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How CPD can help reduce health equity and improve cultural safety
Cultural safety is essential in reducing health disparities and achieving health equity for patients in Australia and Aotearoa New Zealand. The revised CPD standards from the Medical Board of Australia and the Medical Council of New Zealand Te Kaunihera Rata o Aotearoa each emphasise the centrality of reflective and outcome focused CPD activities in supporting the provision of an accessible and culturally safe environment for patients. Launched on 1 July 2021, the new RACS CPD program provides greater recognition of professional development activities that assist to embed cultural safety across the health system and which improve the health outcomes of First National Australians and Māori communities. It is one among a raft of measures RACS is undertaking to help close the health gap between Indigenous and non-Indigenous communities in Australia and Aotearoa New Zealand. RACS Māori Health Advisory Group Chair, Dr John Mutu-Grigg hopes that these changes can help address structural inequities present in the health sector in both countries that leads to a disparity in health outcomes.
“What most people understand is that there are certain people who the current way of doing things works for, but there is another group of people that it doesn’t work for,” Dr Mutu-Grigg said. “That is because the current health system is designed for the majority, which is reasonable. But now that we have a way to address the majority, it is appropriate that we start to try and address those people that have been left behind. “These tend to be the minorities, particularly the Indigenous populations of Australia and Aotearoa New Zealand, or any single colonised country around the world.” Dr Mutu-Grigg points to a bowel cancer screening program introduced in Aotearoa New Zealand as an example of how a mainstream system can disadvantage Indigenous communities. The program offered screening to people aged 60 to 75 years, which was the highest risk group among non-Māori. However, the initial pilot study showed that 58 per cent of Māori females and 52 per cent of Māori males present with bowel cancer from between the ages of 50 and 60 years. Therefore, by design the
new screening would knowingly exclude over half of Māori bowel cancers. It took significant advocacy over a long period from health professionals for the program to be adjusted to include this group, but the change will not occur until 2023. “We need to understand that different people have different requirements,” Dr Mutu-Grigg said. It is not just First Nations Australians and Māori that will benefit from improving cultural safety and health equity; surgeons will also gain new skills and improve their outcomes. “As surgeons, we all want to get better results for all of our patients. We fly around the world to learn new things— this is one thing that we can learn that can have a big impact on our outcomes.” An existing University of Otago program that has been adapted specifically for surgeons, with input from RACS Māori Health Group. To date, it has been rolled out to trainers, with plans to offer it to all RACS Trainees, and more widely in the future.
