Beyond the Biomedical Paradigm: The Formation and Development of Indigenous Community-Controlled Health Organizations in Australia

Int J Health Serv. 2015;45(3):471-94. doi: 10.1177/0020731415584557.


This article describes the formation and development of Aboriginal Community-Controlled Health Services in Australia, with emphasis on the Redfern Aboriginal Medical Service in Sydney. These organizations were established in the 1970s by Indigenous Australians who were excluded from and denied access to mainstream health services. The aim of this research was to explore notions of Indigenous agency against a historical backdrop of dispossession, colonialism, and racism. Aboriginal Community-Controlled Health Services act as a primary source of healthcare for many Indigenous communities in rural and urban areas. This study examined their philosophy of healthcare, the range of services provided, their problems with state bureaucracies and government funding bodies, and the imposition of managerialist techniques and strategies on their governance. Essentially, these organizations transcend individualistic, biomedical, and bureaucratic paradigms of health services by conceptualizing and responding to Indigenous health needs at a grassroots level and in a broad social and political context. They are based on a social model of health.

Keywords: health services; indigenous; managerialism.

Publication types

  • Historical Article

MeSH terms

  • Australia
  • Community Health Services
  • Financing, Government
  • Health Services, Indigenous / economics
  • Health Services, Indigenous / history
  • Health Services, Indigenous / organization & administration*
  • Healthcare Disparities
  • History, 20th Century
  • Humans
  • Native Hawaiian or Other Pacific Islander*
  • Politics
  • Qualitative Research
  • Racism
  • Social Change