An Australia-first report card on levels of institutional racism in Queensland’s health system has found low levels of Indigenous participation in governance, policy implementation, and service delivery across the state’s 16 Health and Hospital Services (HHSs).
The audit was commissioned by the Anti-Discrimination Commission Queensland (ADCQ) and the Queensland Aboriginal and Islander Health Council (QAIHC). Using a tool known as ‘the Matrix’, a set of baseline data has been gathered which can now be used to measure progress towards elimination of institutional racism in health services over time.
HSs were scored on five key criteria – including Indigenous employment in clinical and front-line roles, and services’ financial accountability and reporting – derived from Closing the Gap partnership agreements and federal and state health policy.
Ten of the 16 HHSs scored ‘very high’ levels of institutional racism, and the remaining six ‘high’ level.
Despite the results being disheartening, ADCQ and QAIHC are hopeful that the audit is the first step to a more positive future for Indigenous health equity.
“While the results are indeed disappointing, this report is the first step towards acknowledging and addressing institutional racism in health care,” says Anti-Discrimination Commissioner Scott McDougall.
“Without evidence of the problem, it’s difficult to motivate work towards a solution. This report and the results of this first audit provide an opportunity for our health system – one that Queensland Health has recognised.”
Since the completion of the report, Queensland Health, QAIHC, and ADCQ have collaborated on ways for Queensland Health to address institutional racism in the health system. In November 2018, a panel of experts in Aboriginal and Torres Strait Islander health reviewed and refined the Matrix tool, to more accurately reflect the matters that are within the immediate control of the health service providers.
“We’re pleased that Queensland Health has recognised the importance of acting to address institutional racism in HHSs statewide – and has indeed already begun making changes as a result of this audit,” says Mr McDougall.
QAIHC CEO Neil Willmett says breaking down institutional barriers to Indigenous health equity will require constant vigilance and long term vision.
“A one-off audit and report of this kind is not enough to change the system, but it is a start. Having solid data around levels of institutional racism is particularly helpful in terms of quantifying what Aboriginal and Torres Strait Islander Queenslanders have been anecdotally reporting to us for many years,” says Mr Willmett.
“In order for things to improve, ongoing monitoring will be required – from both within the health system and outside it, by means of audits like this one.”
As part of this ongoing process of change, both ADCQ and QAIHC have committed to undertaking a follow-up audit in 2019-20.
“We would like to repeat this process next year to track how much change has taken place since the first round of figures were published, and to see what work remains to be done. This has been an incredibly useful tool for Queensland Health, who have already implemented some changes as a result of this audit, and we want to give them the opportunity to continue to build on that,” says Mr Willmett.
Mr Willmett also points out that this audit only looked at published data for Queensland’s health system.
“This is the first audit of its type in Australia, and obviously we’d like to see other state health systems take it on board. Queensland is by no means the only state with issues like these.”
Report available at: http://www.adcq.qld.gov.au/resources/Aboriginal-and-Torres-Strait-Islander/health-equity.