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Public health advocates urged to join the fray in welfare reform debates

Stronger links must be developed between the public health and social services sectors in order to advocate for fair, health-promoting welfare reforms, according to Gemma Carey, Research Officer with the St Vincent de Paul Society, National Council of Australia and Research Associate, Centre of Excellence in Intervention & Prevention Science.

Gemma Carey writes:

Under the new Coalition Government, Tony Abbott has signalled the return of  ‘Work for the Dole’ and the expansion of controversial ‘welfare quarantining’ policies to all people on welfare payments across the nation.

The re-introduction of so-called ‘active employment policies’ presents a significant threat to public health, and a major challenge to the public health community to stop their reintroduction.  ‘Work for the dole’ was a key pillar in the Howard Government’s approach to social support.

However, the OECD found that such schemes do not improve economic participation and are expensive for governments, particularly in a slowing economy such as the one faced by the new Coalition Government. Work for the dole schemes were widely condemned as short-term, with no focus on skilling people or preparing them for sustainable employment. Even Howard’s own commission – the McClure Report – recommended a major overhaul.

Welfare quarantining (or ‘Compulsory Income Management’) was first introduced by the Howard Government as Part of the Northern Territory Intervention. Under Labor, it was expanded to postcodes of concentrated disadvantage across the country.

So far, welfare quarantining trials have shown little evidence of being effective. While this has been the subject of much debate, a comprehensive review by the Federal Parliamentary Library described positive outcomes of the trials as “uneven and fragile”.

Research
 on the social determinants of health indicates that these policies will have a detrimental effect on the health of individuals and health inequalities. Work by Michael Marmot has demonstrated that health is intrinsically linked to individual control. The more control we have over our lives, the more likely we are to have better health.

Existing active employment policies are fundamentally disempowering – they remove people’s control over their own lives. Under income management, a percentage of welfare payments are ‘quarantined’ for spending on certain items, such as food and clothing. Other items, such as alcohol and tobacco, are outright banned. Work for the dole schemes stigmatise participants, making the transition off welfare and into employment even harder.

By further entrenching disadvantage, both of these policies will widen social and health inequalities.

Active welfare policies are also extremely expensive, requiring considerable administrative resources to implement. Over ten years, income quarantining has been projected to cost the government $1 billion in trial sites alone. If expanded to everyone on government welfare, these costs will skyrocket.

The opportunity costs are also high. These funds could instead be directly invested in the health, training and education of disadvantaged and unemployment people.

Proponents argue that the effectiveness of income quarantining can only be measured over the long term. But there is simply not enough evidence to justify their expansion. The precautionary principle (that if a action has a risk of harm, it should not be take) coupled with everything we know about the social determinants of health, demands that these policies should be dropped.

In a recent Croakey article, Associate Professor Marilyn Wise from the Centre of Primary Care and Equity highlighted the need to change social institutions that do not reduce people’s exposure to unhealthy stressful living and working conditions.

Yet, our largest social institution – government – is set to pursue policies that increase stress, decrease control and prohibit the transition into work.

What can we do?

The public health community needs to engage with debates about welfare reform. There is now an expansive body of evidence on the social determinants of health that can provide direction in this area.

At the 2013 Public Health Association Conference, Professor Mike Daube, Director of the Public Health Advocacy Unit at Curtin University, revealed his top tips for public health advocacy, including a call for public health to work in coalitions.

When it comes to advocating for welfare reform, these coalitions need to be across sectors. Stronger links must to be built between the social services sector and public health. Working together, they can achieve far more than either can on their own.

The new Social Determinants of Health Alliance, established by Catholic Social Health, provides the ideal platform to begin engaging across sectors over social determinants of health issues.

As the new government prepares to sit in Canberra, the first order of business for both sectors must be to challenge Prime Minister Abbott on his welfare reform policies.

Gemma Carey Research Officer, St Vincent de Paul Society, National Council of Australia & Research Associate, Centre of Excellence in Intervention & Prevention Science

• In Anti-Poverty Week (13-19 Oct), The St Vincent de Paul Society will release its ‘Two Australias Report’. The report provides a plan for addressing disadvantage and unemployment that will not widen social and health inequalities and is more cost-effective

 

Comments 4

  1. @landrights4all says:

    Change Centrelink’s Activity Test

    While in many cases unemployed people want or need certain Centrelink supervision, in the case of an individual who would CHOOSE to do community work for an organisation that has itself already been approved, three current restrictions are inappropriate and unnecessary.

    i) community work is only allowed if it can be shown that it is likely to lead to paid employment or if the individual can satisfy the case manager that it will improve their employability;
    ii) approval is only given for a limited time.
    iii) those wanting to do community work for an approved organisation must have a third party (either Centrelink or its agent) to individually approve and “case manage” their activity;

    To understand why these restrictions should be scrapped, it is helpful to see unemployed people in three groups.

    The three groups are:

    1. Those who will not quickly find employment, and will not choose community work.

    Appropriate Centrelink intervention is needed for people in this group, but because they will not choose community work, any community work restrictions are irrelevant for them.

    2. The majority, who are keen to find employment and do so within 3 months. From within this group, some may wish to do community work. They may see it as a pathway to the job and the income they want, or perhaps as a way of staying productive.

    The three Centrelink restrictions are superfluous for this group because these people return to employment quickly through their own initiative.

    3. Those who will not quickly find employment, but would choose to do community work.

    The three restrictions i), ii) & iii) mentioned above, are inappropriate for this group because –

    • the incentive of a higher income will, by itself, see most of these people back into employment as soon as they can get it;
    • the current restrictions discount the value of continued community work, and a person’s autonomy and self-motivation are discouraged.
    • even if employment is not on the horizon, continuing with community work will still mean unemployment being a more productive experience, particularly for those people having trouble finding work in today’s highly competitive labour market;
    • developing new skills and staying active in the workplace increases employment potential;
    • the fact that someone has chosen to do 32 hours of community work in a fortnight should be evidence enough that they are strongly motivated and keen to participate;

    Community work should be a standard option on the fortnightly claim form. The random phone check, which Centrelink now uses in an attempt to verify job applications to employers, would verify with certainty claims of community work with organisations without any need for Centrelink involvement in arrangements between the volunteer and the organisation.

    If a person who had chosen community work decided not to continue, they would simply tick a different box on the form. This would indicate that they had been doing some other approved activity, such as study or job search.

    This simple change would also help create abundant sustainable work in which people could learn to build social housing & grow their own food ( see http://www.bit.ly/ABqCbx )

    @landrights4all

  2. magoo says:

    @landrights That sounds logical and we well reasoned policy approach I would agree with, pity logic or reason are not prime concerns around policy debate in australia.

  3. Owen Gary says:

    @Lanrights4all

    Dont want to rain on your parade but what about (group 4)
    The group that cant find work because there are not enough jobs. You are assuming there are more jobs out there than people looking for them.

    I fundemental you should be aware of and that has been known since not long after the industrial age commenced.

    Unemployment is kept nominally at around 5% to keep wages down and demand for jobs just where the “bankster world” like it. 2nd point to this governments control nothing, rather they just hang on to the strings that pull them.

  4. @landrights4all says:

    Hi Gary,
    I think my groups 1 plus 3 covers your group 4, right?

    I am suggesting a change that would serve those who won’t get paid employment but would like to do community work, whether there are enough jobs out there or not. That is, the number of paid jobs available is not the point, although I do agree that paid work is hard to find and is destined to get harder as globalisation proceeds.

    The response to the shrinking availability of paid work could be either to try to hold back the tide, or to find a way for people to be happy and able to achieve a secure and better life without paid employment. I think this can be achieved through “localism” and participation in voluntary community work.

    @landrights4all
    Chris Baulman

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National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
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social media and healthcare
suicide
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telehealth
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TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
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Government 2.0
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Health in All Policies
health inequalities
health literacy
human rights
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injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
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National Preventive Health Agency
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Web 2.0
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Royal Commission
Social determinants of health
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Justice Reinvestment
NBN
Newstart
poverty
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Summer reading 2020-2021
Tasmanian election 2021
Testing Croakey News category 1
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
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#OTCC2017
#ResearchTranslation17