Kate Silburn, Alister Thorpe, Louise Carey, Yola Frank-Gray, Graeme Fletcher, Ken McPhail, and Rumbalara Aboriginal Co-operative Ltd
Aboriginal Community Controlled Health Organisations (ACCHOs) have been operating in Australia since the 1970s. They are governed by community-elected boards, vary in size and scope, and provide access to safe, appropriate and effective services for their communities. There are 27 ACCHOs across Victoria, all of which are members of the Victorian Community Controlled Health Organisation (VACCHO). Victorian ACCHOs range from small organisations with a limited number of core programs to large multi-million-dollar organisations providing an extensive range of health, wellbeing and community services. The latter obtain funding from a range of sources and have complex reporting requirements.
All organisations need to be accountable for their use of public funds. However, there are significant issues with the form of that accountability. In the case of Aboriginal and Torres Strait Islander health services, this has been described as a reporting overburden (Dwyer et al. 2009). To examine this further we make the distinction between procedural and substantial accountability and between horizontal and vertical accountability. Procedural accountability refers to accountability for activity, while substantial accountability refers to accountability for benefit. Vertical accountability tends to be rule bound and imposed by an external stakeholder (such as a funder), while horizontal accountability is enacted through strong mutual ties and relationships.
ACCHOs participate in (at least) two distinct forms of accountability. One is a vertical, formal, procedural and directly observable relationship with funders. The second is an accountability relationship with their communities and includes both formal and informal mechanisms and might be considered to be horizontal in nature.
Getting the balance and direction of accountability right is a crucial part of ensuring that organisations can achieve their objectives. Over-burdensome vertical and procedural forms of accountability can not only use up scarce resources but also impact negatively on organisational capacity to fulfil less formal, trust-based accountability relationships with clients and communities. Our concern is that current funding arrangements result in an over-burdensome amount of procedural accounting that can undermine the efforts of ACCHOs to deliver integrated, safe, comprehensive health and community services.
This paper describes a case study of the compliance and reporting requirements of a large Victorian ACCHO—Rumbalara Aboriginal Co-operative. We demonstrate that on top of the reporting overburden, incredible complexity is introduced when single organisations work across a range of health and community service sectors and consequently have to report in different ways, on different performance criteria, using different databases, for funding from different government programs. The irony is that while ACCHOs aim to build their service delivery capability in order to implement holistic responses to individual and community need, reporting to funders appears to work against this.
1 March 2016