Rarely a week passes without headlines about the poor state of services in remote Australia. From the lack of mental health services missing opportunities to prevent suicide in Childers, Queensland, to telecommunications blackspots in Bothwell, Tasmania, leaving people and businesses compromised, the troubles of service provision in remote Australia are well documented.
Those of us who live and work in remote Australia know this is not the whole story. Some great successes in delivering services in remote areas are enabling better life opportunities. Community leaders are patiently coming to the table to influence service provision in local priorities, hard-working government agencies, not-for-profits and community organisations are showing heroic dedication, and many services are delivered with the best of intentions.
But good intentions do not always translate into good results. On most life indicators, including health and education outcomes, people in remote Australia experience greater disadvantage than the general population, and the trend is not favourable. Those of us committed to evidence-based policy and to citizen-centric customer-focussed co-design owe it to ourselves and the communities we serve to take a hard-nosed look at what works and what does not.
From our years of experience working alongside service providers in remote communities, including in the Kimberley and North Queensland, we have looked closely at their circumstances, identified the complications many face and identified how they can achieve better outcomes.
It is not easy to get people in remote locations the services that meet the needs their local communities have identified. Service providers and the communities they engage with face layer on layer of complications.
For starters, there is the sheer logistical difficulty of getting people and equipment to remote areas, sometimes a thousand kilometres from the nearest capital, in the case of Western Australia. Then there are the cultural differences between service providers and recipients, many of whom are Indigenous, given the long history of dispossession and cultural genocide leading to mistrust. And there are the complexities of people receiving services using multiple providers, with procurement and contractual obligations creating silos despite efforts on the ground to collaborate.
Current efforts at remote service delivery struggle to meet community needs. For example, high-risk pregnant mothers in remote Australia, some of whom are experiencing family violence, receive inadequate prenatal care. Often this care involves them being housed away from their home community for long periods with little support at the very time in their lives when a familiar setting is preferred.
When it comes to service delivery, governments need to be clear about their role. Is it to actively deliver services, to facilitate others, to act as a broker or to create the conditions for others to deliver? Too often in remote service delivery this fundamental question is not resolved, or if it is resolved the decision is not clearly communicated.
This lack of communication often extends to the way service designers connect with communities receiving programs. Often priorities are defined and policies designed in capital cities with little input from people in remote locations. It is unsurprising that ill-fitting centrally designed models then need to be localised, consuming resources that had been intended for service delivery itself and straining partnerships on the ground.
Services are often structured to meet the needs of the program rather than the needs of remote communities. There can be complicated rules of access, fragmentation in the services offered and duplication across programs. These services are often delivered by fly-in-fly-out providers, leading to variable quality and making it hard for trust to develop between service providers and remote communities.
Fly-in-fly-out is an understandable response to the limited capacity of some local workforces but it risks exacerbating the problem if there is no strategy for a skill transfer. Many remote locations have moribund economies, a limited local workforce and high costs, so investors need to be patient.
Often the policy logic for programs is vague, so the desired impact and how it will be measured is unclear. When coupled with short funding cycles, it can be difficult for programs to gain traction or demonstrate effectiveness.
Measuring program effectiveness is a perennial weakness. Often the data used is process data from programs or a crude population-level indicator from the Australian Bureau of Statistics. This data is of little value in determining the outcomes of local programs.
The absence of this governance can be seen in the Federal Government’s Closing the Gap efforts, which offer national benchmarks but lack local targets that would be more useful to assess progress and identify local and regional priorities.
These varied challenges can appear insurmountable. But from our experience, significant progress can be made through community engagement and ownership, local design or adaptation, and suitable governance.
Community engagement and ownership requires first understanding community relationships. Each community is different, with a unique dynamic, history and sensitivities. It is essential to understand these relationships, and this can only be achieved by spending time and investing in the community.
Many communities are understandably sceptical about new arrivals delivering new programs. A history of paternalism and outside intervention has delivered a lot of heartache and limited benefits. So engaging with the community is a first step in breaking this cycle.
A location-based Indigenous-led approach is best, working with local leaders to identify priorities, co-design solutions and make joint investment decisions. Co-design means that end users can shape the service as it is being developed rather than being presented with a final design. As well as being empowering, it is also more likely to lead to stronger uptake.
The power of community connections is evident in the 54 Queensland Police-Citizens Youth Clubs. The diversity of the communities it serves, ranging from the Gold Coast to the Torres Strait, means it needs to be aware of local needs among its 73,000 members, many of whom are at-risk, disadvantaged or disengaged young people. The PCYC has set three objectives – youth development, crime prevention and community engagement – and measures its performance against each.
Over time effective community engagement should improve the capacity of each community to effectively receive services and deliver them.
Local design or adaption allows communities to select services that will have a local impact and tailor those services to their circumstances.
Each community has unique needs resulting from its demographics, geography and history. These differences may look minimal from afar but become vast chasms up close. These differences may impact on the range of services offered, the way they are offered and by whom they are offered.
Local leadership and governance are critical to service delivery. Many remote communities seek shared decisions, but funders sometimes struggle to understand the model and are reluctant to support it.
Building on this idea, the most impactful way to adapt a generic service delivery plan to an area is to work with local people to identify and deliver services. It is essential that local priorities be identified by local people and that identifying what services are required is done in partnership with local people and funders. The services that result need to be co-designed by government funders, subject matter experts, recipients and local leadership.
For example, recently Nous worked with Fitzroy Valley Futures to develop a youth engagement strategy. Essential to this strategy was understanding the needs of disengaged and at-risk youth, so we used interviews and workshops to connect, then provided virtual reality headsets to allow young people to provide feedback. The quality of the feedback was an invaluable resource in developing the strategy.
Local procurement can ensure services are relevant and drive systemic change. Contracts, pooled funding and local reinvestment are tools to deliver community priorities and develop job pathways.
Ideally services will be brought to people, but sometimes this is not viable. In cases when people are brought to services, those services need to be person-centred rather than provider-centred. That means that service recipients are fully informed, can ask questions and have agency over what they are doing.
Suitable governance can be the difference between success and failure for a service delivery initiative.
From the outset, governance should establish the government’s role – as a steward, a funder, a deliverer or a regulator – as well as the shared goals and the levers to achieve those goals. Drilling deeper, responsibilities among state and federal stakeholders, not-for-profit and community organisations need to be clearly defined, including accountabilities that reflect their capabilities.
Assessing performance against these accountabilities requires a good flow of quality information that relates to local circumstances. Service providers may need to accumulate relevant data to evaluate the social return on investment.
Data is also vital for dynamic decision making. Real-time meaningful data can give timely information on what interventions make a difference and how. It is important to consider how this data will be governed, including agreeing on key metrics and establishing protocols for sharing information.
Service providers need to demonstrate they are in it for the long haul rather than just providing a sugar hit. Programs that run just a handful of years are inadequate; instead, programs should be in place for a minimum of seven years, preferably a decade or more. Along the way they should be refined and adjusted as community needs evolve, and always focus on building the capability and capacity of locals.
There are several practical next steps available to service providers.
By using the resources available to them service providers can empower Indigenous communities to strengthen their connection to country and awareness of their cultural history.
They can develop, test and refine shared governance and decision-making mechanisms at a regional level, incorporating the lessons into more local implementation.
And they can activate local economies by identifying entrepreneurial ways to leverage native title rights, thereby providing a stable platform for community growth.
Shifting resources to Aboriginal-controlled organisations enables local ownership and a transformed approach to service design in remote Australia. These organisations are best placed to design and deliver on-country programs and anchor service provision in culture.
Partnerships between Aboriginal-controlled organisations and mainstream organisations present an important opportunity to accelerate progress.
Get in touch to discuss how Nous Group can help your organisation co-design, deliver and monitor/evaluate services more effectively in remote areas.
Co-authored by Emma White and Prins Ralston during their time as Nous Principals.