Despite a higher burden of illness and chronic disease, Aboriginal and Torres Strait Islander people access fewer Medicare-rebated specialist services than non-indigenous people, prompting calls from a peak medical group for a national approach to address the inequity.
Royal Australasian College of Physicians president Professor Nicholas Talley said a national framework was needed to address the significant gap for Aboriginal and Torres Strait Islander people accessing specialist medical care.
"We do know, in parts of the country there are actually some systems that are working reasonably well. But they're patchy and isolated and not co-ordinated, and there's lots of areas where that's not working well," he said.
"What we'd like to do is promote the concept of a national network - a co-ordinated, consistent system that leads to equitable access and obviously improves outcomes."
The College has just released a proposal for a national framework, to bring a "systematic approach" to specialist care access for Aborigines and Torres Strait Islanders.
"We're talking about access to a wide range of services, from renal medicine - [because] kidney disease is a huge problem in indigenous people - [to] heart disease, lung disease, infectious disease. So a very wide range of services," Professor Talley said.
"You need co-ordination of care and experts who can manage complex sorts of problems."
Professor Talley said the consensus statement emerged from a recent round-table meeting hosted by the college.
"We need to systematically scope out, identify and work to address all the gaps and look at all the issues in terms of specialist medical care right across Australia, and that includes existing and required funding, workforce issues, patient needs, community needs, what services need to be put in place, what's available," he said.
"The idea is that there would be regionally delineated centres, and it won't be one size fits all because it won't work that way and it's not practical. There would be primary healthcare networks or Aboriginal community-controlled organisations aligned with local health districts.
"In a sense, it's bringing the system together, it's not reinventing the system. It's learning from where things are working really well already ... [and] ensuring the local population is engaged, and having a solution that will really make a difference."
Professor Talley is optimistic a national approach can lead to positive outcomes for Aboriginal and Torres Strait Islander people.
"Assuming we can get this in to practice, incorporating indigenous leadership, ensuring we have culturally safe and equitable people-centred, family-orientated care, we will make a real difference. And I think this is feasible," he said.