Agenda of Economic Development Advisory Committee

Agenda – Economic Development Advisory Committee Meeting 16 September 2016 Page 6 of 7

5. Report of Officers

5.1 BROOME GROWTH PLAN - STATUS UPDATE AND KEY ELEMENTS

LOCATION/ADDRESS: Nil

APPLICANT: Nil

FILE: EDP007

AUTHOR: Director Development Services

CONTRIBUTOR/S: Nil

RESPONSIBLE OFFICER: Director Development Services

DISCLOSURE OF INTEREST: Nil

DATE OF REPORT: 6 September 2016

SUMMARY: The Broome Growth Plan is being prepared as part of the State government’s Regional Centres Development Planning Initiative. At the last meeting of the Economic Development Advisory Committee on 18 August 2016, the Committee considered the status of the Growth Plan and key elements informing the Growth Plan developed in the period leading up to that meeting. The purpose of this report is to provide an update on the work that has occurred on the Growth Plan since 18 August 2016, and seek direction from the Committee on the content and direction of that work to inform the Growth Plan.

BACKGROUND

Previous Considerations

OMC 30 July 2015 Item 12.1

OMC 26 November 2015 Item 9.3.2

SMC 19 January 2016 Item 6.2.2

OMC 26 May 2016 Item 10.1

OMC 25 August 2016 Item 12.1

The Broome Growth Plan is being prepared as part of the State government’s Regional Centres Development Planning (RCDP) initiative. The RCDP initiative is led by the Regional Development Council, through the Department of Regional Development, and funded through Royalties for Regions funding. The growth planning process commenced in late 2015 and the Broome Growth Plan has to be finalised by 31 October 2016.

At its meeting on 18 August 2016, the Economic Development Advisory Committee (EDAC) considered a report on the status of the Growth Plan and the key elements that had been developed to inform the Growth Plan over the preceding five months. A significant amount of work has been undertaken to bring together information and the outcomes of community and stakeholder consultation to inform the Growth Plan.

Since the EDAC meeting on 18 August 2016, more work has been carried out to inform the Growth Plan and key elements of the Growth Plan are starting to take shape. Drafting of sections of the Growth Plan has also commenced.

Since the EDAC meeting on 18 August 2016, the following actions have occurred:

· The minutes of the Project Control Meeting (PCG) held on 9 August 2016 were made available (see Attachment 1 to this report);

· The PCG met on 10 August 2016 to discuss the status of the Urbis and GHD sub-consultancies;

· The Growth Plan Partnership (GPP) met on 15 August 2016 (see minutes in Attachment 2 to this report);

· The PCG met on 24 August 2016 to discuss additional technical input and sub-consultancies required for the Growth Plan;

· Council considered and adopted EDAC’s recommendations in relation to the status and key elements of the Growth Plan at the Ordinary Meeting of Council (OMC) on 25 August 2016;

· Council considered and made resolutions in relation to governance matters associated with the Growth Plan project at the OMC on 25 August 2016;

· A GPP meeting was held on 5 September 2016 (see agenda and supporting documents in Attachment 2, note that the minutes were not available at the time of writing this report);

· Feedback from the Councillor workshop on 8 August 2016 was provided to Urbis, Creating Communities and the PCG, along with additional information on certain projects;

· A paper on the economic resilience of Broome prepared as an initiative of the Eastern Australian Regional Capital Alliance was provided to Urbis, Creating Communities and the PCG as an input to the Growth Plan;

· Initiative areas for the Growth Plan have been developed;

· Discussions were held with the PCG and GPP regarding the use of the list of projects, multi-criteria analysis (MCA) tool and business cases in the Growth Plan;

· The PCG aligned the list of projects with the initiative areas;

· Feedback was provided on the latest draft of the Health and Wellbeing report and on the Scenario Planning Report;

· The Review Point 3 workshop was held in Perth;

· Assistance was provided to RPS to obtain data for the environmental sub-consultancy and feedback was provided on the direction of the sub-consultancy;

· Information was gathered on issues associated with telecommunications infrastructure and potential improvements;

· Work was undertaken on a proposed governance structure for the implementation of the Growth Plan;

· Discussions were held regarding addressing “Theory of Change” in the Growth Plan;

· Creating Communities commenced drafting sections of the Growth Plan;

· Work commenced on the preparation of a draft terms of reference for the GPP and PCG.

Further detail on the output from these actions is provided below.

COMMENT

A number of the key elements informing the Growth Plan have been progressed and work on the Growth Plan document itself has occurred since the last EDAC meeting. These key elements and the draft content of the Growth Plan document are discussed below.

List of projects and project assessment

At the last EDAC meeting, EDAC considered a project list for the Broome Growth Plan and made recommendations to Council in relation to the project list. Council endorsed EDAC’s recommendations at its OMC on 25 August 2016 in relation to the Growth Plan, whereby Council resolved that it:

3. Endorses the draft Project List for the Broome Growth Plan in Attachment 4, subject to:

(1) changes to the list in accordance with the comments in red in Attachment 5;

(2) the inclusion of the Gray Street extension as a stand alone project;

(3) the inclusion of two new projects:

a) A new museum for Broome; and

b) Facilitating flights between Asia and Broome and between East Coast destinations and Broome; and

(4) key enabling infrastructure such as the Regional Resource Recovery Park and improved aged care programs and facilities being recognised in the Growth Plan,

This feedback was provided to Urbis, Creating Communities and the PCG. Additional information on certain Shire projects was also provided.

The PCG’s intention to draft the Growth Plan around objectives for Broome, rather than having the project list as the definition feature of the Growth Plan, was discussed in the agenda item at the EDAC meeting on 18 August 2016. Since this meeting, additional concerns regarding the project list and the assessment of projects against the Project Prioritisation Matrix were raised. GPP members raised concerns regarding projects being missed, and had reservations about the subjectivity of assessment against the Matrix. These concerns mirror the concerns raised by Councillors at the workshop held on 8 August 2016.

Therefore, work has been undertaken to ensure the Growth Plan focuses on initiative areas, rather than just the project list. It is proposed that projects on the list will still be identified in the Growth Plan, but they will be identified as supporting the initiative areas. Additional projects can then be considered through the implementation of the Growth Plan, if they support one or more of the initiative areas.

An overview of the proposed initiative areas is provided below.

The Project Assessment Matrix developed by Urbis was used by the Department of Regional Development (DRD) to develop a multi-criteria analysis (MCA) tool for all the growth plans being prepared across the State (see Attachment 3 to this report). Based on the proposed change in approach for the Broome Growth Plan the Matrix and MCA tool are no longer required to assess and rank projects. Further, the business case/concept plan template prepared by Urbis are no longer required, as these were to be used for a small number of the top ranking projects.

Therefore, it is proposed that the Matrix, MCA tool and the template business case/concept plan be included in the Growth Plan as an example of tools that can be used to assess projects as part of the implementation of the Growth Plan.

Initiative areas

Creating Communities have developed initiative areas for the Growth Plan. A copy of the discussion paper prepared by Creating Communities providing an outline of the initiative areas is shown in Attachment 4 to this report.

In summary, the initiative areas that have been developed for the Growth Plan are as follows:

· Activating the Peninsula - based around the sealing Cape Leveque Road but also involving the following:

o providing assistance to small businesses on the Peninsula, particularly those in the tourism industry;

o addressing challenges such as land tenure, environmental approvals, etc;

o managing of social and environmental impacts;

o identification of and addressing infrastructure requirements; and

o developing the skills of residents so they can benefit.

· Activating the Traded Economy – relates to investment in the existing industry clusters which are as follows:

o Tourism;

o Food (agriculture, aquaculture, beef industry, local native food production, etc);

o Arts and culture; and

o Oil/gas/minerals.

· Activating the Precincts of Broome – relates to the development of specific locations as well as the overall development of the Shire and includes:

o Chinatown revitalisation project;

o Jetty to Jetty project;

o Urban renewal project;

o Tourism precinct improvements;

o Marina;

o Airport improvements;

o Sea port improvements; and

o Development of industrial land.

· Strengthening the base – relates to:

o Improving and ensuring the amenity of Broome;

o Enhancing the domestic economy;

o Encouraging development of local leadership and young people; and

o Encouraging entrepreneurism.

· Activating Pathways to Transforming Services – includes initiatives to improve existing services and transition those not engaged in the mainstream economy to participation in the mainstream economy, with a focus on the following:

o Education;

o Health;

o Housing;

o Welfare dependency; and

o The indigenous labour market.

Some variations in the wording used for the initiatives above are starting to develop as work on the Growth Plan progresses, but the substance of the initiative areas remains the same.

The PCG has gone through the process of linking projects on the project list with these initiative areas. The resulting list of projects indicating which initiative areas they are linked to is shown as Attachment 5 to this report. Note that the additional projects and feedback provided to EDAC and Council in relation to the project list has been incorporated in the list of projects shown in Attachment 5.

The proposed linking of projects on the project list with the initiative areas was discussed at a workshop with Council on 8 September 2016. Discussion and feedback at this workshop identified that the following projects should, in addition to what is shown in Attachment 5, be linked to the following initiative areas:

· Broome Cultural Centre – should also be linked to Activating the Peninsula as the benefit to the tourism industry generated by the Cultural Centre will promote visitation to the Peninsula.

· Environmentally compliant slipways & storage facilities with hard surfacing and WWTP – should also be linked to Activating the Peninsula as it will benefit industry on the Peninsula.

· Improved aged care facilities and infrastructure – should also be linked to Activating Pathways to Transforming Services as it is linked to health services.

· Facilitating flights between Asia and Broome, and between East Coast destinations and Broome – should also be linked to Activating the Peninsula as it will benefit the tourism industry and result in increased visitation to the Peninsula.

In addition, based on discussion and feedback at the Council workshop, it is recommended that the Broome Casino project be removed from the list as it is recognised as not being a viable project. Also, a Rehabilitation Centre providing in-patient treatment for persons addicted to drugs and alcohol should be included on the list. The Rehabilitation Centre project should be linked to the Activating Pathways to Transforming Services initiative area.

Therefore, it is recommended that EDAC recommend to Council that it endorse the linking of the initiative areas to the projects on the project list, subject to the changes outlined above.

Sub-consultancy reports

Sub-consultants were engaged for the Broome Growth Plan to provide specific information on their area of expertise, as follows:

The following sub-consultants were engaged for the project:

· Urbis – economic analysis and project prioritisation and assessment (see discussion above);

· GHD – infrastructure;

· Marella Health Consulting – health and wellbeing;

· RPS - Environment; and

· Carpe Diem Consulting - Education and training.

No work has yet been provided by Carpe Diem Consulting as part of the education and training sub-consultancy. An update on the status of the other sub-consultancies, and the sub-consultancy work being undertaken by AEC Group and ALCES, is provided below.

Sub-consultancy reports – Urbis

As discussed above, it is no longer intended that Urbis will undertake an assessment of individual projects and develop business cases/concept plans for high scoring projects. Instead, the Project Assessment Matrix and template business case/concept plan developed by Urbis is intended to be included in the Growth Plan as a tool for the implementation of the Growth Plan.

Instead of going through this process for specific projects, it is now intended that Urbis will prepare an economic rationale or cost benefit analysis for certain initiative areas or strategies within initiative areas. At present, the following areas/strategies are intended to be subject to this analysis:

· Activating the Peninsula (initiative area – Activating the Peninsula);

· Expanding aquaculture production (initiative area – Activating the Traded Economy);

· Capturing and engaging Aboriginal capital in economic development (initiative area – Activating Pathways to Transforming Services).

Shire officers recommended that the “expanding aquaculture production” economic rationale be expanded to include agriculture. Advice was provided in response that this would make the area too broad for the economic rationale to be prepared by Urbis. Overall, it is considered that preparing an economic rational for expanding agriculture production would be more beneficial and appropriate given that this is a very real and current potential growth industry in the region.

Therefore, it is recommended that the EDAC recommend that Council support an economic rationale being prepared for the above subject areas, subject to “Expanding aquaculture production” being replaced with “Expanding agriculture production”.

The Broome Economic and Situational Analysis is still in draft form and waiting on information from the GHD and ALCES sub-consultancies. In summary, the draft report:

· Provides an overview of the current status of the Broome economy;

· Makes recommendations regarding encouraging growth and investment;

· Models the impact of $20 million investment in industry clusters; and

· Looks at regional strengths and weaknesses.

Overall, the current draft of the report is much improved on the earlier draft and provides much more detail that is specific to Broome. A copy of the current draft of the Broome Economic and Situational Analysis is included as Attachment 6 to this report.

Sub-consultancy reports – GHD

GHD released an updated draft of the infrastructure audit they have undertaken (see Attachment 7 to this report). This draft is an improvement on the previous draft, but there are still significant gaps in the information contained in the report.

As discussed in the last report to EDAC on the Growth Plan, it is intended that on completion of this audit, a further report will be prepared outlining strategies and making recommendations in relation to the physical and social infrastructure required to support Broome’s growth.

A number of meetings have been held with GHD to seek to ensure this sub-consultancy remains on track as there has been a lack of visible progress. Both GHD and Urbis have been advised that they need to work together to ensure their reports are aligned, as follows:

· Urbis is to identify industries and key investment areas to deliver growth; and

· GHD is to identify key infrastructure required to support those industries/investment areas.

Sub-consultancy reports – Marella Health Consulting

An updated draft of the health and wellbeing report by Marella Health Consulting has been provided and is shown as Attachment 8 to this report. The report is considered useful in informing the Growth Plan by providing a good overview of current issues, infrastructure and services. It also outlines the elements required to support the future growth of Broome.

In addition, this updated draft incorporates the following recent feedback from the PCG and GPP:

· The report needs to link moving beyond welfare dependence with health and wellbeing;

· The report needs to link the “Community Wellbeing from the Ground Up: A Yawuru Example” report by Mandy Yap and Eunice Yu;

· Consideration needs to be given to strategies aimed at transformation and driving economic benefit;

· There needs to be an assessment/inclusion of lack of current aged care provision – impact on population retention and the need for facilities for both indigenous and non-indigenous residents;

· Reduce detail in the report on certain issues to ensure relevance to the growth planning process; and

· Remove commentary on matters outside the scope of health and wellbeing.

The key messages from the report are as follows:

· Aboriginal advancement should be pursued to reduce the number of lives dependent on welfare and support;

· Structural changes to services and funding are required to reduce inefficiencies in current funding models;

· Specialist medical, diagnostic and secondary treatment services will be required as Broome’s population grows;

· Bigger, younger populations expect modern health technologies, eg. cancer/chemotherapy, diagnostics (eg. MRI and breast screening), palliative care, ambulatory/in-home hospital treatment, midwife managed low risk birthing, mental health and social, emotional wellbeing and healing services;

· Healthy ageing and aged care needs attention to attract and retain more productive retirement aged people to continue living in Broome;

· Health and schools should work together in a collaboration to leverage the relationship children and their families have with schools;

· Synergies should be formed between industry and education and training;

· Address health concerns which detract from economic participation and benefits;

· Leverage government reforms in the area of health and wellbeing;

· Focus on better quality, affordable food for Broome residents;

· There needs to be community led action on health and better prevention measures;

· Build awareness, optimism and motivation;

· Enhance Broome’s brand as a welcoming and accommodative regional services and visitor destination centre (eg. through the BASSA).

The report states that health and wellbeing measures need to:

· Increase employment, business and material prosperity prospects so people can afford a comfortable and satisfying lifestyle in a modern day world, resulting in greater economic participation, independence, less reliance on welfare incomes and social support services;

· Create and leverage intellectual and technical knowledge and industry know-how;

· Help advance community cohesion, deeper mutual respect and quality of living, improving sporting and leisure amenities; social and artistic activities; and a reality of friendly and safe neighborhoods;

· Enable a celebration of the culture of the Indigenous people as well as that of Broome’s own history which is able to be shared with others;

· Enable freedom to enjoy access to traditional and contemporary places, lifestyles, pleasures and cultural practices;

· Leverage the potential of Native Title settlements – the people, ideas, aspirations and possibilities; their ideas for land development; their influence; and their financial, intellectual and cultural resources;

· Make Broome an attractive and affordable place for people to live as they grow older;

· Cater for people’s care needs as advanced age and/or related disabilities influence their decisions to stay in Broome or return to larger centres or cities;

· Cater for people’s physical, mental, family/birthing, community and end of life care needs through an adequate range of general and specialist medical, diagnostic and therapy technologies and services;

· Reduce public health hazards; early onset preventable diseases and the high cost/low productivity consequences of the associated disability burden.

Some final feedback was provided by Shire officers on the wording of some sections in the report. The report is intended to be finalised based on this final feedback.

Sub-consultancy reports – AEC Group

The scenario planning report prepared by AEC Group has not been updated since the last EDAC meeting. A copy of the current draft of the report is shown in Attachment 9 to this report.

Work has been undertaken by Creating Communities and the PCG on scenarios upon which the Growth Plan should be based (this is discussed further below). AEC Group have been asked to consider these scenarios in their report, based on the outcomes of the scenario planning workshop. AEC Group have been asked to use this to develop high level policy response options.

It should be noted that the scenario planning report is a program level requirement for the Growth Plan, which means that it is a requirement imposed on all Growth Plans by DRD. Therefore, the current draft of the scenario planning report needs to be enhanced to meet program level objectives for the Growth Plan.

Sub-consultancy reports – RPS

RPS have gathered available and relevant environmental and boundary data for the Shire of Broome at a fine grain level and this information has been used to develop a GIS database. RPS will liaise with ALCES to ensure the data is compatible for use by them (the ALCES work is discussed further below).

Weightings have been applied to different datasets for consideration, identifying whether the mapped environmental data is an extreme, high, medium or low constraint.

The next stage of this sub-consultancy is to engage with stakeholders to determine if the approach they are taking is appropriate and if any information has been missed. RPS then need to develop eight risk/opportunity assessments.

Shire officers provided advice that some data is missing. Shire officers also recommended that the following topics could be investigated through the sub-consultancy, with reference to the relevant initiative area:

· Activating the Traded Economy - need to balance environmental values with economic opportunities, i.e. potential impacts of Roebuck Bay Marine Park on operations of the Port of Broome.

· Activating the Peninsula:

o Large tracts of land in the Peninsula are Unallocated Crown Land and increasing visitor pressure will lead to increased spread of weeds and invasive species, increased litter, illegal camping etc.

o Addressing the requirements of the State Planning Policies relating to bushfire and coastal hazards.

o Unmanaged or poorly managed solid waste disposal and effluent disposal facilities in communities.

· Activating the Precincts of Broome:

o The Broome Townsite Coastal Vulnerability Study shows that coastline is at risk of coastal hazards. The Broome Townsite Coastal Hazard Risk Management Adaptation Plan is being developed and may identify coastal protection works requiring external funding.

o Broome’s stormwater management system relies on discharge into receiving bodies such as Roebuck Bay. Further controls on this may impact on future development.

Sub-consultancy reports – ALCES

The requirement for this sub-consultancy arose at a program level. ALCES have developed a GIS tool which collates existing data sources on land characteristics and constraints. Different scenarios can be simulated through the GIS tool, such as showing the effect on the urban extent of Broome under different population growth scenarios.

At this stage, the work of ALCES for the Broome Growth Plan has not been released.

Other inputs to the Growth Plan

The original budget for the Growth Plan provided for a range of sub-consultancies to be engaged on different discrete subject matters. As a result, the above sub-consultants were engaged. The PCG and GPP have discussed what information gaps remain in relation to the Growth Plan, with a view to using the remaining sub-consultancies budget to fill those gaps.

The following approach to identified information gaps has been developed:

· Arts and culture – engage a sub-consultant to provide advice on how Broome’s arts and culture industry can contribute further to the traded economy. The sub-consultant should also consider linkages between Broome’s arts and culture products and other products in Western Australia.

· Governance – it is not proposed that any further external advice on this subject be secured at this time. Consideration can however be given to whether this funding should be used as part of the implementation of the Growth Plan.

· Agriculture/Aquaculture – engage a sub-consultant to provide advice on how to best stimulate growth in this area.

· Aged care – The Ageing in the Bush: An Ageing in place strategy for Regional Western Australia Report (Regional Development Council) will be reviewed, along with the final health and wellbeing report before a determination is made as to whether more information is required.

· Telecommunications – information from the Shire’s Smart Cities project and the work by GHD will be used to inform this element of the Growth Plan.

· Marine infrastructure – no further information is required, and the Growth Plan will instead refer to work being undertaken by the Department of Transport and partners as part of the Broome Boat Harbour Advisory Group.

· Dampier Peninsula activation – engage a sub-consultant to provide advice on matters that will need to be considered to activate the Dampier Peninsula following the sealing of Cape Leveque Road.

Other works required to finalise the Growth Plan

The drafting of the Growth Plan has commenced. The PCG consider that the lead consultant, Creating Communities, is best placed to bring together all the information that has been compiled for the Growth Plan in the drafting of the document. The PCG will be responsible for reviewing the draft Growth Plan document drafted by Creating Communities.

A third party will be engaged to copywrite/proof read the final draft Growth Plan document.

Creating Communities have expertise in-house to design the Growth Plan document and they will be providing a fee estimate for this work. Money is also included in the Growth Plan budget to print and publish the Growth Plan once finalised.

The development of a prospectus for the Growth Plan was discussed. It was considered that the Shire’s Inward Investment Prospectus could be used as a basis for this, as part of the implementation of the Growth Plan.

There is surplus funds available in the Growth Plan budget, and discussions have been held amongst the PCG regarding these funds being used by Creating Communities to hold a number of sessions with stakeholders to provide information on the content of the Growth Plan. Shire officers have asked that sessions be held with Council and the general public.

Draft content of the Growth Plan

As discussed above, Creating Communities has started to draft sections of the Growth Plan. A draft of the work that has been undertaken by Creating Communities is included as Attachment 10 to this report.

One element to note from these sections of the Growth Plan that have been drafted is that the following scenarios have been developed to guide the Growth Plan:

· Scenario 1 – Trend continuation of growth;

· Scenario 2 – Growing Broome according to its comparative advantages (tourism and agriculture, with Aboriginal participation continuing at its current level);

· Scenario 3 – Growing Broome according to its comparative advantages (tourism and agriculture, with Aboriginal participation increased);

· Scenario 4 – Significant growth based on the above plus major investment.

The position currently adopted for the Growth Plan is that Broome should be ready for Scenario 4, however the focus of the Growth Plan will be on achieving Scenario 3.

In addition, the following guiding principles have been identified in the draft Growth Plan:

· Honouring the Natural Environment;

· A Connected Community;

· Strong and Diverse Economy;

· Broome as an International Hub;

· Quality Infrastructure and Built Form;

· Cultural and Heritage Preservation;

· Robust Governance and Local Capacity;

· A liveable and Unique Lifestyle.

These guiding principles were developed in accordance with the project plan for the Growth Plan project and were used as part of the community and stakeholder engagement for the Growth Plan.

At the Council workshop on 8 September 2016, it was discussed that the last principle, “A liveable and Unique Lifestyle”, may be too broad and subjective in its interpretation, particularly in relation to the use of the work “Unique”. Therefore, it is recommended that EDAC recommend that Council endorse these guiding principles, subject to “A liveable and Unique Lifestyle” being reworded to remove the word “Unique” so it is less subjective and more suitable as a guiding principle.

The sections of the Growth Plan that have been drafted refer to the initiative areas as discussed above, and some work has been done on pathways for developing those initiative areas. More information is required, particularly from the sub-consultancies, to inform these pathways.

A final point to note is the requirement at a program level that the Growth Plan incorporate the “Theory of Change” principle. Theory of Change represents sound project/process management principles and the final Growth Plan will be assessed against this as a requirement. The Theory requires cause/effect logic from opportunity to implementation to be sound and evidence based.

An example of the required steps to show the Theory of Change has been applied are as follows:

· Identify the problem/opportunity;

· Develop options to address the problem/take advantage of the opportunity;

· Select options/actions and rationale for selection of particular actions;

· Ensure implementation is achievable;

· Implement;

· Review/measure outcomes.

The Growth Plan is already being prepared in accordance with these principles, as shown in the draft framework of the Growth Plan in Attachment 10.

Overall, the first draft of these sections of the Growth Plan give an indication of where the Growth Plan is headed. The draft sections in Attachment 10 need work and are lacking in firm detail. Some of the language needs to be modified to be more appropriate to a professional report and many areas need editing and expansion. Shire officers will provide feedback on the draft sections on this basis, and continue to provide feedback and input into drafting of the Growth Plan as it proceeds.

Review Point 3 Workshop

A workshop was held by DRD in Perth on 16 August 2016 to allow the Growth Centres to show how they are progressing, obtain feedback from a panel assembled for the day and learn from other Centres’ experiences. The Centres who are due to prepare their growth plans in Stage 2 were also invited to learn more about the growth planning process.

Information was provided at the workshop about investor trends, how to facilitate investment opportunities and how to be “Growth Plan Ready”.

Cr Johnston attended the workshop on behalf of the Shire, and gave a presentation on the Broome Growth Plan with Jeff Gooding from the Kimberley Development Commission (KDC). A copy of the presentation that was provided at the workshop is included as Attachment 11 to this report.

An assessment of the Broome Growth Plan by the panellists and a Summary of Proceedings Report for the Review Point 3 Workshop is included as Attachment 12 to this report. Overall, feedback from the workshop on the Broome Growth Plan indicates that it is on track and meeting the Regional Centres Development Planning State level requirements.

Implementation governance structure

DRD has advised that a governance structure to implement the Growth Plan has to be agreed upon and detailed in the Growth Plan. Creating Communities developed a discussion paper on the governance framework for implementing the Growth Plan which was subsequently included in the draft sections of the Growth Plan shown in Attachment 10 to this report. This discussion paper indicated the governance body may be “hosted” by the Shire.

Shire officers subsequently prepared a discussion paper on an implementation governance structure which is shown as Attachment 13 to this report. The discussion paper prepared by the Shire considers the merits of the following governance models:

· Continuation of GPP;

· Committee of Council;

· Committee formed by KDC; or

· Separate legal entity.

Each option was assessed against the following criteria:

· Independence – does the model allow for a variety of actions and activities to be pursued by a broad range of stakeholders? Is it too closely aligned with any single stakeholder?

· Able to access funding – can the model apply for funding in its own right?

· Resourcing – is the model resourced and capable of being self-funding?

· Deliverable – Do the current members of the GPP have the ability to establish the model?

The discussion paper recommends that an incorporated or unincorporated body is formed to implement the Growth Plan. The body would have some form of executive committee comprising the GPP as fixed members, with other community leaders appointed as members on a rotating membership basis. Sub-committees can be formed for specific projects and activities.

A full time staff member would need to be employed by the body, and this could potentially be hosted by the Shire (with funds for wages sourced externally). Some roles and aims of the body would be:

· Apply for funding;

· Lobbying and advocacy;

· Formation and nurturing of industry groups and networks;

· Education of community leaders and representatives;

· Relationship building with stakeholders;

· Encourage decision making and action by industry groups;

· No intervention in existing projects and activities unless formally requested.

This proposed governance model was considered by the GPP at its meeting on 5 September 2016. At this meeting, the GPP indicated its support for the separate legal entity and there was discussion regarding the amount of work that should be done on defining this model further prior to finalisation of the Growth Plan.

Overall, it is recommended that further work be undertaken for define this governance model prior to finalisation of the Growth Plan.

Ongoing governance matters

At the OMC on 25 August 2016, Council resolved as follows:

That Council:

1. Acknowledges and endorses the invitation that the Growth Plan Partnership (GPP) has extended to Nyamba Buru Yawuru (NBY) to be included as an additional partner to the Growth Plan Partnership Memorandum of Understanding (MOU) in relation to the Broome Growth Plan.

2. Requests the Chief Executive Officer to seek the GPP to provide a revised MOU in relation to the Broome Growth Plan for Council’s consideration and endorsement, which clearly articulates the roles and responsibilities of all partners and updates the membership of the both the GPP and Project Control Group (PCG) to include NBY.

3. Requests the Chief Executive Officer to seek the GPP to provide a Terms of Reference for the GPP and PCG in accordance with the existing MOU as a matter of priority, having consideration for any possible conflict of interest that may arise from any partner’s involvement.

4. Requests the Chief Executive Officer to present all future minutes from GPP meetings through the Economic Development Advisory Committee for recommendation to Council of endorsement or otherwise of items raised in the minutes, in accordance with the GPP Project Plan noted by Council at the Ordinary meeting of Council held 19 January 2016.

5. Notes that Shire Officers, and in particular the Chief Executive Officer, Deputy Chief Executive Officer and Director Development Services, will continue to provide input and advice in relation to the Broome Growth Plan, in accordance with Council resolutions, Council policy and Council adopted strategic planning documents.

In accordance with this resolution, at the GPP meeting on 5 September 2016 the Deputy Chief Executive Officer raised as a matter of general business the need to amend the MOU and develop terms of reference for the PCG and GPP. The GPP agreed that this should occur, and officers will work with the PCG to ensure the MOU is amended and the terms of reference are drafted. An agenda item will be presented directly to Council once drafts have been finalised for its endorsement.

Special Meeting of EDAC in October 2016

An additional meeting of EDAC will be required in October 2016 to further progress the Growth Plan. Between 2pm and 4pm on Thursday, 13 October 2016 has been identified as a suitable date for this meeting. Therefore, it is recommended that EDAC recommend that Council requests that the Chief Executive Officer call a meeting of EDAC for 13 October 2016.

Summary

A significant amount of work continues to be undertaken so that the Broome Growth Plan can be finalised by 31 October 2016. Information on the progress of the Growth Plan and input into its content will be further sought from EDAC at its October 2016 meeting.

CONSULTATION

Extensive consultation has occurred as part of the development of the Broome Growth Plan in accordance with a community and stakeholder engagement plan prepared for the Growth Plan.

STATUTORY ENVIRONMENT

The overarching legislation that governs the operation of the Shire of Broome is the Local Government Act 1995. The Shire’s role and input into the growth planning process has to be consistent with its roles and responsibilities as established by that Act. Local government in Western Australia is established in accordance with the Constitution Act 1889.

Local Government Act 1995

Section 3.1. General function

(1) The general function of a local government is to provide for the good government of persons in its district.

(2) The scope of the general function of a local government is to be construed in the context of its other functions under this Act or any other written law and any constraints imposed by this Act or any other written law on the performance of its functions.

(3) A liberal approach is to be taken to the construction of the scope of the general function of a local government.

Section 3.18. Performing executive functions

(1) A local government is to administer its local laws and may do all other things that are necessary or convenient to be done for, or in connection with, performing its functions under this Act.

(2) In performing its executive functions, a local government may provide services and facilities.

(3) A local government is to satisfy itself that services and facilities that it provides —

(a) integrate and coordinate, so far as practicable, with any provided by the Commonwealth, the State or any public body; and

(b) do not duplicate, to an extent that the local government considers inappropriate, services or facilities provided by the Commonwealth, the State or any other body or person, whether public or private; and

Constitution Act 1889

52. Elected local governing bodies

(1) The Legislature shall maintain a system of local governing bodies elected and constituted in such manner as the Legislature may from time to time provide.

(2) Each elected local governing body shall have such powers as the Legislature may from time to time provide being such powers as the Legislature considers necessary for the better government of the area in respect of which the body is constituted.

Separate legislation governs the activities of other members of the GPP. The Regional Development Commissions Act 1993 governs the activities of the KDC and the Western Australian Land Authority Act 1992 governs the activities of LandCorp.

Regional Development Commissions Act 1993

Section 23. Objects and functions of a commission

(1) The objects of a commission are to —

(a) maximize job creation and improve career opportunities in the region;

(b) develop and broaden the economic base of the region;

(d) provide information and advice to promote business development within the region;

(e) seek to ensure that the general standard of government services and access to those services in the region is comparable to that which applies in the metropolitan area; and

(f) generally take steps to encourage, promote, facilitate and monitor the economic development in the region.

(2) For the purposes of achieving those objects a commission is to —

(a) promote the region;

(b) facilitate coordination between relevant statutory bodies and State government agencies;

(c) cooperate with representatives of industry and commerce, employer and employee organizations, education and training institutions and other sections of the community within the region;

(d) identify the opportunities for investment in the region and encourage that investment;

(e) identify the infrastructure needs of the region, and encourage the provision of that infrastructure in the region; and

(f) cooperate with —

(i) departments of the Public Service of the State and the Commonwealth, and other agencies, instrumentalities and statutory bodies of the State and the Commonwealth; and

(ii) local governments,

in order to promote equitable delivery of services within the region.

Western Australian Land Authority Act 1992

Section 16. Functions

(1) The Authority has the following functions —

(a) to be an agency which provides, or promotes the provision of, land for the social and economic needs of the State;

(b) to be an agency through which the Crown and public authorities may dispose of land;

(c) to be an agency through which local governments and regional local governments may dispose of land in accordance with the Local Government Act 1995;

(d) to complete the development of the Joondalup Centre, in accordance with the plan referred to in section 18, on the land described in Schedule 2;

(e) to identify other potential centres of population, and centres of population in need of urban renewal, and use its powers to bring about the provision, or improvement, of land, infrastructure, facilities or services for the same.

(1a) It is also a function of the Authority —

(a) to do things that the board determines to be conducive or incidental to the performance of a function referred to in subsection (1); and

(b) to do things that it is authorised to do by any other written law.

(2) In subsection (1) —

Joondalup Centre means the project for the provision of infrastructure and facilities for a centre of population (including infrastructure and facilities for community, cultural, recreational and sporting purposes) that before the commencement of this section was being carried on by the Joondalup Development Corporation under the Act repealed by section 50(1)(c).

(3) The Authority may perform any of its functions in the State or, with the Minister’s approval, elsewhere.

POLICY IMPLICATIONS

The draft List of Projects and initiative areas does not align exactly with the Shire’s Strategic Community Plan and Corporate Business Plan. Given that the Broome Growth Plan is not just a Shire of Broome planning document and has input from and will be delivered by other bodies and organisations, this is not necessarily a barrier to EDAC and Council supporting the Growth Plan. However, EDAC and Council still need to be satisfied that the Growth Plan is appropriate to facilitate the future growth of Broome and will not have an unacceptable impact on the Shire’s policy direction and operations.

FINANCIAL IMPLICATIONS

At this stage, the Broome Growth Plan has no direct financial implications to the Shire. However, in considering the direction of the Growth Plan project, the initiative areas, strategies and identified projects, EDAC and Council should be mindful of the Shire’s resources and satisfied that the Growth Plan will not have an unacceptable impact on the Shire’s financial resources and ability to maintain its core operations.

The Shire’s Long Term Financial Plan (LTFP) sets out planned capital projects the Shire intends to undertake from 2015 to 2030. The following are the only projects on the Project List (as amended in response to Council feedback) that are identified in the LTFP:

· Town Beach Revetment/Jetty to Jetty walk infrastructure and redevelopment of the Town Beach Precinct;

· Itinerant camping area for transient Broome residents;

· Lighting for sporting ovals (extend usability);

· Extended sporting/community facilities; and

· Chinatown revitalisation project.

It will need to be clear in the Broome Growth Plan that all other projects on the Project List will be funded by the State or Federal government, or private industry.

RISK

There is a risk that the outcomes of the growth planning project may commit the Shire to a course of action or investment in projects and initiatives that may impact on the Shire’s ability to resource other policy initiatives and its core operations. The risk of this occurring is considered ‘High’. To mitigate this risk, significant resources are being dedicated by Shire Officers in reviewing the inputs to the Broome Growth Plan. In addition, the key inputs to the Growth Plan are being workshopped with Council and are subject to EDAC and Council’s endorsement to ensure that Council is satisfied that the direction of the Growth Plan is consistent with the Council’s strategic direction.

A significant amount of work and resources have been dedicated, utilising Royalties for Regions funding, to develop these key inputs to the Growth Plan. Should Council decide that it wants to alter these key inputs significantly, this may impact on the ability for the Broome Growth Plan to be finalised by the 31 October 2016 deadline. This may impact on the reputation of the Shire with the State government and other stakeholders. The risk of this occurring should Council seek to alter the key inputs significantly is considered ‘High’.

STRATEGIC IMPLICATIONS

Our People Goal – Foster a community environment that is accessible, affordable, inclusive, healthy and safe:

Effective communication

Affordable services and initiatives to satisfy community need

Accessible and safe community spaces

A healthy and safe environment

Our Place Goal – Help to protect the nature and built environment and cultural heritage of Broome whilst recognising the unique sense of the place:

A built environment that reflects arid tropical climate design principles and historical built form

A unique natural environment for the benefit and enjoyment of current and future generations

A preserved, unique and significant historical and cultural heritage of Broome

Retention and expansion of Broome’s iconic tourism assets and reputation

Our Prosperity Goal – Create the means to enable local jobs creation and lifestyle affordability for the current and future population:

Affordable and equitable services and infrastructure

Affordable land for residential, industrial, commercial and community use

Key economic development strategies for the Shire which are aligned to regional outcomes working through recognised planning and development groups/committees

Our Organisation Goal – Continually enhance the Shire’s organisational capacity to service the needs of a growing community:

Sustainable and integrated strategic and operational plans

Responsible resource allocation

Effective community engagement

VOTING REQUIREMENTS

Simple Majority

REPORT RECOMMENDATION:

That the Economic Development Advisory Committee recommends that Council:

1. Endorses the Growth Plan focusing on initiative areas rather than a list of projects, with projects on the project list to be linked to initiative areas;

2. Notes that the Project Prioritisation Matrix developed by Urbis, the Multi-Criteria Analysis Tool released by the Department of Regional Development and the draft business case/concept plan template prepared by Urbis will be included in the Growth Plan as an example of tools that may be used in the implementation of the Growth Plan.

3. Endorses the initiative areas developed for the Growth Plan as described in Attachment 4;

4. Endorses the linking of projects on the project list to the initiative areas as shown in Attachment 5, subject to:

(a) The Broome Cultural Centre project also being linked to Activating the Peninsula;

(b) Environmentally compliant slipways & storage facilities with hard surfacing and WWTP also being linked to Activating the Peninsula;

(c) Improved aged care facilities and infrastructure also being linked to Activating Pathways to Transforming Services;

(d) Facilitating flights between Asia and Broome, and between East Coast destinations and Broome also being linked to Activating the Peninsula;

(e) Removing the Broome Casino project from the project list; and

(f) Adding the “Rehabilitation Centre” project to the list, with this project to be linked to the Activating Pathways to Transforming Services initiative area;

5. Endorses the undertaking of an economic rationale for the following subject areas:

(a) Activating the Peninsula (initiative area – Activating the Peninsula);

(b) Expanding agriculture production (initiative area – Activating the Traded Economy);

(c) Capturing and engaging Aboriginal capital in economic development (initiative area – Activating Pathways to Transforming Services);

6. Notes the status and progress of the sub-consultancy reports;

7. Notes the other inputs required for the Growth Plan and the work required to finalise the Growth Plan;

8. Endorses the use of the following scenarios in the Growth Plan:

(a) Scenario 1 – Trend continuation of growth;

(b) Scenario 2 – Growing Broome according to its comparative advantages (tourism and agriculture, with Aboriginal participation continuing at its current level);

(c) Scenario 3 – Growing Broome according to its comparative advantages (tourism and agriculture, with Aboriginal participation increased);

(d) Scenario 4 – Significant growth based on the above plus major investment.

9. Endorses the Growth Plan adopting the position that Broome will be ready for Scenario 4, with the focus of the Growth Plan being on achieving Scenario 3;

10. Endorses the Guiding Principles identified in the draft sections of the Growth Plan shown in Attachment 10, subject to “A Liveable and Unique Lifestyle” being reworded, with the removal of the word “Unique”;

11. Notes that the Deputy Chief Executive Officer and Director Development Services will provide feedback and input on the draft sections of the Growth Plan shown in Attachment 10 and the draft Growth Plan document as more of the document is drafted;

12. Notes the outcome of the Review Point 3 Workshop held on 16 August 2016 as shown in Attachment 12;

13. Requests that the Chief Executive Officer take steps to secure additional detail on the proposed separate legal entity that will be identified in the Growth Plan as responsible for implementing the Growth Plan; and

14. Requests that the Chief Executive Officer call a meeting of the Economic Development Advisory Committee for 13 October 2016.

Attachments

1.	Minutes of Project Control Group meetings
2.	Minutes of Growth Plan Partnership meeting (includes Agenda and supporting documents for meeting on 5 September 2016)
3.	Multi-Criteria Analysis Tool released by Department of Regional Development
4.	Broome Growth Plan - Strategy Framework Discussion Paper
5.	Project list linked to initiative areas
6.	Broome Economic and Situational Analysis (draft)
7.	Infrastructure Audit (draft)
8.	Health and Wellbeing Report (draft)
9.	Scenario Planning Report (draft)
10.	Draft sections of Growth Plan
11.	Power Point Presentation from Review Point 3 Workshop
12.	Review Point 3 Panellist Assessment and Summary of Proceedings
13.	Discussion Paper - Governance and Implementation Framework

Item 5.1 - BROOME GROWTH PLAN - STATUS UPDATE AND KEY ELEMENTS

Agenda of Economic Development Advisory Committee - 16 September 2016

Prepared for Creating Communities

August 2016

Contents

Key Messages. 3

Aboriginal advancement 3

Structural changes – to services and funding.. 3

Specialist medical, diagnostic and secondary treatment services. 4

Bigger, younger populations expect modern health technologies. 4

Healthy ageing and aged care needs attention. 4

Health and schools working together 4

Synergies between industry and education and training.. 5

Advocating for a new agenda – transformation and deriving economic benefits. 5

Addressing health concerns which will detract from economic participation and benefits 6

Food is powerful on many levels. 6

Community action on health and better prevention measures. 7

Schools and health collaboration. 7

Private sector involvement in an expanded range of specialist medical, diagnostic and allied health services. 7

Growing a healthy and productive older population. 7

Building awareness, optimism and motivation. 8

Enhancing Broome’s ‘brand’ as a welcoming and accommodative regional services and visitor destination centre. 8

Introduction. 9

Situational Analysis. 9

The Current State – A broad description of the health service and wellbeing provision system/s 12

State government hospital and health services. 12

Primary health services – NGOs, state government and private sectors. 13

Primary health care financing and investment – national government reforms. 15

Wellness and services aligned to wellness. 16

Community sector services and wellness. 17

Aged care services. 17

Overview of current health and wellbeing/ statistics and outcomes for Shire of Broome 19

Key Stakeholder Mapping and Network Analysis. 22

Opportunities and Constraints. 24

Existing and Future Plans. 27

Strategies. 32

Strategies for Moving Beyond the Status Quo.. 38

Strategies to Support a Growing Economy. 44

Appendix 1: Summary of Stakeholder Engagement 50

Key Messages

Aboriginal advancement

There is interest in new approaches and most importantly aspirations to shift well away from racism and ‘old think’ paternalistic policies and attitudes to dealing with prevailing problems – like poverty, welfare dependency, social stresses, violence, substance abuse, higher burden of disease and shorter life expectancy.

Solutions to the prevailing barriers associated with land/living ‘reserves’ in town and communities would be a major breakthrough and something everybody wants to see happen.

To reduce the number of lives dependent on welfare and support, Aboriginal people will need to be:

1. Healthy throughout childhood and school years; protected from harm, diseases and disabilities detrimental to their education and job/advanced education readiness – the strategy for a school based and primary health partnership has the potential to be a cycle breaker for the future generation of workers, professionals, partners and parents;

2. Well equipped with effective personal strategies to avoid lifestyle/chronic diseases – prevention strategies will keep young people protected from lifelong medications, inevitable disability; and reliance on welfare/support services;

3. Aspiring to and reaching for better lives - motivated by tangible job, career and personal/family economic possibilities – strategies for a more diverse economy with a range of industry and professional trades, careers, jobs and business enterprise; and access to local training, advanced education and academic research endeavour;

4. Entitled to achievable personal/cultural and material ambitions – strategies to further leverage personal, family and cultural strength and especially those derived through the direct and indirect benefits of Native Title, land ownership, Indigenous enterprise and equal power and authority in planning and decision making;

5. Content with their family, community, cultural and modern day lives as measures of wellness – strategies to improve housing and living conditions which enshrine family and community connectedness; remove imposed barriers/take care not to impose future barriers to the freedoms to access and enjoy cultural places and pursuits;

6. Very competent consumers and independent custodians of their own/family health, lifestyle and economic choices – education which skills up young consumers about the marketing game; navigating conflicting/confusing health and dietary advice, financial advice/coaching for younger people designed to help them set and work to goals (tools to acquire knowledge, social and financial/property assets and equity; how to use credit to advantage and how to avoid debt traps).

Structural changes – to services and funding

State government is looking for more effective funding/service consolidation solutions for town and community client groups in the Kimberley and Pilbara. They have identified a high degree of inefficiency; myriad programs and funding streams and chronically plateaued outcomes when considered in context with the allocated resources.

The Office of Prime Minister and Cabinet are supporting the Empowered Communities development. This is also about looking for ways of getting resources to communities of consumers in ways that enable better outcomes and value for money.

Specialist medical, diagnostic and secondary treatment services

The range of services can only grow well beyond the status quo if there is a much greater and sustainable population growth than already factored into forward demand/supply planning assumptions.

Higher demand from more people usually creates a supply response if market conditions are right. Broome presents some barriers to entry by private sector operators into the service mix. Strategies designed to lower barriers to private sector entry will be needed if/when the population and economic growth gain momentum.

Bigger, younger populations expect modern health technologies

In small towns, people are usually content to settle for a basic range of services. As the population grows in response to economic/industry diversity and expansion, people will expect more contemporary service models. Examples are:

Ø Cancer/chemotherapy;

Ø Diagnostics – including MRI and breast screening;

Ø End of life – palliation for a range of conditions (not just cancer);

Ø Ambulatory/in-home hospital treatment;

Ø Midwife managed low risk family birthing;

Ø Mental health and social, emotional wellbeing and healing services.

Healthy ageing and aged care needs attention

This was discussed through two lenses and the report suggests there is a need for planning to address both aspects:

1. The increased demand for aged care services and infrastructure – as people suffer from earlier age onset of disabilities related to the current epidemic of chronic diseases; and

2. Measures to attract/retain more productive retirement aged people to continue living in Broome – it will be necessary to consider a range of residential solutions (designed to meet the unique lifestyles of different consumers) community and social facilities, amenities and services; and opportunities to participate in a self-determined mix of affordable pleasure/leisure pursuits and part time employment or volunteering work.

Health and schools working together

A primary health service built through health and school collaboration which leverages the constant and enduring relationship children and their families have with schools from a very young age should be further explored – starting with the proposal put forward by Broome schools and also taking into account the model used for ear health at the East Kalgoorlie Primary School in the Goldfields.

Synergies between industry and education and training

Re-energising workforce education and training in Broome needs to be stimulated by a workforce hungry sector of industry and service employers whose job and career offerings are sufficiently motivating to prospective course entrants.

Another aspect of education is growth, nurturing and economic potential of advanced and applied research knowledge aligned to industry solutions.

It was suggested an academic research and development centre be considered for Broome, based on a contemporary redesign of the Combined University Centre for Rural Health which was established in Geraldton many years ago. The underpinning model for this is that all of the universities in WA collaborate so that a rich array of courses, programs, areas of academic and applied research can be sourced, brokered and supported for students and employers.

Advocating for a new agenda – transformation and deriving economic benefits

A health and wellness agenda emerged – with no limitations placed on scope – and encompassed the need for measures which:

1. Increase employment, business and material prosperity prospects so people can afford a comfortable and satisfying lifestyle in a modern day world – and resulting in greater economic participation, independence, less reliance on welfare incomes and social support services;

2. Create and leverage intellectual and technical knowledge and industry know-how;

3. Help to advance community cohesion, deeper mutual respect and quality of living – improving sporting and leisure amenities; social and artistic activities; and very importantly a reality of friendly and safe neighborhoods;

4. Enable a celebration of the culture of the Indigenous people as well as that of Broome’s own history - able to be shared with others; create greater inclusion of locals; offer enjoyment by/enrichment of visitors; and underpinning greater enterprise growth;

5. Enable freedom to enjoy access to traditional and contemporary places, lifestyles, pleasures and cultural practices;

6. Leverage the potential of Native Title settlements – the people, ideas, aspirations and possibilities; their ideas for land development; their influence; and their financial, intellectual and cultural resources;

7. Make Broome an attractive and affordable place for people to live as they grow older;

8. Cater for people’s care needs as advanced age and/or related disabilities influence their decisions to stay in Broome or return to larger centres or cities;

9. Cater for people’s physical, mental, family/birthing, community and end of life care needs through an adequate range of general and specialist medical, diagnostic and therapy technologies and services;

10. Reduce public health hazards; early onset preventable diseases and the high cost/low productivity consequences of the associated disability burden.

Addressing health concerns which will detract from economic participation and benefits

A transformation agenda aimed at improving health – in the prevailing environment where most of the most debilitating ill health is associated with chronic/lifestyle diseases – must encompass measures for prevention that actually work.

Prevention at a population level remains elusive in the prevailing public health policy settings.

Therefore, poor health and disability will continue to limit the scope for participatory benefits of economic growth for many in the community to the extent a great many people are not well informed and able to make good consumer choices.

Engage with and leverage Native Title

There are new avenues for transformative strategies being driven by the Yawuru and possibly other Native Title groups in Broome. Yawuru is actively participating in growth planning for Broome and the scope for economic benefits is significant given the land they own and the range of business and property development interests they have.

They are keen to explore leveraging opportunities for themselves and to benefit Broome as a community. There should be equal interest from the BGP group to explore how plans can be similarly leveraged to drive community wellness/advancement and economic benefits.

The much anticipated thesis by doctoral student –Yawuru women Many Yap – on the ‘Economics of Liyan’ may help to make ideas more tangible.

Leverage government reforms

There could be opportunities for different structures and government funding models through the reform space, although how these might be aligned with economic and/or health and wellness advancements in Broome has yet to crystallise.

Neither agenda is seeking out links with growth planning for Broome specifically.

The Broome development oversight/stewardship group suggested in this report might be a productive way to gain engagement in exploring beneficial interests and ideas central to or linked with the BGP.

Food is powerful on many levels

Food production, enterprise and export is on the agenda for Broome and Kimberley development. Prospective enterprise benefits (in addition to wage/salary jobs) for locals – including for Aboriginal people - should also be in focus as part of the future food production industry growth.

Rather than being seen exclusively as a vehicle for corporate enrichment and local jobs; the evolving food story in Broome and the wider region could be fully exploited for its capacity to better feed local people right throughout the region – at prices able to be managed by a great many people on low incomes.

Community action on health and better prevention measures

Community focus on better food quality and affordability solutions to prevent and reverse chronic diseases could be a powerful way to bring community, local industry and government stakeholders together.

Solutions involving local/regional food basics production, distribution, marketing, preparation, eateries and retailing infrastructure, systems and enterprise would be beneficial.

There could be enterprise opportunity in the traditional indigenous food and medicinal products, cooking (skills teaching) and meals/eatery models.

Schools and health collaboration

Engagement of the education system and the network of schools in Broome to leverage their potential for health advancement with a strong generational ‘legacy’ is a very exciting prospect to envisage.

Other than in tiny pockets, neither the school or health systems ‘have their heads around this’ and in reality, there is probably a mind field of territorial warfare ahead. Health are generally not very good at sharing their space with others; and many schools don’t see themselves as responsible for health.

However, the power, leverage and legacy prospects from a school based and long range student and family health model is compelling and should be fully explored and developed.

In Broome, the schools have already begun applying themselves to the potential for health measures to become built around their relationship over years with students, their siblings and their families. This should be further explored and supported once a workable model is agreed – even on a pilot basis.

Private sector involvement in an expanded range of specialist medical, diagnostic and allied health services

This is not envisaged as a likely option for viability reasons (high entry and operating costs as well as marginal consumer volumes) in current forward capacity planning assumptions for the next decade.

If the Kimberley Blue Print and BGP do cause a paradigm shift in growth with sustained momentum, the planning assumptions will need to be adjusted and it may present an opportunity to explore greater private/public mix of services in health.

This would be a big change from the status quo where government is the only operator of diagnostic and secondary treatment services. A greater proportion of private sector providers would add another dimension of economic productivity related to health.

Growing a healthy and productive older population

Older people – retired and semi-retired – are valuable within a growing local economy and at the present time, this aged group is relatively small in number for non-Aboriginal people.

They can continue to participate in employment and they are consumers of a wide range of products and services.

Healthy ageing is the ideal of course, however, as age advances people’s residential and care/service needs being to change. Being closer to services and supports and being able to access the right type of residential solutions are factors believed to be influencing older people to leave Broome.

So changing from this status quo would require some worthwhile investigation and planning as part of the growth plan. The planning would be an excellent opportunity to explore the unique aspirations and models suited to the Indigenous aged people and their families as well as the standard/westernised models we are typically think about – nursing homes, retirement villages.

Building awareness, optimism and motivation

Promoting the growth plan in ways that encourage thinking and innovation through a range of measures – for example, talking to high school and advanced education and training students, talking in the media and encouraging discussion in corporate, business and public forum settings.

An ability for people to access planning/advisory services to explore opportunities for small enterprise development could be an advantage – as well as some capacity for ‘incubating’ small enterprise and innovations.

Enhancing Broome’s ‘brand’ as a welcoming and accommodative regional services and visitor destination centre.

It wasn’t too many years ago when Derby was the regional centre for the Kimberley and most government services had their regional offices and accommodations in that town. Progressively many regional operations and corporate offices have relocated to Broome and some divide between Broome/Derby and Kununurra.

Being designated as a Regional Resource Centre, the hospital in Broome has undergone redevelopment and expansion from its former role as a small district hospital servicing the needs of the Broome community to being the central operation base for the highest level/capacity clinical services for patients from all over the Kimberley.

This dictates that many more people from around the region need to come to Broome for health care; and indeed for other government services. The ability to ‘digest’ the knock on consequences of this has taken some time and is still a work in progress to some extent. It will be exponentially a greater effect if and as populations in Broome and indeed right across the Kimberley grow as envisaged in the next two decades.

Tourists are the market most typically catered for by businesses in Broome. There are and will continue to be a greater number of health tourists from around the region; as well as intra-regional people who go to Broome for holiday breaks and to access goods and services only available in this larger centre.

A variety of hospitality and leisure solutions are needed; and public transport is another aspect needing some attention – both creating potential for enterprise responses.

Introduction

The context for this piece of work is the work being done to articulate a comprehensive growth plan for Broome as one component the Regional Centres Development Plan (RCDP) being driven by the WA Department of Regional Development (DRD).

The aims of the RCDP are to help designated regional centres such as Broome to realise their economic potential and create a flourishing community that is highly attractive to external investors^{^[2]}.

Serving as a platform for developing the BGP are key documents published by the Kimberley Development Commission:

Ø The Kimberley Regional Investment Blue Print;

Ø The 2013-18 Strategic Plan; and

Ø Kimberley: a region in profile (published by DRD).

Some contemporary profiling, planning and survey work undertaken by the Shire of Broome have also been briefly examined:

Ø Broome Economic Profile

Ø Broome Community Profile

Ø Shire of Broome Strategic Plan 2012-16. (The Shire of Broome Community Strategic Plan 2015 – 2020 was not examined and is being reviewed by the Shire in the latter stages of 2016)

Ø Community Survey.

This particular exercise undertaken for Creating Communities was intended to explore prospective economic development and population growth (as envisaged for the BGP) from health and wellness perspectives.

The scope of inquiry, research and analysis is pitched at a high level as the timeframe for this work was short.

Situational Analysis

A few general observations are offered:

Not surprising was that the agencies and individuals able to be engaged during this exercise are all concerned that economic, industry and population growth in a future Broome is balanced enough to underpin material progress and improvement for the community and all of its people.

Some people were sceptical and even cynical – they see growth based on industry (especially resource and agricultural industry with environmental impacts) would enrich big corporates and a small number of ‘local fat cats’. In the same vein, they talked about ‘token’ initiatives for community wellbeing as having little value unless they are genuinely and adequately targeted to improve inclusion, cohesion and broader enjoyment of the benefits over the long term.

The dimension of wellness as distinct from health care/illness was overwhelmingly what people wanted to talk about. This included the health service providers as much as the agencies and individuals whose interests sit more within the community development and advancement domains.

It was virtually impossible for discussions of health and wellness not to be predominantly focussed on the needs of the Aboriginal people of the community;

Prevailing themes in wellness were:

- Greater inclusion, participation sharing of benefits;

- Changes in the power and intellectual dynamics post Native Title and the potential for this as a ‘game changer’;

- Various assumptions and views on ‘community closures’ and service /funding reforms;

- Looking beyond government’s ability to design and execute effective solutions at national and state levels;

- Prevention of a wide range of diseases through regional/local foods.

Broadly considering wellness as being happiness and a state of satisfaction with measures of quality of life, many people talked about things like:

Ø Opportunity for paid work in a chosen field that pays well;

Ø Good living conditions and a manageable cost of living;

Ø Financial security;

Ø Employment security and career satisfaction;

Ø A good state of mental, emotional and physical health;

Ø Good municipal services;

Ø Justice, fairness and equity;

Ø A living environment and lifestyle that supports good general health – good quality foods and food security, community amenities for leisure, activity; sports and social groups/clubs;

Ø Harmonious and peaceful community and neighbourhood dynamics with good social behaviour standards;

Ø Safety and security;

Ø Freedoms and choices – self-determination, self-agency, sufficient influence and control over own life and wellbeing of self and family;

Ø Access to the things they need most – housing, income, mobility, communications, social contacts, family support, entertainment, recreation, services and advice;

Ø A community where there is fairness for all people; and where there are cohesive, inclusive and respectful relationships between the different cultural groups.

It is stated^{^[3]} that western measures of wellness are not sufficient for Indigenous people, albeit they might serve as statistical measures of use to governments and their programs.

A research paper^{^[4]} published in August 2016 by Mandy Yap and Eunice Yu – both Yawuru women – reports in great detail on qualitative and quantitative research on concepts and definitions of wellness undertaken by and amongst a sample of Yawuru Indigenous people in and from Broome.

These concepts of wellness from an Indigenous perspective – are defined for the first time with academic rigour by people who are centred within the status quo of health and wellness in Broome right now. Importantly, people are considering not only the multi-dimensional frame of wellness from an exclusively cultural perspective; they are also clearly seeing wellness in a contemporary, modern world view and there is some thinking as so how material essentials for a good life and good health are fitting in alongside the cultural frame.

Wellness was defined by study subjects as a mixture of measures essential to ‘mabu liyan’ or health and wellbeing of the spirit/soul and inner self. These are shown below:

Ø Family wellbeing – the strength of connectedness to one’s family;

Ø Community wellbeing – it is necessary for one’s community to also have wellbeing;

Ø Strong culture, country and identity – knowledge of culture and stories, about flora and fauna on country, about fishing and hunting, about eating traditional foods and knowing how to prepare them, and about knowing the language;

Ø Self-determination, rights and autonomy – this mean more than just an ability to ‘have a say’. It is about feeling one’s rights are genuinely respected and that people are free to exercise decisions and rights;

Ø Health and wellbeing – the necessities to live a healthy life and have help when needed for physical health;

Ø Material wellbeing – having an education, good employment, steady income and being able to afford the basic things that make modern life comfortable, satisfying and safe such as housing and transport for mobility;

Ø Subjective wellbeing – a person’s overall rating of their feelings about their state of wellbeing – how good and satisfying personal, family community, modern world and cultural life balance is.

The report quotes a number of statements by study subjects which illustrate how overall wellness is challenging for some contemporary Indigenous people and they reflect the mix and balance of ‘normal and basic’ material essentials (like income, housing, financial and lifestyle resources) together with the essential cultural measures. For example:

Ø One person spoke of needed to redefine the contemporary settings of our sense of wellbeing – it has to have the normal material kind of issues like health, income and housing.

Ø Another observed that there needs to be room for economic and cultural and social wellbeing.

Ø One individual expressed this as feeling under pressure to sustain both culture and work – having to live in two worlds where surviving financially means working fourty hours a week and cultural activities having to be fitted in on weekends. They observed that this was hard.

Ø A couple of quotes from younger study subjects were clear about measures of a good life – such as having all the necessities like clothes, money, a car and probably my own house. Another statement reflected on ambitions and dreams – ticking the milestones, finishing school and going to university.

The Current State – A broad description of the health service and wellbeing provision system/s

State government hospital and health services

The region itself influences health care provision decisions by governments and the private sectors.

The WA Country Health Service (WACHS) operates all government hospital services in the region in addition to population health, community, school, child and mental health services in towns and several remote communities.

Their planning and operating model is based on a ‘hub and spoke’ network. In each of their seven WA regions with the exception of the Wheatbelt, one of their hospitals in the largest regional centre (Broome in the Kimberley context) is designated as the ‘Regional Resource Centre’ (RRC).

The RRCs deliver the highest range and level of service and support the hospitals and other health services and teams in other regional places.

Typically, the specialist medical, diagnostic, allied health and population health services are based in the regional centre.

The hospitals and health services around the regions are then accorded specific designations which prescribe their range and level and capacity in some detail.

The entire WA Department of Health (metropolitan and regional service systems) now plan and develop services aligned to a comprehensive Clinical Services Framework (CSF). The prescribed services range and levels are projected forward based on combinations of modelled population and consumption patterns.

The prevailing CSF 2015-25 documents the services provided by the Broome Hospital and other WACHS services working in and from Broome.

All of the Kimberley’s major townships as well as the regional centre in Broome are a long way from Perth where the major publicly funded and private sector diagnostic, treatment and therapy systems are based.

As in other WA regions, the health care/referral system relationships are exclusively between each region and Perth providers. There are very few service linkages with referral and transfer/transport pathways between WA regions (for example between Broome and Port Hedland). Outside of WA, the Royal Darwin Hospital is used as a referral destination mainly for East Kimberley inpatients due to its relative proximity and depending upon its capacity at the time of requests.

Off all WA regions, the Kimberley is somewhat unique in health system planning because:

Ø The total population is relatively small and Broome as the regional ‘hub’ is also a much smaller population (15,000-17,000 estimated) than Geraldton, Kalgoorlie, Bunbury and Albany which have more than 30,000;

Ø The small population combined with serious cost and clinical viability detractors are constant barriers to advancing hospital services in Broome beyond current range and levels;

Ø The commercial viability of private sector health services is limited by big barriers to entry for general practice, routine medical specialties, advanced diagnostics, advanced secondary hospital clinical care systems like intensive and coronary care units, private hospital services and a full range of allied health/therapy services;

Ø The absence of a good range of private health sector options expresses itself through low levels of private health insurance, the cost of which is generally well beyond the means of many of the highest need/consumer group;

Ø Aboriginal Community Controlled Health Services (ACCHS) are major players throughout the region in provision of culturally aligned primary health and GP services;

Ø In the absence of private or ACCHS GPs who bulk bill, WACHS (mainly through their hospital emergency departments and also in their remote community clinic services) continue to provide ‘default’ free primary medical services;

Ø There are a huge number of remote communities throughout the region of varying population sizes and infrastructure/services capability and servicing arrangements;

Ø The population is uniquely ‘young’ in structure;

Ø Community and residential aged care provision is geared mostly (but not exclusively) to Aboriginal consumers;

Ø Many non-Aboriginal people leave the region (and Broome) when they begin to age to a point their residential, care and family support needs begin to manifest;

Ø Other than standard model residential and in-home aged care/service solutions, ‘retirement aged’ living facilities, amenities/attractions and services best suited for older Aboriginal people and their families have not been well conceptualised or materialised;

Ø Solutions for an older (but not yet requiring care) non-Aboriginal population are generally not a priority due to the younger age structure and relatively low numbers of non-Aboriginal people who chose to ‘age in place’;

Ø The greater proportion of WA’s Aboriginal population live in the Kimberley and the proportion of Aboriginality in the major townships range from upward of 80% in Halls Creek and Fitzroy Crossing to an estimated 35% in Broome.

Primary health services – NGOs, state government and private sectors

Community Controlled Aboriginal Health Services

These operate from clinics based in Broome, Derby, Halls Creek and Kununurra. They are each independent with their own constitution and board of directors and they all service a number of outlying communities in their district.

The Kimberley Aboriginal Medical Service (KAMS) is based in Broome and functions as an umbrella/support organisation for its members (who control the organisation via the governance board). KAMS also delivers direct primary health services to the remote Kutjunka region (Balgo, Bililuna and Mulan) and to the Dampier Peninsular and Bidyadanga. They deliver renal dialysis services in Broome, Derby, Fitzroy Crossing and Kununurra under contract to WACHS; operate a population team; and provide the Head Space (mental health) service. They also operate their own Registered Training Organisation; and host the UWA’s Rural Clinical School.

Other NGO primary care services

Boab Health Service is an established provider of non-medical primary health services for patients with one or more chronic diseases and who wish to have a supported program to help them manage their conditions and lifestyle modifications.

They operate from and in Broome and are also active in the East Kimberley.

Allied Health

In Broome, private physiotherapy services are quite commercially viable thanks to the demand from a significant young professional, sporting and industrial market.

There is one private podiatrist in Broome. Other than these therapy services, there are no private allied health services in Broome or other parts of the region.

Pharmacy

Broome currently sustains four private pharmacies in a very viable retail market. Kununurra and Derby are also able to sustain private pharmacy businesses.

Private medical services

There are four private GP practices in Broome; much less in Kununurra; and as yet none in any of the other towns (Derby, Fitzroy Crossing, Halls Creek and Wyndham).

Specialist medical consultants

There are no region based specialist consultant and diagnostic providers outside of the public system.

Regional based specialists cover the basics of:

Ø Generalist physicians;

Ø Obstetrics and gynaecology;

Ø Surgical;

Ø Paediatrics;

Ø Psychiatry.

Otherwise, specialist services are supplemented by visiting specialist arrangements funded by WACHS and/or with funding support from Rural Health West in Perth (a commonwealth funded rural health service workforce ‘commissioning’ body.

Diagnostic services

The region is well enough served for clinical pathology although this would need to expand in range if there was a paradigm shift in population and demand growth followed by a significant expansion of level and range of hospital services in Broome and other parts of the region.

Medical imaging is well covered for XRay but not for MRI which has become a clinical necessity in diagnosis in many specialty areas.

A Broome MRI service (public and/or private) cannot be supported for the Kimberley with current population levels or even at projected population levels encompassed with the CSF to 2025 based on current growth/consumption patterns.

The absence of MRI diagnostics in the region dictates a range of other specialist medical services are also not very viable; and that patients requiring this type of imaging will continue to be referred/transferred to Perth for their diagnostics and quite probably also for their medical/procedural treatment.

Primary health care financing and investment – national government reforms

In Australia, state governments are responsible to finance and operate public hospitals and a range of other non-hospital programs (community health for example).

Primary general and specialist medical care outside of the public/hospital system is the responsibility of the for-profit private sector funded/reimbursed through Medicare (financed by the Australian Government).

Private medical services are not ‘regulated’ in terms of where business owners choose to operate. This has resulted in medical business/workforce and service distributions consolidated in places where market forces prevail.

The more remote places with lower numbers of more complex patients in the market (higher cost and lower profit margin); where the barriers to entry (operating and living costs) are high; and living conditions not so attractive to professionals and their families are typically underserved.

The Kimberley demonstrates this ‘maldistribution’ system better than most places in WA; although the gaps have been significantly lessened with the establishment of Medicare bulk billing and supplementary block and grant funded ACCHS (through salaried GPs) throughout the region.

Various governments have been collaborating on major health system reforms for several years and most especially (although not exclusively) in the primary medical sector to try and better engage and focus the GP services.

The most recent/current approach is Primary Health Networks (established in 2015). These are exclusively commissioning bodies and don’t deliver services.

There are much higher expectations for preparation for and execution of commissioning functions for primary health services and in the Kimberley region, what they do will be critical to strengthening the secondary prevention/disease management effort.

In WA, a new organisation called the WA Primary Health Alliance (WAPHA) has been established. It is a NGO sector incorporated enterprise. They are Perth based but operate an extensive country arm and have a small office in each region and for the Kimberley, this office is based in Broome.

Other significant national health reforms

Significant funding reforms for hospital services nationally are underpinned by the introduction of Activity Based Funding/Management (ABF/ABM). This is essentially a financing model where volumes of certain types of services are purchased/funded to state governments based on need/consumption patterns and best practice; and also valued on a Nationally Efficient Price (NEP) benchmark.

This presents WACHS with challenges as the actual costs in the WA regional system, most especially in the Kimberley, are so much greater (and probably always will be) than the NEP benchmark.

Finally and perhaps most importantly in terms of the national reforms are the intended synergies between primary and hospital systems. The two systems are intended to function collaboratively – ensuring reduced demand for hospital admissions for preventable conditions. Hospitals for their part must ensure there are much better transition to primary care systems in place.

Wellness and services aligned to wellness

Primary health service providers in the ACCHS, other NGO, government and private sector would lay claim to a wellness agenda and service profile.

This would also include the population health service units in WACHS and KAMS which operate from Broome.

Similarly, environmental health services would see themselves in this space also.

Mental health and drug and alcohol services deal with complex cases therapeutically but a good measure of their models of care embrace general wellness at the person and household/family levels.

Collectively, the grounds for this are that they are concerned to prevent disease and in so doing, promote a state where wellness is created or at least made more possible. They do this by way of:

Ø Influencing prevention of disease and illness through their actions in educating and promoting good personal, domestic, community and lifestyle knowledge and applied behaviours;

Ø Screening of health markers and to identify possible and/or existing health hazards and risks;

Ø Provision of early interventions designed to protect and restore good health and limit exposures to future risks and decline;

Ø Acting early and systematically on communicable and non-communicable diseases and outbreaks;

Ø Respond to community concerns about health issues and risks – for example, in the areas of substance abuse (crystal meth being a very contemporary matter) and outbreaks of suicide including in young children outside of the mental illness domain;

Ø Influence plans, strategies, actions and health policy designed to promote and improve wellness;

Ø Having appropriate public health concerns for the impact of developments and evolving factors on health and wellness.

Community sector services and wellness

Outside of the health service system itself, there is a much broader sector engaged in various aspects of community wellness.

There are some emerging developments – such as surveys, research work, new models and engagement in business and planning which have been empowered consequent to the Yawuru Native Title determination. There are now powerful forces for good at work on several fronts examining questions from a uniquely Yawuru (and more broadly local Indigenous) perspective.

Apart from Yawuru, there are a number of community service styled organisations – mostly Aboriginal owned and controlled but some not – operating in the general wellness space and targeting social problem amelioration (such as meals, counselling, pre-post custodial release support and the like); enterprise creation; training and employment; and other means of advancement of interests.

This exercise has of necessity been only superficial in this domain. Indeed it would require a rather more extensive study to map and examine all the organisations, funding streams and initiatives in process at the present time.

For now though, the most impressive endeavour was observed to be the models and initiatives being developed by some very key agencies and what appears to be a ‘thought and action leadership collaborative’. The intellectual capacity (which has been around for a very long time) is emerging and becoming increasingly influential and empowered due to contemporary developments.

Whilst there was that ‘vein of dissent’ about prospects for major economic and population growth (for fear that the Aboriginal community, the environment and the local community other than the ‘fat cats’ would get very little benefit); there was surprisingly a very strong thought and action front from contemporary Indigenous leaders to join in and help design and guide the solutions.

They appeared to have a strong conviction that there is a far better way to do things other than to wait for government programs to sort things out; and that there are huge benefits to be had for Indigenous people generally, Yawuru in particular and the general community of Broome in taking a place around the tables in the BGP development.

Clearly, the thinking is that wellness – and indeed health itself – will be greatly enhanced if there are equal opportunities for Aboriginal enterprise and inclusion in future developments in mainstream industries; and also in a range of enterprises being nurtured within the Aboriginal land holding and organisational domain.

Aged care services

The aged care services available are structured as they are in other places – governed by the commonwealth government’s aged care services resource allocation policies and the provider industry funded to provide various types of care.

A long standing goal in aged care is to keep elderly people living at home for as long as possible and provide in-home and community based care and supports to enable people/families achieve this goal.

Residential nursing home care is available in mixtures of low and high care formats and for people caring for elderly at home, the residential sector usually accommodates some respite care availability.

There are significant planning challenges to addressing aged care:

Ø Aged care cannot be dealt with in isolation from the chronic disease burden and its impact on premature ageing and disability;

Ø Disability will continue to drive non-Aboriginal older/retired people away from Broome as their care needs transcend the range and level of services available locally;

Ø Aboriginal people will continue to succumb to these diseases at a higher rate and with greater early age onset in the absence of more effective prevention;

Ø New medical and surgical breakthroughs may keep people alive longer, but the burden of disability and demand for care will grow;

Ø A significant driver of demand for aged care services will be the upward trends in earlier age onset dementias and Alzheimer’s Disease; loss of limbs due to diabetes, partial paralysis following strokes, loss of vision, autoimmune and neurological conditions resulting in severe physical disabilities.

To the extent the issue of ageing was raised at all during the consultations for this exploration, the interest was not about ‘aged care services’ but rather about exploring measures to encourage people to keep living in Broome as they begin to age.

At the present time, there is a trend for many people who have lived for several years in Broome to return to live in cities or other places closer to service and family contacts as or before they begin to age. Elders in the Aboriginal context have enormous cultural value. Older –retirement aged but well and generally productive – people generally have great value within families.

Senior people often have time to contribute to community endeavour through volunteering and/or part time work and many have a great deal of knowledge, skills and wisdom to impart to others. This suggests that a future planning agenda is emerging around the aging population and may need to be addressed through two specific dimensions:

3. The increased demand for aged care services and infrastructure – as people suffer from earlier age onset of disabilities related to the current epidemic of chronic disease; and

4. Measures to attract/retain more productive retirement aged people to continue living in Broome – it will be necessary to consider a range of residential solutions (designed to meet the lifestyles of different consumer markets) community and social facilities, amenities and services; and opportunities to participate in a self-determined mix of affordable pleasure/leisure pursuits and employment or volunteering

Overview of current health and wellbeing/ statistics and outcomes for Shire of Broome

The scope of this exercise has not allowed for a thorough going gathering, analysis and presentation of health and wellbeing statistics.

Most of the health outcome statistics gathered during the project relate to the Kimberley as a whole. However, they can reasonably be assumed to reflect outcomes for Broome as well, especially for the Indigenous population.

For Broome itself, very little has been obtained which is exclusive to the area other than Indigenous population enumeration (done in 2011 through the Knowing Your Community (KYC) household survey^{^[5]}); some numbers on homelessness and social meals provision; and community perceptions^{^[6]}.

A ‘potpourri’ of statistics and estimates of health and wellbeing for the Kimberley (reflective of Broome generally) and Broome in particular is summarised in this table.

Table 1: Some Kimberley and Broome health and wellness statistics to consider

Category	Summary detail
Population and growth outlook	Projections vary in different reports: - Living in the Regions 2013 (DRD publication) said Broome’s population was 17,251, with 35% Indigenous and had grown 2.2% over the previous 10 years; and projected that by 2023 the population would be 44,0000 for the Kimberley region; - The Kimberley Blueprint (KDC) projects a Broome population of 48,500 by 2036 and a total Kimberley population of 93,173 is possible if the type and scale of envisaged economic growth occurs. The Blueprint also estimated the impact on new jobs creation in this projects at about 34,000; - The Knowing Your Community (KYC) household survey to better enumerate Broome’s population of Yawuru/Indigenous people and households reported in 2011 there were 3712 people in 997 households. Even allowing for some growth over the 5 years since the ABS 2006 census, the population count was 61% higher. There was a big difference in the number of households as well – 686 in ABS 2006 versus 997 in KYC survey 2011. Importantly, the ‘service population’ of Indigenous people in Broome (8763) was very similar in both ABS Census and the KYC survey.
Stolen Generation Legacy	- In 1958, 25% of Indigenous Kimberley adults and 45% of the children were living in mission settings following removal policy through to the 1970s^{^[7]}; - 96% of Kimberley Aboriginal people belong to a family were members were removed^{^[8]}.
Suicide	- 71% of the people who suicided 2004-2014 did not have a mental illness and had no contact with mental health services; - Determinants of suicide^{^[9]} are violence, dysfunction, homelessness and poverty (data not sourced but prevalence is known to be high); - A 2013 spike in Acute Rhematic Fever followed by a spike in post streptococcal kidney infection are outcomes of overcrowding in housing, very poor domestic/environmental conditions and the potential for “menacing impact on young people living in these conditions”.^{^[10]} - 75% of completed suicides in the Kimberley occurred amongst Aboriginal men; - Aboriginal children regularly attend funerals of relatives who die prematurely and frequently from suicide and violence (statistics not known); - The ‘Feed the Little Children’ service are providing around 300 meals to hungry young people on Friday and Saturday nights in Broome and crime statistics by youth are lower as a result.
Homelessness	- Centacare in Broome^{^[11]} reported over 1400 homeless and at risk adults and children are on their books; - They provide meals for 50 individuals per sitting; - There are around 87 new people turning up each month in need of food and help; - 8 out of 10 of the murder victims in Broome in the last 3.5 years have been alcohol related and in people who don’t usually reside in Broome; - ‘Rough Sleepers’ are more likely to die prematurely; - Regionalisation of services (like health care) stated to be contributing to homelessness and need for meals and social assistance – placing stress onto the community and needing better hospitality solutions.
Health	In their Kimberley Health Profile^{^[12]} WACHS provides a broad overview of health statistics and outcomes: - Low SEIFA scores indicate high exposures to the determinants of health; - Heart and vascular diseases and cancers caused two out of three of all deaths; - Mortality from alcohol and tobacco was higher for the Kimberley than for WA as a whole; - Around 66% of deaths in the Kimberley in the decade 1997-2007 were due to potentially preventable conditions – ie, prevented from occurring in the first place (primary prevention); - More than half of the deaths could have been avoided through better primary health care management of diagnosed conditions (secondary prevention including lifestyle/diet modifications); - Crude rates for notifiable diseases (particularly STIs) were higher in the Kimberley than WA as a whole (2009/10); - In 2008, one in four Kimberley Aboriginal women who gave birth were aged under 20 years and three in five smoked during pregnancy; - In 2009, the proportion of Broome children rated as developmentally vulnerable was 31.4% (compared to 56.3% in Halls Creek); - In Fitzroy Crossing, 1 in 5 children have FASD^{^[13]} - this is a particularly bad area for FASD but reflects also that the problem is region wide. Chronic diseases These are metabolic dysfunction, weight gain and diabetes; micro/macro vascular diseases; and cancers. They are a global epidemic and public health crisis affecting a lot more Aboriginal people due to the poorer foods and lifestyle risks but also non-Aboriginal people in ever growing numbers. These conditions will be massive drivers of demand for health, disability services and service for people who have aged prematurely. Renal disease^{^[14]} is a metaphor: - For underlying exposure to chronic diseases with high morbidity and premature mortality and outcome gaps; - As at February 2016 there were over 2000 cases of diagnosed renal disease in various stages; a vast quantum of undetected disease was a certainty including in children; - There were 108 people having regular dialysis treatments in the Kimberley and around 70 late disease stage patients expecting to transition to dialysis in the next 6 to 18 months; - It costs around $100,000 per patient per year for dialysis treatments in the Kimberley units. BRAMS activity - The health service has 7,500 active enrolled clients on their books; - They do 40,000 episodes of care each year; - They have 2,737 chronic disease cases under active management and this is 30% of their client load.
Food costs	Food cost survey - Food across the Kimberley costs 26.1% more than in Perth^{^[15]}; - The increase in food costs in 2010/2013 was mostly in fresh vegetables and fruit; - Welfare recipients need to spend a higher proportion of their disposable incomes on food than others – food cost stress is a factor once >25% of income is required for food; - All single parent families on welfare are at risk of food cost stress Food generally - Poor quality, poor access, high cost and poor consumer knowledge and skills) is a major contributor to chronic disease.
Community perceptions	- Lifestyle and happiness were rated highest for the Kimberley (78-80%) and safety, education and training were rated the lowest (57-70%)^{^[16]} - Community survey^{^[17]} of people living in Broome and the surrounding rural areas rated the town high as a place to live (85%) and visit (82%) but very low on measures of community governance (48%). Much of the dissatisfaction related to anti-social behaviour - In the remote communities of Broome, the survey of those people rated the communities very high as places to live (91%) and visit (94%) but again very low (44%) on community governance.

Key Stakeholder Mapping and Network Analysis

In the short timeframe set for this piece of work, it has not been possible to develop a comprehensive picture which adequately depicts the network of organisations currently operating in the health and wellbeing space in the Shire of Broome and how they interact.

A fairly simple approach is offered in the table below to enable at least a beginning examination of organised/structural health and wellness business in Broome. The list of organisation in each category is not exhaustive, most especially in the domain of general wellness and community support where there are a very large number of NGOs and locally based Aboriginal owned and controlled entities.

Table 2: Summary of health and wellness related organisations and their services

Hierarchy	Organisations	Service offerings
Providers, lead operators and decision makers	WACHS regional executive group	- Resourcing and operations management
	Broome Health Service	- Hospital inpatient including psychiatric and obstetric, emergency department, medical specialists, community mental health and drug service, community health and allied health (various in therapy and diagnostics)
	Kimberley Population Health Unit (Broome Based)	- Communicable disease and outbreak management, remote community services management; health promotion and education; public health program s for non-communicable and preventable diseases
	Kimberley Satellite Dialysis Centre (KAMS)	- Dialysis treatment for Broome people and some remote community people
	Broome Regional Aboriginal Medical Service (BRAMS)	- Primary medical and health services for Broome
	KAMS (regional focussed member support organisation for ACCHS but also provides some services)	- Remote primary medical and health services for Bidyadanga and Dampier Peninsular communities; - Population Health; - Renal services; - Head Space services; - Health leadership, planning and advocacy.
	WA Primary Health Alliance (Broome team)	- Primary health planning and commissioning (resource allocation)
	Kimberley Aboriginal Health Planning Forum	- Planning, leadership, governance and coordination (all providers and related agencies)
	Rural Health West (Perth based)	- Commonwealth workforce support agency - Finances various medical, allied health and multidisciplinary teams visits to the region and remote areas
	Private GP services (4) Broome Medical Clinic; Broome Doctor’s Practice; Kimberley Medical Group; Roebuck Bay Medical Services	- Private fee payment and limited bulk billing medical services in Broome
	Boab Health Services	- Primary health care financed as a not-for-profit by the WAPHA. - Supports longer term chronic disease management for referred patients through organised programs
	Private pharmacies	- Full dispensing services
	Physiotherapy (several)	- Fee paying and some Medicare rebateable private operators
	Royal Flying Doctor Service (new Broome regional base)	- Primary emergency medical evacuations; - Inter-hospital patient transfers; - Some primary medical services to remote communities; - Emergency medical chests in remote settings
Providers of wellness services	Nirrumbuk	- Environmental health; - Training and work experience
	Shire of Broome	- Municipal and public health services
	Aged care providers (various)	- Community and residential care services
	Centacare	- Homelessness and meals support; - Social care programs.
	Feed the Little Children	- Delivered meals for young people to age 18 years Friday and Saturday nights
	Milly Rumara	- Alcohol detox and rehabilitation
	Anglicare	- Counselling support and other
	Mamabalunjin	- Night patrol (Kularri)and other initiatives - RJCP – Regional Jobs and Community Projects (Kularri CDEP)
	Broome Circle	- Social support for women, children, financial advice and community development support interests
	Men’s Outreach	- Engagement and involvement for men
	Head Space	- National youth mental health – prevention/early intervention
Community support and development agencies	Goolarri Radio Enterprises(Broome Media Association)	- Community engagement and advancement agenda;
	Kimberley Institute	- Innovative models and collaborations
	Nyamba Buru Yawuru (NBY)	- Not-for-profit corporate arm of the Yawuru Native Title Prescribed Body Corporate; - Land development – sales and lease; - Conservation; - Culture and language; - Planning and needs; - Housing – rental relief and purchase support; - Community development; - Legal services/acts; - Funeral fund.
	Nangala Jarndu	- Women’s Resource Centre – arts, crafts, textiles
	Broome Recovery Centre	- Men’s Shed
	Burdekin Youth Broome	- Youth Drop In Centre
	T.H.E. (Traditional Homelands Enterprise) and Kakadu Plumb Company	- Food production enterprise
	Argunya	- Housing
	Red Cross	- Social support
	Jaylgurr Guwan	- Dampier Peninsular Child Care for working mothers and families when taking up training and employment.

Opportunities and Constraints

The next table considers the key opportunities and constraints for a health and wellness advancement agenda in context with prospective economic growth aspirations.

Table 3: A summary of key opportunities and constraints in the health, wellness and growth sphere

Opportunities

Constraints

A shared commitment and forward looking ideas for ‘transformational growth’ for the Kimberley as a whole and for Broome through the BGP

Translation of aspirations into reality – belief and optimism haven’t filtered to the greater community and focus is on every day issues: constrained services, overcrowding, visitor pressure, anti-social behaviour, neighbourhood troubles;

Poor understanding and community support for the major drivers and developments;

Community opposition and negativity to growth – low trust, some cynicism and environment issues.

Economic growth means more jobs and more employment – especially for young regional people and the local Aboriginal people – addresses one or more of the determinants of health deficits

Job readiness amongst young Aboriginal people will need a big boost;

Education and training motivation is low when job opportunities are limited and confined to low level/skill and pay jobs;

Literacy and numeracy are problems – health, social problems, hearing deficits and truancy rates.

More prospects for enterprise – entrepreneurial business, ownership, control and autonomy for local people in response to local, regional and further afield consumer markets

Education, training and business acumen not sufficient at this stage – will need to be developed in alignment with materialising opportunities.

Greater critical mass in the local and broader regional population brings with it prospects for material expansion of the types of health services currently not economically or clinically viable in Broome;

Material Kimberley population growth (for example as envisaged in the KDC Blueprint) will generate a paradigm shift in demand for higher level services from the Regional Resource Centre in Broome – this could conceivably open up consideration for more private sector involvement in services than is currently the case.

Government’s ability to finance the infrastructure and recurrent cost profile of expanding range and volumes of health services;

Current hospital campus in Broome is small – adequate for now and next decade but if the population growth tracks close to aspirational projections, a re-think of its location and a green field development may be necessary;

Private sector involvement (if population and demand growth makes it a possibility) would also depend upon other market conditions, such as the proportion of the consumer population with private health insurance, which at the present time is quite low.

A new era of Aboriginal affairs leadership and community advancement; and the emergence of strong, intellectually advanced and innovative thought leadership in Broome.

There is a clear intent to break some cycles - shake of shackles of old (paternalism underpinning dependence on government and welfare); and to move away from the status quo.

There is a ‘transitioning’ underway from the early era of activism and self-determination to a contemporary post Native Title universe of more sophisticated and legitimate legal power over land and resource development;

This is not very well understood as yet as traditional power bases are beginning to come to terms with it – but perhaps not truly engaging with it and the mutually beneficial opportunities that could be leveraged.

A more varied array of underpinning economic industries with synergies – reducing over reliance on government funded services making up almost half of the Broome economy/GPD.

There is a very strong mindset – amongst the community and within the health professional and governance leadership – that government funding and programs are essential in order to meet needs and make a difference in health and wellbeing outcomes (somewhat regardless of cost);

There is some thought leadership wanting to challenge the tendency for government and NGOs to ‘overreach’ and provide basic services as a compensation for failure of parental and personal accountability. For example, feeding programs for children with homes and parents – there are polarised views.

Workforce development – home grown careers in health and a professional/clinical health workforce comprised of a more equally balanced proportion of Kimberley Aboriginal people (doctors, nurses and nurse practitioners, midwives, allied health practitioners and corporate business, accounting and IT professionals).

Most jobs for Aboriginal people in the health sector are in lower paid positions – Aboriginal Health Workers, Indigenous Outreach, Tobacco Worker, various liaison and program jobs associated with fixed term government funding initiatives; and in hotel/domestic services and transport/orderly roles.

To get young people into meaningful health careers across the full health workforce spectrum and balancing the Kimberley health workforce such that Aboriginal participation is balanced commensurate with the makeup of the population – a very significant investment in creating a healthy, robust and training/job ready market is necessary;

As well, the education (trades and tertiary), training and job practice is going to need to be within the Kimberley.

Leadership in achievement of primary prevention of chronic and infectious diseases – especially via the prospects of higher quality local food production; intra-regional distribution of the produce (rather than shipping it all off to Perth or Asia); with availability through retail food shops at affordable prices.

The KAHPF has begun the process of monitoring health research and findings;

More recently, KAMS and others have been developing a more formal governance solution for stimulating and monitoring research activities and outcomes.

Food is a major problem but could equally be a major solution provided local food production of richly nutritious and fresh meat and produce makes its way into the realm of everyday people who need it the most.

Unlike the NT, WA health leaders have little organised participation and governance authority over academic research and where it interfaces with health delivery, best practice, clinical governance, planning and service design, or the acquisition and dissemination of learnings and knowledge;

Using schools for high risk children/family health and education outcomes improvement – the combined schools model from Broome could examine & develop this concept based on experience elsewhere.

The concept of building primary health improvement – early intervention and better longer term case management for children and troubled families – around their ‘multi-year and every day’ association with their schools is not well developed in either health or education systems.

But there is a development in action to examine - an ear health service for students (and their associated families) of the East Kalgoorlie Primary School.

It is a virtual ‘prototype’ and whilst the focus in this instance is ear health (chronic otitis media and hearing loss prevention) the model lends itself to a more comprehensive approach to dealing with the full gamut of health and wellness issues afflicting school kids (and their pre-school and infant siblings via contact with their families).

It is designed to change hard and measurable outcomes for kids – attendance and good learning;

Good achievements/performance at school; good hearing.

It appears to have a compelling ‘legacy’ benefit built in – changing knowledge and self-agency capacity in schooling children will make them more effective adults, parents and community participants. This could help the younger generation make a break from the current cycle.

Health providers see themselves/their systems as the preferred solution for health care and outcomes – hence they build their strategies around getting people in front of them, at their clinics etc.

For children (who rely on parents to be proactive about their health and care needs), they are mostly only seen opportunistically and/or episodically.

They might be ‘oft screened’ but the alibility for well- orchestrated and highly sustainable follow through and long term case management from health providers is not always very robust or reliable. It depends on programs being funded. These are typically short term and the targeting is built around health services able to put up successful bids for funds and therefore geographically ‘patchy’.

For those children with problems, their ongoing interactions with the health system for their conditions depends upon them being bought back into the health services on a scheduled basis and outside of school (or instead of school).

There may be some resistance to having school systems as the ‘lead agency’ in a health outcomes improvement strategy; and there is not as yet very much momentum within the education system to positions schools as health/wellness leaders for their student populations (and by extension their families as well).

It would take some ‘work’ to convince enough of the most influential and authorised leaders in health and education to develop a schools based health solution where health providers work as ‘technical’ partners to a largely school driven system of case management.

Prospects for local ‘liveability’ improvements shared by all of the community

Most people consider that the Broome Aboriginal community have been chronically excluded from the real benefits of growth and development and see this is the foundation of social and health issues including anti-social behaviour which is on display in public and neighbourhoods;

A more ‘liveable’ Broome means that the local people – especially the Aboriginal people – get a fairer go and that developments pay a lot more attention to the things they need;

An example talked about was the case for modern hospitality amenities for Aboriginal visitors to the town – not rough camps ‘out of sight’ but pleasant places where they are made to feel as welcome and important to the town as any other visitor.

Improved community cohesion through inclusion and well balanced attention to real community needs and solutions

Racism was said to be alive and well in Broome;

Some said “Old Broome wasn’t perfect but it was better than this”;

If economic growth builds upon and keeps the status quo going, some people said they see no value for the general community in growth and really would prefer it not happen at all.

Existing and Future Plans

The following tables set out a high level overview of the current/forward going plans for governments, key institutions and some of the key local organisations. It is not comprehensive. It is drawn from prior knowledge (of the consultant) together with what has been able to be learned from talking/meeting with people over the course of the work.

Table 4: Government plans

Governments	Key plans and strategies
Federal	- Closing the Gap agenda through the COAG continues; - Monitoring KPIs from recipients of health funds for Closing the Gap/COAG initiatives and publishing regular annual reports (for each individual service as part of a Continuous Quality Improvement process; and for the sector at each state and national level; and a report is tabled in the federal Parliament by the Prime Minister each year in February); - A number of programs consolidated and administered as the Indigenous Advancement Strategy (IAS) via the Office of the Prime Minister and Cabinet; - Hospitals funding reforms – paying on volume and efficient price benchmarks nationally; - Primary health system reforms – phased out the Medicare Locals and setting up not-for-profit incorporated entities (PHNs) as planning, commissioning and resource allocation and performance monitoring bodies around the nation; - Health technology – electronic patient held health records; - New focus on Empowered Communities approach; - Sourcing Indigenous strategic advice from outside the traditional community controlled health sector from other leaders – including Andrew Forrest; - Empowered Communities developments – a new and evolving leadership and energy/intellectual source in Aboriginal affairs improvement driven by the Office of Prime Minister and Cabinet; - Welfare reforms – income management; - Medicare items review; - Review of the National Aboriginal Community Controlled Health Organisation (NACCHO) and State Affiliates (for WA, this is the Aboriginal Health Council of WA (AHCWA).
State	- New Public Health Act – Local Governments are also major players; - New Health Act recently enacted introduces a new system of governance of health services into the WA publicly funded health system; - New board chairs were appointed several months ago and most recently following the enactment of the new Health Act, each of the new boards (WA Country Health and the North, East and South Metropolitan Health Service) has been populated with a full set of members; - The new boards are currently setting up their sub-committees and getting about regular governance business; - In the new governance system, the department of health (in Royal Street East Perth) is presided over by the Director General of Health and its function is now described as ‘system manager’. Importantly, the chairs of each health service are now fully accountable for their health service performance to the Minister for Health and the chief executives report directly to their respective chairman. This is a significant departure from the health governance arrangements in place since early 2001 where the Director General of Health has doubled up as the head of the department and as the board chairman for each health service; - A regime of tight cost controls and savings measures continues – the system has just (1 July) come off a whole of system and Treasury/Cabinet imposed staffing freeze lasting six months; - The WA Country Health Service continues as it has for the past fifteen years (albeit now under the direct governance of an appointment board) and is accountable for planning, reforms and operations management, resource allocation and management and performance of all publicly funded health services (including services outsourced to other providers via procurement contracts) in the seven WA regions outside of the metropolitan area; - The Mental Health Commission was established by the current state government in recent years and operates under its own Minister and Commissioner. Funding for mental health was separated out of the Health budget allocation and reallocated to the MHC which has been established on a model of planning, solutions development, commissioning and procurement and performance management and reporting to government; - The overall department of health service sector continues to be the majority provider of mental health treatment services (including in the regions) and continues to do this with funds provided by the MHC; - Since the introduction of the Royalties for Regions scheme from the outset of the first term of the current Liberal government in WA, there has been an evolving regional development agenda – underpinned by extensive planning and investments in infrastructure, capacity building and longer term sustainability; - A great deal of the Royalties funds have found their way into the Health domain through investment programs such as the Southern Inland Health Initiative and others, including in the north west; - In the mid 2005’s the Health Networks section of the department was established and there were several years of collaborative clinical services plans and frameworks developed. The system is still working on building around the models and plans for primary health, chronic disease management and most notably for the Kimberley, the development and investments in renal dialysis services and statewide governance of renal services; - Announcement by the Barnett Government following the Bilateral Agreement with the federal government on funding for remote community utility services (articulated and/or interpreted to mean closure of a large number of small communities); - Undertaking given that the state government would not close any communities – but would be consulting with communities to develop a plan on which particular communities should continue to be supported; - Subsequently two Ministers (Regional Development and Mental Health/Family Services) appointed Mr Grahame Searle (Director General of the Department for Housing) to set up a special unit (called the Regional Services Reform Unit) to undertake examination of how government organisations and funding streams might be better organised and targeted to helping communities achieve much better outcomes in the future.
Local	- The Shire of Broome has been responding to the prospects of community, economic and industry growth for some time. Most recently, the James Price Point development and also the planning work developed through the KDC; - For this work planning documents on the Shire of Broome website were examined- Community Profile and a Broome Economic Profile; - A body of work based on a 2015 Community Survey was also obtained; - The Shire of Broome are a key partner in the BGP process; - Their planning work is focussed on: o Measures for servicing the entire population – having regard to the significant differences between the resident and service populations and the peak/off peak dynamics; o Future population demand in the context of material growth – infrastructure, services, amenities for recreation; o Pockets of disadvantage – promoting more cohesion and equality; o Housing affordability; o Indigenous population engagement in economic growth benefits. - Planning now must be done with due regard to the ramifications and legal technicalities of post Native Title; - The issue of municipal services to remote communities in the future is an as yet unresolved matter. A funding solution for Local Government is necessary for this to be achieved. - The future of the Town Reserves is also an outstanding matter needing to be planned and negotiated with the Native Title owners.

Table 5: Major Institutions

Major Institutions	Key plans and strategies
Broome Hospital and Health Service	- Range, volume of services and bed numbers for medical, surgical, obstetric, psychiatric and high dependency are prescribed and compliant with the 2015-2025 Clinical Services Framework (CSF); - Whether or not some of the prescribed services can be expanded when scheduled in the CSF will depend upon contemporary assessment of the actual situation, clinical viability prospects and affordability to the state government; - Broome Hospital has been redeveloped and is currently operating very well and meeting over 85% of local and regional need. This is a very high retention rate and reflects the fact that the greater majority of health care demand is within the scope of the hospital in Broome; - The linkage of service areas (for example the medical/nursing high dependency unit) to tertiary support and advice via Telehealth in Perth is a major enabling factor.
Royal Flying Doctor Service	- The organisation has recently established a major operating base in Broome.
Notre Dame	- The university has been on the Broome scene for some time. It was able to offer tertiary nursing education but is currently offering Enrolled Nurse level training.
Broome Primary Schools	- Proposal to develop health/wellness responses within and around the school system where children and their families attend virtually every day of the school year and where the relationship between child/family/school spans many years (4 to 17).
KAMS	- This is a regionally focussed umbrella/member support organisation governed by directors from each of the ACCHS around the Kimberley (including BRAMS); - They operate full medical and health primary services in Dampier Peninsular, Bidyadanga and Kutjunka inland remote communities and also provide the renal dialysis services throughout the Kimberley including in Broome; - KAMS runs a number of functional units and programs and has diverse roles and responsibilities; - They are influential health planning and policy leaders in the region and within the universe of the WA ACCHS sector in WA and nationally; - They (along with AHCWA and many other ACCHS in WA) are currently developing their strategic thinking in a new and different future; - They have a very good understanding of ‘the changing nature of the game’ and the need to be a lot more businesslike (pursuing diverse streams of income and avenues for building equity, balance sheet strength and an ability to be a lot more self-determining; - KAMS recently relocated into new purpose built premises which they own; - They continue to expand into land/facilities more recently acquired.
Churches	- This dimension was not explored in this project.
Aged care providers	- The capacity and structure of aged care services was not explored in this project.
BRAMS	- BRAMS are a robust primary health service servicing the population of Broome and offering bulk billed medical care though a team of salaried doctors and other health staff in their clinics and community programs; - They recently took possession of the land and buildings on their wider campus in Anne/Dora Streets once KAMS (who leased premises from them) vacated; - This has given BRAMS a great deal more scope to fully utilise and progressively redevelop their campus; - The first step (other than relocating some offices to create more space in their clinic building) has been to establish a Family Health Service in the building adjacent to their medical clinic; - This will enable them to undertake more ‘slow stream’ and multidisciplinary work with individuals at the family level and helping them a lot more with education and lifestyle modifications – these sorts of measures are in fact very difficult (if not impossible) to follow through properly in an acute medical clinic where the patient demands are high every day, the needs are more acute, and the consultations with the GPs and the other health staff are – of necessity- very time constrained. - BRAMS are very excited about this new model – enabled because they have more space and amenity available to them; - They will require additional resources to fully actualise this new service model to its fullest extent. This adds up to around $2.7 million/annum. Part of their financing model is to ‘drive’ the medical consulting business harder and produce more Medicare income to be invested into the ‘slower stream’ Family Health model.
WA Primary Health Alliance	- Currently established stakeholder advisory groups, governance and Clinical Commissioning Committees; - Have done needs assessments (partnered with Curtin University); - Developing ‘machinery’ for formal health commission procedures including various mechanisms for market engagement and procurement; - Until this is full developed they are continuing with prevailing funding arrangements and relationships with all of the providers who receive funds and deliver services (these were initiated by the former Medicare Locals and there is a significant business continuity requirement pro-tem).

A thorough study of all of the local organisations involved in the broader health and wellness domain and their existing plans was not able to be done during this short exercise.

However, there were some key organisations able to be engaged directly or examined briefly through the content on their websites and other sources which are of particular interest in the context of the BGP and the dimension of wellness. These are very briefly identified in the next table.

Table 6: Local organisations

Local organisations	Current plans and strategies
Nyamba Buru Yawuru (NBY)	- Community census styled survey – improved understanding of their own community; - Transitional housing; - Funeral assistance; - Land use and development; - Creating wealth/prosperity for the land owners; - Working with and influencing future growth, land development and economic plans in Broome in ways which leverage their constituent’s direct interest.
Kimberley Institute	- A ‘think tank’ function for contemporary thought and innovation leaders; - Developed and promulgating ‘The Broome Model’ – a way of moving away from slavish dependence on government programs designed nationally and at a whole of state level based on one-size-fits-all thinking and associated reliance on government funding everything; - A different – shared – approach to funding: proposing that hard outcomes are bought and paid for (rather than price/volume specified outputs) by those who get the best value from them: governments, corporates, philanthropists; - Gathering support for this amongst the universe of Broome Aboriginal organisations and others; - Partners with other organisations and provides project management and consultancy support.
Mamabalunjin	- Transitioned successfully from a former CDEP administration hub (former ATSIC days) to a community development and employment support agency with a number irons in the fire; - Sponsor the Kularri Night Patrol service.
Goolarri Media Enterprise	- A big and active supporter of Indigenous community advancement through entertainment, talent creation and educating and connecting people; - A powerful vehicle for community knowledge and information sharing and to enhance inclusion and participation.
Centacare	- A Catholic Church agency – social support and caring for people at risk and in need.
Broome Circle	- Aiming to build a stronger more inclusive community through connecting people, encouraging collaboration, supporting initiatives and exchanging skills; - Focus is on sustainable future growth; responsive programs; inclusion and participation and strengthening the community through their activities.
Aarnja	- Developing a range of activities and income sources for self-sustainability; - Initially funded by the state government to help develop the Indigenous community’s interests which were intended to evolve following the James Price Point development; - Continue to be funded and have taken on administrative facilitation of the West Kimberley Empowered Communities Developments; - Empowered Community leadership - the driving force is mostly from the East/Kununurra. In the West Kimberley, the participants are still finding their feet.
Nirrumbuk	- Significant pre-employment and employment based training; - Strong involvement in Environmental Health service delivery.
Traditional Homeland Enterprises	- Kakadu Plumb Company is a community owned venture seeking to create prosperity, skills and employment through Indigenous enterprise through scaled up unique foods production.

Strategies

The next table gives a summary of ideas and strategies discovered during the consultation. A brief and very high level assessment is offered for each one.

Table 7: Assessment of identified ideas/strategies

Idea/strategies	Assessment
Family birthing centre – midwife led & enabling interagency maternity care in Broome	This is a contemporary and very popular approach to normal low risk birthing and designed around an enjoyable, non-clinical style of care highly supportive of families; Broome will increasingly provide for many more births and this is the experience most women and families aspire to.
More inpatient psychiatric beds and mental health infrastructure and services development	The growth in morbidity in mental illness and more generally in social and emotional wellbeing is huge; Facilities and service models will need to keep pace with this and have a strong bias to contemporary approaches; prevention and early intervention; and the cultural and existential underpinnings of the unique client population being served.
Cancer services (chemotherapy) A 4 chair/1bed unit	A growing morbidity sector along with chronic diseases generally. New research suggests many cancers are caused by the same diet, inflammatory conditions and chronic exposure to stress and anxiety as metabolic, vascular and mental illnesses; Arguably a contemporary regional health hub in growth mode and serving a high demand population ought to cater for cancer diagnoses and treatment services – this should include quality palliation services (noting that palliation should not be confined exclusively or mostly around a cancer model – for example, there are a growing number of people who chose a palliation route instead of renal dialysis and they have very special needs for symptom management which is quite different to those for cancer patients); Increasing use of Advanced Health Directives also empowers patients with a range of other debilitating conditions to opt out of treatment and to receive only symptom and comfort care through a more palliative approach.
Local/regional breast screening service	A growing population and bringing with it high expectations for local/regional access to what is now considered a ‘basic women’s health screening service’ will make this an increasing necessity for the future; The technology for breast screening might align well to other medical imaging technologies of use in a much expanded range and volume of diagnostic services.
Orthopaedic surgery	Trauma management, sporting injuries and joint replacement surgery; The case for this will grow – the determinant will be cost, viability, demand and value for money compared to other priority areas. Needs some examination of market potential (and it is understood a group of orthopods are looking at this right now).
Resident nephrologist	Identified by regional renal providers – as the number and clinical complexity of existing and prospective renal failure cases increases, so will the need for a region based nephrology service. Ideally, a resident nephrologist should be able to have some capacity for admitting patients to the Broome Hospital and have the necessary nursing and other support available to care for more of these types of patients in Broome; At the present time, any patient beyond the scope of renal nurses and advanced skill GPs must go to Perth if their clinical status is a concern. Most of these problems do get quickly sorted out at RPH and in hindsight, it was not really necessary to transfer the patient to Perth.
Ambulatory care – in the home	Palliative, dressings service, post discharge and ancillary services; Ambulatory care (out of hospital and often instead of hospital) is a very contemporary but as yet under developed model; In a growing Broome and regional population, it is very likely that a vast volume and range of services could be provided to patients by an ambulatory patient work team and would reduce the demand for much more costly admitted patient services with long lengths of stay; Often the longer length of stay for Kimberley patients is simply due to there being no ambulatory care system organised.
Palliative care	End of life care is becoming an increasing need as more people suffer from chronic conditions including cancers. Increasingly, older and sick people these days are taking advantage of Advanced Health Directives through which they can dictate their wishes relating to continuing with specific treatments, being resuscitated or choosing conservative and palliative styled care for symptom control and comfort only. As population, demand and expectations grow, the need for palliative in home and hospice styled respite and final care solutions suited to Aboriginal and non-Aboriginal cultures will manifest and demand a solution. This was identified by WACHS as a priority/evolving issue they currently only have a minimalist solution for.
More Men’s Health models	Reduce domestic violence by men – these are highly regarded mechanism to engage and work with men to improve connections, inclusion and reduced harming behaviours and violent harm to partners/others; A big part of the poor outcomes in chronic disease screening and early intervention is that adult men will not engage very well and consistently with health services; The same applies for young men – once out of school, they tend to access health care infrequently and episodically. For example for STIs or accidental injuries. They are often into substance abuse, very poor nutrition and neglect of personal and oral health.
Improving prospects for ageing and retaining senior citizens in Broome	Regional Development Australia (the Broome office) are keen to develop strategies to entice older people to remain in Broome. There are factors influencing people’s decisions and ability to stay in Broome in the ageing years: need for a range of service, affordability once on retirement incomes, community and neighbourhood stress, loss of connections and isolation. The Wheatbelt RDA team developed some strategies for ageing and the Broome office are keen to do some work in this area too – this would be good to do in context with a future growth plan and would need to be focused on the unique issues in Broome life/community.
New campus for expansion	The prediction is that the current campus, whilst small and tight will continue to be adequate for the next 10 to 15 years. Once and if time comes for material expansion – especially if there is rapid and much higher growth than locked into current planning assumptions; and also if there is a desire and the wherewithal to opt for very contemporary ‘best practice’ models for things like: o Public/private colocation partnership; o Family birthing; o Ambulatory in-home hospital care; o Oncology – chemotherapy; o Mental health and social and emotional wellbeing; o Palliation care options and end of life care. This may trigger a need and an opportunity to re-consider prospects for a green field development site and a very exciting health and wellness precinct development. However, the current campus may be suitable if ‘building upward and outward’ solutions are possible.
Health workforce education and training	Essential but no clear strategies were observed. Employment in health has been constrained with financing and efficiency drives by funding governments. Local training and education is static at the present time.
Better ear health outcomes	Hearing impairment and impact on school attendance and outcomes Microbe load causes other serious mischief (heart value and kidney disease for example) The suggested school/health concept is already maturing in the East Kalgoorlie Primary School.
Research governance	Better ability for industry leaders to set the research agenda, target the areas of interest, set the rules, monitor results and have the opportunity to use the learnings for outcomes improvement and economic advancement.
Combined Universities model in Broome – research careers and learning	Several years ago (mid 1990’s) the department of health in collaboration with all WA universities established an entity called the Combined Universities Centre for Rural Health (CUCRH). It was intended to generate a research and learning agenda, sponsor and support academic/clinical careers and deliver benefits for heath leaders and communities from the research work; It is based in Geraldton and was intended to be state wide. However, it is ‘mostly Midwest focussed’. There is still a lot of merit and attraction to the model however and quite a bit of interest in establishing a re-vamped and modern ‘re-minted’ model into Broome.
Better structure, capital allocation and outcomes from government agencies	Brokerage/case management model to concentrate and coordinate resources and effort around families in trouble
Expenditure reviews	Recently done by RSR in Roebourne and in Youth Services. Clearly mapped ‘the mish mash’ – shows there is scope for structural reform and makes it all very visible
Place and location based solutions which are co-designed	Agreed – externally designed and imposed ideas often don’t work that well; The alternative is just more slow-stream – it takes patience and time and often these are not available commodities for governments and their departments working on specific time horizons, deadlines, reporting frameworks and politically imposed expectations; This is where more locally guided, place based and unhurried solutions might be better ‘brewed’.
Investment pilots of innovations (and evaluations)	Agreed and again – patience and time is of the essence.
Kimberley Schools Proposals	I would want to see this idea developed as a more cohesive and joined up partnership between schools, primary health services and population health; Great opportunity to change outcomes for children at a young age and possibly families if done right. The model (based on ear health) maturing at the East Kalgoorlie Primary School in partnership with Earbus Foundation) is well worth examination in the context of developing a school/health partnership model in Broome.
Joined up approach to maternal and child health outcomes	As above – opportunities abound but not helpful if specific organisations and sectors plan and act in isolation.
Mutual obligations	Much discussed – sense a keenness to get people off the dependency wheels; Problem is that there may be some ‘lost causes’ not able to be helped and in the process, things might even (need to) get a little worse before they get any better; Difficult issues to discuss, very hard for government agencies to act on, rife with politics and strongly polarised views; Something like this as a general framework for the future would need to be strongly owned and supported by community leaders who don’t run for cover the minute fingers start pointing.
Bring back ‘Home Maker’	Another ‘round’ of intensive domestic skills development for the current generation is needed urgently and should include contemporary food and consumer knowledge and skill building. Consumers have the ultimate power to force suppliers to change what produce and products are available
Hospitality industry comprehensive careers	It was said by several people to be difficult to attract young Aboriginal people into working in the hospitality industry in Broome and yet it is currently and in the future a big industry and on a growth trend. To not have employment for locals seems a missed opportunity; Partly the reason given was cultural related to history – not wanting to ‘wait on’ white people doing menial work; Another view is that a lot of young people these days want to start at the top – management and senior positions in their sights and not interested in starting at the bottom and working their way up (like in ‘the old days’). Careers in hospitality might be a solution – start at the bottom as part of a tangible career pathway leading to higher paid and skilled work in the industry and also being prepared if/as opportunities for developing businesses.
Old style growth policies reinforce exclusion – do it differently this time	People mean that there is a lot of learning and listening and genuine inclusion in solution design needed if things are ever going to done to produce different outcomes.
Want the Shire to ‘own and address’ social problems more	People are looking to the Shire to pick up and get solutions into place to deal with some of the community problems more effectively in the future as especially as part of the BGP.
Alternative power	A big concern – environmental wellbeing and cost of living.
Cultural tourism	A great opportunity if community people can get prepared for it so they don’t miss out (due to lack of health, motivation, acumen, ability to get good backing)
Food enterprises	Community Gardens – not at project/volunteer level but as a serious and systematic approach to improving access to affordable in season fresh produce from multiple gardens around the community. Affordable fresh food widely available has more potential to improve health than expensive medicine (subsidised extra virgin olive oil to go with it would increase the impact significantly)
Build a knowledge economy – northern knowledge and know-how, links to SE Asia	Sounds good – not sure on the detail.
Cooking and traditional foods, adapted recipes and techniques	Big role for traditional foods, cooking techniques and medicinal foods to be developed and re-entered into contemporary knowledge and practice; Has enterprise/market potential and well as health benefits.
Living Library - stories	Real people with real stories to share and tell and show; Could be part of cultural tourism experiences.
Indigenous small business – fleet cleaning	Ideas like this abound – need the right people, support and backing; Someone prepared to take some risks.
Integrated BGP stewardship group	Have a modern day go at getting the stakeholders together as equals in power and decision making to steer community development;
Redevelop the ‘Bronx’ area	A major problem most people want fixed; A belief that the Shire of Broome have stood in the way of this and blocked developments (like more houses and redevelopment of the area by the Housing Authority); Racism suspected; The distribution of public housing model is better regarded than the consolidated ‘ghetto/projects’ style of residential settings; In Broome, the distribution model would have to be supported by reliable year round public transport – or it will be unpopular because it reduces access and cuts people off from friends and family and services.
Economics of Liyan	Mandy Yap (local Yawuru woman) will soon complete her PhD thesis on the ‘Economics of Liyan’; Not available for examination as yet, but it sounds encouraging. It is highly anticipated and talked about in the ‘think tank’ circles of Broome Indigenous leadership. This may offer ideas for the future aimed at getting things right on the next leg of the Broome growth journey.
ALT reserve system 19^th century and paternalistic	Land ownership for people, rateability and proper municipal services; This needs to be dealt with – it would be a massive relief to the entire community if done correctly and Broome could become a role model for other areas needing this stuff fixed.
Sort housing	Solutions needed – homelessness, visitors from other towns, overcrowding and better styling of housing suited to Aboriginal extended family way of living.
Quality hospitality facilities and services for Indigenous visitors	Another major social concern for want of a decent solution; The short stay accommodation facility in Derby is helping a lot and very appreciated by the community; A short stay accommodation facility is due to be operational in Broome in 2017.
Food production – locals first	If quality and nutritious food production is trucked and shipped out of the Kimberley for the benefit of other markets and sellers but does not make its way in adequate quantities as a food solution for local people who desperately need it, it will be a massive missed opportunity to move the needle on primary prevention of chronic diseases including many cancers, mental illness and general health and wellbeing.
The Broome Model	Developed by the Kimberley Institute and collaborating interests. A good sign of ‘new think’ on how to allocated resources, quantify, price and measure outcomes. May/should have some appeal to the RSR and E/Community groups seeking better solutions.
BRAMS Family Health Centre	An excellent and much needed approach to differentiating the service model in the ACCHS and it may contribute materially to developing best practice; Relying on rapid throughput GP consult models in busy clinics has reached the end point of utility as the predominant prevention and outcomes improvement tool, especially at a population level. A different approach is badly needed and the thinking behind this effort by BRAMS is good; They will need more support – they will most probably not be able to generate enough funding to fully realise the potential of the model; It is worth being supported as a pilot over a very decent (more than 3 years) timeframe and should be evaluated academically.
Development, conservation, ranger services & food production enterprises	Happening now and a bit under the ‘radar’.
Integrated primary health and family support centre (for multi-agency use in: mental health, chronic conditions, drug and alcohol problems; co-morbid illness; social, emotional and wellbeing issues; family and domestic violence	Great idea – more contemporary and enabling infrastructure and service models go hand in hand with restructured departments and funds targeting systems; Co-location, collaboration and coordinated action should ideally be supported by enabling (rather than detracting) service design and technologies; In integrating, a great deal of duplication can be weeded out – shared IT infrastructure, telecommunications hub, fleet management, meeting and function rooms, staff and community amenities, storage areas, catering and corporate bureau services are possible and overall the savings could be substantial. At the present time, every individual organisation, group and agency are duplicating most of this stuff; Improved access and amenity for consumers is also enhanced in ‘precinct’ models.
Cultural centre – art, stories, commerce, food, learning, entertainment, performance, showcasing	No argument at all why something like this shouldn’t be as big a draw card in Broome as the camel rides and staircase to the moon attractions; Other than for tourists, major potential benefits for community pride, development, and inclusion abound.
Reduce cost of living	Is this possible? This is what makes it virtually impossible to get private sector health and wellness services into Broome; And it is partly why older people don’t stay; There are much cheaper holiday destinations for people who want as much as possible for their dollar – Broome is very costly.
Private sector operators need inducement	Apart from cost of living, access to the essential infrastructure at affordable rates is crucial; It was reported that a dollar in Broome only has spending power of 75c; and that it costs 500.00 rent for half a day for a medical consulting facility; Built medical specialist and diagnostic/treatment and therapy program infrastructure is needed as people will never come if they have to put their own capital into facilities and fit out.
Asset and enterprise acquisition by KAMS	A very logical next step – the community, including the other leading local Aboriginal owned organisations need a health leader to have some financial power and capacity to decide what to do and with whom; In the prevailing economics of the global world, Australia and the state government, it is very wise to start thinking and planning around ways to acquire assets, equity and profitable businesses and reduce to exclusive reliance for your very existence on government’s capacity and will to fund.
Renal best practice leadership	Renal health is big business in the Kimberley with a great deal (financial cost penalty) at stake for governments if the system does not manage to change the current trends. To do this requires some serious work in primary prevention as well as screening, early treatment, quality management long term and excellent management of end stage renal failure, transition to dialysis and care from that point on (including end of life care for a growing number of people with very special and unique palliation needs); Getting a clear and balanced strategy and getting all the right leaders and experts together in collaborative governance of future developments in renal is an opportunity for national and world leadership.
Environmental health a very powerful game changer	Infectious and inflammatory diseases are caused by poor environments either at the community and/or domestic household level; A new generation of householders with poor skills and knowledge require education and assistance through organised programs of monitoring, vigilance and fast mediative action; Environmental health is an important knowledge and skill base and in well structured (and financed) programs there are significant job and career opportunities possible; The cost of not doing environment health aggressively is hearing loss, lifelong damage to heart values, irreversible and severe kidney damage and early age renal failure, poor pregnancy outcomes.
Create avenues for the environmentalists to come up with alternative ideas for economic growth	There is a very vocal anti-development lobby based on concerns for loss of environment; loss of amenity for locals to the places they want to go; stresses on the town services and local community; and concerns that social problems will be put out of sight and out of mind by developers; There is considerable intellect amongst this group of people and their energy could be very productively channelled into some legitimate processes to explore tangible and possibly actionable strategies.
Must have a local public transport solution all year round	A growing and spread out community will need a reliable public transport system designed with at least equal attention to the needs of the resident local and transient Indigenous community; The current system is private, goes mostly to popular visitor points of interest and winds back in the off-peak season.

Strategies for Moving Beyond the Status Quo

Health services – secondary care/hospital

Hospital services are adequate to cope with most secondary care needs in terms of bed capacity and the range of clinical services on offer. These are well aligned to current and forecast population projections and about 85% of all inpatients Broome Hospital deal with are retained for treatment in Broome.

As and if the population in Broome (and the region as a whole) grows by 2036 as suggested in the Kimberley Blue Print, there will be a need along the way for additional capacity to cater for bigger demand volumes. Some of this is already documented in the CSF 2015-25 but it may need revising.

The case to also consider expanding clinical and diagnostic capability as well as just volume may present.

With this in mind, the Robinson Street hospital campus will need to be critically examined.

In the meantime, contemporary capital solutions would be welcomed for innovations like:

- Midwife managed low risk family birthing and multi-provider maternity services;

- Chemotherapy;

- Better integrated mental illness and social and emotional wellbeing services and programs;

- Ambulatory care (cancer, palliation, home hospital and longer term therapies);

- Contemporary residential solutions for older people and facilities and amenities to support healthy ageing and access to care when it is needed.

Given the amount of capital already invested into the current campus, it would be ideal if a campus plan could be developed for capacity and capability growth as well as inclusion of some very contemporary infrastructure models on or very near the campus.

It may be that the next hospital expansionary stages go skyward and a little outside the campus boundary.

There are significant barriers to entry to private health operators such as low population and episode/procedural volumes; poor commercial viability prospects coupled with high operating and living costs; low levels of private health insurance (and a population accustomed to free ‘point of care’ services); and prohibitive costs for capital set up.

If some of these barriers can be lowered, it might alter feasibility prospects.

Realistically:

· Population and volume/demand potential could improve if sustained growth occurs as is currently being envisaged and planned for;

· Operating and living costs are probably always going to be a factor;

· Investment in lease- ready medical infrastructure might change the prospects and would almost certainly be necessary as a means to attracting private sector interests to set up and operate in and from Broome.

Health services – primary care and keeping people out of hospital

At the present time, primary medical and health services are faced with growing demand for episodic medical and clinic treatment services.

Their program styled services – especially for chronic disease and lifestyle intervention education, counselling and support are at capacity with very high numbers of cases on their books needing follow up checks and tests and fine tuning of medications for symptom control.

It is not uncommon for program staff to get ‘pulled off’ their jobs to work in the clinics just to get through the daily patient load.

Within this typical picture, there is little practical scope for establishing and supporting innovative models designed to work in a more ‘slow-stream’ way with individuals and their families including in their own home and community environs to tackle what is often an extremely complex set of factors acting as compliance barriers; and neutralising their prospects for effectively managing their conditions.

The Family Health Centre model being developed by new management in BRAMS is quite a breakthrough (at least conceptually) in innovation. With support, collaboration from others and clear focus on outcome measures and their value this model could ‘move the needle’ on outcomes.

Wellness – disease prevention

There is an epidemic of diet and lifestyle diseases worldwide. Diabetes, obesity and the metabolic syndrome are starting to overtake communicable diseases as major threats to health worldwide. The prevalence rates of diabetes and obesity are rising sharply^{^[18]}

Younger adults and even children are gaining weight, some are already obese or heading that way and many have or are on their way to full blown diabetes and the other chronic disease complications and disabilities that go with it.

This affects Aboriginal people – and the younger ones too - extremely badly because of the generally poor quality and very metabolically damaging foods they are doomed to consume on low incomes. But it also affects non Aboriginal people increasingly and worldwide.

Medicine has developed means to diagnose, monitor and medicate to bring markers like LDL cholesterol, blood glucose and blood pressure into clinically acceptable ranges.

However, unless something changes the causes of these conditions, Broome’s much bigger population looks well on the way to being prematurely old, disabled and sick a lot of the time – and this is in spite of regular medical checks and medicines.

Hardly the stuff of a robust and successful growth plan with good health and wellness outcomes and participatory benefits for the community.

Good nutrition (from quality, fresh, affordable and ideally locally produced seasonal vegetables, fish, meat, fruit) before and after birth and for life positively supports good health and generally protects the body’s inherent ability (through its own immune and healing systems) to keep itself healthy and strong and even deal better with infections and other occasional insults.

It would be hard to argue against a case for doing whatever it takes to improve food quality, availability and affordability and that to some extent, doing so would be a game changer in future population wellbeing and economic participation.

Developments in the food production domain – large and small scale, community enterprise and a system of well supported community gardens – should be exploited for enterprise, economic and health and wellness outcomes.

Wellness – a general state of happiness, wellbeing and freedom from disease

Broome is stuck deep into the groove of the ‘haves and have-nots’ profile of the community. A place so lovely and with so much to offer and yet troubled by a significant pocket of poverty, neglect and regular displays of anti-social behaviour and tragic violence and death.

As the community grows and strengthens, this aspect of community life in Broome is probably getting generationally worse. It stands as a big concern for most people – either because they just don’t want to see it; or for many, because it is genuinely concerning to the point where they don’t even want economic growth if it means they have to see all this get any worse. Either way, it is quite a detractor.

Endless attempts to meet needs and improve the situation by governments through funding programs, by departments through their various efforts and strategies and by community organisations and the church and charitable sectors have not materially changed the situation.

This is a piece of the status quo that people don’t want ‘dragged’ forward into a new Broome future. A new approach is needed and in this post Native Title Broome world, there appears to be a groundswell of thinking people willing to step forward and take some of this on in new ways.

At the same time, governments are looking at ways they can change and work with change agents. At the federal government level the Empowered Communities movement is evolving. At the state level, the Regional Services Reform exercise has got underway.

If these interests could align, the potential to set and steer a different course for Broome and improve life and prospects for traditional owners would position Broome as a national leader.

Community amenity

This is a big theme in peoples’ minds with the prospect of expansion and growth. This encompasses dimensions of:

- Cultural celebration and ways of living;

- Hospitality;

- Arts and performance;

- Community media;

- Cost of living – especially food, housing affordability and power;

- Public transport;

- Integrated health, wellness and culture precinct;

- Retaining seniors in Broome;

- Land – Aboriginal Lands Trust ‘reserve’ solutions and municipal services for surrounding communities.

Investments in a cultural centre; housing solutions; a pleasant and welcoming hospitality solution for visiting Aboriginal people from other towns and communities and year-round public transport will be needed.

As well as a cultural centre, a very modern and well integrated primary health and family support services precinct development would enable and align very well to new departmental/agency service and government financing models.

A massive show of faith and perhaps a way to open up new possibilities right now would be to address the reserve land and community municipal services issues. This needs ownership and leadership by the Shire of Broome, state government and land owners together.

Structural reform

The number of funded organisations, agencies and programs providing an enormous range of health, human and social service support programs funded by governments is immense and confusing.

There is considerable interest – at community leadership and government levels to explore ways to restructure service models and fund allocations.

There is a lot of shared frustration at the intractability of problems and the relatively low impact on outcomes from the myriad streams of funding and complex corporate structures and programs.

New models of funding and service are needed – it seems most people think these should be:

- Place based;

- Co-designed;

- Given sufficient time; and

- Integrated, collaborative and somehow really well logistically and financially better coordinated than they presently are.

Through the vehicles of innovative new models/structures and funding arrangements, schools and health providers could become powerful collaborators in proactive health and wellness intervention, changing outcomes and improving learning.

The model put forward by the combined schools has merit and should be further developed. Schools have substantial under exploited leverage on outcomes by way of the very enduring relationship they have with children and their families over many years.

A well leadership group to help guide the BGP developments was suggested where Native Title Holders and other community leaders and key stakeholder could work as equal partners to steer future developments aligned to economic and industry growth through the BGP.

Enterprise

Low levels of participation in employment, career pathways and locally owned business in the hospitality and other economic sectors could be improved.

A market of educated and training/job ready people is needed – and for this they need to be healthy and ready to take on new beginnings, training and education, gaining qualifications through study.

Having a significant proportion of the Aboriginal and non-Aboriginal youth and young adult population overweight, reliant on medications, frequent doctor visits and endless specialist referrals, illiterate and not numerate will ensure the status quo.

Tourism is a staple industry for Broome but the participation rates by young Aboriginal people is low. The industry relies on 457 Visa and backpacker visitors for its seasonal workforce.

There is genuine enterprise in culture – living people have much to share by way of stories and experiences and many visitors place high value on this.

Homemaker and consumer skills

There is at least one generation of people who are poorly prepared for home making and raising families. The skills and knowledge are low across most areas of household and family management.

There is a component of public health policy and political action driven by the community and consumers which will be essential to advance the health and wellness agenda. And there is no reason why this cannot be driven by Broome’s community leaders.

Food knowledge is very poor and consumer skill levels are generally low. Consumers have considerable power and it would be useful for a lot more of them to be better educated so they can leverage their power on retailers and food producers more than they currently do.

Broome as a knowledge economy

A health workforce in a Broome and regional population scenario around three times bigger than it is now in twenty years will mean a lot more jobs.

To ensure that workforce comprises around a 40% Aboriginal mix means a lot of people will need to achieve entry standards into professional and clinical disciplines.

A move away from the status quo on health workforce means more Aboriginal medical, nursing, midwifery, allied health and pharmacy professionals and a range of corporate and technology professionals.

This will need a paradigm shift away from lower paid jobs in hotel and clerical services and also building upon the more traditional Aboriginal Health Work, liaison and outreach worker roles.

Outside of the health industry a growth in the economy will also create jobs and career opportunities on a broad spectrum.

The key to making this possible – apart from a wide range of jobs, careers and even academic researchers materialising – is access to education, qualifications, training and mentored jobs in the Kimberley rather than needing to go to cities to study and seek opportunities.

In the Northern Territory, the health system is buffered by a robust community of academic research undertaken by people who also work in the system. As such, it is recognised as a ‘knowledge’ economy because it generates so much learning and evidence able to be applied in practice systematically.

A great deal of knowledge is generated by the NT system of health and academia and as a result, the Territory has a very high profile in Indigenous health leadership and enjoys substantially more attention, favour and funding benefits from the federal government.

Getting research funding, support and opportunity in the Kimberley is much less easy for prospective students and researchers. Hence, the current efforts are patchy at best.

It is time the region’s leaders – in health, education, wellbeing and community development – were solidly positioned to develop and drive a highly relevant and productive research agenda. This would help them and their university partners and students access better research funding and could also be a much more welcoming environment for researchers to feel valued and have their work regarded critically and with great interest for its applicability regionally and beyond.

A re-imagined contemporary model based on the best attributes and achievements of the Combined Universities Centre for Rural Health was considered by many to be an ideal solution to Broome.

Broome currently has one private university satellite campus struggling to sustain its full potential in the current market.

A substantial and well-designed academic research and education sector with excellent industry linkages and utility needs investing into the Broome milieu.

Leaders in such a development should have a suitable degree of expectation and performance obligation placed upon them. They need to deliver specific outcomes aligned to and enabling Broome’s economic, health and wellbeing advancement growth and development.

Strategies to Support a Growing Economy

This short study has identified some key requirements and ideas for a health and wellness agenda within a broader economic growth plan for Broome.

They are summarised very briefly here:

1. Expansion of health care - as population grows, both the need and the viability prospects for a greater range of secondary/acute hospital and maternity/obstetric services will emerge – the scope for this will depend upon the pace, quantum and sustainability of population growth, mix and health status/demand;

2. Primary health innovation – these are critical in the chronic disease prevention and management domain. Some scope and support for innovation to deal with harder to reach people and problems – like a more family centric and slow-stream model – is desperately needed, especially by the Aboriginal Community Controlled Health Services sector;

3. Leverage schools - health outcome systems designed around the uniquely strong and long relationships children, their siblings and family units have with schools looks to be one of the most exciting prospective ideas emerged from this exercise. It is highly developmental but the potential for what is inherently offered through schools is under exploited. In an environment where the ‘needle’ is just not moving any more, this should be thoroughly explored and tested for the potential to change measurable hard outcomes in the short to medium term as well as a longer term legacy impact on the next generation of adults, parents and employees.

4. Community and social amenity - the community of Broome needs some of its amenity problems treated. Living conditions and exclusion policies have the power and do ‘neutralise health treatments and advice/counselling’. What is needed for Broome are:

- A precinct for culture;

- A hospitality solution for visiting Aboriginal people;

- Local housing – better neighbourhoods;

- Solution to the long standing land problem – reserves and municipal services for the remote communities;

- An all-year round public transport system geared as much to the needs of the local consumers as for tourist visitors.

5. Education, training and on the job work experience –infrastructure and systems are needed in Broome to nurture careers in health and other industries in a growth scenario.

6. Knowledge and research - the organisation and execution management of research and its learnings and applicability for the Kimberley could and should be driven out of Broome.

7. Nutrition – this is a huge and systematically overlooked problem most people wrongly assume can be:

- Dealt with by doctors;

- Educated away through mass media health promotion campaigns; and

- Fixed with greater promotion of exercise.

8. Structural changes - are essential in order to change things. The way things are financed and managed, the way solutions are designed and how they are executed all need to be re-designed. This is currently being explored by both state and federal governments (Regional Services Reform and Empowered Communities) and also by local organisations and leaders (for example NBY and Kimberley Institute). In the context of the BGP, some alignment and leveraging of some of the ideas and measures which will emerge is an opportunity.

Consideration of this ideas framework from the perspective of ‘tradability/export’ suggests some – but at this stage a somewhat narrow scope – possibilities:

1. Expansion of secondary health care systems – potential for private sector economy in health operating in a Broome hub and leveraging the broader Kimberley market;

2. Primary health innovation – exportable as best practice region wide and beyond;

3. The schools/health model – enormous best practice exportability state/nationwide (noting that this idea was sourced from research into a program established by an education leader in Kalgoorlie. If it is adopted (or something like it) in Broome, it would be already proven to be ‘exportable’). There are a few people within the education system also trying to drive this innovation;

4. Cultural tourism (including art and performance) – enormous potential;

5. Research – as in the NT: greater recognition, influence, leadership, benefits flowing into Broome and Kimberley from a knowledge and research economy;

6. Leadership on prevention (especially community/politically drive) influencing reforms to food and public health policies on diet and nutrition coming from a strong driving force in Broome;

7. A food economy – enormous health benefits as well as enterprise and economy benefits.

There are a number of requirements contextual to the suite of ideas and strategies identified through this brief exercise and the aim to shift from the status quo in health and wellbeing as part of the BGP evolving.

Most of the ideas and actions would need to be progressed incrementally; and some would be more or less dependent on actual achievements in enterprise, economy, population growth and supply and demand dynamics. On the other hand, some developments within the health and wellness domain could positively influence achievement of population and economic growth targets. For example, things that get more kids achieving school graduation and being training/job ready would go hand in hand with enterprise and jobs growth.

The health system is not generally very good at enterprise thinking. Of course, there are some pockets emerging strongly nationwide. Examples are mole scanning; corporatized general practice; cardiac catheter laboratories; radiology and medical imaging are highly profitable enterprises in somewhat ‘cornered markets’.

As most health systems are publicly funded (in the Kimberley), the predominant ‘appetite’ is for more government funding and by that measure, there is usually always some degree of a real/perceived burden of hardship and lack.

In this segment, we are suggesting that at least some of the ideas could be developed with the underlying intent being to establish working systems, patent them; possibly even package and franchise them; and market them with all the ongoing support and business enterprise that goes with it.

There is no reason why a ‘culture of innovation and enterprise’ cannot be threaded into health and wellness advances in Broome. It just is an overall idea that would require a bit of ‘work’ and finding of champions and highly competent individuals whose skill sets are aligned well to each and different stage/s of developments.

The table below is a beginning attempt to envisage how the key ideas might be framed over the short, medium and longer term time frames.

Requirement	Short term - 2024	Medium term - 2031	Long term – 2036+
Expanded secondary/hospital services – both volume/capacity and range/level of clinical specialty and diagnostics	Capacity and range satisfactory for current population; Planning for expansion scenarios in the next few years – including for the next ‘stage’ of infrastructure and service initiatives; Planning and roll-out of new infrastructure for midwifery based birthing and maternity care; for chemotherapy; for mental health and social and emotional wellbeing services; and for ambulatory hospital at home and comprehensive palliation services; Start exploring feasibility prospects for a attracting private health sector suppliers into the service mix in Broome (& for the region); Critical assessment of private health insurance levels; Preparation of the consumer market for private services – need and benefits of PHI.	Re-cast population growth and demand assumptions; Continue and complete roll-out of contemporary service infrastructure; Develop a longer term campus plan – explore upward and outward solutions on and from existing campus.	Consider any need/case for a green field hospital and health campus development for the future beyond the next 20 years.
Innovation in primary health care	Explore avenues to advance the Family Health Centre model being developed by BRAMS – as a pilot co-designed to test very specific parameters; Develop a business case and seek financing (the WAPHA might be interested); Look to the Broome Model (KI) for possibilities to assist by securing investment partners; Create some patent on the model if possible; Explore packaging with franchising and licensing (like the Head Space business)	Evaluate and build on primary health innovation model; Promulgate and market license; Develop franchise/license management and systems for the market (if successful as a patented and tradeable model).	Continue development of packaged models and systems for a national and international market.
Leveraging schools & their enduring and constant relationship with children, their siblings and families	Examine and engage with key players in education and health – with the Broome Combined Schools group; Explore and design a leading edge model for Broome; Prepare a business case and seek out funders and investment partners; Have some regard for ‘franchising’ to a broader market – perhaps good enterprise for NGO health services and schools which operate as Independent Public Schools (IPS); Have some careful respect for the enormity of the potential here – nurture and safeguard it for its potential tradability within the Broome economy.	Promulgate and market the model; Develop business enterprise; Plan for and implement system growth to accommodate the enterprise; Take great care to keep refining the local model.	Enterprise growth in national and international markets.
Cultural enterprise	Consider the development of a well sighted and scoped cultural precinct in Broome.	Continue development of culture activities; community functions; entertainment; tourism and enterprises	Expansion and growth in range, depth and value of activities, offerings and community value.
Research and knowledge economy	Explore and plan for trades and undergraduate advanced training and education in Broome; Strong focus on a wider range of key health professional and corporate and business courses; Explore the CUCRH model and engage people in designing a model suited to Broome’s BGP aspirations; Undertake feasibility and business case development.	Consolidation and sustainability of new initiatives in training, education and applied research linked to a variety of industries (including health); Expand investor and partner base; Look for trading opportunities.	Growth and expansion.
Preventing chronic diseases caused by poor quality food & malnutrition	Get community leadership together to expand & promulgate leading edge scientific evidence & knowledge; develop outcome measures; and plan executable actions for chronic disease and disability prevention in Broome; Develop political influence – align with leading thinkers, champions and advocates; Create and action an applied research agenda around the prevention measures and outcomes measurement.	Publish and promote learnings and improvements using political and media vehicles (this will help establish a strong evidence base and push/pull effect on languid (and wrong) public health prevention policies and move them forward much faster; Leverage Broome’s leading position in this space; Work on next stages of emergency possibilities;	Actualise next stages of development and growth.
A food economy in Broome	Identify and action existing opportunities to get local and/or regional produced food in all Broome food retail outlets or alternatives (farmer’s markets, farm shop sales); Investigate ways to lower (or subsidise) prices on the most nutritionally dense and appetite satisfying foods; Scope out a robust ‘community garden’ business system for all year-round seasonal vegetables and fruits; Explore ways to expand food interest, knowledge & skills – build around traditional diet and medicinal foods template (modernised adaptable interpretations).	Evolve food business over a wide front; Infrastructure and systems in place to support (and be supported by) a robust mix of food related enterprises; Build traditional foods, cuisine, products and eatery businesses and link them into the cultural tourism experience and cultural precinct; Ensure every food product raised, caught and grown in the district (and region) feeds local people at very attractive prices – open up distribution and marketing systems region wide (health benefits and a growing local food economy); Leverage global interest in grass fed animal products (eg rendered fats & both broth); traditional healing herbs; organic herbal health and skin care products – for local economic enterprise and for export.

Appendix 1: Summary of Stakeholder Engagement

Kimberley Development Commission – Jeff Gooding

Notre Dame University – Sandra Wooltorton

Professor Patrick Sullivan – NDU/ANU

Sandra Joffe

Dr Jeanette Ward – Kimberley Population Health

Andrew Waters and staff – Kimberley Population Health

Bec Smith – Regional Director, WACHS

Peter Yu and Howard Pederson – Nyamba Burra Yawuru

Eunice Yu and Paul Lane – Kimberley Institute

David Wirken – Aarnja, Empowered Communities

Chris Mitchell – Regional Development Australia and Shire of Broome

Aletta Nugent and Sam Mastrolembo – Shire of Broome

Vicki O’Donnell and Robert McPhee – KAMS

Bob Mahony – BRAMS

Jeff Moffet – WACHS

Graham Searle – Regional Services Reform

Tracey Gillett – Regional Services Reform

Neale Fong – WACHS

Margie Warne – Boab Health Service

Andrew McGraw – WAPHA

Jan Lewis – KAHPF Secretariat

Broome District Health Advisory Council

Broome Hospital Operations

Former Principal, East Kalgoorlie Primary School

Earbus Foundation team (associated with EKPS).

Item 5.1 - BROOME GROWTH PLAN - STATUS UPDATE AND KEY ELEMENTS

Table of Contents

project background.. 3

broome Scenario Planning workshop summary.. 4

2036 Scenario 1 - Drivers of change.. 5

2036 scenario 1 - features and characteristics.. 6

2036 Scenario 1 - challenges and priorities.. 8

2036 Scenario 2 - Drivers of change.. 10

2036 scenario 2 - features and characteristics.. 11

2036 Scenario 2 - challenges and priorities.. 13

Project background

The Regional Centres Development Plan (RCDP) initiative is about supporting the long term economic and population growth of the Regional Centres and SuperTowns identified in the Western Australian 2013 State Planning Strategy through the preparation of Growth Plans for nine Regional Centres and their catchment areas.

Regional Centres and SuperTowns are critically important to the Western Australian economy, providing a focal point for economic activity and opportunity across a range of industries. The first four Regional Centres are Broome, Greater Bunbury, Geraldton and Kalgoorlie. In the second stage of the process Growth Plans will be prepared for the Regional Centres of Albany, Busselton, Carnarvon, Kununurra and Mandurah.

Growth Plans are place based socio-economic development strategies that address a Regional Centre and its catchment area, and provide a vehicle for communities to set the direction for their future growth. The aim of a Growth Plan is to strengthen a Regional Centre’s strategic positioning, attract business and investment, support the growth of competitive industries, and build a better place to live for existing and new residents.

The Scenario Planning stage is designed to explore future drivers and scenarios that have the potential to impact on the sustained growth of the Regional Centres, and work through a process of identifying solutions and opportunities to understand the future and assist communities in making more informed and better decisions about the future.

broome scenario planning workshop summary

A half day scenario planning workshop was held in Broome on 15^th July to explore responses to the strategic challenge:

“How does Broome position its economy and community for sustained future growth?”

2036 was chosen as the horizon year for the session and two scenarios were developed to acknowledge the uncertainty in planning for such a long-term range.

The purpose of this workshop was to develop scenarios that enabled participants to address the following questions from an informed, future perspective:

· What are the challenges to Broome becoming a diversified economy by 2036?

· What are the enablers for Broome becoming a diversified economy by 2036?

· What are the challenges to Broome becoming a tourism and lifestyle destination by 2036?

· What are the enablers for Broome becoming a tourism and lifestyle destination by 2036?

The workshop process followed three logical steps:

1. Identifying the significant external forces (drivers of change) which could shape Broome’s economy and community between 2016 and 2036

2. Generating two future scenarios for 2036 which describe the different impacts these drivers of change could have on Broome’s economy and community

3. Assessing the challenges to positioning Broome’s economy and community for sustained future growth within each scenario, and the enablers (policies, actions) necessary to overcome these challenges.

2036 scenario 1 - Drivers of change

Drivers of change are the external forces or factors (trends) which drive the general direction of a scenario. Obviously there are a multitude of forces which could impact Broome’s economic and social future. Sorting through these forces and determining those considered to be the most significant in terms of their potential to impact Broome’s future was the first task of building the scenarios.

In this scenario, the drivers of change that were discussed in detail included the following:

· Technology and tele-commuting

· Government budgetary pressures

· Asian growth

· Workforce automation

· Ageing population

· Rise of renewable energy

· Climate change

· Social and economic participation

The two drivers considered most significant to the future of Broome’s economy and community were:

· Asian growth

Broome airport’s proximity to Asia provides opportunities as hundreds of millions of people over the next 20 years enter ‘middle class’ status. This rising income on Broome’s doorstep equals rising trade opportunities, as the “middle class can now afford our prices”.

Asian growth presents opportunities in gourmet food exports (barramundi, oysters, beef, etc.), tourism (niche, cultural experiences) and education (regional university, more secondary schools).

Investment in capital projects including port and airport upgrades were seen as essential to capitalise on these opportunities.

· Social and economic participation

The current status of social and economic participation in Broome is low. Broome was described as having a “misery economy”, with a large proportion of its residents receiving government welfare (“a drain on the economy”) and government services being the biggest employment sector.

This under-represented sector of the community was seen as an essential ‘untapped resource’ that needed to be realised if Broome was to reach its potential in 2036.

As participation grows, it was perceived that government services would decline as a proportion of economy, and new industries could emerge or prosper.

The major challenge to growing social participation was being overwhelmed by community opposition or anti-development crusaders who wanted to maintain their historic ‘snapshot’ version of Broome (“Broome is beautiful, leave it as it is”).

The opportunities were seen to be working collaboratively and collectively with the multiple corporations undertaking long-term projects in the region and developing local employment opportunities. Likewise, there had to be better facilitation and co-ordination of ‘local voices’ so that they could be heard.

2036 scenario 1 - features and characteristics

In this scenario we see a confident and competent Broome that has the policies and infrastructure in place to exploit the opportunities presented by the growing middle class in Asia. In 2036 Broome has benefited from this global mega-trend by promoting and optimising use of its natural advantages, namely:

· Proximity to Asia

· Authentic cultural experiences

· Natural resources and climate

· Availability and production of gourmet food

· Gateway to the Kimberley

Central to this success has been the ability to develop and promote a compelling vision for Broome’s future that has evoked ‘buy-in’ and advocacy from local residents. In 2036 Broome residents and decision makers are united in their vision for Broome as a leading provider of premium and ‘iconic’ experiences.

In 2036 Broome is a proud community where consistent policies since 2016 have been successful in facilitating and improving social and economic participation. In effect, these policies have unlocked the latent potential within Broome’s population. As a result, social cohesion is strong, community well-being and safety is high, crime is relatively low, and dependency on welfare has dropped significantly since 2016.

Significant features and characteristics of this scenario include:

1. Dynamic, thriving economy

· The tourism and resort industry is thriving as Broome capitalises on the growing middle class and ageing market for authentic wilderness and cultural (Indigenous) experiences

· Global tourism is an ultra-competitive industry and Broome’s success is due to taking a deliberate position to deliver premium / niche / unique / ‘iconic’ experiences

· There is an increased desire for the iconic experiences Broome can deliver including Cable Beach and local Indigenous culture

· Tourism and food opportunities are tied together, and unlike other regions, Broome has never aspired to become the ‘food bowl’ of Asia, preferring to play to its strengths in more ‘high end’ food offerings

· Regional exports of gourmet beef and fish products are booming, as the Broome economy benefits from upgrades to its port and airport facilities

· Professionalism within the hospitality and services industry has improved markedly

· In 2036 Broome has a world-class service and hospitality culture, reflecting concerted effort over a sustained period of time and the level of buy-in that locals have to the Broome vision

· The Social Services industry now represents a smaller proportion of the local economy in line with the greater social and economic participation

· By freeing up land assets the Broome community was in effect enabled to “take the economy to the local Indigenous”, providing a massive upside for the local community

· Education is one of the industries that thrives within this scenario as demands on education have increased significantly

· More children attending and staying in school has led to the demand for more teachers, more schools, more facilities, and better education services including secondary schools, etc.

2. Sustained high population growth

· A high-end population growth rate driven by a greater retention of local population, and improved attractiveness as a place to live, due to the delivery of better services, greater employment opportunities, and improved levels of community safety.

· Greater economic opportunities, delivered via prosperous and sustainable local businesses and industries have led to a decline in population transiency (E.g. The decline in the government services sector)

3. Improved home ownership rates

· Individuals take greater responsibility for their own housing and health, with a home ownership target of 60% vs the current rate of ~30%.

· Introduction of a seasonal home ownership model (6 months) for Australian ‘snowbirds’ (people who follow the warmer weather)

4. Discerning consumption

· Consumers becoming more discerning with regard to the quality and choice of their food (‘gourmet’) and the experiences they are seeking (niche, authentic)

5. Community cohesion

· Greater social and economic participation leads to improved community safety, well-being and cohesion

· A decrease in crime improves opportunities to promote the ‘live-ability’ aspects of Broome

· Increased social participation leads to greater demand for recreational facilities and services

· Hospital admissions for violence, alcohol and drug abuse have fallen significantly since 2016

6. Improved infrastructure and services

· Upgraded port and airport facilities lead to improved services, particularly to Asia

· Tele-communications, internet and mobile services are comparable with Perth, again driving the ‘live-ability’ status of Broome

2036 scenario 1 - challenges and priorities

This scenario provided the backdrop against which challenges and opportunities were assessed for positioning Broome’s economy and community for sustained future growth, with particular focus on positioning Broome as a tourism and lifestyle destination and as a diversified economy by 2036.

Challenges to Broome becoming a diversified economy in this scenario include:

· Lack of free-hold land (97% of state is lease-hold)

· Scant infrastructure (“pitiful infrastructure”)

o “We have a wharf called a port”

· Government budgetary pressures will make it harder to secure funding for urgently needed infrastructure and services upgrades

· Overcoming community and environmental opponents who want to maintain Broome as it is

· Economic leakage to bigger retail centres

o Broome’s limited market size impacts retail choices

Positioning Broome as a diverse economy can be enabled in this scenario by prioritising the following:

· State-led tenure reform (market-ised)

o Land needs to be unlocked as a useable asset to enable cultural tourism and agriculture opportunities to boom

· Broome must develop and promote a compelling vision for its future that evokes ‘buy-in’ and advocacy from local residents

o United in its vision and voice - premium / niche / unique / ‘iconic’ experiences

· Explore and develop partnerships for common use infrastructure which are cohesive with the longer term vision

· Developing and co-ordinating long-term strategies with long-term investors (i.e. Shell, etc.), particularly around local employment programs

o Many investors have programs, but there is a lack of co-ordination amongst them

Challenges to Broome becoming a tourism and lifestyle destination in this scenario include:

· Under-developed capacity, particularly in the area of Indigenous skills for tourism

· Poor infrastructure and facilities

· Generational legacies such as welfare dependence

o History and heritage

· Community opposition to growth (NIMBY)

· Lack of “stickiness” (transient population)

· Not a lot of options for seasonal Baby Boomer accommodation

· How will the tourism sector provide high quality, high paying jobs?

o Workforce transiency

Positioning Broome as a tourism and lifestyle destination can be enabled in this scenario by prioritising the following:

· Capacity building in the tourism, hospitality and services industry

o Emphasis on training to develop a world class service and hospitality culture

· Providing a pathway from welfare dependence (e.g. free housing) to full participation in the economy

o Including health and education initiatives

· Communication of the 2036 vision and meaningful community engagement

· Providing the appropriate range of facilities and infrastructure for Grey Nomads

· Advocating for policy changes to government benefits currently provided for employees (nurses, teachers, etc.) which make renting more desirable vs home ownership

· Increased income in the local community will provide additional funding for improved community facilities and services

2036 scenario 2 - Drivers of change

In this scenario, the drivers of change which were discussed in detail included the following:

· Unlocking the potential of the community through land tenure reform

· Values driving social change

· Education

· Mental health and wellbeing

· Telecommunications infrastructure

· Government funding

· Have’s and have not’s

· Asian growth

· Housing affordability

· Workforce and skills development

· Climate change

· Participating in the decision making

The drivers considered most significant to the future of Broome’s economy and community were:

· Values driving social change

In the context of Broome this driver was about respecting and valuing community culture, and not just talking about it, but making sure all key stakeholders and the community in general are walking the talk. There is a need to understand the values that drive the community in order to facilitate change and drive a better future for the community.

Education and mental health and wellbeing are drivers in their own right, but they are also seen as critical challenges to get right in order to really drive social change across the community, and the benefits that will flow from this for all members of the broader Broome community.

The Yawuru corporate group and traditional owners will play a critical role in facilitating outcomes related to this driver of change.

· Unlocking the potential of the community through land tenure reform

The resolution of land tenure reform was identified as the key driver in unlocking the potential of the Broome community. There are high levels of disengagement across the community, and this driver presents the opportunity to engage with the community and utilise this experience to drive a unified community and a diversified economy.

2036 scenario 2 - features and characteristics

In this scenario we see a Broome economy that is diverse but with strong connections to local community and culture. It is a community that is tied together by a ‘Development Charter’ that sets the direction for the types of development and growth the community wants to see, and it is a community that is completely engaged and has high levels of ownership over the decisions that are made for the best interests of the community.

Significant features and characteristics of this scenario include:

1. Diverse economy closely connected to community, culture and the land

· The Broome ‘Development Charter’ has set the scene for what drives economic and social opportunity across the entire Broome region.

· The environment and climate change have generated opportunities in areas such as the carbon economy, science and research, renewable energy and with strong links to education and training for local residents.

· Industries that grow sustainably from natural resources are strong contributors to the local economy, including sectors such as aquaculture and agriculture.

· The creative arts and associated industries (IT) are part of the Broome economic climate.

· Economically Broome operates successfully as a broader region including the Hinterland.

· Broome is the gateway to the regional economy.

· Broome has developed a reputation for education and research in the major economic contributors of the region.

· The Broome economy has developed a significant number of industry cooperatives that facilitate job creation and economic critical mass.

· The Broome tourism industry is flourishing in the areas of culture, arts, nature based experiences and research based tourism. The Broome tourism market is defined by relationships and experiences.

2. A highly engaged and socially strong community

· The Broome community is connected by its high levels of engagement and community participation.

· An engaged community has facilitated a social license to operate.

· Broome has a high level of quality community events and activity designed to bring the community together.

· Engagement is focused on bringing the entire community together to participate in community decision making.

· Relationships are at the heart of the community.

3. Broome is a community where access to opportunity (wealth, education, etc.) is evenly distributed.

· The social behaviours and challenges have been addressed and the residents of the broader Broome community have equal access to opportunities.

· There is an increased level of home ownership across the Broome region, and home ownership has become a means to family wealth generation.

· All corners of the community are actively engaged and respecting of the cultural environment.

· Historical grievances have been settled and formal relationships now ensure Broome is a strong community where all people have access to equal opportunities.

· “Mabu liyan” – healthy mind, people and country.

4. Technology is driving cultural development and enabling economic diversification

· The uptake of technology has enabled the diversification of the economy.

· Technology has assisted to bring indigenous culture into the mainstream.

· The greater Broome region has access to the infrastructure required to drive access to technology.

· Engagement in education is at an all-time high driven by the use of technology.

· A greater level of local youth are retained in the region as a result of increased technology access and understanding.

5. Broome is an urban environment driven by outside activity and participation

· Broome is a highly engaged and active community driven by a network of urban connectedness.

· The amazing Broome climate encourages people to be outside and active.

· Broome is a modern community defined by its urban design that encourages outside community participation.

2036 scenario 2 - challenges and priorities

This scenario provided the backdrop against which challenges and opportunities were assessed for positioning Broome’s economy and community for sustained future growth by 2036.

Challenges to the sustained future growth of Broome’s economy and community in this scenario include:

· Finding strong leadership that can help to engage the community effectively.

· Getting the public and private sector on board to deliver local and sustainable employment outcomes that are driven by identified and commonly agreed targets.

· Getting the broader community and key stakeholders across the community on board and supportive of the community direction.

· Environmental risks associated with mining and managing controversial development negotiations associated with this industry.

· Settlement of native title land tenure.

· Access to technology and education to facilitate opportunities.

· Resolving social and economic inequities.

Positioning Broome’s economy and community for sustained future growth can be enabled in this scenario by prioritising the following:

· Establishment of a ‘Development Charter’ for the Broome community that takes into consideration the following requirements:

o Broome needs the right protocols and support mechanisms in place that will drive strong leadership.

o The community through identified community leaders will endorse and sign up for what is important to the City and what we want to achieve. This will be an excellent tool to get the community as a whole on the same message.

o Key community leaders will be offered the opportunity to sign on from the outset. The key challenge will be to get everyone on board, but it is important to make a start and now wait for everyone to sign on, we need to get it happening and provide the opportunity for others to sign on when they are ready.

o The initial priority is to get key community leaders on board. The timing is right to do this now, we need to start with the willing participants and grow from there.

· Explore the establishment of a policy and regulatory framework that supports and incentivises local employment.

· Establish a comprehensive settlement agreement that all community, private and public sector stakeholders support that is linked to the Development Charter. It is believed that there is an opportunity for Broome to become a national leader in this space.

· Broome needs one unified and consistent voice in the persistent pursuit of our priorities.

[1] Assumes investment currently 10% of GRP, all other components of GDP remain at long term averages and direct flow-on effects contained in region.

[2] www.drd.wa.gov.au Regional Centres Development Plan

[3] Operationalising the Capability Approach: Developing culturally relevant indicators of Indigenous Wellbeing – An Australian example. Mandy Yap and Eunice Yu

[5] Statistics for Community Governance: The Yawuru Indigenous Population Survey of Broome, J Taylor, B Doran, M Parriman, E Yu. Centre for Aboriginal

Economic Policy Research, ANU College of Arts and Social Sciences (CAEPR Working Paper 82/2012)

[6] Shire of Broome, Community Perceptions, 2015

[7] Kimberley Stolen Generation Aboriginal Corporation website

[8] Kimberley Aboriginal Health Planning Forum: Suicide Position Paper 20 May 2016

[9] Suicide 2020: Mental Health Commission 2015

[11] Fr Matthew Digges: Article on Homelessness (website)

[12] WA Country Health Service (website) regional profiles

[16] Living in the Regions (Kimberley) Department of Regional Development 2013 social survey

[17] Shire of Broome: Community Perceptions 2015

Director	Nicki Hutley
Associate Director	Michael Knight
Senior Consultant
Consultant	Alex Batchen
Project Code	EMR0501
Report Number	Economic and situational analysis

Industry	Agriculture – livestock, crops and horticulture	Mining	Business services*	Tourism**	Transport and freight
Additional economic activity ($m)
Direct	10.0	10.6	11.5	10.3	8.4
Indirect	8.4	6.9	9.6	11.7	11.1
Total	18.4	17.5	21.1	22.0	19.5
Additional employment (no.)
Direct	72	13	34	124	43
Indirect	46	35	49	63	59
Total	118	48	83	87	102

	Broome	Kimberley	Australia
Population	17,308	38,801	23.8 million
Median age	32.1	31.4	37.3
Working age	71.2%	71.5%	66.5%
Indigenous	29.1%	40.0%	2.6%
Migrant	22.8%	23.1%	30.2%

	Broome	Kimberley	Australia
	% of total population aged 15 and over
Any post school qualification	60.2	56.7	55.9
Bachelor degree or higher	14.3	12.1	18.8

	2014 and 2015 Annual Average
Intrastate	154,000	58%
Interstate	79,000	30%
International	31,300	12%
Total	264,300	100%