Erwin, there may not be any point in flogging Centrelink …

Comment on A message from this vineyard: go horticulture! by Bob Durnan.

Erwin, there may not be any point in flogging Centrelink about this. As far as I can see, Centrelink staff are doing their job, which is to provide people with their welfare entitlements, and refer people who are unemployed and seemingly able to work to the privately-owned Job Services Australia (JSA) providers. This is the process decreed by successive governments. (Centrelink staff also give their clients access to current information about available jobs, and employers who are looking for workers. This is fine for highly motivated job seekers, but many unemployed are not ‘job-ready’).
The deal is supposed to be that if unemployed people don’t register with the JSA providers, then they won’t continue to get benefits from Centrelink.
The JSA providers tender to DEEWR for their contracts, which seem to be fairly lucrative, on the basis that they have the skills and determination to get unemployed people job ready and into available jobs. The JSA providers are responsible to DEEWR, not to Centrelink, which is marginalised in this loop.
If the unemployed people don’t co-operate with the JSA provider, or don’t accept jobs, then the JSA provider is supposed to report this to Centrelink, which cuts them off their benefits. Centrelink probably can’t physically take the unco-operative unemployed people to the grape farm at gun point, and chain them to the trellises without water until they pick the grapes. All it can do is to cut off the welfare supply.
What puzzles me, and what I think would be worth pursuing, is the issue of why DEEWR does not breach and penalise the JSA providers who seem to be entering contracts to get the unemployed into jobs, but then not carrying out their contracts. They seem to be not able, or maybe not willing, to do what is necessary to deliver the goods: they enter their contracts on the basis that they are expert wranglers, but then they seemingly fail to perform the most important wrangling on their agenda.
Does this failure include not being tough enough with their unemployed clients, i.e. not reporting quickly the failures to take up training and job opportunities?

Recent Comments by Bob Durnan

The millions and the misery
Jones (Posted June 10, 2018 at 12:46 pm), you display an unreasonably negative and incorrigibly antagonistic attitude towards the Central Australian Aboriginal Congress and its considerable achievements in the health field.
You may have heard the old adage that a little knowledge is a dangerous thing? This certainly applies to you. You continually use your ignorance as a cloak for confidently, and very unfairly, maligning Congress.
For your information:
1. The primary causes of most renal disease are very long term, and are mainly associated with poverty. The impacts of the chronic stresses from living in poverty begin in utero, then early childhood, with kidney stones and infections much more common. The stress burdens and infections contribute to weaknesses in organs such as the kidneys. These experiences are all imprinted on a person in ways that may lead to renal disease in later life, irrespective of what health service a person attends. As already discussed, a great deal of the global obesity / diabetes epidemic is socially determined, and health services can only do so much on their own.
2. The rate of end stage renal failure requiring dialysis amongst Congress’s own long term resident clients is vastly less than the rate in the rest of remote central Australian Aboriginal communities. The rate in remote areas is generally more than eight times greater than the town. If you are going to use data, you should use it correctly.
3. There is no basis for your statement that “the [overall] incidence of this terminal disease [i.e. renal failure] is a good measure of the success or failure of diabetes programs for which Congress has responsibility”. The situation is much more complex, as explained above, and health services can only do so much.
4. In light of the above facts, there is no validity in your statement that “the incidence of end stage [renal] disease is out of control despite the tens of millions of funding provided to Congress.” Rather, it would appear that Congress’s funded programmes have contributed to the rate of end stage renal disease being much lower in the long term Alice Springs Aboriginal population than it would have been without those programmes.
Jonesy, it is now incumbent upon you to relinquish your pathological denial of Congress’s achievements, and “agree that Congress has long been a leader and good practitioner in prevention and early intervention strategies and practices.”


The millions and the misery
Yes Evelyne Roullet, I have heard of HTLV-1. It would be hard to not have, given the recent publicity.
But no, I don’t know how much Congress, or anybody else, contributes for research and cure of it.


The millions and the misery
You are being perverse, Jones (Posted June 8, 2018 at 7:18 pm), and you are not nearly as well informed as you seem to think that you are.
Being a provocateur perhaps, just for the sake of it?
I pointed out that Congress (Central Australian Aboriginal Congress, or CAAC) has helped to greatly increase the average length of Aboriginal life expectancy in our region.
CAAC has played a leading role in achieving this increase in average life expectancy, not just by medical interventions, but also by fostering social and behavioural changes, such as by helping to ensure that when children are quite sick that they are brought to Congress by their parents, and are referred to hospital when needed.
You are possibly unaware that before Congress started providing health services in 1973, many sick Aboriginal babies were not being treated in the hospital, for a range of reasons.
Most important was the fact that the hospital was only desegregated in 1969.
Added to that was the fact that the hospital had also formerly played a key role in informing the Native Welfare Branch about the presence of mixed race children in the hospital, or where they were living, and this often lead to their removal.
Thus there were some powerful legacy issues.
In this context, many parents had been very reluctant to take their children to the hospital.
Although you agreed with me about CAAC helping to greatly extend the average rate of Aboriginal life expectancy in our region, you then went on to condemn CAAC for not preventing diabetes, and for allegedly not taking effective steps to intervene in its progress.
These are clearly unreasonable accusations on your part, based on a simplistic understanding of the complexity of the relevant issues, and the history of the situation with diabetes.
Much of what you say about this matter is factually untrue.
It is clear that you have not looked at the CAAC annual reports carefully, otherwise you would know the proportion of Congress diabetic patients who have their blood sugar tested regularly each year is quite high. Further data shows that a high proportion of patients have excellent sugar control.
These figures and many other key performance indicators (KPIs) are published every year in Congress’s annual reports.
This is in stark contrast to most other general practices, which rarely publish such data in their annual reports.
Please have another, more careful look at the CAAC annual reports, which are available on line.
You will find a wealth of information which you and other interested members of the community can use to judge the success of Congress.
As for prevention of diabetes, it has a very long development period.
Most of the CAAC diabetes prevention programmes are also long term by their very nature, and begin with trying to ensure healthy pregnancies, healthy births, and good early childhood health and emotional wellbeing programmes.
CAAC is now providing these services to many of its clients.
However, some of these programmes have only been funded in the last 10 years, some of them only starting quite recently. Several of them are not yet funded in many remote Aboriginal communities.
As you may be aware, the diabetes epidemic is a massive global health crisis that has been caused by what is known as our “obesogenic” social environment, which is rich in high fat, high sugar, high salt, high carb ultra-processed foods, and increasingly sedentary, inactive lifestyles.
Congress alone cannot be expected to change this.
There is much that is still needed to be done in public health terms.
For example, Congress has been advocating for a sugar glucose tax of 20% for more than a decade.
Congress has long advocated that funds raised by such a tax should be hypothecated, or reserved, to be spent solely on a subsidy to ensure fresh fruit and vegies are affordable in all remote communities.
This key position and advocacy has been Congress policy well before the AMA and other peak medical groups around the world adopted it.
Congress removed soft drink machines back in the late nineties, something that most of Australia’s public hospitals and major medical centres are only starting to do now, 20 years later.
Another key endeavour, where CAAC has had some success in recent years, is in the area of reform of the NT Government’s regulation of alcohol consumption and sales, in order to reduce the average level of consumption amongst problem drinkers and those at risk of becoming problem drinkers.
This is widely acknowledged to be a necessary pre-requisite before many further advances in the preventative programmes area can be expected to take place.
You can’t have it both ways, Jones.
You should admit that Congress has long been a leader and good practitioner in prevention and early intervention strategies and practices.


Fewer pokies, help for gambling addicts
Bev Emmott, I don’t understand some of your comments, but I get the drift. “Where are the drunks in Sadadeen,” indeed?
Maybe you could try some of these activities?
Swimming, athletics, archery, shooting, motorbike riding, keeping bees, knitting, embroidery, playing pool, darts, training dogs, raising birds, keeping cats,
following non-Aboriginal art at Araluen, the Art Shed and elsewhere, doing painting, visiting the prisoners, assisting the disabled, helping young single mums, volunteer work, making sculpture, writing, cooking, helping Maureen York, soothing Matthew Langdan’s feelings, dining out, dining in with friends, cycling, walking, running, netball … etc etc etc.
There are not enough hours in the day, or days in the week, or weeks in the year!


The millions and the misery
Re Michael Dean’s mean minded aspersion against the Central Australian Aboriginal Congress (CAAC) staff (Posted June 5, 2018 at 11:37 am: “Amazing … $32m budget and $28m in salaries. They know who to look after, don’t they.”)
Michael, you need to stop and think a bit before you make statements like that.
Consider that the 333 full-time equivalent (FTE) positions on the Congress payroll include about 20 FTE doctor positions, covering seven town clinics (at Gap Rd, Sadadeen Shops, the Diarama Village shopping centre, the Alukura Women’s Clinic on Percy Court, the male health Ingkintja, the youth mental health service at headspace, the after-hours service for the whole community at the hospital), plus a clinic at Amoonguna and four remote clinics (at Mutitjulu, Utju, Ntaria and Ltyentye Apurte).
Most of the rest of the staff are nurses and other health and allied health practitioners, working over these same twelve sites, as well as doing outreach into other services and agencies.
If you deduct the salary packages and on-costs of the doctors from the total, you will see that the average annual wage packages, including on-costs, of the 313 FTE non-doctor staff is around $75,000 per annum.
This is not excessive, considering their skills, the difficult jobs that many of them perform, and the remote locations in which many of them work.
In the last 20 years this workforce has contributed greatly to improving the life expectancy of local Aboriginal people and reducing the gap with other Centralian residents.
Considering the continuing shorter average life expectancies of Aboriginal people, and the gap between their health and the average health levels of other Australians, do you really think that this expenditure is not warranted, Mr. Dean?


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