Elder abuse and profit shifting go hand-in-hand in the age care sector?

Any regular reader of online news would have seen mentions of elder abuse, neglect and sub-standard health care over the years.

hellocaremail.com.au, 2017:

Elder abuse is a critical issue in aged care homes, with thousands of cases reported to the Health Department every year…. In 2016-2017, there were 2853 reports of “reportable assaults’’ and 2463 allegations of “unreasonable use of force”.

Australian Law Reform Commission, Elder Abuse (DP 83), Abuse and neglect in aged care, 12 December 2016:

1.34   Stakeholders reported many instances of abuse of people receiving aged care. These included reports of abuse by paid care workers[55] and other residents of care homes[56] as well as by family members and/or appointed decision makers of care recipients.[57] For example, Alzheimer’s Australia provided the following examples of physical and emotional abuse:

When working as a PCA [personal care assistant] in 2 high care units, I witnessed multiple, daily examples of residents who were unable to communicate being abused including: PCA telling resident to ‘die you f---ing old bitch!’ because she resisted being bed bathed. Hoist lifting was always done by one PCA on their own not 2 as per guidelines and time pressures meant PCAs often using considerable physical force to get resistive people into hoists; resident not secured in hoist dropped through and broke arm—died soon after; residents being slapped, forcibly restrained and force-fed or not fed at all; resident with no relatives never moved out of bed, frequently left alone for hours without attention; residents belongings being stolen and food brought in by relatives eaten by PCAs.[58]

1.35   The ALRC also received reports of other forms of abuse, including sexual[59] and financial abuse.[60] Restrictions on movement[61] and visitation[62] were also reported. Many submissions also identified neglect of care recipients.[63]

The Sydney Morning Herald, 15 October 2017:

Across NSW, 58 per cent of aged care workers surveyed said they have not been able to provide the level of care residents deserved because of budget cuts. Of those, 80 per cent said staff shortages were the main barrier to providing proper care.

The Courier-Mail, 19 April 2018: 

PROFIT-HUNGRY aged care companies are charging fat “administration fees” to skim up to 40 per cent of government payments for in-home nursing care.

More than 100,000 elderly Australians are on a waiting list to receive as much as $50,000 a year in a “homecare package” to pay for nursing, housekeeping or companionship at home. But an investigation by The Courier-Mail has revealed that some home-care companies are pocketing as much as $19,000 of the taxpayer cash through hefty “administration” or “case management” fees.

The fees are billed on top of hourly charges for home help – leaving clients with less cash to spend on in-home care such as nursing. And if clients want to switch to a cheaper provider, they are being slugged up to $1000 in “exit fees”.

The Age, 3 May 2018:

Scandals, including a recent national audit showing 600 aged-care homes failed in the past five years to provide minimum standards, prompted a government review. The Coalition, accepting a key recommendation, has ended the ridiculous practice of alerting operators to spot checks. The review also urged the streamlining and strengthening of the regulator.

If one does a simple online search many of the big ‘for profit’ aged care providers are named in relation to such abuse, neglect and sub-standard health care allegations.

Now in May 2018 the Tax Justice Network^[1]  is looking at aged care provision from another angle. One which shows that the budgetary meanness which sees these big companies expect elderly residents to remain in sodden incontinence pads or live-off meagre meal rations occurs in spite of the millions in profit made on the back of billions in taxpayer funding of the age care sector.

It has released A Tax Justice Network – Australia Report, TAX AVOIDANCE BY FOR-PROFIT AGED CARE COMPANIES: PROFIT SHIFTING ON PUBLIC FUNDS.

Sadly, this report only confirms the fact that corporate greed runs rampant through all major aspects of Australian life, including aged care.

Executive Summary, Background, p.5:

Older people are a growing proportion of Australia’s population; in 2016, 15% (one in seven) Australians were aged 65 years or older. By 2056 this percentage is expected to grow to 22% (8.7 million).1 The need for aged care services is increasing. Between 2015– 2016 almost 214,000 people entered aged care in Australia. On average, older people in Australia spend three years in permanent residential care, just over two years in home care, and one and a half months in respite care.2 The Australian tax payer, via the Commonwealth Government contributes around 75% of the expenditure in aged care in Australia, which is around 96% of the total funding on aged care from Commonwealth and State Governments. Government recurrent spending on aged care services in Australia was $17.4 billion Australian dollars (AUD) in 2016- 2017, with residential aged care services accounting for 69.3% ($12.1 billion AUD).3 Some of this funding is provided as subsidies to aged care provider companies including those that operate for profit. In 2018 the Australian Nursing and Midwifery Federation (ANMF), Australia’s largest national professional and industrial nursing and midwifery organisation with over 268,500 members, commissioned the Tax Justice Network - Australia to analyse possible tax avoidance by for-profit aged care companies and to provide recommendations for improving transparency on Government spending on for-profit aged care.

Key points from the report

* By number of beds, not-for-profit providers are the largest aged care provider group in Australia (52% in 2013-2014), however there has been a rapid growth in the size and spread of for-profit companies; Bupa, Opal, Regis and Estia are the largest aged care providers nationally. If Japara and Allity are included, these 6 for-profit companies operate over 20% of residential aged care beds in Australia.

* In the most recent year (mostly the 2017 financial year) the six largest for-profit companies were given over $2.17 billion AUD via government subsidies. This was 72% of their total revenue of over $3 billion. These companies also reported profits of $210 million AUD (2016-2018).

* Companies can use various accounting methods to avoid paying tax. One method is when a company links (staples) two or more businesses (securities) they own together, each security is treated separately for tax purposes to reduce the amount of tax the company has to pay. Aged care companies are known to use this method as well as other tax avoiding practices. Another practice is by “renting” their aged care homes from themselves (one security rents to another) or by providing loans between securities and shareholders.

* The six largest for-profit aged care providers have enormous incomes and profits:

* The largest company, BUPA, had almost $7.5 billion in total income in Australia (2015-16) but paid only $105 million in tax on a taxable income of only $352 million.

* BUPA’s Australian aged care business made over $663 million in 2017 and over 70% ($468 million) of this was from government funding.

* Funding from government and resident fees increased in 2017, but BUPA paid almost $3 million less to their employees and suppliers.

* The second largest, Opal, had total income of $527.2 million in 2015-16 but paid only $2.4 million in tax on a taxable income of only $7.9 million.

* 76% ($441 million) was from government funding in 2016.

* Allity had total income of $315.6 million in 2015-16 and paid no tax.

* 67% ($224 million) of Allity’s revenue was from government funding in 2016-17.

* Regis, Estia, and Japara are listed on the Australian Securities Exchange (ASX) but appear to be using methods to reduce the amount of tax they pay while earning large profits from over $1 billion of government subsidies.

* Family owned aged care companies (Arcare, TriCare, and Signature) receive between $42-$160 million each in annual government subsidies but provide very little public information on their operations and financial performance and may use accounting methods to avoid paying tax.

 * (All figures quoted above are in AUD)

* The Australian Government and the Federal Opposition (the Australian Labor Party) have proposed several ways to fix the problems with companies avoiding tax by using trust structures and other methods but there are still loopholes.

* It is difficult to get a detailed and complete picture of the full extent to which these heavily subsidised aged care companies are avoiding paying as much tax as they should, because Australian law is not currently strong enough to ensure that their financial records and accounting practices are publicly available and fully transparent.

Conclusion

The six largest for-profit aged care providers in Australia received over $2.17 billion AUD in annual tax payer funded subsidies which provided after tax profits of $210 million AUD. The actual operating profits were much larger. These providers only paid around $154 million AUD in tax in 2015-16. Companies that receive millions of tax payer dollars via Australian government subsidies must be required by law to meet higher standards of transparency in financial reports and be publicly accountable. The report calls upon the Government, Opposition, and cross-bench Senators to work together to make laws to stop aged care providers from avoiding the taxes they should pay and provide clear records of their business dealings.

The Tax Justice Network – Australia strongly supports recent government legislation that has been introduced to close loopholes in the Multinational Anti-Avoidance Law and government reforms to stapled structures. However, there is still a need for additional transparency measures. The Tax Justice Network – Australia also strongly supports a policy proposed by the Australian Labor Party to introduce minimum taxation of discretionary trusts. These reform measures are examined in more detail by this report in the section: Current Reform Measures.

This analysis of tax payments and corporate structures of the largest for-profit aged care companies provides clear evidence that simple common-sense reforms are needed immediately to restore integrity to the tax system and to ensure public accountability on billions of dollars in government spending.

RECOMMENDATIONS FROM THE REPORT

Any company that receives Commonwealth funds over $10 million in any year must file complete audited annual financial statements with Australian Securities and Investments Commission (ASIC) in full compliance with all Australian Accounting Standards and not be eligible for Reduced Disclosure Requirements. Public and private companies must fully disclose all transactions between trusts or similar parties that are part of stapled structures or similar corporate structures where most or all income is earned from a related party and where operating income is substantially reduced by lease and/or finance payments to related parties with beneficial tax treatment.

Australia’s Largest For-Profit Aged Care Companies

In Australia, non-profit providers collectively operate a majority of residential aged care beds. However, the market share of large for-profit providers continues to grow rapidly. Likewise, the influence of for profit providers on shaping government policy and influencing broader trends in the aged care sector has never been greater. Ranked by the number of government allocated residential aged care places (beds) in 2017, the six largest for-profit aged care companies in Australia are; Bupa, Opal, Regis, Estia, Japara, and Allity. Combined, they operate over 20% of all residential aged care beds in the country. These companies continue to expand market share through new developments and acquisitions. These companies are also expanding to provide more retirement living and home care services, which allow access to additional government funding. In the most recent financial year (2016-2017), these six for-profit aged care companies combined received over $2.17 billion in government subsidies.4 This made up 72% of their combined total revenue of over $3 billion.5……

COMPANY SNAPSHOT

Bupa: A United Kingdom-based mutual insurance company with global operations including aged care services. Australia is Bupa’s largest and most profitable market.

Regis, Estia, and Japara: Public aged care companies listed on the ASX.

Opal: A private aged care company owned by subsidiaries of two listed companies, AMP Capital and Singapore-based G.K. Goh.

Allity: controlled by Archer Capital, an Australian private equity firm with large foreign pension fund investors.

Arcare, TriCare and Signature (formerly Innovative Care): three family-owned, for-profit aged care companies.

NOTE:

1. The Tax Justice Network - Australia is the Australian branch of the Tax Justice Network (TJN) and the Global Alliance for Tax Justice. TJN is an independent organisation launched in the British Houses of Parliament in March 2003. It is dedicated to high-level research, analysis and advocacy in the field of tax and regulation. TJN works to map, analyse and explain the role of taxation and the harmful impacts of tax evasion, tax avoidance, tax competition and tax havens. TJN’s objective is to encourage reform at the global and national levels.

Membership of the Network can be found here.

Turnbull Government has just placed a multinational corportion with an appalling human rights record at the first contact interface with the National Disability Insurance Scheme

“It has a history of problems, failures, fatal errors and overcharging”  [Senior Appleby compliance officer quoted in The Guardian on the subject of Serco, 7 June 2017]

If the National Disability Insurance Agency (NDIA) didn't have enough internal structural problems to deal with along comes the UK-based multinational Serco Group.

A group implicated in: human rights abuses in prisons and immigration detention centres it has managed; poor to unsafe health service delivery including at Fiona Stanley Hospital in Perth, overcharging for services rendered under government contracts, fraudulent record keeping and manipulating results when there was a failure to reach targets; mishandling of radioactive waste and labour rights abuses.

The Guardian, 23 Apri 2018:

Disability rights groups, Labor and the Greens have slammed a decision to hire the multinational outsourcing giant Serco in a key role administering the national disability insurance scheme.

The National Disability Insurance Agency (NDIA) announced on Friday afternoon that Serco, a company with a chequered corporate history, would help run its contact centres under a two-year contract.

The decision would put the company at the frontline of the NDIS, interacting frequently with people with disability and service providers, many of whom are still grappling with a vast, complex and sometimes confusing scheme.

 “Sourcing our contact centre services from Serco will give ongoing flexibility, responsiveness and value for money,” the NDIA said in a statement.

But the decision has outraged disability rights campaigners, who say Serco’s poor history abroad and its lack of experience in disability should have precluded it from any role delivering the landmark scheme. 

People with Disability Australia co-chief executive, Matthew Bowden, said he was “gravely concerned” that Serco would, like other third-party providers, fail to uphold the values, objectives and principles underpinning the NDIS.

“We have no details on what expertise Serco have in providing communication services for people with disability, or why the NDIA has decided to outsource such a vital part of its services,” Bowden said.

“The NDIA needs to hire more staff and make their communication avenues with people with disability more transparent. Instead, they are offloading their responsibilities, and requirements, to deliver services to people with disability.”

Paralympian Kurt Fearnley was among those expressing concern at the decision, saying Serco would be “racking their brains on how they can bring lived experience of disabilities into their workplace”.

“The NDIS will be worthless if people with disabilities aren’t at its core!” he tweeted.

Miranda's IPA inspired rant

This was the News Corp mouthpiece for that far-right pressure group the Institute of Public Affairs (IPA), Miranda Devine, in full rant (though sticking closely to IPA's wish list) and under multiple mastheads on 18 April 2018:

Malcolm Turnbull has a rare opportunity to put a stop to the Left’s long march when the Race Discrimination Commissioner’s term expires in August

Race Discrimination Commissioner Tim Soutphommasane’s term expires in August and the Turnbull government cannot afford to miss this opportunity to stake out its ground in the culture wars.

Conservatives are sick of ­Coalition governments that ­appease the Left, curl into a ball and try not to cause outrage while Labor-Green governments remake the culture in their own image.

The country always takes two steps to the Left with a Labor government and not much better than one step to the Right or even staying in place with the Coalition, which puts us on a very bad trajectory indeed…..

So government gets bigger and more intrusive, the ABC continues unimpeded, destructive quangos such as the Australian Human Rights Commission proliferate and the cancer of identity politics takes hold. Little by little, our remarkable nation is transformed, and division takes root. The self-reliance and entrepreneurial spirit of Australians is sapped and the bonds of mateship are eroded.

But it doesn’t have to be that way.

The only way to arrest this dispiriting drift to the left is for Coalition governments to stop pretending there are no culture wars and get into the trenches and fight.

With a one-seat majority, a prime minister with fashionably progressive views and an election in the next year, we can’t expect bold actions by the Turnbull government that were beyond the Howard and Abbott governments. Such as closing down the Human Rights Commission.

But Malcolm Turnbull cannot ­afford to keep making mistakes like he did at the ABC when he appointed as chairman a man who is such a leftie he said he couldn’t see any bias.

The symbolic value cannot be over-estimated of replacing Soutphommasane with a commissioner who doesn’t want to use race to divide us.

That’s all this pesky 36-year-old French-born son of Laotian refugees has done since he was appointed to a five-year term by Kevin Rudd in 2013, a month before the Abbott government was elected. Despite the fact Australia gave Soutphommasane’s family a home, a free education at Hursltone Agricultural High and the University of Sydney, and a Commonwealth scholarship to Oxford University, he preaches that this is a racist country.

Despite the fact this is the most successful immigrant country in the world, which has mostly harmoniously absorbed as many as 200,000 new people each year from around the world, Soutphommasane tells us that the culture is toxic.

The former freelance journalist has bought the identity politics agenda, hook, line and sinker. He saw the great honours bestowed on him, such as membership of the board of the National Australia Day Council and the $340,000 gig at the Australian Human Rights Commission, as proof, not that this was a country that offered equality of opportunity to all comers, regardless of the colour of their skin. No, he saw it as more evidence of anti-white racism that needed to be set straight with social engineering.

He will never be forgiven for soliciting racial complaints against a cartoon by the late and much missed Bill Leak, whose persecution under Section 18C of the Racial Discrimination Act only really ended with his ­untimely death last year of a heart ­attack at 61.

Soutphommasane’s latest obsession is to impose ethnic diversity quotas on corporate Australia. He declared last year that there were too many white people running Australian companies.

In his five years he has just ­libelled Australia, created race-based social divisions and helped fuel a backlash against immigration.

So it’s not good enough for the government to appoint, as is mooted, an innocuous replacement who just avoids the headlines. Restitution is needed. If we must have a racial commissioner, then let it be a clear-eyed patriot who loves this country. Warren Mundine is the best person for the job. Well-respected, brimming with common sense and optimism, he has a proven track ­record as a businessman, and as an Aboriginal and political leader. He would unite us around what’s best about Australia.

This was a restrained Race Discrimination Commissioner Tim Soutphommasane in rebuttal the following day:

Liberals continue to behave badly in 2018 - Part Four

Just five months after Australian voters signalled their widespread acceptance of the Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) members of the community by voting for the introduction of same sex marriage, a number people in the Victorian Liberal Party want to turn back the clock in the name of sheer bigotry.

The Age, 14 April 2018:

A motion by a conservative Liberal branch linked to Federal MP Kevin Andrews has called for state legislation allowing health practitioners “to offer counselling out of same sex attraction or gender transitioning to patients who request it''.

With seven months before the Victorian election, it also urges Mr Guy to advocate for laws ensuring “parents and young people are all given full information about the psychological harms of social, medical and surgical gender transitioning”.

It further states that any claims supporting prescribing puberty blockers, cross-sex hormones and gender re-assignment surgery as safe and reversible, are in fact "both false and harmful".

The motion was drafted by the Victorian Liberal Party’s Menzies-Warrandyte branch and will be one of dozens debated when rank-and-file delegates meet on April 28 and 29 for the party’s annual state council meeting….

Other motions to be debated at state council include:

* Calls for the Commonwealth Sex Discrimination Act to re-insert "man" and "woman" in the place of "sexual orientation" and "gender identity". The aim is that a person will define their gender as either male or female, according to their biological and reproductive function.

* Calls to ban the Safe Schools program from Victorian schools and any other curriculum teaching a person's gender may be different from their biological sex or that people can transition.

On 16 April 2018 it was reported that the 'gay conversion therapy' motion along with those other nasty motions were removed from the agenda for the Liberal's annual state council meeting - apparently the party's state president didn't like the negative publicity these motions was gathering ahead of the November 2018 Victorian state election.

When it comes to human rights and civil liberties is it ever safe to trust the junkyard dog or its political masters?

On 18 July 2017, Prime Minister Malcolm Bligh Turnbull announced the establishment of a Home Affairs portfolio that would comprise immigration, border protection, domestic security and law enforcement agencies, as well as reforms to the Attorney-General’s oversight of Australia’s intelligence community and agencies in the Home Affairs portfolio.

 On 7 December 2017, the Prime Minister introduced the Home Affairs and Integrity Agencies Legislation Amendment Bill2017 into the House of Representatives.

This bill amends the Anti-Money Laundering and Counter-Terrorism Financing Act 2006, the Independent National Security Legislation Monitor Act 2010, the Inspector-General of Intelligence and Security Act 1986 and the Intelligence Services Act 2001.

The bill was referred to Parliamentary Joint Committee on Intelligence and Security which tabled its report and recommendations on 26 February 2018.

This new government department on steroids will be headed by millionaire former Queensland Police detective and far-right Liberal MP for Dickson, Peter Craig Dutton.

His 'front man' selling this change is Abbott protégé, former Secretary of the Department of Immigration and Border Protection and current Secretary of the new Department of Home Affairs, Michael Pezzullo. 

The question every Australian needs to ask themselves is, can this current federal government, the ministers responsible for and department heads managing this extremely powerful department, be trusted not to dismantle a raft of human and civil rights during the full departmental implementation.

It looks suspiciously as though former Australian attorney-general George Brandis does not think so - he is said to fear political overreach.

The Saturday Paper, 3-9 March 2018:

On Friday last week, former attorney-general George Brandis went to see Michael Pezzullo, the secretary of the new Department of Home Affairs.

The meeting was a scheduled consultation ahead of Brandis’s departure for London to take up his post as Australia’s new high commissioner. It was cordial, even friendly. But what the soon-to-be diplomat Brandis did not tell Pezzullo during the pre-posting briefing was that he had singled him out in a private farewell speech he had given to the Australian Security Intelligence Organisation on the eve of his retirement from parliament two weeks earlier.

As revealed in The Saturday Paper last week, the then senator Brandis used the ASIO speech to raise concerns about the power and scope of the new department and the ambitions of its secretary. Brandis effectively endorsed the private concerns of some within ASIO that the new security structure could expose the domestic spy agency to ministerial or bureaucratic pressure.

In a regular Senate estimates committee hearing this week, Pezzullo described his meeting with Brandis – on the day before The Saturday Paper article appeared – as Opposition senators asked him for assurances that ASIO would retain its statutory independence once it moves from the attorney-general’s portfolio to become part of Home Affairs.

“I had a very good discussion on Friday,” Pezzullo told the committee, of his meeting with Brandis.

“He’s seeking instructions and guidance on performing the role of high commissioner. None of those issues came up, so I find that of interest. If he has concerns, I’m sure that he would himself raise those publicly.”

Labor senator Murray Watt pressed: “So he raised them with ASIO but not with you?”

“I don’t know what he raised with ASIO,” Pezzullo responded. “… You should ask the former attorney-general if he’s willing to state any of those concerns … He’s a high commissioner now, so he may not choose to edify your question with a response, but that’s a matter for him. As I said, he didn’t raise any of those concerns with me when we met on Friday.”

The Saturday Paper contacted George Brandis but he had no comment.

“ANY SUGGESTION THAT WE IN THE PORTFOLIO ARE SOMEHOW EMBARKED ON THE SECRET DECONSTRUCTION OF THE SUPERVISORY CONTROLS WHICH ENVELOP AND CHECK EXECUTIVE POWER ARE NOTHING MORE THAN FLIGHTS OF CONSPIRATORIAL FANCY…”

Watt asked Pezzullo for assurance there would be no change to the longstanding provisions in the ASIO Act that kept the agency under its director-general’s control and not subject to instruction from the departmental secretary. The minister representing Home Affairs in the Senate, Communications Minister Mitch Fifield, said: “It is not proposed that there be a change to that effect.”

The new Department of Home Affairs takes in Immigration and Border Protection, the Australian Federal Police, the Australian Criminal Intelligence Commission, the Australian Transaction Reports and Analysis Centre, known as AUSTRAC, and ASIO.

ASIO does not move until legislation is passed to authorise the shift, and will retain its status as a statutory agency.

Pezzullo addressed the fears of those questioning his department’s reach. He said some commentary mischaracterised the arrangements as “being either a layer of overly bureaucratic oversight of otherwise well-functioning operational arrangements or, worse, a sinister concentration of executive power that will not be able to be supervised and checked”.

“Both of these criticisms are completely wrong,” he said.

Pezzullo had already described his plans, both to the committee and in a speech he made in October last year, in which he spoke of exploiting the in-built capabilities in digital technology to expand Australia’s capacity to detect criminal and terrorist activity in daily life online and on the so-called “dark web”.

But the language he used, referring to embedding “the state” invisibly in global networks “increasingly at super scale and at very high volumes”, left his audiences uncertain about exactly what he meant.

Watt asked if there would be increased surveillance of the Australian people. “Any surveillance of citizens is always strictly done in accordance with the laws passed by this parliament,” Pezzullo replied.

In his February 7 speech to ASIO, George Brandis described Pezzullo’s October remarks as an “urtext”, or blueprint, for a manifesto that would rewrite how Australia’s security apparatus operates.

Pezzullo hit back on Monday. “Any suggestion that we in the portfolio are somehow embarked on the secret deconstruction of the supervisory controls which envelop and check executive power are nothing more than flights of conspiratorial fancy that read into all relevant utterances the master blueprint of a new ideology of undemocratic surveillance and social control,” Pezzullo said.

As for day to day human resources, financial management and transparent accountable governance, media reports are not inspiring confidence in Messrs. Turnbull, Dutton and Pezzullo.

The Canberra Times, 2 March 2018:

Home Affairs head Mike Pezzullo was one of the first to front Senate estimates on Monday.

It's been up and running for only weeks, but his new department is part of one of the largest government portfolios.

Having brought several security agencies into its fold, and if legislation passes letting ASIO join, the Home Affairs portfolio will be home to 23,000 public servants. 

Mr Pezzullo was also quizzed on the investigation into Roman Quaedvlieg, the head of the Australian Border Force who has been on leave since May last year, following claims he helped his girlfriend - an ABF staff member - get a job at Sydney Airport.

It was revealed the Prime Minister's department has had a corruption watchdog's report into abuse of power allegations for at least five months while Mr Quaedvlieg has been on full pay earning hundreds of thousands of dollars.

Is Australian welfare reform in 2018 a step back into a dark past?

Last year saw the completion of the Royal Commission into Institutional Responses to Child Sexual Abuse which revealed generational abuse within the Australian education and child welfare systems. 

That year also revealed the ongoing failure of the Dept. of Human Services and Centrelink to fix its faulty national debt collection scheme, which possibly led to the deaths of up to eleven welfare recipients after they were issued debt advice letters.

The first quarter of 2018 brought a scathing United Nations report on Australia's contemporary human rights record titled Report of the Special Rapporteur on the situation of human rights defenders on his mission to Australia.

Along with a report into elder abuse in Oakden Older Persons Mental Health Service in South Australia and the release of a detailed Human Rights Watch investigation of 14 prisons in Western Australia and Queensland which revealed the neglect and physical/sexual abuse of prisoners with disabilities, particularly Aboriginal and Torres Strait Islanders.

The National Disability Insurance Scheme represents yet another crisis. The Productivity Commission has warned there is now no carer of last resort for patients in an emergency, care provider agencies are reportedly owed up to $300 million and disabled people are often receiving inadequate care via untrained staff or sometimes no care at all, as government disability care services are being closed in favour of the new privatised service delivery scheme.

None of these instances stand in isolation and apart from either Australian society generally or government policies more specifically.

They all represent the frequently meagre nature of community compassion and the real level of care governments have been willing to organise and fund for vulnerable citizens. In reality the ideal level of support and care for the vulnerable - that politicians spout assurances about from campaign hustings every three years - is just so much political hot air unless ordinary voters insist that it be otherwise. 

As the Turnbull Coalition Government clearly intends to push forward with the full gamut of its punitive welfare reforms perhaps now it the time to consider if we have made any great strides towards a genuinely fair and egalitarian society in the last two hundred years or if we are only dressing up old cruelties in new clothes and calling this "looking after our fellow Australians”, "an exercise in practical love, "an exercise in compassion and in love".

History and Policy, Katie Barclay, Creating ‘cruel’ welfare systems: a historical perspective, 1 March 2018, excerpts:

Over the last two decades, commissions and reports on institutional care across the western world have highlighted widespread physical, sexual, emotional and economic violence within caring systems, often targeted at society’s most vulnerable people, not least children, the disabled and the elderly. These have often come at significant cost not just to the individual, but the nation. As Maxwell has shown, national apologies, that require the nation to render itself shamed by such practices, and financial redress to victims, have impacted on political reputation, trust in state organisations, and finances. As each report is released and stories of suffering fill newspapers and are quantified for official redress, both scholars and the public have asked ‘how was this allowed to happen?’ At the same time, and particularly in the last few years as many countries have turned towards conservative fiscal policies, newspapers also highlight the wrongs of current systems.

In the UK, numerous reports have uncovered abuses within welfare systems, as people are sanctioned to meet targets, as welfare staff are encouraged to withhold information about services or grants to reduce demand, and through systematic rejection of first-try benefit applications to discourage service use. Often excused as ‘isolated incidents’ on investigation, such accounts are nonetheless increasingly widespread. They are accompanied by a measurable reduction in investment in welfare and health systems, that have required a significant withdrawal in services, and have been accompanied with policies of ‘making work pay’ that have required that benefits be brought in line, not with need, but with low working incomes. The impact of these policies and associated staff behaviour have been connected to increasing child and adult poverty, declining life expectancy, growing homelessness, and the rise in foodbank use.

Importantly, public commentators on this situation have described this situation as ‘cruel’. One headline saw a benefits advisor commenting ‘I get brownie points for cruelty’; another noted ‘Welfare reform is not only cruel but chaotic’. The system depicted in Ken Loach’s I Daniel Blake (2016), described by reviewers as a Kafka-esque nightmare, a ‘humiliating and spirit-sapping holding pattern of enforced uselessness’, and a  ‘comprehensive [system of] neglect and indifference’, was confirmed by many as an accurate depiction. Whether or not this representation of the current welfare system is held to be true, such reporting raises significant questions about when and how systems designed to provide help and support move from care to abuse. A focus on ‘isolated incidents’ today can be compared to the blaming of ‘isolated perpetrators’ in historic cases of abuse, an account that is now held by scholars to ignore the important role of systems of welfare in enabling certain types of cruelty to happen…..

The capacity of welfare systems to support individuals is shaped by cultural beliefs and political ideologies around the relationship between work, human nature, and welfare. Here late-eighteenth- and early-nineteenth-century Ireland provides a productive example. Ireland in this period was marked by significant levels of poverty amongst its lower orders, particularly those that worked in agriculture. The capacity to manage that poverty on an individual level was hindered by several economic downturns and harvest failure, that pushed people to starvation. As a nation without a poor law (welfare) system until 1838, the poor relied on charity, whether from individuals or institutions for relief. In the late eighteenth and early nineteenth century, the ‘state’ (usually local corporations) introduced more direct welfare, sometimes in the form of relief payments but more usually access to workhouses. 

After 1838 and until the crisis of the 1847 famine, relief payments were removed and all welfare recipients had to enter the workhouse. Accompanied by a growth in institutional charitable services, the success and ‘care’ of the system could vary enormously between areas and organisations. What it did not do is significantly reduce poverty levels in the population.

Indeed, it was important that the poverty levels of welfare recipients were not reduced by the workhouse system. Like current ‘make work pay’ policies, poverty relief measures were designed so that those in the workhouse or receiving charity elsewhere did not have a significantly higher standard of living than those who provided for themselves. This principle was determined based on the wage of an independent labourer, one of the poorest but also largest categories of worker. The problem for the system was that independent labourers earned so poorly that they barely managed a subsistence diet. Their living conditions were extremely poor; many slept on hay in darkened huts with little furnishings or personal property.

Those who managed the system believed that a generous welfare system would encourage people to claim benefits and so could potentially bankrupt those paying into the system. This encouraged an active policy of ‘cruelty’. Not only were benefit recipients given meagre food and poor living conditions, but families were routinely broken up, the sexes housed in different wings and prohibited from seeing each other. Welfare recipients were often ‘badged’ or given uniforms to mark their ‘shame’, and workhouse labour was designed to be particularly physically challenging.  

It was a system underpinned by several interlocking beliefs about the Irish, the value of work and the economy. Hard work was viewed as a moral characteristic, something to be encouraged from childhood and promoted as ethical behaviour. Certain groups, notably the Irish poor but also the British lower orders and non-Europeans more generally, were viewed as lacking this moral characteristic and required it to be instilled by their social betters. Welfare systems that were not carefully designed to be ‘less eligible’ (i.e. a harsher experience than ‘normal; life for the working poor), were understood to indulge an innate laziness…..

Throughout history, welfare services have required considerable economic investment. Unsurprisingly, this has required those who run institutions of care for people also to keep a careful eye on their financial bottom line. More broadly, it has also required a monitoring of services to ensure value for money for the state and its taxpayers and to protect the interests of the service users. As has been seen recently in discussions of targets placed on staff providing welfare provision in the UK, such measuring systems can come to shape the nature and ethos of the service in damaging ways.

A relevant historical example of this is from the Australian laundry system in the late nineteenth and twentieth century. Young women were placed in youth homes and registered as delinquent for a wide range of reasons from petty criminal behaviour to perceived immorality (ranging from flirting with the opposite sex to premarital pregnancy), to having been neglected by parents. These homes, often run by religious organisations, were designed to ‘reform’ young (and occasionally older) women, preventing them from entering prostitution or other criminal pursuits. The main mechanism for ‘reform’ was through a moral discipline of work, which in many of these organisations revolved around a professional laundry service. Work was often unpaid or paid at very nominal sums, given to women on their release. The service, which catered to the general public, kept institutions financially afloat, and many became significant-sized businesses. They required women to work very long hours, in challenging conditions. Accidents, particularly burns, were not unusual. As businesses grew, other ‘reform’ efforts that ran alongside, such as education, became rarer.

The laundry became the driving focus of the institution. The women were cheap labour, and managing that machine became not just a means to an end, but shaped the logic and functioning of the care service. It is an example of how an economic imperative can come to adversely impact on care, by disrupting the purposes and functions of the service. It was also a process that significantly reduced the level of ‘care’ that such institutions provided, not only through a physical job that wore on the body but one reinforced with physical punishment, which came to include emotional and sexual abuse, and poor food and living conditions……

There are significant variations between the institutional care described here for the nineteenth century and a contemporary welfare state that encourages users, as much as possible, to remain outside ‘the system’. The capacity for ‘the state’ to control every dimension of a person’s life today is significantly reduced; conversely, the ability of those in need to fall into service ‘gaps’ as they cannot access services or negotiate bureaucratic systems, is in some ways increased. Nonetheless, there are parallels in the operation of both systems that should give contemporary policymakers pause. Abusive care does not just emerge from individual perpetrators, from the institutional model, or even a lack of policies on staff-client relationships, but also from the wider values and beliefs that shape the production of welfare systems; from the financial and emotional investments that we place in institutions; and from the corruption or occlusion of institutional targets and goals.

Ensuring that the ‘cruel’ practices reported of current systems do not become systematic issues on the scale of previous institutional abuses therefore requires not just monitoring a few rogue individuals, but a clear goal about what our welfare systems should achieve. The needs and interests of service users should be placed at their heart, coupled with a significant social, cultural and political investment in ensuring that goal is achieved. All other goals and targets for welfare service providers, especially their frontline staff, should be secondary to that and carefully designed so as not to interfere with that end. With rising rates of poverty, homelessness and illness, welfare systems look to continue to hold a central role in society for the foreseeable future. It is imperative that the abusive practices of previous ‘caring’ regimes are left firmly in the past.