Aboriginal participation in health service delivery : coordinated care trials in the Northern Territory of Australia

Australian Aborigines have much higher rates of illness and life expectancy, up to 20 years lower than the Australian population as a whole. Community based primary healthcare to Aborigines in the Northern Territory of Australia has, historically, been under-resourced, in part due to distinctive characteristics of the Australian healthcare funding system which has disadvantaged rural and remote regions. From 1998, the Northern Territory was the site of two Coordinated Care Trials (CCTs) which sought to achieve three main objectives: to significantly increase funding available to health services; to implement a system of clinical best practice; and to improve Aboriginal participation in health service delivery through the establishment of Aboriginal community health boards to act as funds managers and providers of health services to the trial populations. The paper outlines general CCT outcomes according to the findings of the commissioned evaluation studies and examines the possibilities and constraints encountered in improving Aboriginal participation in complex health service developments