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Substantial and ambitious reform needed for Queensland’s “fundamentally broken” approach to remote Indigenous service provision

Service delivery to Queensland’s remote Indigenous communities was “fundamentally broken” and in need of a radical rethink, the state’s Productivity Commission has found, calling for sweeping structural, economic and logistics reform.

The Queensland Productivity Commission was scathing in its final report into service provision to the state’s remote and discrete Indigenous communities, finding a paternalistic system plagued by inefficiencies which fostered passive dependence and undermined outcomes.

“There is a strong commitment from government, service providers and communities to address the complex and longstanding issues facing remote and discrete communities, but the system they are operating under is fundamentally broken,” the report states.

It calls for “substantial and ambitious” reform across structural, economic and logistic domains to place accountability and decision-making with communities, refocus delivery on real needs and priorities, and build capacity so that Indigenous people benefit most.

“The potential benefits are large, both in terms of improving wellbeing in communities and the savings that could be directed towards activities communities value most highly,” it says.

Structural reforms are required to put communities at the heart of planning, procurement and provision. Source: Queensland Productivity Commission
A new vision for service delivery in remote and discrete Indigenous communities. Source: Queensland Productivity Commission

Byzantine bureaucracy

Led by Professor Bronwyn Fredericks, who is UQ’s Pro Vice Chancellor for Indigenous Engagement and a Murri woman from South-East Queensland, the inquiry examined service delivery in more than 40 remote and discrete communities across the state.

Ranging in population from 50 people to some 2,700, these communities are mostly concentrated on the Torres Strait Islands and Cape York Peninsula. About 40,000 people, or 20% of Queensland’s Aboriginal and Torres Strait Islander population live in remote or very remote parts of the state.

Despite state government spending totalling some $1.2 billion every year (roughly $29,000 per person) in service delivery, the inquiry found outcomes for people in these communities compared poorly with other residents of the state, as the graph below shows.

People living in remote and discrete Indigenous communities perform poorly on a range of indicators compared with the rest of Queensland. Source: Queensland Productivity Commission

When it delved into service delivery to these communities, the Commission found that “framework-level issues contribute to suboptimal outcomes”, with a complex, labyrinthine system of funding and governance that disempowered and discounted Indigenous communities.

These Byzantine arrangements meant at least 13 Queensland state government departments as well as the federal government were involved in coordination, policy development and service delivery for any given community, as well as a host of peak bodies and NGOs also funded from the public purse.

This resulted in “overlaps in roles and responsibilities, unclear lines of accountability and difficulties getting things done, particularly when the challenges associated with delivering services into remote locations are added to the mix,” the report says.

Inefficiencies were endemic, with infrastructure built that was not fit for purpose; services funded and provided that did not match local demands or priorities; high indirect and ancillary costs and excessive compliance burdens or other red tape.

Funding and contracting models (particularly short-term grants) contributed to systemic inflexibility and high administrative cost, as well as fostering a climate of uncertainty that undermined long-term planning, innovation and local capacity building, it said.

These communities found themselves trapped in a recurring policy cycle of service delivery failures and patchwork solutions, where the government was little more than a modern-day mission manager who “essentially ‘operates’ the community: individual choice, markets, rewards and responsibilities have a limited role”, the report said.

This served to distort incentives, not just for service users (by “rewarding” welfare dependency), but also the government (through a bias towards “visible action”) and providers (who perpetuated these sorts of services in order to win funds). It resulted in short-term approaches that offered “no or limited alignment between decision-making and accountability to service users, communities, government or taxpayers”, as well as significant transactional costs and red tape.

The net outcome was a system “so large and bureaucratic that it risks serving itself rather than communities”, the report found.

The bureaucratic maze of service delivery in remote and discrete Indigenous communities. Source: Queensland Productivity Commission
Some of the feedback from stakeholders on service provision in remote and discrete Indigenous communities. Source: Queensland Productivity Commission

Community at the centre

The report, which was made public on Monday, some six months after being handed down to the Queensland government, offers 22 overarching recommendations for reform touching on a range of issues.

Land administration was identified as being a major barrier to economic development, home ownership and service delivery, and the report offered some practical steps to address this including the transfer of deed of grant in trust (DOGIT) to Aboriginal freehold, facilitation of Indigenous Land Use Agreements (ILUAs), and the establishment of a functioning rates system for Indigenous councils.

The report also called for the transfer of property and tenancy management to community control; for infrastructure funding to include whole-of-life costs with greater long-term funding certainty; local knowledge and expertise to be utilised during planning and construction, and capacity-building — including training and mentoring — within communities, particularly around the building and maintenance of community infrastructure such as roads.

It said economic reform should mean an end to “crowding out” of local opportunities in spaces such as community stores.

Some other ideas of interest in the report:

  • Rewards-based funding such as social impact investment (a $2 million social reinvestment pilot was run in Cherbourg and Yarrabah in 2017-18)
  • Shift away from the government being funder, purchaser and direct provider to a funder and co-purchaser of services
  • Extension of the ACCHO model beyond health into other policy areas
  • Pooled flexible funding and business capacity-building within communities
  • Place-based, demand-driven approaches
  • Reframing what is perceived as value for money in service provision to include community engagement and governance, collaboration and coordination with existing providers and community bodies and employment and training of local and/or Indigenous staff

Though only dealing specifically with Queensland communities, the report offers valuable insights and a framework for improved service provision to remote communities across Australia, including in Western Australia and the Northern Territory.

On health and wellbeing, the report specifically recommended a greater focus on prevention and early intervention, including strategies to address the socioeconomic determinants of health, and gaps in suicide, foetal alcohol syndrome disorder and disabilities.

Services should be informed by data and individual and community input, with an emphasis on accessibility, cultural appropriateness and effectiveness; attracting, retaining and growing the health workforce, particularly Aboriginal and Torres Strait Islander health workers; improved collaboration with the non-government sector, particularly ACCHOs; streamlined pathways and access to mental health and substance use services.

• Read the report here.

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Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014