I never said Aboriginal health workers are charlatans

Sara Hudson

13 April 2012

In the wake of the release of my report Charlatan Training: How Aboriginal Health Workers are Being Short-changed, I have been accused of calling Aboriginal Health Workers (AHWs) charlatans.

This statement grossly misinterprets what I said. I did not blame Aboriginal health workers; rather, I blamed the system and the Registered Training Organisations (RTOs) for failing AHWs with substandard training.

The fact that some AHWs – with Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care Practice – perform well in highly responsible positions did not escape my notice. However, the variability of the roles and functions of AHWs, and the lack of a nationally consistent definition of Aboriginal health work, undermines their relationship with other health personnel and contributes to AHWs feeling undervalued.

A 2010 review of AHW training in the Northern Territory, the Aboriginal Health Worker Profession Review, cited in my report, noted that regular monitoring of AHWs’ performance in the workplace was limited. There were few structured approaches to performance appraisals and management, so that good performance was not recognised and poor performance was not held to account. The review found that some managers avoided confronting AHWs about their performance, and in some services there were high levels of absenteeism and presenteeism (being at work without working).

The national Indigenous newspapers frequently run advertisements offering free training for Aboriginal health work. It seems RTOs are given so many financial incentives by government to deliver training to Aboriginal people that they do not have to charge students course fees.

Although this may seem like a benign policy designed to increase the number of Aboriginal people working in health, it has also led to a lack of accountability. Rather than complaining about substandard training and demanding their money back, AHW students simply drop out. At an RTO in Western Australia, of the 60 students enrolled in health worker training last year, 36 withdrew before completing the course. Presumably the RTOs got the money they wanted when the students were enrolled, so improving course delivery or retaining student numbers was of no concern to them.

I expected to receive some flak from those with a stake in maintaining the status quo. But I was criticising the Aboriginal health industry and RTOs – not the AHWs personally.

Only vested interest groups would argue that Aboriginal people don’t deserve better training. Instead of continuing with separate training and careers that tend to entail lower standards of entry, pass rates, and inferior pay, Aboriginal people should be encouraged to take up broader and more widely recognised qualifications and careers such as nursing.

Sara Hudson is a Research Fellow at The Centre for Independent Studies. Her report, Charlatan Training: How Aboriginal Health Workers Are Being Short-changed, was released in March.

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