Video transcript
Human Services Reform in Victoria
Gill Callister, Secretary, Department of Human Services
Community and human services reform conference – Building better lives for Victorians in
need
Thank you, Chris. Thank you, Minister. Good morning, everybody. Can I start by acknowledging the
Wurundjeri people of the Kulin nation, as the traditional owners of the land on which we meet today
and pay my respects to the elders, past and present and, of course, pay my respects to elders of
other communities who are with us today.
So, a couple of weeks from Christmas – thank you to everybody for making the time to be here for
this event. Our community sector partners, colleagues from local government and others from
Victorian government departments. It seemed a very opportune time, as we reach the end of 2013,
to stop and take stock of the vast array of reform challenges that are either underway or in front of
us and try and have some sense of how these things fit together, as we go forward into 2014.
Because, whether you are actively engaged in some of these things at present, or observing some of
them or sitting poised, ready to jump into some of them, there is a substantial amount of reform
underway and, I think, that one of the big opportunities for us today is to try and lift up and look at
how some of these things fit together. Some of the challenges that they pose for us, going into next
year and beyond and how, in our day-to-day efforts, we start to think about some of the key reform
themes.
It’s also an opportunity and, I think, this is a very concrete deliverable that we need out of today, to
think about what are the various structures and dialogues and ways in which we come together,
either currently or that we would prefer to in the coming year, to make sure that we are interacting
and talking and having dialogue about the myriad of things that we have to discuss, both at that
higher level reform end and at the day-to-day business end and, I’m hoping through the various
discussions and workshops and presentations, that that is something that we have some very
specific discussion about. And, some of the challenges that we’re facing aren’t dissimilar to those
that many of us have faced in our entire careers. Some of these challenges have been around for
generations. Read any annual report from the department for the last century or reports from
VCOSS since 1946 and they outline challenges such as fragmentation, silo structures, workforce and
demand. But, I think what’s different now is the intensity and the intensity has escalated
these
challenges from sometimes frustrating, to potentially debilitating and that intensity is now slowing
the rate and, in some cases, potentially reversing the rate at which we’re shifting the dial on
disadvantage and vulnerability in social problems and issues in Victoria.
So, I want to talk a bit about what some of the data and figures are telling us about vulnerability and
disadvantage and then I want to talk about some of the reform themes.
Every year, disadvantage in Victoria is estimated to cost at least $5 billion, when we consider both
the costs of services and welfare systems and the impact on reduced economic activity by a whole
group of Victorians. The household income and labour dynamics in Australia’s survey showed that
64% of people who exited poverty in 2002 were back in poverty within 6 years and, increasingly, a
lot of the data shows us that people rarely present with a single problem that is easily solved and
people talk about increasing complexity but one of the challenges for us, I think, is to try and get
underneath that complexity and understand what might be driving it. Increasing numbers of people
are seeking assistance and the demand for services is rising across the board. But, it’s important for
us to try and understand what’s driving that demand. Is it an expression of churn, of people being
referred and re-referred around the system? Is it an expression of some of our interventions being
inadequate and needing significant review? Is it an expression of referral behaviour, whereby people
feel the need to involve families in more and more services and the Minister gave a good example of
that before? And, I just want to take you through some of the data that we have about demand and,
it doesn’t cover the interests of necessarily everybody in the room, but it does tell us some things
about our service system.
In Child Protection, there has been a 15% increase in reports over the last 12 months. 15% from last
year to this year, and it continues to rise. If that doesn’t change, reports are projected to increase by
a further 15% to 96,000 in 2014-15 and 111,000 in 2015-16 and that’s without any unforeseen policy
changes that might drive that even further. But the interesting thing is what’s driving that growth,
with an 87% increase between 2005-06 and 2012-13 is its re-reported children. There is a group of
children who, over the course of their 0-18 childhood, are reported multiple, multiple times into the
Child Protection System. And, it’s really important for us to try and unpack and understand what’s
driving that. Whether it’s episodic intervention with services, whether it’s inadequate interventions,
as I talked about before. There’s a whole range of possibilities. It’s certainly telling us something
about the impact of family violence, substance abuse and mental illness because those three things
are the key things that are most likely to drive re-reports into the Child Protection System. And, what
does it mean about our Child First platform and have we made the most of the potential that that
platform offers? What’s the relationship between participation in some of those protective services
that help build resilience and strength in child development? Early childhood services, for example,
and what’s the relationship between early childhood services and our Child First platform? And, we
have the age-old disconnect here between adult-focused services for adults with mental illness and
adults with drug and alcohol problems and child services. Those services such as child protection and
early childhood focused more on children and their families. And that disconnect is something that
the vulnerable children strategy is aimed at, trying to break down and change the ways in which
those services work together but we have a fair way to go.
If we look at Child First, there is a correlation between the rate of reports to Child Protection and the
number of referrals from Child Protection to Child First. So, we’ve seen a 94% increase in referrals to
Child First from Child Protection from 2076 in 2009-10 to 4026 in 2012-13 but the bulk of families
being referred into Child First are not from Child Protection. The bulk of those families are going in
from other referral sources and I don’t know entirely what that means. This may be a very good
thing, whereby people are finding their help earlier and getting to the right services earlier, but it
certainly hasn’t affected the re-reports into Child Protection. And there are increasing numbers of
vulnerable children and families presenting to Family Services, with complex issues. Over 63% of
families referred in 2012-13 had one or more complex issues, compared with 55% in 2007-08. 42%
of the families being referred from Child Protection had experienced family violence and 30% had
experienced mental health problems.
And, one of the other interesting pieces of information is that the average hours of family services
case work has risen by 118% between 2007-08 and 2012-13. It’s gone from an average of 38 hours
spent with a family, to 82 hours and, again, this raises an interesting question about whether we
have any strong data that indicates length of service being provided to a family, relating to better
outcomes or more sustained improvement over time. Because an increase in average number of
hours like that drives cost and access enormously.
Our out of home care rates in Victoria are growing at around 5% each year and, for Aboriginal
children, this is even higher. It’s close to 9% growth each year and this is against a context of Victoria
still being a jurisdiction that removes the lowest per capita rate of children of anywhere in Australia.
If the rate of growth of children in out of home care had matched the child population growth rates
of the past 10 years, we would have 1800 fewer children in care. We continue to have children in out
of home care, likely to be more involved in the youth justice system and much more likely than other
children to have contact with the police. And, if we look at this more closely, we see the rate of
children in out of home care varies greatly by area, with key hot spots in rural localities. So, why is an
Aboriginal child in inner Gippsland twice as likely to be in care, as an Aboriginal child in Goulburn.
And, for me, part of this answer goes to the question of ‘place’ and the need to have a much
stronger focus on ‘place’ in how we can figure our services. Not just the needs of people but our
service responses, our level of integration, our practices and culture vary across places in Victoria.
Homelessness itself increased by 31% between 2006 and 2011, with 22,789 people counted as
homeless on Census night and one of the questions to ask is what’s driving that? Is it is mental
health problem and, we know that in part, it is. Almost half of those people were under the age of
25 and 1 in 6 was a child under 12. And, perhaps one of the most concerning, and yet not necessarily
front of frame issues, about that high number of children and young people in the homelessness
system, is the crisis that it brings for their education. And, we have 34,400 people on the public
housing waiting list, with over 10,000 of those in the priority one housing category. And, while
slightly less than 1% of the Victorian population, Aboriginal people account for 7% of the Victorians
accessing specialist homelessness services and currently on our Disability Service Register, we have
4,201 people waiting for services.
Increasingly, this data doesn’t tell us enough and, increasingly, we need to understand the interrelationship between the drivers of demand, in order to respond effectively. Making a lasting change
in people’s lives, requires a range of inter-related and increasingly integrated responses. We can
often improve peoples’ life circumstances at a point in time, but despite the significant efforts,
dedication and resourcing, we are struggling to change the tide, in terms of chronic disadvantage.
And, how should we respond? I won’t dwell on the changes today in the department itself but, one
of the things that our reorganisation has been designed to do, is to significantly transform the way
we think about and are arranged to provide services to vulnerable Victorians and this goes to both
our policy and program development, as well as our area-based structure for service delivery. We
have been trying to lead by example and model that it can be done in a different way and there is no
intention for this to be confined to the, developing more integrated place-based responses, which
we’ll talk about in a moment, is one of the most core themes underlying much of the reform
underway.
And, I think the other important thing about all of that data is that it says perhaps our efforts in the
areas of prevention and early intervention remain quite substantially elusive. During Peter
Shergold’s consultations, we heard many times that we need to be better connected to universal
systems to develop better planning and coordination across all levels of government and there are
still 150,000 children living in jobless households in Victoria and the youth unemployment rate is
nearly four times that of the overall unemployment rate. And, around 70% of job services Australia
clients seeking employment, do not get successful outcomes through engagement with the
Commonwealth Employment system. This is possibly the single biggest indicator for life-long
exclusion and disadvantage and, while we have some promising examples of how we bring this to
the forefront of our operating and delivery models across the state, it is still a long way from being
systemic. And, then if we add, by the year in which we have the full roll-out of the new SAX award,
Victoria will be spending an additional $450 million a year, just on the existing services, without any
increases.
So, I want to turn to the reform landscape and talk a bit about it, not just from the perspective of the
actual reforms, but to try and draw out, what I think are some of the common themes and some of
the themes are more common to some of the reforms than others. The Minister talked about the
need for better integration and coordination that offers holistic delivery that meets clients’ needs.
We talk a lot, at the moment, about client-centred approaches. Coordination and integration are
different things and, as we put integration and client-centred approaches into the frame for how we
think about reforming service delivery. We need to be clear that these are different approaches and
there’s a number of reforms underway that are tackling this. The action plan to address violence
against women and children is an example of the theme at work, with an emphasis on prevention,
early intervention and a better response driving partnerships across government and community
sector organisations.
Another theme is more flexibility to innovate and design and deliver services that put clients at the
centre and have a maximum impact and we can see this at work in the Victorian Homelessness
Action Plan, particularly the innovation action projects that are part of the plan.
The need for cross-government, whole of government, cross provider collaboration is a stronglyemphasised theme, in order to achieve better outcomes for people and their communities and the
Victorian Vulnerable Children’s strategy underlines that commitment across government to improve
outcomes for vulnerable children and families. But how we actually realise that on the ground, is still
something significantly in development. That creates a performance management framework, so a
measurement framework to monitor outcomes and is committed to establishing local networks to
improve how we deliver services at the local level.
A strong focus on area. So, moving from a problem and program approach to some of the problems
and demand that I described earlier to a people and place approach. And, the department’s
transformation has been largely focused around ‘can, in fact, we make that shift and transition?’
And, greater client choice and control and we’ve been – Victoria has really pioneered the way in
choice and control in disability services for a number of years now, but the NDIS takes this to
universal entitlement. It broadens the focus on choice and control, in the form of individual support
packages and makes those support services for people with a disability a universal entitlement. And
the NDIS won’t make many, many changes in the way people with disabilities receive their services.
It separates assessment and planning from service delivery. It gives people choice and control over
how and where they receive their services and it will fundamentally change the structure of the
relationship between Commonwealth and State governments, between service providers and
governments and between service providers and clients using those services. And, one of the
interesting things, I think, for other parts of the service system is, should we have that concept of
packages? Should we think about separating access and planning and delivery and should we think
about opportunities to give clients greater choice and control in other parts of the service system?
Partnerships between government service providers and clients to co-design services is a key reform
element and I think we’re seeing that substantially in the establishment of the community sector
reform council, which the Minister talked about. A stronger focus on productivity and efficiency and
maximising public value from investment. And, I think, this theme is being played out, not just
because we’re in tight fiscal times, but because there is an increasing need for accountability to
demonstrate the best possible outcomes, both to clients themselves and to the Victorian
community. And, some of the reforms, the recommissioning in community mental health and drug
and alcohol services are targeting at simplifying access, improving service effectiveness and
efficiency and then there’s the other aspect of that, which is more – which is increasing
accountability, and creating a service system accountable for the outcomes that it achieves and this
will come up increasingly through the Royal Commission. It’s come up through various audits by the
Auditor-General and, from time to time and increasingly, is a focus of the Ombudsman. That is, to
say, not just the activities of government, but the activities of the broader service sector. And, we’re
looking to a much stronger focus on outcomes and we talk about this a lot and we know how
difficult it is to change the system from an output-driven system to an outcome-driven system and
that, in fact, we’ll probably need both. That we can’t necessarily trade all outputs for outcomes but
we need a better understanding of how we get sustained improvements for our efforts and the
Minister talked about Services Connect and Simon will present Services Connect in more detail later.
So, I won’t go into it, but Services Connect is at the heart of how we want to have more integrated
systems services that deliver a broader, inter-related set of outcomes.
So, I think, the focus for us is how we keep these reform themes, and the actual reforms that they
are related to, in frame. How in our day-to-day work, we start thinking about these themes, how we
think about the structure of our delivery, the models of our services, the research or evidence that
they’re based on, the impacts they appear to be having or not having, the opportunities to bring all
of these themes together, as we go forward and the service sector reform project is one very
important but one very important component of that. The Minister spoke about the principles and
the challenge will be to put the principles into action. I think we agree on the principles. I’m not sure
we’ll all agree on the best way to interpret some of the principles and the establishment of the
Sector Reform Council which I know Michaela will talk about, is an important step in ensuring there’s
strong dialogue between government and the sector, on these issues, but it isn’t the only avenue
and it can’t be the only avenue, where we are having this set of complex and inter-related
discussions about reform. Some of which is delivery, some of which is structural, but all of which is
pretty critical.
So, I think, this is a terrific opportunity to commence this discussion. To get in our frame what some
of these reforms mean. What the size of them are, how far progressed some of them are. Where
we’re up to and what role each and every person in this room in their organisation, and beyond,
plays in taking this forward. And, of course, in doing that, we have a myriad – we have a number of
relationships. We have a partnership around reform, policy, service delivery, going forward. We also
have a regulatory relationship. We have a business relationship and we have an on-the-ground
working with the client service delivery relationships. It’s not one single relationship between
government and the community sector, it is a myriad of those and there are a myriad of
relationships between yourselves as well. So, this has to be part of how we talk today. This group of
relationships are the various ways in which we need to have dialogue, going into next year, and
there’s two workshops this afternoon that will give you the opportunity to tell us what you think
about the way we are working together and the transformation program and talk about what the
structure of dialogue and discussion and interaction around these issues should be next year.
This should be the start of very high level engagement around reform. I know, for example, in
Geelong, where the NDIS launch site is well underway, there are many providers and government
and a whole range of bodies, sleeves rolled up, integrally involved in how that launch rolls out. But, it
is very important that other organisations get closer to that and understand the implications of
what’s being trialled in Geelong for how we roll that out across the state. Services Connect is in pilot
sites in a few places and, as the Minister said, now needs to be expanded. So, this is something on
the ground that we are doing together, rather than something that you’re observing. And it needs to
be something that a broader range of people are participating in. Those are just two of the reforms
that I mentioned but it is important, out of this, that we have a clear road map for next year about
how we are engaging in discussion and participating in the development of all of these things. So, I
anticipate this being a beginning and next year being a year of very high intense engagement
between us at a range of levels, and I hope that today, we can get some clarity about how we
actually make that happen. And, I look forward to the discussions, as the day goes on.
Thank you.