The world of work has changed significantly in the last 25 years. Permanent employment is declining and casual and part time work are on the rise. Outsourcing is fashionable, and markets (we are told) can deliver whatever we need. Trade unions are in retreat, real wages have flatlined, and our personal household debt, per capita, is amongst the highest in the world.

In this environment the ranks of the self-employed have risen, in our industry and others. There are now around 2,000 social workers in private practice across Australia, counseling, consulting, teaching and training. Needs must when the devil drives! We are all familiar with the alphabet soup of acronyms that are the sources of our income- DVA, MBS, NDIS, and EAP to name a few.

Whilst not telling the whole story of the rise in private practice, a cursory glance at MBS item number 80160, (individual focussed psychological strategies provided by a social worker) illustrates some of this growth in the mental health social work sector.

In the financial year 2007/2008, almost 71,000 services were provided, and this had more than trebled by 2015/16 to over 231,000 services, for which Medicare payed out approximately 18 million dollars. The strongest growth was in Victoria.

The story of how the AASW gained social work access to Medicare goes back to the 1990’s. In 1997 the Commonwealth Department of Health, as part of a mental health services reform process, held consultations with social work, nursing, psychology, occupational therapy and psychiatry, as well as consumers, to discuss the future of education and training of the professional mental health workforce.

The AASW was granted $50,000 by the Department of Health to develop standards of social work practice in mental health settings. When these competencies were published in 1999 they were groundbreaking, and remain the foundation document on which the AASW Practice Standards for Mental Health Social Workers is based. It is these standards that informed the mental health accreditation of social workers and their entry into the Better Access program in 2006.

It was also around this time too, that the AASW set recommended fees for its private practitioners. These fees were unfortunately set lower than Australian Psychological Society recommended fees for similar services- a mistake that would come back to haunt us, as Medicare used our own recommendations against us when setting MBS fees and rebates. Since then the AASW has made repeated representations to government (to no avail) to establish rebate parity with psychologists for similar services. On top of this social workers have suffered the further indignity of a Medicare rebate freeze since 2013.

Many social workers will remember the 2010 budget cuts that threatened social work clients access to Medicare rebates. The AASW led a strong political campaign, reminding the public at the time that more than one-third of social workers using Better Access were based in regional, rural and remote parts of Australia, more than 60% of them offer bulk-billing to at least some clients, and more than two-thirds of clients when surveyed, said they would be unable to access these services without Medicare funding. The direct action of the private practitioners forced the government to back down.

Private practitioners have become a cornerstone membership cohort within the AASW. In other parts of social work, membership penetration is usually no more than 25% to 30% of the maximum membership potential. But in private practice it is likely to be more than 90%. That constitutes a relationship of profound significance for both sides.

The AASW is not a trade union, but it should by necessity include some elements of industrial representation for its members in private practice. There is no alternative.- and private practitioners are doing it tough. Those of us working for an employer enjoy regular pay rises, but the self employed are forced to pass on rising costs to their clients or take a pay cut. And the current Federal Government is as mean spirited as they come in setting rates in ‘markets’ it has created in education, health and welfare.

Whilst the AASW cannot be faulted for its efforts in making representations to bureaucrats, these are not administrative issues, but politics pure and simple.

We have governments that are hostile to pay rises, and indifferent to the marginalized and the disadvantaged. ‘User pays’ and ‘outsourcing’ are their chief weapons. Political problems require political solutions. The AMA has no fear when it comes to political campaigns on behalf of its members. Go to their website and you will find a range of campaign resources related to the Medicare freeze, including templates that can be used to print a copy of the AMA’s Medicare Freeze poster in the tear off portion at the bottom of computer prescription forms. You will also find instructions on how to share campaign material on social media. The poster itself is highly emotive, featuring a distressed mother and a crying baby with some bold text stating- “The cost of running this practice will rise substantially between now and 2020. You will pay a new or higher copayment every time you visit you GP, every time you visit other medical specialists, every time you need a blood test, and every time you need an x-ray or other imaging. Tell your local MPs and election candidate you are not happy.”

There is an urgent need for a well resourced political campaign of this kind on behalf of social workers and their clients, perhaps in concert with the other allied health professions affected by the freeze. It is about time that every Coalition and independent MP heard from us.

 The AASW also need to think very seriously about the resources that private practitioners need in order to thrive in the current marketised environments. On top of their annual membership fees ($670 in 2016), mental health practitioners pay an additional $200 pa for their ongoing accreditation. Assuming 2,000 members, that amounts to $1,340,000 pa in regular fees and $400,000 pa for the accreditation surcharge. Add this up and it reveals that 20% of the members account for 45% of member revenue! Despite achieving their highest ever profit in 2016, and having a strong ratio of assets to liabilities, the AASW has introduced a 4% fee hike this year to both the full membership component ( to $697 pa) and the accredited mental health social worker fee (to $208 pa). It will be interesting to see how this hike is justified.

The $208 pa fee is levied only on the mental health accredited practitioners – and so ought to be applied exclusively towards capacity building for that group. This includes not only customized CPD, but also workshops to train our most experienced private practitioners so that they can pass on their knowledge and skills to fellow members. We can create a virtuous circle, skilling up our experienced members, on the proviso that they will offer some of their time in the following year or two, to teaching fellow members at subsidised rates. I am fed up with seeing non social workers advertising expensive training in our National Bulletin. Access to our members is a precious resource, and our motto must be ‘members first’.

Just as important is enabling those who want to take the next step beyond solo practice. Professor Ian Hickie, a National Mental Health Commissioner has called on PHN’s to deliver more appropriate, multidisciplinary care for those service users with complex and ongoing needs. Wholistic models of care are built in to the social work DNA. The AASW needs to be providing the skills and resources to help social workers build multidisciplinary practices that can bid for tenders to provide packages of care.

And last but not least, private practitioners need a professional networking platform on their smartphones linking them to fellow members in a community of practice. The small proportion of private practitioners who use AASW SWOT will agree with me on how clunky it is.

These urgent steps have not been taken because of a failure of governance. Private practitioners do not have a proper voice in the life of the AASW. They need a well-resourced policy development forum, a transparent conduit to the Board, and some measure of independence in running their own affairs.

The use of the word “corporation” in the same sentence as “social responsibility” usually conjures up cartoon-like images of global pharmaceutical firms or telecommunication giants being caught behaving immorally.

But even small non- profit professional associations are not immune to poor behaviour. Indeed, not long ago the American Psychological Association (APA) substantially watered down its Code of Ethics in order to provide psychological services to the US Department of Defence (DoD) during the investigation and torture of terror suspects. An independent report concluded that the principal motive was to curry favour, to keep the growth of psychology unrestrained and to create a good public relations response to terror interrogations.

There is clearly a growing disconnect between a moral conscience and a social conscience; between public relations and truth. In a recent book on values and ethics in social work, Professor Richard Hugman and Jan Carter raised the issue of whether the social and moral aspects of conscience could be brought together again.

“It has become common to distinguish between different types of ‘values’, between personal morality on the one hand and a desire or impetus for social, economic and political change, reform and social justice on the other, as though these two aspects of conscience could be bifurcated and operate independently one of the other. This is a contemporary distinction that would have been foreign up to even only a century ago, when conscience was social and moral, indivisible and unitary. But now a moral conscience has become understood as being confined to the private sphere of life, whilst a social conscience is seen as an appropriate responder to those injustices detected as public issues, particularly those involving vulnerability, suffering and victimization for human and other species and the environment.”

 The very mechanism of being a corporation must, in and of itself, shape the way an organization thinks and behaves, responding to the distinction between what is legal and what is moral. I note with considerable disappointment that the recent changes to the AASW Constitution almost completely expunged the section on the values and principles that inform our code of ethics. These include belief in the equal worth of all human beings, respect for others, compassion fairness, respect for privacy, and the promotion of human rights. The deletion was justified by legal advice that the Constitution was not the ‘appropriate’ document to detail values. According to the AASW, there is the risk that the Constitution could be used,

“inappropriately and therefore not for its proper purpose. This particular proposal is about moving, not deleting, language to its proper document. It’s an administrative change to ensure the Constitution remains contemporary.”

Weasel words. Just how could a commitment to human rights be used “inappropriately”? Being a corporation is a legal mechanism that allows us to exist. It should not shape what we believe in.

Ironically, the business world is moving to acknowledge that corporations should not just be motivated by the desire for profit. ‘Benefit’ corporations are now becoming legal entities. In the United States, a benefit corporation, in addition to ‘profit’ as its legally defined goal, includes a requirement to have a positive impact on society, workers, the community and the environment. The Italian Parliament has also introduced a new type of for-profit corporate entity named Società Benefit, a virtual copy of the US legislation. Australia too is in the process of drafting their own legislation.

A benefit corporation’s directors and officers operate the business with the same authority as a traditional corporation, but are also required to consider the impact of their decisions on shareholders, on society and the environment. In a traditional corporation, shareholders judge the company on financial results; with a benefit corporation, shareholders judge performance based on the company’s social, environmental, and financial performance. Transparency provisions require benefit corporations to publish annual benefit reports of their social and environmental performance using a comprehensive, credible, independent, and transparent third-party standard.

Despite having stripped many of its values from is Constitution, the AASW is clearly remains a ‘benefit’ corporation in the broader meaning of the term. Clause 3g of the Constitution, for example, states that one of the objectives of the AASW is to “advocate for the pursuit of social justice and changes to social structures and policies in order to promote social inclusion and redress social disadvantage”.

If the AASW were to hold itself to a third party social responsibility standard, the most relevant would probably be ISO 26000:2010, Guidance on Social Responsibility (International Organization for Standardization). IOS is a worldwide federation of national standards bodies. It is the world’s largest developer of voluntary international standards. Nearly twenty thousand standards have been set covering everything from manufactured products and technology to food safety, agriculture and healthcare. ISO 26000:2010, Guidance on Social Responsibility, was developed using a multi-stakeholder approach involving experts from more than 90 countries and 40 international or broadly-based regional organizations involved in different aspects of social responsibility. These experts were from six different stakeholder groups: consumers; government; industry; labour; non-governmental organizations (NGOs); and service, support, research, academics and others. The core subjects covered by the Standard are organizational governance, human rights, labour practices, the environment, fair operating practices, consumer issues and community involvement and development.

In relation to governance, ISO 2600:2010 states that,

“An organization’s performance in relation to the society in which it operates and to its impact on the environment has become a critical part of measuring its overall performance and its ability to continue operating effectively. This is, in part, a reflection of the growing recognition of the need to ensure healthy ecosystems, social equity and good organizational governance.” (my emphasis)

In relation to stakeholder engagement, the standard provides “guidance on the underlying principles of social responsibility… and on ways to integrate socially responsible behaviour into the organization”.

and

“Some stakeholders are an integral part of an organization. These include any members, employees or owners of the organization. These stakeholders share a common interest in the purpose of the organization and in its success. This does not mean, however, that all their interests regarding the organization will be the same.” (My emphasis)

Located as we are in an affluent Western democracy, many areas of the standard might not be relevant to the AASW, but it should be noted,

“an organization might assume that because it operates in an area with laws that address core subjects of social responsibility, then compliance with the law will be sufficient to ensure that all the relevant issues of such core subjects are addressed. A careful review .. may reveal, however, that some relevant issues are not regulated or are covered by regulations that are not adequately enforced or are not explicit or sufficiently detailed.”

A cursory glance at the Standards would suggest that governance- particularly in the area of stakeholder identification and engagement is a key vulnerability for the AASW. The contours of our vulnerability are clear. Our governance complies well with auditing standards and corporate law, but does not maximize member engagement.

The Standard states,

“Organizational governance is the most crucial factor in enabling an organization to take responsibility for the impacts of its decisions and activities and to integrate social responsibility throughout the organization and its relationships.”

Member engagement is vital in three key areas of the AASW; office holder elections, policy consultations and member forums.

In annual elections only around 16% of eligible members vote. Serious efforts are needed to make it easier to access information about candidates. The option of online voting needs to be explored. Optional preferential voting should be reintroduced. (It was changed to first past the post without explanation!)This method is not only acknowledged by experts to be the most democratic election method, it is more likely to honor diversity.

Governments and many organisations involved in developing policies or position papers have transparent and inclusive consultative processes. This involves clarity around who in the organisation is considering the submissions as well as calling for submissions and publishing them online. The AASW does not make a habit of publishing internal submissions- a major flaw in its governance processes. A recent consequence of this flaw saw the AASW endorse two different positions on gambling reform in Tasmania! Similarly, the AASW did not publish my submission arguing against the changes that stripped the values from our constitution. The overwhelming number of members who sent proxy votes on this issue were therefore not exposed to the full range of arguments against the change.

As I have indicated elsewhere on this blog one of the elements of membership most valued by members is belonging to a network within the AASW. These networks need to be nurtured and listened to, whether they be divisions of the College, branches, mental health social workers, interest groups and so on. The feedback that I receive about networks suggests that, too often, access is clunky, and management is top down, rather than inclusive or empowering.

As yet, there is no agreed way of measuring member engagement or the value that should be put on it. Nevertheless it remains the constitutional duty of the AASW Board to pursue “social justice and changes to social structures and policies in order to promote social inclusion”.

We need an independent review of AASW governance, which is not just focused on fiduciary duties, but on finding governance models designed to build member networks and nurture member engagement. A robust review would ask, how the AASW can,

• help members to make an informed voting choices and participate in AASW elections
• help member forums to be a real policy voice in the Association
• increase the number of member who are contributing their expertise to the AASW
• increase the number of members who renew their memberships
• increase the number of members who actively engage in member networks
• increase the number of members who support each other’s professional development and career aspirations

Wouldn’t it be great to read an AASW annual report that included an independent audit against the relevant sections of ISO 26000:2010.

One day.