The vital roles of Aboriginal and Torres Strait Islander health workers and health practitioners

As the world's only culturally-based workforce underpinned by national training and regulation, the Aboriginal and Torres Strait Islander health worker and health practitioner workforce plays an essential and unique role in Australia’s healthcare system. The workforce was established by Aboriginal and Torres Strait Islander people for Aboriginal and Torres Strait Islander people.

Evidence directly connects the workforce to improved health and wellbeing outcomes across the course of a life. The workforce has lived experience in, and a deep understanding of, the communities they serve and act as cultural brokers and health system navigators. Their combination of clinical, cultural, social and linguistic skills delivers an engagement capability and community reach that sets them apart from other healthcare workers. Yet, across mainstream Australia, few would know, understand, or recognise Aboriginal and Torres Strait Islander health workers and health practitioners as standalone professions.

Despite the broad range of clinical and primary healthcare services the workforce delivers, it continues to be under-supported, under-recognised and under-utilised. The overall lack of understanding and value of the workforce’s role, health system bias and ad-hoc inconsistent workforce policies continue to hinder the expansion and development of the workforce nationally. Greater support and investment are needed to embed the workforce as a vital, valued and professional component of Australia’s healthcare system.

Aboriginal and Torres Strait Islander peoples have the right to long heathy lives that are centred in culture. They have a right to access health services that are prevention-focused, culturally safe and free of racism. Better health outcomes are achieved when our mob has access to culturally safe care.

This is why it is critical to increase the Aboriginal and Torres Strait Islander health workforce, not only across the Aboriginal Community Controlled Health Sector but also government hospitals, health services and private practices.

Aboriginal and Torres Strait Islander health workers and health practitioners are vital members of the health workforce, and are integral to providing and embedding culturally-safe healthcare. Implementing measures to increase and facilitate the professional deployment of the workforce is key to meeting current and future population health needs, and facilitating health and wellbeing outcomes. The workforce has the capabilities and skills to help respond to workforce shortages across health, aged care, disability services, justice health and other specialty areas, where there is demand.

Drivers for change

The National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021-2031 is a key policy driver to reform the Aboriginal and Torres Strait Islander health workforce. Its implementation should be priortised. Importantly, it was developed by, and for, Aboriginal and Torres Strait Islander peoples and it aligns to other policy reforms, including the National Agreement on Closing the Gap (2020) and the National Aboriginal and Torres Strait Islander Health Plan 2021–2031.

All of these policy reforms stress the need to eliminate racism in the health system. Additionally, it is vital for our systems and institutions to consider their governance structures and organisational practices that embed patterns of disadvantage and enable racist behaviours. To address the ongoing health inequities for our mob, our health services must be publicly accountable in delivering culturally-safe and responsive services to prevent the ongoing harm and even worse, death, of our peoples.

While increasing the number of Aboriginal and Torres Strait Islander health workforce is one strategy, it is also critical for all non-Indigenous staff to undertake cultural-safety training and embed anti-racist approaches.

At the National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners (NAATSIHWP), we are working in partnership with many states and territories to:

• update or develop workforce plans
• review the status of the professions
• assist with the development of career structures, scopes of practice and models of care.

This work is critical to expanding and supporting the workforce and ensuring the healthcare system better meets the needs of Aboriginal and Torres Strait Islander peoples.

More broadly, we partner with other organisations and campaigns such as the Close the Gap campaign and the Partnership for Justice in Health (P4JH) to urge the ongoing need to centre Aboriginal and Torres Strait Islander voices and leadership, eliminate racism, transform the way things are done and ensure a focus on the social and cultural determinants of health and self-determination.