Table of Contents
Appropriate healthcare services and culturally safe care is necessary for “Aboriginals and Torres Strait Islander” people to gain health benefits and reduce imbalance of their mortality and life expectancy with non-Indigenous people. As per the case scenario, funding of “Closing the Gap” enables Matt’s mother to travel between Brisbane and Townsville as well as pays for her accommodation, but the facilities of “Closing the Gap” is criticised by AHRC “Close the Gap” 2018 report. Therefore, in this report, the difference between “Closing the Gap” and “Close the Gap” is evaluated along with the fifth finding of “Close the Gap” and the role of “Aboriginals Liaison Officers” to provide “culturally safe care” to Matt and his mother.
“Closing the Gap” is an Australian governmental strategy that has a purpose of reducing the disadvantages among “Aboriginal and Torres Strait Islander” people for improving life expectancy and child mortality. It also aims to help in accessing the education in early childhood and employment of Aboriginals and Torres people (Pmc.gov.au, 2020). Seven measurable targets have been set by the “Council of Australian Governments” (COAG) to track the wellbeing of “Aboriginal and Torres Strait Islander” population. On the other hand, “Close the Gap” is a campaign for social justice or “National Indigenous Health Equality Campaign'' that is operated by Aboriginal and Torres Strait Islander” and “non-Indigenous health agencies”, non-government agencies and human rights organisations (Healthinfonet.ecu.edu.au, 2020). “Close the Gap” 2018 report of The “Australian Human Rights Commission” (AHRC) critiques this “Closing the Gap” approach. “Close the Gap” ensures equal access to healthcare as a human right that involves a social awareness campaign that is directed by Oxfam.
“Closing the Gap” report has been brought by the Prime Minister to parliament. Seven targets of COAG are to close the gap of life expectancy, mortality and health equality by 2030, reduce child mortality rate by 2018, and ensure 95% “Aboriginal and Torres Strait Islander” enrolled for education in early childhood (Closingthegap.niaa.gov.au, 2020). It also includes reducing the issues in writing, reading and numeracy, halving the gap of employment, halving the gap for attendance in school and in year 12 accomplishment of Indigenous students by 2020.
However, as per “Close the Gap” report, the governments have not been succeeded yet to reduce the gap that is disappointing and frustrating and as per “Australian Institute of Health and Welfare” report 2017, life expectancy and mortality gap has widened in recent years (Malley, 2020). “Close the Gap” campaign has been established in 2007 to influence the decision making of government and improve action. “Close the Gap” has gained support from federal and state governments after COAG set seven health targets. This campaign ensures whether the Australian Government are interested to work for the Indigenous communities and commits additional funding.
Five major findings of “Close the Gap” analyses the rights of the Indigenous people and their right to health, infrastructure of health and responses obtained by “Aboriginal and Torres Strait Islander” communities. As per the fifth finding, there is a “funding myth” about “Aboriginal and Torres Strait Islander” health in many areas where Indigenous people live and lack of progress is observed in these areas. Therefore, the Australian government need to be serious to develop health quality among “Aboriginal and Torres Strait Islander” and refreshed “Closing the Gap” strategy must be implemented with equitable and realistic level of investments (Humanrights.gov.au, 2018). High spending on Indigenous health is required along with spending on elderly more than the young people due to their higher needs.
It has been identified that the “Aboriginal and Torres Strait Islander” population suffered from diseases in average 2.3 times than none-Indigenous people. However, in 2013-14, expenditure of government for health has been $1.38 per “Aboriginal and Torres Strait Islander” person whereas it has been $1.00 for a non-Indigenous person (Humanrights.gov.au, 2020). Therefore, duration of the expenditure of Australian government for “Closing the Gap” Strategy is not proportionate with the complex and greater health needs of Aboriginals. The situation of “Aboriginal and Torres Strait Islander” health is considered as “market failure” and private resources cannot decrease the shortfall.
As per the “Close the Gap” campaign, any Australian government has low possibility to reduce life expectancy and mortality rate but can maintain target without additional funding. Australian government must follow some recommendations provided by this campaign to increase expenditure that includes primary health services given to “Aboriginal Community Controlled Health Services” (ACCHSs), addressing institutional racism and health enabling infrastructure. “Aboriginal and Torres Strait Islander” people need to be trained to employment level. Alongside, federal government needs to provide fund for five-year “National Aboriginal and Torres Strait Islander Health Implementation Plan” from 2018-2019 Federal budget to develop satellite and outreach services of ACCHSs.
A patient escort can be termed as an entity which works along with the patient for providing them the requirements of immediate needs (Nasiri et al., 2016). In this manner, the medical staff can get valued time for treating the other serious patients who are in different terrains in a healthcare unit. However, in the case of Matt, it has been witnessed that the lack of patient escort has led to some challenges due to which there has been some lacking taking care of Matt. However, with an enhanced patient advocacy care, there has been more number of patients for taking utmost care of Matt.
It has been witnessed that the patient escorts face many challenges while performing their duty. The lack of mentoring by senior healthcare officials does not provide clarity to the patient escorts regarding their roles in fulfilling the requirements of patients in the right manner. There is also a lack of advancement opportunity for the patient escort to rise to higher grades by virtue of promotion. Most of the healthcare workers like the doctors and nurses do not behave properly with the patient escorts since they are treated as second hand professionals in the healthcare units of Australia (ter Hofstede et al., 2019). The main cause of this is the inadequate model of organisational culture which is present in most healthcare units of Australia for Indigenous people. This leads to lack of motivation for the patient escorts which eventually forces them to quit the prospectus as patient escort.
The workload is extremely high which is involved in the job as a patient escort due to lack of availability and training of the nurses. Furthermore, the wages provided to the patient escorts are comparatively much lower as that of a nurse or other healthcare workers. The combination of lower salary along with a higher workload has demotivated the patient escorts thereby causing them low satisfaction in their job. In addition to this, the patient escorts do not have much access to technology due to which they are not able to perform their duties providing excellent efficiency.
“Aboriginal hospital Liaison Officer” (ALO) provides support from social, cultural and emotional aspects to the patients of “Aboriginal and Torres Strait Islander” and their families at the time of using hospital. “Liaison Officers” assist the “Aboriginal and Torres Strait Islander” patients to understand the treatment in a better way by breaking communication barrier. They fetch information to give support to the patients and coordinate travel and communication of the patients (Alfredhealth.org.au, 2020). Liaison Officers support medication and advocacy of referrals to the social workers as per requirements. In case of Matt and his mother, “Liaison
Officers” may support them to pay their accommodation and food as well help in travelling as per their needs. It helps Matt to obtain better treatment in her mother’s home. “Liaison Officers” of Queensland may also consult the hospital staff to seek information about the condition of Matt and his mother that is necessary for Matt to get better healthcare service.
Alongside, Liaison Officers make face-to-face contact with the patients as well as assist the discharge planning and access resources. They also assist the equation of patients and families that is effective to maintain positive relationships with Aboriginal communities, government unit and healthcare providers (Health.qld.gov.au, 2020). It is required for Liaison Officers to identify values, norms and principles of “Aboriginal and Torres Strait Islander” and overcome the cultural power imbalances to contribute to health improvements. Therefore, Matt and his mother can get help from the officers at the time of discharging from the hospital of Brisbane. The culturally safe care such as shared respect and shared knowledge regarding Matt’s treatment can also be obtained by Matt and his mother if they take help from Liaison Officers of Queensland. Cultural competence, cultural support and sensitivity are the main attributes of Liaison Officers that reduces barriers of communication between officers and Matt that is helpful to improve health service.
In conclusion, the purpose of “Closing the Gap” strategy of Australian Government is to improve life expectancy and child mortality of “Aboriginal and Torres Strait Islander” people along with education in early childhood and their employment. “Close the Gap” campaigns supports Aboriginals to improve their health, supports self-determination and mobilise government's action by influencing decision making. However, as per the fifth finding of the “Close the Gap” campaign, spending of the government on Indigenous health is not as much as their needs. However, patient escorts face difficulties to manage the heavy workload in the absence of healthcare professionals like nurses owing to lack of training sessions. “Aboriginals Liaison Officers” help Matt and his mother to improve communication, accommodation and health service after discharge.
Alfredhealth.org.au. (2020). Aboriginal Hospital Liaison Officers | Alfred Health. Retrieved 9 May 2020, from https://www.alfredhealth.org.au/patients-families-friends/while-you-are-here/aboriginal-and-torres-strait-islander-patientsHospital Liaison Officers | Queensland Health.qld.gov.au. (2020). Hospital Liaison Officers. Retrieved 9 May 2020, from https://www.health.qld.gov.au/sunshinecoast/html/atsi-health-serv/aboriginal-and-torres-strait-islander-health-team/hospital-liaison-officers
Closingthegap.niaa.gov.au. (2020). Closing The Gap |. Closingthegap.niaa.gov.au. Retrieved 9 May 2020, from https://closingthegap.niaa.gov.au/
Healthinfonet.ecu.edu.au. (2020). Closing the Gap - Health System - Australian Indigenous Health. Retrieved 9 May 2020, from https://healthinfonet.ecu.edu.au/learn/health-system/closing-the-gap/
Humanrights.gov.au. (2018). Close the Gap 2018 Report launch | Australian Human Rights Commission. Retrieved 9 May 2020, from https://humanrights.gov.au/about/news/speeches/close-gap-2018-report-launch
Humanrights.gov.au. (2020). Close the Gap. Retrieved 9 May 2020, from https://humanrights.gov.au/sites/default/files/document/publication/CTG%202018_FINAL-WEB.pdf
Malley, N. (2020). Rudd strongly rejects PM's criticism of Closing the Gap. The Sydney Morning Herald. Retrieved 9 May 2020, from https://www.smh.com.au/national/rudd-strongly-rejects-pm-s-criticism-of-closing-the-gap-20200213-p540if.html
Nasiri, J., Khatib, N., Kheiri, S., & Najafi, M. (2016). The influence of escort during upper endoscopy and colonoscopy on patient satisfaction and anxiety. Journal of family medicine and primary care, 5(1), 134. doi: 10.4103/2249-4863.184638
Pmc.gov.au. (2020). Closing the Gap. Retrieved 9 May 2020, from https://www.pmc.gov.au/sites/default/files/reports/closing-the-gap-2018/sites/default/files/ctg-report-20183872.pdf?a=1
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