Shared decision making is key to Closing the Gap

11 August 2025 | Selwyn Button

It's been five years since the National Agreement on Closing the Gap was signed in 2020.

In 2025, it's easy to forget why this Agreement is so important and why it is fundamentally different from policy approaches of the past.

The National Agreement on Closing the Gap is historic because it was the first agreement made with Aboriginal and Torres Strait Islander people as equal partners.

In the past we have treated the inequality experienced by too many Aboriginal and Torres Strait Islander people as a list of problems for government to solve.

The four priority reforms move us away from the failed government-knows-best approach of yesterday and presents a new way forward: sharing decision-making with Aboriginal and Torres Strait Islander people. This isn't just a nice idea. Decades of evidence and experience show that this is smart policy.

My colleagues at the Productivity Commission have been measuring and assessing the implementation of the Agreement from the start. We publicly report progress on the Closing the Gap outcomes through a dashboard and annual data compilation report and conduct a comprehensive review every three years.

This is an enormous task that requires all of the statistical and analytical rigour that the PC is known for: regression analysis; likelihood ratio tests and confidence intervals are all brought to bear.

This is important because Aboriginal and Torres Strait Islander policy is an area where false assumptions and ‘quick fixes’ abound. Let’s look at what the data actually shows.

Our latest assessment of progress is mixed. Socio-economic outcomes for four targets are on track to be met and progress for six targets is showing improvement. Progress for four targets is worsening, one shows no change and four targets have no data to assess progress.

But what the evidence also shows is that where government treats Aboriginal and Torres Strait Islander people as equal partners and invests in community-led solutions, progress follows.

That’s clear in the case of outcomes in earlier stages of life. While the target for healthy birthweights at 91% is not on track to be met, most Aboriginal and Torres Strait Islander women have healthy pregnancies, and healthy birthweights are improving in most jurisdictions.

This is in part due to the success of antenatal care programs led by Aboriginal Community Controlled Health Services (ACCHSs), which have been shown to have an impact on maternal smoking and alcohol use during pregnancy. Programs such as Birthing in Our Community (BiOC) and Birthing on Country are also demonstrating significant improvements in health birthweights for Indigenous babies, leading to reduced interaction with the child protection system for families over time.

Beyond target headlines, supporting indicators can provide context and information on the drivers of the outcomes. Part of the PC's role under the Agreement is developing those indicators. While many are now available there is still more work to be done by the PC in partnership with others.

Data development on foetal alcohol spectrum disorder (FASD) is planned over the life of the Agreement. A recent opinion piece published in this masthead speculated about the impact of FASD on closing the gap outcomes. This is the kind of idle conjecture that our rigorous approach to the data safeguards against.

The truth is that nationally, the prevalence of foetal alcohol spectrum disorder for First Nations people is not known.

But here again, we have seen evidence of community led success to respond to a known issue. A community-led project in Fitzroy Valley achieved outstanding results in lowering the risk of FASD in the area. Guided by Elders and the evidence-based Marulu Strategy, the project was developed in consultation with research partners and experts.

The data that we do have on alcohol consumption cuts against lazy stereotypes. Data from AIHW shows that most First Nations mothers did not report consuming alcohol in the first 20 weeks of pregnancy (92%) or after 20 weeks (96%). Aboriginal and Torres Strait Islander people are more likely than non-Indigenous people and the overall population to abstain from drinking alcohol, including my own 70-year-old mother, who was born and raised on a former Aboriginal Mission and never consumed alcohol in her lifetime.

In remote areas Aboriginal and Torres Strait Islander people are twice as likely to have abstained from alcohol than non-Indigenous people (40.8% compared to 18.6%) and the proportion who exceed guidelines (risky drinking) is similar for both groups (37.5% of Aboriginal and Torres Strait Islander people, compared with 40.6% of non-Indigenous).

The Productivity Commission was charged with monitoring progress of the Agreement’s targets and supporting indicators precisely because it demands the careful and rigorous approach to analysing and contextualising data that we are equipped and qualified to provide.

Closing the Gap is important and getting it right matters for everyone. Fully implementing the priority reforms and accelerating improvements in the lives of Aboriginal and Torres Strait Islander people should be a priority for us all.