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6. Tier 3 – Health system performance

Aboriginal and Torres Strait Islander Health Performance Framework - Summary report

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 (First Nations) people have improved over the last decade. However, there are still barriers to, and disparities in level of, access for First Nations people compared with non-Indigenous Australians.

According to findings from the 2018–19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), barriers to accessing health services for First Nations people 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 First Nations 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 – cultural respect is achieved when the health system is a safe environment for First Nations people, and where cultural differences are respected. How is health care provided, and is cultural respect reflected in structures, policies and programs?

Patient experience of health care – what are the experiences of First Nations health care users? Is their cultural identity respected? Aspects of cultural safety include good communication, respectful treatment, empowerment in decision making and the inclusion of family members.

Access to health care services – do First Nations people have the same level of access to health services as non-Indigenous Australians? (AIHW 2022e).

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