Negotiation of culturally safe practice for individuals, organisations and the health system

Ms Robyn Williams1

1CDU, Darwin, Australia


This presentation shares the author’s insights and questions about the position of national rural and remote health organisations regarding cultural safety.

Over the last few years there have been a number of events that have engendered considerable and robust discussion about this topic. Three of the recent occurrences that prompted this paper are: 1. The AHPRA public consultations on a proposed definition of cultural safety; 2. The NRHA cultural safety project; and 3. The CRANAplus Introduction to Culturally Safe and Inclusive Practice Module.

There is still considerable debate about the definition and applications of cultural safety resulting in ongoing conceptual confusion and lack of clarity of purpose and responsibility.

Cultural safety is a “philosophy, an epistemology, and a practice” (Cox & Best, 2019), and is about the cultures of practitioners, professions, and systems. Therefore, it is a model that can and should be applied across the spectrum of health service users and not simply focused on one particular ethnicity or category.

The author wholeheartedly and actively supports Indigenous organisations’ right to develop a specific cultural safety model in keeping with determining their own approaches and outcomes. This right is not being contested here.

However, in the current debate about cultural safety, there is often conflation with Indigenous health issues and priorities; hence a lack of recognition or acknowledgement of the normalcy of culture for all, or of the equal importance of acknowledging social construction of gender, class, race, age and sexual orientation.

It is not the author’s intention to critique the three events mentioned earlier, instead these will be discussed in relation to various national health organisations’ potential role and responsibilities to bring about culturally safe practice that meets everyone’s needs.


Robyn has nursing and education qualifications and nearly forty years of experience of working with Indigenous peoples, primarily in the NT but also all over Australia.

This year Robyn is on leave from Charles Darwin University where she teaches Indigenous health, cultural safety, and rural and remote health. She is also working with various Indigenous health and rural and remote health organisations and projects and is co-editing a textbook on cultural safety and diversity in health care.

Robyn recently submitted her PhD thesis on exploring preparation for health professionals to be effective practitioners in Indigenous primary health care settings.