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On the Robodebt debacle, some reflections for the health sector

Croakey is closed for summer holidays and will resume publishing in the week of 15 January 2024. In the meantime, we are re-publishing some of our top articles from 2023.

This article was first published on Wednesday, July 12, 2023


The report from the Royal Commission into the Robodebt Scheme runs to more than 1,000 pages.

Many Croakey readers will find it worth making the time to review it carefully, for the revelations about policy-making, how bureaucracies and governments can operate, and as a reminder of the need for eternal vigilance to ensure they remain accountable to those they are meant to serve.

After an admittedly quick read on my part, here are some takeaways from a Croakey perspective. We’re keen to hear your thoughts too.

1. Absence of health expertise

The report brings many grounds for critical self-reflection by politicians, public servants, the media, consultancies (looking at you, PwC) and others.

But it also raises some questions for the health sector.

While Robodebt’s harmful impacts upon health and wellbeing are well documented, both by the Royal Commission and previously, the voices of the health and medical sector are strangely absent from the report, with a few notable exceptions.

While acknowledging that some health leaders did speak up against Robodebt, it’s important to consider whether the sector could and should have done more, and acted earlier to push for an end to this cruel and wasteful scheme.

The report notes that the disastrous effects of Robodebt became apparent soon after it moved, in September 2016, from an initial limited release involving around 1,000 recipients, to sending out 20,000 notifications per week. In December 2016 and January 2017 the media, traditional and social, were saturated with reports about people who had had demonstrably wrong debts raised against them, and in many instances heard of it first when contacted by debt collectors.

The Australian Council of Social Services (ACOSS) wrote to the Minister for Human Services in December 2016, pointing out the inaccuracies which were being produced by averaging, instead of applying actual fortnightly income figures, the unfairness of charging a penalty where it was not established that a recipient had even been contacted, the difficulty for people in recovering information from employment years past, the technical difficulties with the online system, the lack of assistance from Centrelink officers and the commencing of debt collection often without warning to the recipient.

“The beginning of 2017 was the point at which Robodebt’s unfairness, probable illegality and cruelty became apparent,” reported the Royal Commission.

“It should then have been abandoned or revised drastically, and an enormous amount of hardship and misery (as well as the expense the government was so anxious to minimise) would have been averted. Instead the path taken was to double down, to go on the attack in the media against those who complained and to maintain the falsehood that in fact the system had not changed at all. The government was, the DHS and DSS ministers maintained, acting righteously to recoup taxpayers’ money from the undeserving.

“The Scheme’s demise, for all of its seeming inevitability, took far longer than it should have, particularly for all of those harmed by a Scheme to which they should never have been subject.”

If the powerful medical lobby had thrown its weight behind the critique of Robodebt during that critical period in early 2017, in a sustained and organised fashion, what difference would this have made?

Perhaps the most well-resourced health lobbies, such as the Australian Medical Association and medical colleges, could publish an audit of their related advocacy and media statements on Robodebt?

Organisations working in the mental health and suicide prevention space also might reflect on these questions, given the traumatic assaults of Robodebt upon mental health and wellbeing.

And another question: could the health and medical sector have done more then, and be doing more now to challenge and re-write harmful, entrenched narratives that undermine the security and wellbeing of people receiving income support?

The Royal Commissioner, Catherine Holmes, wrote in the report’s preface that politicians need to lead a change in social attitudes to people receiving welfare payments.

“The evidence before the Commission was that fraud in the welfare system was miniscule, but that is not the impression one would get from what ministers responsible for social security payments have said over the years. Anti-welfare rhetoric is easy populism, useful for campaign purposes, ” she said.

“It is not recent, nor is it confined to one side of politics, as some of the quoted material in this report demonstrates. It may be that the evidence in this Royal Commission has gone some way to changing public perceptions. But largely, those attitudes are set by politicians, who need to abandon for good (in every sense) the narrative of taxpayer versus welfare recipient.”

But other powerful groups in society have a role here too.

2. Health in all policies

If ever there was an argument for structures to promote and embed health in all policies, then Robodebt must be it.

But the Royal Commission’s report also brings reminders of the barriers to health in all policies approaches, including examples of government departments failing to collaborate, share information and indeed actively withholding information from other departments.

Also this report reveals the dominance of political imperatives in policy-making. It is painfully clear that the health and wellbeing of the community was not even a consideration for many of those involved.

3. Lessons from health policy

It’s difficult to imagine a scheme like Robodebt getting off the ground in the health arena, given the power of stakeholders in health policy, and where there is an expectation they will be consulted and involved in policy development.

Health, for all its problems, is way ahead of the Robodebt developers, in engaging stakeholders and listening to and valuing the voices of lived experience.

4. Support civil society and whistleblowers

The heroes in the Royal Commission report are, by and large, not the agencies and entities charged with holding policymakers and governments to account. So many failed the public interest test.

Rather, it is the civil society champions, ACOSS, Twitter activists, and a handful of journalists who forced accountability. Yet these are the sectors and people who are often so stretched and relatively under-resourced.

The Robodebt story is a reminder of the importance of the health sector supporting and developing networks with wider civil society and those who champion more accountable governments and policy making.

It is also an example of why the health sector must advocate loud and strong for better protections for whistleblowers.

It’s worth also noting that governments that invest in supporting civil society reap the benefits in better policy through greater community input and participation.

5. Caution on automation and artificial intelligence

The report says the terms ”automated decision making” and “artificial intelligence” (AI) are often used interchangeably, and have been in commentary about the Scheme, though they are distinct concepts.

The Scheme’s use of automation at its outset, removing the human element, was a key factor in the harm it did, the Commissioner reported.

“The Scheme serves as an example of what can go wrong when adequate care and skill are not employed in the design of a project; where frameworks for design are missing or not followed; where concerns are suppressed; and where the ramifications of the use of the technology are ignored.

“The complexity and incohesiveness of the legislative landscape in respect of automated decision making indicates that oversight is warranted, and the Robodebt experience demonstrates the need beyond argument. This was a massive systemic failure, on which the availability of individual recourse to review could make no impression.”

The Commission considers that there should be an independent oversight entity capable of reviewing both the technical aspects and human impacts of government automated decision making.

In the social security context, human oversight of the system is needed to mitigate the risk of error, the report says. “As systems containing automation, and artificial intelligence, become more common, it is still the case that human intervention appears to be one of the most effective safeguards against the system failing.”

The report highlights the importance of governance, regulation and transparency to mitigate potential risks from AI and automated decision-making.

These are also timely messages for the health sector.

6. Role of commercial actors

The growing interest in the impact of the commercial determinants of health is relevant to Robodebt.

The report brings many examples of how private sector entities, including debt collectors, consultancies and labour hire firms, contributed to the scheme and its adverse outcomes.

7. Rebuilding trust and transparency

We have heard much about the need to rebuild the capacity of the public service since the Albanese Government was elected. This report also underscores the importance of rebuilding integrity, transparency and trust. One wonders whether a Royal Commission into COVID might also throw up similar issues.

The Royal Commissioner, Catherine Holmes, wrote in the report’s preface: “It is remarkable how little interest there seems to have been in ensuring the Scheme’s legality, how rushed its implementation was, how little thought was given to how it would affect welfare recipients and the lengths to which public servants were prepared to go to oblige ministers on a quest for savings.

“Truly dismaying was the revelation of dishonesty and collusion to prevent the Scheme’s lack of legal foundation coming to light. Equally disheartening was the ineffectiveness of what one might consider institutional checks and balances – the Commonwealth Ombudsman’s Office, the Office of Legal Services Coordination, the Office of the Australian Information Commissioner and the Administrative Appeals Tribunal – in presenting any hindrance to the Scheme’s continuance.”

The breadth and depth of the Royal Commission’s adverse findings make it clear that this report is not the end of the story, and that continued monitoring and advocacy will be important, for justice and accountability, and for preventing such a disaster from occurring again.


Further comments

Croakey editor and health policy analyst Jennifer Doggett says: “For the health sector I think this issue should prompt some reflection on its role in advocating for broader determinants of health.

Given the evidence of the health impacts of poverty, housing stress and food insecurity, there was clearly a role for health groups in engaging with government, media and policy makers on Robodebt, and it is disappointing that (apart from some isolated examples) this did not occur. Hopefully health groups and experts will now consider their role in advocating on other determinants of health, such as climate change, racism, economic and housing policies. There is so much potential for the health sector to play an influential role in these areas which we know have direct and pervasive impacts on health.

For government, the report should encourage exploration of how to improve policy making and budget processes to deliver the outcomes that this Government says it wants to achieve.

The Treasurer has highlighted the importance of “the state of our environment; our health; the way that people do or do not feel connected to their communities” which he has said “all go to that core aspiration of enabling our people to live with meaning and with purpose,” but current policy making and budget processes are not designed to focus on these outcomes.

The incentives and underlying philosophy that drove Robodebt still exist in many current health policy areas; for example, the individualistic approach which has been adopted in relation to COVID-19, where those at higher risk from infections are responsible for protecting themselves, and the reliance on private health insurance to subsidise health care for people with chronic illnesses.

An increased focus on the determinants of health and the drivers of health inequality, in the light of the Robodebt report, would support the Government in reorienting budget priorities to promote well-being and community connection, rather than narrow economic outcomes.”

Croakey columnist and health policy analyst Adjunct Associate Professor Lesley Russell says: “Treasurer Jim Chalmers said earlier this week that the Measuring What Matters Framework – which will provide the measures whereby national wellbeing is assessed – will be released soon.

He says this will “help us track our journey towards a healthier, more sustainable, cohesive, secure, and prosperous society that gives every person ample opportunity to build lives of meaning and purpose”.

A Health in All Policies approach and/or a Whole of Government approach to implementing this framework would ensure that the issues raised by my colleague Jennifer Doggett and others that must be tackled to reform of the social welfare system are not run as a separate exercise, entrapped in their own bureaucratic silo, but are seen as an integral part of delivering on the national wellbeing commitment.

Let’s hope that at least some of the Framework’s 50 indicators provide accurate and timely measures of the wellbeing of people who rely on social welfare payments.”

From Twitter

 


See Croakey’s archive of articles on Robodebt

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