National Close Gap Day highlights much more to be done

As a recent media investigation has so starkly illustrated there is still a very long way to go to achieve this.

The College is deeply shocked by the Four Corners report on the preventable deaths of Betty Booth, and other Indigenous women, in remote Australian communities.

ACEM acknowledges the grief and despair of bereaved family and community members on their unimaginable losses, and emphasises responses announced since the airing of the Four Corners episode must result in answers and meaningful change that is so desperately needed.

The media report brought into stark focus issues of inadequate care despite multiple attendances to a health service, and the inability to access appropriate care when needed, as well as the unacceptable prevalence of rheumatic heart disease in First Nations Communities, in a supposedly developed nation.

The revelations must also be the catalyst for reflection, further acknowledgement and genuine action to address the social determinants of health, as well as the systemic and institutional racism still present in too many facets of the healthcare system.

ACEM acknowledges the recent announcement of a coronial investigation into the circumstances of the deaths and the adequacy of the care and treatment received in emergency departments.

The College hopes any findings and recommendations will contribute to addressing the distressing issues raised, while preventing further deaths from happening in similar circumstances in the future.

During the week of National Close the Gap Day, the College acknowledges and strongly supports the call from the Close the Gap Campaign for Australian governments to embrace genuine partnership with Aboriginal and Torres Strait Islander peoples.

ACEM also acknowledges the key role institutions must play in promoting and supporting Aboriginal and Torres Strait Islander leadership in transforming health and community services, policies and programs. ACEM stands as an ally beside Aboriginal and Torres Strait Islander health organisations.

ACEM envisages a future where all EDs support Aboriginal and Torres Strait Islander peoples to experience culturally safe emergency care that is self-determined, free from bias and racism, and enhances opportunities for quality health outcomes.

In order to progress towards these goals, ACEM encourages health systems to better serve Aboriginal and Torres Strait Islander communities by: ensuring cultural safety training across healthcare systems; providing adequate funding, education, and resourcing for rural and remote health services; improving prevention, surveillance, screening and treatment of infections and diseases (including RhD); improving services for rural and remote health access through outreach services; and, more robust levels of clinical governance.

ACEM believes it is imperative to tackle institutional racism within health care organisations as an essential element to creating a health system that is free from racism and in which Aboriginal and Torres Strait Islander peoples are safe to participate at all levels.

Co-Chair of ACEM’s Indigenous Health Committee, Dr Glenn Harrison said, “The disparity in health outcomes and equity for Aboriginal and Torres Strait Islander patients are real, disproportionate and complex.”

“They reflect the need to mandate measures and programs to ensure we address structural and systemic failures that pervade the lives and influence the futures of our most valuable but vulnerable populations.”

ACEM President Dr Clare Skinner said, “Emergency departments must be a culturally and psychologically safe space for all people. Racism has no place in our healthcare system. We must continue to work hard to provide better emergency care.”

In 2017, the College implemented its first ACEM Reconciliation Action Plan (RAP). The RAP aims to address the inequities in health outcomes for Aboriginal and Torres Strait Islander peoples. The third Innovate RAP for the period 2022-2024 will be launched in June 2022.

In early March, the College made a submission to the Queensland Human Rights Commission (QHRC) Anti-Discrimination Act Review. Our submission contends that racism in healthcare can only be eradicated by recognising and defining institutional racism as a form of racism in the Anti-Discrimination Act 1991 (Qld).

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