Podcast episode 4: ethics and morality in a postmodern world

podcts whit text psdA conversation with social work researcher, Dr Sacha Kendall

Dr Sacha Kendall began her social work career in acute mental health. She is now a qualitative health researcher. Her research investigates the social, cultural and ethical aspects of health, with a focus on marginalised populations. She is passionate about promoting qualitative approaches to understanding health and addressing health inequity.

Sacha contributed a chapter to a book I reviewed last year- Rethinking Values and Ethics in Social Work. In her chapter, she wrote about postmodern ethics for practice, drawing on the work of Zygmunt Bauman.

In our conversation, we mulled over some big questions.

  • What is the difference between morality and ethics?
  • How can social workers honour commitments to social justice?
  • Is professionalism grounded in ethics technical competence?
  • Are social workers experts in managing uncertainty?
  • How do we handle our moral responsibility for the Other, particularly in circumstances where the Other is a person with impaired competence as a result of severe mental illness?
  • And in the sphere of health and social science research- has research ethics delivered on its promises?
Posted in Ethics, podcast | 2 Comments

Black Panther: a film review – and a thoughtful lesson in post-colonial ethics

Black Panther is well on the way to be the most successful superhero movie of all time.

Kudos to the overwhelming number of African Americans, both in front of and behind the cameras, who made this movie so entertaining.

But many of the audience will not know or care who made the movie. They will simply enjoy it because it is a bit funnier, a bit smarter, and a bit easier on the eye than the average super hero film. (And a warning – there a plot spoilers ahead.)

So why bother to review this film? Black Panther also offers a delightful thought experiment on the choices that a nation has when it finds itself with the means to become an imperial conqueror.

Imagine a country with superior weapons, and a belief that its technology, culture, language, religion, medicine and forms of rule are the best on the planet. It could, like the ancient Romans, set about building an empire. Or in a similar vein a thousand years later, behave like the Europeans, fanning across the globe, with lawyers, guns, money, alcohol, flour and missionaries to spread its beneficence.  A beneficence that includes setting nations against each other and enslaving people with no means of defence. Or in an example closer to home it might mean (Like the Russians or Americans), arming minorities just enough to irritate you enemies and maintain an uneasy balance of power.

Alternatively, a potential global superpower might choose a more ethical course. Although we currently lack a worked historical example!

In the world of Black Panther, Wakanda is such a country. Hidden from view in central Africa, it is fabulously wealthy, high tech, and populated with a happy, stylishly dressed and enlightened citizenry. They have great music too!

Although my utopian dreams of government tend more towards decentralised anarcho-syndicalist collectives, I cannot fault the Wakandan King’s decision.

After some elegant CGI battles, the King emerges victorious from an internal civil war in which his opponent was intent on using Wakandan resources to forcibly establish an empire. (A very cool villain, with a heart- tugging back story)

We next see the King at the United Nations, offering his country’s wealth, science and technology to promote peace and prosperity for all.

And why not?

There is a corrupt hypocrisy that operates between governments and their citizens. All nations claim that whatever they do in the foreign policy space is guided by the noblest of motives. But everyone privately acknowledges that any congruence between good ethics and the “national interest” is a happy coincidence.

By and large the drivers of “national interest” are racism, sectarianism, fear of refugees and short term economic gain.

Lets hope we grow before we blow up.

Posted in Culture, Politics | Leave a comment

Just Another Do Gooder podcast- episode 3: stories of identity and belonging

 

In this episode I bring yolarge pod photou a conversation with well known author Patti Miller. As well as her long list of publications, Patti is also well known for conducting writing workshops in Australia and in Paris,  teaching aspiring authors the art of writing memoir.

She’s helped over 40 authors to publish their work commercially.

In our conversation  we talked about one of her memoirs entitled, The Mind of a Thief, and about her writing workshops.

Patti grew up in the town of Wellington in Western NSW. A few years ago Patti noticed a news item about the first post-Mabo Native Title claim in the Wellington Valley.

She began to wonder where she belonged in the story of the town. It led her to the question at the heart of Australian identity – who are we in relation to our cherished stolen country?

Feeling compelled to return to the valley, Patti uncovered a complex history of convicts, zealous missionaries, farmers and gold seekers who had all stolen land from the original inhabitants.

But not until she talked to the local Wiradjuri did she realise there were another set of stories about her town, even about her own family. As one Wiradjuri elder remarked ‘The whitefellas and blackfellas have two different stories about who’s related to who in this town’.

Black and white politics, family mythologies and the power of place are interwoven as Miller tells a story that is both an individual search for connection and identity, and a universal exploration of country and belonging.

In  our conversation-Patti and I burrowed further into the theme of identity as Patti told me how me she goes about helping writing workshop participants find their narrative voices and craft their  stories.

Many of our listeners will relate to the healing power of this process.
If you would like further information about her writing or her workshops- check out her website.

 

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Just Another Do Gooder podcast: episode 2- Is democracy dead?

podcts whit text psdIn this episode I ‘m bringing you an interview with Joanne Cotterill.

Joanne has a private practice as a clinical social worker in Mudgee – a small rural town in Western NSW. But the focus of my interview is her community development work- particularly in the northern rivers region of NSW  and her related research around the practice of democracy.

Joanne’s hope for democracy is

  • that it will evolve to become more direct, rather than mediated by politicians,
  • that it will be more inclusive of people from all backgrounds,
  • that it will be more thoughtful and deliberative,
  • and that it will never lose sight of our dreams of a better future.

She developed a process and a methodology called Polivote to collect the views of residents in her local government area and feed them back to her local Council, and she conducted some research into the efforts of like minded organisations in Australia and New Zealand.

The resulting work is available on the web, and I will post a link here shortly.

Her research details the efforts of 24 NGO’s working to improve citizen participation in government decision making.

Enjoy!

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Just Another Do-Gooder podcast- episode one: leaving christian fundamentalism

podcts whit text psdLeaving Christian Fundamentalism

Welcome to episode one of Just Another Do-Gooder.

I aim to bring you in depth interviews with social workers from across Australia,  as well as commentary and interviews from the realms of politics culture and human services.

In this episode I will be bringing you an interview with Josie Mcskimming, followed by some commentary on how we are being used and abused by social media. You may find yourself -like me- in surprising agreement with billionaire investor George Soros.

But now to my first guest Josie McSkimming – who has written a fascinating book based on her Phd.

Its title;  Leaving Christian Fundamentalism and the Reconstruction of Identity, and you can find it on Amazon.

The research project on which the book is based explores the stories of 20 volunteer subjects who have left Christian fundamentalist churches, their experiences  of how power operates in those churches, and how those people changed after they left.

The book is made all the richer by Josie frankly sharing some elements of her own story in leaving her church.

Josie is an adjunct lecturer at UNSW,  She ‘s previously worked in post-adoption services, couple and relationship therapy and drug and alcohol counselling. She has been in private practice for the last 18 years , specialising in adult mental health, addiction issues, relationship counselling and clinical supervision.

 

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AASW election 2017: reflections on our voting system and the challenges ahead

Another AASW election has come and gone. Most of the membership barely noticed.

8,917 members were eligible to vote, but only 1,608 did so; a bare 18%, and only a small improvement on last year. Of the remaining 7,309 members, most would have tossed their ballot papers into the bin. Well-intentioned but overly restrictive election by laws have contributed to keeping AASW elections a low participation sport.

The AASW however, has a very simple means at its disposal to significantly increase participation. It can ensure that every year there is an online forum/debate available for any member to log in live, or view later. This would give every candidate an opportunity to present their policies and answer questions. The mechanism to establish the format with an independent chair can easily be set up with appropriate by laws.

Candidates might also be more civil to each other if they conversed live – face to face. Indeed, I have on occasion felt that some candidates seem appalled that I have the temerity to be standing against them at all. They forget that a contest enhances legitimacy for the winners. We honour democracy and our opponents by showing up.

For a handful of members (around 500) the election was much livelier, due to their membership of social work Facebook groups that encouraged election discussion. (Kudos to the administrators of those groups). I do wonder what the non member social workers in those groups thought about some of the exchanges.

The results were as follows

National President

Christine Craik was elected National President.

Christine Craik (Craik ticket) 689 votes 43%

Vittorio Cintio (members first ticket) 626 votes 39%

Marie-Claire Cheron-Sauer 293 votes 18%

 

National Vice President

Lynne Harrold is elected National Vice President.

Lynne Harrold (members first ticket) 864 votes 57%

Barbara Moerd (Craik ticket) 639 votes 43%

 

National Directors

Peter Munn and Jenny Rose are elected National Directors.

Peter Munn(Craik ticket recommendation)  626 votes 21.4%

Jenny Rose (Craik ticket) 568 votes 19.5%

Julianne Whyte (members first ticket) 532 18.2%

Christine Fejo-King 479 votes 16.4%

David Gould 477 votes 16.3%

Jill Garratt 237 votes 8.1%

Congratulations to the winners. I am particularly pleased that my friend and members first running mate, Lynne Harrold, won a Vice President position. She will be a breathe of fresh air on the Board.

The result of the election was a serious wake up call for the ruling majority on the Board. Support for the ruling majority ticket declined again this year. In the election for President, Vice President and 2 Board members, the ticket of the current ruling majority yielded very similar percentages; for President 43%; for Vice President 43%; and for Board members 41%.  It is clear that 57% of voters are now unconvinced by the scare tactics of the ruling majority, or their narrative of trusting an experienced, safe pair of hands.

Despite their low 40’s percentage, the Craik ticket won three of the four positions up for grabs. This is simply due to the vagaries of ‘first past the post’ voting, particularly in circumstances where there are more than two candidates. If Christine Craik had only faced one challenger, either myself or Marie Claire, she might well have been defeated. And equally in an optional preferential system, facing two opponents swapping preferences, she might also have lost. Similarly, in an optional preferential system, challengers swopping preferences where two Board positions are available, would have in all likelihood, ensured that the Craik ticket and challengers got one position each, in the voting patterns apparent in 2017.

Let me be very clear that I am not questioning the legitimacy of the result. The rules are the rules. British government elections have been run in ‘first past the post’ fashion for many years. If I had been successful in a first past the post system, I would have taken the result- thank you very much! To quote an old Persian proverb- the dogs bark but the caravan moves on.

What I am questioning is the ‘first past the post’ system itself. Three years ago, on the recommendation of the independent Returning Officer it hires to run elections, The AASW adopted the optional preferential system. It is a system Australians are very familiar with, being used in most government elections. In 2016 however, the AASW returned to first past the post voting, without explanation, despite the Returning Officer’s advice to the contrary. To make matters worse, the AASW refused to release the Returning Officer’s report from last year’s election; something that most organisations release as a matter of course.

The optional preferential system is widely acknowledged as both fairer and more likely to honour diversity. Second and third preferences are meaningful, and matter when there are more than two candidates for a position.  Two years of ‘first past the post’ voting have ensured that the ruling majority have six out of the eight contested positions (75%), whilst having less than 50% of voting member support. Monocultures might be convenient in the short term, but cultures need diversity to thrive. An optional preferential system would have delivered a far more diverse and representative Board. The first past the post system is blind to any sense of representative fairness-  it will deliver lopsided, winner take all results, for whoever gets their nose in front.

As I have stated repeatedly, it is a disgrace for an organisation with a commitment to fairness and social justice to continue using a ‘first past the post’ system.

 Policy Challenges

Turning to the policy issues, six years of treading water has led to an urgent build-up of issues that need to be addressed.

  • The revised ASWEAS is imploding before the ink is dry on the new rules.
  • There is a shortage of quality student placements. We have no analysis of the root causes, and as yet no clear plan to address the issue.
  • We are far too reliant on member fees for income. For other associations CPD is a significant part of their revenue stream.
  • Members are crying out for specialisation and credentialing.
  • 14,500 social work students need to be signed up en masse.
  • We need to work with trade unions to protect social workers being asked to provide services in unethical circumstances.
  • We need innovation in providing networks for our members to connect with each other. This can’t be left to Facebook.
  • We need better and more responsive service to private practitioners.
  • We have 1,500 members on the introductory new graduate fee. Without a nationwide mentoring program, we can expect a significant number of these new graduates will not transfer to full fee membership.

The new Board has much work to do. I am sure we all wish it well, and hope it gets cracking.

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A personal reflection on the 2017 election and beyond

I am exhausted, and glad the election is just about over. All that is left is to ask people to take the time to go to the post office.

As is my habit of past years, I have taken down all my election posts. They are flotsam and jetsam against the hard shores of reality. But this post will stay.

Maybe because I am an optimist, I think that this will be the last election that looks backwards, and is overshadowed by the events of 2010/11.

I have regrets about that period. As a senior person in the AASW I could and should have done more to de-escalate the passions and tensions of that time. I suspect that there are other more eminent social workers than me, who now also feel the same.

Over the years it has become more and more apparent to me that the best way to live is to recognise the indivisible dignity of every human being. Easy to say and very hard to do.

We are wired for fight or flight. Decisions are arrived at through adversarial debate rather than a spirit of enquiry.  Social media quite consciously corals us into our separate camps: convenient echo chambers that reinforce our self-righteousness and sense of entitlement. Feuds that could be settled go on and on. I don’t claim any high moral ground in that regard.

But if we are to proceed in the best interests of social work we need to be respectful, inclusive and magnanimous. We need to focus on areas of agreement and strive for consensus. (Just about the opposite of the way elections are conducted!) The last thing the new Board will need is a forensic raking of the coals of this election. I put my hand up for having made that mistake before. Never again! Our members are entitled to a harmonious Board that does not nurse grudges and looks to the future.

Anybody who makes a voluntary contribution to the AASW, whether we agree with their politics or not, ought to be appreciated and honoured. Members who serve in elected positions build up rich knowledge and experience: not something to be lightly discarded. Outgoing Board members should be encouraged to stay involved and serve in other capacities. Past Presidents in particular have an enormous amount to offer. If we do not take advantage of this, we have failed in the simplest measures of our own values, allowing political passions to overcome common sense and decency.

If (by some miracle) I am the next President of the AASW, I will make every effort to reach out to Karen Healy. She has put in 6 years of hard work on behalf of all of us, built up networks, knowledge and insights that are invaluable. She deserves to be thanked and  revered, as do all past Presidents. I would hope that she would join the College. It would be a rich addition. And I would hope that she would continue to offer her counsel to the AASW in her areas of expertise. I would certainly welcome it. I hope to have the kind of relationship where I can just pick up the phone and ask for her advice. I would certainly need it.

We also owe our members this kind of continuity within and between Boards.

The average member might be mystified that these things need to be said at all, (and so this post is more a message for my senior colleagues). Most people would expect that this is the way we always do business. So let’s do our best to live up to it.

In the event that I am not elected, I will be back again next year and in following years offering my service. I think I have something to give by way of leadership and the right policies to set us up for a healthy future.

Next year I also plan to venture into podcasting with a colleague: a mixture of culture, politics and interesting interviews. I am anticipating it will be fun. We have a working title: “A Pair of Do- Gooders”!

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Aged Care: opportunities for social work to make a difference

Building an Integrated Practice in the Private Sector

By Lynne Harroldsocial work aged care

The community aged care sector for older adults is growing exponentially and will continue to do so as our population ages. The facts are there and the projections are clear, but despite this knowledge it seems that private social workers are lagging somewhat behind other professions in moving into this sector.  The challenge has in part been to do with the reluctance of this current aged cohort to seek our services,  and the restrictions of Medicare funding for residents in high care facilities. However all that is changing.

The current ageing of the very psychologically minded baby boomers has begun to change the culture in this sector with the demand growing for any type of service that can assist their needs. Furthermore funding streams are opening up. Prior to the introduction of My AGED CARE and the NDIS, private work in this field has been primarily limited to accredited mental health social workers via Medicare and DVA.

Changing systems creates opportunities and this is the time to start embracing these changes and start claiming our space in the market. We are needed and if we do not take leadership as a profession to claim that space, social workers will miss out and so will our clients.

The sector is becoming increasingly competitive with corporate enterprises vying for their share, in what is expected to be an increasing consumer driven market. Large GP super clinics employing allied health teams are partnering with some of the larger retirement villages and residential aged care facilities, which in effect make it difficult for the sole practitioner to access clients. Psychologists are developing specialist gerontology courses and positioning themselves in Aged Care facilities.

So how does the lone social worker navigate this terraine? How do we position ourselves in the market? Do we go it alone or are there safer options?

I would like to share my experience of how I am attempting to navigate this changing system on the NSW Central Coast an area which has the highest proportion of people aged 65 and over in the country. After many years of working as a sole practitioner in Sydney I made the decision only 12 months ago to resettle.  I also wanted to work with a team of like- minded social workers. The professional isolation of the sole practitioner was no longer for me.  I wanted to build a service that included a team of social workers who could deliver an array of services to the community aged care sector. My vision was to create mobile services for older adults living at home, and educational support to the aged care workforce. Not quite 10 months later I now have three people on that team with huge potential to grow.

So how has this been achieved?

We have aligned ourselves with several other private allied health services to set up the Central Coast Allied Health network. This network provides an array of mobile services to give wrap -around assistance to older adults  at home. Being able to offer a more holistic service to our clients is something that is crucial in being able to work with this age group who often have complex physical, social and mental health needs.

The network includes occupational therapists, dieticians, speech therapists, exercise physiologists, physiotherapists, podiatrists, naturopaths and of course social workers. It is this alliance and the cross referrals from these services that has created the foundation from which we grew our business in the early months. We facilitated this by educating each business as to our role, when referrals would be appropriate to our service and how we could best work together.

Apart from the advantages of cross referral the network is an effective way to market our service as a team or as individual service which is another bonus. It is a much easier way to access clients than attempting to market directly to GP’s. We did attempt to see individual GP’s when commencing the service but there was little interest in us as social workers. As our service has grown we are now beginning to get referrals directly from the GP’s! A sign to us of emerging success.

As a large network of specialised allied health providers we are also more strongly positioned to apply to funding bodies like our local Primary Health Network, which is more interested in funding larger conglomerates than individual providers.

We are not aligned to a large medical conglomerate choosing to keep autonomy of our business and our work and not be restricted to a medical model. The strength in this is that we are not paying the exorbitant rent and commission fees that many allied health providers are forced to do if they work in a large medical practice, or are contracted by many of the emerging corporate allied health companies that are now emerging.

As private social workers we are guided in business by our strong social work values and ethics, which in fact lend themselves beautifully to growing an ethical business.

As the business develops new opportunities arise.

Recently we signed up with two major community care providers as the sole service to provide counselling & general social work services to their clients and carers. Our services are being funded through the new care packages and also through Medicare and DVA. We are extremely interested to see how these packages work for our clients and for us. By working closely with these organisations, educating them on the bio/psycho/social needs of their clients and how we can assist them with their clients we believe that we are facilitiating cultural change within these organisations to better care for the needs of this age group.

We are very much aware that if our service is to survive and grow into the future there are real challenges ahead. Our challenges are the challenges that we as a profession are needing to address now if we are to secure a space for social work .

The first is recruitment. It is difficult to find social workers who have mental health accreditation and experience in either working with older adults or knowledge of the aged care system. Both are needed as are social workers with palliative care experience.

Secondly we need to stand out from the crowd as offering specialist skills.

Community aged care organisations provide untrained support workers and pastoral care positions to largely service the emotional distress needs of their clients. We need to be able to market ourselves as offering specialist skills. Credentialing gerontology and palliative care social work is much needed as is the opportunity to develop evidence based individual and group programs.

We also need the infrastructure as a profession to be able to network each other not only for recruitment purposes but to be able to strongly advocate for our clients. We are dealing with some of the most marginalised people in our society and need to be united in our quest for social justice in this sector.

I can truly say that I have never felt more of an advocate for my clients or for my profession since moving into the private sector. I strongly encourage others to get involved. Yes it is challenging but extremely rewarding and there is more than enough work for all of us now and in the future.

Lynne Harrold BSW/MSW had over two decades of working in community mental health before moving into fulltime private practice in 2006.She has subsequently worked predominantly in the private Aged Care sector. She is  the convenor of the NSW self-employed practice group as well as an executive member of MHSWiPP.

It was a pleasure to host this article on my blog. It was originally slated to appear in the AASW magazine- In Focus- but was pulled as it was deemed to give unfair publicity to Lynne during the AASW election period!

 

 

Posted in AASW Election 2017, Ethics, Private Practice, Social Policy | 1 Comment

Why aren’t more social work students joining the AASW?

older graduate image This year there are approximately 14,500 students enrolled in social work across Australia; a staggering number! (the entire membership of the AASW is only 10,000).

In 2017 we can expect around 1,200 graduates from qualifying masters programs, and 1,700 from bachelors programs.

Which universities are doing the heavy lifting? Actual figures from 2014 indicated that five universities had enrolments of more than 500 students. These were the University of South Australia with 778, Charles Sturt with 676, Western Sydney University with 550, Latrobe with 546, and Deakin with 528.

The AASW keeps its student membership numbers secret (why?). Nevertheless, I can be confident in guessing that AASW student membership is a tiny proportion of 14,500.

When I talk with students about this, a few themes emerge,

  • Many students are in abject poverty and the membership fee is beyond their means
  •  some students see the AASW requirements around recognition of prior learning, and  placement hours and attendance as punitive and irrational
  • Exposure to AASW marketing is on campus is patchy or limited

I would add to this by saying that in my estimate, only around 50% of social work academics are members of the AASW.

Boosting student membership is an issue of real urgency. The future health of the social work profession is in the hands of the next generation.

We must have,

  • a $10 membership for students
  • free mentoring for students and new graduates
  • a memorandum of understanding between Heads of Schools of Social Work and the AASW that guarantees regular access to students for marketing purposes
  • a placement regime that strikes a sensible balance between outcomes and hours
  • an AASW student club on every campus
  • a national student advisory body

 

 

Posted in AASW Election 2017, AASW Policy and Strategy, Uncategorized | 8 Comments

The NDIS: ethics, dignity and choice: some dilemmas for social workers

smaller finger painting

Let me frame this piece by stating unequivocally that the NDIS is a genuine capacity building initiative and a great social good. Its current target is to improve the lives of 460,000 Australians with individual funding packages, to help them to participate more fully in their communities. It enshrines in legislation the assertion that,

people with disability have the right to determine their own best interests, including the right to exercise choice and control, and to engage as equal partners in decisions that will affect their lives (National Disability Insurance Scheme Act 2013, Section 4 (8))

and that people with disabilities should be supported so that,

in all their dealings with the NDIA..their capacity to exercise choice and control is maximised in a way that is appropriate to their circumstances and cultural needs (Section 4 (9))

 Our taxes (via the Medicare levy) have been increased to help cover the costs, and no sensible person would begrudge paying a bit more to help their fellow citizens to participate more fully in their communities.

The design of the scheme and the manner of implementation does however create risks which will inevitably continue to cause harm if not dealt with quickly.

Firstly a few words about outsourcing. This is the ‘go to’ methodology of governments captured by free market thinking. Outsourcing ensures that labor markets are fluid and flexible. But as we know the ‘flexibility’ is one way. Workers are paid less, career prospects diminish, 12 month contracts are standard, and professional development is less likely to be employer subsidised.

Governments are also striving to outsource risk and responsibility; not always successfully. And when things go wrong, the fallout can degenerate into enquiries, commissions, and a farrago of fingerpointing.

The NDIA has outsourced to varying degrees the assessment for eligibility, service planning and delivery of the scheme. In NSW for example, the NDIA has “commissioned” three “Partners in the Community”, for what is described as “local area co-ordination”. These partners are Uniting, the St Vincent de Paul Society, and Social Futures.

To use the word ‘partner’ in this context is to stretch the word completely outside its ordinary meaning of – a joint venture with shared risks. The NDIS has designed and funded the rollout to its smallest detail. In this context, comparing even the largest NGO to the NDIA is to compare a mosquito to a 160 kilo gorilla. It is a franchise, not a partnership; and the NDIS has done its best to outsource all risk to its franchisees.  Every NGO, every relevant NGO employee and every sole provider or small business must sign a Declaration of Suitability to be registered as a service provider with the NDIS. Providers declare that they are compliant with all employment and workplace health and safety laws, and that they have mechanisms in place to ensure that any contractors engaged also comply.

The Royal Commission into the Home Insulation Program (HIP) had some relevant points to make about the attempts of the Australian Government to outsource risk. Why, do you ask, am I bringing the ‘pink batts’ disaster into this discussion? We are all familiar with mess and chaos around outsourcing refugee processing and the operation of detention centres, but the example closest to the NDIS is probably the HIP rollout; A huge scaling up of existing services, a significant social good, and the apparent necessity that it be done in a hurry. In its wake, there were four tragic, avoidable deaths, as well as number of enquiries and a royal commission. Most readers will recall that the aim for the HIP was to install insulation into the ceilings of some 2.2 million Australian houses in a period of two and a half years. This was a stimulus package in response to the global financial crisis, that was also designed to bring significant environmental benefits.

In relation to outsourcing, there are some comments of the Royal Commissioner, Ian Hanger, that are worth quoting at length,

Government must recognise that as much as it might seek to do so, risk cannot be abrogated. The responsibility of Government is to care for its citizens and to exercise care and diligence to do everything reasonable to ensure citizens are not placed in danger by its actions…

It was said, by a number of federal public servants, that the Australian Government had no regulatory power in the field of workplace health and safety, and therefore that it was not a risk that the Australian Government could control. In my view, this attitude was deplorable. I discuss..the purported reliance of the Australian Government on the States and Territories and conclude that such reliance was both unjustified and unreasonable

Pretty blunt!

In my view, the most serious flaws in the NDIS occur at the very beginning of the assessment and planning process, and continue for those participants who need service coordination funded by the NDIS.

As things stand, at the beginning of the planning process, potential participants are asked a range of questions by “local area coordinators” to determine eligibility and formulate a plan. All the information needed to generate goals, support and a 12-month budget are gathered; usually in one meeting. Participants may have some verbal confirmation of the answers they give. This data is uploaded for a centralised desktop assessment and a plan is sent back to the participant as a fait accompli. The legislation makes it quite clear that as soon as a plan is approved, it comes into effect. But there is in fact no reason why a paper copy of the participant’s answers could not be left with them for a week, in order to double check completeness, accuracy, and to fully digest the implications for the participant; and further, that the plan be considered a draft, subject to discussion. Remember that the Act states,

people with disability have the right to determine their own best interests, including the right to exercise choice and control, and to engage as equal partners in decisions that will affect their lives. (my emphasis)

This a lopsided transaction; it is not a partnership. It is an insurance assessment that gives the most vulnerable participants no time to review or reflect. (Sixty percent of approved plans in the third quarter of 2016/17 were for participants with an intellectual disability or autism.) I have heard anecdotal evidence of 12 month reviews of plans that revealed unreasonable anomalies between what was needed and granted to assist participants in achieving their goals. But this is not just a question of efficiency and accuracy; it is one of fundamental dignity.

I don’t know what has been happening behind the scenes, but I find it puzzling that disability advocacy groups have not made more of a public fuss about this? I do know however, that governments of all persuasions have lately paid lip service to human rights, whilst simultaneously de-funding robust advocacy. Any consumer group funded by government has difficult choices to make, if it involves biting the hand that feeds it.

These ‘take it or leave it’ plans also present ethical dilemmas for local area coordinators. Some of these frontline workers might make an ethical choice to defy NDIA driven KPI’s and routinely give participants time to reflect in a genuine partnership. But this could be a hard choice for anyone to make, working on low paid 12 month contract.

Ironically, in the Royal Commission into the HIP, Commissioner Hanger had plenty to say about ethical pressures faced by public servants fearful of their tenure.

It has been a long-standing principle that public servants had security of tenure giving them both longstanding experience in the field of public administration, a great depth of knowledge about that art and the workings of various portfolios. Security of tenure has another important consequence: public servants could, if warranted, advise their Minister against certain courses of action, and in trenchant terms if necessary.

 I found the APS Values and Code of Conduct .. a valuable resource..(in particular) the concept of frank, honest, comprehensive, accurate and timely advice, referred to in ..the Public Service Act. After having read all of the documents provided to the Commission, and having heard all of the evidence given particularly by public servants, I have little doubt that had such advice been given at key junctures of the HIP, the tragedies that occurred would have been avoided..

Commissioner Hanger couldn’t however bring himself to recommending security of tenure. Instead he advised these senior civil servants to include a “devil’s advocate” section in their briefing templates! Astonishing advice to some of the smartest and most skilful people in the country.

This underlines just how unreasonable it is to expect individual workers, either in management or the frontline, to defy the powerful, when dignity and human rights ought to be built into the system. Only a concerted, combined effort by the relevant trade unions, disability advocacy groups, and the range of professional associations that cover these frontline workers, will ensure that justice prevails.

And, as can be seen from the pink batts disaster, should some scandal or tragedy occur, there is no guarantee that the senior public servants will be able to successfully argue that they washed their hands of all risk.

Turning our focus to ‘support coordination’, it is important to note that this is the only funded service that gets a mention in the Declaration of Suitability. It will soon become apparent why this is the case. (The role of support coordinators is to work creatively and resourcefully with NDIS scheme participants in how they utilise their support budgets to achieve their goals.)

Social workers (along with other Allied Health professionals) can register to provide specialist support coordination; their tertiary qualification and relevant experience being routinely accepted as sufficient credentialing. But few participants need specialist support, and the more generic ‘line item’ of support coordination is open to a broader range of workers. Obtaining credentialing to provide generic service coordination requires the provision of extensive evidence to state based credentialing agencies. It is time consuming, and may cost thousands of dollars. Workers who already have specialist support coordination credentials, are given no recognition, or advanced standing in applying for generic support coordination; an illogical anomaly that also has important consequences for participants.

NGO’s have put themselves in the business of providing support coordination in the marketised environment of the NDIA. Importantly some of them seek to provide a ‘one stop shop’ that offers both coordination, as well as the services themselves. (Sometimes as a hangover from how they used to do business pre the NDIS era.) The inherent conflict of interest is so great that the Declaration of Suitability document seeks to outsource this risk. Paragragh 12 requires that individuals and agencies to declare that

If you are seeking approval in relation to both the provision of supports and managing the funding for supports under plans- the provider has mechanisms in place for dealing with conflicts of interest when performing both of those roles in relation to the same participant.

Because of social work’s robust code of ethics, it is reasonable to say that social workers (along with other health and disability professionals) have been at the forefront of embracing the disaggregation of service coordination from service provision. Let me remind you again of Section 4 (8) of the Act,

people with disability have the right to determine their own best interests, including the right to exercise choice and control, and to engage as equal partners in decisions that will affect their lives 

Hypothetically, if a sole practitioner social worker were providing support coordination, and a participant wanted to stay with agency XYZ for occupational therapy based services, but wanted to change their speech therapy from agency XYZ to another provider, the social worker would do their best to honour this choice. If, however agency XYZ is providing support coordination and a range of services (as it might have before the NDIS), it is a nonsense to think that the agency will be as scrupulous in honouring the wishes of the participant, no matter what “mechanisms” it has “in place”. The proper intent of the Act could easily be implemented, by simply stating that agencies cannot provide both coordination and services to the same participant. Problem solved; end of story.

Let us hope that it does not take a scandal or a tragedy for this problem to be fixed. And again, we ought not rely on individual whistle blowers to bring it to the public’s attention. The combined efforts of trade unions, consumer groups and professional associations is a better way to get the changes we need. To continue to allow agencies to provide a ‘one stop shop’ simply facilitates patronising attitudes that no longer have a place in a society that respects the worth and dignity of every human being.

Want to continue the conversation on Facebook? I have created a page connected to my blog for just that purpose. fb.me/socialworkblogger

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