Ursula Stephens (NSW, Australian Labor Party, Shadow Parliamentary Secretary to the Leader of the Opposition (Social and Community Affairs)) Share this | Hansard source

I too welcome the opportunity to speak about the implications of the Employment and Workplace Relations Legislation Amendment (Welfare to Work and Vocational Rehabilitation Services) Bill 2006. Senator Wong has outlined Labor’s position on this bill—the concerns that we have about the bill and the inequities that are built into it. I listened with interest to the debate in the House of Representatives last month. I was intrigued that the focus of so many government members seemed to be on the people who are undeserved recipients of disability services. I will give just one example: Mr Johnson, the member for Ryan, spoke on 15 February about ‘strapping young blokes living in Byron Bay and going surfing’. It seemed to me that that was an extraordinary way to think about the people who are going to be most affected by this legislation.

Tonight I want to talk about the disadvantage that will be suffered by the deserving recipients of disability services under this legislation. These are the people who will be affected. I need to say at the outset that Labor do not encourage or in any way condone people who are exploiting the system. We recognise that such an element exists in every society, and Australia is no different in this regard from anywhere else. That is why the Keating government took such a strict approach to people defrauding the Commonwealth by claiming benefits to which they were not entitled. But the focus of this bill is not at all the opportunistic element which exists at every level of society; it is deliberately narrow in its focus, targeted at those people receiving disability benefits.

The government has made two assumptions which need to be questioned in the interest of every person living with a disability and labouring to have a fulfilling life in this country. The first of those mistaken assumptions is that they do not want to work, do not want to be a full and contributing member of society and do not want to lead a life as close to the norm as their unfortunate personal circumstances allow. The second is that these people exaggerate or distort the degree of their disability. For disabled people suffering social and financial limitations, these assumptions are not only offensive but also proof positive that the Howard government is out of touch with reality, prepared to make hard lives even harder by the application of stringent and inflexible laws which keep the have-nots firmly in their place so that the haves can flourish and prosper. If we as a society can help those living with a disability to participate and make a useful contribution, that is a positive step. Welfare to Work is a great idea, provided that the passage from one mode of life to the other is carefully designed and monitored along the way—that support is always available for those who find the going tough and that those who embark on it are not handicapped financially.

I repeat: I have no truck for people who rort the system, but what about all those Australians in receipt of disability benefits who are justly entitled to our support to lead a fulfilling life and whose future is threatened—and, yes, I use the word ‘threatened’ advisedly—by this legislation? I need to speak out for those people because, in pursuit of exploiters, the government is in danger of throwing the baby out with the bathwater. In particular, tonight I want to speak on behalf of the mentally ill—those whose disability is already a stigma and whose suffering under the proposed legislation can almost be guaranteed.

In my role as co-convener of the Parliamentary Friends of Schizophrenia, I have certainly learnt a lot about mental illess. I have met a range of carers, employers, doctors, counsellors, case managers and of course people living with various forms and degrees of this disability. Overwhelmingly, they would prefer to be working than sitting at home receiving welfare, but we cannot ignore the emerging evidence about the obstacles that mental illness poses to productive employment. First, there is the issue of time. People with mental health difficulties are more likely than others to receive public assistance, and unless they respond well to treatment they are likely to continue to need assistance for long periods of time. These are people who are least likely to respond to the pressures of time limits. Timeliness and other such inflexible rules place them in real jeopardy of facing severe and long-term poverty. All welfare to work programs must determine how best to assess these clients’ needs and design services in ways that will both facilitate steps towards employment and allow for the changes in circumstances and ability to work that is such an intrinsic aspect of life for those suffering from mental illness.

It is essential to understand and appreciate the relationship mental health issues have to welfare dependency and employment. This relationship is very complex, to put it mildly. First, there is that long-established problem of definition. Mental health issues are defined in a variety of ways which result in different assessments of the severity of the mental illness. Narrowly defined, serious mental health issues are psychiatric disabilities that seriously interfere with one or more aspect of a person’s daily life. Such disabilities or illnesses meet diagnostic criteria for effective disorders, including major depressive disorders. More broadly defined with less rigorous assessment criteria, mental health issues may also include symptomatic problems or indicators for risk of mental illness. Although diagnosable mental illness may exist in these cases, these broadly defined mental health issues may actually be merely symptoms of other difficulties in a welfare recipient’s life.

Definition is not just splitting hairs; it affects perception of what people can do. Mental health issues defined narrowly, such as meeting the diagnostic criteria above, tend to be estimated as less prevalent than those defined broadly as merely symptomatic of depression. The barrier that a disability presents to employment can be similarly assessed differently according to who makes the assessment or where the information on which the assessment is made is derived. I am talking about the familiar problem of bias. We are all aware of how using different techniques to collect data can cause variations in the estimates. For example, when sensitive data is collected in person or when data for an entire family unit is collected from a single household member, rates of mental illness can be distorted.

So we cannot simply bundle all people on disability pensions for mental health reasons together. The first step to help people move from welfare to work must be accurate identification and proper diagnosis of clients with mental health needs. Again, this is not a simple matter. The Commonwealth Rehabilitation Service, which currently provides this service, is aware of just how complex it is. I am very worried about the introduction of contestability for vocational rehabilitation services and the reduction of parliamentary oversight of the guidelines. The difficult business of identifying and diagnosing people with mental health needs involves two main processes: screening and assessing. Screening refers to determining the probability that a mental health need exists, often by identifying symptoms of mental illness or other mental health needs; and assessment refers to a formal psychiatric diagnosis of the type and severity of mental illness. Both steps must be done properly.

Under this legislation, private providers would be able to tender for contracts for vocational rehabilitation services, but there is nothing in this legislation to guarantee that the requisite care be taken with people with mental health needs. The fact is that few private agencies use formal instruments to identify clients with mental health needs. Rather, welfare agency staff generally identify clients in need of mental health services simply by observing symptoms, such as anxiety or behaviour problems and depression.

The other main means of identifying the nature and extent of these people’s disability and estimating the effect it would have on their employment is to ask questions in the course of initial and follow-up interviews—questions that are designed to illicit information on symptoms. I guess I do not need to labour the point here. Mental health advocates are understandably very concerned that removing the Commonwealth Rehabilitation Service’s right to approve individual rehabilitation services will be a very retrograde step. We want to create a society which strengthens rather than weakens people’s rights, which helps people rather than hinders people with disabilities to lead as full a life as possible, and which solves rather than creates problems for them. Many private providers are not compliant with the provision of the Disability Services Act. The development of effective mental health screening instruments for use by providers is much needed before we can authorise them to oversee a client’s participation in the workforce.

I said this issue of moving a person with mental health issues was complex. Let me explain. After a client is screened for mental health illness, mental health professionals conduct psychiatric evaluations to arrive at a comprehensive assessment. These assessments do not just allow diagnosis of a client’s mental illness; they also cover understanding of how that illness interacts with other possible personal difficulties, such as substance abuse, homelessness or domestic violence. This is clearly a delicate area where practitioners need training and expertise.

To approve legislative amendments which remove safeguards to this effect rather than strengthen them would be completely irresponsible. The responsible way to move mental health clients from welfare to work would of course be to offer them enhanced services that are directly linked to preparing them for employment, usually combining mental health care and counselling with employment related services, such as vocational assessment and training, job preparation and placement, work experience, on the job training and accommodations and adaptations, post employment support, and interpersonal and life skill training. Depending on the degree of disability, there might actually be a need for more intensive support, such as home visits, case staffing, interactive service plans and the involvement of specialised mental health treatment workers. These kinds of programs are typically operated not by vocational rehabilitation services but rather by mental health agencies. It is abundantly clear that enabling people with mental health disabilities to make the transition from welfare to work successfully will require an enormous effort in coordination.

Before the dinner suspension I was speaking about the Employment and Workplace Relations Legislation Amendment (Welfare to Work and Vocational Rehabilitation Services) Bill 2006 and the importance of more intensive support for those people who have mental health issues. I am concerned that the legislation does not acknowledge the need for improved coordination of services and support and it certainly does not allow for the necessary coordinated efforts between welfare agencies and mental health agencies, as well as between mental health agencies and supported employment providers. The kind of coordination offered could range from structured referral mechanisms to shared funding arrangements and beyond.

In my research into the evaluation of welfare to work programs, I could find very little empirical evidence that isolated the role of mental health strategies in their evaluation designs and analyses. But an examination of programs that integrate mental health treatment with employment related services showed that this combination of services, when properly implemented, can help clients with mental health needs prepare for employment and stay employed successfully, providing that ongoing support and accommodations in the workplace are provided.

I reiterate: to be successful, the programs need to encompass both treatment and employment services, and cannot be short term. That is the problem with this legislation—it simply does not recognise the importance of such a coordinated approach, or the degree of foresight, detailed planning and follow through that are essential. I have known many people with disabilities, particularly with mental health issues, who want nothing more than to move from welfare to work, and I would be happy to support legislation that would help them do that successfully. But the legislation in its current form does not meet these criteria.

A very common feature of mental illness is its volatility: it is usually not a stable state, even when medical treatment is working ‘successfully’. This raises the issue of not only the difficulty at the screening and assessing stages, and the need for ongoing support, but also the need for flexibility and accommodation of change to be built into the legislation. A good example was given by Ms Annette Ellis in the House of Representatives. In her speech on this legislation in the other place, she related the experience of a client who bit off more than he could chew in trying to get off his disability pension and into work and then was locked out of returning to his disability pension. That is what we are going to see as a consequence of the bill before us.

So while I share the desire that people with a disability engage more fully in the workplace, and I can see it is for the benefit of society in many ways to encourage and support them in vocational rehabilitation, I cannot believe that the current legislation will do so successfully. Instead of a long-term, integrated plan to enhance our society, it appears to be a short-term, hastily drafted plan motivated by a belief in the value of increased competition.

We cannot say nothing while the lives of the most vulnerable members of our society are being used in an attempt to win votes—for instance, as a chance for the member for Ryan to appeal to hardworking mums and dads about being taken for a ride while their taxes are funding a lifestyle of ease for surfers and other rorters. The fact is that those mums and dads, all too often, have someone in their family or amongst their friends who suffers from a disability—someone they want to see helped to participate in society. These mums and dads know that welfare to work transition for these people will not be a single, easy step. They know it will require coordinated efforts. And they know that the legislation needs to be carefully drafted and redrafted to ensure that our social policies in Australia are first class. On behalf of these people, I express my reservations with the bill.

I have one final point. There are, of course, people whose disabilities severely limit their ability to participate in the workforce, even on a part-time basis. What I said about screening and assessment applies to these people. I fear that they could easily become victims of the kind of thinking demonstrated by the member for Ryan, again, when he said of people on welfare:

It is not in their interest to stay on welfare and it is not in the national interest of this country.

Well, sometimes it is. What sort of society would we be if we could not look after those incapable of looking after themselves? Is that what the government considers in the national interest?

Senator Wong has forecast Labor’s position on this bill: we will not support it. I am pleased to support the comments made by Senator Siewert in her contribution to the debate, on the lack of coordination between this legislation and other social security legislation. I believe it is poorly conceived and poorly targeted legislation that does not deserve Labor’s support.