Older people from multicultural communities and their access to, and experience of, healthcare

Older people from culturally and linguistically diverse communities can face significant barriers when accessing healthcare in Western Australia. These barriers extend beyond language differences and include difficulties navigating the health system, digital exclusion, transport, cultural understanding, trust, trauma, and limited awareness of available services.

To better understand these experiences, Health Consumers’ Council WA (HCCWA) convened a Diversity Dialogues forum bringing together community leaders, healthcare professionals, researchers, service providers and consumers. Participants shared lived experience, professional insights and practical examples of the challenges older people encounter when seeking healthcare and aged care.

Across diverse communities, participants consistently identified common issues. These included difficulties accessing information and services, limited cultural responsiveness within healthcare settings, challenges using digital systems such as MyGov and My Aged Care, and the importance of building trust through long-term community relationships.

The discussion also highlighted practical solutions already being implemented across Western Australia. Community-led navigation services, culturally responsive education, Care Finder programs and stronger partnerships between community organisations and health services were identified as important approaches to improving access and health outcomes.

The findings reinforce the importance of involving multicultural communities in the planning, design and delivery of healthcare services. They also demonstrate that improving equitable access requires both system-level change and ongoing collaboration with the communities most affected.

About Diversity Dialogues

Diversity Dialogues is an ongoing initiative of Health Consumers’ Council WA that brings together consumers, community organisations, healthcare providers and policymakers to explore issues affecting culturally and linguistically diverse communities.

The forums provide an opportunity to share lived experience, identify barriers to healthcare, and develop practical recommendations that can improve health services across Western Australia.

Key Findings

Read the in-depth report here.

1. Healthcare systems are often difficult to navigate

Participants described healthcare and aged care systems that can be difficult to understand, particularly for people who migrated to Australia later in life or who have limited English proficiency.

Common barriers included:

• complex forms and eligibility processes
• difficulty using MyGov and My Aged Care
• limited awareness of available services
• uncertainty about how to access support

Many participants emphasised that services may exist, but understanding how to access them remains a significant challenge.

2. Language and communication remain significant barriers

Participants discussed how language barriers affect every stage of healthcare.

Challenges included:

• limited English proficiency
• low literacy in any language
• complex medical terminology
• translated information that does not reflect cultural context
• interpreter availability and quality

Some participants also described concerns about privacy when interpreters come from small local communities.

These communication barriers may contribute to misunderstanding, delayed care and reduced confidence in healthcare services.

3. Trust is essential for good healthcare

Many participants explained that trust strongly influences whether people seek healthcare.

Past experiences of conflict, displacement, trauma or negative interactions with institutions can influence how some older people engage with Australian healthcare services.

Participants noted that trust often develops through long-term relationships with healthcare professionals and trusted community organisations rather than through single appointments.

4. Cultural understanding influences healthcare experiences

Participants shared examples where cultural practices or expectations had been misunderstood within healthcare settings.

Examples included:

• differing expectations about family involvement in care
• culturally appropriate food during hospital stays
• differing understandings of ageing and illness
• differing expectations about consultation length

Participants suggested that greater cultural understanding could improve communication, person-centred care and consumer experience.

5. Digital exclusion is becoming a healthcare barrier

As healthcare increasingly relies on digital systems, many older consumers experience additional barriers.

Participants highlighted difficulties using:

• MyGov
• My Aged Care
• online appointment systems
• SMS verification
• email-based communication

Without practical support, digital systems may unintentionally reduce access for older people with limited digital literacy.

6. Social isolation increases health risks

Participants described social isolation as an important contributor to poorer health outcomes.

Examples included:

• delayed assistance following falls
• reduced access to appointments
• fewer opportunities to receive health information
• increased loneliness

Community organisations highlighted the importance of regular outreach and trusted relationships to reduce isolation.

Community-led solutions

The forum highlighted several initiatives already improving access for multicultural communities across Western Australia.

These included:

• Care Finder services
• community health navigation
• digital literacy programs
• culturally responsive community education
• seniors’ support programs
• intergenerational community initiatives

Participants emphasised that community-led approaches help build trust and support people to navigate complex healthcare systems.

Recommendations

The discussions identified several opportunities to improve healthcare access for older people from multicultural communities.

These include:

• Increase cultural responsiveness across health and aged care services.
• Improve representation of culturally and linguistically diverse consumers in health service planning and decision-making.
• Expand community-led navigation and Care Finder services.
• Improve access to face-to-face assistance with digital health systems.
• Increase awareness of available health and aged care services through trusted community organisations.
• Strengthen partnerships between health services and multicultural communities.
• Ensure culturally appropriate food, communication and care are recognised as components of quality healthcare.
• Continue investing in community-led mental health education and culturally appropriate support.

What this means for Western Australia

The experiences shared during this forum demonstrate that improving healthcare access for older people from multicultural communities requires more than translation services alone.

Participants described the importance of trust, culturally responsive care, accessible information, community leadership and meaningful partnerships.

Many of the barriers identified are interconnected. Addressing them will require collaboration between consumers, community organisations, healthcare providers and government.

By listening to lived experience and working alongside multicultural communities, Western Australia has an opportunity to create a more equitable, accessible and person-centred health system.

It is also worthwhile considering that improvements to help older people from multicultural communities would benefit everyone in WA, for example trust, accessible information and meaningful partnerships make healthcare fair for all.

Acknowledgements

Health Consumers’ Council WA thanks the forum panellists, participants and community organisations who generously shared their knowledge, lived experience and practical insights.

The experiences documented in this report reflect the views shared during the forum and are intended to inform ongoing discussion, collaboration and continuous improvement across Western Australia’s health system.

About Health Consumers’ Council WA

Health Consumers’ Council WA is the independent peak body representing health consumers across Western Australia. HCCWA works alongside consumers, carers, communities, clinicians and policymakers to improve access, equity, safety and person-centred care across the health system.

What is culturally safe GP care? New research from Aboriginal and Torres Strait Islander consumers

A new paper, “Towards assessment of culturally safe general practitioners: co-designing with Aboriginal and Torres Strait Islander peoples’ perspectives, the Calgary–Cambridge guide and clinical yarning”, published in the Australian Journal of Primary Health on 25 May 2026, puts Aboriginal and Torres Strait Islander consumer voices at the centre of the conversation about cultural safety in general practice.

The research was carried out in Queensland across four sites, including three Aboriginal Medical Services and one mainstream general practice, spanning regional, rural and very remote communities. A total of 131 Aboriginal and Torres Strait Islander people took part through surveys, interviews and group processes. The work was guided by an Aboriginal Community Reference Group to ensure the findings reflected community perspectives.

This research matters because cultural safety is often discussed in policy or training settings, but less often defined by consumers themselves.

What Aboriginal and Torres Strait Islander consumers said matters most

Participants were clear about what they expect from a GP consultation. The priorities people identified were not theoretical; they were grounded in what really helps people feel respected, understood and confident about their care.

The most important attributes were:

• knowing how to diagnose and treat disease properly
• explaining things clearly, using basic words
• greeting people respectfully
• not stereotyping Aboriginal people
• listening carefully

Other highly ranked elements included recognising what matters to the patient, not interrupting, being polite and respectful, creating a welcoming environment, and providing enough time for the appointment.

These findings show that culturally safe care is not something separate from everyday practice but is built through how care is delivered and whether people feel heard and taken seriously.

What does culturally safe care look like in a GP appointment?

Consumers said they want GPs who get clinical care right, use plain language, listen without interrupting, speak respectfully and as an equal, and avoid assumptions.

Participants also described the importance of privacy, comfort, and having enough time in appointments. Cultural safety also sits in the environment, including how welcoming the service feels, whether privacy is maintained, and whether people feel comfortable in the space.

What consumers want to see change

Consumers are asking for consistent, high-quality clinical care, clear communication, genuine listening, respectful interactions, freedom from stereotyping, and adequate time, privacy and follow-up.

There was also a strong message about consent. Participants wanted control over who is involved in their care and how information is shared, including during consultations, procedures and examinations.

Participants also valued continuity of care. Seeing the same GP over time, not having to repeat their story, and having follow-up on results and referrals all contributed to feeling safe and supported.

Important findings about culture and identity

Participants had mixed views about being asked about Country, Mob or cultural identity. For some, this was helpful. For others, it was intrusive or distressing, particularly where identity had been questioned or where people were disconnected from family or community. The paper recommends allowing these conversations to develop over time, rather than making them a standard opening question.

The research also goes further in challenging routine identification processes in general practice. It highlights that asking people to identify as Aboriginal or Torres Strait Islander in a standard administrative way can create fear of stereotyping, mistrust and disengagement. It points to the need for safer systems, where identity can emerge over time through relationships and where access to supports does not depend on a process that can cause harm.

What this means for general practice

The authors recommend strengthening existing GP consultation approaches by embedding relational practices such as respectful greeting, listening and clear communication, and integrating elements of social yarning into standard practice.

The paper also challenges commonly taught approaches. It shows that practices such as asking about Country, using silence, or trying to find common ground should not be assumed to be culturally safe for everyone. These approaches need to be used carefully and in response to the individual.

Where to next

Suggested future work includes testing the proposed consultation model in real settings and developing tools to assess cultural safety from a consumer perspective. This research was conducted in specific Queensland communities, and further work is needed across different regions and communities.

Why this matters in Western Australia

This paper provides clear direction based on what Aboriginal and Torres Strait Islander consumers have said themselves.

The key message is straightforward, people want care that is clinically sound, clearly explained, respectful, and free from judgement or stereotyping.

For services, this means reviewing how care is delivered and making practical changes that reflect these expectations.

Further reading & reference

Training for healthcare professionals

The insights in this article reflect what Aboriginal and Torres Strait Islander consumers have shared with HCCWA over many years. They also inform the content of our Aboriginal Patient Advocacy Training, where we work with community workers, advocates and health professionals to turn these insights into practical skills. Visit our training and events page to register for our next training session, or contact us to find out more.

Further reading

Brumpton K, Evans R, Sen Gupta T, Ward R (2026) Towards assessment of culturally safe general practitioners: co-designing with Aboriginal and Torres Strait Islander peoples’ perspectives, the Calgary–Cambridge guide and clinical yarning. Australian Journal of Primary Health, 32, PY25245. doi:10.1071/PY25245

ABSTRACT
Background. Cultural safety is a key component of quality general practice for Aboriginal and Torres Strait Islander peoples; however, few tools exist to assess this from the patient’s perspective. This study aimed to explore the qualities of a general practitioner (GP) that support culturally safe consultations, as described by Aboriginal and Torres Strait Islander peoples, and to examine how these align with two consultation models: the Calgary–Cambridge Guide and clinical yarning. Methods. A mixed methods approach was used, including a survey, qualitative interviews and a modified nominal group technique (mNGT). Participants were Aboriginal and Torres Strait Islander peoples who had previously engaged with general practice care. Data were both described and analysed thematically. Results. In total, 131 Aboriginal and Torres Strait Islander peoples participated (70 in the survey and interview; 43 in mNGT to validate the findings; and 18 in three separate mNGTs to rate desirable attributes of a GP). Participants identified several qualities underpinning a safe GP consultation. Within the top five attributes in the mNGT were universal skills – clinical competence, avoidance of jargon and attentive listening – alongside welcoming patients with a greeting and avoiding stereotyping. Although there was strong emphasis on respectful, individualised care, preferences varied significantly, highlighting the limitations of a generic approach to consultation skills. Some findings challenged core assumptions regarding clinical yarning and elements of cultural safety training. Conclusion. We propose a refined, integrated consultation model that enhances the Calgary– Cambridge Guide with relational elements of the social yarn, particularly during initiation of the consultation. This integrated model, grounded in Aboriginal and Torres Strait Islander peoples’ perspectives yet familiar to GPs and academics, offers a promising foundation for culturally safe practice and assessment, with potential applicability across other diverse populations.

Keywords: Aboriginal and Torres Strait Islander health, Australia, Calgary–Cambridge guide, clinical yarning, cultural safety, equity, general practice, Indigenous health care.