Australian Health Review November 2008 Vol 32 No 4 639 Indigenous Health Aust Health Rev ISSN: 0156-5788 1 November 2008 32 4 639-647 ©Aust Health Rev 2008 www.aushealthre- view.com.au Indigenous Health Abstract 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 manage- ment 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 organisa- tional change management processes, and fea- tures 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 funda- mental 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 manage- Aust Health Rev 2008: 32(4): 639–647 ment processes both internally and externally. IT HAS OFTEN BEEN SAID that the surest way to fail in the long term is to continue doing what you have always done. 1 The same can be said for efforts to improve health of Aboriginal people, as demonstrated by the health status of the Indi- genous versus non-Indigenous populations. “Over the period 1999–2003, Indigenous males and females died at almost three times the rate of non-Indigenous males and females. Indigenous Australians also had higher rates of mortality from all major causes of death.” 2 (page 178) The need to change the service model to address the discrepancies in health status has led to a renewed interest within Queensland Aborigi- nal and Torres Strait Islander communities in taking control of health service delivery where Leanne L Coombe, Consultant Apunipima Cape York Health Council, Cairns, QLD. Correspondence: Ms Leanne L Coombe, PO Box 134, Stratford, Cairns QLD 4870. leanne_coombe@yahoo.com.au The challenges of change management in Aboriginal community-controlled health organisations. Are there learnings for Cape York health reform? Leanne L Coombe What is known about the topic? There is considerable literature available on change and organisation management. While there has been a recent increase in the literature on cross- cultural interpersonal relations in management and the need for effective governance and management of Aboriginal community-controlled health organisations, there is a gap in any detailed analysis of these issues combined. What does this paper add? This paper contributes to understanding effective Aboriginal and Torres Strait Islander health intervention strategies through examining Western change and organisational management processes and how they can assist community-controlled health organisations and both non-Indigenous and Aboriginal management staff to undertake major organisational reforms to improve the health of Aboriginal and Torres Strait Islander people in Australia. What are the implications for practitioners? The findings of this paper indicate that any health intervention strategies for Aboriginal and Torres Strait Islander communities need to be based on participatory change management processes and a fundamental systems change management approach that recognises change as an inherent quality of a living system, not an imposed driving force, in order to ensure that the interventions will be sustainable.