Overcoming barriers: health care in the Mallee

While country life has its upsides, it also has its challenges, with reduced access to services and resources continuing to impact the health and wellbeing of those outside metropolitan areas. Addressing these limitations is critical to the viability of regionally based health services and to the outcomes of the communities they support.

Mallee District Aboriginal Services (MDAS) delivers programs to Aboriginal and Torres Strait Islander people living in some of the most isolated areas of Victoria. As one of the state’s largest Aboriginal Community Controlled Organisations, MDAS is a recognised leader in innovative Aboriginal services, committed to fostering partnerships and collaboration. Like many health providers, MDAS is feeling the pressure of the national health system crisis, which is driven by escalating operational costs and a lack of qualified staff. In response, MDAS is leveraging its ability to partner and adapt, to ensure the health needs of community are met.

Director of Health and Clinical Services at MDAS, Kelly Dart, is familiar with the issues confronting regional areas, but even she is wary of the growing pressure.

‘Our community has poorer than average health outcomes – chronic disease, mental ill health – and this is increasing demand [on health services]. Wait lists are long and the ability to provide life-changing health care is impacted.’

Ms Dart says that MDAS is spending more on health provision – forced to hire locum doctors at increased expense, without the buffer that Medicare once provided– while also absorbing higher operating costs.

‘Attracting staff to regional areas has always been challenging and, with city employers able to offer higher salaries, we’re behind the eight-ball.’

Accepting those things which cannot be changed, and focusing on those that can be, is part of Kelly’s mantra.

‘There are issues, but if you get stuck looking at those, you miss the opportunities.’

The positives MDAS does have are strong relationships and an ability to think outside the box.

‘We’re benchmarking salaries where we can but it’s about more than money. We’re providing a work–life balance for our staff. We offer Health and Wellbeing Days, and flexible work arrangements, including adapting hours to suit working parents. We have competitive salary packaging and relocation support. We’re also rethinking how we operate and collaborate.’

Included in their reimagined model, Ms Dart is encouraging the development of district positions – staff based in Mildura but providing outreach support to other regions – and job sharing with other agencies.

‘We found it was easier to recruit staff to Mildura than to the smaller towns, so we trialled district roles, building travel into the positions. It‘s worked well and is alleviating the pressure.

‘Job sharing and secondment have also been successful. With partners, we can employ someone to work across both organisations, splitting the costs while sharing knowledge and experience. We shouldn’t be in competition with other services locally. We all have important things to offer.’

Beyond the recruitment and retention strategy, Ms Dart says MDAS is committed to driving a new focus for Aboriginal health care, one that removes the restraint of traditional approaches which tend to prioritise governance and compliance.

‘Health care must be safe, but we need a holistic way of viewing that safety, outside of regulatory compliance. We’ve successfully embedded cultural safety into mental health support and it’s time it was introduced across the health sector.’

Ms Dart envisions a model that embeds Aboriginal Healing into health service provision.

‘We will take health care to the community, caring for them in a way they want, where they want it.’

Culturally safe care may prove to be an important step in overcoming the barriers to better health outcomes for Aboriginal people – and not before time.