‘And the right reality is if governments are truly trying to close the gap, you know, like, close the gap has been on the agenda for years now. And if they were serious about doing that, any of that work should be complemented by an anti-racism (approach) or underpinned by anti-racist ways of working.’82 However, First Nations stakeholders felt that it is unclear how including a specific antiracism requirement in the National Agreement would work in practice, and that there was ‘no guidance or detail on how to operationalise it’.83 A key barrier identified to achieving change was the lack of accountability across policy frameworks, including the National Agreement. Stakeholders maintained that this requires significant attention to address existing targets and enhance existing provisions concerning racism: ‘…we just see so many times, you have these beautiful frameworks and plans and what have you, especially the national ones, and you start to see state and the jurisdictions cherry pick little bits and pieces because no one is holding them to account.’84 As noted elsewhere in this report, First Nations stakeholders raised the need for monitoring and evaluation approaches to be embedded in government anti-racism work at all levels of government to ensure greater commitment. 4.4.2 Strengths The ongoing resilience and capacity of First Nations people and the Aboriginal and Torres Strait Islander community-controlled sector were identified as clear strengths in addressing racism and its effects. The progress made by the First Nations health sector was raised as noteworthy, with stakeholders emphasising that the introduction of the Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025 by the Australian Health Practitioners Regulation Agency (AHPRA) with the aim of eliminating racism from health settings had been impactful. This Strategy is now part of AHPRA’s core business and, since the introduction of legislation in December 2023, has led to action being taken to address racist behaviour by health practitioners.85 Offering an avenue for complaints provides a level of protection for First Nations health practitioners and patients. Given what is known about the extent of racism experienced by First Nations people in health settings, this reform has the potential to lead to genuine systemic change in the health system. 82 First Nations stakeholder. 83 First Nations stakeholder. 84 First Nations stakeholder. 85 First Nations Stakeholder and AHPRA (2023) Doctor banned for discriminatory and offensive behaviour, accessed 12 February 2024 45