Noel Hayman: Improving Aboriginal and Torres Strait Islander access to a Mainstream Health Service using a Centre of Excellence Model: The Inala experience

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About the speaker

Dr Noel Hayman was one of the first two Indigenous medical students to graduate from the University of Queensland in 1990. Noel is Clinical Director of the Inala Indigenous Health Service in Brisbane. In developing this service, he has been instrumental in demonstrating how mainstream primary health care services can be made appropriate to the needs of urban Aboriginal populations. Noel’s interests include improving Indigenous access to mainstream health services and supporting medical education in Indigenous health.

Noel received the 2003 Centenary Medal for his long service to primary health care in Aboriginal communities and the 2007 inaugural Close the Gap Indigenous Health Award (Australians for Native Title and Reconciliation Queensland). In 2011 he was Queensland Australian of the Year. Noel is on numerous National and State Committees.

Seminar recording

Seminar overview

Lack of appropriate health service provision for Aboriginal and Torres Strait people in Australia still remains an important social determinant of ill health. Historically, health services have been absent or inappropriate. Cultural factors, financial factors and distance from health services have been important barriers limiting indigenous access to mainstream health services. Aboriginal and Torres Strait Islander people access primary and specialist care poorly. Only five percent of our Indigenous patients were accessing Hospital based specialist clinics.

The Inala Indigenous Health Service (IIHS), a mainstream health service has been in operation since 1995. In the first year of operation only 12 Indigenous patients were identified. Today the service has over 10,000 patients registered with around 4,000 regular patients. The IIHS has been analysing Adult Health Check data aged 15-54 years since 2009. The Adult Health Checks provide an opportunity to evaluate health status, identifying chronic disease risk factors and for implementing preventive care. For every 26 health checks completed and new diabetic is diagnosed. High prevalence rates of CVD risk factors were found.

The high quality primary health care service delivery provided by the IIHS has been recognised by Queensland Health. Queensland Health in 2010 provided $7M to build a Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care and $2M recurrent to staff the new Centre. At the official opening in July 2013, another $10.5 M was announced by Queensland’s health minister to build an adjoining Centre to house allied health, Community workers and research.

Aims of the Centre of Excellence

1. Improve health outcomes for Aboriginal and Torres Strait Islander people through high quality primary health care service delivery.
2. Provide an integrated structure to address the current shortfalls in workforce development in Indigenous settings. This will be achieved by establishing strong links with the Faculty of Health Sciences at Universities to deliver high quality teaching to Health Science students (medical, nursing and allied health). Training advanced trainees from Colleges will also be a priority.
3. To develop a research agenda focusing on Indigenous chronic disease and child and maternal health.
4. To integrate specialist care into a Primary health Care Setting.
5. Establish a health team that would provide expert outreach clinics to areas where Indigenous access to primary health care is problematic.

Since establishing the Centre of Excellence a range of specialties have been integrated into our service delivery; including Cardiology, Ophthalmology, Endocrinology, Pediatrics, Hepatology, nephrology, Psychiatry, Rheumatology, Dermatology, Rehabilitation Medicine and Geriatrics. All Specialist Clinics have a higher attendance rates compared to Public Hospital Specialist Outpatients.