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'Pathways to Community Control' Co-operative Framework

Category: Policy/Strategy
Binomial Name: Northern Territory Government
Date: 11 November 2009
Sub Category:Policy/Strategy
State/Country:Northern Territory, Australia
Subject Matter:Access | | Consultation | Health and Community Services | Implementation | Leadership | Local Government | Management / Administration
Summary Information:
This framework, to be implemented in the Northern Territory, allows Aboriginal Australians the right to participate in decision-making related to their health through community controlled governance of health services.
Detailed Information:
On Wednesday 11 November, the 'Pathways to Community Control' Co-operative Framework for the Northern Territory was announced in Darwin by Warren Snowdon AM, Federal Minister for Indigenous Health.

Northern Territory Aboriginal Health Forum (the principal partnership mechanism created by the framework) partners have produced a report outlining the objectives and details of the framework.

This framework allows Aboriginal Australians the right to participate in decision-making about their health. It suggests that community controlled governance of health services is the best way indigenous people can be involved in decision making about health.

The Framework is designed with the objective that Aboriginal communities will move a step closer to designing and managing their health care needs. The key principles include:
  • Aboriginal participation is an important element of the sustainable, viable, effective and efficient provision of primary health care;
  • Shared commitments to developing a strategy that will secure a higher level of Aboriginal community control in delivering primary health care should be in place;
  • Shared commitments to fostering effective partnerships between governments, providers and communities that will ensure best practice governance of services and favourable health gain should be in place; and
  • Shared commitments to personal and community development will act as important contributors to higher levels of community participation and control

    It is planned as a staged process in which community participation will be encouraged. The stages are anticipated as follows:

    1. Development
    2. Consolidation
    3. Implementation
    4. Evaluation

    1. Development

    Largely, the development stage will not affect health service provision directly, but will include:
  • Improving the community's access to information on health issues
  • Eliciting preferences from the community about the form of health service desired
  • The community evaluating their options and making some decisions about whether certain models reflect their preferences
  • The community weighing up the options, discussing the results and choosing a model that best suits their preferences
  • The community electing a leadership group
  • Health planners considering equity, cost, capacity, quality and consistency of services and the management of risk, among other things
    This should take place over a period of 12 to 18 months.

    2. Consolidation

    The consolidation stage will work on ensuring the capability of communities, the leadership group and service providers to accommodate the reform. This will include:
  • Making the leadership group into a legal entity that is an elected health board with greater accountability to the community
  • The leadership group meeting regularly
  • The leadership group creating a health plan for the community
  • The leadership group having a firm view of how they plan to implement the transition
  • The leadership group demonstrating effective community engagement with the reform
  • The leadership group and others building alliances with relevant stakeholders
  • The leadership group demonstrating strategic management, corporate performance, inserting corporate framework and preparing an annual business plan
  • The leadership group deciding on an evaluation strategy
    This stage should take 12 to 24 months. The Forum will monitor the progress.

    3. Implementation

    The implementation stage will begin when the necessary transitional arrangements are in place and the health services committee has assumed management of the delivery of primary health care on an initial basis. The provision of health and family services will commence at this stage. This will include:
  • The government and Forum monitoring change
  • Service managers ensuring a sound business plan exists
  • Partners maintaining effort and a commitment to the community
  • An assurance that the community, the funders and the corporate regulators still have confidence in the model
  • Appropriate data collection to be carried out
    This stage should take between 12 to 24 months.

    4. Evaluation

    The evaluation stage is seen as important to the ongoing success of the program. This will include:
  • The engagement of key stakeholders
  • The evaluation of main service components and business objectives
  • An evaluation report

    The evaluation should take place no sooner than two years after the beginning of the implementation stage or no more than 12 to 18 months after the implementation stage has been finalised.

    The report states that it is hoped that several outcomes will result from the framework, such as:
  • greater levels of community involvement will bring benefits both to the process of health and family service delivery and to the health of those that are engaged
  • a more responsive health system
  • a health system of improved quality
  • more successful family and community functioning
  • health and well-being in general.

    The report also acknowledges that management of primary health care services is a function that requires specialised skills and knowledge and that organisational arrangements structured under this framework should reflect specific competence and experience in an organisation primarily dedicated to the purpose of primary health care service delivery.

  • Related Entries

  • Aboriginal Medical Services Alliance Northern Territory (AMSANT)
  • Northern Territory of Australia
  • Commonwealth of Australia
  • Council of Australian Governments
  • National Aboriginal Community Controlled Health Organisation

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