Introduction by Croakey: At Parliament House in Canberra yesterday, a group of cross-party politicians, academics, business leaders and health and community advocates called on the Albanese Government to deliver a substantial increase to JobSeeker and related income support payments in the May Budget.
Brought together by the Australian Council of Social Service (ACOSS), these prominent Australians all signed an open letter to Prime Minister Anthony Albanese urging him to increase income support payments to help address “structural injustice” and “increased deprivation”.
The strong support for this measure from health leaders builds on longstanding advocacy by the health sector on this issue, and raises questions about the role of the health portfolio in influencing broader government policy and budget decision making.
Below Croakey editor Jennifer Doggett highlights some options for embedding health considerations in all government policies, and reports some related insights from a former Health Department Secretary and public sector economist.
Jennifer Doggett writes:
The ACOSS letter from CEO Dr Cassandra Goldie and co-signed by over 350 people makes a strong case for increasing income support payments in the upcoming Federal Budget.
The letter states:
“Even before the cost-of-living crisis, income support payments weren’t nearly enough to cover basic expenses, but now people struggling to get by on $50 a day face increased deprivation. In the last twelve months, rents in capital cities have risen by about 22 percent and food prices have skyrocketed. While everyone in our community is feeling the impact of these cost-of-living pressures, people on income support are going without food and other basics because they have nothing left to cut back on in their budget.”
The letter also cites research from ACOSS which found that seven in ten people on income support were eating less or reporting difficulty getting medicine or care. It points out that given 80 percent of people receive JobSeeker payment for 12 months or more, these deprivations have a compounding effect over time.
This can make it more difficult for people to find a job, especially when they can’t afford basics like a haircut or new shirt.
Broad support
Showing an unusual degree of unity, representatives from across the political spectrum have signed the letter, including the following:
Greens: Adam Bandt, Janet Rice, Stephen Bates, Max Chandler-Mather, Penny Allman-Payne, Elizabeth Watson Brown, Barbara Pocock, Sarah Hanson-Young, Jordon Steele-John, Mehreen Faruqi, Larissa Waters, Dorinda Cox, David Shoebridge.
Independents: David Pocock, Helen Haines, Dr Monique Ryan, Zali Steggall, Kate Chaney, Andrew Wilkie, Dr Sophie Scamps, Lidia Thorpe, Kylea Tink.
Labor: Alicia Payne, Louise Miller-Frost, Dr Michelle Ananda-Rajah, Kate Thwaites (and more also are reported to have signed it.)
Liberal: Bridget Archer.
Jacqui Lambie Network: Jacqui Lambie.
Former politicians, including Robert Tickner AO, Jenny Macklin, John Hewson, Fred Chaney, Brian Howe and Doug Cameron are also co-signatories, along with a raft of economists and over 100 community sector leaders and prominent people including June Oscar, Mick Gooda, Antoinette Braybrook, Eva Cox, Professor Megan Davis, Professor Andrew Podger, former Treasury Secretary Ken Henry, Simon Holmes à Court, Marie Coleman, Kathryn Greiner and Tim Costello.
From the health sector signatories included:
Dr Elizabeth Deveny – Consumers Health Forum of Australia
Nicole Bartholomeusz – cohealth
Dr Nicole Higgins – RACGP President
Dr Zena Burgess – Australian Psychological Society
Gill Callister – Mind Australia
Patricia Turner – NACCHO
Kylie Ward – Australian College of Nursing
Peta Wootton – Fremantle Women’s Health Centre
Robert Hunt – Dietitians Australia
Tish Sivagnanan – Australian Medical Students Association (AMSA)
Terry Slevin – Public Health Association of Australia
Jason Trethowan – headspace
Professor Pat McGorry
Professor Fiona Stanley
ACOSS is inviting community members to add their signature to the letter here.
Health sector advocacy
This letter follows calls over many years from health groups for an increase in the Newstart and Youth Allowances (see examples from PHAA, CHF and NACCHO) and raises questions about the role of the health portfolio in advising broader government decision making on issues impacting the social determinants of health.
Croakey has previously covered the role of the health portfolio in broader government decision-making (see here and here), including exploring the potential for a “Health in all policies” (HiAP) approach to deliver policies that support population and public health.
HiAP and HfAP
HiAP recognises that population health is largely determined by policies outside of the health sector. This framework is supported by the World Health Organization in order to embed health considerations into policies such as those influencing transport, housing and urban planning, the environment, education, agriculture, finance, taxation and economic development so that they promote overall health and health equity.
South Australia is the only jurisdiction in Australia to have formally adopted a HIAP approach to date.
Another related approach which has been suggested by some experts as an improvement on HiAP is “Health for All Policies (HfAP). This approach focusses on two-way engagement by health in broader decision making, highlighting both what the health sector can do for other sectors while simultaneously attaining co-benefits for its own sector.
In relation to the Raise the Rate campaign, this would involve the Government taking into account both the health benefits of increased income support (such as supporting people to maintain their health through affordable food, housing and healthcare) and also how these health considerations would assist the Government in achieving broader policy goals (such as ensuring people receiving income support can afford the pre-requisites of seeking employment, such as a haircut and appropriate clothing).
Learning from international experience
Governments around the world have adopted approaches such as these, which are also supported by international organisations, such as the WHO and OECD, which has undertaken extensive work to develop indicators of wellbeing, which can be used to measure a country’s progress outside of narrow economic measures.
Aotearoa/New Zealand has adopted a “well-being” approach to budget decision making, incorporating a number of measures to build broader considerations of wellbeing into government processes.
One of these is the Living Standards Framework (LSF) Dashboard,developed as measurement tool by the New Zealand Treasury to advise Ministers on priorities for improving wellbeing. The LSF Dashboard provides the indicators that the Treasury believes are most important to inform wellbeing reporting and policy advice on cross-government wellbeing priorities.
Croakey has reported this week on some concrete gains to have resulted from the Well-Being of Future Generations (Wales) Act 2015.
Current government approach
On its election in 2022, the Albanese Government signalled its interest in taking a broader approach to budget setting, building in measures of wellbeing and quality of life into what has traditionally been seen as a narrow economically-focused process.
In its first Budget in October last year, the Federal Government outlined its early ideas on this issue in its Budget Paper 4: Measuring What Matters, including exploring the features, strengths and weaknesses of several other frameworks currently available – such as the OECD’s Wellbeing Framework and New Zealand’s approach – and kickstarted a first round of consultations.
The Government has committed to releasing a new standalone Measuring What Matters Statement later this year. This will be Australia’s first national framework on wellbeing and will evolve over time.
A second round of consultations on this issue is currently open for submissions from interested groups and individuals with input due by 26 May 2023.
A former Secretary’s perspective
Professor Andrew Podger AM is a former Secretary of the Department of Health (1998-2001) and now Professor of Public Policy at the Australian National University.
He told Croakey that when he was leading the Department they would likely have provided some broad policy advice about the determinants of health including inequality and disempowerment, drawing on international evidence.
However, he said that specific advice on a social security proposal would only be triggered by the Department being informed, and he that doubted the Department of Social Service (DSS) would have included Health in the coordination comment process for Cabinet submissions.
“In my time the Health Minister was on the Expenditure Review Committee and would frequently refer submissions to us for comment even when we were not directly involved in the coordination comment process. That happened all the time for the first year or so and we certainly provided comments not just from a Health perspective but also from our broader knowledge of social policy,” he said.
Podger added that if this issue had been raised with him, he would have provided advice along the lines of that he gave in his previous roles in Finance, DSS and Prime Minister and Cabinet – that unemployment benefits should provide the same minimum income guarantee as the pension.
Economic benefits
Dr Joanne Flavel, an economist and public health researcher at the University of Adelaide, told Croakey that she believed the health portfolio should have a greater role with regard to social determinants issues such as #raisetherate.
“It has long been recognised that there are links between health outcomes, social determinants of health and health equity. This is especially important given the current consultations around measuring what matters,” she said.
“Public policy impacts on health and wellbeing should be considered in all sectors of government, and the health and wellbeing impacts of social security are very powerful given income is a key social determinant of health.”
Flavel suggested that a combination of mechanisms are needed for intersectoral collaboration to occur. These include the South Australian HiAP approach, which she said has been judged as an exemplar for successful intersectoral collaboration to produce healthy public policy.
She also suggested following the New Zealand example of incorporating a wellbeing framework into budget and policy-making processes and requiring all new policy proposals to specify their contribution to wellbeing and evaluate the contribution. This would show the positive impacts of raising the rate for wellbeing, as was found when evaluating impacts of the 2020 Coronavirus Supplement on wellbeing.
With an international recession looking increasingly likely, Flavel argues for the economic benefits of increasing income support, pointing to the success of Australia’s response to the Global Financial Crisis as an example of how payments to people on the lowest incomes helped Australia’s economy perform much better than the rest of the world.
“Raising the rate is not only the right thing to do from a social justice perspective, it also aligns with the Government’s stated objectives of keeping our economy strong while also considering the impact of policy on wellbeing,” she said.
“While inflationary pressures must be considered, much of the cause of current inflation is from the supply side and business increasing prices by more than is needed to cover costs. An increase in income support payments will be better in the long run for our labour market and for the economy.”
Note: Croakey contacted the Department of Health and Minister for Health Mark Butler for comment, but has not received a response.
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