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Many public health delivery services for Aboriginal people are in the hands of community controlled organisations, particularly in remote areas. These are largely funded by government grants, and the main Commonwealth health agency, the Office for Aboriginal and Torres Strait Islander Health (OATSIH), keeps tight surveillance on its expenditure. This is in the public interest, but it also leads to heavy burdens of administration both for the Department and for the organisations themselves. If better forms of administration can be found this will free up some of the existing money to be better directed to service clients, improving outcomes in Closing the Gap in health.
This research investigated approaches in public administration and applied them to the Aboriginal community controlled health area. New, more flexible, forms of contract between government and health services; new decentralised networks of service centres; and new understandings of what outcomes the communities value are all part of these recent theories. Along with these must come new forms of accountability for public money. This was a major focus of this research project. While public sector theories such as ‘public value management’ and ‘network governance’ can reduce the overburden of administrative costs, they are typically quite weak in the area of explaining how money has been well spent to produce better lives for Aboriginal people. This research project suggested models for accountability that assist with planning, implementation and assessment as a single process, building trust between suppliers and overseers for health services, and substantiating the public value added by community control of Aboriginal health services.
Dr Patrick Sullivan
Australian Institute of Aboriginal and Torres Strait Islander Studies