Creating effective & meaningful engagement with Aboriginal and Torres Strait Islander Peoples

Dr Mark J LockAustralian Research Council (ARC)

Discovery Indigenous Research Fellow

How to structure effective engagement spaces with Aboriginal and Torres Strait Islander Peoples?

• Overview: This inter-active workshop will cover-off on five domains of collaboration which, if embedded into the routine processes of Primary Health Networks, will establish foundations for effectively bringing Indigenous voices into this complex collaborative space. The five domains of collaboration – governance, administration, autonomy, mutuality and norms – will be explained and acted on through the lens of community advisory committees. Afterwards, you will leave feeling confident that Indigenous voices are reflected throughout your Primary Health Network.

• Theme: for primary health networks to design effective engagement strategies.

• Aims: Identify the concerns of PHNs in engaging effectively with Aboriginal people; discuss the concepts of collaboration & governance; review some work on the concept of meaningful engagement; point to some online resources; and create discussion around questions of collaboration.

Aboriginal Voice Integration & Diffusion in Public Health Collaboratives (AVID Study)

• @MarkJLock, @StudyAVID, www.avidstudy.com• ‘there should be collaboration between and within

Governments at all levels, their agencies and funded service providers to effectively coordinate services and programs’

1) Lutschini, M. (2005). Engaging with holism in Australian Aboriginal health policy – a review. Australian and New Zealand Health Policy, 2:15. Online.

2) Lock, M. (2007). Aboriginal holistic health: A critical review. Cooperative Research Centre for Aboriginal Health. Online.3) Lock, M. et al. (2011). Indigenous participation in an informal national Indigenous health policy network. Australian Health

Review, 35(3): 309-15.4) Lock, M. (2012). The bright sides of assimilation. Med J Aust, 197(7):417-418. Online.5) Lock, M. (2015). I want to end meaningless rhetoric in Indigenous politics. Online.6) Lock, M. (2015). Shame and disgrace in the governance of food and nutrition policy for Aboriginal and Torres Strait Islander

Peoples. Online.

Primary Health Networks

• Grant Programme Guidelines – – PHNs will have broad engagement (p.7)– Boards, Community AC, Clinical Councils– For Medicare Locals, James Lamerton (formerly NACCHO

project officer) – Know the community, PHN member, meet with Chair & CEO, don’t rush, appreciative listening, develop projects, respect ownership.

Sweet, M. & Lamerton, J. (2012). “Some practical advice for Medicare Locals on engaging with the Aboriginal community controlled health sector.” Online

Aboriginal people and Medicare Locals

• Horvarth review: Medicare Locals expected to fully engage…the ACCHS sectors

• Diverse approaches by multiple ML (with lack of clarity in objectives & roles) impeded planning, coordination & delivery of services to Aboriginal people

• Success noted where Aboriginal CEO sat on the board of the ML• Need contracts, reporting requirements, funding guidelines to improve

clarity; continued consultation on planning & funding processes

1. Victorian Aboriginal Community Controlled Health Organisation (2013). “Submission to the National Review of Medicare Locals.” Online

2. Horvarth, John (2014). “Review of Medicare Locals. Report the Minister for Health and Minister for Sport”. Online

3. Ernst & Young (2014). “National Evaluation of Medicare Locals: Final Report”. Online

Governance

1. Audit Office of NSW (2014). “GovCentre for Aboriginal Economic Policy Research (2004-2008). “Indigenous Community Governance Project”. Online.

2. NSW Auditor-General (2011). “Governance Lighthouse – Strategic Early Warning System”. Online .

3. NSW Auditor-General (2011). “Corporate Governance – Strategic Early Warning System”. NSW Auditor-General’s Report Volume Two 2011. Online

4. NSW Auditor-General (2015). “Governance Lighthouse – Strategic Early Warning System (Checklist)”. Online.

“the evolving processes, relationships, institutions and structures by which a group of people, community or society organise themselves collectively to achieve the things that matter to them”1

2-4

ASX Governance• “the framework of rules,

relationships, systems and processes within and by which authority is exercised and controlled within corporations. It encompasses the mechanisms by which companies, and those in control, are held to account.” (ASX 2014)

1) ASX Corporate Governance Council – Online.2) Australian Public Service Commission – Online.

What Works in Engaging with Indigenous Australians?

• an appreciation of—and the cultural competency to respond to—Indigenous history, cultures and contemporary social dynamics and to the diversity of Indigenous communities; valuing the cultural skills and knowledge of community organisations and Indigenous people

• clarity about the purpose and the relevant scale for engagement, which may call for multi-layered processes: engagement needs to relate to Indigenous concepts of wellbeing

• long-term relationships of trust, respect and honesty as well as accessible, ongoing communication and information

• effective governance and capacity within both the Indigenous community and governments themselves

• appropriate time frames (including for deliberation and responsive funding, where applicable).

1) Hunt, J. (2013). “Engaging with Indigenous Australia – exploring the conditions for effective relationships with Aboriginal and Torres Strait Islander communities”. Issue paper no. 5 produced for the Closing the Gap Clearinghouse, Online

2) Hunt, J. (2013). “Engagement with Indigenous communities in key sectors.” Resource sheet no.23 produced for the Closing the Gap Clearinghouse, Online

Collaboration: Meaning & MeasurementCollaboration is a process in which autonomous or semi-autonomous actors interact through formal and informal negotiation, jointly creating rules and structures governing their relationships and ways to act or decide on the issues that brought them together; it is a process involving shared norms and mutually beneficial interactions.”

1. Thomson, Ann Marie, and James L. Perry. "Collaboration processes: Inside the black box." Public administration review 66.s1 (2006): 20-32.

2. Thomson, Ann Marie, James L. Perry, and Theodore K. Miller. "Conceptualizing and measuring collaboration." Journal of Public Administration Research and Theory 19.1 (2009): 23-56.

3. Thomson, Ann Marie, James L. Perry, and Theodore K. Miller. "Linking collaboration processes and outcomes." Collaborative Public Management(2008): 97-120.

How can we relate collaborative performance to Aboriginal health outcomes?

How much…governance

Not at To a great all extent

a. Your organisation relies on a formal agreement that spells out relationships between partner organisations?

1 2 3 4 5 6 7

b. Your organisation relies on standard operation procedures (like rules, policies, forms) created by partner organisations to coordinate each other’s activities in the collaboration?

1 2 3 4 5 6 7

c. Your organisation participates on a board or steering committee specifically created for making decision about the collaboration?

1 2 3 4 5 6 7

d. Partner organisations take your organisations opinions seriously when decisions are made about the collaboration?

1 2 3 4 5 6 7

e. Partner organisations (including your organisation) formally evaluate the success of the collaboration?

1 2 3 4 5 6 7

f. All partner organisations (including your organisation) have to agree before a decision is made about the goals and activities of the collaboration?

1 2 3 4 5 6 7

g. Your organisation knows what resources (like money, time, and expertise) the partner organisations bring to the collaborative?

1 2 3 4 5 6 7

h. Your organisation knows the reasons why partner organisations belong to the collaboration?

1 2 3 4 5 6 7

i. Your organisation brainstorms with partner organisations to develop solutions to vision-related problems facing the collaboration?

1 2 3 4 5 6 7

j. Your organisation is involved in implementing specific solutions to vision-related problems facing the collaboration?

1 2 3 4 5 6 7

k. Partner organisations (including our organisation) rely on vision statement for the collaboration different from each individual partner organisation’s vision statement?

1 2 3 4 5 6 7

l. Your organisation relies on informal personal relationships with partner organisation when making decisions about the collaboration?

1 2 3 4 5 6 7

How can Aboriginal voice be reflected in every point and pathway of primary health network governance?

How much…administration

Not at To a great all extent

a. Partner organisations (including your organisation) rely on a manager to coordinate the collaboration’s activities?

1 2 3 4 5 6 7

b. Your organisation brings conflicts with partner organisations out in the open to work them out among the organisations involved?

1 2 3 4 5 6 7

c. Your organisation relies on an external authority to resolve conflicts with partner organisations about matters concerning the collaboration?

1 2 3 4 5 6 7

d. Your organisation relies on formal communication channels when contacting partner organisations about issues related to the collaboration?

1 2 3 4 5 6 7

e. Your organisation has problems getting in touch with partner organisations when you need to contact them?

1 2 3 4 5 6 7

f. Your, as a representative or your organisation in the collaboration, understand your organisation’s roles and responsibilities as a member of the collaboration?

1 2 3 4 5 6 7

g. Partner organisation meetings accomplish what is necessary for the collaboration to function well?

1 2 3 4 5 6 7

h. Partner organisations (including your organisation) agree about the goals of the collaboration?

1 2 3 4 5 6 7

i. Your organisation’s tasks in the collaboration are well coordinated with those of partner organisations?

1 2 3 4 5 6 7

j. You feel partner organisations keep an eye on your organisation’s activities to make sure you are doing what you are supposed to be doing in the collaboration?

1 2 3 4 5 6 7

k. Your organisation keeps an eye on partner organisations’ activities in the collaboration to make sure they are doing what they are supposed to be doing in the collaboration?

1 2 3 4 5 6 7

What are the underlying values in engaging with Aboriginal & Torres Strait Islander peoples?

How much…autonomy

Not at To a great all extent

a. The collaboration hinders your organisation from meeting its own organisational vision?

1 2 3 4 5 6 7

b. Your organisation’s independence is affected by having to work with partner organisations on activities related to the collaboration?

1 2 3 4 5 6 7

c. You, as a representative of our organisation, feel pulled between trying to meet your organisation’s and the collaboration’s expectations?

1 2 3 4 5 6 7

d. Your organisation is up-front with partner organisations about what is can and cannot give (in time, money, energy and other resources) to achieve the collaboration’s goals?

1 2 3 4 5 6 7

e. You, as a representative of your organisation, are allowed to make commitments to the collaboration without having to first get your organisation’s approval?

1 2 3 4 5 6 7

f. Your organisation protects its own organisational integrity in matters concerning the collaboration?

1 2 3 4 5 6 7

g. Your organisation would be hurt if it decided to pull out of the collaboration today?

1 2 3 4 5 6 7

h. Information your organisation is willing to share with partner organisations for the good of the collaboration even though you would be better off withholding it?

1 2 3 4 5 6 7

i. Your organisation is familiar with the programs and operations of the partner organisations?

1 2 3 4 5 6 7

j. Your organisation feels it worthwhile to stay and work with partner organisations rather than leave the collaboration?

1 2 3 4 5 6 7

How can you embed the principle of vertical equity into routine governance processes?

How much…mutuality

Not at To a great all extent

a. Partner organisations have positively influenced your organisation’s services or operations?

1 2 3 4 5 6 7

b. Professional philosophies between your organisation and partner organisations make it difficult for you to work together?

1 2 3 4 5 6 7

c. Your organisation sends clients to or receives clients from partner organisations?

1 2 3 4 5 6 7

d. The goals and activities of your organisation are similar to goals and activities of partner organisations?

1 2 3 4 5 6 7

e. Your organisation’s understanding of the issues that initially brought you to the collaboration differ from those of partner organisations?

1 2 3 4 5 6 7

f. Our organisation, to accomplish its goals, needs the resources, services or support of partner organisations?

1 2 3 4 5 6 7

g. Partner organisations, to accomplish their goals, need the resources, services or support of your organisation?

1 2 3 4 5 6 7

h. Partner organisations (including your organisation) have combined and used each other’s resources so all partners benefit from collaborating?

1 2 3 4 5 6 7

i. Your organisation shares information with partner organisations that will strengthen their operations and programs?

1 2 3 4 5 6 7

j. You feel what your organisation brings to the collaboration is appreciated and respected by partner organisations?

1 2 3 4 5 6 7

k. Your organisation achieves its own goals better working with partner organisations that working alone?

1 2 3 4 5 6 7

l. Partner organisations (including your organisation) work through differences to arrive at win-win solutions?

1 2 3 4 5 6 7

m. Partner organisations (including your organisation) hold celebrations to recognise joint successes in the collaboration?

1 2 3 4 5 6 7

Reflect on the range of your personal experiences with Aboriginal people, what are the defining memories?

How strongly you disagree or agree with the statements below…norms

Not at To a great all extent

a. The people who represent partner organisations in the collaboration are trustworthy.

1 2 3 4 5 6 7

b. Partner organisations take advantage of organisations in the collaboration that are vulnerable.

1 2 3 4 5 6 7

c. My organisation can count on each partner organisation to meet its obligations to the collaboration.

1 2 3 4 5 6 7

d. Partner organisations try to get the upper hand when they negotiate in the collaboration?

1 2 3 4 5 6 7

e. My organisation will work with partner organisations only if they prove they will work with us?

1 2 3 4 5 6 7

f. My organisation will find ways to punish partner organisations that do not keep their word.

1 2 3 4 5 6 7

g. If partner organisations treat my organisation unfairly, we will leave the collaboration.

1 2 3 4 5 6 7

h. My organisation will pursue its own interests even at the expense of partner organisations.

1 2 3 4 5 6 7

i. Even if they don’t always meet their obligations to us, my organisation has a duty to meet its obligations to partner organisations.

1 2 3 4 5 6 7

j. Developing long-term personal relationships with partner organisations is the most important part of collaborating.

1 2 3 4 5 6 7

Conclusion – Thoughts on Committees

• Where you stand depends on where you sit, but if you don’t have a seat then you don’t have any standing (after Rufus Miles)

• The most effective committee consists of three members two of whom are usually absent (after Robert Copeland)

• A committee is a group that keeps minutes and loses hours (Milton Bearle)

• A committee is a cul-de-sac down which ideas are lured and then quietly strangled (Sir Barnett Cocks)