A "top-down approach" to decisions that affect Basin communities won't work, the 76th national conference of Murray Darling Association heard on Monday.
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Association national president David Thurley, of Albury, said Basin governments had long-term plans but their success depended on these schemes working together.
"The time for one-off initiatives and random grants is long past, we need co-ordinated solutions to deliver sustainable change with the many small towns spread across this wide brown land," he said while introducing the three-day online program.
Mr Thurley said a transport strategy and high-performing National Broadband Network were just two areas for improvement in the regions.
"We need a revolution in the delivery of education and health care to enable people to live and work in regional towns or else we face capital city gridlock, escalating house prices and poorer social outcomes," he said.
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More than 300 participants registered for the virtual conference Local Leadership: A National Priority, hosted by Greater Shepparton Council.
About 14 association members gathered at Albury Entertainment Centre to watch the proceedings.
Deputy Prime Minister Michael McCormack announced the National Water Grid Advisory Body, which aimed to provide independent advice on water infrastructure to the federal government.
Mr McCormack assured listeners the government would continue to rely on community consultation.
"Yes, people will be able to have a say and they will be able to have input into all those discussions," he said.
Scientist and environmentalist Tim Flannery told the conference "a holistic unified approach to water management" offered the best solution for the Murray-Darling Basin.
"How can we prevent the powerful and wealthy and politically connected few from taking so much water that it disadvantages all, it's a political and social problem," he said.
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Professor Flannery stressed the importance of getting involved to help direct policies and actions.
"It does comes down to the community, to individual people asking their representatives what they think, how will they vote in certain issues," he said.
"Australians should not be voting for people unless we have had the chance to engage with them about their environmental views."