"Change and immediate action" to alleviate pressure on rural basin communities has been called for after last year's extensive, independent information sessions.
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The Independent Assessment of Social and Economic Conditions in the Basin draft report was released by Federal Water Minister Keith Pitt on Monday.
It highlighted mental health, front-line services, trust in government and water reform as top priorities for the Federal Government to address.
The report outlines an array of factors attributing to communities' 'distress'.
These included water reform, drought, fires, compounded by new technology, commodity price swings, and Aussie dollar movements.
In October last year, panel member Bruce Simpson listened to the Griffith and Coleambally communities as part of the invite-only sessions, and said at the time the biggest fear was around 'uncertainty'.
The Panel's report highlights the need for change for struggling communities, and the need to consider the long term opportunities likely to help communities get towards a positive future.
Panel chairwoman Robbie Sefton said the report is the result of listening - to the families, businesses, First Nation's communities and experts who "not only understand the complexity of the Basin's conditions but also recognise the need for a shared vision for change."
"Our role was to listen ... and reconcile those lived experiences with the changing political and environmental landscape," Ms Sefton said.
In the draft report's foreword, Ms Sefton said some communities were 'over-consulted and under-listened to', frustrated at decisions being made for them, their morale 'eroded away'.
Additionally, the Panel sought further evidence based economic and social research projects to fill 'information gaps'.
She says achieving the recommendations will require a "strong partnership" with communities and the government to deliver future outcomes.
It is clear that water reform has benefited some basin communities over the past 15 years and we are not about to strip that away.
- Robbie Sefton
"It is clear that water reform has benefited some basin communities over the past 15 years and we are not about to strip that away."
Yet she said the panel "strongly advocate" the need for flexibility, adaptability and genuine consultation between all groups involved in order to deliver significant and necessary change, "particularly when it comes to water policy and reform."
The Draft Report's release launches a call for submissions to provide insights and feedback on the twenty recommendations.
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"We are asking the Basin community, whether you represent a local farming family, a community group, a First Nations group or a small business in the Basin, to read the Draft Report and the recommendations and submit your thoughts on the findings to date," Ms Sefton explained.
"Now is the time to contribute to help shape and influence the conversation with Government on next steps for the Murray-Darling Basin," she said.
The Final Report will be delivered to Mr Pitt, on April 30.
Community submissions close April 5. To read the report, click here.