Duty of care: Meeting the aged care workforce challenge
Read CEDA's report on Australia's aged care workforce challenge.
'Unprecedented’ is wearing out as a description for 2020. First the summer’s bushfires and then the COVID-19 pandemic created massive social and economic disruption. Now with the recovery well under way, it is important not to lose sight of the things we learned through this experience.
For one thing, 2020 showed us how health and human service providers can innovate at a grassroots level to better serve their communities. One example is the family violence service that brought forward a digital transformation plan to enable women to seek help online while locked down with abusive family members. Another example is the drug and alcohol service that developed a new pathway to treatment for people on methadone programs when daily visits to pick up medication had to be curtailed to maintain social distancing. We can also look at the collaboration between different services that enabled them to stay in touch with vulnerable members of their community who might be alone and isolated or at risk of abuse or neglect in lockdown.
Health, legal assistance and other services were already working flat out to respond to the needs of the communities they serve before lives and livelihoods were hit by bushfire and pandemic. As the needs of the community changed over the past year our health and human services changed with them.
Another key lesson from COVID-19 is that these services were able to identify and respond to this change so rapidly because of their connection to the communities they serve. This connection is based on trusted relationships between people and the health, legal and other practitioners they turn to for help, extending well beyond transactional relationships between service providers and their ‘clients’ or ‘customers’. These trusted relationships are critical to identifying and responding to the multiple, intersecting needs that drive disadvantage in people’s lives.
The connection that health and human services can have to the people they help is a vital but intangible form of community infrastructure. It extends from services understanding community experience and establishing relationships with local leaders, to a willingness to try new things and work in different ways when existing approaches do not work for the people they are intended to assist.
Community infrastructure encompasses the physical assets that we typically associate with infrastructure, but it is not limited to these things. Buildings and internet and telecommunications enable services to exist but it is the less tangible aspects of community infrastructure – trusted relationships, community knowledge and understanding – that make services effective.
Aboriginal and Torres Strait Islander community-controlled organisations exemplify the value of trusted relationships between communities and the services that support them. As the pandemic set in, it was Aboriginal community-controlled health services that identified the risks COVID-19 posed to their communities and staff and developed and advocated for policies to governments still struggling to estimate the likely impacts of the virus. It was these community-controlled organisations that led the development of protocols to protect communities and vulnerable people within them.
The latest Close the Gap report from the Australian Human Rights Commission recognises this:
“The rapid public health control measures put in place were led by Aboriginal and Torres Strait Islander health leaders and services who understood the risks and worked tirelessly with federal, state and territory governments to deliver collective, culturally appropriate and localised solutions."
These frontline services operating with the trust and confidence of their communities rapidly identified and responded to the crisis, not only preventing catastrophic harm but ultimately preserving health and wellbeing at a time of global pandemic. This is a far cry from government-led approaches of the past that too often have had a disastrous effect on Indigenous communities. We can learn a lot from this leadership about how to support good health and justice outcomes for Aboriginal and Torres Strait Islander communities.
We can also recognise that the value of working in this way extends to all communities, including but not limited to those of Aboriginal and Torres Strait Islander people. Indeed, many non-Indigenous services have built and maintained the trust of the communities they serve also, from health through to legal assistance and social services. Yet, too often the policies, programs and funding that enable their work consider these components by-products or secondary to the delivery of a service, rather than critical to its effectiveness.
Building and maintaining the relationships that enable services to address complex need takes time and effort. Just as bricks and mortar infrastructure requires investment, so too do the intangible aspects of community infrastructure. In our journey towards a new normal after COVID-19, frontline services should be funded and resourced in a way that reflects the value of these relationships and gives them what they need to nurture connection so they can continue to serve their communities effectively.