2. Healthy communities (P2) and good health care (P1) are primary goals But policy for health and health care, and the systems for implementing programs and services, can support or undermine them In P3, the CRC seeks to work directly on these ‘infrastructure’ issues Program 3: Enabling Policy and Systems

3. There is room for improvement Policy and funding responsibilities are not anchored in law or treaty - no government has enduring stewardship ‘Partnerships’ are complex, difficult, sometimes dodgy There is lack of trust and respect in working relationships Inadequate infrastructure for good health care Inadequate, complex, insecure funding Competing priorities and fundamental tensions among stakeholders about policy goals and program methods Commitment to time lines that don’t work

4. And so we see…. Stop-start interventions Long lead times and complex multi-party program co-ordination activity Burdensome administrative and reporting AND lack of good data to measure progress and shape policy And, of course, lots of good things in practice in spite of these problems

5. P3’s modest goal To develop knowledge that will enable governments, communities and the health system to plan and implement better policies and programs for health, more effectively

6. Strategies Focus on basic constraints and problems that contribute to poor performance by government and health system And aspects of health policy and systems that are known to be important current barriers against (or important potential contributors to) improvement.

7. Agenda in 3 domains Health policy and program effectiveness Workforce for Indigenous health Organisational effectiveness of Aboriginal PHC and health system more generally

8. Health policy and programs Stewardship for Indigenous health and health care – Ie role of government Links between performance measurement and policy Making cross-portfolio action work (later in agenda)

9. Indigenous health workforce Resources for good practice in recruitment and retention Effective policy instruments for improving capacity and supply

10. Organisational effectiveness Better contracting End-user needs for integrated PHC data systems Better hospital care Models for rapid synthesis of evidence

11. Capacity building In all projects Ph D and other scholarships for Indigenous researchers Other work by training and development unit of CRC

12. Discussion We would like to hear your thinking about this idea and the projects What are the aspects you want to discuss? – Let’s make an agenda and then work through it