While it is possible to make much greater progress towards Closing the Gaps for child mortality and life expectancy, there are no short cuts or easy fixes.
There are a number of things that don't work and equally some must do's. What doesn't work is assuming that minor tweaking of mainstream services will somehow meet the special needs of Aboriginal and Torres Strait Islander people.
Equally, just painting a picture of a perfect world without working out in detail what would have to be done in practice to bring that world into being, has not worked and will not work.
Bewailing the lack of progress and hoping next year's statistics will somehow be better without figuring out why and taking the necessary action to improve results is a recipe for continuing failure.
Spending less per capita on a needs basis on people with worse health and hoping for dramatic improvements, defies logic.
Having misleading and poor quality statistics which pretend that somehow key goals are "on track" one year but not the next has to stop.
Throwing clinical, bureaucratic and other staff in at the deep end without the necessary training for the complex issues of Aboriginal affairs is inefficient and unproductive.
Stop start processes for generational agendas makes no sense. And most importantly, not listening to the voice of Aboriginal and Torres Strait Islander people or appointing Indigenous people to leadership positions in key government agencies is inexcusable.
So what would a root-and-branch reform involve? Targets need to be set out in measurable terms rather than terms so vague that they could mean almost anything.
Most importantly there needs to be a proper analysis of what actually needs to be done and what services would be required to achieve the targets.
What would the services cost? Who would provide the services? Who would pay for them? How long would it take to achieve the desired outcomes?
Then a proper forward plan over say, five or 10 years, set down to progressively provide the necessary Aboriginal Community Controlled services. And training in basic planning skills at national, state, regional and service delivery levels - real planning not ersatz planning.
Nothing unheard of here - this is simply the way that efficient organisations achieve their objectives.
This will require placing Indigenous staff in leadership positions, recruitment of staff who have the specific skills required and service delivery experience, and training of staff at all levels, including the most senior levels, rather than perpetuating the myths so beloved of consultants, that leadership does not require a knowledge of the business you are running.
But there also needs to be an overhaul of information and management processes.
The Productivity Commission was previously responsible for two key reports: the Indigenous Expenditure Report (IER) and the Overcoming Indigenous Disadvantage (OID) report - both now apparently the responsibility of the joint council on Closing the Gap.
However, the IER takes no account of need or private expenditure. The fundamental principle ought to be that Indigenous people ought to receive the same level of expenditure as anyone else in the population with equivalent need, no more no less, and that means all relevant expenditure, public and private (an important consideration given the higher levels of private expenditure for non-Indigenous people).
It is hard to argue that Indigenous people ought to receive less funding per capita than others in the population with similar need.
This is a well established position as those over 65 years for example, typically receive three times the level of health spending as those in their 20s and 30s - because they have higher levels of need.
The OID report is long on documenting disadvantage but more or less ignores the overcoming part of the title and needs to provide a description of the services to be provided to overcome the disadvantage, and measure their adequacy and effectiveness - and most importantly, current service gaps.
And finally, there is not so much a need to overhaul management practices but to institute them. Year after year government agencies like the Productivity Commission produce report after report showing lack of progress.
The Aboriginal and Torres Strait Islander Health Performance Framework in particular, not only documents lack of progress but often outlines what would need to be done to achieve the desired progress.
But at present these reports are simply ignored or only seem to induce despair or wild and often unfounded assertions about waste of enormous sums of money.
No one asks why there has been so little progress and more importantly, what actually needs to be done to achieve the desired targets and objectives.
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That can't go on. There needs to be say, quarterly management meetings at service delivery and regional levels, and annually at state and national levels, to consider reports on the availability, quality and effectiveness of services, progress in achieving stated objectives and most importantly taking management decisions on steps that need to be taken so that the national goals can be achieved. Indigenous leadership in these processes is paramount.
These processes are generic and used by successful organisations all around the world and they apply whatever targets and objectives the joint council may determine.
Without these processes, Australia will continue its current trajectory with disappointing progress in Closing the Gap but with these processes, in health at least, and no doubt in other fields as well, much greater progress can be achieved in relatively short time frames, with affordable levels of expenditure and the agreement and support of Indigenous peoples and Commonwealth, state and territory governments.
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