Public policy expert Prof Mark Considine says Australia’s current approach to social service delivery is failing the most vulnerable people in our communities, the very people it is meant to support and protect.
In a keynote address at the recent Catholic Social Services National Conference, he argued that the so-called ‘service market’ model, in which ‘choice’ is held up as the best driver of efficiency and innovation, should be overhauled in favour of an approach that empowers vulnerable people by listening to them more carefully and by focusing on their complex needs rather than on profits and politically convenient theories about ‘consumer’ behaviour—a move from ‘choice’ to ‘voice’ in which, he says, ‘mission-driven’ agencies such as the Catholic Church’s social services can play a vital role.
On Friday 23 February, Prof Considine—currently Redmond Barry Distinguished Professor of Political Science and Provost of the University of Melbourne—presented his audience at the Catholic Leadership Centre with a thought-provoking overview of the Australian social services landscape, much of it drawn from his latest book, The Careless State: Reforming Australia’s Social Services. The culmination of 10 years of research, the book presents a sober critique of the ways governments of all persuasions have attempted, but largely failed, to support the most vulnerable in Australian society over the past 25 years, along with a vision of what a more effective approach could look like.
Throughout Australia in recent decades, ‘the choice revolution’ in social services has been embraced as a response to rising costs, changing demographics and growing criticism of inefficient and paternalistic government services. Focusing on the outcomes of this shift, The Careless State examines the experiences of the long-term unemployed in employment services, trainees undertaking vocational education and training (VET), older people in the aged-care system, small children in childcare, disabled people in the National Disability Insurance Scheme (NDIS), vulnerable workers in the occupational health and safety system, and mothers and infants in the maternal and child health service, honing in on the weaknesses and strengths of each approach.
Central to Prof Considine’s critique is his argument that the very idea of a services ‘market’ is based on a fundamental misunderstanding of the behaviour of people who use social services and of the constraints that affect that behaviour.
In an interview for Melbourne Catholic, he explained that one of the reasons he doesn’t like the word ‘market’ to describe these services is that for many social services, ‘there aren’t a suitable range of choices that would define a market and enable people to move between different options … If we take childcare, for example, there just aren’t vacant places—there just aren’t enough providers in most areas—so there isn’t, effectively, a menu from which people can choose. In a market, there have to be multiple options.’
We’re kidding ourselves. We’re trapping ourselves into bad logic every time we describe social services as markets.
Even where there are options, the ‘market’ approach assumes freedom of movement between them, and that the ‘consumer’ can exercise their power simply by exiting a service and choosing another one if they are dissatisfied—in the way a supermarket shopper, say, might move their trolley to a different aisle. But the reality, Prof Considine says, is far more complex, with many services proving very ‘sticky’. In aged care services, for instance, contractual arrangements and the often large deposits required before ‘signing up’ mean that ‘exiting’ is no simple process, particularly for the frail and vulnerable.
A second reason to doubt that social services are a real ‘market’, he said, is a frequent lack of transparency or suitable information about the choice that the individual is being asked to make. ‘It’s only when you’re consuming the service that you know about it,’ he points out. ‘With a product, the product is made well before you consume it, but a service only exists at the moment you’re consuming it. And that puts a huge burden back onto the individual receiving the service to try to anticipate in advance.’ Most people won’t have opportunities to talk to previous or current clients to find out whether a provider is ‘a good guy or a bad guy’, he says.
‘If I’m lucky—let’s say I live in one of the areas that has four or five childcare providers—I might be able to go and visit them and attend one of their information evenings,’ he says. ‘But I won’t know how that service is experienced until it happens. And if it’s a small child or a baby, I won’t even know then, because they can’t tell me. So there just isn’t, in most of these complex services, the level of transparency that would get you to market-type behaviour.’
A third reason—one that ‘almost trumps them all’—is that most of these services are ultimately funded by the taxpayer. ‘The level of subsidy now required to run childcare or aged care or VET is so large that … just on the finance side, they’re public services; they’re not market services. So we’re kidding ourselves. We’re trapping ourselves into bad logic every time we describe them as markets.’
Promising individualised care for clients, the market service model expects individuals to empower themselves by exercising their ‘sovereign power of choice’, an approach that, paradoxically, often isolates and disadvantages them, according to Prof Considine, leaving them at the mercy of competitive, opaque and overwhelmingly complex systems that tend to ‘innovate’ more in the direction of increased profits for owners and shareholders than improved outcomes for vulnerable people.
The non-profits who have that long history and historical mission-driven approach seem to me to be the likely contenders for driving the service standard up ... They can have a catalytic effect on finding, demonstrating and sharing the success of a really elite service.
The complex needs of clients should be central to any reformed system, according to Prof Considine, with less emphasis on royal commissions and ‘top-down’ regulation and a greater emphasis on ongoing engagement and consultation with clients at a local level and on cooperative problem-solving. ‘It’s only in the voice of the individual, the vulnerable individual, that we learn how to respond to their needs and to understand what they want,’ he says.
While affirming the importance of maintaining a ‘mixed economy’ of private, public and not-for-profit service providers, he would nevertheless like to see governments take back some responsibility for the overarching design and direction of social services policy, and for greater public investment in infrastructure, pointing out that the ‘market’ model has allowed governments to avoid accountability and to shift responsibility for any failures of the system to providers and individual ‘consumers’.
Instead of a model that pits service providers against each other as competitors, fostering cultures of distrust, secrecy, rorting and exploitation within the sectors that have adopted this approach, Prof Considine advocates for a more social approach to social services in Australia. Pointing to the successes of models like the one adopted in maternal and child health, for example, he argues for systems in which providers and service professionals are encouraged to collaborate and to share good ideas and innovations, so that ‘a rising tide lifts all boats’.
‘We don’t want inefficiency,’ he says. ‘But if we have that client centrality, then we can say, well, what are the business systems that maximise that? How do we get there? … If you’ve got transparency in the service, then you’re going to … end up with a service model that everybody can look at. We can have a look and see: How’s the Catholic model running? Where are they in their overall capability? And what can we learn from that? And what can they learn from, you know, Baptcare, or whoever it is, that would actually lift the whole game?’
Prof Considine sees the more mission-focused approach of not-for-profit service providers such as the Catholic Church playing an important role in this model, highlighting particularly the Church’s ‘determination to make the needs and the dignity of the people receiving the service the high priority’.
I think the mission-driven sector has a much better chance of developing that kind of cadre of professional, committed people who support one another to do the job well and build capability.
Placing the highest possible support for vulnerable individuals at the centre of the service is not exclusive to the Christian mission, he says, ‘but it’s so central to it [that] in the Western canon, it’s hard to prise the two apart. So that’s … [a] connection that I think needs to be made more explicit on the policy side, to say we want people delivering these services who have that mission and who are prepared to put the effort behind it.
‘These are complex services, generally speaking, and the way the individual approaches them and connects with them is often quite unique. The non-profits who have that long history and historical mission-driven approach seem to me to be the likely contenders for driving the service standard up in the model. They don’t have to be the only ones in the model, but they can have a catalytic effect on finding, demonstrating and sharing the success of a really elite service.’
Church providers, Prof Considine says, can also play an important role in attracting the kind of people who will deliver better services. For example, both in aged care and to some extent in childcare, he says, ‘we’re really struggling on the labour force front. We’re really finding that it’s getting harder and harder, partly because of what we pay, but also just because we’ve made some of these services look pretty unattractive as an employment story. I think the mission-driven sector has a much better chance of developing that kind of cadre of professional, committed people who support one another to do the job well and build capability.’
With the rapid disappearance of volunteers, he also believes that many social services have ‘lost their community connection’, particularly in areas like aged care and child care, to the detriment of the people they serve.
‘And that’s another place where church-based services have a huge capability to show the way forward.’
All photos courtesy of Catholic Social Services Victoria.
