Budget spending sprees are not enough

Federal and State Treasurers love a good spending spree. Even when they’re carefully cutting taxes with one hand, they’re usually spending furiously with the other.

For two years running, Peter Costello has offered cash hand-outs to carers of the disabled and chronically ill. These carers are amongst the most disadvantaged and isolated people in the community, and while a cheque for $1,000 is better than a poke in the eye, it changes none of their real problems. Indeed many regard it as an insult.

Does Peter Costello really think his $3.6 billion worth of spending on welfare to work programs will get more than a handful of beneficiaries into employment? Or that more government advertising campaigns on skin cancer or tobacco will make us healthier?

What’s wrong with the list of big budget social spending we get from Federal and State Treasurers every Budget night? Nothing at all - if it worked in delivering better schools and hospitals, and stronger, healthier, and more secure communities.

The trouble is, it doesn’t work. In education, health, family support, and community safety, governments are stuck in the habit of trying to buy favour with voters by spending big, as if the volume of government spending is the main factor in determining good outcomes. It’s not, of course.

Who really believes that pouring more money into public hospitals will relieve waiting lists? Last year the Bracks Government injected an additional $2 billion into the state’s health system, and this year’s budget found a further billion for emergency department upgrades and an extra 900 hospital staff. When the demand for health care is growing exponentially each year, this extra money will disappear quickly with little return. Australia’s hospitalisation rates are ballooning, and are now the highest in the western world.

Who really thinks that the quality of public school education will be improved by this year’s additional $868 million allocation? Governments can’t seem to get away from the “bricks and mortar” approach to education. How many parents have been urging their local MPs to support the introduction of broadband computer access to all secondary schools? None at all, I suspect. It’s the absence of quality teaching and individualised learning that are more likely to be the subject of parents’ letters to MPs. Meanwhile, more parents each year vote with their feet in going private.

The headlines on mental health are perhaps the cruellest of all. Families and friends of people with mental illnesses know that the support services available in Victoria are vastly inadequate and are often dysfunctional in their operation. Like the wider health system, mental health services are built around disconnected practitioners and providers who are rewarded for their illness interventions, not for prevention or continuity of care. Throwing more money at these services without a thorough redesign is akin to an investor sinking money into a failing business.

So why is this budget ritual of more spending equals social improvement repeated year after year? Part of the answer is that there are no organised consumer voices in education, health and welfare that command serious political attention. All the public voices in these areas are provider voices, and the provider voices have a vested interest in ever-increasing spending in their industries.

In Aboriginal affairs, there is a growing acceptance that indigenous disadvantage cannot be alleviated by throwing money at the problem. Indeed we now understand that “passive welfare” among blacks has been generated by the very service delivery structures intended to “help” them.

Yet these same service delivery models remain intact in education, health, family support and white welfare. In stress-ridden public schools or over-crowded public hospitals or chaotic disability services, the supply-side model of service delivery still rules: agencies dispense services to passive and disempowered “clients” using standardised programs for which the agencies are accountable - not to their clients or consumers - but to their funders (that is, governments).

In 2005, we are living in an era of individuality and consumer choice, and the supply-side model of service delivery no longer satisfies us. All the evidence around us tells us that human beings are wonderfully diverse, and make cultural, lifestyle, economic and religious choices that are their own. We need governments that can now find the will to treat us in the same spirit.

Education resources, across state and federal jurisdictions, can and should be allocated to parents in the form of a student-centred school funding voucher, to allow parents to drive choice and accountability in education.

Health funding across federal and state programs can and should be tied to patient-centred health plans, with patients choosing a health broker or agent to access the best health services and supports they need to keep them well. Disability, mental health and aged care services can and should be funded by individualised payments to persons and their families/carers.

Governments can do a lot to empower individuals and families. The first step is to give up the annual budget night spending spree.

Can someone please tell our Treasurers this before next budget night?