Hidden privatisation of disability revealed

The Lamp December 2013

The O’Farrell Government has announced there will be no state government involvement in disability services by 2018 and that the National Disability Insurance Scheme will be fully privatised in New South Wales.

“The O’Farrell Government has rushed through with obscene haste laws that codify privatisation as the only option.”

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Left to right: Michael Grant, Vicki Yep and Jenny Preston.

The bombshell of Ageing Disability and Home Care’s privatisation was announced in an email to staff by ADHC Director-General Michael Coutts-Trotter.“By 2018 our department will no longer provide disability services. People with disability will get their supports from non-government organisations and possibly, the Commonwealth,” he wrote.

“One thing is crystal clear. To make sure there is no disruption to supports for people with disability we have to encourage as many of our staff as possible, who now support people with disability, to move to the non-government sector as NSW moves out of direct service delivery.

“Having our staff transition and continue to work in the sector is critical to the success of the NDIS.”

The seeds of this agenda to privatise ADHC lie in the agreement between the O’Farrell and Gillard Governments on the adoption of the National Disability Insurance Scheme.

Buried deep in the agreement is a clause which states: “following the commencement of the full NDIS, the NSW Government will not provide any residual specialist disability services or basic community services”.

The O’Farrell Government has since rushed through legislation to “enable” the NDIS that codifies the privatisation, gives the government extraordinary powers of compulsion to move ADHC staff and unprecedented interference in the rights of workers.

The legislation was pushed through parliament with little consultation with staff and their representatives and after a hurried debate in which amendments to protect staff, proposed by the ALP and the Greens, were overruled by the Coalition majority supported by the Christian Democrats and the Fishers and Shooters Party.

Some of these extraordinary powers include:

  • It is at the discretion of the Minister whether a staff member gets a job or not.
  • A transfer to an NGO or the private sector “does not require the consent of the person transferred”.
  • There is no access to redundancy payments and no capacity to argue “comparable employment” or locality factors.

NSWNMA General Secretary Brett Holmes says both the intent and the method of the privatisation are disgraceful.

“This is another example of the O’Farrell Government bulldozing through parliament in the dead of night, without consultation or adequate debate, laws that further their ideological agenda.

“The NDIS is a worthy reform that is long overdue and strongly supported by nurses and midwives. But it has never been put before the community that it is to be a fully privatised system.

“The O’Farrell Government has rushed through with obscene haste laws that codify privatisation as the only option, and which have coercive elements towards staff, when much of the policy development around the NDIS is still to be done.”

Brett says the NDIS is a massive undertaking and there should be an open discussion with all stakeholders, including families and staff, about the right solutions for clients.

“Right now, having some public provision of disability services gives families a choice about the sort of care they can have. That choice is being taken away.

“Some of these people have very complex needs requiring intensive care. Who is going to be the provider of last resort if a private provider finds these cases too difficult or unprofitable?”

Key points

  • Following commencement of the full National Disability Insurance Scheme the NSW government will not provide any specialist disability services or basic community care services.
  • Privatisation is to be completed by 2018.
  • There is no certainty of employment for staff in the transfer. Continued employment will be at the discretion of the Minister.
  • A transfer of employment “does not require the consent of the person transferred”.
  • There will be no access to redundancy provisions.

“That’s my career gone.”

Vicki Yep, Residential Unit Nurse Manager, Norton Road Specialist Supported Living, North Ryde

“The NDIS is a great reform that will deliver funding to people who desperately need it. But it’s being used as a cover for the privatisation of the whole system of disability services.

Families of some of our clients assume they will have the option of choosing to spend their NDIS funding packages on government-provided services for their sons and daughters. However privatisation means that choice will be taken away from them.

I worked in the community sector for 10 years then large residentials and specialist supported living for 12 to 13 years, so I’ve seen both sides.

There are good non-government services but history has shown that the public sector has always taken the most difficult cases, the clients with intensive – and expensive – support needs.

Many non-govs are unable to fully support people with complex medical conditions and demanding behavioural needs – clients who do not have the ability to understand what our community deems acceptable, clients who assault, strip in public, destroy property. What happens to them after privatisation?

You need knowledge, confidence and discipline to implement a consistent approach in managing such difficult behaviour.

Public sector wages and conditions are better so we tend to attract the better-qualified and experienced people.

I don’t want to be forced out of the public sector and told you’re no longer a nurse, you’re a disability support worker. That’s my career gone.”

“There is currently nowhere else for clients to go.”

Gary Dunne RN, ADHC Summer Hill centre

“We haven’t been told anything about the future of Summer Hill. I assume the service will have to continue because there is currently nowhere else for our clients to go.

The non-govs have not wanted our clients in the past because, being both disability and complex health, they are by far the most expensive to look after. They need an experienced registered nurse close by, 24/7, plus easy access to allied health professionals such as physio and OT.

Yet it seems the government wants all of us off their books by 2018. If the service is put out to tender, will a private agency continue to offer the same level of staffing and service? It’s hard to see how a private provider could run Summer Hill for less except by cutting the service.

Many long-term staff members have said they would transfer back to general nursing in the public hospital system rather than work under a private provider.

We find it hard to get staff now for what are public service positions. There is a nursing home down the road that’s paying more per hour for RNs. Any new management will have a difficult time just getting enough experienced staff to keep the service running.

It’s not that we are desperate to hang on to our jobs, but we are desperate to hang on to what we have built up and the quality care we currently provide for a very unique group of vulnerable people.”

“Our clients will lose nurses’ expertise.”

Michael Grant RN, president of NSWNMA Stockton Centre branch

“This is a tough time for our staff because they care about their clients and fear for their future. And they know their own livelihoods and careers are under threat.

Privatisation threatens to eliminate our career paths, regardless of whether you are an AiN, EN or RN. All of us face the potential of having our careers terminated.

The non-government sector has disability support workers with a few nurses in a few situations but the only ones paid relatively appropriately are in the government sector.

I gather the enabling legislation [to the NDIS] says our wages and conditions will be maintained for an undisclosed period of up to five years. Then we revert to whatever award is followed by whatever company takes us over. I don’t know of any non-government award that would pay any of our staff the rates we are currently on.

If privatisation results in nurses leaving the disability sector our clients will lose those nurses’ expertise. These clients are people who are multi-handicapped and with medical, psychological, and psychiatric issues.

Many can’t do much for themselves, many others have issues with aggression and inability to control themselves, all of them require specialist nursing care, and their families are worried about their futures.”

“Private companies could put profit before care”

Jenny Preston, RN and NSWNMA branch delegate, Tomaree Lodge residential centre, Shoal Bay

“We had no idea the government was going to privatise disability services – it was a huge shock to us all. Our concern is that private companies could put profits before quality care. Paying low wages for staff with basic training and working with low staff numbers would lead to high staff turnover, which adversely impacts on clients.

It looks like the government will close Tomaree and relocate our clients. It’s anyone’s guess where they will be sent. I think most would prefer to stay together, in the local area. They have known each other a long time and care about each other.

Our centre provides cluster housing, which mirrors the type of accommodation the government says it wants people with disabilities to live in. But it is on prime waterfront land and developers have been trying to get their hands on it for years. A local councilor said recently the site should be redeveloped as a casino with our clients relocated on a farm somewhere.

If our clients are forced out of Tomaree they will lose their strong interaction with the local community.  They access local medical services and local volunteers help with activities on site and in the community. There’s a fishing club and a group who travel to Newcastle to see the Jets play soccer and the Knights play rugby league. How will they rebuild those community connections somewhere new?

The NDIS is a fantastic scheme but its not a one size fits all. There are clients who have tried to live in the community and failed dismally. They need to have somewhere they can live a life with a degree of freedom and support – including from experienced nurses.”

Privatisation agenda gathers pace

2013 has seen a number of major announcements of public health services to be privatised by the O’Farrell Government:

MAY 2013 — Northern Beaches Hospital NSW Health Minister Jillian Skinner announced that the private sector would design, construct, operate and maintain a public hospital on Sydney’s northern beaches. The new Northern Beaches Hospital will take over acute services relocated from Mona Vale and Manly hospitals.

August 2013 — Mental Health Services NSW Minister for Mental Health Kevin Humphries announced that two pilot mental health services would be put out to tender to private companies and the non-government sector to deliver mental health, physical health and drug and alcohol support.

October 2013 — Palliative Care Health Minister Jillian Skinner announced that palliative care services in the local health districts of Central Coast, Northern Sydney, South Eastern Sydney, Western NSW, Murrumbidgee, Southern NSW and Far West would be given to a private consortium made up of Hammond Care, Sacred Heart and Calvary Health Care. Silver Chain Group will be given palliative care services in the LHDs of South Western Sydney, Nepean Blue Mountains, Western Sydney, Sydney and Illawarra/Shoalhaven. Silver Chain Group will also care for patients in Hunter New England, Mid North Coast and Northern NSW.

November 2013 — ADHC NSW Minister for Disability Services John Ajaka announced the privatisation of ADHC with 14,000 jobs (check) including 1700 nurses (check) to move to the non-government sector in one of the state’s largest privatisations.

What the politicians had to say

The full privatisation of NSW disability services is enshrined in the National Disability Insurance Scheme (NSW Enabling Bill) 2013. The bill was debated for five hours in the NSW parliament. This is what some of the participants in the debate had to say.

“There is a side to this legislation that is aimed at the comprehensive transfer of all disabilities service provision to the private sector. The legislation is not about the National Disability Insurance Scheme; it is about privatisation of the 40% of service delivery that currently occurs in the public sector. This is probably the largest single privatisation that NSW has ever seen.” — Dr John Kaye (NSW Greens spokesperson on health)

“Non-government organisations are mainly inclusive, participatory and quality-focused and have the capacity to generate social capital in a way that the government and the private sector cannot.” — John Ajaka, (Liberal Party) Minister for Disability Service

“The government is targeting and manipulating workers because it knows how much the community wants and needs a national disability scheme. It is disappointing that the O’Farrell Government is playing political games with disability support workers. It takes the gloss off this wonderful reform.” — Shaoquett Moselmane (ALP)

“This legislation is about devolution. I think we all believe passionately that through allowing devolution and choice we will see a thousand flowers bloom in the form of local solutions.” — Catherine Cusack (Liberal Party)