2017 DRAFT REPORT Service delivery in remote and discrete Aboriginal and Torres Strait Islander communities h © Queensland Productivity Commission 2017 The Queensland Productivity Commission supports and encourages the dissemination and exchange of information. However, copyright protects this document. The Queensland Productivity Commission has no objection to this material being reproduced, made available online or electronically but only if it is recognised as the owner of the copyright and this material remains unaltered. ABN: 18 872 336 955 h DRAFT REPORT: Service Delivery in remote and discrete Aboriginal and Torres Strait Islander communities Service Delivery in Indigenous Communities: Have Your Say The Treasurer has asked the Queensland Productivity Commission (the Commission) to undertake an inquiry into service delivery in Key dates Queensland's remote and discrete Aboriginal and Consultation paper released Torres Strait Islander communities. 31 March 2017 This draft report has been released to provide an Initial consultation opportunity for consultation on the issues raised by April – June 2017 this inquiry—and, in particular, on preliminary Release of the draft report analysis, findings and recommendations. October 2017 The final report will be prepared after further Further consultation consultation has been undertaken, and will be October 2017 forwarded to the Queensland Government in December. Submissions due 8 November 2017 Make a submission Final report submitted to the The Commission invites all interested parties to Government in December 2017 make written submissions on the draft report. Submissions are due by close of business 8 November 2017. They can be lodged online or via post: Service delivery in Indigenous communities The Queensland Productivity Commission is an Queensland Productivity Commission independent statutory body that provides PO Box 12112 independent advice on complex economic and George St QLD 4003 regulatory issues. The Commission has an advisory role and Submissions will be treated as public documents operates independently from the Queensland and published on the Commission's website. If your Government—its views, findings and submission contains genuinely confidential recommendations are based on its own information, please provide the confidential analysis and judgments. material in a clearly marked separate attachment. After undertaking a public inquiry, the Contacts Commission provides a written report to the Treasurer who must provide a written Enquiries regarding this project can be made by response within six months. Following this, the telephone (07) 3015 5111 or online at Commission publishes the final report. http://qpc.qld.gov.au/contact-us/ Further information on the Commission and its functions can be obtained from the Commission's website www.qpc.qld.gov.au DRAFT REPORT: Service Delivery in remote and discrete Aboriginal and Torres Strait Islander communities Contents OVERVIEW VII 1.0 INTRODUCTION 1 1.1 What has the Commission been asked to do? 2 1.2 Our approach 3 1.3 Conduct of the inquiry and stakeholder participation 3 1.4 Report structure 4 PART A: BACKGROUND 7 2.0 BACKGROUND 9 2.1 The remote and discrete communities 11 2.2 Historical context 11 2.3 The service delivery environment 17 2.4 Conclusion 24 3.0 LEVELS AND PATTERNS OF GOVERNMENT EXPENDITURES 25 3.1 Background 27 3.2 Understanding expenditures 28 3.3 Queensland Government expenditure in context 29 3.4 Constructing estimates of Queensland Government expenditure in remote and discrete Aboriginal and Torres Strait Islander communities 31 3.5 Headline estimates—how much does the Queensland Government spend on service delivery to remote and discrete communities? 34 3.6 How does this compare with other jurisdictions? 37 3.7 Where do the expenditures go? 39 3.8 Alternative estimates—agency estimates 45 3.9 Community-level estimates—case studies 46 4.0 OUTCOMES 51 4.1 Data sources and challenges 53 4.2 Education 54 4.3 Economic participation 58 4.4 Health 61 4.5 Community safety 63 4.6 Housing 66 4.7 Wellbeing 68 Queensland Productivity Commission ii DRAFT REPORT: Service Delivery in remote and discrete Aboriginal and Torres Strait Islander communities 4.8 Indicators for the Torres Strait 69 4.9 Conclusion 71 5.0 OVERALL ASSESSMENT 73 5.1 Social and economic outcomes 75 5.2 A summary assessment of current service delivery policies 75 5.3 Policy failures when good intentions abound 76 5.4 Institutional design and funding problems 77 5.5 Underlying problems 83 5.6 Key implications for this inquiry 97 PART B: THE WAY FORWARD 99 6.0 OVERVIEW OF PROPOSED REFORMS 101 6.1 Options for reform 103 6.2 Widespread support for reform 104 6.3 The reform proposal 107 6.4 Implementation issues 110 7.0 STRUCTURAL REFORM 113 7.1 The structural reform proposal 115 7.2 How the structural reforms address performance 126 7.3 What are the risks? 128 7.4 What is happening elsewhere? 131 7.5 Conclusion 136 8.0 DIRECTIONS FOR POLICY REFORM 139 8.1 Changes in approach are required 142 8.2 Building capabilities and ongoing support 143 8.3 Community voice and engagement 145 8.4 Choosing policy instruments that support development 146 8.5 From supply- to demand-oriented models of service delivery 157 8.6 Aligning incentives 160 8.7 Support for ‘holistic’ service delivery 165 8.8 Conclusion 169 9.0 ECONOMIC AND COMMUNITY DEVELOPMENT 171 9.1 Why development is important for service delivery 173 9.2 Changing the approach 175 9.3 Viability and service delivery costs 177 9.4 Role for government in economic development 178 9.5 Employment 188 Queensland Productivity Commission iii DRAFT REPORT: Service Delivery in remote and discrete Aboriginal and Torres Strait Islander communities 9.6 Conclusion 191 10.0 EVALUATION 193 10.1 Why evaluate? 195 10.2 Methods for evaluating 195 10.3 Best practice in program evaluation 197 10.4 Limitations and challenges 201 10.5 Measuring wellbeing 204 10.6 Current practice 206 10.7 Stakeholder views 206 10.8 Moving forward to a new model 210 PART C: KEY SERVICE DELIVERY ISSUES 215 11.0 LAND TENURE 217 11.1 Current status 219 11.2 Key issues and challenges 224 11.3 Potential solutions 232 12.0 HOUSING 237 12.1 Current status 239 12.2 Issues and challenges 243 12.3 Possible solutions 249 12.4 Homelessness 253 13.0 MUNICIPAL SERVICES AND INFRASTRUCTURE 255 13.1 Current status 257 13.2 Key issues and challenges 260 13.3 Potential solutions 269 14.0 EDUCATION AND TRAINING 273 14.1 Education 275 14.2 Training 293 14.3 Conclusion 296 15.0 COMMUNITY SAFETY 299 15.1 Introduction 301 15.2 The nature of violence and neglect 301 15.3 The costs of violence, neglect and abuse, and the benefits of interventions 302 15.4 Community safety outcomes 303 15.5 Expenditure on community safety 305 15.6 Recent government responses on community safety 306 15.7 Opportunities for improving community safety 308 Queensland Productivity Commission iv DRAFT REPORT: Service Delivery in remote and discrete Aboriginal and Torres Strait Islander communities 15.8 Conclusion 318 16.0 HEALTH AND WELLBEING 319 16.1 High-level outcomes 321 16.2 Factors affecting health service delivery 322 16.3 The health system 324 16.4 Conclusion 339 APPENDICES 341 Appendix A: Terms of reference 342 Appendix B: Submissions 344 Appendix C: Consultations 346 Appendix D: Remote communities 350 Appendix E: List of discrete communities 351 References 353 Queensland Productivity Commission v DRAFT REPORT: Service Delivery in remote and discrete Aboriginal and Torres Strait Islander communities Queensland Productivity Commission 6 Overview Overview Queensland Productivity Commission vii Overview This overview summarises the key findings and recommendations from the draft report for the inquiry into service delivery in Queensland’s remote and discrete Aboriginal and Torres Strait Islander communities. Key points • The Queensland Government invests in remote and discrete Aboriginal and Torres Strait Islander communities to support people to live healthy, safe and fulfilling lives. • This report considers how available resources can best be used to achieve these outcomes. • We have talked with those living in communities, service providers and other stakeholders to understand how well the current system meets their needs. The results are mixed. • There are examples of good service delivery that can be built upon, but most stakeholders agree there are opportunities to improve how programs and services are designed, funded and delivered to better meet expectations of performance and improve outcomes. • The service delivery system involves all three levels of government, numerous agencies, and a wide range of Indigenous and non-Indigenous organisations. There is a strong commitment from stakeholders to address the complex and longstanding issues facing communities. • In our view, the key to sustained change is to address the underlying incentives inherent in the current system. This means a change to the overall policy and service delivery architecture as follows: – structural reform to transfer accountability and decision-making closer to where service users are—to regions and communities – service delivery reform to put communities at the centre of service design – economic reform to facilitate economic participation and community development. • These elements will need to be underpinned by: – capability and capacity building within government, service providers and communities to support a new way of doing things – timely and transparent data collection and reporting to support performance and accountability. • This proposal, put forward for further discussion, aims to enable Aboriginal and Torres Strait Islander communities to improve outcomes for themselves. The potential benefits are large, in improving wellbeing and in re-prioritising expenditure to where communities value it most. • The proposal is realistic but ambitious—gains will take time. The Commission has put forward 16 recommendations to achieve better performance in delivering outcomes and promote further discussion.