Chapter 6 - Improving social infrastructure

Chapter 6Improving social infrastructure

6.1One of the key challenges to attracting and retaining a permanent workforce to Northern Australia is a lack of, or reduced, social infrastructure for people living in the region.[1] In fact, this inquiry found that the two main issues impeding workforce development in Northern Australia are housing affordability and accessibility, and lack of access to social infrastructure.[2]

6.2Social infrastructure includes health care, aged care, disability services, childcare, education and community safety. Social infrastructure consists of basic services and facilities which encourage people to reside and stay in an area —in other words, it relates to the 'liveability' of an area. Typically, the smaller and more remote a community is, the greater the likelihood that it is disproportionately affected by a lack of services.[3] As the Australian Institute of Architects informed the committee:

While it is not possible to replicate all the services and amenities available in larger economic centre's; people rightly expect a minimum level of amenities such as access to doctors and other medical services, police, childcare and schools. Lack of access to these services reduces the quality of life of those that live in these areas and acts as deterrent for people to move into such areas.[4]

6.3Many of the previous inquiries and reports on the development of Northern Australia have emphasised export-oriented industries and the physical infrastructure needed to support them. However, development of the workforce in Northern Australia should account for the fact that the health care and social assistance sector is the largest employer in regional Australia.[5] Further, access to social infrastructure is a key reason for people remaining in or moving to an area.

6.4As such, this chapter considers in detail issues raised about inadequate social infrastructure in Northern Australia and the improvements needed to enable workforce development in the region. The chapter identifies pathways for improvements in:

healthcare;

aged and disability care;

childcare and school education;

housing;

crime and anti-social behaviour; and

emergency services responding to weather events.

Health care issues

6.5Responsibility for funding of Australia's health services is split between different levels of government. Similarly, responsibility for service provision is also split between different levels of government and the private sector. Health services in Northern Australia include the following:

Primary Health Networks, which are independent organisations funded by the Australian Government to provide health services tailored to each region;

Aboriginal Community Controlled Health Organisations, which are funded by the Australian, state and territory governments to provide primary health care to Aboriginal and Torres Strait Islander peoples;

General Practitioners, who operate in private practice but whose fees are partially or fully subsidised by the Australian Government through the Medicare system;

Allied health services, whether provided through private practice (partially or fully subsidised through the Medicare system) or in hospitals; and

Public hospitals, with funding split between the Australian and state and territory governments, or private hospitals, with some funding provided by the Australian Government through the Medicare system. Service provision for public hospitals is the responsibility of state and territory governments.[6]

6.6People in Northern Australia tend to have shorter than average life spans, greater rates of disability, and higher rates of chronic disease—including diseases which have been all but eradicated in metropolitan centres, such as rheumatic heart disease and strongyloidiasis.[7] They are also more likely to rely on hospital care, given limited access to primary health and allied health services.[8]

6.7Key issues related to healthcare in Northern Australia include:

higher prevalence rates of certain conditions;

issues with access to healthcare;

insufficient healthcare workforce and services; and

the need for more Aboriginal and Torres Strait Islander-controlled health care services.

Increased prevalence of certain conditions

6.8Poor housing and overcrowding in some remote Aboriginal and Torres Strait Islander communities directly contributes to poor health outcomes, including trachoma, otitis media, scabies, acute rheumatic fever and rheumatic heart disease (RHD).[9]

6.9Aboriginal and Torres Strait Islander peoples, especially those in rural and remote areas and children, are disproportionately affected by RHD and strongyloidiasis. Poor living conditions, including overcrowding, poor sanitation and inadequate hygiene, increase the risks of contracting these conditions, along with acute rheumatic fever (ARF). Rates of strongyloidiasis, ARF and RHD for Aboriginal and Torres Strait Islander peoples are among the highest in the world. Strongyloidiasis has prevalence rates of up to 60 per cent in some remote communities.[10]

6.10As Dr Ben Reeves and colleagues informed the committee, 'RHD is a perfect example of how a chronic disease' can significantly impact 'economic development, industrial investment, population growth, economic and business growth, workforce development infrastructure development and Indigenous economic participation'.[11]

6.11The committee heard that the solutions to address high rates of prevalence of RHD in Northern Australia are well-researched and known. However, Dr Reeves expressed concern about increasing numbers of cases of rheumatic fever, which can lead to rheumatic heart disease, with his area being 'totally overwhelmed'. He argued that 'what we're doing isn't working'. He called for adequate funding to prevent and treat RHD.[12]

6.12Dr Reeves also called on the Australian Government to 'fully resource NACCHO [National Aboriginal Community Controlled Health Organisation] to deliver an Aboriginal and Torres Strait Islander led National Implementation Unit to coordinate RHD elimination efforts across Australia'.[13] Dr Reeves informed the committee that 'by 2031, if we continue with the same level of funding and resourcing, we'll have another more than 600 deaths and will spend more than $270 million on the care for those patients'.[14] He further proposed a 'national register' for RHD.[15]

6.13Witnesses at the public hearing in Cairns on 18 April 2024 called for strongyloidiasis to be a national notifiable disease, given there is significant risk that people with undiagnosed strongyloidiasis will die if they are immunosuppressed or are given high doses of corticosteroids.[16] Associate Professor Richard Bradbury and colleagues also called for the establishment of a Collaborative Research Network for the Elimination of Strongyloidiasis.[17]

6.14The former Chief Medical Officer, Professor Paul Kelly, informed the committee that the Australian Government is 'committed to ending RHD as a public health issue by 2030'. Further, it has a number of initiatives underway to address the above health issues:

the Rheumatic Fever Strategy;

development of a vaccine against Strep A (which can lead to development of ARF); and

funding of $45.4 million over four years, from 2021–22 to 2024–25 to NACCHO to deliver a nationally coordinated approach to address RHD.[18]

6.15In addition, Professor Kelly advised that the Communicable Diseases Network Australia 'is currently considering an application for ARF and RHD to be included on the National Notifiable Disease List'. Extraintestinal strongyloidiasis is a notifiable condition in the Northern Territory. However, he was of the view that 'it is best' for diseases with status as Nationally Notifiable Diseases to be 'notifiable in most states and territories', if this status is 'to have any practical effect'.[19]

6.16Funding for the Rheumatic Fever Strategy is due to end on 30 June 2025.[20]

Access issues

6.17The committee received substantial evidence that the inability of many Northern Australians to access affordable health care services is impacting workforce development and retention, with inadequate access to services 'a major factor in decisions to relocate'.[21]

6.18People living in rural and remote areas may be required to travel further to access health services, and services may be more expensive than in regional and metropolitan centres, especially when travel and accommodation are factored in. Poorer living conditions, limited access to clean water and quality food, and exposure to extreme climate and weather also negatively impact the health of many Northern Australians.[22] Further, fly in-fly-out (FIFO) workers 'can have significant health risks related to occupation and lifestyle, including mental health risks', and they may not have easy access to healthcare'.[23]

6.19For Aboriginal and Torres Strait Islander peoples, healthcare challenges are exacerbated by higher rates of social disadvantage, lack of access to Aboriginal and Torres Strait Islander healthcare workers, and/or limited access to culturally appropriate care.[24] The Aboriginal Medical Services Alliance NT wrote in its submission:

We believe that the workforce crisis is already starting to affect clinical performance across the Aboriginal primary health care sector …

There has been a failure to invest in long term workforce initiatives over many years which has now culminated in the current unsustainable workforce structure in NT Aboriginal primary health care … we need new strategies and policies to attract and retain staff into the sector who are willing to give longer term commitment to Aboriginal PHC [primary health care].[25]

The healthcare workforce

6.20As discussed in Chapter 2, the healthcare and social assistance sector is the largest employer in Northern Australia and 'among the largest employers of Aboriginal and Torres Strait Islander people'.[26] However, the committee heard there are chronic, critical workforce shortages and maldistribution of specialists, general practitioners, nurses, allied health professionals and paramedics across Northern Australia. Further, the various policy initiatives by government to address these issues have met with limited success.[27]

6.21The committee further learned that there are particular challenges for health professionals working in the healthcare sector in Northern Australia, in addition to the liveability issues outlined in this chapter. Workers tend to deal with people with higher rates of disease and disability, a larger per clinician population load, and they may work over large distances.[28]

6.22Recruitment is challenging due to isolation, perceived lack of career development and advancement, inadequate housing (in particular for workers in the community) and supporting services for families (such as employment, education and childcare). Staff turnover is high, impacting patient continuity of care, quality and outcomes, and increasing recruitment and staffing costs.[29] Health services also compete with other industries—such as mining—for staff and may be unable to match the higher pay and conditions offered.[30]

Aboriginal and Torres Strait Islander models of care

6.23The committee heard that primary health care service delivery models are changing, with services in Northern Australia more likely to be delivered by not-for-profits and Aboriginal Community Controlled Health Organisations (ACCHOs) rather than private practice.[31]

6.24NACCHO advocated for more Aboriginal and Torres Strait Islander community-controlled health services. It advised that these services are '23 per cent better at attracting and retaining Aboriginal clients than mainstream providers', and 'up to fifty per cent more health gain or benefit can be achieved if health programs are delivered … via ACCHOs, compared to if the same programs are delivered via mainstream primary care services'.[32]

6.25The Department of Health and Aged Care confirmed that 'investment in this sector provides for more direct economic participation and savings from the flow on benefits employment provides in improving the social determinants of health'.[33] ACCHOs provide a key opportunity for local employment of and sustainable economic participation for Aboriginal and Torres Strait Islanders. Building local capacity also helps ensure that communities and their specific needs are put at the centre of decision making.[34]

6.26The Department of Health and Aged Care has released two plans related to the Aboriginal and Torres Strait Islander health workforce:

the National Aboriginal and Torres Strait Islander Health Plan 2021–2031; and

the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021–2031.[35]

6.27Mid-term reviews of the plans are due to be conducted in 2026.[36]

Opportunities for improving healthcare

6.28The committee heard that more flexible and responsive models of healthcare are needed to meet the needs of Northern Australians, including Aboriginal and Torres Strait Islander peoples.[37]

6.29Evidence called for local networks of Aboriginal and Torres Strait Islander health workers who live in community and have a personal relationship with communities to be replicated in communities across Northern Australia.[38]

6.30Submitters, such as NACCHO and the National Rural Health Alliance, noted that use of initiatives such as Aboriginal Community Controlled Health Registered Training Organisations (ACCHRTOs), the Rural Generalist Training Scheme (RGTS), the Northern Territory Medical Program (NTMP), and the Rural Health Multidisciplinary Training (RHMT) program have led to improvements in retaining healthcare workers in the north. For example, since 2011, over 150 students have graduated from the NTMP, 15 of whom were Aboriginal and Torres Strait Island doctors, with 54 per cent of graduates remaining in the NT beyond their four-year service obligation.[39] The National Rural Health Alliance verified:

Evidence confirms that selecting students from rural and remote backgrounds and Aboriginal and Torres Strait Islander people to undertake training in rural regions is more likely to supply early career doctors and dentists to rural Australia.[40]

6.31Submitters and witnesses to the inquiry had several proposals for creating and expanding the healthcare workforce. Several common themes emerged, including the need for:

better coordination of programs within and across governments;[41]

more responsive and adaptable models of primary health care (for example, nurse-led clinics, rural generalist medical practitioners, visiting doctors, and multidisciplinary team care), supported by appropriate funding models, particularly for Aboriginal and Torres Strait Islander people;[42]

planning and development of local community and in-place services reflective of and adaptable to local needs;[43]

improved wages and conditions for healthcare workers;[44]

incentives to attract and retain healthcare workers in the north (e.g. extend Higher Education Contribution Scheme- and Higher Education Loan Program-debt waver schemes, and employer subsidies for workers, especially those in ACCHOs);[45]

longer term investment in programs to enable the development of confidence and trust, collaborative partnerships, and longer-term employment opportunities;[46]

shared leadership and accountability for programs and services, with performance measures that favour 'cross-sector impacts and long-term measures of progress', including improvements in health;[47]

measures to empower, support and upskill local Aboriginal and Torres Strait Islander services and peoples to fill workforce shortages and improve accessibility and cultural safety of health services;[48]

access to quality, local education and training to keep locals employed and provide education and career pathways in communities (discussed further in Chapters 3 and 4);[49]

investment in health (and aged care) infrastructure;[50] and

improved access to digital health services (for example, through improved digital connectivity).[51]

6.32The Australian Government has announced a range of investments in the health sector, which will benefit Northern Australia, including:

$24.6 million over four years from 2024–25 (and an additional $72.7 million for a further five years) for Charles Darwin University to operate a medical school from 2026;[52]

$12.5 million over four years from 2024–25 to NACCHO to facilitate community-led distribution of menstrual products to First Nations communities;[53]

$94.9 million over two years to expand national strategies for First Nations vaccination uptake, sexual health services and communicable disease testing;[54]

expansion of the Midwife Professional Indemnity Scheme to cover privately practicing midwives, including births on Country;[55]

$4 million over four years to the Australian Indigenous Doctors' Association to support First Nations doctors to become medical specialists;[56]

$31.4 million over four years to continue programs to manage communicable diseases in the Torres Strait Islands and Far North Queensland;[57]

$74.1 million from 2022–23 to 2025–26 to increase financial incentives for rural doctors and generalists with advanced skills to practice in rural and remote communities;

$29.4 million from 2022–23 to 2025–26 to improve the Workforce Incentive Program to increase access to nurses, allied health practitioners and First Nations health workers working as part of multidisciplinary teams; and

$24.7 million from 2022–23 to 2025–26 to expand the Innovative Models of Care program to trial a broader range of care models.[58]

6.33The National Medical Workforce Strategy 2021–31, Nurse Practitioner 10 Year Plan, and Health Workforce Taskforce are also intended to guide longer-term workforce planning, distribution and training, including across Northern Australia.[59]

Aged care

6.34The committee heard that some areas of Northern Australia have a significant ageing population and insufficient facilities to accommodate them.[60] In Northern Australia in 2021 there were 149 701 people aged 67 years and older, with nearly 70 per cent of these receiving the age pension.[61] At that time, 3.4 per cent of people aged 65 years and over lived in cared accommodation (versus four per cent nationally), with most people living in private accommodation. This potentially reflects the lack of service availability in Northern Australia.[62]

6.35Further, many remote communities are experiencing 'urban drift', where younger people and families are moving away from remote communities to pursue more opportunities in urban centres, leading to an older or ageing workforce, and an increased need for services such as aged care in remote communities.[63]

6.36As the Rural Doctors Association of Australia advised, the ageing population 'must be considered in any Northern Australia development and workforce and other planning' given the rising proportion and number of older people.[64]

6.37The Australian Government is the primary funder of the aged care system, with people using aged care services also providing a financial contribution to their care, depending on their capacity to contribute. Aged care is provided in people's homes, in the community and in aged care homes (nursing homes or residential aged care facilities).[65]

6.38Workforce shortages in the aged care sector in Northern Australia—as well as more broadly across Australia—are impacting the ability of services to meet the needs of their communities.[66] Like other care sectors in remote areas, the aged care sector has difficulty attracting workers due to isolation, lack of suitable housing, relatively low salaries, and lack of incentives for people to work in remote areas.[67]

6.39The National Aboriginal and Torres Strait Islander Health Plan 2021–2031 prioritises enhanced access to person-centred aged care for people aged 50 and over.[68] In 2021, there were 23 147 people aged 55 years and over who identified as Aboriginal and/or Torres Strait Islander living in Northern Australia.[69]

6.40The National Indigenous Australians Agency considers aged care to be one of the sectors especially suited to creating lasting employment and long-term, local economic benefits, particularly for Aboriginal and Torres Strait Islander people.[70] The committee heard that in response to the need for aged care:

A smaller but growing number of ACCHS are providing aged care services including aged care packages. There are substantial career opportunities in both fields [disability and aged care] within our services and more broadly within the NGO [non-government organisation] sector in the areas of NDIS [National Disability Insurance Scheme] and aged care.[71]

6.41The 'growing trend' for aged care services to be provided in the home or the community was seen as a positive development, with the Aboriginal Medical Services Alliance NT—the NT peak body for ACCHOs—noting 'it will support Aboriginal people to stay in their community and be cared for in familiar surroundings and ultimately pass/die on country'.[72]

6.42NACCHO reported 'an additional 8,233 Aboriginal and Torres Strait Islander workers will be required in aged care by 2025 to ensure population parity, to meet the growth needs of the sector and action the recommendations of the Royal Commission into Aged Care Quality and Safety'.[73] However, as the Aboriginal Medical Services Alliance NT warned:

Many positions in these areas are relatively poorly paid with casualised employment which does not easily lead to career advancement. This needs to be rectified so that there are appropriate career pathways and training for Aboriginal staff in these growth areas.[74]

6.43The Australian Government has a number of measures in place to improve access to aged care in Northern Australia, including:

development of the co-designed National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021–2031. The plan specifically considers how to attract and retain Aboriginal and Torres Strait Islander peoples in the aged care workforce;[75]

the National Aboriginal and Torres Strait Islander Flexible Aged Care (NATSIFAC) Program which provides grant funding to organisations to deliver culturally safe aged care services to people close to their home and community. There are currently 23 (out of 45) such services in Northern Australia, with 13 in the NT, and five each in Queensland and WA;[76]

scholarships for Aboriginal and Torres Strait Islander students under the Aged Care Nursing and Allied Health Scholarship Program;[77]

the Indigenous Employment Initiative ongoing grants program which subsidises the employment of Aboriginal and Torres Strait Islander people in aged care. The program aims to create employment opportunities for Aboriginal and Torres Strait Islander peoples, and 'culturally appropriate aged care to First Nations people';[78]

expansion of the pilot to increase the number of Pacific aged care workers under the Pacific Australia Labour Mobility (PALM) scheme. Under the pilot workers can earn a Certificate III in Individual Support (Ageing) and work in Australia for up to four years;[79] and

the Trusted Indigenous Facilitator program to provide face-to-face support to help people access aged care services.[80]

6.44Submitters and witnesses called for further action to address the need for aged care services in Northern Australia, including:

incentives and training recommendations aligned with those made for the healthcare sector to promote training and work in remote areas;[81]

an expanded initiative along the lines of the previous Community Development Employment Projects (CDEP) program to provide training and employment pathways for culturally appropriate aged care in place in Aboriginal and Torres Strait Islander communities;[82] and

infrastructure funding for aged care (and other) facilities through the Northern Australia Infrastructure Facility (NAIF) and/or the development of a regional infrastructure strategy.[83]

6.45Rural Workforce Agencies advised the committee that 'funding models that support blended funding across health, disability and aged care are required to meet smaller population and community needs'.[84]

Disability care

6.46Northern Australia has slightly higher than national rates of disability. However, workforce shortages mean that people with disabilities 'cannot access the support and interventions they need and are eligible for'—including services under the NDIS.[85]

6.47Before the introduction of the NDIS, the Australian Government block funded disability services, by providing funding for supports for people with disability directly to providers. Under the NDIS, participants are allocated funding based on their individual needs, with the market then expected to provide the services that NDIS participants are funded for. The Australian Government funds the NDIS with contributions from state and territory governments. State and territory governments also fund programs for people with disability, although many programs ceased with the introduction of the NDIS.[86]

6.48NACCHO submitted to the committee that the estimated rate of disability among Aboriginal and Torres Strait Islander peoples is around 24 per cent, compared with about 18 per cent of Australians overall.[87] Despite this, just seven per cent of NDIS participants with a plan identify as Aboriginal and Torres Strait Islander. It highlighted the 'chronic underutilisation of plans due to thin markets and workforce shortages'.[88]

6.49The Aboriginal Medical Services Alliance NT and NACCHO observed that a growing number of ACCHSs are providing NDIS services, but there are 'major system issues … that make implementation in remote and rural Aboriginal communities very difficult'. The Alliance argued that major reform of the NDIS is required to improve equity and cultural safety for Aboriginal and Torres Strait Islander people, with the Scheme needing to be less rigid and more community focused.[89]

6.50The Northern Australia Indigenous Reference Group reflected on the 'unrealised opportunity in Indigenous communities to build' the NDIS workforce, noting that many residents of Aboriginal and Torres Strait Islander communities already provide unpaid, informal care to community members with a disability. The Reference Group argued that these individuals should be provided with the training, support and facilities to establish careers as NDIS workers and establish NDIS-based businesses.[90]

6.51Dr Francis Markham agreed, telling the committee:

In terms of the Commonwealth government, probably the biggest thing which I think could provide real opportunities at this point is the NDIS. Its massive expansion across Australia has brought a lot of jobs into the economy, more broadly, but in remote Australia that rollout hasn't happened to the same extent, I think it's fair to say. There's a great deal of work that First Nations people want to do, and are really well placed to do, that could be done if that NDIS program rollout in remote Australia were better facilitated.[91]

6.52Issues with limited service provision in rural and remote areas, leading to people with disability choosing to relocate to large towns and cities, are not new. The National Disability Insurance Agency previously had a Rural and Remote Strategy to build the NDIS workforce in rural and remote parts of Australia, and it has also conducted research into the thin markets that are a particular issue for rural and remote areas.[92] Issues with limited access to NDIS providers and services have been highlighted in multiple reports by the Joint Standing Committee on the NDIS.[93]

6.53The Department of Health and Aged Care drew attention to existing initiatives to improve services for people with disability in Northern Australia, including the Trusted Indigenous Facilitator program, intended to help people access the care they need, including disability supports.[94]

6.54Submitters and witnesses proposed the following measures to improve disability care for Northern Australia:

workforce development measures, similar to those discussed under healthcare;[95]

Community Development Program (CDP)[96] reforms to create jobs, particularly in rural and remote communities, and ensure that people with disability receive the services they need and are entitled to;[97]

training and employment pathways for culturally appropriate disability care in place in communities;[98]

more wrap-around support services to support people with disability to study and/or enter the workforce;[99]

more funding for Australian Government initiatives such as the NDIS, given the thin markets, and higher costs of service delivery in Northern Australia;[100] and

more services for people with disability, including appropriate childcare and employment services.[101]

Childcare and school education

6.55A key barrier to workforce development and participation in Northern Australia, particularly for women, is lack of access to affordable childcare and appropriate school education.[102]

Childcare

6.56Childcare services are largely operated private providers, with state and territory governments also delivering limited services. The Australian Government subsidises the cost of childcare directly to families using the services, while state and territory governments are responsible for the health, safety, wellbeing and educational outcomes of children attending early childhood education and care services.[103]

6.57In relation to childcare, the committee heard that almost 1.1 million Australians—many of them Northern Australians—live in regional and remote areas where there is little or no childcare.[104] Where there is childcare, it is not unusual for centres to have a 12 to 24 month waiting list to access services.[105]

6.58A further issue associated with childcare in North Western Australia is limited childcare hours, with some residents calling for flexible and extended childcare services, such as 24 hours and after hours care for the children of shift workers.[106]

6.59The Shire of Wyndham-East Kimberley noted that 'critical industries' like childcare are 'operating under considerable reduced capacity due to staff shortages (primarily driven by lack of affordable housing)'. As a result, workers in the region unable to secure childcare have left or do not work full-time hours.[107] AgForce Queensland Farmers expanded:

Women play a vital role in agribusiness across the north, with the most common reason women are unable to work is caring for children. Northern Australia can have geographical restrictions to childcare and early childhood education. Some live too far away from town and potential childcare options, others may live in town but face incredibly long wait times for placements within childcare centres due to limited availability. Early years educators are in short supply Australia wide, according to the National Skills Commission and when you overlay that with the isolation of rural and remote communities in Northern Australia the situation is compounded.[108]

6.60Low wages and lesser conditions in the childcare sector, combined with limited housing availability, higher cost of living and other factors, reduce the ability of the childcare sector to attract workers.[109]

6.61The Northern Australia Indigenous Reference Group also pointed to lack of accessible and affordable childcare as a barrier to improving wider workforce participation by Aboriginal and Torres Strait Islander peoples. Lack of childcare also prevents vital foundational grounding for children for future academic and social achievement.[110] The National Indigenous Australians Agency asserted 'without access to these childcare services, First Nations employees, especially women, are limited in their workforce participation as the care of children and extended kin is often their primary responsibility'.[111]

6.62Given the workforce challenges faced by childcare providers, submitters like Regional Development Australia Tropical North suggested that regional considerations be factored into the requirement for mandatory accreditation regulation, particularly for entry-level employees. It argued that more flexibility would enable providers to build capacity, continue to provide a service, and allow new workers to enter the industry 'without the undue pressure of completing a formal Cert[ificate] III', particularly where they face literacy and language barriers.[112]

6.63Childcare shortages are a well-acknowledged issue across Australia. In September 2024, Jobs and Skills Australia released a report commissioned by the Australian Government into the workforce capacity of the early childhood education and care sector. The report found that:

current workforce levels are not sustainable to even meet current levels of demand, let alone future demand;

the workforce will need to grow by an extra eight per cent to satisfy current estimated unmet demand for early childhood services and another eight per cent to meet unmet demand for qualified workers; and

workforce shortages are apparent in most regions across major cities, regional and remote Australia.[113]

6.64Recommendations for improving access to appropriate childcare included:

incentives and more flexible funding models for providers, as well as increased funding or subsidies for childcare training in regional areas;[114]

culturally appropriate early childcare services, preferably provided by a skilled, local, Aboriginal and Torres Strait Islander workforce and supported by mandated levels of staff cultural training for non-Indigenous workers;[115]

study reimbursement and/or discounted course fees for students completing childcare qualifications;[116] and

enabling employer-provided assistance such as extension of Fringe Benefit Tax (FBT) exemptions for on-premises childcare assistance to off-premises, the inclusion of childcare services in salary sacrificing packages, FBT exemptions for children's education costs for employees required to live in remote areas.[117]

School education

6.65State and territory governments are responsible for the provision of education in public schools, with private providers offering education through private and independent schools. State and territory governments provide some funding for nongovernment schools and the majority of public funding for government schools. The Australian Government provides the majority of public funding for non-government schools, and some public funding for government schools.[118]

6.66The committee was told that in some cases the local schooling option is not available for families in Northern Australia—particularly high schools in remote communities—or is 'not seen as good enough' so children are sent to boarding schools, or families choose to move to locations which are seen as having better schools which are cheaper than boarding arrangements.[119]

6.67Submitters and witnesses called for increased connections between schools, industry, employers and education providers to help address issues with limited school options. They also proposed increased traineeships and vocational education and training (VET) programs through high schools to reengage students and help up-skill students for further training and/or participation in the workforce (as discussed in Chapter 3).[120]

Housing

6.68The committee considered the adequacy of housing in Northern Australia in detail in its first report, making several recommendations to improve access to housing to improve health outcomes, liveability in the North, and ensure access to a Northern Australia workforce.[121]

6.69The committee heard that young workers in rural, remote and very remote communities struggle to access independent housing. For example, at the committee's public hearing in Alice Springs, Mr Leslie Manda from the Central Desert Regional Council highlighted that in communities existing and new public housing is being built for families—not young people:

Mr ENTSCH: Now, you talk about how one of your biggest challenges is the drift of the youngsters from about 18 through to 35. How many units of accommodation in any of those nine and 13—so what's that? That's 22 communities. How many units of accommodation do you have in those 22 communities where you have independent single-person accommodation.

Mr Manda: None.

Mr MacLeod: None.[122]

6.70Mr Manda continued:

They're family homes, and, remember, they're trying to address overcrowding. There are some households where we come from, in our neck of the woods, where there are still 14 family layers that are residing in one house. By 'family layer' I'm saying that there will be the grandparents and then there's the father and then there are all the different aunties all in one household. Guess what happens? In a community, I'll have only six new houses being built—six new houses for households, where, on average, there are 14, 13, 10 or six family groups, which means we're not really addressing the overcrowding. That independent living or public houses—understanding that it is public housing that's being built, but they're family homes. They're not independent structures.[123]

6.71Lack of independent housing in communities denies young people the opportunity to become independent and learn how to manage their own household and may be particularly problematic for young shift workers who need to be able to sleep well enough to be to be ready for work.[124]

6.72Mr Jeff MacLeod from the MacDonnell Regional Council agreed, and pointed out that lack of suitable housing impacts family members across multiple generations, including young children attending school.[125]

Ensuring safer communities

6.73Justice and community safety were identified as key factors in liveability impacting on workforce development in Northern Australia.[126] Community safety, including policing and justice, is a key part of attracting and retaining a local workforce.[127]

6.74The committee learned that crime and anti-social behaviour in some parts of Northern Australia are impacting individual safety, staff attendance and mental and psychological health, and is leading to high levels of staff turnover.[128] For example, the Shire of Wyndham-East Kimberley considered that adverse publicity of crime rates, especially as published on social media, was leading to potential new employees refusing job offers to work in the region. It suggested that local solutions, rather than 'metrocentric-imposed solutions', are needed to address problems with family dysfunction, alcohol and youth crime.[129]

6.75Unions NT underlined that more needs to be done to develop social infrastructure and services in Northern Australia to help prevent crime and make communities safer:

… for roughly 2 years, the entire Darwin city and its suburbs have gone without a drop-in centre for its youth. Whilst our 'youth crime' wave has been national news for months now, there has been little to no reporting into the fact that many parts of the NT do not have access to basic social programs that are needed for addressing challenges such as youth crime.

There are lots of community leaders who are ready to implement purpose-built programs to empower the local indigenous community. The fact is these programs are currently underfunded or not funded at all. The issue of crime has become particularly polarising among NT residents and there is a perception among the broader NT community that funding empathetic community led programs is taking a 'soft on crime' approach. It is important to be aware of this perception as it is a big impediment to building social infrastructure.[130]

6.76Other witnesses also called for more services—and youth services in particular—to disrupt crime. For example, Ms Clare Smith from the East Kimberley Chamber of Commerce and Industry spoke about the National Justice Reinvestment Program in their local community. The program looks to divert young Aboriginal and Torres Strait Islander people from the criminal justice system, and fund 'community-led solutions as to how to divert funding away from the justice system and put it into locally-led sort of programs'.[131]

6.77Submitters thought that more could be done to improve community safety in Northern Australia, through:

family assistance payments to be impacted if family members commit an offence;[132]

improved collaboration across governments to address crime and community safety;[133]

more focus on delivering more flexible, local solutions including social infrastructure and services;[134] and

addressing other core liveability issues such as more accessible and affordable housing to help address domestic and family violence.[135]

6.78In the 2024–25 Budget, the Australian Government announced that it would provide $14.2 million over two years to improve community safety measures in Alice Springs.[136]

Ability to respond to extreme disasters and emergencies

6.79Northern Australia is particularly vulnerable to natural hazards. Managing disasters and emergency situations in Northern Australia is especially challenging given its low population density, population movement and workforce capability.[137] Climate change is expected to exacerbate the frequency and impact of extreme weather events.[138]

6.80Witnesses like Professor Hurriyet Babacan from Regional Development Australia said that more could be done to disaster-proof communities, asking 'what do we mean by building resilience, particularly post disasters? Often a lot of money pumps in after the disaster. We don't do a lot of early work around mitigation that enables resilience for workforce economies and communities'.[139]

6.81There are also economic impacts post-disaster on communities and the workforce in Northern Australia. For example, the Hon Simone McGurk MLA described the 'economic crisis' and challenges in the construction sector in the Kimberley in 2022 following the landing of ex-tropical cyclone Ellie.[140]

6.82The Australian Government has dedicated funding and worked with states and territories to put in place disaster planning, mitigation and community resilience and recovery measures like the Disaster Ready Fund (DRF) to reduce the cost and impacts of disasters. The National Emergency Management Agency explained the intent of the DRF:[141]

The DRF will curb the devastating impacts of natural hazards by investing in important disaster prevention projects like flood levees, sea walls, cyclone shelters, evacuation centres, firebreaks, telecommunication improvements and systemic disaster risk reduction initiatives.[142]

6.83The National Emergency Management Agency also informed the committee that capability development programs like the Regional Recovery Exercising Program, the National Recovery Training Program and the development of a Certificate III and diploma-level VET qualifications have also been implemented to help ensure the availability of skilled workers relevant to disaster management.[143] The Australian Government has also invested in Aboriginal and Torres Strait Islander communities in recognition of the fact that 'First Nations communities are often disproportionately impacted by disasters and required tailored, culturally appropriate support'.[144]

6.84Further funding to improve disaster resilience and recovery were announced in the 2024–25 Budget, including through $519.1 million to the Future Drought Fund, $13.9 million over four years from 2024–25 and $3.4 million per year ongoing from 2028–29 to help farmers and their communities better prepare for future droughts.[145]

Committee view

6.85It is clear from the evidence the committee received to this inquiry, that tax offsets and other financial incentives are not sufficient inducements, in and of themselves, to ensure that Northern Australia has a stable workforce. Liveability is a key reason employers struggle to attract and retain employees, whether the workforce is drawn from those who have grown up in Northern Australia or those who have moved there.

6.86As highlighted by Infrastructure Australia's report into Regional Strengths and Infrastructure Gaps, and reiterated by submitters and witnesses to this inquiry, in-place health, care and education services and associated social infrastructure which is tailored to meet the needs of Northern Australian communities is desperately needed. Such services will help to improve diversity and liveability and attract workers to the region.[146]

6.87Access to key social services like healthcare, aged care, disability care, childcare and school should not be dependent on where a person lives; after all, the amount of tax that Australians pay and the tax that funds those very services, does not vary according to where they live.

6.88Previous inquiries have focused on physical infrastructure as key to the development of Northern Australia—roads, phone signal, internet and so on. As outlined in Chapter 2, the Minister for Northern Australia called the Northern Australia Infrastructure Facility 'the centrepiece of the northern Australia agenda'.[147] While the Australian Government's Northern Australia Action Plan 2024–2029 acknowledges that stakeholders highlighted challenges involved in accessing government programs that support community amenity, the plan stated only that the Australian Government would 'continue to work to find ways to promote opportunities to access government programs'.[148]

6.89Australians in 2024 rightly expect access to basic services besides roads and technology. Coordinated approaches to the provision of adequate social infrastructure in Northern Australia seem to have been a limited focus of government policy. It is time that the Australian Government gave serious consideration to improving social infrastructure in Northern Australia, not just because access to these services is a right for all Australians, but also because the lack thereof is leading to adverse outcomes, particularly in the case of healthcare, and leading to the exodus of Northern Australia's population.

6.90The committee notes that in a survey carried out by the Office of Northern Australia between September 2023 and February 2024, respondents listed 'delivering amenity' as ninth out of 14 priorities for sustainable and resilient development. Even so, reduced life expectancy and increased morbidity because of increased rates of preventable disease, should be a priority for any government. Further, this committee's focus is on workforce development. It is clear, from the evidence outlined in this chapter, that besides housing, the main reason potential employees are not taking up opportunities in Northern Australia (and many people are leaving) is because of a lack of social infrastructure.

6.91As noted in the committee's First Report, inquiries into the development of Northern Australia have existed since 1937. The time has come for decades of policy initiatives and funding to improve conditions in Northern Australia to be properly evaluated. Initiatives to improve social infrastructure should form a key future focus for the Office of Northern Australia.

6.92As explored in Chapter 4, the committee heard that communities want to see a return to a jobs program which more closely resembles the previous Community Development Employment Program (CDEP), which was perceived to build social cohesion and individual self-respect. Further to the committee's Recommendation 3, the committee further recommends that the Office of Northern Australia be resourced to closely monitor the progress and implementation of the new Remote Jobs and Economic Development (RJED) program to ensure it benefits communities and the people living in them.

6.93Funding for an audit and evaluation of the success of Commonwealth policy initiatives on social infrastructure, including health care, aged care, disability care, childcare, schools, community safety and natural disaster management is also necessary. In addition, these future policy initiatives should include clear, measurable targets, key performance indicators and clear dates for evaluation.

Recommendation 10

6.94The committee recommends that the Australian Government adequately resource the Office of Northern Australia to:

closely monitor progress in relation to the recovery and revival of community jobs and the associated work ethic and social capital that were developed under the former Community Development Employment Program, and which were lost as a result of the abandoning of that program;

evaluate what other policy initiatives to improve social infrastructure have worked in the past;

focus on initiatives to improve social infrastructure in Northern Australia going forward; and

ensure that future policy initiatives are evaluated in terms of their effectiveness, with clear key performance indicators and evaluation dates.

6.95It is not acceptable that the prevalence rates of certain preventable conditions, such as acute rheumatic fever and rheumatic heart disease, in parts of Northern Australia are among the highest in the world, nor that strongyloidiasis has prevalence rates of up to 60 per cent in some remote communities. The committee was dismayed to hear that existing action and funding may lead to more cases, not less, and in the case of strongyloidiasis, it is astonishing to the committee that this condition is not yet a notifiable disease, given its health impacts.

6.96Preventable chronic disease—including rheumatic heart disease and strongyloidiasis—is affecting the ability of people to engage in work, and even worse, it is contributing to a higher health burden and higher mortality rates. As a first step, further action is needed to address housing shortages, overcrowding and poor sanitation in remote communities. The committee made a number of recommendations in the First Report intended to improve housing in Northern Australia.

6.97The committee has also heard that young, single people in rural, remote and very remote communities do not have access to independent housing. They are being forced to live in family homes—which are often congested and house multiple generations—and do not have the opportunity to become independent and learn how to manage their own households. This is particularly problematic for young workers who need to be work-ready but may struggle to get enough sleep in a household where others are operating on different timelines across their day.

6.98The Australian Government is aware of the housing challenges being experienced by many Australians, including those in Northern Australia, and has put a number of measures in place to address the crisis. The committee strongly advocates for more housing, particularly in rural, remote and very remote communities, for young, single workers, to provide them with the best opportunities at the start of their working lives.

Recommendation 11

6.99The committee recommends that the Australian Government, when developing and implementing measures to address housing shortages in Northern Australia, consider the provision of suitable housing for both families and people in other situations, including young, single workers in rural, remote and very remote communities.

Footnotes

[1]The Chamber of Minerals and Energy of Western Australia, Submission 39, p. 4.

[2]Joint Select Committee on Northern Australia, Issues Paper – Workforce Development in Northern Australia, June 2023, p. 7.

[3]NT Department of Industry, Tourism and Trade, answers to questions on notice from the public hearing on 31 March 2023 and written questions on notice, 11 April 2023 (received 12 May 2023), p. 1.

[4]Australian Institute of Architects, Submission 43, p. 16.

[5]Services for Australian Rural and Remote Allied Health, Submission 35, p. 6.

[6]Australian Institute of Health and Welfare, Health System Overview, 2 July 2024, (accessed 24 October 2024);South Australian Health and Medical Research Institute, ACCHO Funding Challenges: Policy Brief, February 2020, p. 1; Australian Government, What Primary Health Networks are, (accessed 24 October 2024).

[7]Dr Donald Mackie, Executive Director, Medical Services, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 17 April 2024, pp. 55–56; Services for Australian Rural and Remote Allied Health, Submission 35, p. 4; National Rural Health Alliance, Submission 72, p. 3; Associate Professor Richard Bradbury and colleagues, answers to questions taken on notice, public hearing, 18 April 2024 (received 16 May 2024), p. 2.

[8]Ms Louise Livingstone, President, Atherton Tablelands Chamber of Commerce, Committee Hansard, 17 April 2024, p. 47; Services for Australian Rural and Remote Allied Health, Submission 35, p. 4; Dr Donald Mackie, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 17 April 2024, p. 56; National Rural Health Alliance, Submission 72, p. 3.

[9]National Aboriginal Community Controlled Health Organisation, Submission 75, p. 9.

[10]Additional information provided by Professor Paul Kelly, Chief Medical Officer, Department of Health and Aged Care on rheumatic heart disease and strongyloidiasis (received 12 September 2024), pp. 1– 2; Associate Professor Richard Bradbury, Associate Professor of Public Health and Tropical Medicine, School of Public Health and Tropical Medicine, James Cook University, Committee Hansard, 18 April 2024, p. 3.

[11]Dr Ben Reeves and colleagues, Submission 80, p. 2.

[12]Dr Ben Reeves, Paediatric Cardiologist, Queensland Health, Cairns Hospital, Committee Hansard, 18 April 2024, p. 11.

[13]Dr Ben Reeves and colleagues, Submission 80, p. 1.

[14]Dr Ben Reeves, Queensland Health, Cairns Hospital, Committee Hansard, 18 April 2024, p. 11.

[15]Dr Ben Reeves, Queensland Health, Cairns Hospital, Committee Hansard, 18 April 2024, p. 13.

[16]Dr Wendy Page, Founding Member, Strongyloidiasis Australia, Committee Hansard, 18 April 2024, pp. 2–3; Associate Professor Richard Bradbury, James Cook University, Committee Hansard, 18 April 2024, p. 5; Professor Darren Gray, Director, Population Health Program, QIMR Berghofer Medical Research Institute, Committee Hansard, 18 April 2024, p. 6. See also Associate Professor Richard Bradbury and colleagues – answers to questions taken on notice – public hearing, 18 April 2024 (received 16 May 2024), pp. 2–3, 5.

[17]Associate Professor Richard Bradbury and colleagues – answers to questions taken on notice – public hearing, 18 April 2024 (received 16 May 2024), p. 4.

[18]Professor Paul Kelly, Department of Health and Aged Care, additional information rheumatic heart disease and strongyloidiasis (received 12 September 2024), p. 1.

[19]Professor Paul Kelly, Department of Health and Aged Care, additional information rheumatic heart disease and strongyloidiasis (received 12 September 2024), pp. 1, 2.

[20]Professor Paul Kelly, Department of Health and Aged Care, additional information rheumatic heart disease and strongyloidiasis (received 12 September 2024), p. 1.

[21]Services for Australian Rural and Remote Allied Health, Submission 35, pp. 6–7; Rural Doctors Association of Australia, Submission 46, [p. 8]; Ms Jodie Wallace, Executive Director, Policy Planning and Innovation, Department of Training and Workforce Development (Western Australian Government), Committee Hansard, 31 March 2023, p. 19.

[22]Dr Donald Mackie, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 17 April 2024, pp. 55–56; Services for Australian Rural and Remote Allied Health, Submission 35, p. 4; National Rural Health Alliance, Submission 72, pp. 3–4; Rural Doctors Association of Australia, Submission 46, [pp. 5–6].

[23]Rural Doctors Association of Australia, Submission 46, [p. 6].

[24]National Aboriginal Community Controlled Health Organisation, Submission 75, p. 8; Rural Doctors Association of Australia, Submission 46, [p. 6].

[25]Aboriginal Medical Services Alliance NT, Submission 58, pp. 2–3.

[26]Services for Australian Rural and Remote Allied Health, Submission 35, pp. 3 and 8–10; Parliamentary Library, Department of Parliamentary Services, Advice: Northern Australia workforce and characteristics: Table 7a, 29 August 2024; Rural Doctors Association of Australia, Submission 46, [p. 10].

[27]Department of Health and Aged Care, Submission 49, p. 4; Dr Donald Mackie, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 17 April 2024, p. 58; Services for Australian Rural and Remote Allied Health, Submission 35, p. 3; National Rural Health Alliance, Submission 72, pp. 5–6; Rural Doctors Association of Australia, Submission 46, [p. 5]; Queensland Nurses and Midwives' Union, Submission 15, p. 3; Adjunct Associate Professor Ray Bange OAM, Submission 53, pp. 18–21 and Supplementary Submission 53.1, pp. 12 and 22–23.

[28]Dr Donald Mackie, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 17 April 2024, pp. 55–56; Services for Australian Rural and Remote Allied Health, Submission 35, p. 4; Queensland Nurses and Midwives' Union, Submission 15, p. 5.

[29]Department of Health and Aged Care, Submission 49, p. 6; Dr Donald Mackie, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 17 April 2024, pp. 56 and 58; Services for Australian Rural and Remote Allied Health, Submission 35, p. 4; National Rural Health Alliance, Submission 72, p. 2; Rural Doctors Association of Australia, Submission 46, [p. 10]; Queensland Nurses and Midwives' Union, Submission 15, pp. 5 and 7–8; Aboriginal Medical Services Alliance NT, Submission 58, pp. 1–2 and 5.

[30]National Aboriginal Community Controlled Health Organisation, Submission 75, p. 10; Department of Health and Aged Care, Submission 49, p. 6.

[31]Ms Louise Livingstone, Atherton Tablelands Chamber of Commerce, Committee Hansard, 17 April 2024, p. 47; Dr Donald Mackie, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 17 April 2024, pp. 58–59.

[32]National Aboriginal Community Controlled Health Organisation, Submission 75, pp. 7–8 and 11. See also: Department of Health and Aged Care, Submission 49, pp. 15–16.

[33]Department of Health and Aged Care, Submission 49, p. 21.

[34]National Aboriginal Community Controlled Health Organisation, Submission 75, pp. 7–8 and 11; Aboriginal Medical Services Alliance NT, Submission 58, p. 5.

[35]Department of Health and Aged Care, National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021–2031, 7 March 2022 (accessed 9 September 2024); Department of Health and Aged Care, The National Aboriginal and Torres Strait Islander Health Plan 2021–2031 (accessed 9 September 2024).

[36]National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021–2031, p. 27; The National Aboriginal and Torres Strait Islander Health Plan Brochure 2021–2031, p. 2.

[37]Ms Louise Livingstone, Atherton Tablelands Chamber of Commerce, Committee Hansard, 17 April 2024, p. 47.

[38]Dr Ben Reeves, Queensland Health, Cairns Hospital, Committee Hansard, 18 April 2024, p. 14.

[39]The Northern Territory Medical Program (NTMP) is a collaboration with Flinders and Charles Darwin Universities, the NT Government and the Australian Government. Department of Health and Aged Care, Submission 49, pp. 6–8 and 13–14; National Aboriginal Community Controlled Health Organisation, Submission 75, pp. 12–16; Coalition of Peaks, Submission 78, [p. 5]; National Rural Health Alliance, Submission 72, pp. 5–6; Department of Infrastructure, Transport, Regional Development, Communications and the Arts, answers to written questions on notice, 11 April 2023 (received 8 May 2023), [pp. 5–6].

[40]National Rural Health Alliance, Submission 72, p. 5.

[41]Services for Australian Rural and Remote Allied Health, Submission 35, p. 7; National Rural Health Alliance, Submission 72, p. 4.

[42]Dr Donald Mackie, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 17 April 2024, p. 60; National Aboriginal Community Controlled Health Organisation, Submission 75, pp. 7–9; National Rural Health Alliance, Submission 72, pp. 5–6 and 9; Rural Doctors Association of Australia, Submission 46, [p. 5]; Queensland Nurses and Midwives' Union, Submission 15, pp. 10–11; Rural Workforce Agencies, Submission 9, [p. 4].

[43]Services for Australian Rural and Remote Allied Health, Submission 35, p. 7; National Aboriginal Community Controlled Health Organisation, Submission 75, pp. 9–10; National Rural Health Alliance, Submission 72, p. 4; Rural Doctors Association of Australia, Submission 46, [p. 10]; Charles Darwin University, Submission 50, p. 9; Rural Workforce Agencies, Submission 9, [p. 4].

[44]Department of Health and Aged Care, Submission 49, p. 6; Rural Workforce Agencies, Submission 9, [p. 4].

[45]National Aboriginal Community Controlled Health Organisation, Submission 75, p. 10; National Rural Health Alliance, Submission 72, p. 6; Rural Doctors Association of Australia, Submission 46, [pp. 5 and 10]; Queensland Nurses and Midwives' Union, Submission 15, pp. 4 and 9; Aboriginal Medical Services Alliance NT, Submission 58, pp. 1 and 4.

[46]Services for Australian Rural and Remote Allied Health, Submission 35, p. 7; National Rural Health Alliance, Submission 72, p. 4; Aboriginal Medical Services Alliance NT, Submission 58, pp. 3–4.

[47]Northern Australian Indigenous Reference Group, Submission 62, pp. 31–32; Services for Australian Rural and Remote Allied Health, Submission 35, p. 7. See also: Rural Doctors Association of Australia, Submission 46, [p. 8].

[48]National Aboriginal Community Controlled Health Organisation, Submission 75, p. 9; Rural Workforce Agencies, Submission 9, [p. 3]; Services for Australian Rural and Remote Allied Health, Submission 35, p. 7; National Rural Health Alliance, Submission 72, p. 4; Rural Doctors Association of Australia, Submission 46, [pp. 6 and 11]; Aboriginal Medical Services Alliance NT, Submission 58, p. 1, 4 and 6.

[49]National Rural Health Alliance, Submission 72, pp. 1–2 and 5–6; National Aboriginal Community Controlled Health Organisation, Submission 75, pp. 10–16; Queensland Nurses and Midwives' Union, Submission 15, pp. 9–10; Aboriginal Medical Services Alliance NT, Submission 58, pp. 1, 4 and 6.

[50]Livingstone Shire Council, Submission 22, pp. 3 and 7; Rural Workforce Agencies, Submission 9, [pp. 3–4].

[51]Northern Australian Indigenous Reference Group, Submission 62, p. 12; Rural Doctors Association of Australia, Submission 46, [pp. 8–9]; Queensland Nurses and Midwives' Union, Submission 15, p. 9.

[52]Department of Health and Aged Care, Budget 2024–25: Ensuring all Australians get the health care they need, [p. 7] (accessed 9 September 2024); Australian Government, Budget 2024–25: Budget measures: Budget paper no. 2, 14 May 2024, p. 63.

[53]National Indigenous Australians Agency, Budget 2024-25: Delivering better outcomes for First Nations people (accessed 9 September 2024).

[54]National Indigenous Australians Agency, Budget 2024-25: Delivering better outcomes for First Nations people.

[55]National Indigenous Australians Agency, Budget 2024-25: Delivering better outcomes for First Nations people.

[56]National Indigenous Australians Agency, Budget 2024-25: Delivering better outcomes for First Nations people.

[57]Australian Government, Budget 2024–25: Budget measures: Budget paper no. 2, p. 114.

[58]See also: Department of Health and Aged Care, Our work related to the Aboriginal and Torres Strait Islander health workforce (accessed 9 September 2024); Department of Infrastructure, Transport, Regional Development, Communications and the Arts, answers to written questions on notice, 11 April 2023 (received 8 May 2023), [pp. 5–6].

[59]Department of Health and Aged Care, Submission 49, pp. 12–14.

[60]Such as the Livingstone Shire Council around Yeppoon, Rockhampton and Gladstone; as well as Innisfail, Mareeba, and Bowen. Parliamentary Library, Department of Parliamentary Services, Advice: Northern Australia workforce and characteristics: Table 9, 29 August 2024; Livingstone Shire Council, Submission 22, pp. 3 and 7.

[61]Parliamentary Library, Advice: Northern Australia workforce and characteristics: Tables 1a and 9, 29 August 2024.

[62]Parliamentary Library, Advice: Northern Australia workforce and characteristics: Table 11, 29 August 2024.

[63]Mr Leslie Manda, Chief Executive Officer, Central Desert Regional Council, Committee Hansard, 27 June 2023, p. 14. See also: National Aboriginal Community Controlled Health Organisation, Submission 75, p. 5.

[64]Rural Doctors Association of Australia, Submission 46, [p. 6].

[65]Ms Rebecca Storen, Aged Care: A Quick Guide, Parliamentary Library, Canberra, 30 April 2021 (accessed 22 November 2024).

[66]Local Government Association of Queensland, Supplementary submission 54.1, p. 20.

[67]Central Desert Regional Council, Submission 73, p. 1; Western Australian Department of Training and Workforce Development, answers to written questions on notice, 11 April 2023 (received 5 May 2023), [p. 15]; Regional Development Australia: Tropical North, Submission 52, p. 9.

[68]Department of Health, The National Aboriginal and Torres Strait Islander Health Plan Brochure 2021–2031, p. 5 (accessed 9 September 2024); Australian Institute of Health and Welfare, Aged care for First Nations people, 7 September 2023 (accessed 22 November 2024).

[69]Parliamentary Library, Advice: Northern Australia workforce and characteristics: Tables 1a, 2a and 9, 29 August 2024.

[70]National Indigenous Australians Agency, answers to questions on notice from the public hearing on 31 March 2023 in Canberra (received 18 July 2023), [p. 44].

[71]Aboriginal Medical Services Alliance NT, Submission 58, p. 5.

[72]Aboriginal Medical Services Alliance NT, Submission 58, p. 5.

[73]National Aboriginal Community Controlled Health Organisation, Submission 75, p. 9.

[74]Aboriginal Medical Services Alliance NT, Submission 58, p. 5.

[75]Department of Health and Aged Care, Submission 49, p. 19.

[76]Department of Health and Aged Care, Submission 49, p. 17.

[77]Department of Health and Aged Care, Submission 49, p. 16.

[78]Department of Health and Aged Care, Submission 49, p. 18.

[79]Department of Foreign Affairs and Trade, Submission 11, p. 5; Department of Home Affairs, Submission 27, p. 10.

[80]Department of Health and Aged Care, Submission 49, p. 18.

[81]National Aboriginal Community Controlled Health Organisation, Submission 75, p. 13; Central Desert Regional Council, Submission 73, pp. 1–2.

[82]Mr Harvie Stiller, Community Campaigner, Unions NT, Committee Hansard, 29 June 2023, p. 21; Ms Theresa Roe, Secretariat Coordinator, Aboriginal Peak Organisations NT, Committee Hansard, 29 June 2023, p. 32; Emeritus Professor Jon Charles Altman, Private capacity, Committee Hansard, 31 March 2023, pp. 6–7; National Indigenous Australians Agency, answers to questions on notice from the public hearing on 31 March 2023 in Canberra (received 18 July 2023), [p. 45]; Northern Australian Indigenous Reference Group, Submission 62, pp. 23, 27–28; Dr Josie Douglas, Executive Manager, Policy and Governance, Central Land Council, Committee Hansard, 27 June 2023, pp. 23 and 26–27.

[83]Mr Paul Sjogren, Principal, Trinity Anglican School, Committee Hansard, 17 April 2024, p. 60; The Hon Simone McGurk MLA, Minister for Training and Workforce Development (Western Australian Government), Submission 67, p. 1.

[84]Rural Workforce Agencies, Submission 9, [p. 4]. See also Adjunct Associate Professor Ray Bange OAM, Submission 53, pp. 25–26.

[85]For example: five per cent of Northern Australians receive the Disability Support Pension, compared with 4.7 per cent nationally. Parliamentary Library, Department of Parliamentary Services, Advice: Northern Australia workforce and characteristics: Table 9, 29 August 2024; National Rural Health Alliance, Submission 72, p. 9; Services for Australian Rural and Remote Allied Health, Submission 35, p. 4; Australian Institute of Aboriginal and Torres Strait Islander Studies, Submission 5, p. 1.

[86]Rosalind Hewett, National Disability Insurance Scheme: A Quick Guide, Parliamentary Library Quick Guides 2021–22, 17 February 2022 (accessed 24 October 2024); Rosalind Hewett, 'Where are the other lifeboats? Services for people with disability outside the NDIS', Flagpost, 25 August 2022, (accessed 24 October 2024).

[87]Australian Institute of Health and Welfare, People with Disability in Australia, 23 April 2024 (accessed 24 October 2024).

[88]National Aboriginal Community Controlled Health Organisation, Submission 75, p. 9.

[89]Aboriginal Medical Services Alliance NT, Submission 58, p. 5; National Aboriginal Community Controlled Health Organisation, Submission 75, p. 5.

[90]Northern Australia Indigenous Reference Group, Submission 62, p. 10.

[91]Dr Francis Markham, Private capacity, Committee Hansard, 31 March 2023, pp. 3–4.

[92]See National Disability Insurance Agency, Rural and Remote Strategy 2016–2019 (accessed 16 May 2023); National Disability Insurance Agency, Markets and innovations research (accessed 16 May 2023).

[93]Joint Standing Committee on the NDIS, NDIS Planning – Final Report, December 2020, Chapter 9;Joint Standing Committee on the NDIS, General Issues around the Implementation and Performance of the NDIS, December 2020, pp. 93, 96, 98, 126–127; Joint Standing Committee on the NDIS, General Issues around the Implementation and Performance of the NDIS, November 2021, pp. 48–49.

[94]Department of Health and Aged Care, Submission 49, p. 18.

[95]See, for example: The Hon Simone McGurk MLA, Minister for Training and Workforce Development (Western Australian Government), Submission 67, p. 2.

[96]See Chapter 4 for further discussion of the CDP.

[97]Dr Josie Douglas, Central Land Council, Committee Hansard, 27 June 2023, pp. 23 and 26–27; Emeritus Professor Jon Charles Altman, Private capacity, Committee Hansard, 31 March 2023, p. 4; Ms Tua Snowball, Community Development Program Manager, Kalano Community Organisation, Committee Hansard, 28 June 2023, p. 32.

[98]Mr Harvie Stiller, Unions NT, Committee Hansard, 29 June 2023, p. 21; Ms Theresa Roe, Aboriginal Peak Organisations NT, Committee Hansard, 29 June 2023, p. 32; Emeritus Professor Jon Charles Altman, Private capacity, Committee Hansard, 31 March 2023, pp. 6–7; National Indigenous Australians Agency, answers to questions on notice from the public hearing on 31 March 2023 in Canberra (received 18 July 2023), [p. 45]; Northern Australian Indigenous Reference Group, Submission 62, pp. 23, 27–28; Dr Josie Douglas, Central Land Council, Committee Hansard, 27 June 2023, pp. 23 and 26–27.

[99]Northern Territory Chamber of Commerce, answers to questions on notice from the public hearing on 29 June 2023 in Darwin (received 23 August 2023), pp. 13 and 15; Professor Maree DinanThompson, Deputy Vice Chancellor Education, James Cook University, Committee Hansard, 17 April 2024, p. 9.

[100]Department of Training and Workforce Development (Western Australian Government), answers to written questions on notice, 11 April 2023 (received 5 May 2023), [p. 7].

[101]Northern Australia Indigenous Reference Group, Submission 62, pp. 11–12; National Indigenous Australians Agency, answers to questions on notice from the public hearing on 31 March 2023 in Canberra (received 18 July 2023), pp. 2–3 and 6; Western Australian Department of Training and Workforce Development, answers to written questions on notice, 11 April 2023 (received 5 May 2023), [pp. 6 and 13].

[102]Department of Training and Workforce Development (Western Australian Government), answers to written questions on notice, 11 April 2023 (received 5 May 2023), [p. 15]; Northern Territory Government, answers to questions on notice from the public hearing on 31 March 2023 and written questions on notice, 11 April 2023 (received 12 May 2023), p. 2; Australian Institute of Architects, Submission 43, pp. 16–17; Department of Home Affairs, Submission 27, p. 13.

[103]Department of Education, Early Childhood (accessed 24 October 2024).

[104]Northern Australia Indigenous Reference Group, Submission 62, p. 11; AgForce Queensland Farmers Ltd, Submission 51, p. 2; Northern Territory Government, answers to questions on notice from the public hearing on 31 March 2023 and written questions on notice, 11 April 2023 (received 12 May 2023), p. 10; Rural Jobs and Skills Alliance, Submission 7, Attachment 1, pp. 23 and 25; Rural Doctors Association of Australia, Submission 46, [p. 5].

[105]Department of Training and Workforce Development (Western Australian Government), answers to written questions on notice, 11 April 2023 (received 5 May 2023), [pp. 2 and 15]; Councillor Tony Chafer, Deputy Shire President of the Shire of Wyndham-East Kimberley; Director, Gelganyem Trust; and Chief Executive Officer, Cambridge Gulf Limited, Committee Hansard, 24 August 2023, p. 3.

[106]Department of Training and Workforce Development (Western Australian Government), answers to written questions on notice, 11 April 2023 (received 5 May 2023), p. 15.

[107]Shire of Wyndham-East Kimberley, Submission 13, p. 2.

[108]AgForce Queensland Farmers Ltd, Submission 51, p. 2.

[109]Department of Training and Workforce Development (Western Australian Government), answers to written questions on notice, 11 April 2023 (received 5 May 2023), [p. 15].

[110]Northern Australia Indigenous Reference Group, Submission 62, p. 11.

[111]National Indigenous Australians Agency, answers to questions on notice from the public hearing on 31 March 2023 in Canberra (received 18 July 2023), [p. 43].

[112]Regional Development Australia Tropical North, Submission 52, p. 7. See also: Councillor Tony Chafer, Shire of Wyndham-East Kimberley, Committee Hansard, 24 August 2023, pp. 4–5; Ms Clare Smith, Chief Executive Officer, East Kimberley Chamber of Commerce and Industry, Committee Hansard, 24 August 2023, pp. 15 and 18; Regional Development Australia: Kimberley, Submission 1, [p. 4]; Central Desert Regional Council, Submission 73, p. 2.

[113]Jobs and Skills Australia, The Future of the Early Childhood Education Profession: Early Childhood Education and Care Workforce Capacity Study Summary Report, September 2024, pp. 8, 10.

[114]Regional Development Australia: Tropical North, Submission 52, p. 7; Department of Training and Workforce Development (Western Australian Government), answers to written questions on notice, 11 April 2023 (received 5 May 2023), [p. 3]; Department of Youth Justice, Employment, Small Business and Training (Queensland Government), answers to written questions on notice, 21 April 2023 (received 25 May 2023), p. 6; Chamber of Minerals and Energy WA, Submission 39, p. 5; Shire of Broome, Submission 32, p. 4.

[115]Northern Australia Indigenous Reference Group, Submission 62, pp. 11–12.

[116]Shire of Broome, Submission 32, p. 4.

[117]Chamber of Minerals and Energy WA, Submission 39, p. 6.

[118]Dr Shannon Clark, 'School Education', Parliamentary Library Briefing Book – 47th Parliament, June 2022 (accessed 22 November 2024).

[119]Dr Francis Markham, Private capacity, Committee Hansard, 31 March 2023, p. 4; Ms Tegan Peirce, Owner and Operator, Dragonfly Catering and Events, Committee Hansard, 28 June 2023, p. 36; Ms Annabel McIarty, Owner, Katherine Outback Experience, Committee Hansard, 28 June 2023, pp. 38–39; Mr Lui Ned David, Executive Chairperson, Gur A Baradharaw Kod Torres Strait Sea and Land Council Torres Strait Islander and Aboriginal Corporation (GBK), Committee Hansard, 18 April 2024, p. 32; NT Farmers Association, Submission 26, [pp. 2–3].

[120]Ms Kerry Robertson, Secretary, East Kimberley Chamber of Commerce and Industry, Committee Hansard, 24 August 2023, p. 18; Mr Mark Olsen, Chief Executive Officer, Tourism Tropical North Queensland, Committee Hansard, 18 April 2024, pp. 20 and 22; Ms Vonda Malone, Chief Executive Officer, Torres Strait Regional Authority Committee Hansard, 18 April 2024, p. 29; Mr Vincent Lange, Chief Executive Officer, Centrefarm Aboriginal Horticulture Limited; Aboriginal Land Economic Development Agency, Committee Hansard, 29 June 2023, p. 2; Northern Australian Universities Alliance, Submission 19, [pp. 2–3].

[121]Joint Select Committee on Northern Australia, Northern Australia workforce development: First report, November 2023, Chapters 3 and 4.

[122]The Hon Warren Entsch MP, Member for Leichhardt, Queensland, Mr Leslie Manda, Central Desert Regional Council, and Mr Jeff MacLeod, Chief Executive Officer, MacDonnell Regional Council, Committee Hansard, 27 June 2023, p. 17. See also: Ms Alison Jacks, Administration Manager, Jawoyn Association, Committee Hansard, 28 June 2023, p. 2; Mr Alan Mole, Chief Executive Officer, Kalano Community Association, Committee Hansard, 28 June 2023,p. 33.

[123]Mr Leslie Manda, Central Desert Regional Council, Committee Hansard, 27 June 2023, p. 17.

[124]Mr Alan Mole, and Ms Tua Snowball, Community Development Program Manager, Kalano Community Association, Committee Hansard, 28 June 2023, p. 33; Ms Theresa Roe, Secretariat Coordinator, Aboriginal Peak Organisations Northern Territory, Committee Hansard, 29 June 2023, p. 28; Mrs Kathleen Hoare, Director, State Workforce Planning, Department of Training and Workforce Development, Western Australia, Committee Hansard, 31 March 2023, p. 22.

[125]Mr Jeff MacLeod, MacDonnell Regional Council, Committee Hansard, 27 June 2023, p. 18.

[126]See, for example: The Hon Simone McGurk MLA, Minister for Training and Workforce Development (Western Australian Government), Submission 67, p. 9; Ms Vonda Malone, Torres Strait Regional Authority, Committee Hansard, 18 April 2024, p. 28; Local Government Association of the Northern Territory, Submission 38, [p. 7]; Rural Doctors Association of Australia, Submission 46, [pp. 5 and 10]; Regional Development Australia: Kimberley, Submission 1, [pp. 3–4]; Ms Clare Smith, East Kimberley Chamber of Commerce and Industry, Committee Hansard, 24 August 2023, pp. 15 and 20–21; Ms Nicole Walsh, Chief Operating Officer, Chamber of Commerce Northern Territory, Committee Hansard, 27 June 2023, pp. 29–30; Chamber of Minerals and Energy WA, Submission 39, p. 4.

[127]Local Government Association of Queensland, Submission 54 – Supplementary submission, p. 15.

[128]Regional Development Australia: Kimberley, Submission 1, [pp. 3–4]; Local Government Association of the NT, Submission 38, [p. 7]. See also: Mr Sean Holden, Chief Executive Officer, Local Government Association of the Northern Territory, Committee Hansard, 29 June 2023, pp. 35–36.

[129]Shire of Wyndham-East Kimberley, Submission 13, pp. 2 and 4.

[130]Unions NT, Submission 74, p. 3. See also: Livingstone Shire Council, Submission 22, p. 9.

[131]Ms Clare Smith, East Kimberley Chamber of Commerce and Industry, Committee Hansard, 24 August 2023, pp. 21–22. See also Ms Nicole Walsh, Chamber of Commerce Northern Territory, Committee Hansard, 27 June 2023, p. 32; National Indigenous Australians Agency, Submission 16, p. 4; Attorney-General's Department, Justice Reinvestment (accessed 12 September 2024); Livingstone Shire Council, Submission 22, p. 9.

[132]Regional Development Australia: Kimberley, Submission 1, p. 4.

[133]Regional Development Australia: Kimberley, Submission 1, [pp. 3–4].

[134]Shire of Wyndham-East Kimberley, Submission 13, [p. 4]; Professor Allan Dale, Cairns Institute, James Cook University, Committee Hansard, 17 April 2024, p. 2; Chamber of Commerce and Industry WA, Submission 39, p. 5.

[135]Australian Institute of Architects, Submission 43, pp. 10–11; Australian National Audit Office, Submission 4, p. 12; Northern Land Council, Submission 57, p. 17.

[136]The Hon Catherine King, MP, Minister for Infrastructure, Transport, Regional Development and Local Government of the Commonwealth of Australia and The Hon Kristy McBain, MP, Minister for Regional Development, Local Government and Territories of the Commonwealth of Australia, Budget 2024–25: Regional Ministerial Budget Statement 2024–25: Delivering a resilient and prosperous future for Regional Australia, 14 May 2024, p. 22.

[137]National Emergency Management Agency, Submission 60, pp. 2 and 6; Local Government Association of Queensland, Supplementary submission 54.1, pp. 15–16; The Hon Simone McGurk MLA, Minister for Training and Workforce Development (Western Australian Government), Submission 67, p. 11.

[138]The Hon Simone McGurk MLA, Minister for Training and Workforce Development (Western Australian Government), Submission 67, p. 11.

[139]Professor Hurriyet Babacan, Chair, Regional Development Australia Tropical North, Committee Hansard, 18 April 2024, p. 17.

[140]The Hon Simone McGurk MLA, Minister for Training and Workforce Development (Western Australian Government), Submission 67, p. 11.

[141]National Emergency Management Agency, Submission 60, pp. 4–7.

[142]National Emergency Management Agency, Submission 60, p. 5.

[143]National Emergency Management Agency, Submission 60, pp. 4–7.

[144]National Emergency Management Agency, Submission 60, pp. 5–6.

[145]Australian Government, Budget 2024–25: Regional Ministerial Budget Statement 2024–25: Delivering a resilient and prosperous future for Regional Australia, 14 May 2024, pp. 16, 17–18.

[146]Infrastructure Australia, 2022 Regional Strengths and Infrastructure Gaps: overview [report], pp. 35–36.

[147]The Hon Madeleine King MP, Minister for Northern Australia, Message from the Minister: Northern Australia Action Plan 2024–2029 (accessed 25 October 2024).

[148]Australian Government, Northern Australia Action Plan 2024–2029, August 2024, p. 55.