174.

Sims, S., Houston, L., Schweinzger, I. and Samy, R.N., 2017. Closing the gap in cochlear implant access for African-Americans: a story of outreach and collaboration by our cochlear implant program. Current opinion in otolaryngology & head and neck surgery, 25(5), pp.365-369.