Aboriginal and Islander Community Controlled Health Services (AICCHSs) in Queensland discussed ‘regionalisation’ over the triennium 2009/2010/2011. There were two elements to this discussion:
(i) setting up Regional Aboriginal and Islander Community Controlled Health Organisations (RAICCHOs); and
(ii) re-engineering the state-wide peak body, Queensland Aboriginal and Islander Health Council (QAIHC).
These two discussions are related: if and when RAICCHOs were set up, QAIHC would devolve functions and re-focus on a smaller set of core roles and functions of genuinely state-wide relevance.
By 2009 it became clear that the South East Queensland (SEQ) region, where 40 per cent of the State’s Aboriginal and Torres Strait Islander population lives serviced by four AICCHSs, was consistently missing out on an equitable share of resources as both the Australian Government and the Queensland Government fixated their concerns and resources on Cape York.
The emerging success of the Apunipima Cape York Health Council (ACYHC) and the Deed of Commitment to transition Commonwealth and State primary health care delivery to community control for the 17 Cape communities through ACYHC, pointed in the direction of strength through regional cooperation and enhanced opportunities for gaining increased resources through regional-scale coordination.
A former chief executive officer of QAIHC led the development of dialogue with the Departments for Health of both the Australian Government and Queensland Government and obtained some seed funding for preparing a comprehensive proposal for a regional organization. By pulling together a small technical team which included constitutional solicitors, he was able to present to the two Governments a costed proposal to establish the Institute for Urban Indigenous Health for South East Queensland, or IUIH, which is usually referred to as “the Institute”. Queensland Health agreed to fund the core infrastructure of IUIH while DoHA/OATSIH agreed to fund its start-up programs. The Hon. Warren Snowdon, MP, was engaged in discussions at an early stage.
Following the incorporation in 2009 of the IUIH as the first regional organization (RAICCHO) comprised of multiple member organizations – unlike ACYHC, which is a single incorporated entity – QAIHC then proceeded to address the issues of regionalization across the whole of Queensland and to undertake an internal Review. Several consultations were held with member AICCHSs and discussions took place at QAIHC Board meetings. In 2011, QAIHC came out in support of RAICCHOs.
Central Queensland was the most advanced of all regions in setting up its own RAICCHO. The strategic approach adopted was in two stages. The first stage was to start to build up a sense of regional cooperation and coordination in the AICCHSs in Central Queensland. The second stage was to encourage the dialogue around setting up a CQ RAICCHO.
The opportunity to build a sense of regional cooperation and coordination arose when Queensland Health called for tenders in selected regions for delivery of its COAG-funded “Multi-Disciplinary Model of Care” Project (MDMC) for complex chronic disease clients. Nhulundhu Wooribah AICCHS based in Gladstone decided to take the lead role in a consortium tender response that covered two regions – Wide Bay/Burnett and Central Queensland. By teaming up with GP Links Wide Bay, Nhulundhu Wooribah was able to develop and submit a proposal for $3.8 million in a consortium with a total of seven members – including Queensland Health. This proposal was accepted in 2011, and Nhulundhu Wooribah was then able to play the lead role in a regional program delivery across the AICCHSs that would form the founding members of CQ RAICCHO, thereby gaining access to meetings with the Boards of the region’s AICCHSs.
Nhulundhu Wooribah then commissioned the development of a “Concept Paper” about CQ RAICCHO – what its membership, roles, functions and operations could look like, with a range of options for its governance. Discussions were held with individual AICCHSs; some of them, such as Bidgerdii and Barambah, were going through difficult times during 2011 and the process could not be rushed. Discussions focused on Chairpersons of the AICCHSs during 2011.
On 9th January 2012, Nhulundhu Wooribah hosted a meeting of regional delegates to discuss key issues of CQ RAICCHO – its objects and its governance. This meeting was well attended, and invited representatives also came from IUIH, QAIHC and ACYHC, so there was a wide sharing of insights and views. The meeting came up with specific suggestions, which were turned into a Constitution with assistance from the same solicitors who had prepared the IUIH Constitution, HynesLawyers. CQ RAICCHO was incorporated under the Corporations Act 2001 (Cth), regulated by ASIC, in March 2012. Further corporate-legal development work was undertaken in subsequent months to obtain gift deductibility recipient status and exemption from State payroll tax. In 2013, CQ RAICCHO was granted PBI status.