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Category: Welfare

17/03/2024

The Australia Card and Data

16 March 2024

The Australia Card debate, which was from 1985-7 was whether we should all carry a card that would link all the information about us.

I was in favour of it because my concerns at that time in occupational health and safety was as to whether exposure to various workplace chemicals had an adverse effect on health.

The best data came from Sweden, where people’s occupation was on a database and their mortalities could be compared. Nowhere else had comparable data.

It seemed to me that the data was going to be collected inevitably and we should have a debate then and there as to who would collect it and what could be done with it.

I was in the Australian Democrats, who were usually quite sensible and given to rational argument, but the view was that people would be safer if the data was not collected at all so they opposed the card and the naysayers won the day in the Party and the nation.

The Credit Reference Association was already collecting data about unpaid bills and there was a debate as to whether the subject of the data, (who was usually only alerted to its existence when they could not get a loan), could have access to their own record to respond with reasons for whatever was on it.

Naturally financial data was of use to the tax office and now buying habits, web-search histories and emails result in changes to the feed of ads on social media.

Now that financial data is collected, the discussion can move on to more socially helpful data. Apparently Facebook can announce a flu epidemic earlier than the public register of viral tests or hospital admissions just from reading the frequency of the words ‘flu or sick’ on the posts.

In life I have progressed from dealing with acute diseases in heroic medicine and intensive care settings to looking at how to do prevention. Prevention is always the poor cousin, because if you spend money on it is hard to show results in the short time frame that accountants and politicians want.

As I moved from medicine to social policy and tried to advocate for ‘preventive social policy’ the situation became even more difficult, despite the well known fact that increasingly social disadvantage gives rise to poorer health outcomes. This is acknowledged with lip service, but the late-stage capitalist growth in inequality powers on regardless.

In 2001 as a NSW MLC I initiated an inquiry into DoCS (Dept of Community Services), which was then called FACS (Family and Community Services), and is now called DCJ (Dept of Communities and Justice). My inquiry showed that the Dept was dysfunctional, which we knew already, and the changes since have not helped much. Initially the problem was that they wanted to concentrate on the children most at risk, which meant still minimal supportive prevention for cases that were not at risk yet. Then the Department became even more defensive and privatised cases, so the kids became a commodity with NGO and ‘for profit’ corporations getting packages to look after kids with problems and then giving them to carer families for about a third of the money that they were given. ‘Management’, it seems, is a very expensive and lucrative business.

Obviously looking after kids whose parents are dysfunctional is a very difficult undertaking. Does one take the child and give it a good foster care family? What is a good foster care family? How much do you support dysfunctional parents? Are the grandparents, who presumably brought up the dysfunctional parents a good bet? Who makes the decision and what appeal mechanisms are there? Presumably all this is rendered ever more difficult by the fact that the gap between rich and poor is rising, there is no longer anywhere near enough public housing, and welfare payments are not really enough to live on.

It seems that the best way to see what policy works is to follow the kids in a lifetime study and see how they turn out. The criticism is that the OOHC (Out of Home Care) system has a hugely higher percentage of kids graduating to juvenile justice and then adult prisons. But data is hard to get as the Department, despite its numerous renamings, will not release the information as it is politically embarrassing. Naturally the privacy of the children is cited, but the data could easily be de-identified as much epidemiological data is.

We need to get data to make better decisions, ones based on facts as far as possible, with transparent assessment procedures with honest assessments of what is happening and a minimum of political or bureaucratic interference. With ‘issues management’ aka PR BS getting more sophisticated all the time, it will be an increasing struggle. The Aust Bureau of Statistics, which tries to produce facts, but can only work with the data it is given and presumably cannot be political in trying to get better data, was significantly defunded by Tony Abbott as part of his war on facts. Meanwhile the private sector hoovers up personal data and a few diehards try to keep using cash.

Ross Gittins, the SMH Economic Editor who generally writes good commonsense in a digestible form and has recently been recognised for his good work, has penned the article below in today’s SMH.

Australia Card anyone?

How the digital world is getting better at measuring us up

Ross Gittins, Economics Editor

SMH March 15, 2024

These days we hear incessantly about “data”. The media is full of reports of new data about this or that, and there’s a new and growing occupation of data analysts and even data scientists. So, what is data, where does it come from, what are people doing with it, and why should I care?

Google “data” and you find it’s “facts and statistics collected together for reference or analysis”. The advent of computers has allowed businesses and governments to record, calculate, play with and store huge amounts of data.

Businesses have data about what goods and services they’re making, buying and selling, importing or exporting, and paying their workers, going back for 30 or 40 years.

Our banks have data about what we earn and what we spend it on, especially when we use a credit or debit card – or our phone – to pay for something.

Much of this data is required to be supplied to government agencies. If you ever go onto the Australia Taxation Office’s website to do your annual tax return, it will offer to “pre-fill” your return with stuff it already knows about your income from wages, bank interest and dividends.

Try it sometime. You’ll be amazed by how much the taxman knows and how accurate his data are.

Another dimension of the “information revolution” is how advances in international telecommunications – including via satellites – have allowed us to be in touch with people and institutions around the world in real-time via email and the web – news, entertainment, social media, whatever.

Last month, the Australian Statistician – aka the boss of the Australian Bureau of Statistics – Dr David Gruen, gave a speech outlining some of the ways these huge banks of “big data” about the economic activities of the nation’s businesses, workers, consumers and governments can be used to improve the way we measure the economy in all its aspects: employment, inflation, gross domestic product and the rest.

We’re getting more information and more accurate information, and we’re getting it much sooner than we used to. But we’re still in the early days of exploiting this opportunity to be better informed about what’s happening in the economy and to have better information to guide the government’s decisions about its policies to improve the economy’s performance.

Gruen starts by describing the Tax Office’s “single-touch” payroll system, software that automatically receives information about employees’ payments every time an employer runs its payroll program.

Not all employers have the software, but those who do account for more than 10 million of our 14 million employees.

Gruen says the arrival of the pandemic in early 2020 made access to this “rich vein of near real-time information” an urgent priority. The taxman pulled out the stops, and the stats bureau began receiving these data in early April 2020.

With a virus spreading through the land and governments ordering lockdowns and border closures, they couldn’t afford to wait a month or more to find out what was happening in the economy. Thus, the whole project of using big data to help measure the economy received an enormous kick along – here and in all the other rich economies.

So, in addition to the longstanding monthly sample survey of the labour force, we now have a new publication: Weekly Payroll Jobs and Wages Australia. These data allowed the “econocrats”—and the rest of us—to chart the dramatic collapse in jobs across the economy over the three weeks from mid-March 2020.

They show employment in the accommodation and food services industry falling by more than a quarter in just three weeks. Employment in the arts and recreation services industry fell by almost 20 per cent. By contrast, falls in utilities and education and training were minor.

The monthly labour force survey has a sample size of about 50,000 people, compared with the payroll program’s 10 million-plus people, meaning it provides information on far more dimensions of the workforce than the old way does.

So, the bureau’s access to payroll data taught it new ways of doing things. And the pandemic increased econocrats’ appetite for more info about the economy that was available in real-time.

With household consumption – consumer spending – accounting for about half of gross domestic product, improving the timeliness and detail of the data was a great idea.

So, in February 2022, the bureau released the first monthly household spending indicator using (note this) aggregated and de-identified data on credit and debit card transactions supplied by the major banks. This indicator provides two-thirds coverage of household consumption, compared with the less than one-third coverage provided by the usual survey of retail trade.

The bureau has also begun publishing a monthly consumer price index in addition to the usual quarterly index. This is possible because big data – in the form of data from scanners at checkout counters and data scraped from the websites of supermarket chains – is much cheaper to gather than the old way.

The bureau has also started integrating different but related sets of big data from several sources, so analysts can study the behaviour of individual consumers or businesses. It has developed two large integrated data assets.

The one for individuals links families and households with data sets on income and taxation, social support, education, health, migrants and disability.

The one for businesses links them with a host of surveys of aspects of business activity, income and taxation, overseas trade, intellectual property and insolvency.

The purpose is to allow analysts from government departments, universities or think tanks to shed light on policy problems from multiple dimensions.

For instance, one study showed that people over 65 who’d had their third COVID vaccination within the previous three months were 93 per cent less likely to die from the virus than an unvaccinated person. But that’s just the tiniest example of what we’ll be able to find out.

16/02/2024

‘Health Policy’

Chesterfield-Evans, A. (2024)

Journal of Australian Political Economy No. 92, pp. 98-105.

HEALTH POLICY
Arthur Chesterfield-Evans

Just before the 2022 federal election, Mark Butler, now the Minister for
Health in the Albanese government, spoke to the National Press Club,
praising the courage of the Hawke government in creating Medicare in
1984. His speech also set modest priorities for a prospective Labor
government, committing to (1) improve the digital health record and make
the MyHealth record actually useful; (2) develop multidisciplinary care;
(3) establish a new funding model for ‘MyMedicare’; and (4) grow the
medical workforce, with special mention of nurses and pharmacists (Butler
2022). Significantly, Butler did not commit afresh to Medicare as a
universal health scheme free at the point of delivery, the key element of
the original 1984 scheme that he praised. In an environment where,
politically, it seems that taxes cannot be increased, perhaps this ideal may
be an impossibility, but it is surely significant that it is no longer stated as
an aspiration.
Currently, Medicare is quietly dying as the low rebates cause doctors to
abandon it. Australia is moving to a US-type private system by
default. This has resulted in large amounts of hand-wringing rhetoric, but
so far little action. This short article comments on the changes initiated by
the current Labor government during its first year and a half, contrasting
these with the deep-seated problems needing to be addressed if better
health outcomes are to be achieved.
Labor’s reforms
The government has made some minor changes to Medicare which came
in with great fanfare on November 1, 2023. There were new item numbers

for new specialist technologies or treatments and an increased Medicare
rebate for GPs, up to $41.40 for a standard visit for a RACGP member,
which is 40.6% of the AMA fee. Doctors without the RACGP qualification
still get $21, which is 20.6% of the $102 AMA fee.
When Medicare was born, the Medicare rebate was 85% of the AMA fee.
The rebate has risen at half the inflation rate for 39 years, so doctors now
feel ripped off every time they see a Medicare patient. Labor blames the
disparity on the rebate freezes of the previous LNP Coalition governments,
but its own record is poor. Successive governments of all types have
deferred to the private health lobby and are starving Medicare, slowly
defaulting towards a principally private system, as in the USA. This is a
deeply-troubling prospect because the US health system has been
recurrently criticised (Commonwealth Fund 2021) – and rightly so –
because it makes access to health care dependent on ability to pay. Notably,
however, it is the world’s best system at turning sickness into money.
The other recent Labor ‘reform’ was to allow pharmacists to process
prescribed medications to cover patients’ requirements for 60 days, rather
than 30 days, thereby halving the costs of prescribing and dispensing.
While this may seem helpful, patients are often confused by complicated
generic names and generic brands; and compliance or discontinuation of
medicines is a largely unquantified problem. These are existing problems
with the current arrangements for dispensing medications: the recent
policy change, while well-intentioned, does not redress them. It transfers
resources from professional staff to the pharmaceutical industry.
The ‘Strengthening Medicare Taskforce’ had good medical and allied
health representatives and support. Its December 2022 report defined the
problems but, trying to avoid controversy, positive suggestions were thin
on the ground. A deeper analysis and more comprehensive approach to the
redress of health issues is needed.
Basic problems in the health system
Diverse funding sources causes cost-shifting
Fundamentally, no-one is in overall control of the health system. It has a
number of different funding sources: the Federal and State governments,
the Private Health Insurance industry (PHI), Medicare and individuals

themselves. Workers Compensation (WC) and Compulsory Third Party
(CTP) insurers also put in a bit. These arrangements lead to a situation
where each funding entity attempts to shift costs without any real care for
the overall cost of the system. Private entities such as pathology and
radiology also have an interest in providing more services, whether they
are needed or not.
The broad division of the health system is that public hospitals and
emergency departments (EDs) are State-funded, and non-hospital services
are Federally, PHI or self (patient) funded. There is some overlap,
however, because the State’s provision of some community-based services
allows them to save on hospital-bed days; and private funds paid to State
hospital in-patients are eagerly sought. The starvation of Medicare (which
reduces the Federal government’s spending) has resulted in more patients
going to EDs at higher (State) cost, as well as increasing PHI and patient
costs.
This cost-shifting has evident implications for the affordability of health
care: notably, a recent study showed that Australia, when compared to 10
other countries, scored poorly on its measure of affordability
(Commonwealth Fund 2021).

A new health paradigm is needed
Yet more fundamentally, there is a huge problem with the conceptual
model of the health system. In common parlance, the ‘health system’ is the
‘paying to treat illness’ system. Paying doctors to see and treat patients is
seen as the major cost and is the most politically fraught element in the
system.
Historically, everyone was assumed to be healthy and had episodes of
either infectious diseases or surgical problems. They went into a hospital
for a brief period and either recovered or died. The legacy of this is that
heroic interventions are over-resourced and the more cost-effective early
interventions are under-resourced.
Infectious disease is now relatively uncommon, notwithstanding the recent
and ongoing coronavirus concerns. Most disease is chronic; and the
objective is to maintain health for as long as possible and to support those
who need support in the community rather than in institutions. ‘Health’
must be re-defined as a state of physical and mental wellbeing; and
maintaining it as ‘demand management’ for the treatment system.

Life-style diseases of diet, obesity, smoking, vaping, alcohol, drug-use and
lack of exercise need attention. It might be commented that these habits
are more determined by the political economy of the products than by any
health considerations; and the government should intervene to re-balance
this market failure.

Hierarchies, cartels and corporatisation
The medical system is hierarchical with specialists at the top and GPs at
the bottom. The specialist colleges have produced less practitioners than
would have been optimal. The starvation of General Practice has led to
increasing specialist referrals for simple procedures. Most patients are
happy to go along with this, though often much less happy about the rising
costs. Practitioners tend to work down to their station rather than up to
their capacity. GPs, if given the appropriate additional education and
empowered to act, could do what quite a lot of specialists do now, while
nurses could take the load from GPs; and, in terms of home support, a more
comprehensive and flexible workforce needs to be developed.
Private medical insurance systems are a further source of problems. They
have marketing, churn, profits, liability and fraud issues; and they make it
necessary to account for every item of every procedure. While the
corporations watch every cost, the regulator cannot. Corporations buy
medical practices and take up to 55% of the gross revenue. Smaller
radiology practices are being gobbled up as investments (Cranston 2020).
If overheads are defined as the amount of money put in compared to the
amount paid for treatments, Medicare costs about 5% and PHIs, as they
are regulated in Australia, about 12%. In the USA, the private health funds
take up to 35%, and Australia’s CTP system got close to 50%. A universal
health insurance system could avoid many of these costs and would be far
superior from a social equity point of view.
Similar problems are evident in the provision of care for people with
disabilities. Labor pioneered the NDIS when last in office a decade ago,
and rightly claims this as evidence of its commitment to redress the
previous neglect. However, the NDIS can be considered as a privatisation
of the welfare system. It overlaps medical system functions and is poorly
regulated. If its efficiency is judged by the percentage of money put in that
is paid to the actual workers delivering the service, care is not very

efficient. There have also been significant criminal rip-offs (Galloway
2023).
Retirement care arrangements have major flaws too. Aged-care
accommodation is largely driven by the real estate industry; and access to
continuing care is an add-on of often dubious quality.

What should the government do?
The problems described above are diverse, deep-seated and not easily
rectified. However, a government intent on staying in office for a series of
terms could heed the call for some big thinking, drawing on the experience
of health practitioners themselves. Here is a list of what might be done,
becoming more medical and more politically difficult as it progresses:
• Keep people healthy with education, clean water, sanitation, housing,
good food, regular exercise, high vaccination rates, road safety,
universal swimming lessons, CPR and first aid training and the active
discouragement of smoking, vaping, alcohol and drug use, junk food
and gambling.
• Provide housing with graded community support options for those
people with disadvantage or impairment. Create a registration and
insurance system for home and community support services, so that
individuals can buy standardised services from other individuals.
• Maintain fixed staff-patient ratios related to the disability
classification of residents in institutional care.
• Make maximum use of community and school interventions and
support services such as District and Community nurses and School
nurses, mental health support networks, Aged Care Assessment
Teams, Hospitals in the Home etc.
• Address health problems as early and as low down the support and
treatment hierarchy as possible, by empowering those who provide
the services.
• Create a meaningful regulatory, inspection and enforcement system
for support services, both community and residential, and for
workplaces and recreational facilities.
• Use the medical information system to research drug and treatment
effectiveness.

• Support General Practitioners and try to increase their ability to solve
problems without referral. Have GPs work in Health Centres with
community support workers as far as possible; and improve
communication with data collection a by-product of normal work, not
an additional imposition.
• Have independent evaluation of the numbers needed in the specialties
and pressure the colleges to provide these numbers. Use waiting times
as an initial index.
• Initiate either university-based or college-based continuing medical or
professional education, with mandatory refresher exams every
decade.
• Have universal professional indemnity insurance, with doctors and
other health professionals unable to be sued if they report all incidents
of sub-optimal outcomes within 48 hours of becoming aware of them,
and participate in regular quality control meetings.
• Publicise and promote organ donation, end of life plans, wills and
enduring powers of attorney as sensible steps in life-management.
• Evaluate Intensive Care interventions in QALY (Quality-Adjusted
Life Years) terms, researching their outcomes and comparing them to
earlier intervention initiatives.
• Change the composition of the Pharmaceutical Benefits Advisory
Committee so that it has no pharmaceutical industry representative on
it; and remove ministerial discretion from its decisions. The previous
system evaluated new drug listing approvals with a cost-benefit
analysis (Doran et al. 2008), but the Howard reforms of 2007,
following the Australia-US Free Trade Agreement and lobbying by
Pfizer, put a drug industry representative on this committee, making
its negotiations more transparent and thus more difficult for the PBS
to negotiate prices (Access to Medicine Working Group 2007).
• Work towards replacing Workers Compensation and CTP insurance
schemes with income guarantee schemes (this will only be possible
when Medicare allows timely treatment).
• Create a credible and indexed scheme for paying medical
professionals which does not have KPIs that distort performance.

• Make Medicare a universal taxpayer funded health system that is free
at the point of delivery and stop subsidising PHI. It might be noted
that the Government currently quotes Medicare and PHI costs
together as a sum rather than itemising the two, which serves to
disguise the subsidy to PHI (Parliament of Australia 2022).

Conclusion
The current federal Labor government has made statements about health
policy reform and done minor tinkering during the first year and a half in
office. Based on this start, it is doubtful that it will have the courage to
make the necessary major changes, addressing the systemic problems.
Fine rhetoric is unlikely to achieve much. That makes it doubly important
to develop proposals for more fundamental reform. Written with this
intention, the suggestions made in this article could be the basis for
tackling the fundamental institutional and political economic issues
problems associated with personal and societal ill-health.
Dr Arthur Chesterfield-Evans trained as a surgeon in Sydney and the UK
and is a Fellow of the Royal College of Surgeons. He currently works as a
GP with interests in workers’ compensation and third-party injury. He has
been a tobacco activist and an elected member of the upper house of the
NSW Parliament. He has Master’s degrees in Occupational Health and in
Political Economy.
chesterfieldevans@gmail.com

References
Butler, M. (2022) ‘Address to National Press Club, 2 May,’ available:
www.health.gov.au/ministers/the-hon-mark-butler-mp/media/minister-for-health-and-aged-
care-speech-national-press-club-2-may-2023.
Commonwealth Fund (2021) US Report, available:
www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-
reflecting-poorly.
Cranston, M. (2020) ‘Radiology enjoys a post-virus buying boom’, Australian Financial
Review, available: www.afr.com/policy/economy/radiology-enjoys-a-post-virus-buying-
boom-20201106-p56c7k.

Doran, E., Henry, D., Faunce, T.A. and Searles, A. (2008) ‘Australian pharmaceuticals policy
and the idea of innovation’, Journal of Australian Political Economy, 62, pp. 39-60.
Galloway, A. (2023) ‘Federal crime syndicates using cash vouchers and gifts to steal NDIS
funds’, The Sydney Morning Herald, available: www.smh.com.au/politics/federal/criminal-
syndicates-using-cash-vouchers-and-gifts-to-steal-ndis-funds-20230414-p5d0ma.html.
Parliamentary Library (2022) Health overview, available:
www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/p
ubs/rp/BudgetReview202223/HealthOverview.
PBS (2007) ‘Access to medicines working group’, available: www.pbs.gov.au/info Access to
Medicines /general/working-groups/amwg/amwg-jul-2007.
Sax, S. (1984) A Strife of Interests: Politics and Policies in Australian Health Services,
Sydney: George Allen and Unwin.
Searles, A., Jefferys, S., Doran, E. and Henry D.A. (2007) ‘Reference pricing, generic drugs
and proposed changes to the Pharmaceutical Benefits Scheme’, Medical Journal of Australia,
187(4), pp. 236-39.
Strengthening Medicare Taskforce (2022) Taskforce Report, Commonwealth Department of
Health, available: www.health.gov.au/sites/default/files/2023-02/strengthening-medicare-taskforce-report_0.pdf.

23/11/2023

Apartheid Education Buses

23 November 2023

I live near a turning circle in a good area of Sydney. There is a Bus Stop there and the government bus there has an ad with a picture of a forlorn looking schoolgirl saying that she cannot have a decent education, so would I donate to The Smith Family so she can.

As the ad displays there, 8 shiny new buses take private school children from the turning circle to 8 different private schools.

It seems that our governments are happy to subsidise ‘choice’ so that they do not have to fund a fair go and we are happy to tolerate an apartheid education system.

www.theguardian.com/australia-news/2023/nov/23/australia-100-wealthiest-schools-earnings-income-data-education-department?utm_term=655e79e42ab1fedfc11542549409ff2e&utm_campaign=AustralianPolitics&utm_source=esp&utm_medium=Email&CMP=aupolitics_email

17/11/2023

Loneliness is a Major Public Health Issue

17 November 2023

The World Health Organisation (WHO) has declared that loneliness is a major public health issue. The COVID isolation worsened the situation, but at least drew attention to it. Declining family size, the stress on the individual, and the ability to live alone have worsened the long-term trend to loneliness.

The Japanese have recognised this for some time, but have not mastered the problem. In Australia it seems only to get attention when some old person is discovered dead for months when the smell emanates from their flat or their electricity is cut off. In the younger age groups, suicide may be the first and last sign.

From a medical point of view, I have quite a lot of patients that have long-term painful problems that cannot be resolved and render them unable to work. They are often financially embarrassed also, a fact that they often try to hide. They are recognised as depressed but people are reluctant to acknowledge that medications do not help much. This week I had a patient who asked if the insurer would pay for a companion dog, as he could not really afford to feed it. We discussed dog sources and sizes. My guess is that workers compensation insurers will be willing to pay for tablets that don’t work as they are a ‘medical expense’, but not a little dog that may be a more practical solution.

An article in the Guardian surprised me that loneliness is a bigger problem in Africa than in Western countries. I had assumed that the strong family ties and interdependency would make it a worse problem in Western rather than African societies.

What is needed is governments to recognise that there is a value in the relationships between people. It used to be called ‘social capital’, but the term seems to have fallen out of favour. We could encourage ‘Meet Your Neighbour Day’, street Christmas parties and other activities that encourage interpersonal contact beyond the social media apps. Both civic and domestic architecture could give more thought to encouraging human to human contact.

www.theguardian.com/global-development/2023/nov/16/who-declares-loneliness-a-global-public-health-concern

03/12/2022

Children in Care- a Brief History

3 December 2022

One summer evening when I was still a medical student, I was strolling with friends through a festival with stalls and lights in Hyde Park. A young woman approached me and said “I’m a ‘Hookah for Christ, will you come with me?”, and handed me a leaflet. She was a few years younger than I and one of the most stunningly beautiful women I have ever seen. I paused, somewhat shocked, and wondered how much Christ and how much hookah was in this Goddess incarnate and whether I should follow her path to enlightenment. My girlfriend reappeared at this point and was very definitely of the opinion that I should not.

Some years later, in 1992, I had further cause to rue this ignorance as DoCS (Department of Community Services) were involved in a court case with a sect called the ‘Children of God’, who, it was alleged, had used young girls sexually to recruit members for their cult. The sect maintained that the term ‘Hookahs for Christ’ was merely a rhetorical device. The sect had expensive lawyers and won the case , though there was considerable public doubt about the freedom of cult members. DoCs was highly criticised over the case and the Premier, Nick Greiner, cut huge number from its middle management.

Neo-liberalism was new at that time, and his slogan was ‘Putting people first by managing Better’, which was in itself reflected an attitude of the time that managers knew better than those who actually did the work. A contemporary management slogan was ‘If it ain’t broke, don’t fix it’, which tended to translate into ’Don’t spend any money on prevention, as it might not break’. Money spent supporting families has trouble showing big returns on management KPIs. The NSW Public Service was being massively downsized and there are some of the view that DoCS has never recovered from this downsizing, as human organisations rely on human knowledge and if there are just generic managers and new recruits, there is not enough corporate memory and experience to handle cases.

In 1999 when I was in Parliament, I was approached by a number of people telling me that DoCS was failing children at risk. The children with dysfunctional families from drug abuse, alcohol or domestic violence were not getting home support, and the initiation and supervision of fostering arrangements were poorly executed. I tried to set up an inquiry into DoCS. I had a number of NGOs speak to the cross bench. I had to get enough numbers so that there was a majority in the upper house. One of the groups suggested that the UN treaty on the Rights of the Child be a term of reference. This seemed reasonable, but Fred Nile said that he and Elaine would not vote for the inquiry if this was in the terms of reference. Richard Jones said he would not if it was omitted. I needed both of their votes to be sure of the numbers. I thought Richard would fold if I left it out- I was pretty sure Fred Nile wouldn’t. The Liberals, who were in Opposition at the time, were generally up for anything that would embarrass the Labor Government. I asked if they would support it, and told them that if Richard Jones changed, we had the numbers. They said, “We are a serious political party. If you cannot guarantee the numbers, we will not support you”. I regretted telling them about Richard and I did not move the motion. 21 months later the Liberals decided to support the idea, and approached me to amend my motion slightly, which initiated an inquiry (10/4/2002) .

The 2003 Inquiry found that DoCS was indeed dysfunctional . It had contracted out quite a lot of work to charitable NGOs without them having either the funds or the expertise to deal with difficult cases. Huge resources were spent monitoring wayward adolescents to keep them out of the criminal justice system until they reached 16, after which DoCS were not legally responsible for them. Cases did not have much preventive work done or decisions made and tended to stay on the desks of managers ‘unallocated’ until there was a problem . When there was a crisis or the matter went to Court, a relatively junior DoCS person would be allocated the case and have to face a crisis situation. The plans given to the Children’s Court for approval were hastily cobbled together at the last minute, often by new case managers who had only just got the brief. The Government had introduced ‘mandatory reporting’ with a phone and fax Helpline. This meant that there were huge numbers of reports, and huge efforts dealing with multiple reports on the same child or situation, but the call centre gobbled up resources that would have been better spent actually managing cases. The government was reluctant to get rid of the mandatory reporting ’Helpline’ as it was supposed to force schoolteachers etc. into reporting cases, which would leave no stone unturned. The function of DoCS seemed more concerned with appearances than reality and it got a lot of negative press.

Behind all this was the Children’s Court, where the conscientious Senior Magistrate, Scott Mitchell, was about the only quality control on the Department as he insisted in fulfilling his legislated role of ensuring that there was a realistic plan for children placed into custody of relatives or foster homes.

The Minister for Community Services, Fay Lo Po was sacked as was the head of DoCS, Carmel Niland. Neil Shepherd, who had been Deputy Director of the Cabinet Office and Health of the EPA replaced Niland. The Labor government promised a billion dollars over 10 years (most towards the end of the 10 years). Prevention was addressed with a new program, Brighter Futures, but the key problems remained with lack of action on 21% of cases noted by the Helpline, so there was another Special Commission into Child Protection Services in NSW in 2008 by Justice Wood , (who had achieved fame because of his work on Police corruption and paedophiles in 1997 ). Wood was helped by DoCS officers and one of their complaints was the stress that the Children’s Court put them under when they had to front up to Scott Mitchell with their child management plans. The report recommended weakening the power of the Children’s Court, and Scott Mitchell was disposed of by appointing a new President of the Children’s Court, who was to be a Judge- a level higher than Mitchell, who would have had to apply for the promotion that he was not going to get. On 1/9/2009 Attorney-General John Hatzistergos appointed Judge Mark Marien the new President , claiming he was strengthening the Court as he expanded on the new Judge’s CV, which lacked anything relating to child welfare.

An academic researcher, Katherine Macfarlane, noted that even in 2015 there was no data collected on how many Australian children in Out of Home Care ended up in the criminal justice system. She termed it ‘Care Criminalisation’ and noted that this data is collected in other jurisdictions .

It would seem that DoCs, which had a name change to Dept. of Family and Community Services (FACS) and then in 2019 came to be part of the Dept. Communities and Justice, still has its problems .

A report in the Sydney Morning Herald on 28/11/22 noted that a private contractor, Lifestyle Solutions, had subcontracted a child’s care to another subcontractor, Connecting Families and the children in question could not go to school as they were too cold without a winter uniform, despite the payment of $77,000 per month to the contractors to look after them . The Office of the Children’s Guardian has not accredited the Dept of Community and Justice Western NSW District to look after the 547 children in its care as it did not ‘meet the requirements‘ in the frequency of visits and that it had ‘limited evidence to demonstrate the district’s support for children’, its record-keeping was inconsistent, and its work in keeping in touch with families came in for questioning .

The Department has never been run properly. One of my minders in Parliament had worked there and spoke of the immense stress of going to Court almost unbriefed or accompanying Police to take children from the parents to foster homes. One of my patients who is an upper-middle level case manager has been off work on stress for 14 years, with no serious effort made to rehabilitate her.

But when there is no public housing, rents are unaffordable, welfare payments are insufficient to survive on, day care is expensive, Aboriginals are becoming increasingly isolated from both mainstream Australia and their own community leaders, ‘choice’ and subsidies have left poorer public schools as ghettos of disadvantage, inflation is rising and services are now for profit, it is hardly surprising that things are not going well. Anyone trying to put together a stable social situation for a disadvantaged family would struggle without these basic elements.

Society’s systemic problems need to be addressed if we are to return to the halcyon Aussie concept of a fair go.

https://www.smh.com.au/national/nsw/left-hungry-and-too-cold-to-go-to-school-urgent-review-of-children-in-care-20221127-p5c1kr.html

27/11/2022

Robodebt- an ongoing saga

25 November 2022

Robodebt involved looking at the tax records of welfare recipients over a year, and then demanding money back from them over their year’s income. The Social Services Act specified that their income should be calculated fortnightly. Many people, particularly unemployed and disadvantaged ones, live from week to week, and don’t keep good records for tax purposes, as mostly they do not have enough income to pay tax, or the tax is already deducted from their income before they get it. So when a computer algorithm stated that they owned money to the Taxation Dept. and they had to prove that they did not, they were in no position to dispute this and the money was automatically taken from their already meagre welfare payments.

It seems that a number of public servants told the government that the process was neither wise nor legal, but it went ahead anyway.

This was in sharp contrast to the JobKeeper scheme, where businesses could estimate the costs of keeping their staff and be reimbursed. The JobKeeper legislation was modelled on New Zealand legislation, which had ‘claw-back’ provisions if businesses were overpaid. So the government did not ‘forget’ the claw-back provisions, they actively deleted them from the template.

It is difficult to see these actions as anything other than an ideological, punitive approach to people on welfare combined with a willingness to overpay those were approved of. It is difficult to see the Morrison government except in the light of rewarding friends and punishing people that were not approved of. The exemption of university academics and the performing arts from JobKeeper is further evidence of this proposition.

Since one of the significant public servants has now died, it may be that there will be no answer as to who is responsible for the Robodebt fiasco, but this maladministration has immense consequences for those denied income, with a number of suicides linked to the stress.

We can only hope that our arcane legal system will find a crime was committed and that someone will be charged and found guilty. What is more likely is that there will be shared responsibility, ministerial discretion, people in charge protesting their unawareness of the effect of the algorithm, a few embarrassing moments for a few people and nothing substantial happening. I hope I am wrong.

Here is part of the legal saga so far, as told by an ex-public servant.

Robodebt: can you recall a greater failure of public administration?

19/11/2022

The Myth of Liberal Competence-1

19 November 2022

One of the enduring myths of politics is that conservatives are better money managers. This is the case in the US, where the Republicans, who enthusiastically dismantle government programs that help poor people and the UK Conservatries who do the same. And it is the case here with the Liberals.

Perhaps the logic is that since they are rich, they must be better with money. But I wonder at the influence of Christianity. The key message is that you must suffer to be redeemed. Suffering is worthy and will later be rewarded. This seems to play into notions that the country will benefit if we all suffer now, ‘we’ in this case being those more dependent on welfare, or those at the bottom of the heap.

The other overarching fact in a market economy the more wealthy people can set the prices, which effectively means they set their incomes. At the bottom of the social pyramid, those at the bottom compete for the jobs and wages set by others. In short, the rich get richer and the poor get poorer. The game ‘Monopoly’ was designed to illustrate this. People play Monopoly, and when they win or lose, they stop the game and go on with life. But what is the game were real and never ended? The losers would get poorer and poorer until they had nothing else to give. That arguably is what a market economy will do without some intervention from an outside force, like a government, to intervene in the cause of those going backward.

Arguably the world’s leading economist is Thomas Piketty. He is a Frenchman who, as he rose, was offered a post in Harvard. He did not take it, opining that economics in the US was theoretical and not based on hard data, as a science should be. Records of national income and death duties going back for 400 years in 4 countries had been put together and he analysed it. His book, ‘Capitalism in the 21^st Century’ is a towering work. It is long, but it is very well-structured with concise conclusions at the beginning and the proof in the later chapters for those who want to read more. He observed that the wages of the population go up at the inflation rate, and the income of the rich who loaned money go up at the interest rate, but the interest rate was always higher than the inflation rate, otherwise there would be no profit in lending. So the income of the rich would always go up faster than the rest of the population, so social inequality would increase in the absence of other interference.

It has always been known that money goes round, and to stimulate the economy people have to spend more. But Piketty points out that poor people spend a greater percentage of their money than rich people. Very poor people spend all the money they have, rich people save about a third. So if you want to stimulate an economy, you should give money to poor people. This is of course not what conservative governments do. They give money to infrastructure, which these days means big private contractors or have industry assistance packages. But these initiatives are giving money to the rich, on the assumption that it will generate more jobs in the long term than the extra consumption would have generated.

(You might ask why Piketty has not got a Nobel Prize for being the first economist to use real data over centuries and come to such a profound conclusion. If you did ask that you might wonder if the Nobel prize economics committee are all neo-liberal economists and you might be right).

The point is without government intervention, the rich will get richer and the poor will get poorer. The best way to minimise this is to have as much shared wealth as possible in the form of park and public facilities, such as transport, health, education and essential services that blunt the significance of income disparities, as a base-line is set without it having the stigma of charity.

But conservative governments, like the Nobel committee want to ignore Piketty and the obvious facts as they do not suit their ideological agenda. A cynic would say that the ideological agenda from right wing ‘think tanks is merely an endless list of convenient reasons to keep the money flowing to the top end of town, to lessen government ‘interference’ which might act for fairness, and to commodify everything such as housing, transport and education so they can become profitable, increase inequality and profit those at the top. How can this agenda ever be considered the foundation of good financial management?

But as Treasurer, Morrison was not even clever in his management of his own revenue. Here is a tale of how his GST deal with Western Australia was out by a factor of almost 10 times over 3 years. Yet the legacy of this shambles is contracts and deal that other have to grapple with.

One of the modest contributions that I am seeking to make to political discourse is to sheet home the blame for failures to the people responsible for them. Here is a start, from the SMH:

Cost of Morrison’s WA GST deal blows out by $20 billion as debt hits record high

By Shane Wright SMH November 14, 2022 — 5.00am

A deal put in place to placate Western Australia when its share of GST revenue was tumbling is on track to cost the nation’s taxpayers 10 times more than originally forecast, helping drive up federal government debt and interest payments to record levels.

Pulled together by then-treasurer Scott Morrison in 2018 before being put through parliament by his successor, Josh Frydenberg, the deal that was originally expected to cost $2.3 billion is now on track to cost more than $24 billion.

WA, which delivered four seats to Labor at the May election on the back of a 10.6 per cent swing, is vowing to fight to keep the arrangement, due to expire in 2026-27.

Morrison struck the deal at a time WA’s share of the tax pool had fallen to an all-time low of 30 cents for every dollar of GST raised within the state. Its iron ore royalties were effectively being redistributed among the other states and territories based on a Commonwealth Grants Commission formula that takes into account each state’s revenue sources and expenses.

Under Morrison’s deal, from 2022-23 WA must receive a minimum of 70 cents in the dollar before increasing to 75 cents in 2024-25. When the policy was put in place, it was expected iron ore prices would fall and WA’s share of the GST pool would therefore rise. Instead, prices have soared.

The Morrison government ensured other states and territories wouldn’t be worse off, which requires the top-up funding for the deal to come from outside the $82.5 billion GST pool.

It was originally forecast to cost federal taxpayers $2.3 billion over three years, including just $293 million in 2021-22, but the surge in iron ore prices has meant more top-ups and for longer.

The October budget revealed that last year, the deal cost $2.1 billion and is forecast to jump to $4.2 billion this financial year. By 2025-26, the cost of the entire deal is on track to reach $22.5 billion, with another $2-3 billion likely the year after that.

Throughout the entire period, the budget is expected to be in deficit, forcing the extra cash to be borrowed. In percentage terms, the blowout in cost is larger than the NDIS, aged care, health or defence.

Independent economist Chris Richardson said the deal had been ill-conceived from the beginning with the cost to be borne by future taxpayers.

He said all significant spending programs needed to be properly assessed, including the GST deal.

“Yes, the politics of it are difficult. But we have a whole host of other issues, like the NDIS, and the economics of them have to be dealt with,” he said.

Any change to the GST deal would create enormous political problems in WA which is likely to gain more political power with an additional seat in a looming federal electorate redistribution.

WA Premier and Treasurer Mark McGowan, who reported a $5.6 billion budget surplus for the 2021-22 financial year, told this masthead he expected the GST deal to remain.

“I have made it very clear that West Australians will not accept any changes to the GST distribution,” he said.

“Those on the east coast who are demanding WA lose out still do not realise that under the reforms, WA will receive 70 per cent of its population share of the GST next financial year. In complete contrast, no other state has ever received a share of the GST lower than 83 per cent.

“WA will continue to subsidise all the other states into the future under this arrangement. No state has lost a dollar under these reforms.”

The extra borrowing for the GST deal has contributed to the lift in gross debt, which on Friday reached a record $909.4 billion.

Ahead of the COVID-pandemic, gross debt was expected to reach $576 billion this financial year. Instead, it is now forecast to reach $927 billion before reaching $1 trillion in 2023-24.

Treasurer Jim Chalmers said the cost of servicing the debt was getting more expensive and was now the budget’s fastest-growing expense.

“We’ve made good progress in a very short space of time. We’ve found $22 billion in savings and kept real spending growth flat across the forward estimates,” he said.

“[But] it will take more than one budget and more than one term of government to make up for a decade of missed opportunities and messed-up priorities.”

15/11/2022

Submission to Inquiry into Online Gambling

11 November 2022

Dr Arthur Chesterfield-Evans

The Internet Problem

The issue of online Gambling is similar to many problems in that online gambling involves an area of activity that is largely beyond the direct control of the Australian Parliaments, or indeed any single Parliament. The internet was designed to be anarchic, and so it is.

Programs to deal with gambling regulation are thus ineffective, but the limited terms of reference of this inquiry suggests that governments are not thinking in terms of what they can do at a systemic and global level and are turning instead to a focus on the individual.

Need for an Industry focus rather than an Individual Focus

It must be noted that where creating public health problems benefits an Industry, the response must be against that Industry. Concentrating on individuals while the Industry markets to the world is a very inefficient strategy. To use a historical example, the Tobacco Industry marketed with ubiquitous ads, sponsorships, product placements and many other techniques, yet wanted medical professionals and school education to be the only techniques used against them, framing the issue as personal choice (and responsibility) and ‘smokers v. non-smokers’ requiring courtesy (and no criticism and restrictions).

This is the situation that the Gambling Industry is in now. They demand to be able to market to the world, but want all harm minimisation programs directed at individuals. They know that this is a winning strategy for them.

What the Federal Government Can Do

While it is true that the Australian Federal government has no effective jurisdiction over the internet, and does not licence or control the Hotels, Clubs and Casinos with their poker machines, it has control over Australian media advertising laws and also allocates grants to States. The Federal government could ban all Gambling advertising on electronic media in Australia, and lessen grants to States in proportion to their revenue from Gambling. This would stop the States getting any benefit from gambling revenue, which they rely on quite highly. Western Australia, which is missing out on Gambling revenue would certainly support this.

The ban on tobacco advertising and sponsorship has set a precedent for action on public health issues, and there was censorship of certain opinions that were antithetical to a national COVID strategy, so the idea of a ban on Gambling advertising is not new or radical. VicHealth also replaced tobacco advertising with ads for healthy lifestyles and anti-Gambling advertising could replace ads for Gambling. The protest group, BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions) in the 1980s used satire of tobacco advertising to sharpen the focus on the Tobacco Industry’s absurd imagery and callous disregard for the lives of their customers. They won hearts for their Robin Hood approach to the entrenched power of the Tobacco Industry and set the world standard for action against tobacco, because compared to their actions, everything else became ‘moderate’. But less recognised than their billboard campaign was the re-framing of the debate from ‘smokers v non-smokers’ and ‘personal choice’, to a ‘Tobacco Industry campaign to make a profit even though it kills people’. This reframing in the public mind allowed governments to stand up to the Tobacco Industry and forced political parties to eschew their donations (at least publicly)..

Gambling Industry Strategy

The Gambling Industry’s ads are very clever, appearing to take the loser’s side to identify with (usually) him and dangle the prospect of a win, though of course this is statistically impossible in the medium term. They are perverting the idea of ‘mateship’ to a group Gambling session with a cheery comparison of who they are backing as they watch sport. This would be very vulnerable to a satiric response, based on a commiseration as to which mug lost the most and a final comment that ‘gamblers are losers’.

Laissez-faire v. Health

The Federal government is responsible for the health of Australians and with an increasing percentage of health problems being related to lifestyle choices, the government cannot simply ‘leave health to the market’. ‘The market’ will sell anything that makes money irrespective of whether it has good health outcomes or not, so leaving the national wellbeing to ‘the market’ is a highly flawed strategy as the government in the end picks up the tab for all problems. The Federal government should unashamedly promote sales and practices that are good for health and discourage things that are not.

Encouraging good personal decisions

Any reasonable management textbook will say that the best way to manage things is to have good decisions made at the lowest possible level within the organisation. Yet gambling advertising uses distractions and dreams of riches that are statistically extremely unlikely to encourage people to gamble, and thus not use their money wisely. If the ads said ‘Do not contribute to superannuation’, ‘Do not save’, Do not worry if you do not have enough money to feed your kids’, there would be a huge outcry. Yet this is the outcome with a large percentage of gambling money received being from people who cannot really afford it. The social problems created take an immense amount of effort from government and NGO charitable organisations to try to rectify them. Often they cannot. This problem is entirely created because of bad decisions on gambling made by people who the Gambling Industry has conned. It is exactly like people taking up smoking. It was portrayed as a bit of harmless pleasure, but when people were hooked, it did them immense harm. Gambling is the same.

Need for Gambling Research

One the other problems of Gambling is that the research is funded by the industry, so its scope and nature are controlled. The amount of harm that it does is poorly quantified, so that there is little evidence for those opposing Gambling to use in political debate. The lack of evidence and the lack of debate suits the Gambling Industry fine- they are more than happy to continue and extend the status quo. Given that the Federal government is a major player in cleaning up the social problems created by the Gambling, it should insist that there be well funded research on the social consequences of Gambling, and the nature of this research should not be determined by the Gambling Industry. The Gambling Industry in Australia is extremely large by world standards, perhaps the largest in the world apart from little enclaves like Monaco or Macau where the money is retained by the State and the social problems are either ignored or assumed to be manifest elsewhere. The social indices of distress are very high in Las Vegas. It might be said that the Gambling Industry in Australia is like the gun lobby in the US; it is almost unchallengeable. This must change, and the Federal government must initiate the change.

Off-line Gambling

It is interesting that the Clubs lobby is under challenge at a state level. The origin of this is uncertain. There has always been a lobby against Gambling, and this may have been helped by the rapid rise in the inflation rate which is straining the family budget, particularly of disadvantaged people, who are the ones most affected by Gambling losses. It is also no doubt helped by the revelations that the Casinos have happily laundered money for organised crime, by-passing their regulatory systems, and being perceived by organised crime as an easier target than foreign jurisdictions. The public also notice that the Casino boards were well stacked with ex-politicians, who were presumed to be there to smooth the political pathway of the Casinos in their dealing with regulation or (even) enforcement. It might be noted that despite the huge amounts of money being laundered and the findings that the Casinos were not fit to have licences, their share prices have only suffered modestly, showing that everyone knows that eventually their licence will be restored and it will be ‘business as usual’. The public is also well aware that the charade, ‘’I had no idea what was happening’ from the politically connected people at the top, merely leads to a resignation or two, but there is no penalty on the individuals. An aboriginal youth can go to gaol for petty theft, but laundering billions for organised crime merely leads a Casino director to a sojourn in the yacht club. While the major political parties have been very reluctant to upset the Hotel and Club industry, as evidenced by the 20 year delay in introducing smoke-free indoor air legislation, the rise of the Teal candidates threatening once safe seats, has pressured the major political parties to take a more ethical stance, and also blunted the financial advantage that support from the pubs and clubs lobby gives to their campaigns.

Online v. Off-line Gambling

But the final possibility for the pressure on the Clubs and Hotels may have come from the Online Gambling lobby. If it is assumed that people who want to gamble will use what is available, there is a real possibility that the lack of poker machines availability in pubs and clubs may lead to an increase in online Gambling. Supporters of the pubs and clubs are quick to point out that the clubs are non-profit and spend their monies enlarging their premises and providing facilities in Australia, as well as paying at least some tax to State governments. If there were a change towards online Gambling this money would go overseas. This overlooks the social context of gambling. Playing a poker machine is quite different from going online, so there is unlikely to be a direct transfer, even if the online experience is made more similar.

Need for Federal Government Action on all Gambling

The lesson for the Federal government, however, is that Gambling must be discouraged at both the pub and club level, and online at the same time. Both have similarly detrimental financial consequences for the players and punters, though the industries are distinct. From the public’s point of view, it is worrying that the terms of reference of this inquiry neglect that issue of Gambling in pubs, clubs and the TAB, as it suggests that these influences have restricted the terms of reference. The regulation of the internet is also a wider problem, which usually comes into focus with the issues of inflammatory hate speech, medical disinformation, defamation or an aspect of pornography. Gambling for money should be in a similar category to these and discussed in a similar context.

Recommendations:

The Federal Government should recognise that the Gambling Industry and its power is the reason that Australia has a worse Gambling problem than almost any other developed country and the the Gambling Industry has a hold on Australian politics as strong as the Gun lobby in the USA, and with a detrimental effect that could be of similar magnitude.
The Federal government should take an unequivocal stand that Gambling is harmful in that it encourages poor financial decision-making which puts a strain on the whole welfare system, Federal, State and NGO.
The Federal government should recognise that all forms of Gambling need to be discouraged, pubs, clubs, TAB, on-course and online and this needs to be an unequivocal campaign, similar to Quit or for the necessity for vaccination.
The campaign against Gambling needs to be in schools and have both a mathematical component as part of statistics, and a more practical part looking at online Gambling, and the social institutions which encourage Gambling.
The campaign against Gambling must involve electronic media advertising bans on TV and all advertising and sponsorship. It must involve active ads against Gambling as well as merely bans on pro-Gambling ads. It should use satire and be prolonged.
The control of online Gambling should be seen in the context of minimising the harm of the ubiquitous internet, and research on how to lessen Gambling should be pursued with endeavours to lessen other social harms such as child sexual exploitation, bullying, vaccine disinformation, tobacco and vaping advertising and disinformation, hate speech, video games that promote violence and defamation.
The Federal government should fund Gambling research so that the social consequences can be quantified and rational decisions made about the cost-benefit to society. Gambling research should not be neglected, limited, financed and controlled by the Gambling Industry as is currently the case.
There must be support for people who have a gambling problem. Such services need to be publicised, and destigmatised, as happened for those with mental illness. However, individual services must not be a substitute for a more systemic industry-focussed approach.
There needs to be a national register of addicted gamblers to allow better exclusion from gambling facilities. If this were comprehensive, it could be used to prevent addicts losing money online with a caveat emptor for those who took the bets from registered addicts. The credit card companies could be recruited not to allow Gambling to such addicts and not to honour Gambling debts incurred by registered addicts.
The Federal government should consider family support for addicted gamblers in the same way that child support is available for at risk families.

About the Author

Dr Arthur Chesterfield-Evans is medical doctor, who trained in surgery and became a tobacco-control advocate, then an Australian Democrat MLC in the NSW Upper House. He is currently working as a GP.

16/10/2022

A Robodebt Re-Run? Labor bound by Pre-election contracts?

22 July 2022

It seems that the Liberals are ruling beyond the election, by letting long-term private Centrelink contracts that Labor must honour. With the public service effectively dismantled, all work is done by private contractors, and doing tasks defined in a highly ideological framework. Even if the contracts were rescinded, with whatever penalty clauses the Libs and their contractors had agreed on, the Labor party has insufficient public administration staff capable to do the job of paying people in the short term. So they default to the Liberal contract.

This is about managing Centrelink’s Jobseeker program and ‘debt recovery program’. We have seen how the Liberals used Tax Office records in the Robodebt scandal, with totally unsubstantiated financial demands, then enforced by garnisheeing payments leading to suicides. Behind this sort of activity is a philosophy that those on welfare have only themselves to blame and need to be forced back to work, even when it is obvious that there are fewer jobs than job seekers, so that all that will change is who gets what jobs there are. Labor has to change the philosophy to a more realistic one, then have a serious plan to help those who cannot get jobs. Everyone knows that technology is replacing people in many areas, and jobs are moved offshore in manufacturing or services such as call centres because it is cheaper.

The fact that Labor was dependent on contractors chosen by the Liberals is another feature of privatisation that must be reversed. The Public Service must be rebuilt, and staff given guarantees of long-term employment- like they used to have. They must do their job helping people without the cost constraints of false bonuses that reward them for doing the easy tasks and leaving the hard ones.

www.sydneycriminallawyers.com.au/blog/robodebt-2-0-labor-moves-to-hit-up-the-unemployed-for-debts-caused-by-mismanagement/?fbclid=IwAR1S4n-kMmQIO70ABi_kStmuTgnqw2zQOE6RgXRz_C31hFJfQ3_0vik_Pio

24/02/2022

Loneliness and its solutions

25 February 2022

I sometimes watch Foreign Correspondent on ABC TV and by chance on 15/2/21 I came across this excellent programme on loneliness in Japan.

The ABC correspondent there looks at loneliness in the Japanese population from older folk dying alone, to younger people simply withdrawing from society.

Some of the older ones had no family or jobs. Some of the younger ones were so pressured to succeed and felt that they had failed, so simply withdrew from society. It seems that the pressure on kids all to be CEOs is an absurd and unachievable objective.

I am not sure that the situation in Australia is as bad, but I thought about some of my patients and could think of half a dozen immediately. With some of them , I am one of the only two or three people in the world they have any contact with, their relationships are tenuous.

None of them started with mental health problems. Here are some examples:

A 60 year old man worked for a security company looking after an insurance company. He was doing surveillance for them, but it took over his life as he was contacted 24 hours a day for various crises. Case management employees having conscience over what they were doing had to be rescued from self-harm in the toilets. Enraged claimants with refused claims threatened to blow up the company offices with cans of petrol. He saw staff high-fiveing as some claimant got a derisory settlement when they deserved and needed a lot more. It went on like this for years. When he said that he could not do this anymore he was treated as badly as any of the people he had dealt with. He told me this story, and I had hoped that with his considerable management skills and experience, he could be put into a less stressful position. But he deteriorated. Everything reminds him of the corruption of the world. He is estranged from his wife and they communicate with post-it notes on the frig. He goes for a walk at 11 at night so he will not have to speak to people in the street. One son has stuck by him and visits daily, and will build him a self-contained unit in his new home.

Another patient is a 62 year old ethnic taxi driver who was so badly bashed 11 years ago by a gang stealing his takings that he lost an eye, has never worked again and never recovered mentally or physically. He was divorced; lives alone and sometimes will not even answer the phone.

One is a 42 year old foreign student who came to study theology, wanting to become a pastor. Her English is not great. She is a trifle unworldly, and thought that the world is basically kind and people look after each other. She had a casual job in a motel and her boss asked her to move a bed down the stairs between floors. She said it was too heavy and she could not, but he threatened to sack her. She did it and got an injury to two discs in her back. She was frightened to have surgery, so was in agony for a couple of years and eventually agreed. She had minimal surgery, which was not successful. The insurer decided that she was not complying with what they wanted so refused to pay her. She was effectively broke and homeless, so an old lady from her church offered her a bed and food. But she lives a long way away and up a drive that is hard for my patient to walk up. She was effectively trapped. As a foreign person she did not even have Medicare for the minimal psychological help it offers (6 visits a year). Her mental health deteriorated and she shunned all outside contact, and would not even answer the phone. She has gone home to her family- I can only hope she improves there.

One is a 39 year old from a religious and teetotal family with a high sense of ethics. He was a top salesman of a computer company and became aware that they were ripping off some customers. He drew this to management’s attention, but they declined to do anything and he was labelled a whistleblower. Management supported him by putting out an email asking that he be supported for his mental health issues. He felt that this ostracisation was the end of his career, because he had asked them to behave ethically. He was certain that no one in his tight top group will now employ him, so he withdrew and started to drink to lessen the pain. His family then rejected him because of the drinking and his sales friends are estranged also. The psychologist gives him Cognitive Behavioural Therapy exercises and I try to get him to drink less and somewhat ironically counsel him that you cannot withdraw from the world merely because the baddies generally win. He lives alone, answers the phone and is just able to do his own shopping, but is not improving much.

These are just some examples that I know. Coasting home as GP at least keeps you in contact with life. The point is that many people have broken lives, but just keep living. None of these examples have done anything wrong themselves. Is a sense of ethics a mental illness?

As everyone has to ‘look after themselves’ in a consumer-oriented society, more people will fall through the cracks, especially as the gap between rich and poor is enlarged by pork barrelling which puts resources into areas that need them less, tax breaks for the rich, subsidies for private schools and private health insurance, derisory welfare payments, and insurers allowed simply to refuse to pay without penalty.

People need basic support with universal housing and universal health case. They need jobs or at least occupations and an adequate income to survive. And we need outreach and support services that can be called upon.
When people say, ‘There are not enough jobs’, they are taking nonsense. Anyone can think of many worthwhile things that need doing. And there are plenty of people who would be happy to do them. The problem is that in a world where nothing can be done that does not make a profit, a lot of things that need doing are not done. That is where the policy change are needed. We cannot simply look at the money and see to what level existing activities can be maintained. We need to look at what needs to be done, and then work out how to achieve it. We need to decide that everyone has a right to live and those who have a good life will live in a better society if everyone can share at least a basic quality of life. There has to be recognition that the ability to be profitable need not be the overwhelming criterion for what is done. Tax may go up, but if there is real re-think of priorities, it is not likely to be all that much.

The link to the ABC program that initiated this tirade is below.
https://iview.abc.net.au/show/foreign-correspondent/series/2022/video/NC2210H002S00