Seasonal labour, systemic injustice: health inequities in the pacific australia labour mobility scheme
1
Centre > Health Equity in Regional and Remote Communities C>HERRC, CQUniversity, Rockhampton, Australia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Pacific Australia Labour Mobility (PALM) scheme seasonal worker participants make vital contributions to Australia’s economy. However, they face significant structural and social barriers to accessing healthcare while living and working in Australia. This research explored the barriers to access experienced by PALM Scheme participants in agricultural settings in far north Queensland, Australia. The study focused particularly on blood-borne viruses (BBVs) such as hepatitis B (HBV) and sexual health (STIs), and identified strategies to improve equity and responsiveness within the Australian health system.
METHODS:
A sequential mixed-methods design, integrating semi-structured interviews and surveys with PALM workers, healthcare providers, and employers. Co-designed workshops tested and refined policy and service-level recommendations. The research adopted a health equity lens, underpinned by human rights principles.
RESULTS:
A complex interplay of factors impacting healthcare access and navigation were described, revealing challenges beyond BBVs/STIs. System-level restrictions were identified, with mandatory private health insurance (and a lack of access to Australia’s Universal Health Coverage, Medicare) creating barriers and fragmented care due to inconsistent coverage and billing. Regional locations were associated with transport challenges and gaps in primary healthcare infrastructure. Systemic gaps lead to reliance on individual goodwill and informal workarounds by health providers and employers. Underlying these factors were concerns related to living and working conditions, and a fear of job loss/deportation leading PALM participants to conceal illnesses.
CONCLUSIONS:
The gaps identified in effective healthcare access call for considerable policy/funding shifts in order to provide respectful models of care for PALM seasonal workers, underpinned by better continuity of care. This includes a fundamental review of the health insurance system, access to universal health coverage, improved paid sick leave entitlements, and innovative models such as onsite healthcare, as well as screening and vaccination for HBV and STIs. Such models require strengthening cultural safety, guided by a co-designed approach.
Pacific Australia Labour Mobility (PALM) scheme seasonal worker participants make vital contributions to Australia’s economy. However, they face significant structural and social barriers to accessing healthcare while living and working in Australia. This research explored the barriers to access experienced by PALM Scheme participants in agricultural settings in far north Queensland, Australia. The study focused particularly on blood-borne viruses (BBVs) such as hepatitis B (HBV) and sexual health (STIs), and identified strategies to improve equity and responsiveness within the Australian health system.
METHODS:
A sequential mixed-methods design, integrating semi-structured interviews and surveys with PALM workers, healthcare providers, and employers. Co-designed workshops tested and refined policy and service-level recommendations. The research adopted a health equity lens, underpinned by human rights principles.
RESULTS:
A complex interplay of factors impacting healthcare access and navigation were described, revealing challenges beyond BBVs/STIs. System-level restrictions were identified, with mandatory private health insurance (and a lack of access to Australia’s Universal Health Coverage, Medicare) creating barriers and fragmented care due to inconsistent coverage and billing. Regional locations were associated with transport challenges and gaps in primary healthcare infrastructure. Systemic gaps lead to reliance on individual goodwill and informal workarounds by health providers and employers. Underlying these factors were concerns related to living and working conditions, and a fear of job loss/deportation leading PALM participants to conceal illnesses.
CONCLUSIONS:
The gaps identified in effective healthcare access call for considerable policy/funding shifts in order to provide respectful models of care for PALM seasonal workers, underpinned by better continuity of care. This includes a fundamental review of the health insurance system, access to universal health coverage, improved paid sick leave entitlements, and innovative models such as onsite healthcare, as well as screening and vaccination for HBV and STIs. Such models require strengthening cultural safety, guided by a co-designed approach.
| eISSN: | 2654-1459 |
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