3rd of October 2025
House Standing Committee on Health, Aged Care and Disability
PO Box 6021
Parliament House
CANBERRA, ACT 2600
Via e-Mail: Health.Reps@aph.gov.au
SUBJECT: Submission to the Parliamentary Inquiry into the Thriving Kids Initiative
To the House Standing Committee on Health, Aged Care and Disability,
Thank you for the opportunity to provide input into the Parliamentary Inquiry into the Thriving Kids initiative. As an Aboriginal Community-Controlled Health Organisation (ACCHO), our submission is grounded in community voices and lived experience. We believe that the success of Thriving Kids will rely on culturally safe, accessible, and community-led approaches that prioritise the strengths and aspirations of First Nations families.
We provide the following feedback against the Terms of Reference:
1. Evidence-based information and resources to assist parents in identifying and supporting children with mild to moderate developmental delay
At present, there is a lack of culturally safe screening tools for developmental delay. While tools such as ASQ-Trak and the Vanderbilt Assessment exist, they are not widely accessible, nor are there enough qualified professionals to administer them consistently. The ASQ-Trak training is delivered in Victoria via a 2-day face-to-face workshop that is a significant cost to the organisation, and not a culturally safe or inclusive pathway for First Nations professionals. This makes supporting staff to become qualified ASQ-Trak Assessors unattainable for many ACCHOs, especially considering the recruitment and retention challenges in remote regions. Parents are also not provided with adequate education or support to understand these tools, nor how to contribute their own observations of their child’s development.
Furthermore, existing measures of developmental milestones are largely based on Western concepts of progress and fail to recognise First Nations frameworks of child development. For example, the ability to perform Bunggul (traditional dance) may be a meaningful developmental milestone in a Yolŋu context, but such skills are not acknowledged within Western assessment models.
There is a pressing need for resources to be developed in first languages and in accessible formats. These must be co-designed rather than developed from a purely government perspective. Families also experience distress when their children lose supports due to program or eligibility changes. A stepped-down or transitional model is necessary to prevent abrupt withdrawal of supports and to
allow families time to adjust. Finally, when children receive a new diagnosis, families need culturally safe and holistic support to understand and respond to this information in ways that align with their cultural context and family needs.
2. Effectiveness of current and previous programs and initiatives
Current services and programs designed to support children with developmental delay or autism are under-resourced and unable to meet existing demand. Services such as the Community Allied Health Teams, Families as First Teachers (FAFT), Aboriginal Community-Controlled Maternal and Child Health programs, paediatric services, and schools are stretched well beyond capacity.
Health clinics are often relied upon as the “catch-all” when families experience difficulties, but these clinics are not adequately resourced to provide specialised, ongoing developmental support. Remote areas also tend to attract staff at the very beginning of their careers, such as new graduates or early-career teachers. While these staff bring enthusiasm, they often lack the skills and expertise to accurately assess developmental milestones or provide specialised supports, which in turn limits children’s access to timely and effective intervention.
Infrastructural challenges further compound these issues. Many communities lack appropriate venues for playgroups, young mothers’ groups (including space for safe preconception/antenatal care) or other developmental programs. Where engagement is strong, it is typically because Yolŋu and bilingual staff are involved, such as through Clontarf, Stars, Remote Community Connectors, Social and Emotional Wellbeing teams, Miyalk Yolŋu Navigators, Yothuw Mulka, and Aboriginal Health Assistants. This demonstrates the value of embedding local staff and culturally safe approaches into all service delivery.
3. Equity and intersectionality issues
For First Nations children, equity and cultural safety are not optional add-ons, they are central to ensuring programs succeed. Aboriginal Community-Controlled Organisations are best placed to deliver this because they are trusted within communities, culturally embedded, and able to integrate local knowledge with service delivery. Funding ACCHOs and ACCOs to implement initiatives such as Thriving Kids, offers an opportunity to streamline funding, reduce silos, which is proven to improve patient engagement and outcomes. Equity must also account for geographic remoteness, language diversity, and the need for flexible approaches that prioritise community strengths.
4. Workforce support and training gaps
The challenges of building and sustaining a skilled workforce in remote communities are significant. Workforce models must reflect a “both-ways” approach, where Western knowledge is complemented by First Nations knowledge systems. Training pipelines should be designed and led locally, for example through Remote Australia Employment Services (RAES) and the Remote Jobs and Economic Development (RJED) programs (formerly known as the Community Development Program), to ensure that skills and employment opportunities are developed within communities themselves. Funding
silos across programs such as NDIS, Medicare, MOICD, and community allied health create barriers and duplication. Streamlining funding models would make service delivery more efficient and would reduce the risks to local providers, enabling them to operate more sustainably. Workforce retention is also a persistent challenge, exacerbated by housing shortages, professional isolation, and burnout. The development of more local houses is required to improve and maintain local service delivery. FIFO models may help to stabilise service availability, but only if they are implemented in ways that support, not replace, the development of a local workforce, in a stepped down approach.
5. Domestic and international best practice
There are valuable lessons to be drawn from other Indigenous-led frameworks. For example, the Te Whare Tapa Whā model from Aotearoa New Zealand provides a holistic, strengths-based approach to Māori wellbeing that could inform Thriving Kids.
Birthing on Country Models of care are holistic, community driven and have proven to improve outcomes for infant health services. Across ACCHOs within Australia, First Nations health care services are adopting a redesign that focuses on utilising pillars of the RISE Framework; the RISE framework aims increase continuity and quality of care, whilst focusing on strengthening families’ capabilities at a community level, embedding governance engagement and control over early childhood service provision.
Some health services, such as Malala Health Service Aboriginal Corporation in Maningrida, operate with a dedicated 0-5 child health program focused on well child assessments and developmental screening. This model ensures a skilled child health nurse is available to deliver scheduled and routine assessments, ideally alongside a Yolŋu trained worker. It also provides opportunities for family education on key topics such as starting solids, immunisations, brushing teeth, and other early childhood health practices.
In contrast, the MHAC child health program across six of the seven East Arnhem communities is primarily staffed by short-term agency nurses who are not trained in child health. These nurses cover the 0-17 age group and are also required to participate in acute care and on-call services. This model leaves a significant gap in the delivery of well child assessments and developmental screening. Families are left uncertain about where to access consistent, reliable well child services, creating inequities in early childhood health and development outcomes.
6. Seamless transition through mainstream systems
For Thriving Kids to succeed, children and families must experience smooth and supported pathways through services. This requires consistent case management and strong cross-sector coordination to ensure families are not left to navigate complex systems alone. Referral pathways should be streamlined to create a “no wrong door” approach, where families can access the right supports regardless of their entry point.
Community hubs, led by ACCOs, could represent a trusted and effective model for families. These hubs could function as one-stop entry points for health, developmental, and family supports.
Implementation of Thriving Kids should be staged, with priority given to the most at-risk communities, to allow families and services to adapt to the changes. Importantly, deep and ongoing consultation with remote First Nations communities must underpin every stage of planning and delivery, ensuring that decisions are co-designed with those most impacted.
Recommendations
Based on the feedback provided, Miwatj Health Aboriginal Corporation recommends that the Thriving Kids initiative:
- Embed Aboriginal Community-Controlled Organisations at the centre of design, governance, and delivery, ensuring that cultural safety and community priorities are central to all decisions.
- Invest in culturally safe developmental screening tools and parent education, including the development of resources in first languages and formats designed by communities.
- Address service gaps by resourcing existing programs and infrastructure, particularly in maternal and child health, paediatrics, allied health, and early childhood education, with a focus on remote settings.
- Strengthen local workforce pathways through both-ways training models, community-led career pipelines, and streamlined funding that reduces duplication across systems.
- Adopt international best practice Indigenous frameworks and adapting these to the Australian First Nations context.
- Ensure seamless transitions for families through case management, cross-sector coordination, and the establishment of community hub models led by ACCHOs and ACCOs.
- Prioritise deep and ongoing consultation with remote First Nations communities, with staged rollouts that allow those most at risk to be supported first.
Conclusion
We strongly advocate for Aboriginal Community-Controlled Organisations to be central in the design, delivery, and governance of Thriving Kids. Community voices, cultural knowledge, and local leadership must drive this initiative if it is to genuinely support all children to thrive.
Thank you for considering our submission.
redacted
CEO
Miwatj Health Aboriginal Corporation