*1.7. Expenditure*

The Indigenous Expenditure Report (IER) aims to contribute to better policy making and improved outcomes for Indigenous Australians and will

"3. include expenditure by both Commonwealth and State/Territory governments (and local governmen<sup>t</sup> if possible), and over time will:

	- (c) Be reconcilable with published governmen<sup>t</sup> financial statistics.

4. focus on on-the-ground services in areas such as: education; justice; health; housing; community services; employment; and other significant expenditure

6. provide governments with a better understanding of the level and patterns of expenditure on services which support Indigenous Australians, and provide policy makers with an additional tool to target policies to Close the Gap in Indigenous Disadvantage" [19].

Reports have been produced periodically since 2010 with the most recent report being the 2017 version.

While the IER produced by the Productivity Commission focuses on governmen<sup>t</sup> expenditure, expenditure analysis carried out by AIHW for the HPF "encompasses government, non-government, private and individual expenditure on health and medical services, hospital services (admitted and non-admitted patients), community health services, dental services, aids and appliances, pharmaceuticals, patient transport and public health programs ... ". It points out that "four interacting factors within Australia's health system potentially have major consequences for the health of many Aboriginal and Torres Strait Islander people, namely limited Indigenous-specific primary health care services; Indigenous Australians' underutilisation of many mainstream health services and limited access to governmen<sup>t</sup> health subsidies; increasing price signals in the public health system (such as co-payments) and a low Indigenous private health insurance rate; and failure to maintain real health expenditure levels over time" [20]. An important element of the AIHW expenditure analysis is that, unlike the IER, it includes non-governmen<sup>t</sup> expenditure as well as governmen<sup>t</sup> expenditure, allowing for a more meaningful comparison of Indigenous and non-Indigenous expenditure on health and social areas.

#### *1.8. Indigenous Data Developments*

A range of conversations and meetings to identify what is required for data to support the needs and aspirations of Aboriginal and Torres Strait Islander people have occurred more frequently over the past 5 years. Emerging from these discussions, Aboriginal and Torres Strait Islander people identified the need for strategic governmen<sup>t</sup> and organisational partnerships to work towards the development of the data capabilities of Aboriginal and Torres Strait Islander communities for the purpose of community advancement.

Initiatives such as the Maiam nayri Wingara Indigenous Data Sovereignty Collective [21] and the Indigenous Data Network (IDN) [22] have emerged as Indigenous-led groups to support the systems and governance of Indigenous data. Further, there has been a range of advocacy and negotiations between Aboriginal and Torres Strait Islander leaders and governments to further develop Indigenous data, particularly at the regional level. Recently, the IDN was funded by the Australian Government via the National Aboriginal Community Health Organisation (NACCHO), and is a part of the National Agreement on Closing the Gap [23] (National Agreement), which focuses on shared access to data and information at a regional level.

The \$1.3 million project, led by Indigenous researchers and experts from around the country, was to support Priority Reform Four of the National Agreement that aims to improve and share access to data and information to enable Aboriginal and Torres Strait Islander communities to make informed decisions.

The IDN had been working in partnership with the Coalition of Aboriginal and Torres Strait Islander community-controlled peaks (Coalition of Peaks) to support the development of a new platform, which will enable Indigenous organizations to upload and analyze their own data.

"The data collected will be focused on the areas and targets, including the Priority Reforms, in the newly agreed National Agreement on Closing the Gap. It will span health, education, employment, justice, environmental managemen<sup>t</sup> and cultural heritage services, ensuring Indigenous organisations can make evidence-based decisions to set strategies that are aligned to community needs".

"The launch of this project is the latest achievement for the IDN, which was established in 2017 to give voice to the principles of Indigenous data sovereignty—the recognition of intellectual property and other rights [24] of Indigenous people and entities in their data so that it cannot be harvested without consent by governments or any other data collector—and to lead a push for the implementation of national Indigenous data governance framework" [22].

Announcing the data project in his 2021 February address, Closing the Gap Statement to Parliament, Prime Minister Scott Morrison said that "a vital part of empowering Indigenous communities is giving them the data and information to inform their decision making." [25].

### *1.9. Data Sharing*

The Australian governmen<sup>t</sup> has invested significantly in its national data capabilities to monitor the progress of the nation's health through data sharing. In August 2018, the Prime Minister and Cabinet established the Office of the National Data Commissioner to build and support the infrastructure and use of public data [26]. Other national initiatives have included the National Collaborative Research Infrastructure Strategy and the Strategic Committee for National Health Information to make better use of research and health data [27]. These initiatives are developments arising from a range of internal governmen<sup>t</sup> developments in data sharing. This includes the ABS Multi-Agency Data Integration Project (MADIP) in 2015. After its establishment, almost \$131 million was invested in the Data Integration Partnership for Australia (DIPA) from 2017 to 2020 to improve technical data infrastructure and data integration capabilities across the Australian Public Service. These data assets have and continue to be used for a range of governmen<sup>t</sup> projects and have the potential to improve statistical understandings as well as data quality.

For Aboriginal and Torres Strait Islander people there are limited mechanisms to govern Indigenous data within governments. There is currently no available information regarding who is making decisions regarding linked Aboriginal and Torres Strait Islander data and the above-mentioned data assets. In terms of data sharing, there is still a way to go regarding the interoperability of the data systems and platforms outside of government. This includes the linkage of primary health care, disease registries, and surveillance systems, and broader sectors of data collections, such as education and justice, which can provide critical insights to the distribution and determinants of health and disease in Australia.

#### *1.10. International Indigenous Information Developments*

The International Group for Indigenous Health Measurement [28] (IGIHM) was founded in 2005 and brings together Indigenous and non-Indigenous, governmen<sup>t</sup> and non-government, statisticians, researchers, and health professionals from the four founding members of this group, Australia, Canada, New Zealand, and the United States, and, more recently, representatives from Sami organizations and Indigenous peoples from South America. The IGIHM's goals are "first, to promote awareness of the deficiencies of health data for Indigenous populations in our four countries and second, to collaborate internationally on improved methods and policies that will contribute to the improvement of Indigenous health. Since its founding in 2005, the IGIHM has pursued a variety of activities to further its goals. These activities have centred on multi-national partnerships as well as the promotion of improved methods for the collection, analysis, interpretation and dissemination of information useful for improving the health of Indigenous populations, enhancing Indigenous health knowledge and data, and the elimination of health disparities" [29]. A major recent focus has been on promoting Indigenous measurement issues in international forums including UN Statistical agencies, and the International Association for Official Statistics.
