Secretary General's Report

By Francis SullivanEurope’s economic turmoil can seem far away.  Distance tends to bring disengagement, even complacency. 

But commentators are optimistic about Australia’s economic circumstances and this, in turn, bolsters community confidence.  Even so, the Federal Government forecasts a tough Budget next year, with a return to surplus being its main goal.  This places health at the centre of budget cuts territory.  That, in turn, heightens the risk of reduced access and affordability for consumers.  The Government may have the Parliamentary support it needs to deliver the cuts, but will it achieve its policy aims at the same time?

From its inception, this Labor Government has been committed to a social inclusion policy agenda.  It firstly concentrated on addressing the spread of homelessness across the community.  However, the most recent report from the Social Inclusion Board covered a range of areas, including mental health and disability, particularly as these applied to disadvantaged people and communities caught in a cycle of poverty and impoverishment.  The Report indicated that the barriers to participation in the community for jobless families were profound.  Entrenched poverty unfortunately has a postcode in Australia despite the wider community perceptions that our economy is doing relatively well.  Clearly it all comes down to the vantage point.

In recent studies on economic hardship for families, the stark realities paint a picture of two nations - those with opportunity and resources, and those with neither.  Close to 85 per cent of all jobless families are single parent.  Over 60 per cent of these are non-homeowners.  Even where Government benefits are paid, a person loses $200 a fortnight if they are shifted from the Disability Support Pension to the New Start benefit.  This is a massive hit given they are left with around $245 a week.

Moreover, the poverty rates in households with a disabled adult are up to 16 times those for households without a disabled adult.

Research conducted on patients with chronic disease in lower socio economic areas indicated that nearly 78 per cent of them indicated economic hardship as a result of coping with their condition.  In real terms, this meant that household payments were delayed, charitable help sought, or assets were sold.  Nearly 40 per cent of those surveyed experienced health costs up to 10 per cent greater than their income for the period in question.

Associated research found that changes to the PBS co-payment system in 2005 saw a 10 per cent drop in anti- depressant scripts that matched similar trends in the purchase of medications, vaccinations, and other primary care services.

On top of these financial burdens comes the complicating factor of caring for people with a disability or chronic condition.  Current research shows that 62 per cent of primary carers were in the lowest income households.  Carers have less capacity to bring income to the household so the financial burdens are exacerbated.  So too are the health risks for all involved.

Under our current system, there are robust safety nets through bulk billing and associated subsidy arrangements for out-of-pocket costs.  These are working well.  But they will be the target for cost cutting in the Budget.  Behind every cut is another story of social disadvantage, usually too hidden to cut through the news cycle and too voiceless to get a hearing.  This is where bland economics fails our social policy discourse.

Where governments reel at the expenditure growth trends in safety net programs, and free marketeers rant about the ravages of welfare payments, the disadvantaged fall prey to a reduction in essential support and opportunity.  Their hope is in a political process that has their inclusion at heart.

But what will this mean when push comes to shove?

Recently, massive cuts to mental health patient rebates were passed through the Parliament despite near record submissions to a Senate Inquiry objecting to the action.  Whether the cuts are best described as ‘severe’ or ‘substantial’, it is recognised that they produce a relatively large removal of money from patient rebates at a time when mental illness is a priority for the Government’s social inclusion agenda.  Despite this, the cuts were upheld and the micro effects for patients, carers and families under pressure were disregarded.

In the theatre of politics, it is often too easy to dismiss protest as a tactic and not a cry of distress.  Disadvantaged people who keep slipping away with less benefit support, left to rely on governments, have every right to feel cynical and wary.

Let’s hope this next Budget doesn’t do it to them again.