This policy brief examines how systemic racism in Australian hospitals continues to affect the experiences and outcomes of Aboriginal and Torres Strait Islander patients, and outlines the evidence needed to drive reform. It highlights the need for a nationally coordinated approach led by Indigenous voices and backed by clear policy direction, consistent standards and comprehensive data collection. The brief provides five recommendations.

Far from isolated incidents, institutional racism in Australian hospitals is a systemic issue shaping patient experiences and clinical decision-making, and creating significant barriers to care. Culturally unsafe care erodes trust, deters people from seeking treatment and contributes to poorer outcomes. 

Although tools exist to assess institutional racism, their inconsistent use limits accountability and progress. Meaningful reform requires a coordinated, Indigenous-led approach that goes beyond fragmented or superficial efforts. This involves embedding cultural safety and anti-racism as core elements of healthcare delivery and governance. 

Healthcare institutions must move beyond tokenistic consultation and establish genuine partnerships that recognise and compensate Indigenous expertise in shaping policies and services. By standardising education, strengthening accountability and empowering communities to lead reform, Australia can begin to dismantle institutional racism and build a health system that is culturally safe, trustworthy and equitable for all.

Recommendations

1. Establish a national framework for cultural safety and anti-racism.
2. Mandate and standardise cultural safety and anti-racism education and training.
3. Implement independent and transparent complaints and reporting mechanisms.
4. Strengthen data collection and measurement of racism and cultural safety.
5. Enhance meaningful community engagement and shared decision-making.