And so it begins: Government by the Religious Right

The day after the election, a Herald/Nielsen survey showed that most people, well, 50% - thought that the state of health care in NSW was our most urgent issue.

The new Liberal parliamentary party contains many on the religious right, including Opus Dei member David Clarke, and former Right to Life president, Greg Smith. Therefore it is worth considering the influence of the religious right, and its possible outcomes for health and aged care over the next four, or eight, years.

Hospitals

Health is expensive for governments, and hospitals are the biggest ticket item within the health budget: in 2008-09, state and territory governments funded $18.4 billion of the total expenditure of $33.7 billion for public hospital services. This amounts to 66.4% of the states' total recurrent health funding.

That is why governments, state and federal, have been actively seeking opportunities to 'privatise' hospitals since the early 90s. We can easily speculate that this trend will continue.

In NSW there are presently 85 private hospitals and 89 day procedure centres. Many are owned and operated by an arm of one of the churches. One such is the Hawkesbury District Hospital, run by the largest private provider of health services in NSW, Catholic Health Care Services. Hawkesbury District Hospital is in fact the only hospital in the Hawkesbury Local Government Area, where a population of 62,000 is growing and likely to grow faster. Catholic Health Care Services runs the public hospital, which contains a private hospital, and extensive community care services.

Bad luck then, if you live in Windsor and wish to have a termination. Or a vasectomy, IVF or any 'artificial' contraception, or the 'morning after pill' to induce abortion after rape. Amniocentesis, the procedure used to test for possible birth defects, is also banned at Hawkesbury, and indeed in every Catholic hospital.

This is not an exaggeration. What must be understood is that Catholic hospitals are legally constructed so that they report to a legal entity similar to a religious order, in this case an order subject to the Bishops. Religious orders are under an obligation to observe canon (church) law. Under canon law, the Code of Catholic Ethics (2001) must be put into practice. There is no wriggle room.

Much of the Gillard/O'Farrell negotiation for reform is still in play, but health care in NSW is already a mutual convenience for governments desperate to outsource their responsibilities and churches eager for new relevance and a regular income. And further privatising of hospital services, under the new Liberal Government, will probably be in favour of the churches – and the Parliamentary Religious Right may be relied upon to ensure this occurs. The churches will remain effectively free to operate hospitals in accord with their own beliefs, regardless of community values or the wishes of the individual.

Aged Care and community services

Similarly, churches are the dominant players in aged care, and in a huge variety of community services. Such services include disability services, family services, paediatric, children and youth services, mental health services, palliative care, alcohol and drug services, veterans' health, step-down transitional care, rehabilitation, diagnostics, preventative public health, medical and bioethics research institutes.

'Special Purpose Payments' SPPs

State governments spend more on health care than they actually have. The balance is made up by the Commonwealth, which gives Special Purpose Payments (SPPs) to help fund public health activities done by, or on behalf of, each state and territory government. The Australian Immunisation Programme was funded in this way; the money involved is substantial. Commentators see these SPPs as likely to increase, helping the Commonwealth to have ever more say in State health issues.

Imagine, for a moment, a couple of years hence when an Abbott-led Coalition comes to power. Abortion, you will remember Mr Abbott telling us a couple of years ago when he was Minister for Health, is a 'national tragedy'. At that time, a swag of state based pregnancy counseling services were publicly funded.

What hope when Centrecare (the Catholic aid agency) again becomes the provider selected? None of these services would refer for abortion.

'Administrative arrangements'

In a sense, the Catholic Church in Australia is the creation of lawyer Fr Brian Lucas. Widely disliked amongst the bishops, Fr Lucas is nonetheless relied upon to organise legal fictions that create the means for increased church income and to avoid church risk/responsibility. For example, the law was quietly changed under then Minister Bob Debus allowing property and assets from a defunct religious order to be simply transferred to the local Bishop.

So when the Carlingford Order of St Gerard Majella – disgraced after widespread, proven paedophilia – was wound up, not only did the Bishop of Parramatta gain millions of dollars of their assets, but every victim of sexual abuse lost any hope of winning damages. Once the assets have gone, there is nothing to sue for. Does no one wonder why dioceses in other parts of the world have been bankrupted by the sexual abuse crisis and why, in Australia, not one suit for damages has been successful?

Tax concessions

One of the great scandals of administration is the way the State colludes with the Church to reduce its community responsibilities. For example, the Church does not participate in ordinary recycling. This is because it does not pay rates, and therefore is out of the local government loop and the ordinary obligations of citizens to recycle. At a state level, churches do not pay rates, motor vehicle registration, payroll tax, or other land taxes. This applies to every church concern: schools, hospitals, community services, administrative office blocks, investment properties, etc. Tax concessions do not make very interesting reading perhaps, but the sums involved that churches do NOT contribute to the community as a result are huge.

Our new - and very Catholic - Attorney General may be counted on to ensure legislative arrangements for churches (and their activities, whether for profit or not-for-profit) serve the agenda of the churches – starting with all forms of non-disclosure. Whether or not they serve the public will be the hard issue.

As an occasional commentator on church/state matters, it is frustrating when other writers entirely miss the point. NSW under an Uglies-influenced Liberal Party will not suddenly be forced to accept creationism in schools. Nor will there be a rash of shootings at abortion clinics. These things happen in the United States, where fundamentalism is of a Protestant, 'prosperity-gospel' kind. That brand of fundamentalism wants you to believe. Australian, more orthodox Christian practice (Catholic, Anglo-Catholic) wants you to obey. And to pay, of course.

Most commentators, including the ABC, obsess over the Exclusive Brethren and its excesses. Vile as that group might be, such media attention can direct NSW citizens away the real dangers arsing from the large churches, themselves dominated by their own conservative wings.

What we need to fear from the new Liberal government is the wholesale outsourcing of health, education and welfare systems that State government is meant to deliver. Once in the hands of other organisations, with other rules and ideologies, these essential services will increasingly become a tool to impose a particular vision of social order. While the nature of that social order is a matter for a separate article, the new service deliverers will be able to press for compliance; yours and mine.

The new Liberal government may take the last chocks off what Labor began. If we are not careful, our health, education and welfare systems in NSW will be privatised, the mechanisms obscured, the outcomes non-accountable, and each service, a matter of ecclesiastical noblesse oblige.