LINKS CORPORATE MEDICINE WEB SITE Disclaimer The many extracts on these pages are from copyright material. They are owned by the reference given or its owner. They are reproduced here for educational purposes and to stimulate public debate about the provision of health and aged care. I consider this to be "fair use" in the common interest. They should not be reproduced for commercial purposes. The material is selective and I have not included denials and explanations. I am not claiming that the allegations are true. The intention is to show the general thrust of corporate practices as well as the nature and extent of any allegations made. Links to Site Maps Central Initial USA Australian International Corporate Practices (to print) Path to this page Home Australia Markets & aging Story of corporatisation Aged Care Story of corporatisation   Nonprofit dilemma    BUPA Aging bonanza Banks Retirement Villages Nursing homes Home Care Breadth health corporat. Health care Hospital Corporatisation   Entry to Privatisation   Privatisation Background   Australian states Pathology & Radiology Gen. Pract. Corporatisation Introductory page This corporate web site addresses the issues of corporate health care within a broad framework. A web page describing this broad context should be considered as an introduction to each page on the web site. If you have not yet read it then CLICK HERE to open it in another tab or web page. Content of this page The difficulties experienced by humanitarian institutions, the personal dilemmas, and the process of adaptation are discussed and then illustrated by an article from The Age. Also what happened when the conflicts with their mission became intollerable.  Australian section    The Not-for Profit Dilemma

 CONTENTS

• Copyright and fair use
• The article
• The issues
• Agenda - Church Inc.
• 2006 : The churches say No!
• Catholics quit 'immoral' program
• AN AUSTRALIAN CASE STUDY

The article reproduced on this page is copyright material and should not be reproduced for profit. On this web site I have used extracts from published material extensively to illustrate issues and events. In fairness to copyright owners I rarely reproduce whole articles. I only do so when they are particularly important and explore key issues. The use of the full article here is I believe acceptable and fair use in the public interest. To break it up would be to emasculate it.

This in depth analysis is so revealing that it should be readily available and not be allowed to rot in the Fairfax archives.

The focus in this article is on the conflicts for charitable and altruistic community services when community services provided, and funded, by large numbers of volunteers and donors, are turned into a multimillion dollar business generating profits. It expands on a web page which examines the marketisation of aging. That page explores the progressive encroachment of for profit market enterprises and publicly listed corporations responsible to shareholders on what was once a humanitarian mission.

While the focus of the article below is on welfare services the same dilemmas are faced in other areas including health and aged care.

I do not want to hold out the not-for-profit aged care system in the 1980s and early 1990s as a shining example to go back to. It was under- funded, fragmented and disorganised. There was no accountability. It badly needed attention. The restructuring of the sector has produced some benefits.

The argument is that the market paradigm used to restructure the system is an inappropriate framework for humanitarian services and better results could have been achieved in other ways. The collateral damage in human and social costs far outweighs any benefits. At the time this should have obvious on intelligent reflection, but insights and arguments were ignored. Ideology and reason are poor bedfellows.

The article addresses issues which I have drawn attention to on this web site. They include:-

1. The dissonance (mental discomfort) and conflict created by a situation where participants must live and act using two conflicting frames of understanding. Some call these frames of understanding "starting points" or world views. Another word I often use is conflicting paradigms. I have devoted another page to conflicting starting points in health care.

2. These contradictory understandings force participants to carry out their day to day activities within the framework of a dominant understanding that imposes its imperatives. At the same time wider society and their own consciences require that they pay service to the world view best suited to that service and to which they all aspire - a world view which challenges the legitimacy of their actions. In an article "Belief versus Reality in Reforming Health Care" published in Health Issues in 2005 (download pdf file) I explored the dissonance created and the split consciousness which we use to cope with this dissonance.

On other web pages I explore the idea of conflicting paradigms in greater depth and look at the behavior of different personalities within the context of conflicting paradigms.

The article below describes an instance where corporate language and concepts are used to dehumanise events and handle them within a manageable marketplace pattern of thinking so avoiding the discomfort of a failure in humanity. Also revealing is the Alice in Wonderland way in which the provision of humanitarian services is rephrased in market terms and so insulated from the humanitarian paradigm.

3. The consequence for not for profit charitable groups is particularly worrying as the dominant market paradigm directly challenges their not for profit mission. Yet to survive they must adapt and act within the market paradigm. By adapting and participating, and through their actions they progressively make this adaptation legitimate - even ultimately desirable and obviously sensible. Participants increasingly assume the dominant world view, some enthusiastically even criticising their original position. Personal success becomes validation. Much of this is apparent in the article below. New recruits are socialised into these new patterns of thinking. They know no better and accept this as the norm.

The conflicts and the method of coping are reflected in the abundant public display of Mission statements in most organisations. These do not necessarily reflect what is happening. These missions were once an integral part of charitable culture. They were secure and valued by society. Those serving had no need to flaunt them and so externalise their beliefs publicly.

4. Many find these coping mechanisms more than they can swallow. They continue to experience intense discomfort and alienation. Those with most integrity, usually those best suited to provide the humanitarian service are unable to tolerate the situation and walk with their feet so aggravating workforce shortages. There is a high staff turnover particular in senior positions. This angst is reflected in a number of web pages written by nurses or about nurses available from the Aged Care Crisis web site <http://www.agedcarecrisis.com/>

5. As important is the destruction of the culture within institutions. The pressures cause distrust, conflicts, disinterest, lack of motivation and loss of a sense of humanity and care. The service draws employees motivated by personal greed or need and drives away those who are motivated to serve. I have addressed some of this on a web page looking at the spectrum of responses to the pressures generated in these conflict situations. This dysfunction is readily apparent in nursing home care in the USA. It is now revealed in Australia and is documented on the Aged Care Crisis web site and on the aged care pages on this web site.

6. Equally important in my view is the erosion of social capital, values, norms and morality in the wider community. Social capital, trust, trustworthiness, community values, morals and other patterns of behaviour are dynamic entities. They are formed, maintained, reinforced and modified as we act out our lives and interact with one another. If we do not have venues within which we can do this then those cultural attributes which have no use cease to be relevant to our lives and consequently degrade. The not for profit church and secular charitable institutions are critically important in mediating our humanity and our care for the community and its members. It is worrying that the decline in the influence of the churches has not been matched by a rise in the influence of secular community services.

The change in ethos and practice within the not for profit charities alienates volunteers and truncates their involvement in serving their fellows. The entire community is impoverished as a consequence. In my view this erosion of social capital, and the values that go with it are an even greater threat than the many documented failures in care. These issues are touched on in this article.

The issue of Social Capital was explored by Eva Cox in her ABC Boyer Lectures on "Social Capital". The Canadian John Ralston Saul explored some of these issues when he analysed what he called our "Unconscious Civilisation" in his Massey lectures published under that name.

7. The plethora of external measuring agencies, and the focus of market management on measurable outcomes has resulted in goals and motivations being driven by incentives linked to narrow measurable outcomes. Some not for profits have even resorted to the common commercial practice of paying kickbacks in return for support, although they never call them kickbacks. This has reinforced self-serving activity and devalued reflective value driven motivation.

As this article points out important components of service such as empathic human interaction with those in need are not measurable and are consequently ignored. This is particularly so in nursing homes.

This "results - followed by rewards" (carrot and stick) style of living is an essentially behaviourist understanding of life (originally based on experiments in rats). As in rats, it is very effective in attaining defined goals. Unfortunately it devalues our cognitive and reflective human functions - our humanity.

A behaviourist approach was enthusiastically adopted by many educationalists in the 1960s. It was effective for rote learning and short term retention but has long since been abandoned. It was destructive of the essence of education - thought, reflection and understanding - called deep learning. As an educator I lived through this period. In my view a narrowly focussed behaviourist paradigm of understanding is even more destructive for society. It turns us into rats!

8. Even the most reflective and insightful not-for-profit leaders have a problem. They correctly see that charitable institutions, whose frames of understanding lead to a cooperative service meeting need, have no place in a competitive market. Here groups are competing to create and meet a demand for that service in order to make money. There is no need for a charity and they should direct their services to areas where they are needed.

The problem is that those who have insight are only too aware of the consequences the competitive marketplace focus will have for those they serve if they walk away. Their presence reduces the influence of the marketplace ethos. It reduces the overall adverse impact. They have little choice but to compete and do their best to provide real care. In nursing homes only the Salvation army has elected to vacate the sector and leave it to the marketplace.

Three years after this article was written the conflict between the humanitarian ethos and the government's policies became intolerable and most of the Churches backed out of the contracting system claiming that what they were asked to do was immoral.

The bolding in the article is mine and is intended to emphasise points which I believe are particularly relevant. Try to stand back and think beyond what the author is saying.

Welfare used to be an issue. These days it's a market, and the biggest players are church groups. But as their agencies become more like businesses, are they leaving their core values - and the people they're meant to serve - behind?

THERE'S money in poverty. The Christian charity Mission Australia, keen to get more of the long-term unemployed off its books, last year rewarded employers who hired them with gold watches, DVD players, televisions and golf clubs.

It seems incongruous. But the incentive scheme was a sound one, says Peter Richardson, Mission Australia's manager of employment services. "It's a really good investment of public money. We budgeted for 330 job placements and we ended up with 670."

Ask how much the rewards cost, though, and Richardson turns cagey. "That would be confidential. I'm not going to tell my competitors what I'm spending on promotions. It's a competitive market."

The "market" he is talking about is the jobless - or, more accurately, the government-awarded contracts for finding work for the jobless, the main area of social welfare that the Howard Government has outsourced to private contractors. Many of Richardson's "competitors" in this marketplace are fellow religious organisations, such as the Salvation Army and the Catholic Church's Centacare. Welcome to the brave new world in which church-based welfare finds itself.

The work of God has always involved the tools of Mammon; it is impossible to help the poor without the pragmatic use of wealth. But as agencies have grown larger, increasing revenue and responsibilities have forced them to change the way they operate. In many, the Christian vision of a world transformed by spiritual values such as compassion for the poor is increasingly being overlaid with the language, structures and goals of business. This month's issue of the Uniting Church's Crosslight newsletter has a lead story headlined, "Church: A business to control".

The two ethoses do not always mix comfortably. In January, an audit of the Girrawheen Nursing Home in Brighton, which is run by the Uniting Church, found it failed to meet 32 out of 44 federal standards. The audit claimed, among other things, that one resident had been left on a toilet for one-and-a-half hours; that a complaint about a resident's 32-kilogram weight loss had been ignored; and that a resident was admitted to hospital with dehydration after staff refused to take her to the toilet when she asked (in response, she drank less).

When the issue was aired publicly, the church did not discuss it in terms of a moral failure, or an apparent lack of kindness on the part of some staff. The problem was one of corporate governance, according to Colleen Pearce, director of Uniting Care Victoria.

"How did HIH fail? How did One.Tel fail?" she asks. Her answer? Poor information flow up the chain of command. In the case of Girrawheen, the board had not been told of problems, she says. They had not known what was happening, just as the Packers and Murdochs had not known what was happening with One.Tel. "If the information didn't get from the CEO to the board (of Girrawheen), how did the church know?"

There is a bemusing, Alice-in-Welfareland quality to such talk; some even call poverty a market, and welfare an industry. But the tight charity dollar, government outsourcing of social services, and the introduction of competitive tendering have created an environment in which those doing the Lord's work must play by more worldly rules. Many church organisations sign contracts that measure their effectiveness in production-line terms, measuring throughput and unit costs rather than spiritual wellbeing.

For true believers, this raises confronting questions. Should a welfare agency based on religious values be run like a business? Is the gap between what the churches profess and how they behave becoming wider? Ultimately, are church welfare agencies in danger of losing their souls?

The two biggest religious providers are the Catholic Church and the Uniting Church, which each spend well over $1 billion a year on welfare services, excluding their health and education systems. The Church of England's Anglicare, which has nearly 11,000 staff, spends $500 million. The Salvation Army, with 10,000 staff, spends $354 million.

These organisations work in a different landscape to the one that existed in the 1970s, when governments first began to offer them substantial funding. Then, grants were largely non-directive and agencies set their own priorities, deciding how best to use that money.

In Victoria, church agencies have always done much of the welfare work. But the nature of the partnership with government changed in the 1990s as mandatory reporting brought more children and families into the child-protection system. Much of this work has been outsourced by government. At the federal level, the biggest change has been the privatising of the Job Network. Mission Australia, for example, runs federal employment programs worth $120 million a year.

Particular moral dilemmas came for those who took on federal job services. Agency workers who had previously understood their role as one of advocacy on behalf of the poor suddenly became enforcers, "breaching" the jobless who failed to meet guidelines.

There has been agonised debate, particularly among Catholics, about their role in privatisation generally. Critics fear church agencies are allowing themselves to be enlisted as an alternative civil service, making them captive to the economic rationalist agenda.

Many concede that churches' closer entanglement with government is muffling their "prophetic voice" - their obligation to speak out against injustice. Government contracts often include commercial confidentiality clauses that forbid public comment about the social issue or program being funded. This shields governments from policy criticism while weakening the churches' ability to advocate for the poor.

Market rules have also brought market prices. At least two Victorian agencies pay six-figure packages to their CEOs, despite the fact the managers are also ministers of religion, the kind of people who, once upon a time, would have been expected to do such work for love and a modest stipend.

The big-salary phenomenon first came to public notice three years ago with reports that the then superintendent of Wesley Central Mission, Reverend Tim Langley, was on a salary package worth $160,000 a year. Today two Anglican priests - Ray Cleary, chief executive of Anglicare Victoria, and Nic Frances, executive director of the Brotherhood of St Laurence - acknowledge that they are on six-figure packages (though they both decline to reveal details).

"I don't think I earn a lot of money," says Cleary, whose priestly vestments hang on the back of his office door. "If I was running a similar sort of business (in the private sector) I'd be earning three times as much. My son shows me ads in the paper: 'Here's a company that does such and such, you'd be earning $450,000.'

"I work six days a week. I'm accountable to a board, I'm on a three-year contract, subject to performance review. I've got to ensure the financial viability of the organisation, I've got to look after all the negotiations with government and all the negotiations with the church, and ensure that all our services meet occupational health and safety and legal requirements. No parish clergy person is doing all that."

Cleary adds that, because he is not on a stipend, he does not receive the free house and schooling for his children for which most ministers are eligible.

Nic Frances seems a little more conflicted over the issue. "I can't justify it," he says. "So I won't justify it. I understand the reasons for it. This is not a job that's designed for a priest. The board needs to set in place the structures to ensure that they can find the best person (in the marketplace)."

Frances points out that he's not earning as much as he was initially offered. He knocked back "a house in Gore Street and some other things", he says.

But Jan Carter - a social policy analyst, a former director of the Brotherhood of St Laurence, and the author of the State Government's Community Care Review - sees big salaries as symptomatic of the way market principles have infiltrated a sector that used to run on more idealistic ones.

She believes there are still agencies that cling to the ascetic view that "if you want to work in church agencies and minister to the poor, that does involve some economic sacrifice on your part; that your rewards are intrinsic rather than extrinsic, that you get a buzz from what you're doing".

Her own view? "I don't understand how you can go to the public and ask them for donations if you've got executives on very high pay. Non-government agencies also benefit under tax laws, and the commercialisation of them has clouded that issue enormously."

The churches enter the embrace of government because it offers them money to do their good works. For government, outsourcing offers the promise of lower costs, the use of a committed, altruistic workforce, and service delivery that is close to the people who need it.

There are those, like Nic Frances, who see little difference between a good humanistic secular agency and one run by believers. Then there are those, like Ray Cleary, who beg to differ.

"Church agencies would state that in their work, they're seeking to name the divine in the midst of human suffering," Cleary says. "It means finding God within the world, and that God enters into partnership with human beings to try and build better communities and transform people's live. Issues about identity, meaning, purpose are central: 'Who am I? What's the meaning of my life? Why am I in this mess?'

"Our job is to provide opportunities for social and personal transformation based on values of a common humanity, such as compassion, justice, mercy, forgiveness, personal autonomy."

So how does that calling fit with bureaucratic indicators? Not well, says Father Peter Norden, policy director of Jesuit Social Services. Take the work of the Brosnan Centre, which helps young male offenders. "If they were to say, 'You've only had 50 per cent of the young people you've worked with not re-offend, therefore your service is ineffective', we'd say, 'No. If we weren't there, it might be only five per cent.'

"And we're not just a welfare service, we're also a Christian ministry. So we choose the young people we work with on the basis that they're the most likely to fail, the most in need. You don't measure your success on the numbers, but by what you're actually communicating to this person; a sense of care and respect and belonging. And out of that, potentially, would come a change in behaviour.

"(Bureaucrats) would say, 'You've been working with this person too long. Why have you got so many people who are still hanging around after two years?' And we say, 'Well, it's a bit like family, you know?'" Norden grins and shrugs.

Jan Carter says Meals-on-Wheels was an early example of how number-crunching alone misses the point. "People were paid to deliver in the shortest possible time. They were leaving meals on old people's doorsteps, but part of the point of it all was the chat between the person delivering and the old person. So much of what community agencies do is hard to specify; the whole relationship-building and relationship-maintenance aspect of agencies' work was completely ignored."

In 2000, the then Catholic bishop of Wagga Wagga, William Brennan, forbade the Centacare agency in his diocese from tendering for employment contracts. Brennan had no difficulty with the church accepting contracts to help find jobs for disabled people; he just didn't want the church entering into bidding wars against private service providers. "It is true that finding work for the unemployed can be a charitable work," he wrote in a newspaper article. "But only, I suggest, if no one else is doing it.

"How just is it for the church to move in and take over the jobs of non-church people? Can it not be argued that, when tendering against private, as distinct from public, interests, the church's various taxation exemptions give it an unequal advantage, and where is the justice in such an unequal contest?"

Such deals also raised questions about the relationship between God and Caesar. "Do the churches want to be seen to be, and actually to be, agents of government?" he wrote.

That same year, a paper prepared for the Australian Catholic Bishops Conference warned, with regard to mooted church-government partnerships, that "Co-operating ... might be seen as the church giving credibility to the stated agenda of the civil authority". The Catholic Church had earlier strongly opposed the privatisation of the Commonwealth Employment Service.

But for Patrick McClure, a former Franciscan priest who is now CEO of Mission Australia, involvement is a no-brainer. "If non-profit organisations like Mission Australia aren't in these privatised marketplaces for employment, who will be? One of the major providers of welfare-to-work programs in the United States is Lockheed Martin, which produces military hardware. We wouldn't want that to happen in Australia." (Of the gold-watches giveaway by his organisation, he says only, "We wouldn't do that again".)

For the Salvation Army, job services have always been important, says communications director John Dalziel. "It's important to give people food and clothing, but the best thing is to get them a job," he says. Like McClure, he points out that church agencies plough any "profits" back into services, which would not happen if a commercial company had the contract.

He says the Salvos argued with the Government over the ethics of breaching and reached a compromise. "We're not against penalising people for the purposes of their own good," he says, "but we now have the right to exercise discretion."

Paul Oslington is an economics lecturer at the Australian Defence Force Academy and a theologian at St Mark's National Theological Centre in Canberra. In an essay in the book The Church and the Free Market, he argues that governments have outsourced a lot of social welfare to the churches because they hoped the churches' altruistic, experienced workers could deliver lower costs and better service, as well as the financial back-up provided by the donated dollar.

But, he says, the changes might kill the very altruism the Government is trying to harness. "One of my fears is that the whole thing will work nicely for a few years but it will eventually destroy the thing that made the church organisations attractive in the first place. Very good people who are working hard for very little will decide they are being exploited, especially as organisations are changing to run more like businesses. People are not as willing to supply voluntary labour or give money to organisations that have changed in that way."

On the other hand, staff in the church-based welfare organisations are now more likely to be receiving award rates: "We have to practice what we preach," says Cleary. "If we're telling the rest of the world that salaries for poor people are too low, we can't be paying our own staff low salaries."

The changes have also affected volunteers. According to Marilyn Webster, manager of social policy research at Good Shepherd Youth and Family Services, the uncertainties of the contract system make it harder for agencies to stay connected to their supporters in local church communities. She calls this "the erosion of social capital". "As each tender for a pre-existing program goes to another agency or organisation, the volunteers don't necessarily go with it, because their identification is with the first organisation."

Volunteers can sometimes find themselves eased out of an agency as their work is "professionalised". Several elderly women in Malvern are still smarting over a local op shop to which they had given many decades of service but which suddenly introduced a new manager, profit targets and rules for volunteers. The volunteers were asked to sign contracts and found themselves on three months' probation. Many resigned in outrage. (One volunteer in her seventies got her own back in a market-style coup de grace: she was headhunted by a rival op shop.)

But the reality is that more money does lie in upmarket retail, as the Brotherhood of St Laurence has found. Its Brunswick Street outlet Hunter Gatherer could not be further from the classic daggy little op shop run by old ladies with big hearts. Its second-hand clothes are funky retro-style street fashion: beaded '60s evening gowns, lairy '70s ties in olive green or orange. Its sales assistant, 22-year-old Beth Chapman, has bi-coloured hair done in a rockabilly quiff with pigtails, wears a sleeper in her nose and can talk you through the attributes of the Miller cowboy shirt.

There is a second Hunter Gatherer store in Acland Street, St Kilda, where Chapman also works. Combined, they bring in $1 million a year. But the fact that the shops are commercial, with staff who are paid, does not make them bereft of altruism.

Nicole Bride is a fashion graduate who oversees the stores and designs a "no-sweatshop labour" clothing range to sell in them. "It's brilliant," Bride says. "I didn't really like fashion that much. I couldn't understand why I was doing it; I couldn't see the benefit to the world or the community. I have that sort of slant. Where do you get the meaning in your life? When I came here, I mixed the two.

"We all love working here and we all do stuff for the store. A staff member will sew the curtains at the weekend."

Frances, the Brotherhood's head, is a "social entrepreneur" who believes that modern welfare must link with business to create jobs and other opportunities for the poor. He plans to hassle small businesses to hire residents of a local public housing estate, and the Brotherhood has connections with the communications company Axa, from which he also hopes to extract jobs.

But corporate links, like government ones, carry risks as well as benefits. John Enticott, a community housing worker and former manager with the Brotherhood, says: "It doesn't matter if the value shift is that corporate Australia becomes more aware of the plight of people it shares the country with. But if it works the other way ..."

Like a teenage girl trying to protect her virginity in the back seat of a car, agencies must struggle with how far they can go while still keeping themselves nice. It's an analogy that makes Frances laugh. "I guess the thing for me is, I'm willing to be had," he says, throwing his head and his arms back in a pose of abandon.

Then, more seriously, "Who am I protecting in that little game? I'm protecting me. If I say, 'No, I won't come over there', I get to be the good righteous person, but guess what? The person on the other end of it, in poverty, they don't move either. So the only person who gets to feel good about that is me."

Everyone concedes there have been benefits to agencies becoming more businesslike: they are better at keeping the books, their staff are better trained and supervised, and they are more savvy about fund-raising. But they are also finding the corporate model has its limitations.

The Uniting Church realised in the wake of the nursing home scandal that business structures must be adjusted to fit human services. Colleen Pearce says that, traditionally, the boards of community organisations ran things on a day-to-day basis. As the organisations became bigger, they adopted the management structures of business.

But, she says, "The board can't be concerned with just finances. There might be quality committees, but the board actually has to have clinical governance (in nursing homes)."

To maintain their integrity, agencies sometimes have to walk away from the embrace of government. One Uniting Church agency reportedly handed a contract for a child-protection service back to the State Government because it believed the funding being offered was inadequate to allow proper care of the children.

Ray Cleary says Anglicare won't touch work-for-the-dole schemes because of ethical concerns. The agency also withdrew from an "under-funded" program for high-risk teenagers. "Potentially these kids could come back at us in five or 10 years and say, 'We were in your care and you didn't provide the care for us that you should have'. And it has legal liability implications. We got caught up in this with indigenous Australians and we did things for government we now regret. We do not wish to do that again."

But the main issue at stake here is not the welfare of the agencies but the wellbeing of the people they are trying to help. The Brotherhood's John Enticott believes the disadvantaged are better off under today's arrangements in that governments demand that services be integrated. A housing worker will be obliged to liaise with mental health services to help a person with schizophrenia, for example. But he also believes the system stifles dissent.

"Ronald Henderson actually demonstrated a poverty line. No one's doing that kind of analysis any more. We're all busy meeting performance criteria and achieving outputs, and nobody's actually saying that unemployment is (only) 'low' because anybody who works for one hour in any fortnightly period is considered to be employed. Nobody's doing the critique of the system. In that sense (the poor) are losing."

The belief that criticising government leads to program cuts seems widespread. The Brotherhood of St Laurence has been an outspoken critic of the Federal Government's detainee policy. Recently, one of its refugee programs lost up to $100,000 of government funding. A coincidence? Nic Frances doesn't think so. "They say there are good reasons, but I think (speaking out) has cost us."

Peter Norden says the Jesuits, too, resist being silenced. He strikes out clauses about confidentiality and intellectual property before he signs government contracts, he says. "After a while you wear them down, even government bureaucrats."

Mission Australia's Patrick McClure points to some apparent benefits of the changes. "If you look at, say, employment services, what's claimed is that there's improved outcomes in terms of getting people into jobs and that the cost is lower. Obviously, from a funder's point of view, the taxpayers are better off."

But are the battlers themselves better off? "I think the jury's out on that one," he says. "What it's done is put much more pressure on non-government organisations to work with the most disadvantaged, and that's people like those with mental illness, the long-term unemployed, many of the indigenous communities. And the disparity between rich and poor is growing."

The dilemma for the major churches became intolerable when the government ruthlessly cracked down on welfare services in 2006. The Catholic church backed out of its contracts calling what it was supposed to do immoral. Other churches did not apply for contracts. Only an evangelical group closely associated with some members of government continued with their contracts. In their disinterest the general public hardly noticed.

THE welfare arm of the Catholic Church has withdrawn from a government deal to help unemployed people who are punished by Centrelink, claiming the system is immoral.

The Government pays charities $650 to manage each eligible unemployed person cut off from payments for eight weeks. Charities assess the person's essential expenses and notify Centrelink, which would pay the bills.

But the board of Catholic Social Services Australia has decided that it would be immoral to help the Government "police" its new system.

The decision leaves the Hillsong Church as the biggest religious-based non-government provider of services to unemployed people.
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Catholic Social Services Australia executive director Frank Quinlan said two of his agencies had signed up to the system, but had now informed the Government they no longer believed it was right to do the work.

"We decided not to sign up nationally. We think vulnerable people will not be adequately protected," he said.
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Mr Quinlan said he was outraged when he saw a Centrelink description of a typical person, who was described as mentally ill, with children and on medication.

"Our question was how on earth could we be contemplating a system that sees somebody who is mentally ill ... suspended from income support for eight weeks."
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The biggest charities have refused to take part in the program to financially case-manage the most vulnerable unemployed, including sole parents and disabled people, who will be left without income.

National Welfare Rights Network president Michael Raper said it was not surprising that the established churches did not want anything to do with it.

"Financial case-management is a deeply flawed, impractical and very paternalistic system, designed to cover up for an even worse social security penalty system where people can have payments stopped for eight weeks," Mr Raper said.
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"Many people would be reluctant to deal with such an avowed evangelical outfit as Hillsong and there are legitimate concerns in the community about the blurring of an organisation's religious pursuits and its relationship with their welfare services."

The giant UK not for profit health care group, BUPA operates as an insurer in Australia. In October 2007 it became one of our largest nursing home operators.

BUPA is a good case study of what it takes for a not for profit to be very successful in the marketplace

Click Here to go to the BUPA web page

For Updates:- A good way to check for recent developments in aged care is to go to the aged care crisis group's search page and enter the name of the company, nursing home or key words relating to any other matter in the search box. Most significant press reports are flagged there. The aged care crisis web site has recently been restructured and some of the older links used from this site may not work.

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Web Page History This page created March 2006 by Michael Wynne Updated Sept 2006, Oct 2007