Dr Tessa Boyd-Caine, the Deputy CEO of the Australian Council of Social Service, suggested at Croakey yesterday that the low level of income support payments, particularly for unemployed people relying on the Newstart allowance, is an important health issue.
She wrote:
“It’s important that health groups and medical professionals join their voices to the call to increase these payments. As long as Australia continues to pay the lowest rate of unemployment in the OECD, we cannot hope to improve the health status of our country overall. Closing the gap, supporting community-based primary care, and relieving the burden of unnecessary hospitalisations will not be enough if we don’t also ensure that everyone in Australia can access a living wage. $35 a day is just not enough.”
ACOSS has also been raising the alarm about reports the Government is planning to cut payments to single mothers in tonight’s budget.
Croakey contributors were asked whether the health and medical sector should be lending its clout to the campaign to increase the Newstart allowance.
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The unemployed deserve better
Andrew Podger, Professor of Public Policy at the ANU and former secretary of the Department of Health and Ageing
I have much sympathy with ACOSS. I would not object to strengthening the work test for sole parents whose youngest child is over eight years old. But to cut their payments if they cannot find work cannot be defended.
The underlying problem, of course, is that this Labor Government, like its conservative predecessors, has consistently denied the unemployed the level of income protection it guarantees to the aged, the disabled and carers.
Under pressure from the Opposition in 2008 it spent billions in the 2009 Budget on increasing those pensions which were already much higher than assistance for the unemployed, or even sole parents.
Henry has subsequently highlighted what everyone who knows about our social security system can tell you, that support for the unemployed is falling way behind what the Australian community considers is a reasonable minimum income to live on.
Moreover, as a roundtable of experts from around Australia agreed last October, the failure to provide adequate income for the unemployed does not materially affect incentives to work: those incentives are far more effectively achieved by work tests, and need to be complemented by training and other interventions to increase work opportunities particularly for the long=term unemployed.
Moreover, most Newstart recipients now are long-term recipients with substantial and genuine obstacles to gaining and sustaining employment.
The 1970s saw major advances in our social security arrangements including the dismantling of distinctions between the deserving and undeserving poor, and the establishment of a common standard of adequate income support for all those genuinely unable or not expected to work. Sadly that has steadily been eroded as politicians detect the public lacks a charitable view towards the unemployed and sole parents.
I am hoping the Government will make a first step in this Budget towards reducing the gap between Newstart and pension payments. But it would be terribly retrograde if it simultaneously pushed a whole group of sole parents onto a Newstart payment that, notwithstanding an overdue increase, is still less than what they get now, even if they do their best to find work but are unsuccessful.
I may be politically naive, but the most obvious way to save billions in social security is to reverse, in full or in part, the unjustified largesse involved in the pension increases in the 2009 Budget.
Helping the truly needy requires increasing payments to the unemployed and sole parents, and all social security recipients in private rental accommodation. Especially given all the support for superannuation, increasing the age pension was never an appropriate priority, and only adds to the problems of our ageing population.
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We’re stuck with a siloed system while service providers maintain the status quo
Vern Hughes, National Campaign for Consumer-Centred Health Care
The allowances paid by the Commonwealth to support unemployed people are appallingly low. This is a serious social policy failing in Australia.
But arguing that every segment of social disadvantage is also a health issue that should be taken up by health organisations is an approach that has been taken for several decades by ACOSS with very little impact.
Health and social security in Australia are two different worlds, run by different provider industries, in different silos of government. ACOSS knows this as well as anyone.
The idea that health and welfare funding streams might be aggregated so that supports for each individual, family and community are integrated in holistic packages is a good idea, but it is actually not something that ACOSS, or the health providers, favour.
Industry bodies of service providers in both sectors are adamant that they want to retain funding programs that allocate block payments to service providers rather than direct resources to the users of services, and for so long as we retain these provider-centred funding systems, the fragmentation of health and welfare will remain firmly intact.
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It’s hard to be healthy on a low income
Mary Chiarella, Professor of Nursing, Sydney Nursing School, University of Sydney
The links between poverty and ill-health are well documented. When income support is so low, there is a natural tendency to purchase the cheapest and most filling food, which is often fast food, this creating a vicious cycle of obesity, poor nutrition and ill health.
Investment in primary health care (as opposed to primary care), so that people are able to take control of their own health, requires health professionals to be on the ground in communities working with them to improve diet, nutrition and exercise and to support people to develop healthier lifestyles.
However, people cannot focus on these activities if they are continually stretched to make ends meet due to inadequate income support.
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Health sector has a role in advocating for action on poverty and Newstart increases
Associate Prof Gawaine Powell Davies, CEO, UNSW Research Centre for Primary Health Care and Equity
I think the health and medical sector should concern itself with poverty, and therefore low pay. The difficult bit will then be deciding which elements of poverty/low pay to target.
The argument for those on unemployment pay will be that this is stark, affects a lot of people, and can easily be remedied. On this basis, I would support advocacy on this issue.
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Applying the fairness test to the budget
Hal Kendig, Director of the Ageing, Work, and Health Research Unit in the Faculty of Health Sciences, University of Sydney
The Australian Council of Social Services recognises that there is a strong and accumulating evidence base for action on socio-economic inequalities and health as a fundamental way to improve life chances and well-being across the life course.
Adequate income, jobs, and secure housing for impoverished single parents are priority investments that will improve the health of the next generation of children and young adults with further benefits later when they are entering later life in the future.
I would add that action to promote the health of ageing workers and combat ageism in the workplace also are win-win policies for national productivity as well as healthy and productive ageing.
The Government’s Living Longer, Living Better initiatives, when backed up by adequate public budgets and fair contributions from those who can pay, can take us a long way towards more a more secure, comfortable old age as well as a more sustainable care and health system in an ageing Australia ageing.
An essential test of fairness for the Government’s Budget will be how well it supports the most vulnerable people, and how well it applies savings and revenue measures, on the basis of people’s needs and capacities irrespective of age.’
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Look beyond Newstart to wider inequities
Tim Woodruff, Doctors Reform Society
Despite the very poorly written stories in the daily broadsheets in the last few weeks about how we are not doing too badly in Australia, the real story is about inequity. The appalling support for those on Newstart is just one example.
When one looks at how fair this country rates over the last decade or so, we see Federal Governments which have presided over increasing inequity. The rich/poor divide is increasing.
The Australian Bureau of Statistics measures this in various ways, one of which is the Gini coefficient. It has risen substantially since 1996 ie more inequality (with a slight fall since the GFC probably because the very rich lost a little which would only affect their egos).
Economist Saul Eslake has written of this increasing inequality, referring to data from a Federal Labor member (Andrew Leigh).
The fact that this Government still has done so little about the issue is a sad reflection on Labor values which appear to have essentially accepted that safety nets are the way to address structural inequity (notwithstanding the minor changes to the private health insurance rebate and the introduction of the watered down mining tax).
This is all despite a clear understanding that health issues in Aboriginal communities are not just about access. The social determinants are crucial. Poverty is a major barrier to health.
But in the general community the maintenance of relative poverty continues as is well illustrated by the approach to date on the Newstart Allowance.
If we think that all Australians deserve a fair go, it is time to look much harder at not just the Newstart Allowance, but at all the policies which perpetuate and increase inequities in our society.
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Strong primary health with a focus on access and equity is essential for low income and disadvantaged Australians
Justine Caines OAM, Consumer Health Advocate
In the 2009-10 budget former Health Minister, Nicola Roxon announced a $120M initiative to provide Medicare funding to midwives.
Since then there has been no funding allocated to promotion of the scheme or mentoring of midwives wanting to transition to Medicare practice.
Why does this matter to low income families? Continuity of midwifery care provides health care within a social model and assists a woman and her family to address and improve all areas of their life.
The relationship provided by one known midwife has been proven to be the best preparation for new motherhood. These models have provided strong health outcomes in the most disadvantaged areas of the UK and even in dysfunctional indigenous communities in remote Canada; where incredible community benefit, led by indigenous people themselves, has been reported.
