Investing in Aboriginal health and wellbeing infrastructure: securing safe and sustainable Community-controlled care

Evidence shows that services delivered by Aboriginal Community-Controlled Organisations (ACCOs) have a 50% greater impact than if those same interventions were delivered through mainstream health services.

But an initial $150 million urgent investment is needed by 2030 in Victorian ACCO infrastructure to deliver safe and effective care and help close the widening gap in health outcomes for Aboriginal Victorians.  

Another $30 million of funding is needed each year over the next 5 years for Aboriginal Community-Controlled organisations to urgently repair existing infrastructure.

Despite the state of infrastructure, the Victorian ACCO model delivers quality outcomes and early interventions that improve health and wellbeing and reduce pressure on other healthcare services. Aboriginal and Torres Strait Islander people are more likely to adhere to treatment plans when they are facilitated by ACCOs (96%) compared to mainstream health services (78%).  

The research finds ACCOs could do much more if their infrastructure worked.

This research report, jointly developed by Infrastructure Victoria and the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) recommends the Victorian Government act now to fund urgent repairs to make ACCO buildings safe, operational and efficient.

Key findings

• More than 80% of Victorian health and wellbeing ACCO buildings need replacing or substantial repairs within the next 15 years.
• An audit of 200 ACCO buildings across 31 organisations found that 52% of ACCO infrastructure is already at the end of its useful life and 42% of the total floor space is in a critical condition.
• Recent building energy audits found ACCOs could collectively save $3 million a year through energy upgrades.
• 98% of the 160 buildings assessed for cultural safety were found to be culturally unsafe. The low scores largely reflect that the buildings are cramped or not fit for purpose or are located in inherited colonial buildings or places where Community has a negative shared history. The low scores do not reflect the cultural safety of the organisations or their services. 

Recommendations

This report makes 3 recommendations to the Victorian Government:

• Provide additional annual funding to further develop the skills and capacity of health and wellbeing ACCOs to plan, develop and deliver new and upgraded infrastructure in a self-determined way.
• Establish an interim fund for minor works and repairs until a self-determined perpetual infrastructure fund is introduced.
• Fund and start health and wellbeing infrastructure projects for ACCOs.