The challenges of change management in Aboriginal community-controlled health organisations. Are there learnings for Cape York health reform?

The health status of Aboriginal and Torres Strait Islander peoples continues to be significantly poorer than Australia's general population. Clearly there is a need for change, hence the renewed interest in transitioning to a community control model for health services as a health intervention. Yet this requires a significant change management process, which is a process developed using Western business philosophies, and may not be applicable for community-controlled services that need to operate within the Aboriginal cultural domain. This paper examines the literature on organisational change management processes, and features of Aboriginal community-controlled health organisations and Aboriginal management styles. It identifies challenges and synergies that can be used to inform more effective transition processes to a community-control model for health services. The findings also highlight the need for a fundamental systems change approach to achieve such major reform agendas through the creation of a "collective responsibility" to achieve the vision for change, utilising participatory change management processes both internally and externally.