BACKGROUND INFORMATION
This document is designed to be a starting point for your thinking and discussions. It contains some information drawn from research done by NWMPHN, the Ethnic Communities Council of Victoria (ECCV) and others.
This material will provide you with some background and context for your ideas. It is not intended to limit your contributions.
What are the health care issues common to all communities?
NWMPHN’s most recent Health Needs Assessment identified the 4 top barriers to accessing health care in the region as:
cost
waiting time
not knowing where to go
not being able to get an appointment
What other barriers confront people from multicultural communities?
Different communities have different cultural needs and different sets of values so it serves no purpose to make blanket statements. However, research by NWMPHN and other organisations found some common issues.
Most general practices do not provide services that are appropriate, accessible and culturally safe for members of at least some multicultural communities.
Language can be a major barrier. This includes limited access to interpreters, and a shortage of appropriately translated written material.
People from some communities can find navigating the health system challenging.
In some countries, under some regimes, governments and other state organisations are treated with suspicion. For some communities here, learning to trust Australian institutions is neither easy nor rapid.
All these factors are amplified for refugees and asylum-seekers.
Case study: Improving access to culturally safe primary health care
In 2020, NWMPHN commissioned the Ethnic Communities Council of Victoria and Community-Owned Primary Health Enterprises to consult widely with people of multicultural heritage about their experiences accessing health care.
This was in response to the discovery – through NWMPHN’s health needs assessment process – that people from some cultural backgrounds were over-represented in hospital emergency departments for matters that could be dealt with in general practice.
The result was a report, Improving access to culturally safe primary health care services during the after hours period for culturally and linguistically diverse communities, published in April, 2021.
The report made several important findings about how the primary health care sector and multicultural communities interact. They were:
· The primary health system provides good quality services, but can be difficult to access and navigate for consumers from multicultural communities.
· Cultural responsiveness in service design and delivery is inconsistent across the primary care sector.
· The general practice sector needs to build its cultural responsiveness.
· The use of interpreters is inconsistent and underutilised.
· Data about culturally and linguistically diverse communities are not used sufficiently in planning and commissioning processes.
· The mainstream medical model is not culturally responsive to the primary care needs of a diverse community.
During your discussions on this panel you might want to examine whether these findings reflect your own health care experiences, and reflect on what changes might need to be made to rectify the issues.
Case study: Using bilingual cultural navigators
A recent pilot project instigated by the University of New South Wales tackled the common barriers of language and cultural mores experienced by members of some multicultural communities.
After extensive research and consultation, community members fluent in English and the particular target language were placed in 2 general practices. One of these had a large number of patients from the Samoan community; the other had significant patients from Chinese backgrounds.
The bilingual workers served as culturally safe navigators for patients who were not fluent in English.
Patients were referred to them by practice GPs. With each, they discussed needs, priorities and potential solutions. This included providing emotional support, help with referrals and appointments, and information about locally available resources.
The UNSW research team concluded that placing bicultural navigators in general practices was feasible and acceptable to patients. It recommended accredited training for such roles – and education for GPs about when and how to refer to them.
More details about this project can be found in this peer-reviewed research paper.
During your discussion on this panel you might like to consider whether bilingual cultural navigators could make accessing primary health care easier and safer. If so, what other factors might need to be addressed?
Important terms
What do we mean by ‘multicultural’?
Australia is a wonderful multicultural society, which means it contains a vast number of communities, each united around a common set of values or characteristics. These might concern language, beliefs, ethnic heritage or geographic origin.
What do we mean by ‘primary health care’?
Primary health care is the first point of contact with the health care system. It includes general practices, pharmacies, community health centres, dentists, mental health clinics, drug and alcohol treatment centres, maternal and child health care facilities, and allied health providers such as physiotherapists and psychologists.
What is NWMPHN?
With a focus on at-risk population cohorts, NWMPHN is a not-for-profit organisation driven by a vision for a primary care system that is person-centred, comprehensive, coordinated, accessible, high quality and safe.
It receives annual funding from the Australian and Victorian governments.
It works closely with general practices, mental health, allied health and other primary health care professionals to identify service gaps. Then we collaborate to co-design and fund innovative and effective solutions that make it easier for people to get the care they need.
NWMPHN’s catchment covers 3,200 square kilometres, and is home to 1.9 million people. Collectively they speak more than 220 languages.
Almost a third of people living in NWMPHN catchment were born overseas. Add in the people who have at least one parent born overseas and the number of people enjoying a culturally diverse heritage increases to almost half.