Part Four: Emerging Issues

• Focus Groups
• Worker's Compensation
• Counselling Needs
• Infrastructure and Equipment

Focus Groups

Focus groups were accessed in the communities from existing groups, e.g. Health Action Groups or Justice Groups, Prison Inmates, Women's Refuge Centre Workers, and the Community Councils (see examples, Appendix B). Often attendance at a focus group meeting would lead to further discussions with elders and other concerned community members at an individual level. (see Appendix C).

This allowed the impact of accidents and injuries on the community to be assessed, while promoting a general awareness in the communities of the value of the project. It also allowed for a closer relationship with Aboriginal people for the documenting of the relevant injuries. The community perspective generated from focus groups identified jealousy as the principal cause of person to person conflict. (Appendix B).

Focus groups identified that in some communities males were having difficulty in accepting the perceived freedom of their spouse/ girlfriend whilst they themselves were obligated to employment under the C.D.E.P. scheme. Focus groups also revealed that payback is an issue within communities. (Appendix B andAppendix C)

Concern was regularly expressed about the apparent inability of younger parents to care for their children. The responsibility of the care of the children was too often left to the older grandparents who in many cases were struggling with health problems themselves. This caused a breakdown in the family structure. (Appendix C1, and supported in case study themes.)

Persons returning from extended stays in prison have revealed the difficulties in their acceptance back into communities. They felt that while many community members were supportive of them, they were often victims of person to person conflict which regularly led to further prison terms. This conflict was often premeditated and provoked by elements in the community (both male and female) but always led to their persecution. They felt their inability to get work (C.D.E.P) for extended periods after their return also created tension.

Focus groups were very aware of the need for education as a means of overcoming many health issues. Examples given included:

• Counselling Focus groups in all communities have recognised the need for counselling. Instances of focus groups recognising the counselling needs of community members prior to serious injury, (including suicide) have been recorded. The lack of a support mechanism to assist these groups in addressing these issues has been identified.
• Social Alternatives Focus groups identified the need for education to be undertaken among the very young in relation to social values. It was felt that younger people were not being offered alternatives, and were exposed to violence and alcohol as an accepted part of their lifestyle.
• Payback The issue of payback as culturally acceptable was discussed on a number of occasions. It was felt that education into the use of meaningful mediation was required to overcome the sometimes violent outcomes. (Appendix C2)

Worker's Compensation

An overall lack of awareness exists within Aboriginal Communities with respect to their rights under both Workers Compensation and Third Party Insurance. (Appendix B and Appendix case study D2) This lack of education is apparent throughout the communities and often at a senior decision making level.

• Worker's Compensation
  This study has identified instances where the lack of knowledge in relation to workers compensation is affecting the health care of Aboriginal people. The lack of medical attention immediately after accidents, coupled with a loyalty to their employer (including C.D.E.P.) has resulted in long term health problems being inadequately attended to. Cultural issues relating to embarrassment and an acceptance of a disability have also been revealed. (Appendix D2)

  The issue of re-employment under the C.D.E.P. scheme after injury, has also been identified as a major deterrent in Aboriginal workers seeking Worker's Compensation.

  The large no-claim bonuses being offered to Aboriginal Community Councils are also a temptation to under-record workers compensation. Concerns in relation to under-recording, and the lack of verifiable statistical data for the funding of worker's compensation and workplace health and safety initiatives have been raised.

• Third Party Insurance
  Aboriginal people are generally not aware of either third party or third party property insurance, its role, or their entitlements under the scheme. (Appendix B)

  This study has identified an urgent need for education into these issues at all levels, including the cultural difficulties associated with claiming compensation. The possible need for litigation to be applied against a family and/or community member who may be the driver of the vehicle, is seen by many Aboriginal people as culturally inappropriate.

  It has been further identified that the cost of Registration and Insurance being paid by many Aboriginal people, has never been identified to them in the context of their insurance entitlements.

Counselling Needs

The lack of suitable community counselling services has been identified in most of these case studies. Counselling services and the need for a networking mechanism between these services and focus groups such as Justice and Health Action groups have been identified.

Infrastructure and Equipment

Instances of inadequate equipment and problems with equipment maintenance have been identified within this study. Instances of patient and health worker safety compromise have been identified, recorded and observed. A lack of appropriate equipment, particularly associated with clinic pick-up vehicles, back-up vehicles, and night time call outs has been identified in case studies. In many cases, a lack of appropriate maintenance of vehicles and equipment which could seriously affect patient access and safety was also identified.

In some communities it appeared that a lack of a clear cut administrative responsibility had been partly responsible for the maintenance problem. However the equipment supplied was in many instances inadequate for the specific needs of the community.