Consultations in various locations indicated that there is often little direct contact or co-operation between NSP services and local Aboriginal Medical Services or other Indigenous-specific services. Workers at a secondary NSP in one town noted that although their organisation had a good working relationship with the local AMS, there was never any comment or input from the latter relating to NSP services. Building closer relationships or partnerships around BBV infection and drug use was thus seen as having the potential to improve access to services for Indigenous IDUs. A non-Indigenous stakeholder in Melbourne commented that service providers found themselves 'in a bit of a quandary' as to how best to meet the needs of Indigenous IDUs; in part this was because there was little if any pressure or advocacy on this subject from Indigenous organisations.

A number of stakeholders believed that Aboriginal Health Workers generally have insufficient training in issues around hepatitis C. People consulted in Cairns, for example, emphasised that need for increased training relating to hepatitis C for both mainstream and Indigenous health personnel. It was also apparent in discussions at some Aboriginal Medical Services that staff did not know much about local NSP services. Some specifically made this point themselves; in other instances AMS workers were unable to offer information about NSP services or else gave inaccurate information.

Staff consulted at one or two AMSs commented that they did come across clients who were injecting drugs, when they visited the service for other reasons. Some medical services (eg at Mt Druitt in western Sydney) had pamphlets on safe injecting available. Staff members consulted at WuChopperen Health Service in Cairns were familiar with the local NSP outlets, and stated that they made reference to safe injecting in their health education work – including work in schools. At another medical service, senior staff reported that AHWs and nurses were happy to distribute clean equipment to clients who requested it; conversation with frontline staff members, however, suggested that some were in fact quite reluctant to do this.

At WuChopperen in Cairns it was said that Board members were open-minded and realistic on issues such as services for IDUs – 'They don't bury their head in the sand'. The possibility of operating an NSP had been considered, but the judgement was that the existing mainstream services were currently adequate. Similarly, Congress in Alice Springs was reported to be clearly committed to harm minimisation principles and to have considered the possibility of offering NSP services; however it had concluded that the existing local services were currently adequate for Aboriginal people. In Darwin it was said that there were small numbers of referrals to the NTAHC NSP from the Danila Dilba Health Service, but that drug injecting was 'a pretty taboo subject' in the community. When asked whether their medical service might consider introducing an NSP, staff at one AMS replied 'You'd be pushing the friendship there'.
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There are some medical services – eg the Aboriginal Medical Service Western Sydney Co-op – which operate a methadone program. It was suggested here that the methadone clients were probably 'the tip of the iceberg' in relation to injecting drug use. Establishing the methadone program at western Sydney had reportedly been controversial within the Service, and 'took a long time'. However, its operation was said to have helped inform and change some staff and Board attitudes around drug injecting.

The range of reasons why Aboriginal Medical Services may be reluctant to provide NSP services is further discussed in section 3.2.3 of this report. Some people emphasised, however, that an Aboriginal health service did not need to be an NSP provider in order to play a constructive role in reducing the spread of BBV infections among IDUs. For example, a health service could demonstrate support for NSP services by providing information pamphlets and the like, offer hepatitis C testing, provide advice on meeting Indigenous IDUs' needs, raise awareness among its staff, and make referrals.