TABLE OF CONTENTS Page CHAIRMAN'S SUMMARY ............................................................................................ 1 INTRODUCTION............................................................................................................. 3 THE COMMITTEE................................................................................................. 3 TERMS OF REFERENCE...................................................................................... 3 APPROACH TO THE INQUIRY ........................................................................... 4 BACKGROUND ............................................................................................................... 5 THE PROJECTS .............................................................................................................. 8 PRIMARY HEALTH CARE CENTRES - ABORIGINAL COMMUNITIES ........ 8 Definition of the Facilities........................................................................... 8 Present Facilities.......................................................................................... 9 Site Selection.............................................................................................. 11 The Design.................................................................................................. 11 Procurement................................................................................................ 12 Co-ordination Between Departments and the Planning Process ................. 13 Consultation................................................................................................ 14 Cultural Education of Department Staff ..................................................... 15 Staff Accommodation................................................................................. 16 COMMUNITY HEALTH CENTRE - COOKTOWN ............................................ 16 Introduction ................................................................................................ 16 History of Existing Facilities, Including Hospital Design........................... 18 Lack of Local Control................................................................................. 18 Consultation................................................................................................ 20 REDEVELOPMENT OF THURSDAY ISLAND HOSPITAL .............................. 20 Introduction ................................................................................................ 20 The Community Role.................................................................................. 21 Existing Facilities ....................................................................................... 21 Need .......................................................................................................... 21 Land Availability and Suitability................................................................ 22 Consultation................................................................................................ 22 Design Parameters ...................................................................................... 22 Community Facilities in CBD .................................................................... 23 Proposed Life of Redevelopment................................................................ 23 Sewerage..................................................................................................... 23 PRINCIPAL ELEMENTS .............................................................................................. 24 CAPITAL EXPENDITURE ................................................................................... 24 Budget ........................................................................................................ 24 PLANNING AND CO-ORDINATION.................................................................. 25 Effectiveness of Capital Works Planning ................................................... 25 Department's Assessment Evaluation/Criteria ............................................ 26 Consultation Procedures, Use of Consultants ............................................. 27 Timetabling of Consultation and Ramification on Quality of Response ......................................................................................... 27 Interdepartmental Co-ordination................................................................. 28 Intradepartmental Co-ordination................................................................. 28 MAINTENANCE AND LIFESPANS .................................................................... 28 Existing Facilities ....................................................................................... 28 LOCAL EMPLOYMENT AND TRAINING ......................................................... 29 LAND TENURE .................................................................................................... 29 Need for Guaranteed Tenure....................................................................... 29 CONTRACT PROVISIONS .................................................................................. 30 CONCLUSION ................................................................................................................ 31 RECOMMENDATIONS................................................................................................. 32 APPENDIX A - Call for Submissions............................................................................. 34 APPENDIX B - List of Submissions Received ............................................................... 35 APPENDIX C - List of Witnesses ................................................................................... 36 APPENDIX D - Health Flow Chart................................................................................ 38 APPENDIX E - Health Timeline..................................................................................... 39 Chairman's Summary Health Facilities in Far North Queensland CHAIRMAN'S SUMMARY The issue of Aboriginal and Torres Strait Islander health has been a priority of Governments throughout Australia and the poor health status of these people has been the subject of extensive research and Government attention over the last two decades. Despite this attention the standard of health of Aboriginal and Torres Strait Islander communities is far lower than for the majority of Australians and would not be tolerated in the community at large. The Committee is pleased that the level and standard of health facilities previously provided on Aboriginal and Torres Strait Islander communities is now being improved and widened and the Government's allocation of some $34 million is welcomed by these communities. The construction of the new Health Centres and new Hospital facilities will not on its own affect the health status of residents in Aboriginal and Torres Strait Islander communities but it is an important first step in a process of improving the level of health status for the communities involved. The Committee undertook this inquiry to determine whether the construction of these facilities would provide maximum returns on the funds appropriated by the Parliament. In particular, the Committee sought to review the process of capital works procurement used by Queensland Health to assess its effectiveness. As outlined in the Committee's Preliminary Report into Health Facilities in Far North Queensland, tabled in Parliament on 3 December 1993, the Committee believes that the on-going development of appropriate public works within Aboriginal and Torres Strait Islander communities should be a matter of highest priority for the Government. The Committee has raised a number of concerns which are examined throughout this Report and issues such as the provision of local employment and training associated with new works are examined. The Committee has recommended that the generation of local employment be included as a mandatory element of tender evaluations for work done in Aboriginal and Torres Strait Islander communities. In the course of its inquiry the Committee also considered the extent of co-ordination and co-operation between the different Departments and the relationships between central and regional offices. The Committee was concerned that there had been minimal consultation between Queensland Health and the Department of Family Services and Aboriginal and Islander Affairs in relation to the construction of these facilities. The Committee believes that it is essential that the greatest range of expertise possible is employed in ensuring that appropriate facilities are provided in response to community needs and take into account community views. Such an outcome is jeopardised when Departments adopt an insular approach to the problem. 1 Chairman's Summary Health Facilities in Far North Queensland The Committee believes that these new facilities will make a significant contribution to the communities involved. However, to effect further meaningful changes to the underlying issues of disadvantage in these communities a considerable amount of on-going effort is required by each of the Departments involved. Ms Judy Spence MLA Chairman 2 Introduction Health Facilities in Far North Queensland INTRODUCTION THE COMMITTEE 1 The Committee was established by the Public Works Committee Act 1989, and consists of seven Members of the Legislative Assembly. Four Members are nominated by the Leader of the House and three by the Leader of the Opposition. The