Aboriginal Community Controlled Health Services: Controlled or Controlling their own Destinies?

Abstract

The Indigenous people in Australia are the Aboriginal and Torres Strait Islanders. Since colonisation in 1788 this population has diminished significantly. Following years of advocacy addressing inequitable government policies towards Aboriginal and Torres Strait Islanders, the first Aboriginal Medical Service was established in Redfern, New South Wales, in 1971. From this one Aboriginal Medical Service there grew many more across Australia; in some jurisdictions they are referred to as Aboriginal Community Controlled Health Services (ACCHS). This study was designed to examine the bureaucratic and organisational structures, functions and operations of these ACCHS, and how these services meet both the organisation’s requirements and the community’s expectations when delivering a culturally-appropriate health service to Aboriginal and Torres Strait Islander people. This research applies a case study method within a qualitative paradigm for the depth needed to explore the research aims. Following discussions with the Queensland Aboriginal and Islander Health Council, the sites for this research were identified in central and southern Queensland. The three sites were vastly separated by distance but at the same time subjected to similar historical abuse. The participants drawn from these sites were Aboriginal and Torres Strait Islanders and the research attempted to capture their perceptions. Each case was subjected to a conceptual and thematic analysis to draw out the key themes and concepts and thence to develop a theoretical model of how the ACCHS balance their organisational requirements and community expectations.