Introduction
I want to begin with a quote from a 1986 Brotherhood of St Laurence research study.
An Italian man interested in joining the study asked the researcher why there are so many welfare groups – he believes that unity is strength and that we will always be conquered if we do not unite. The researcher replied that when the pressure is really on, the welfare sector unites, and gave the example of the united stand at the tax summit against a broad-based consumption tax. He thought for a moment and then replied, ‘that’s all very well but how do you know when the pressure is really on me’.
Today I want to talk about a project that has attempted to monitor and respond to changing pressures on people on low incomes: the Brotherhood of St Laurence’s Changing Pressures Project.
The purpose of this presentation is to argue that united to illustrate aspects of what has been a concerted attack on the value of the social wage and the quality of life of low income Australians.
In the presentation today I want to do four things:
The rationale and broad aims for the project
The project was developed in discussion within the Brotherhood of St Laurence in 1994 and 1995. There were three main rationales for its development.
One was the view that that the we were entering a period where there would be significant cut backs in the value of the social wage, particularly affecting people on fixed Social Security incomes. We felt that we needed some way of monitoring and responding to these changes. We also believed that the best way to do this was through direct contact with people who were likely to be affected by change.
A second view was that the likely fast pace of change required a different approach to traditional research where there could be a period of 12 months or more between collecting data and making public use of it.
A third view was that our efforts would be more effective if we provided support to research participants to take action themselves, including involvement in the public media.
The four broad aims of the project became:
1. To monitor the positive and negative effects of specific changes - social, economic, service delivery and procedural - on the lives of a range of people on low incomes.
2. To identify the issues which, according to low-income people, are significant influences on their living standards or life chances.
3. To undertake social action, including timely public comment, on the issues identified.
4. Where desired, to provide opportunities and support for people in the project to engage in self-help or other relevant social action.
Description of the project
Method
The original method was to develop a panel of people on low incomes who we would talk to on a regular basis. Such a panel was established with 21 participants. However, while this approach yielded valuable insights and provided the material for the first bulletin from the project, it was disappointing in terms of monitoring change. Other methods, such as feedback from our own service providers, proved to be more useful. The main method of the project then shifted to a focus on selected issues affecting people on low incomes.
The usual approach has been to conduct focus groups or face to face interviews involving between 18 and 36 participants on a particular issue. The exception to use of personal or group interviews, was work undertaken on household costs of electricity, gas and water, which used material from a self completion survey of 300 households using a Brotherhood of St Laurence material aid service.
The research findings have been used to provide illustrative material linked to an analysis of the underlying policy issues and presented in the context of research conducted elsewhere on the topic. Individual and group interviews have been taped in order that we would be able to provide the experiences of people in their own words. In the case of public hospital care for older people the experiences of our service providers were also included as part of the research.
The main issues examined through the project are as follows:
Products
The main product has been the production of an eight page bulletin in each topic area. The usual production run is 2,000 copies which are distributed at no cost to key decision makers and other interested organisations and individuals. Because of widespread inter-state interest in the bulletin on dental health, an additional 2,000 copies were printed. The research material has also been used in a number of public submissions, public talks and articles in the Brotherhood of St Laurence newsletter Brotherhood Comment.
Advocacy strategies
Three kinds of advocacy strategies have been used.
One relates simply to the identification of key decision makers and the distribution of the material to them. For example, bulletins are normally provided to Victorian and Commonwealth politicians and there is a list of other interested individual and groups who receive all bulletins. Additional lists are developed for each bulletin; for example the public hospital care bulletin was distributed through the health care networks, with addresses provided by the Victorian government.
A second approach has been to publicly launch a number of the bulletins as a way of attracting media attention. Some research participants have agreed to speak to the media as part of this. These participants have been provided with media training.
A third approach has been to identify and act on particular opportunities to influence key decision makers. Examples include a meeting with the Victorian Minister for Health over public hospital care issues for older people, and using the research interview material on low-waged work as part of a submission to the Australian Living Wage case before the Industrial Relations Commission.
What does the project tell us about changing pressures on people on low incomes?
In broad terms the research has highlighted a number of the effects of worsening economic conditions, reduction in the value of the social wage and adverse impacts arising out of the new deregulatory environment.
I want to highlight three different types of themes that have arisen out of the comments of research participants. These concern the adverse effects of new fees for service, reduction in the quality of service outcomes and worsening economic conditions.
Fees and charges
In recent years there has been a trend towards the introduction of fees for previously free services. The main effects of this has been exclusion from some services and activities and additional financial stress within families.
I want to illustrate this with quotes in relation to the household costs of electricity, gas and water, fees for participating in primary and secondary school activities and the introduction of fees for public dental services.
One indication of the difficulties people had in meeting energy and water bills was that one in five of the 300 households surveyed had been disconnected from one or more of the services in recent years. Participants identified three strategies for coping with these bills: using less heating and water to keep bills down, going without food in the fortnight when they paid the bills, or going without other things, such as children’s clothes and school excursions. A participant comments:
As we are on the dole ... the cost of electricity impacts on our other living costs, especially clothes [which] we cannot afford to buy... the increasing cost of electricity, gas and water affects our food and children’s school expenses. (Couple with four children)
Direct payment for household water consumed is a new charge for households. Two research participants comment:
There are seven of us showering every day plus I am washing every day. The water bills average $100 to $120 every three months, which has put a big strain on the budget. That’s put enormous pressure on us.
Foods the most important thing, all the things you can’t live without–food, light and gas , your rent and your water. Other things are hard. Before we had the excess water it wasn’t too bad but you now have to pay for every drop you use.
There has been an increasing trend to charge fees for activities in primary and secondary state schools. Parents identified a variety of costs which they found difficult or impossible to meet. These included school fees, books, uniforms, stationery, course fees and fees for activities organised at the school (such as visiting writers). One parent referred to these two types of demands as incursions and excursions. Parents were asked to pay for extra costs on a weekly basis. While some of these costs were optional, not paying them came at the price of not being able to participate in aspects of the school community. Two participants comment:
They ask me every week for [money for] different excursions and if I can’t afford it I hurt my child because he can’t go. [It’s] too much, every week something different and I have to keep some money for them. it’s too difficult for me.
They designed a whole new uniform when they [changed the name of the school]. Then in VCE she [my daughter] had to change her uniform all over again... She also had to pay $400 for a subject that she wanted to do which was outdoor education. [But] when they changed the uniform I couldn’t afford the second year for her to continue because I didn’t have the money. So it ruined the subject she was doing and now she doesn’t have the correct amount of subjects to get into university which I’m very upset about.
In regard to dental health, most of the 36 people interviewed expressed concern about their poor dental health. These concerns involved loss of teeth, gum disease and frequent pain. The reasons for their poor dental health varied considerably and included long term financial disadvantage and other major health problems that affected their teeth. With the abolition of the Commonwealth Dental Health Program in 1996, public dental services in Victoria introduced charges of $20 per visit up to a maximum of $80 for a course of treatment. Many of those interviewed said they would not be able to use public dental services any longer because of these fees; others said they would sacrifice their own dental health in order that their children received treatment. Two participants comment.
I’m a supporting parent, I have two children. Until now because of the free dental service I’ve been able to keep their teeth looking absolutely wonderful. But with this paying system unless they’re really in pain it’s going to be difficult to take them in. Last year I went myself because I suffer from gum disease. I have been seen at the Royal Melbourne [Dental] Hospital over something like eleven years... Since that [free treatment] has stopped I’d only go in when I was in severe pain and because of that I’ve lost two front teeth.
Since that payment, obviously you’ve got to pay all the time, you don’t go in to see them, and even the dentists think twice about giving you another time [to visit]. They actually apologise to you when they ask you to come in.
Decreasing quality of service outcomes
A second effect has been declining quality of service outcomes. This was illustrated in relation to public hospital care for older people Reducing the length of stay in hospital through increased use of day surgery or earlier discharge does not necessarily lead to decreased quality of care. However the situation for patients can too easily worsen if the planning and resources are not in place to ensure that the needs of those receiving treatment are fully met. The major problem from a service user perspective was inadequate care following discharge from hospital. Two participants comment:
One big change [in hospitals] is that up until three and a half years ago there was no trouble with me staying as long as was needed. Somehow about 1993 this problem developed that once something was finished they wanted to get you out. That’s fair enough but not without cross referencing with all the other [hospital] departments that are involved with your health. It’s become a fairly traumatic experience [for me] to have to front up and say I’m not going [home] because of so and so. Sometimes when they agree to keep you there you get this feeling of resentment, we don’t really want you to be there, you’re in the way.
They sent me home too early and then I got a rather severe attack and had to go back again. The doctor sent me back in, my blood count dropped, it was something to do with my medication. I didn’t have anything to say about my discharge, they sent me home. I was moved because they wanted my bed. I went from one hospital to another... I felt like a shuttlecock.
Doing worse in changed economic conditions
A third effect has been about some groups in our society doing worse during a period of changing economic conditions. Low wage workers talked to us about work intensification, loss of conditions, reduced bargaining power and extended hours and weekend work.
From a man working in the retail industry
In a normal way I’m gone before my kids get up and I get home after they’ve gone to bed. I see them every other weekend and on my days off–or if they wake up in the middle of the night. It’s not really conducive to family life.
A second example relates to the private rental market in an inner urban area where there was a 25 per cent increase in median private rent levels for a one bedroom flat between the December quarter 1996 and 1997.
So basically the rents are just going up in St Kilda. I have quite a few friends around here and I think since my stroke, my partner feels happier about us staying around here because it means that I have a support network. I feel happier about it. I don’t tend to go out much but I do have people popping in to see me. But the rents are just going up. [I’m paying] $180 per week rent which is to be honest a bit above what we could afford, a bit above. It makes it hard but we manage. For example, we’re behind at the moment and we’ve had one letter saying that if it wasn’t paid within a week, we would be asked to leave.
Strengths and limitations
What are the strengths and limitations of the Changing Pressures Project?
Strengths
The following strengths can be identified;
Limitations
The project also has a number of major limitations.
References
Trethewey, J 1986 When the pressures in really on, the interim report of the income and expenditure study, a study of change in income and expenditure among low-income households, Brotherhood of St Laurence, Melbourne.