The Queensland Aboriginal and Islander Health Council (QAIHC) is calling for immediate reform and genuine partnership with government after an independent review found the National Agreement on Closing the Gap is failing to deliver on its commitments.

Gunggandji woman and QAIHC Chief Executive, Paula Arnol, said the findings confirmed long-held concerns from Aboriginal and Torres Strait Islander communities that governments are falling short of meaningful change.

"Closing the Gap isn't just about policy, it's about improving the health outcomes of our people," Ms Arnol said.

"Without real change on the ground, the unacceptable gap in health outcomes will continue."

The review, led by Aboriginal and Torres Strait Islander experts, support previous assessments including the Productivity Commission's finding that governments are not delivering the Priority Reforms in full and that national progress remains inconsistent.

It also found little evidence of governments making structural changes required under the agreement.

The review highlighted limited understanding of Aboriginal and Torres Strait Islander cultural frameworks and restricted opportunities for communities to influence programs, systems and decision-making.

It said the Priority Reforms must be implemented as an integrated framework, rather than isolated actions, to be effective.

"We are not seeing the change on the ground that was promised," Ms Arnol said.

"Until we see genuine action in the priority reform areas, the way governments engage with our communities will not improve and the gap will not close."

The four reforms include building formal partnerships, strengthening a culturally safe workforce, enabling shared access to data, and transforming government systems to work better for Indigenous people.

Ms Arnol said many agencies had failed to embed these reforms into their day-to-day practices.

"Too many government bodies are still paying lip service to these commitments, without changing how they operate," she said.

"There is an urgent need to shift from a narrow focus on reporting frameworks and bureaucratic processes to practical reform that communities can see and feel."

In response, QAIHC and the Queensland Aboriginal and Torres Strait Islander Child Protection Peak (QATSICPP) are proposing a new direction for how Closing the Gap is delivered in the state.

"There is a real opportunity for Queensland to show leadership by working in genuine partnership with our organisations," Ms Arnol said.

"Both QAIHC and QATSICPP are ready to work with government to refresh the way Closing the Gap is implemented in Queensland.

"We need to move beyond consultation and into shared decision-making, especially in areas like governance reform, investment priorities, and community control."

The proposed reset would include designing new mechanisms which share authority and decision-making power, and ensuring funding supports long-term, community-led models in regional and remote areas.

Ms Arnol also underlined the critical work of the Aboriginal community-controlled health sector.

"Governments must work in genuine partnership with the ACCHO sector," she said.

"We understand our communities, we are trusted by our people, and we deliver comprehensive, culturally safe, high-quality care every day.

"It's time to stop talking about transformational change and start delivering it."

The review was commissioned by the Coalition of Peaks.