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Integrating private and social responsibilities
'Why recognise 1994 as the International Year of the Family in Australia? The most compelling reason is that the year provides a major opportunity to build and strengthen partnerships between families, governments at all levels, community organisations, business and unions in order to support and share the responsibility of care for children and other family members made vulnerable by illness, disability or old age. The objective is a better distribution of resources and opportunities to improve living standards and quality of life, strengthening the essential interdependence of families, communities and government policies, thereby integrating private responsibility and social responsibility'. This theme of building better partnerships between families, governments and communities is a priority issue identified by the National Council for the International Year of the Family. The author focuses on instances of the merging of private and social responsibilities - these are partnerships which support the care of children, frail elderly people and people with disabilities. She also discusses the theme adopted by the National Council: 'Supporting the many faces of families', pointing out that although there is great diversity in family composition, there is an essential similarity in the roles and functions of families. 'The heart of the matter is that families are generations of caring'.
The United Nations' theme and objectives for the International Year of the Family - Family: Resources and Responsibilities in a Changing World - are concerned with stimulating local, national and international actions to increase awareness of family issues among governments, the private sector, and community organisations. It is the intention of the UN to spread knowledge of the economic, social and demographic processes affecting families. There are two aims: strengthening the functions of care and nurturing which all families hold in common (families' private responsibilities); and strengthening the resolve of national institutions to develop, implement and monitor policies which will support families (social responsibilities of governments and communities).
United Nations goals for IYF programs reflect these dual aims.
- To encourage organisations and agencies, whether government or non-government,national or international, to recognise that their decisions and actions will usually influence how families are formed, whether they will survive, and how well they function as nurturers and providers.
- To develop and implement policies which help families to provide the emotionaland material supports and cultural heritage essential to family members' development and wellbeing, particularly for children and young people.
The key issue is recognition, internationally and nationally, that access to resources is essential for families to carry out their central responsibilities - that of providing material and emotional care and nurturing for children, young people and other family members. The ability of families to contribute to their own wellbeing and to the wellbeing of the community depends on their having education and training, jobs, adequate income, good housing, health care and community services, and a healthy and sustainable natural and built environment.
LINKING PRIVATE AND SOCIAL RESPONSIBILITIES
Why recognise 1994 as the International Year of the Family in Australia? The most compelling reason is that the year provides a major opportunity to build and strengthen partnerships between families, governments at all levels, community organisations, business and unions in order to support and share the responsibility of care for children and other family members made vulnerable by illness, disability or old age. The objective is a better distribution of resources and opportunities to improve living standards and quality of life, strengthening the essential interdependence of families, communities and government policies, thereby integrating private responsibility and social responsibility.
GENERATIONS OF CARING
The theme adopted by the National Council of the International Year of the Family, Supporting the Many Faces of Families, embraces two fundamental principles: inclusively recognising the diversity of family life according to family composition, stage in the life cycle, ethnicity, race, culture and religion; and promoting social justice and social responsibility, as reflected in the words 'the responsibility for families rests on the shoulders of us all'.
Political debate about the definition of 'family' in this International Year has revolved around the two poles of an exclusive definition and a more broadly encompassing concept of family. The National Council speaks of families, because it recognises the many ways in which families create and conduct their lives, sometimes in response to considerable adversity. This diversity arises from family composition (two-parent and sole-parent families, for example) and stage of family life (for example, caring for young children or teenage children, perhaps with a grandparent as well). It progresses to children leaving the parental home, and perhaps returning several times before forming their own families, when the ties of care, affection and responsibility spread well beyond the front door of the family/household. The definition also recognises differences in language and/or culture which derive from race or ethnic identity or religious faith. To adopt an exclusive definition would exacerbate social division, marginality and disadvantage.
The respect accorded to difference and recognition of the essential similarity in the roles and functions of families can encompass all concepts of family. The heart of the matter is that families are 'generations of caring' - for children, spouse/partner, siblings, parents, grandparents, grandchildren, family members who are sick, have a disability, family members who are aged and infirm, both within the household and beyond in the extended family. This definition includes two parents with dependent and older children, sole-parent families, stepfamilies and blended families; it does not make arbitrary and stigmatising judgements about better or worse family forms. In emphasising the extended family network, it is recognised that the extent of contact, cooperation and exchange of resources and care between family members living in different households is very great in Australia (McDonald 1992).
The research which shows the growing importance of extended family support systems for the majority of Australians also highlights the disadvantages and difficulties for people who are isolated from their extended families. These include homeless young people; some aged people; people in financial and personal distress because of unemployment or joblessness who have lost contact with family; sole-parent families whose contact with their relatives may be limited by poverty or geographical distance or the social dislocation of separation from the spouse/partner; and immigrants and refugees whose family ties have been lost through traumatic events in their countries of origin.
CHANGING WORLD OF FAMILY LIFE
Since the late 1960s, social, demographic, economic, labour market and employment changes of fundamental importance have had significant effects on families and their members. These changes include longer years of education and training for young people, which have increased the period of young people's dependency on their parents. Equally important, the increased rate of unemployment and especially long- term unemployment since the mid 1970s profoundly affects family wellbeing; in 1993 this resulted in 17 per cent of families with dependent children having no member in employment(ABS 1993a). An ageing population makes greater calls on families as carers of elderly relatives, but it also enables active and healthy grandparents to make vital contributions to the care of their grandchildren (ABS 1993b).
Also, there is a much greater community acceptance of the central value of gender equality in family life and in employment opportunities. Women's participation in employment has increased markedly. And while the trend has hardly kept pace with women's increased workforce participation, the importance of men's greater involvement in family care and nurture has been increasingly recognised. There is a growing recognition that paid employment is as much an expression of women's care for and contribution to their families as is their family-based work as carers, and that sharing in the care and nurture of children, young people and other family members is a vital expression of the human qualities of men as well as women.
Following the labour force changes of the last 20 years, increasing proportions of families with children have two earners. Organising the hours and responsibilities of working time and family time, with children's time in child care, kindergarten and school has become central to the daily lives of parents and children. In 1993, the majority of people with dependent children were in the labour force: 94 per cent of fathers and 60 per cent of mothers in two- parent families, and 78 per cent of male and 52 per cent of female sole parents (ABS 1993a).
These dual responsibilities are not always easily borne. The Australian Bureau of Statistics Survey of Families in Australia in 1992 shows a substantial proportion of employed family members with children under 12, particularly women, stating they had difficulty managing paid work and child care. This was the response of 37 per cent of all employed women, rising to 46 per cent of those employed for 35 hours or more per week. There was a considerably smaller, but still significant proportion of men who indicated that they had difficulty managing employment and child care (24 per cent), but this proportion did not increase with longer hours of employment (ABS 1993b). In addition, the ageing of the Australian population has contributed to the family responsibilities of employed women and men. Of employed people who provided care or home help for an elderly, long-term ill or disabled family member, 35 per cent of women and 21 per cent of men said they had difficulties in managing the dual responsibilities of work and care (ABS 1993b).
These sometimes conflicting responsibilities call for attitudinal changes leading to a better sharing of the responsibilities and pleasures of family life, particularly the sharing of child care and household work. Such changes require a context enabling both women and men to choose more flexible employment arrangements, including the opportunity to withdraw from employment either fully or partially to put more time and energy into family care, if that is their wish, particularly when children are young. This requires both the extension of income support and better access to community services to support work and family choices. Such choices include access to affordable and appropriate child care of high quality for preschool age children and outside school hours child care; and day care, day centres and respite care for elderly family members: and day centres and supported and open employment (where appropriate) for people with disabilities.
But to share the responsibilities of care, both within the household and between family and community, is not the only purpose of community services. Of equal importance are benefits which accrue to those who are participants in the services - enhancing the social and cognitive development of children, and enhancing the autonomy and dignity of the elderly and people with disabilities.
PARTNERSHIPS BETWEEN FAMILIES, GOVERNMENTS AND COMMUNITIES
The National Council for International Year of the Family has developed nine priority areas for discussion and policy development of which the following is the focus of this paper: 'To strengthen the partnerships between families, governments, education and community services, business, unions, religious organisations and community groups.'
Families in an advanced industrial society cannot be self- sufficient; they require and receive support from public and private sources which complement the many roles and tasks of families. This paper focuses on several special instances of the merging of private and social responsibilities - these are the 'partnerships' which support the care of children, frail elderly people, and people with disabilities,
PARTNERSHIPS AND CARING FOR CHILDREN
Child care services play a crucial role in supplementing parental care, promoting children's social, cognitive and personal development. Their role is vital in enabling parents, especially women, to participate in employment, education and training. Access to good quality child care arrangements are the priority for families combining employment and family care, including care for children of preschool age, before and after school hours care, school holidays and vacation time care (Russell 1993; Ochiltree and Greenblat 1991). Child care services are important too, in terms of children's needs for companionship, play opportunities and social and emotional development either through regular care or occasional care. Also, child care matters greatly for children with disabilities, for parents with disabilities, for children in families experiencing conflict, abuse and other emotional distress (AIHW 1993).
What is the demand for child care?
There have been significant increases in the demand for child care over recent years, reflecting changing patterns of workforce participation, education and training requirements of parents, and increased recognition of the benefits of good quality care for children.
- The 1990 ABS Child Care Survey showed that slightly more than half (51.6 per cent) of all children under 12 years of age were in some form of child care arrangement, whether formal or informal. This was an increase from 47.5 per cent in 1987 and represented a shift in the balance of care: a majority of children are now receiving some form of child care in addition to family care.
- The total number of children in formal child care services increased by 16.5 per cent, while the total number of children in informal care increased by 14 per cent. There was a 32 per cent increase in children using both formal and informal care.
- The proportion of children in formal child care was 18 per cent, a further 16 per cent were in both formal and informal care, and 66 per cent of children were in informal care only. Two-thirds of children in informal care were cared for by relatives, predominantly their grandparents (ABS 1990a).
Expansion in the demand for child care has resulted from changes in the workforce, primarily the increased employment rates of women; an increase in the number of sole-parent families requiring work-related care; changes in community perceptions about the appropriate social roles for men and women; and a recognition of the benefits to children of good quality child care (AIHW 1993).
There is no doubt that partnerships around child care involve all sectors of the community.Informal child care comprises the largest amount of care in the community, outside of the immediate family. Amongst children of preschool age, the percentage of children in formal child care services increases as children grow older, but does not reach more than 40 per cent of all care until the child is four years. This is partly due to the parents having access to informal carers, usually in the family circle, and partly due to an unmet demand for formal services.
What has been done to meet the child care needs of families?
The Commonwealth Government's Children's Services Program was developed primarily in the context of the Accord with the Australian Council of Trade Unions (ACTU). Children's services were identified as a major component of the 'social wage', in the arena of a 'new order' of wage fixation where market wages, employment benefits (occupational superannuation) and community services (universal health insurance, child care) were all seen as contributors to family living standards. Government financed children's services (usually on a cost-shared basis between Commonwealth and State/Territory governments ) were expanded significantly. In addition, a range of new partners was brought by the Commonwealth Government into the establishment, funding and management of child care services. These included community-based organisations, employers, commercial providers and local governments. The predominant rationale for the program, and no doubt one of the major reasons for its successful expansion, was the explicit linkage with facilitating the increase in women's workforce participation, including the support of women's education, training and job search, as reflected in priority of access guidelines to children's services funded under the Children's Services Program. It is of interest that this Program is recognised within OECD countries as an example of effective partnership between government, community providers and the business sector (OECD 1990).
Between 1983 and 1992, the numbers of children attending services funded by the Children's Services Program increased from 46,000 to 230,000 and the largest expansion was in long day care services. An additional feature of the program is the needs-based planning approach which guides funding on the basis of an equitable distribution of new services and child care places across the States and Territories. Also, subsidies for child care fees (Child Care Assistance), the level of which is related to parents' income, have been introduced for users of community-based and commercially provided long day care, family day care services, occasional care and outside school hours care, to assist parents on middle and low incomes with their child care costs. The results of this very considerable expansion of investment in children's services include the provision of a range of services, distributed on the basis of indicators of need across regions, and with fees subsidised on an equitable basis.
One of the most recent initiatives in the Children's Services Program is the establishment of the National Child Care Accreditation Council, which aims to foster good standards of care in children's services and to accredit those services which meet the standards. This is important because the main purpose of children's services must be to meet the developmental, cognitive, emotional, social and physical needs of children. Accreditation is a means of ensuring that good standards are established and maintained, in commercial services, as in community - based services.
A recent measure by the Commonwealth Government is the introduction of a child care cash rebate which will be payable to parents with children in child care who do not necessarily attract Child Care Assistance, to offset the fees which they pay. Unlike all other family- directed payments, this rebate is not income-tested on parental income, eligibility depends on incurring substantiated costs on child care, which need not necessarily be carried out in a formal child care service.
Unfinished agenda in children's services
The first issue is concerned with unmet demand for services. Despite significant expansion, the number of children whose parents indicated that their child care needs were not met more than doubled from 242,000 in 1987 to 514,000 in 1990. Long day care, family day care and outside school hours care (services associated with parental employment) together account for 57 per cent of the expressed unmet need for child care (AIHW 1993).
With the Commonwealth Government's ratification of ILO Convention 156 in 1990 has come the formal recognition of the rights of workers with family responsibilities. The Commonwealth has introduced a range of taxation-based measures to provide incentives for employer-sponsored child care and it is official expectation that employer initiatives will grow in size and scope. This might involve employers providing advice and referral, reservation of places through financial contributions to existing services to secure priority of access for their employees, and the establishment of new services, either independently operated by one employer or a group of employers or in conjunction with a community- based or other child care provider, eg local government.
The period of recovery from the 1989-1993 recession will be the test of employer capacity and willingness, in both the private and the public sectors, to involve themselves more actively in employer-sponsored child care, as part of the recognition that child care is an investment in a well- trained and motivated labour force, as well as supportive of family life.
In addition to the expansion of employment-related child care, other concerns have been raised about the role of the Children's Services Program in giving better access to children for other than employment- related purposes. As noted, current guidelines give priority of access for entry into long day care, family day care and outside school hours care to children whose parents are in the workforce, looking for work, in education or training. Other groups accorded a high priority are children of sole parents, children with a disability, children from non-English- speaking backgrounds, children from Aboriginal and Torres Strait Islander families and children at risk of abuse or neglect.
Overall, however, priority of access to Commonwealth- funded services is based mainly on the workforce requirements of parents. It has been cogently argued that greater attention should be given to the needs of children whose parents are not in paid work, where child care would be of great benefit to the child's development and to family relationships (Gifford 1992). Children's services are also beneficial for families who are not in the workforce, because of illness, disability or unemployment or where children are at risk from family violence or neglect.
Fernandez (1993) has argued convincingly that policies for child welfare in the broadest sense must be concerned with improving the socio- economic circumstances of families whose capacities to care are made much more difficult by poverty and isolation from informal and formal support networks. The best safeguard against child abuse and neglect, in all communities and particularly in economically disadvantaged communities, is the existence of networks of informal support services, particularly child care, family support centres, effective schools, information services, and supportive neighbours.
The Australian Law Reform Commission has a Reference to examine various aspects of legislation in the Commonwealth portfolio of Human Services and Health, including the Children's Services Act. Following the release of its Child Care Discussion Paper in 1993, the Law Reform Commission carried out extensive community consultations on which the Commission has not yet reported. These consultations raise a number of issues including the views of parents employed in part-time, casual and shift work, and those engaged in tertiary education, that they have particular child care needs which do not always fit into regular service provision.
Other matters raised in the consultations include: the scarcity of child care services in rural and remote areas; the affordability of services; and the need for adequate funding for and provision of outside school hours care (before and after school care usually for primary school children).
Further areas for development have been identified - in particular, culturally appropriate children's services for Aboriginal and Torres Strait Islander people through the Secretariat for National Aboriginal and Islander Child Care (SNAICC) and Multifunctional Aboriginal Children's Services (MACS). These have been established to provide a range of services to meet the developmental, educational, health and welfare needs of indigenous children, and also serve a related family support and community development role (Butler 1993).
The child care needs of families from non-English-speaking backgrounds include culturally appropriate services that value cultural diversity. Also important is support in the area of settlement after migration where appropriate child care enables parents, particularly women, to participate in English language courses and other labour market programs, and gain employment essential to their families' standard of living (Alcorso and Harrison 1993).
Supporting home-based child care
There are important family-government partnerships providing assistance for parents home-based child care. They include occasional care and play-groups, and family income support through Basic and Additional family payment and the Home Child Care Allowance to be introduced in September 1994. How might these partnerships be developed?
To enable better combinations of employment and family care to be supported, enterprise agreements in workplaces might increasingly cover flexible working hours, including permanent part-time work with pro-rata entitlements for people with family responsibilities, particularly when children are young, and where employees have responsibility for the care of elderly or disabled family members. One of the key issues is leave or time off for family reasons, particularly to care for sick children. The ACTU is bringing a Family Leave Test Case to the Australian Industrial Relations Commission and the Commonwealth Government has signalled that it will be introducing legislation based on the outcome of this case. This is a matter of considerable importance to Australian families.
Support for parents with very young children
Unpaid maternity leave for up to 52 weeks has been available to women employees since 1974, following the Maternity Leave Test Case, and from 1990, the Parental Leave Test Case in the Industrial Relations Commission extended the maternity and adoption leave standards to parental leave. In addition, parents have a limited entitlement to permanent part-time work up to the child's second birthday, subject to employer agreement. By July 1993, the unpaid parental leave standard had been inserted in more than 390 Federal awards and adopted in principle by most States.
However, in respect of paid maternity/parental leave, Australia is not up with OECD 'best practice', being an outsider, along with the United States and New Zealand, in not providing a widespread entitlement to at least 12 weeks paid maternity/parental leave (OECD 1990). Paid maternity leave of this duration is provided mainly to women in the public sector (in the Commonwealth but not all States since legislation removed the right to new employees in Victoria) and to only a very small minority of private sector employees. It is available after a period of continuous employment, usually 12 months for full-time employees and much less often to part-time and casual employees. Those who miss out include most private sector employees, women employed on a casual, part-time basis in both the public and the private sectors, and women who have not worked long enough to qualify (students, unemployed women, those caring for previous children).
It must be recognised however that income support when a parent is caring full-time for a baby is not just an industrial relations issue.
Social responsibility might encompass all families, through the introduction of a young child or infant parenting allowance for all parents taking care of a new-born or adopted child in the first 12 weeks, with the community sharing the costs as with other family payments - through the social security system. The welfare of children and their carers would be enhanced at that vulnerable time when family income falls (usually because one parent, predominantly the mother, leaves the workforce) and the costs of family formation increase.
In most OECD countries, the costs of maternity/parental leave are shared by employers, employees and government through their social security systems. Australia could usefully follow this example by introducing a parental allowance for 12 weeks, as a development of family payments in the social security system. The payment would be available to all parents, conditional only on the full-time care of a child, with no reference to previous labour force status. Thus provision would become a social issue, not only an industrial relations issue.
If we were to consider such a proposal, this might establish a two-part system of parental benefits:
A young child or infant parenting allowance, which would be a development ofthe current family payments in the social security system, paid for 12 weeks to the parent caring full- time for the child, whether or not the parent has been in paid work. This payment, like the Home Child Care Allowance, would not be means-tested on the income of the partner who is likely to be in paid work.
Paid maternity leave for those who have award or enterprise agreemententitlements; these parents would, therefore, not receive the parenting allowance inthe period for which they are receiving an employment-based payment.
This proposal reflects the theme of partnership central to policy initiatives in the family-employment context in the International Year of the Family, and is aimed at ensuring that Australian policies provide effective choice in supporting employment and family care combinations.
Rather than see older Australians primarily as people requiring care, provided by family members and by health and community services, it is more accurate to recognise that older people are themselves healthy and vigorous contributors to the wellbeing and care of their extended families. The Survey of Families in Australia 1992, shows that many older family members are providing a significant amount of care for their spouses, their adult children, particularly those with disabilities, and for their grandchildren.
Grandparents are an important source of informal child care. Over 755,000 grandparents (two thirds of whom were women) provided care for their grandchildren aged under 12, accounting for almost half of all informal carers and two thirds of those providing child care each week.
Reciprocally, the ageing of the Australian population, particularly the increase in the numbers of the very old, the subsequent increase in rates of disability, coupled with the growth of 'community care policies' to enable elderly people and people with disabilities to maintain home- based living and the accompanying shift of funding from institutional care to 'community-based' care, have culminated in expanding responsibilities for family caregivers in recent years (Schofield and Herrman 1993).
The Australian Bureau of Statistics survey of Disability, Ageing and Carers, carried out in 1993, found that people with disabilities and those needing assistance with various activities of daily life were much more likely to receive that help informally from family members, friends and neighbours than they were from formal community services or through commercial services. Informal providers of care were almost three times as likely to provide assistance as were formal providers (ABS 1993c).
This survey found that there are 577,500 carers in Australia who are the principal providers of care for people with a handicap (defined as a disability which limits the performance of certain tasks related to daily living). Of this group of carers, 74 per cent are living in the same household as the person being cared for, and two thirds of carers are women (ABS 1993c).
The survey also found that for people with disabilities living in the community, help with a range of activities necessary for daily living (self- care, mobility, health care, help in the home, meal preparation, home maintenance, amongst other tasks) is provided predominantly by the spouse/partner, with equal proportions of men and women providing care for their partner (ABS 1990a). Parents were the most important source of care for children with disabilities, with mothers comprising 80 per cent of parent/carers. Adult daughters and sons provided a great deal of care for their elderly parents with disabilities and here women were 56 per cent of the main providers of care. Men were much more likely to help family members through home maintenance; women through self care, health care, housework and meal preparation (ABS 1993c).
In addition to care within the same household, family members provide a great amount of care for the aged and for people with disabilities across households in the extended family network. The Survey of Families in 1992 used a broader definition than that of extent of family care provided between households to family members requiring assistance because of long-term illness, disability or old age. Using this broader concept, about 1.5 million people (11 per cent of all adults) had cared for at least one family member in the previous six months. Almost three quarters of the providers of these forms of care did not live with the person who had received their care. Here there is a clear gender division: women comprise 72 per cent of carers providing personal care, nursing care, meal preparation and housework, while men provide 75 per cent of the house repairs and maintenance.
These studies indicate that relatives, mainly but not entirely women, are the major sources of support for family members who are aged or have a long-term illness or severe disability. Carers experience satisfaction and fulfilment in caring for family members, but there are limits on what family members believe is appropriate or possible for them to carry out, without significant strain on the health of carers themselves, and on their capacity to earn income essential for family wellbeing (Schofield and Herrman 1993).
SHARING THE COSTS OF DISABILITY AND CHRONIC ILLNESS
In the International Year of The Family, it is timely to consider the adequacy of the partnership between families with a member who requires care and the range of government and community-based services sharing that responsibility.
Disability places a heavy burden on family wellbeing because of the increased costs of providing care for the family member, both through formal services and informal family care (Graham 1991). In addition, there may be long- term costs to both the person with a disability and to the whole family because of barriers to employment (DSS 1990). People with disabilities have lower rates of participation in the labour force and higher unemployment and long-term unemployment rates compared with the rest of the working age population (Committee on Employment Opportunities 1993).
There is a further cost of care; carers for family members with a disability and for aged relatives are themselves much less likely to be in the labour force. The Australian Bureau of Statistics study of carers of family members with handicaps showed that the average labour force participation rate was 72 per cent, falling to 51 per cent for carers. For women, the average participation rate was 59 per cent and only 41 per cent for those with caring responsibilities (ABS 1990b). The costs of care include the direct costs of providing nursing and disability aids, health care and medication, special transport, adaptation of the household, etc. But there are also indirect costs: the income not earned by adults with disabilities who might otherwise have been in the workforce, and the income foregone by carers who might otherwise have been employed.
The high costs of providing care for family members with disabilities and for the frail aged fall predominantly on the shoulders of families. Health, disability and aged care policies over the last decade have emphasised care at home and in the community as a means of achieving integration, social participation and improved quality of life for the individual being care for and reduced the role of institutional care (in nursing homes, for example, or psychiatric hospitals). However, these policies have been sustained by the availability of at least one family member, usually a woman, to be the principal carer, or to complement formal services.
Focusing on care for people with mental illness, the Report of the National Inquiry into the Human Rights of People with Mental Illness (HREOC 1993) found that de- institutionalisation, and the subsequent redirection of resources, have placed a much greater burden of care onto the family, particularly women. Mental health resources have not been sufficiently reallocated within community settings to meet these new needs. As a result, there are insufficient respite services and other forms of community- based care supporting carers and people with psychiatric illness. The people with least access to services are the most ill, have the lowest incomes and are from non-English- speaking backgrounds.
Much of the burden of care therefore has fallen on the lowest income families and families of non-English-speaking background. The costs of care, in the broadest sense, have an overwhelmingly negative impact on family relationships and finances, particularly for women. This Report also notes the additional difficulties faced by families in rural and isolated areas in getting information about and access to appropriate services.
The Commonwealth Government's recent Discussion Paper in response to the Report of the National Inquiry into the Human Rights of People with Mental Illness recognises some of these issues, putting forward proposals which are relevant to all families where a member has a disability (Lavarch and Howe 1994).
The Disability Services Program is under review, with the intention of opening up better employment opportunities for people with disabilities. This is particularly important because a strong response to the over- representation of people with disabilities among the long-term unemployed requires well-financed and intensive labour market programs as well as a properly resourced Commonwealth Rehabilitation Service.
The Commonwealth Government has indicated that it will provide increased funding for new kinds of service delivery for people with psychiatric disabilities. Across the range of disability services, it would be in the spirit of community/government/carer partnerships if better services were planned cooperatively, in consultation with people with disabilities, their carers and community-based service providers.
The Government has also signalled its intention to review the Domiciliary Nursing Care Benefit paid to carers who are providing intensive care to people with disabilities and to the elderly who would otherwise need residential care. Currently, this payment provides very little real compensation for the considerable direct and indirect costs of care, and there are very tight criteria for its receipt. It is timely to discuss the issue of more adequate and appropriate income support for carers, looking to the model of carers payments in the social security system and their extension to those caring part-time as well as full-time.
The challenge for all governments is to invest further in the network of community services needed to ensure that people with disabilities, including mental illness, can get appropriate and adequate supported accommodation, including high level support equivalent to institutional care where necessary, supported employment and open employment opportunities, day care and respite care.
Caring for frail older people
Demographic projections by the Economic Planning and Advisory Committee (EPAC) have shown that the number of older people over 65 years of age is expected to double and those over 80 years are expected to at least treble into the 21st Century (Clare and Tulpule 1994). To fulfil our social responsibility to care for frail older people will therefore require a substantial expansion and strengthening of programs. Recent reviews have assessed the effectiveness and appropriateness of existing Commonwealth and State/Territory aged care policies and programs, taking into consideration population projections so as to plan for future services (House of Representatives Standing Committee on Community Affairs 1994).
The Home and Community Care Program (HACC), introduced in 1985, is jointly funded by the Commonwealth and State and Territory Governments, providing the major source of funding for home-based care for frail elderly and younger people with disabilities. Services, delivered through a range of providers including local governments, community groups and religious organisations, include home nursing, home help, meals on wheels, centre-based respite care, transport, home-based respite care, gardening and home assistance. HACC services are essential to support a relatively independent life for people who would otherwise be compelled to enter residential care, inappropriately.
The demand for HACC services far exceeds supply and the gap is increasing (House of Representatives Standing Committee on Community Affairs 1994). Challenges identified for the HACC Program by the EPAC Report on Australia's Ageing Society include the availability of volunteer carers, the movement of 'traditional' carers (that is, women) into the workforce, the level of involvement which might or should be expected from the aged themselves in caring for spouses and relatives, the appropriateness, or more accurately, the inappropriateness of making an even greater shift in the balance of care to the community (Clare and Tulpule 1994).
Evidence to the House of Representatives Standing Committee on Community Affairs Inquiry into HACC reported that there are groups whose special needs are not being properly met, including Aboriginal and Torres Strait Islander people, those from various non-English-speaking backgrounds and people in rural and remote regions. Also of considerable concern is the lack of sufficient support for carers.
Creating stronger partnerships between family-based carers, the Home and Community Care Program and increased investment in respite care, day care, as well as hostel and nursing home care are crucial considerations in the 1990s. Such partnerships enhance the dignity of older people and their capacity to participate in the community. They would also support the dedicated efforts of carers and provide them with choices: to continue employment, to maintain social contacts, to sustain other family commitments, to enjoy leisure - forms of social and economic participation which carers often are compelled to forgo.
Strengthened partnerships between families, who are clearly carrying out their responsibilities with vigour and commitment, and governments, community and religious organisations, business, industry and trade unions, will integrate private and social responsibility for families.
The implementation of effective and equitable partnerships which support families depends upon sustained public and private sector investment in social infrastructure in community services, children's services, family support services, day care and respite care for the elderly, hostels and nursing homes, home and community care services, adequate and appropriate income support for carers. This requires a strong community as well as governments' recognition that community services, whether provided by governments at Commonwealth, State and local government levels or by community and religious organisations, or sponsored by employers, are not unproductive appendices to the productive, wealth producing sectors of the economy, as they are often depicted. They are equally productive of goods and services, equal contributors to the aggregate of economic and social welfare, productive of emotionally, socially and educationally enriched children, productive of strong family relationships, productive of richer and more vital social/educational/employment opportunities for people with disabilities, productive of environments for the elderly which treat them with dignity and enable them to live their lives fully.
These are some of the challenges for policy development which would constitute a lasting legacy of the International Year of the Family.
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In this issue
- International Year of the Family: What are the Issues?
- The many faces of families: Diversity among Australian families and its implications
- Sharing the pleasures and pains of family life
- Integrating private and social responsibilities: Better partnerships between families, governments and communities
- Families and financial disadvantage
- The rights of indigenous peoples in the International Year of the Family
- Supporting people with a disability and their families
- Regional disadvantage and unemployment
- The Value of Care and Nurture Provided by Unpaid Household Work
- Responding to Family Crisis: Past and Future Roles of the Professional Helper
- Developing coherent community support networks
- Human rights, families and community interests
- Child support: A step towards changing parenting after separation
- Achieving a family supportive workplace and community
- Child abuse and neglect: Incidence and prevention
- Violence against women in the home: How far have we come? How far to go?
- Abuse and Neglect of Older People