6. Tier 3 – Health system performance
To provide effective health care, health services must be accessible, responsive, and culturally respectful. Some aspects of health system performance for Aboriginal and Torres Strait Islander people have improved over the last decade. However, there are still barriers to, and disparities in level of, access for Indigenous Australians compared with non-Indigenous Australians.
Barriers to accessing health services for Indigenous Australians include services not being available in their area (especially for those living in remote areas), services being too far away and lack of transport, cost, waiting times, and the availability of culturally safe and responsive health services.
For Aboriginal and Torres Strait Islander people to feel confident and safe in accessing health care, health services should ensure that they provide services equitably, and the level and range of accessible health care should be driven by patient needs. Cultural safety and cultural respect should be an integral part of all health services provided.
Cultural safety in the health system
To measure progress in achieving cultural safety in the Australian health system, the AIHW has developed the Cultural safety in health care for Indigenous Australians: monitoring framework. This framework looks at 3 elements of cultural safety:
Culturally respectful health care services – does provider behaviour, attitude, and culture understand and respect Indigenous Australians and culture, including cultural differences?
Patient experience of health care – what are the experiences of Indigenous health care users? Is their cultural identity respected?
Access to health care services – do Indigenous Australians have the same level of access to health services as non-Indigenous Australians? (AIHW 2022a).