Cultural Respect and Consumer Directed Care
Over the last month I have been facilitating workshops with front-line Aboriginal staff working across NSW to start a conversation about the changes being implemented in disability and aged care services. The front-line staff have raised many concerns about the confusion for Aboriginal people on what the changes in aged care and the roll out of the National Disability Insurance Scheme actually mean for older people, people with disabilities and their families.
Any reforms in aged care and disability services for Aboriginal and Torres Strait Islander people and communities should be embedded in the principles of cultural respect. The principles of cultural respect include: trust; recognition and valuing of Aboriginal and Torres Strait Islander culture and heritage; and collaborative partnerships and genuine participation of Aboriginal and Torres Strait Islander voices in decision-making. Cultural respect in the context of service delivery is more than just the visible provision of services that are deemed to be ‘culturally appropriate’. It is about the machinations and systems of an organisation demonstrating respect for the values, knowledge and insights that come from understanding Aboriginal worldviews and the incorporation of these into program, policy and service system design and delivery.
Embedding Cultural Respect in the Change Process
If cultural respect was embedded in the implementation of Consumer Directed Care and individualised funding for older Aboriginal and Torres Strait Islander people and people with disabilities then what would this look like? Firstly, Aboriginal and Torres Strait Islander people should have been consulted and engaged across Australia about the proposed changes in aged care and disability services before they were implemented. There has been some testing of what the National Disability Insurance Scheme will look like for Aboriginal and Torres Strait Islander people in the Barkly trial site in the Northern Territory. In contrast, there has been little testing of what Consumer Directed Care means for older Aboriginal and Torres Strait Islander people across Australia.
Secondly, there would have been education and preparation for Aboriginal and Torres Strait Islander people about what these changes mean for them and how to make the most of these changes. In NSW there have been education and workshops for Aboriginal people living with disability and their families, through the Aboriginal Disability Network and through My Choices Matters in preparation for the roll out of the NDIS. In contrast there has been very little preparation of older Aboriginal people for the implementation of Consumer Directed Care in Aged Care.
More work is needed in engaging Aboriginal and Torres Strait Islander people and communities in how models of consumer directed care and individualised funding will impact on their support and communities. The KPMG formative evaluation of Home Care Packages in aged care identified the need for further engagement with Aboriginal people. Aboriginal and Torres Strait Islander people need to have a voice and have their knowledge and insights heard and respected in the implementation of reforms in aged care and disability services.