Some health-based analysis of the Gonski review of schools funding

(Extra comments have been added to the bottom of the post, Feb 22)

For those with a concern for the community’s health, the Gonski review of schools funding is important reading, not least because of its strong focus on equity.

The report recommends that federal, state and territory governments, in consultation with the non-government school sector, should make reducing educational disadvantage a high priority in a new funding model, with resourcing to be targeted towards the most disadvantaged students.

Gonski and co identify “five factors of disadvantage that have a significant impact on educational outcomes in Australia”. They say: “At the student level these factors are socioeconomic status, Indigeneity, English language proficiency, and disability. At the school level, remoteness is demonstrated to have an impact on student outcomes.”

The inequities that the report identifies in education are related in many ways to the inequities that occur in the distribution of health, as well as in access to healthcare.

Its recommendations aim to ensure that “differences in educational outcomes are not the result of differences in wealth, income, power or possessions” and that “all students have access to a high standard of education regardless of their background or circumstances.”

Imagine what might be different if Australians were committed to ensuring that “differences in health outcomes are not the result of differences in wealth, income, power or possessions” and that “all Australians have access to a healthy environment and a high standard of health care regardless of their background or circumstances.”

Clearly it is not only health policy that might take a different tack.

Similarly, the solutions to some of the inequities identified by Gonski don’t really lie within the realm of school funding mechanisms.

Addressing inequities, whether these are reflected in health and/or education outcomes, requires broader social and economic action, including community development.

More fundamentally, it requires an electorate who understands these things matter, for society as a whole, as well as for those who are not currently getting a fair deal.

Below are some Gonski-related comments from Croakey contributors and below that are some extracts from the report, and (if you’ve still got the eyepower) some links to further reading.

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If only Gonski was driving health reform

Professor Stephen Leeder, Director of the Menzies Centre for Health Policy at the University of Sydney and Chair of the Western Sydney Local Health District:

The Gonski Report is a refreshing and excellent document that takes the matter of equity seriously in ways that in health care we seem to have forgotten.

The report recognises that disadvantage and marginalisation require the investment of more resources to achieve relatively equitable outcomes. Equity is not equal amounts of cake for everyone with an appetite, but measured amounts according to need.

It would be wonderful to hear discussions such as the Gonski Report contains informing our deliberations about efficient pricing in the context of Activity Based Funding where an assumption appears to be that one national efficient price can be set for a clinical service irrespective of the socioeconomic or other marker of disadvantage of the patient.

And then Gonski also speaks about outcomes!!  Wow!  Not just activity!  Bring him on!

 

 

 

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Gonski a boost for public health

Professor Helen Keleher, president of the Public Health Association of Australia:

Evidence-based resources related to education

Jodie Doyle, Managing Editor, Cochrane Public Health Review Group, and Research Fellow, McCaughey Centre, University of Melbourne:

Reference to the reviews done and underway with the Education Group of the Campbell Collaboration might be appropriate. Their published reviews are here: http://www.campbellcollaboration.org/reviews_education/index.php

Many more are underway, including one that the Cochrane Public Health Group is leading and the Education Group are co-registering, on “Later school start times for supporting the education, health and well-being of high school students” (see published protocol at http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009467/abstract).

This review will look at differential effects by geographic and socioeconomic factors as well as private vs public schools, and resources required for implementation.

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What are we seeking to achieve?

Associate Professor Gawaine Powell Davies, CEO, UNSW Research Centre for Primary Health Care and Equity, University of NSW:

The Gonski review is all about school funding, according to its terms of reference. We might ask: funding for what?

The terms of reference talk of ‘promoting excellent educational outcomes for all Australian students’, ‘improving educational outcomes’, ‘educational achievement’ and ‘ensuring all students have access to a world class education’. All unarguable, and all splendidly content free.

What educational outcomes do we want? What is a world class education? Is it about performance in tests? Life skills? Emotional maturity?

There is also little about the social function of schooling. There is reference to the ‘role of government funding in providing parents with choice among diverse schools’, but what about the role of schools in promoting social cohesion? A shared culture? Evening up the playing field of opportunity for each new generation?

It is easy to snipe, and of course a review of school funding needs to focus on just that; and the growing incivility of public debate makes open discussion difficult. But the poverty of debate about education means that we have not really thought about the services we are paying for, and what we want them to do for us.

Sound familiar? The health reforms suffered the same limitations: no real debate about the purpose of the health system, the services that people needed to receive, and therefore the health care that we wanted from our newly structured system.

What might we be looking to achieve with our education expenditure?

From a perspective of wellbeing we might look for progress in areas such as young people:

·        believing they are worthwhile and have a valued place in our society
·        understanding their social, emotional and physical being in ways which enable them to look after themselves and their friends
·        having a sense of the evolving history and culture of the country in which they live
·        having a sense of joy and competence in creativity and problem solving
·        having a strong foundation in the basic skills of daily living: language, numbers, communication…
·        being well placed to take part in the working, social and cultural life of their communities.

From the school system we might look for progress towards:

·        mutual understanding and acceptance between different social and economic groups
·        equality of opportunity for each new generation.

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Education is about so much more than literacy results

Dr David Briggs, Adjunct Associate Professor, School of Rural Medicine and School of Health, UNE, Editor, Asia Pacific Journal of Health Management:

From a health perspective, the Gonski review should provide some focus on the social determinants of health and on preparing young people with life skills and an appreciation of lifelong learning.

While the focus appears to be on measuring literacy in maths, science and English, we are now seeing generations that have had little background in supportive stable home environments on which they might model their future behaviours.

The value of relationships, healthy activity, fitness, lifestyle, good nutrition and productive effort need to be seen as equally important.

There are many good examples of these endeavours already in place in our schools but a funding system that focuses purely on performance measures on literacy needs to not only be avoided, but should be an opportunity to highlight the importance of these fundamental educational objectives in building good lives and opportunities for young people.

In the end they will be our future leadership and their education and socialisation will determine what sort of a health system we need.

Too much concentration on ideology around public/private funding will obscure the importance of these more fundamental issues.

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Focus should be on those who need the most help

Professor Gavin Frost, University of Notre Dame Australia:

I think the evidence that health status rises with educational level should mean that primary and secondary education should be pushed to those at greatest need – Aboriginal and Torres Strait Islanders, refugees and families in social/financial distress.

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Broadening the discussion about youth health

Richard Eckersley, researcher and writer:

Young people’s health and wellbeing does not only depend on how they personally respond to social, economic, cultural and environmental issues in terms of their own choices and behaviour and how these shape their health, but also on their role as citizens or social agents in changing those conditions to improve population health.

This broader, social role has particular relevance to the cross-curriculum priorities (sustainability, Asian studies, Indigenous studies) and how they might bear on, and incorporate, young people’s health and wellbeing.

Indeed, students’ health and wellbeing could provide an integrating framework for the whole curriculum.

I’ve included a few extracts from my writing below to elaborate on these points…

Population health:

….Acknowledging the importance of culture and mental health highlights the social significance of health in two ways: by casting new light on human development and national progress, and by showing health is an important social dynamic: a cause as well as a consequence of social change and people’s resilience. A broader view of the science and politics of population health would not only benefit health directly, it would allow public health to play a more influential role in public and political debate about national and global issues and priorities, including sustainable development, so having a more indirect, but ultimately powerful, effect on people’s health and wellbeing.

Sustainability:

…. Population health perspectives can make an important contribution to sustainable development: they provide a means of integrating, balancing and reconciling different social priorities by allowing them to be measured against a common goal or benchmark: improving health and wellbeing. Population health is, then, a key element of the quest for a socially, economically and environmentally sustainable way of living – humanity’s greatest present challenge.

….A broad view of population health and its social determinants – socio-economic, cultural and environmental – challenges the legitimacy of the dominant worldview or paradigm of material progress (which gives priority to economic growth and a rising standard of living), and supports the alternative, sustainable development (which seeks to balance and integrate social, economic and environmental goals to achieve a high, equitable and enduring quality of life). The contest between the two models, or narratives, of progress has been framed in economic and environmental terms, and the social dimension has been neglected. Population-health research can help to correct this distortion.

For example, it is clear that material progress does not simply and straightforwardly make people richer, so giving them the freedom to live as they wish. Rather, it comes with an array of cultural and moral prerequisites and consequences (for example, giving priority to money and what it buys) that affects profoundly how people think of the world and themselves, and so the choices they make. The pursuit of material progress, of evermore enrichment, as a cultural (and political) priority is jeopardising global health in ways that go well beyond issues of socio-economic disadvantage and inequality.

Thus the core social challenge is not primarily a poverty of the means to the end of ‘the good life’ as it is currently defined and pursued; it is a poverty of the end itself. Giving the poor and marginalised the opportunities and privileges of the majority, however much it will help them, will not solve the problems of population health; nor will reducing inequality. This is especially true in the developed world, but it also applies to developing countries such as China and India, which have a rapidly growing middle class that is increasingly susceptible to diseases of affluence and modernity. Worldwide there are over 1.3 billion people who are overweight and about 800 million who are underweight, and the numbers are diverging rapidly.

Indigenous studies:

…. Sveiby and Skuthorpe suggest in Treading Lightly that traditional Aboriginal society provides a model or recipe for sustainability. But the word that came to my mind in reading the book was that this was a parable or allegory for our times, an extremely important one. The moral is not that we could or should adopt an indigenous lifestyle, but that we need to recognise that other, quite different, and even better, ways of making sense of the world and our lives are possible. And not only that: we need to examine our present situation at this most fundamental level if we are to have any chance of achieving a high, equitable and durable quality of life.

Asian studies:

…other evidence for the need to look beyond happiness scores comes from studies that suggest collectivists have a higher tolerance for contradictions, cope better with change, are more flexible across social situations, and think more holistically. East Asians exhibit ‘holistic’ cognition, characterized by paying attention to the entire stimulus field and the use of dialectical reasoning, while Americans exhibit ‘analytical’ cognition, characterized by paying attention to isolated details and the use of Aristotelian-type logic. East Asians focus more on relationships and connections, on fitting in rather than standing out. Being less concerned with self-esteem, they are more willing to appraise their strengths and weaknesses, to address their shortcomings and to persevere in the face of difficulties. These differences have obvious implications for how societies deal with modern conditions and challenges. Even the most cursory assessment of China and the United States today exposes the danger of using happiness as a measure of their national performance.

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Extracts from the Gonski review

Recommendations include:

That all recurrent funding for schooling, whether it is provided by the Australian Government or state and territory governments, be based on a new schooling resource standard.

This standard would provide loadings taking into account socioeconomic background, disability, English language proficiency, the particular needs of Indigenous students, school size, and school location.

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Problems identified by the report include:

Australia lacks a logical, consistent and publicly transparent approach to funding schooling.

In addition to declining performance across the board, Australia has a significant gap between its highest and lowest performing students. This performance gap is far greater in Australia than in many Organisation for Economic Co-operation and Development countries, particularly those with high-performing schooling systems.

When compared to other high-performing OECD countries, Australia’s schooling system is characterised by a strong concentration of disadvantaged students in certain schools, and conversely, a strong concentration of advantaged students in other schools. Australia also has a relatively low proportion of students who attend schools with average or mixed socioeconomic backgrounds.

In 2010, 36 per cent of all government school students were from the lowest quarter of socio-educational advantage compared to 21 per cent of Catholic school students and 13 per cent of independent school students.

Across all sectors, there are some schools with far greater concentrations of students in the lowest quarter, as well as other schools that cater for more students from the higher quarters of socio-educational advantage. Of all students in the lowest quarter of socio-educational advantage, almost 80 per cent attended government schools.

Research commissioned by the panel found that one-third of all Australian schools serve a student population where the average socioeconomic background of students is below the national average.

Data indicate that there is a more even spread of socioeconomic backgrounds among students attending Catholic schools, than government and independent schools. In 2010, 21 per cent of students attending Catholic schools were from the bottom quarter of socio-educational advantage.

Almost half of all independent school students (47 per cent) fall into the top quarter of socio-educational advantage. Some 13 per cent of students in the independent sector are in the bottom quarter of socio-educational advantage.

Enrolment data also confirms a steady drift of students from the government sector to the non-government sector that has been evident since the late 1970s, as well as a tendency for parents from higher socioeconomic backgrounds to move their children from government schools to non-government schools or select-entry government schools.

Almost 60 per cent of the decline in government school enrolments between 1975 and 2006 occurred in the top half of the socioeconomic status distribution.

Government expenditure on schooling in Australia is relatively low in comparison to other OECD countries. The OECD estimates that public expenditure on primary, secondary and post-secondary non-tertiary education in Australia was 3 per cent of gross domestic product (GDP) in 2008, compared to an OECD average of 3.5 per cent of GDP.

In terms of private expenditure on primary, secondary and post-secondary non-tertiary education, Australia is above the OECD average, with private expenditure equating to 0.6 per cent of GDP in 2008, compared with the OECD average of 0.3 per cent of GDP. These data can be explained in part by Australia’s large non-government school sector.

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On the positive side…

The number of Australian students who attain a Year 12 or an equivalent qualification has progressively increased over the past decade. In 2001, 79 per cent of the population aged between 20 and 24 had completed Year 12 or AQF Certificate II, and 77 per cent had completed Year 12 or AQF Certificate III. By 2010, these percentages had increased to 86 per cent and 84 per cent respectively.

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On links between education and health

As many researchers have found (Johnston 2004; Levin 2003; Lochner 2011; Wilkinson and Pickett 2009), higher levels of education are associated with almost every positive life outcome—not only improved employment and earnings, but also health, longevity, successful parenting, civic participation and social cohesion. Countries that have significant numbers of people without adequate skills to participate socially and economically in society endure higher social costs for security, health, income support and child welfare.

High-quality schooling fosters the development of creative, informed and resilient citizens who are able to participate fully in a dynamic and globalised world. It also leads to many benefits for individuals and society, including higher levels of employment and earnings, and better health, longevity, tolerance and social cohesion.

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Beyond policy silos

Strategies to address educational disadvantage in school are most effective when integrated with, and complementary to, approaches to support early childhood development… to help ensure that disadvantaged students arrive at school with the skills and capabilities they require to participate in schooling.

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Further reading

• Response from experts at The Conversation

• One Croakey contributor recommended this article from The Atlantic about what can be learnt about education from Finland (it’s all about equity).

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Update, February 22:

Gonski recommendations are in the public interest

Dr Matt Fisher, Research Officer at the Southgate Institute for Health, Society & Equity at Flinders University:

The current national approach to education funding contributes to inequities between private and public education sectors; both in terms of funds per student, and a growing social divide in the SES backgrounds of those attending private or public schools.

Both contribute to a concentration of students from disadvantaged backgrounds, or with health or learning problems, in underfunded public schools in disadvantaged areas. And, as argued in the Gonski report, the outcome is social inequality in educational achievement.

A wealth of Australian and international evidence make clear that a person’s level of education is a significant predictor of their mental and physical health status later in life; probably in part because it is so closely linked to employment prospects and income, which may in turn affect other factors such as housing.

Early childhood and primary education are especially crucial in enabling children to reach their cognitive and educational potential.  Thus, education is especially important as a social policy tool because it influences a number of other determinants of health, over the whole life course. Inequities in education today will feed tomorrow’s inequities in health and well-being, with all the long-term downstream public costs that implies.

Thus, there is a strong public-interest case in favour of measures recommended in the Gonski review to reduce inequities in education funding and infrastructure investment, and address the needs of disadvantaged schools. Hopefully the Gillard government has the courage to make this argument.

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… but real reform is unlikely

Stephen Long, the ABC’s economics correspondent, writes that the Gonski report shows that the wealthier “independent” schools (to use the report’s terminology) are bastions of privilege, while government schools are a repository for the disadvantaged.

He thinks the chances of genuine reform are slim given the Labor Party’s fears of being accused of “class warfare”.

Long says: “The sad truth is that the “class warfare” is being waged in the opposite direction – as public money disproportionately subsidises wealthy schools, while the disabled, the disadvantaged, and sons and daughters of low-to-middle income earners are left to languish in underfunded schools denied a fair share of the pie.”

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Also, my piece in the Crikey bulletin looking at the “lesser known Gonski review”, joining the dots between inequities in health and education.