This paper aims to explore the barriers and facilitators for Aboriginal and Torres Strait Islander Australians with chronic disease to access urban, mainstream general practice and primary health care. Six focus groups and five interviews were conducted with 40 participants that included Aboriginal people with diabetes, health service providers and policy makers. Using diabetes as the exemplar, participants were asked to relate their own experiences of diabetes management. Data was thematically analysed. Two overarching themes and seven other factors were identified as influencing Aboriginal people’s access to health services. Cultural competence can be achieved within a health service when all nine factors are addressed in the context of the local community. Closing the health gap between Aboriginal and non-Aboriginal Australians requires a particular sensitivity and understanding of the facilitators and barriers for urban Aboriginal people accessing mainstream health services.