Advocating for Health Equity Following the passing of the Health Legislation Amendment Act 2020 (the Act) in August 2020, amendments were made to the Hospital and Health Boards Act 2011 requiring Hospital and Health Services (HHSs) to develop and implement Health Equity Strategies. A subsequent piece of legislation, the Hospital and Health Boards (Health Equity Strategies) Amendment Regulation 2021 (the Regulation) is due to be considered by the Executive Council (Cabinet) soon. According to the Act, the Regulation will define who must be involved in the development and implementation of a Health Equity Strategy (prescribed persons), and the way in which they must be consulted. Consultation workshops have commenced across the state, and will continue into June. The aim of these workshops is to understand the types of support required for Health Equity Strategies (HES) to be successful. The vision is that HHSs will co-design, co-own and co-implement HESs with their local Aboriginal and Torres Strait Islander Community Controlled Health Organisation (ATISCCHO) and other partners. What the journey looks like in practice will be influenced by these consultations and the legal requirements that will be outlined in the Regulation. Members should have received a copy of the Health Equity Discussion Paper which outlines the context
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Sector Leader M AG A Z I N E
Making Tracks
towards health equity with Aboriginal and Torres Strait Islander peoples—working together to achieve life expectancy parity by 2031 Discussion paper: a shared conversation
for health reform, the content of the Health Regulation and longterm reform opportunities.
determine their political status and freely pursue their economic, social and cultural development”.1 Similarly, according to the United Nations Declaration on the Rights of Indigenous Peoples, “Indigenous peoples have the right to determine and develop priorities and strategies for exercising their right to development. In particular, Indigenous peoples have the right to be actively involved in developing and determining health, housing and other economic and social programmes affecting them and, as far as possible, to administer such programmes through their own institutions”.2
The following principles are consistently raised by Members and QAIHC is advocating that they must underpin the health equity agenda:
Partnerships and co-design
The term ‘co-design’ reflects shared decision-making authority through genuine partnerships. Partnerships require the sharing of decision-making, power, control, resources, responsibility and accountability. In partnerships, trust is built and there is an agreed and shared purpose, vision and intent in working together in a supportive and transparent way. Partners design and review outcomes together and problem solve solutions. In other words, strategies must include co-design, co-development, co-implementation and coevaluation with Queensland Health, Hospital and Health Services (HHSs) and ATSICCHOs, which are formalised through agreements.
Self-determination
Self-determination is a principle preserved in international law. According to law, all peoples have the right of self-determination and “by virtue of that right they freely
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For Aboriginal and Torres Strait Islander peoples in Australia, the right to self-determination has, and continues to be, of fundamental importance in improving health and wellbeing outcomes.3
Community-driven solutions
When Aboriginal and Torres Strait Islander peoples take charge of developing their own strategies, they better reflect their interests, values, vision and concerns, increasing ownership and accountability.4 A communitydriven approach to health policies and programs is the true reflection of self-determination
