Ian Ring | Indigenous Voice to Parliament must include executive government

The wording of the relevant section of the proposal is " the Aboriginal and Torres Strait Islander Voice may make representations to the Parliament and the executive government of the Commonwealth on matters relating to Aboriginal and Torres Strait Islander peoples;" and the suggestion is that the words "and the executive government" be deleted to boost the prospect of the referendum being passed.

Leaving aside firstly, the fundamental issue that First Nations peoples themselves have made it clear that this provision is important as what is needed is actual rather than symbolic change, and secondly, whether this deletion would actually materially improve the prospect of the referendum being passed, what practical effect would the ability to directly advise executive government make?

Much can be learnt from recent experience and the relative lack of progress in Closing the Gaps. Many hold that Tom Calma and Kevin Rudd led a process that turned Australia's Indigenous policy on its head. Tom Calma, then Aboriginal and Torres Strait Islander social justice commissioner, helped put the concept of Closing the Gap onto the political landscape through his 2005 Social Justice Report.

In 2008, Kevin Rudd led a revitalised national approach, with approval by the Council of Australian Governments of the National Indigenous Reform Agreement to close the life expectancy gap in a generation as well as other targets for child mortality, education and employment, with proposed action on these topics and housing, remote communities and governance.

For the first time, instead of unfunded targets and aspirations, significant additional funding was allocated to achieve the targets. What went wrong? Essentially it was the implementation phase that went off track.

At the outset there was a lack of genuine partnership, on anything like equal terms, between executive government and Aboriginal and Torres Strait islander peoples. There was no Voice.

It was not until 2015 that an implementation plan was devised and even then this was an implementation plan in name only. The plan lacked the real-world attributes of pinning down the services and funding required to achieve the targets, let alone evaluation to see what was working and where changes needed to be made so the targets would be achieved.

Worse, the Closing the Gap Strategy was effectively abandoned after five years with a change of government. This led to not just an unravelling of the national funding agreements but significant reductions in important areas of Commonwealth government responsibility.

Fundamentals such as needs-based funding never became anything like a reality, and in health, even today spending on important schemes like the Medical and Pharmaceutical Benefits Schemes are nowhere near meeting the needs-based requirements. Importantly, too little funding was directed to services run by and for Indigenous peoples (National Aboriginal Community Controlled Health Organisation) which have been shown to outperform mainstream services in recognising and dealing with key Indigenous issues like chronic disease and maternal health. Service gaps were not defined, let alone filled, and there were lots of words but too little action on ensuring that an appropriate workforce was trained, recruited and retained.

And how could it be otherwise? The public service has been politicised, deskilled and important roles farmed out to private companies - with results which have recently attracted public and political concern. Despite Indigenous health branches in most Australian states and territories and in similar countries being led by Indigenous professionals, the Commonwealth seemed to have a policy of rotating non-Indigenous health bureaucrats through leadership positions and moving them on just when they were starting to find their feet.

There seemed to be a notable lack of service experience amongst staff, and efforts to train staff in important roles required in the complex field of Aboriginal and Torres Strait Islander health, vestigial to non-existent. The essential field of health planning never got a guernsey.

So, where is the necessary skill base, experience and context to Close the Gaps? Not surprisingly, amongst Aboriginal and Torres Strait Islander people who - as far back as 1971 - realised that health services provided by the mainstream were never going to meet the specific health needs of Aboriginal people, and commenced the Aboriginal Medical Service in Redfern.

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Today there are 145 such services throughout Australia each under the governance of a community board, and some of these services are amongst the best health services in Australia. Importantly, these services understand the important cultural issues which are fundamental to Indigenous health care provision, and crucially, provide better access for Aboriginal and Torres Strait islander people to health services in general and, of course, to the health and social services that are essential for Closing the Gap.

Fundamentally, the service model in Aboriginal Community Controlled Health Services is, unlike that for mainstream health services, one of comprehensive primary healthcare, regarded around the world as the preferred model of care.

The lessons and experience from the lack of progress in health are also broadly applicable to other areas of Indigenous social policy. It is actions by the executive government that actually changes what happens on the ground.

The notion that gaps might be closed without a close partnership between executive government with Aboriginal people through the Voice, would be to ignore the experience of the last 250 years. For those who really wish to see the gaps close and the relationship between Australia's First Nation peoples and the entire population put on a sound footing, advice from the Voice not just to Parliament but also to the executive government is an absolute requirement.