(Introduction by Melissa Sweet)
The Minister for Social Services Dan Tehan has reaffirmed the Federal Government’s commitment to introducing drug testing of welfare recipients.
“The Government still strongly supports the drug testing trial because it wants to reduce any barriers people have to meaningful employment,” the Minister said in a statement provided to Croakey today.
The proposed trial – which was opposed by many health and medical groups and experts (see links at the bottom of this article) – was dropped from a package of welfare reforms last month because it would not have passed the Senate.
However, the previous Social Services Minister Christian Porter said at the time the Government was committed to resurrecting the proposal at some later stage.
Today’s comment by Tehan, appointed to the portfolio in a pre-Christmas Ministerial reshuffle, confirms that this remains the Government’s policy.
It comes as the Nick Xenophon Team confirmed recent media reports that it plans to support the amended Social Services Legislation Amendment (Welfare Reform) Bill 2017 – in return for a $40 million funding commitment to rehabilitation services and specialist training in drug and alcohol addiction for regional doctors.
An NXT staffer told Croakey today that negotiations with the Government over the Bill were still underway as there remained “some outstanding matters” regarding further amendments. ACOSS and others have previously raised concerns about the Government and NXT arrangement, as “a bad deal for people struggling on income support payments”.
Under the reform package, welfare recipients would face tougher compliance requirements, including finding it more difficult to use drug and alcohol addiction as a reason for failing to meet mutual obligation requirements.
In the compilation article below, health and medical experts – including a senior member of the Royal Australasian College of Physicians (RACP) – warn that these “draconian” measures will have dire consequences for health, especially mental health.
Punitive systems bode ill
By Dr Tim Senior, GP and a contributing editor at Croakey
Reading about the welfare reforms, and being asked about their health effects always sends me back to scouring the evidence. The link between poverty and poor health has been shown time and time again, and the gradient in health from richest to poorest is well known among health professionals.
I’d direct you to the evidence that economic policy has mental health outcomes, and that welfare policy probably contributes to this, and point out that there is even early evidence that this contributes to suicides.
I’d worry that policies that crack down on welfare will have a disproportionate effect on Aboriginal and Torres Strait Islander Australians, as 47% of Indigenous Australians receive government payment as their main source of income (p112), compared to 14% of non-Indigenous Australians.
Perhaps this is all worthwhile if it means people do get jobs. After all, employment – provided it is not exploitative or abusive – does lead to better heath. Except that it looks like it doesn’t. Reducing welfare payments doesn’t help people find work. It doesn’t create jobs that aren’t there, either.
But I don’t need to convince you. I need to convince our politicians. And I don’t see them being convinced by any evidence about what keeps people well. Our politicians are happy to spend multiple billions harming people in offshore detention and subsidising private health insurance for those who need health care the least – spending that wipes out the potential savings of $204m from these proposals many times over.
I don’t see any desire to help vulnerable people, or to say that human dignity would demand that people have adequate food, a roof over their heads and not try to deliberately bring about circumstances that make them sick.
I don’t see any desire to do anything other than punish people for having the temerity to be unlucky enough not to have opportunities presented to them from birth. I see no attempt to understand all the different problems coinciding to make the total problem faced much greater than the sum of its parts.
People depending on welfare for their income have to deal with the complex form-filling bureaucracies of Centrelink and Housing, the multiple appointments and symptoms of chronic disease, the juggling of caring for family members with similar problems, all the while having their energy and joy sucked out of life by mental health. All I see the desire for is punishment for being on welfare.
I will see people desperate for help, trying to find the sympathetic people in a system designed to make sympathy impossible. While a policy response is required, I don’t see one coming. Health professionals must not only advocate. We must be imaginative in the way we link with services to provide food and shelter. Individual services will struggle to do this, but perhaps PHNs could organise for subsidised fruit and vegetables, or help set up health justice partnerships.
I apologise for my pessimism. The evidence seems clear but doesn’t seem to influence policy. We must continue to advocate for policy, but it’s time for imaginative local solutions to poverty as well. I fear the alternative is food banks and self harm.
Poor policy will lead to poor health outcomes
By Dr Megan Williams, senior lecturer in Aboriginal Health and Wellbeing at UTS in Sydney and a Croakey contributing editor
The most vulnerable in our community, who rely on income support, often have multiple health needs and experiences of trauma, difficulties learning and other issues that mean full time employment in the formal economy is just not viable.
Penalties will create an additional burden – more debt, more financial hardship and stress which erodes health, for the individual and across generations.
Compliance is fraught with difficulties. It costs more money to administer by governments, draining money away from income support. This compliance will divert and potentially cost more money than keeping people on income support, and also investing in support and education strategies to support them.
I don’t think there are as many people who want to be on government income support as politicians think there are. Whilst we debate these income support issues we are diverted from arguably more important issues including the broader health of our environment.
Missing interviews and appointments often has a context. Removal of “intent to claim” as part of this bill is unforgiving and is blatant in its decision to not even seek to address the underlying issues and needs and individual has before they are job-ready. This is the work of a government who has no real-life experience, no empathy and no creativity for addressing complex social problems.
Further, we waste funds placing people in jobs when they are not ready. People with histories of disrupted employment or minimal employment histories often have other things going on. Being more punishing won’t address that. Cheaper, community-based support and education programs for them may.
The savings will not be real. A reduction of payments on the one hand will lead to poorer health and wellbeing on the other. International evidence shows us time and again that people with lowest incomes have poorest health and highest risk of incarceration and early death, not to mention the day to day misery of poverty.
This is the work of a government who is ill-informed, obviously, by the best information in the world readily available about the link between poverty and poor health, and the costs then to taxpayers.
Prevention of poor health is assuredly off the list too. This is a government investing in the most expensive options we have available, and which chooses not to learn the lessons from wealthier, more socially just nations.
Mental health will suffer
Associate Professor Lesley Russell Wolpe, health policy analyst and a Croakey contributing editor
The various changes to welfare payments to be made under the rubric of ‘reform’ look more like stigmatisation of those who receive these payments than any effort to help them overcome the current barriers they face to employment.
Moreover, these policy decisions have clearly been made in isolation from the various issues that impact welfare recipients: their physical and mental health status, levels of disability, transport needs, ability to purchase and prepare healthy foods. Having less money to cover the costs of living will impact all of these.
In particular, at a time when the Turnbull Government is making much of its support for mental health services, data from the UK highlights that cuts to welfare benefits and sanctions there have had a toxic effect on the mental health of the unemployed: levels of severe anxiety and depression among unemployed people have soared by more than 50 per cent in the last four years as the impact of harsh austerity policies take their toll.
Exacerbating difficulties for vulnerable people
Associate Professor Adrian Reynolds, President of the Chapter of Addiction Medicine within the Royal Australasian College of Physicians
If passed by Federal Parliament, we believe the Government’s changes to reasonable excuse and temporary exemptions provisions will put people at increased risk of losing their income support payments when they are struggling with alcohol or drug dependency and are already extremely vulnerable and unwell.
These changes will only compound social and psychological stress for people who are often struggling with mental health problems and trauma.
Overcoming addiction isn’t easy and there are times where people will stumble and relapse. People need to feel supported in seeking help for their problems. We would like to see these welfare recipients referred to an appropriate health professional who can assess their treatment needs to guide them through recovery and onto a path of finding employment, without dealing with the added stress of losing their income support.
As addiction specialists, we want expert involvement in monitoring and evaluating these measures, if they are approved by Parliament.
It’s important staff who are developing job seeking plans have sufficient knowledge and skills to assess mental health and substance abuse issues and are able to appropriately determine what activities are ‘reasonable’ and possible to help someone get back into the workforce
The changes are that an individual will no longer be able to use substance dependency as a ‘reasonable excuse’ for failing to meet their participation requirements, or request a ‘temporary exemption’ from their participation requirements because of substance dependency.
Schedule 13: removal of exemptions for drug or alcohol dependence—provides that exemptions from job seeking participation requirements will no longer be granted in circumstances directly attributable to drug or alcohol addiction. Jobseekers may meet their participation requirements by attending drug and alcohol treatment or will risk losing their welfare payment.
Schedule 14: changes to reasonable excuses—provides that drug or alcohol dependency will no longer be accepted as a reasonable excuse where a jobseeker has failed to meet their participation requirements.
The reasonable excuse and exemption provisions currently allows Centrelink staff to identify people struggling with substance dependency.
In 2016, there were 4,325 occasions where substance dependency was recognised as a reasonable excuse for not meeting participation requirements. In 2016-17, there were 16,157 people granted temporary exemptions from mutual obligations due to substance dependency. The fact the Government holds this data shows it already knows who these people are. We believe they should continue to encourage people to disclose their addiction in a supportive and constructive way, without fear of penalty.
“Draconian sanctions” are a health threat
Emeritus Professor Ian Webster, physician
To save $204.7 million the Government plans to impose draconian sanctions on those needing income support who miss appointments, or work interviews, or who don’t take up the jobs proposed for them. That can’t be the real reason, since the dollar savings count for nothing against the inestimable human and economic costs of these impediments. So much for ”mutual obligation”.
Does anyone ask why appointments are not kept or interviews attended?
The Government assumes the people needing social security are shiftless and “work shy”. Travelling to endless and barren appointments, the process, is soul-destroying, practically difficult and often at high personal costs.
The telephone, “we apologise for the inconvenience but we are facing high numbers of customer calls….” and then…. the line goes dead.
I have watched the frustration and anger of homeless people as they attempt to speak to a Centrelink officer. The tone and body language in these interactions is commonly humiliating and dispiriting– questions asked and assumptions made.
The pervading culture is that people needing income support do not want to work and don’t deserve to be supported. An attitude which says more about us, than them.
In my experience as a physician, more than anything these people want to work with some sense of value and dignity; they want to be able to live a contributing life, like the rest of us.
Punishing sanctions add to the difficulties that people out of work face; they are demotivating not motivating.
There are many groups in the population who need and have entitlements to income support – universally amongst the homeless, almost universal amongst those living with psychotic illnesses, a high proportion of those with continuing physical pain – the list could go on.
Many of those out of work and needing help are impaired in some way or have major obstacles to overcome – single parent families, families without accommodation, usually headed by a mother.
The opioid epidemic in the US caused that nation to realise it has an epidemic of “diseases of despair” – opioid addiction, alcohol diseases and injuries and suicide – to which we would add – ICE addiction, mental illness, obesity, unrelenting and unresolved symptoms such as chronic pain and complex disabilities.
The sanctions on those out of work and needing social support will further impoverish their lives and add to the “diseases of the despair”.
Rather than saving $204.7 million, the community and public health and social services will be further overwhelmed by the diseases and conditions arising out of modern despair – opioid and other addictions, alcohol diseases in injuries, suicides, mental illness, obesity, unrelenting symptomatic conditions such as chronic pain and increasingly complex disabilities and predicaments.
• See some of the speeches from when the Bill was being debated when the Senate rose for the Christmas break. Senator Richard Di Natale’s speech gives an overview of previous health and medical advocacy about the drug testing proposals.
• This article at the Sydney Criminal Lawyers blog gives an overview of the latest iteration of the Bill, although Croakey has been advised that its statement on the bereavement allowance for pregnant women is incorrect, as the Bill has since been amended to protect pregnant women; however, other bereaved people will still get a reduced amount compared with current rules.
• Financial journalist Jim Parker deconstructs the silly season “tabloid hysteria about dole bludgers” at his blog, The Failed Estate. He says Australia’s social spending in 2016 was just over 19 percent of GDP, below the OECD average of 21 percent, while our overall spending on unemployment benefits as a proportion of GDP is also below the OECD average. He says: “The call on taxpayers to fund our not particularly generous social safety net is not especially onerous.”
• Previous Croakey articles on the drug testing proposal include:
Humiliating welfare recipients is no solution to addiction;
Sending a strong message- welfare reform is a health issue;
Health leaders call for welfare drug testing to be scrapped; and
Punitive drug testing of welfare recipients is not an act of love.