The NSW Business Chamber is calling for "urgent water crisis talks" before more jobs and businesses are lost.
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Murray- Riverina regional manager Andrew Cottrill said "water is our most precious commodity" and a review into the Murray Darling Basin Plan needs to happen now.
"Current mismanagement that has allowed over extraction, meter tampering, and over-bank flows is wasting precious and limited resources is leaving regional communities in a much weaker position to deal with drought," he said.
Mr Cottrill said they are calling for an "urgent strategy" on what short-term and long-term solutions are needed to address the water crisis.
"In the short-term, policy makers can't do much apart from sinking more bores and bringing water into communities - the damage from past inaction has been done," he said.
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"Longer-term, decision makers need to do two things: They need to stop wasting water and ensure water usage is balanced and efficient.
"It is also critical for policy makers to put in place long-term infrastructure plans to shore up water security.
"What people don't often appreciate is the fact that the impact of the drought has been made so much worse through widespread water mismanagement and waste.
"That's why we need a thorough review of how we manage water in this country."
Mr Cottrill said the business chamber doesn't advocate scrapping the basin plan or water resourcing plans.
"But it's clear we do need to take a good hard look at them," he said.
"The big question we need to be asking is whether state and federal water plans are irreparably damaging economies and jobs in regional and rural communities.
"These are reasonable questions.
"Obviously, as the drought bites and we head into what is looking to be a hot, dry summer - tensions are going to rise and people are going to get angrier."