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COMMUNITY AFFAIRS LEGISLATION COMMITTEE
DEPARTMENT OF HUMAN SERVICES AND HEALTH
Program 3--Family and Children's Services
Subprogram 3.1--Children's Services
- Committee Name
COMMUNITY AFFAIRS LEGISLATION COMMITTEE
DEPARTMENT OF HUMAN SERVICES AND HEALTH
Program 3--Family and Children's Services
- Sub program
Subprogram 3.1--Children's Services
- System Id
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COMMUNITY AFFAIRS LEGISLATION COMMITTEE
(SENATE-Friday, 18 November 1994)
- Start of Business
DEPARTMENT OF HUMAN SERVICES AND HEALTH
- Program 3--Family and Children's Services
- Program 4--Aged Care
- Program 5--Disability Programs
- Program 6--Corporate Direction and Support
Content WindowCOMMUNITY AFFAIRS LEGISLATION COMMITTEE - 18/11/1994 - DEPARTMENT OF HUMAN SERVICES AND HEALTH - Program 3--Family and Children's Services - Subprogram 3.1--Children's Services
Senator TROETH --I refer to the accreditation system. Page 44 of the Human Services and Health annual report reads:
The Quality Improvement and Accreditation System is to be evaluated and the cost to services of implementing the System will be assessed. The Government will closely monitor the costs to centres of implementing the new System to ensure that good quality child care remains affordable.
When will the Coopers and Lybrand evaluation of the accreditation be finished?
Mr Wight --It is expected that the evaluation will be completed by the end of June 1995.
Senator TROETH --What tendering process was used to award that contract for evaluating?
Mr Wight --I would describe it as selective tendering. Eight firms were invited to tender for the contract. Those submissions were considered by the accreditation council. The successful tenderer was Coopers and Lybrand.
Senator TROETH --Why was the selective tendering process used?
Mr Wight --It is a normal process that is adopted where it is felt that a limited range of firms have the capacity to undertake the work. It required a knowledge of child care and a knowledge of the economics of the industry.
Senator TROETH --Would it be possible to get a list of the eight firms that were selectively chosen from?
Mr Wight --I do not think that is a problem. I am fairly sure that we can provide that. I am being a little cautious because I am not sure whether there is any commercial-in-confidence.
Senator TROETH --Yes, I understand. If it is possible, I will like to have a copy of that. Without asking you for commercial endorsement, why was Coopers and Lybrand chosen?
Mr Wight --That is fairly difficult. I am fairly sure that it was the lowest tender of the tenderers that demonstrated a capacity to undertake the work according to the requirements of the council and the specifications that had to be covered by the tender.
I am sorry. It was not the lowest tenderer, but it was one of the two or three lowest tenderers. There was little difference between the last two or three. It was considered to be the most suitable within a narrow range. The same set of criteria assessing the tenders was applied to all eight tenderers.
Senator TROETH --How many of its staff are engaged in the evaluation?
Mr Wight --I am not sure that I could answer that. A major survey of all services is going on.
Senator TROETH --In the Family and Children's Services Division?
Mr Wight --No. The company that has the job is carrying out a questionnaire of all centres that are participating in the accreditation system. I really do not know how many people in its firm are involved in assessing those questionnaires.
Senator TROETH --How much input will the peak child-care organisations and other interested parties have in that evaluation? Do they have any input into that?
Mr Wight --I do not think they will. The plan is that services will be required to complete a questionnaire that indicates the standard of care that has been delivered in their service. They will also be required to complete information regarding the costs they have incurred over a six-month period. Then there will be another survey at the end of that period to assess how much they have spent and what criteria or principles they have adopted to improve their quality. The entire assessment is based on what happens in the service.
Ms Kerr --In addition to what Mr Wight has said, Coopers and Lybrand will be talking to a number of key bodies and individuals--and that will include some of the peak bodies--to get a bit of a flavour for the background to the system.
Senator TROETH --How will improvements resulting from the accreditation system be measured?
Mr Wight --They will be measured by the accreditation system itself. Services in the first questionnaire will indicate the standard against the various 52 principles. The same principles and standards set down in the accreditation document will be assessed again at the end of the survey period. There will then be a measure of how much they have improved--whether they are still at the same level of quality or whether they have improved to a higher level of quality in that period.
Senator TROETH --The government based its accreditation figures on the Pitcher Partners survey. That found that the increase in costs would be 88c per child per week. Senator Crowley, I and other people have had discussions about this in the Senate, but other more recent studies have found that the increase in costs could be estimated to be as high as $25 per child per week. Given that there is a range of opinion on how high the costs may be, why were not some of those increases in costs more adequately foreshadowed prior to the implementation of the system?
Senator Crowley --Your question presumes an outcome and cost.
Senator TROETH --No. I am just saying that it may well be that the cost is more than 88c. If there is a capacity for increasing costs, there should have been some allowance or foreshadowing of that prior to implementation. That is what I am putting.
Senator Crowley --Your question presumes an outcome. It may well be, in the overall evaluation, that the cost to centres will be less than 88c. I have certainly been told of one centre where it came in at about 55c. You and I know that there is some dispute about the figures that you are referring to, if they are the ones from South Australia which put a figure of about $25. We are concerned about evaluating the cost and getting a real figure of what the accreditation system in practice has cost centres.
Senator TROETH --When the evaluation is finished, I gather that there will be publications of the change in costs if any.
Senator Crowley --That is certainly one of the outcomes, senator.
Mr Wight --There is a range of costs because of a couple of key variables. There are two variables in the cost of the system: firstly, the level or the standard of care in the centre at the time they start the process and, secondly, the speed at which each service determines to go from that standard of care to the full level of accreditation. One of the key factors in the costing exercises that I have seen done by a range of people include moving from the lowest standard of care that exists in some services to what I would call the full accreditation level, the highest level of accreditation, in one year. The system does not require that. It allows the services to go at their own pace, to participate in the process and to gradually improve. It will cost a lot more if the service wants to do everything in one year and concentrate the improvement in one year. That is why you will get variations. The other major factor is that many--not all--of the costings that I have seen include the cost of improving standards that are set down in state regulations. There is a lot of costing of carrying out improvements that should be attributed to state licensing.
Senator TROETH --Yes, I understand that.
Mr Wight --There could be some difficulties in some services in Victoria, for example. I am aware of 100 services in that state that have exemptions from employing qualified staff. If they do not have qualified staff, then they are going to have some problems in lifting their standards. They are not trained to in many instances.
Senator TROETH --I think that will be a matter for ongoing debate, but we will leave that for the moment. How many of the 32 centres involved in the original pilot study of the draft accreditation guidelines actually achieved one-year accreditation standard at the end of the seven weeks?
Mr Wight --I do not know. I would honestly say that I do not believe anybody knows because that information was not provided as part of the evaluation exercise done by Pitcher Partners, and that was all held by the Interim National Childcare Accreditation Council. They engaged Pitcher Partners to do that exercise.
Senator TROETH --Similarly, I guess you would not have any idea how many of the participating centres would have lost fee relief judged on their performance?
Mr Wight --The short answer is none because the system only requires participation in the system, and if they were participating in the system they could not, by definition, lose fee relief.
Senator TROETH --Under the original pilot study undertaken by Pitcher Partners, is it correct that only 31 principles were used?
Mr Wight --I would have to check that. I know the system was changed following the pilot, but I would have to check the number that you are talking about.
Senator TROETH --If you could check that out for me, please. So it was changed after that particular study, was it?
Mr Wight --Yes, the system was changed. My assessment would be not significantly, and I know there are now 52 principles. I would be amazed if the number of principles tested in the pilot was as low as 31, as you have asked me to check. I believe it would be much closer to 50 in the pilot, but I think there were some minor changes after the pilot.
Senator TROETH --So you do not believe that any of the changes were significant?
Mr Wight --That is certainly my assessment.
Senator TROETH --This is a hypothetical question: what action will be taken if it is found that costs have risen as a result of accreditation?
Senator Crowley --If that cost were significant, it would be a matter of the department and my examining those figures very closely and having a look at the consequences of those costs. We do have to have a caution about the costs. I appreciate that there is a concern about how much it might cost, but also I hope that part of the evaluation will highlight a correct interpretation of the process.
For example, on the evidence I have been given, some centres are taking very exact and literal interpretations to the point where noting the evidence of a child's improved skills is being done religiously every morning. In a commonsense and usual understanding of that principle, nobody would necessarily take the time to do it that way. I hope the evaluation will also help people appreciate how to be flexible about, at the same time as doing well, those principles or, for example, costing the time to write messages on a notice board. That is not what most people would assess as an outlay on costs for the accreditation process. I think we will see a lot of hiccups go in the course of the evaluation.
Senator TROETH --But surely, if centres are fulfilling what they believe to be their obligations in maintaining those principles, they would aim for the highest possible standards, and that is what they would need to do. Is that not so?
Senator Crowley --It is not unlike the settling-in process that we had for the assessment of elderly people in aged care homes where sometimes there was an over-commitment to detailed recording of every small change. I think some people in the centres will find a way that allows them to feel absolutely comfortable that they are recording what is needed to be recorded, but not in the same amount of time that some centres might be devoting to measuring now.
Senator TROETH --So you would be happy with a more flexible interpretation of the principles or guidelines, would you?
Senator Crowley --The exact interpretation is something that the evaluation process, with the accreditation council and the centres, is in the process of being worked out--that is, what is the optimal way of implementing those 52 principles?
Senator TROETH --You would think there either would be a standard or would not be a standard. If you are allowing flexibility in the work towards attainment of the principles or the guidelines, you would think there would have to be some sort of an absolute standard by which centres gained accreditation.
Senator Crowley --I think Mr Wight has already said that the important part of the accreditation process is that people show a willingness to be involved--that is, participating--and, as a minimum, progress towards an improved state. Most centres we know in this country, or a very large number of them, are more than ready for accreditation, are going through the process and are finding it very constructive.
We know what we mean by the quality of child care. These 52 principles are a way of decoding that, trying to describe it and giving you some way in which to measure those standards. But if you have a standard that says that attention will be paid to evidence of the children's development, it is reasonable that you would not want to record the changes in their development every day.
Senator TROETH --But if you are going to have that attitude of flexibility towards attainment of the guidelines, how are you going to be able to measure the centres' attainment of accreditation--I do not mean inflexible standard but a minimum type standard because either you have a standard or you do not?
Senator Crowley --Principles are about setting minimum standards for accreditation.
Mr Lindenmayer --It is important to distinguish between the objective to which you are aspiring and the path by which you are moving to that objective. Given that we are talking about centres in a wide diversity of environments, what will be most appropriate for one centre in one sort of environment might not be absolutely appropriate for another centre in another environment. The ultimate objectives are the same but the physical environment is going to differ and it is necessary to have some sort of adjustment both of the process and of the way in which to move through that process from one centre to another.
The other consideration is the point Mr Wight made earlier: the centres are not all starting out from a uniformly low position. Some are doing well in some respects and less well in others, and this varies markedly across the spectrum of centres. So all of those differences combine to make for, optimally, different paths and different approaches from the various centres across the country toward the ultimate objective.
Senator TROETH --Therefore, you would still have to have different standards for different centres?
Mr Lindenmayer --Not different standards but different processes and ways of pursuing the achievement of the standards. They start out from different positions and from different environments in which they are operating, which include the variation from centre to centre of things like the circumstances of parents and the children. It is important that the service, while pursuing uniformly high objectives, recognises the diversity of the clientele it is serving.
Mr Wight --When you are talking about different standards, the accreditation of documents sets down a level, a set of standards, that a service has to achieve in order to achieve the basic accreditation standard. But, beyond that, there are higher levels of improvement that can be achieved where the service still is accredited. The review process, with people coming back and reviewing the standards in that centre, is either one year, two years or three years. There are different levels of standards once they are past the accreditation. They are all set down now in the document.
I think two key things will come out of the evaluation. The terms of reference specifically require: Coopers and Lybrand to measure costs, and the improvements that are made over the survey period of six months; and to comment and provide advice to government, to the minister and hence the government, on the adequacy of training that is provided for support services going through that process.
We are now talking about consultants who are required to provide advice to the minister on the difficulties that are currently being encountered by centres on particular principles in achieving the standards under those principles. It will then be to the minister and eventually the government, because it is a document that has gone through parliament, to consider whether or not, as a result of that evaluation--the advice it receives from the consultant--it does want to modify or improve some because they are not onerous, or modify others centres because they are having great difficulty with it. Alternatively, it could leave those standards where they are and better target its training on assisting services through the principles where they are encountering difficulties.
Senator TROETH --I do not wish to be difficult, but I might be a centre proprietor with an obsessive personality of the sort Senator Crowley indicated in that I would be worrying every morning about whether I had done X, Y or Z to absolutely fulfil the principles. Would not some centre proprietors be confused over the almost sliding scale that you have just indicated as to whether they should aim for the minimum standard or whether they should aim for ultimate perfection in attainment of the guidelines? I would be confused if I ran a centre.
Mr Wight --Personally, I do not think you would be. People often lose sight of the fact that the entire process is based on self-study. The entire process is based on the centre making its own assessment against the principles set down in the handbook. Assume that the director is a central part of that centre's assessment, and assume you were the director. You would know exactly where you have assessed yourself against those principles and where the centre has assessed itself.
Because there are parents involved in that centre accreditation committee that is recommended in the process, the whole group of people in that centre know where they are at. As a group, they make a decision on where they want to move and how fast they want to move. The reviewer's process is a very brief process of confirming that the self-study done by the centre is reasonable, honest and straight. So there is not a fraudulent exercise where a centre has decided that it will mark itself all up the top. A centre reviewer then goes in and says, `I was only there for two days, but I did not notice them doing anything that is up the top.'
It is all based on self-assessment. I think that gets lost in the process. The centre should know very well, and so should its parent committee, where it is at and be part of a decision on where it is going and how fast it is going.
Senator TROETH --If there are any centres that fail to be accredited and do not reach those standards, if and when will they lose their fee relief?
Mr Wight --Your question, as I interpreted it, was if they do not get accredited.
Senator TROETH --Yes.
Mr Wight --A service does not have to get accredited; it has to participate in the process and go through a program of improvement towards accreditation. So, providing that it has a plan, particularly if it assesses itself at a low level and below the standards set down for accreditation, it then develops a plan to improve itself over the next 12 months. Providing it goes through that plan, it is at no risk of losing its fee relief. The objective is participation, not achieving the accreditation standard. Achieving the accreditation stand is a criteria that many have set for themselves. That has a significant implication on costs and fears about losing fee relief. But, as long as they participate and are going along with the general approach of the system, they will not lose fee relief.
Senator Crowley --Centres would have to fall over backwards to lose their fee relief. They would have to put their minds to deliberately remaining outside of it or refusing to participate. We have gone a long way to understand the concerns of centres in the process of setting up the accreditation system. Something like over 85 per cent of all long-day care centres are now participating very successfully.
But there is certainly no hint or prospect of any centre losing child-care assistance before 1 July 1995. I wrote to all centres last year and made it absolutely clear that I would extend my discretion about looking at the removal of child-care assistance from any centre until 1 July 1995 so as to give centres as much time as possible to participate. Even then, it is not an axe falls decision.
Mr Wight --The need for services registering, participating in the process and making progress towards accreditation is set down in clause 21 of the guidelines of the disallowable instrument to participate in the system.
Senator TROETH --An existing centre changed from being a registered company to sole ownership. But it was still run by the same person. He was told that he must register under accreditation because it was deemed to be a new centre. What is the rationale for that procedure?
Mr Wight --I believe to be correct what you have just said. The requirement to participate in the system is about the approval of the centre and the owner of the centre. There is a formal approval process under the legislation that an owner and a centre have to go through. So in this instance it would be a new approval by the minister. The minister has to approve every service for child-care assistance. Approval includes that the new owner has been licensed by the state and so forth.
Senator TROETH --So that would be approval of the set-up under the new business name or something like that?
Mr Wight --Yes.
Senator TROETH --Of the 2,400 centres that have registered for accreditation, how many are new centres and how many are existing centres?
Ms Kerr --As at 1 November, 2,700 centres had registered. You mentioned 2,400.
Senator TROETH --Sorry, it was 2,700.
Mr Wight --I think the number of new centres in that 2,700 is just below 170. The number I have is 167. I am not sure as at what date that is. The number of approximately 170 is in the last couple of weeks.
Senator TROETH --Of the registered child-care centres, how many are private and how many are community based?
Mr Wight --I have it by percentage. I have it split by state. I do not have an Australian figure.
Senator TROETH --Take that on notice and provide me with a national total. Have any centres registered for accreditation and then withdrawn their application?
Mr Wight --My understanding is none. I am a member of the National Childcare Accreditation Council. At a meeting about a month ago, there was discussion about a centre that had written a letter about withdrawing its registration. There was also a phone call to the accreditation council where questions about withdrawal were asked. My understanding is that neither of them has been followed up. My understanding is that none have withdrawn at this point.
Senator TROETH --Did they give any specific reason for thinking about withdrawing?
Mr Wight --No. I am not sure that they did. I remember that the discussion was what about implications it would have for the system. There was no extensive discussion.
Senator TROETH --So it was just a preliminary inquiry?
Mr Wight --That is my memory of it. It was testing out how the accreditation council would treat a service if it wanted to withdraw.
Senator TROETH --Has the NCAC received complaints about the accreditation process, particularly about the questionnaire that is provided?
Mr Wight --Yes. It has about the questionnaire. I presume you are talking about the questionnaire that is linked with the Coopers & Lybrand survey.
Senator TROETH --Yes.
Mr Wight --Some complaints were received by the accreditation council about the circulation of the Coopers & Lybrand questionnaire to services. That survey gave services two weeks to complete the questionnaire and return it to Coopers & Lybrand. There were some problems with the posting. A number of services received it only a day or two before the closing date for returning the questionnaire. So there were a number of complaints. I am not aware of any complaints about the content of it, but there were some complaints about the timing of it. As a result of that, Coopers & Lybrand extended the date from the date when it was fairly sure that all services had the questionnaire, which was the weekend following the complaining people receiving it. It allowed another two weeks after that date.
So the services were advised that they had another two weeks to complete that questionnaire. Then Coopers & Lybrand gave another week in allowing the questionnaires to come in after the closing date. If they came back through the mail a week later, they were still included in the results. I think the closing date was 24 October. They were given 10 days, and the closing date for the returning of the questionnaires was 24 October.
Senator TROETH --Apart from the timing of the questionnaire, it has also been brought to my attention that at least one person regarded the wording or the content of the questionnaire as ambiguous. That was known by the Chief Executive of the NCAC, Quentin Bryce, who acknowledged in a telephone conversation that:
. . . the questionnaire was faulty and that we will fix it next time.
You had no complaints about the content of the questionnaire?
Mr Wight --I am not aware of that, but Sue Kerr may be.
Ms Kerr --I think Coopers & Lybrand, in checking the questionnaire, went to 30 services in order to calibrate the results from the wider survey. In doing that, some of the centres brought to their attention that, if some of the questions were worded differently, only in minor regards, perhaps they would have been easier to understand. Coopers & Lybrand said that it would take that on board because it is going back with a second questionnaire in five months time.
The questionnaire was pilot tested before it was sent out widely, and any issues that people did not understand or were having problems with were picked up at that stage. I think it is quite normal that not every centre of 2,700 centres will understand every question.
Senator TROETH --What was the scope of the pilot study for the questionnaire?
Ms Kerr --They went to a range of centres. I am not sure exactly how many. They made sure that they went to a cross-section of centres. They included private centres, community based centres, multifunctional Aboriginal children's centres, and rural and remote centres. They visited a selection of those so that they got a range of different types of views from different sorts of environments.
Senator TROETH --But you do not have any ideas of the numbers involved?
Ms Kerr --I do not have any information with me as to how many centres they went to.
Senator TROETH --Would you have any idea how much it cost to produce and issue the questionnaire?
Mr Wight --That would be an element of the tender. The total tender price would include the provision of their estimate of that detail, and I do not have that detail.
Senator TROETH --Is it possible to find that out?
Ms Kerr --I am not sure that we would be able to get that exact estimate. As Mr Wight mentioned earlier, a whole range of staff in Coopers & Lybrand was involved with the production, the assessing and the printing. It would be difficult to work out exactly what that element of the evaluation cost.
Mr Wight --I think there may be difficulties in that element being the commercial in confidence part of a total tender. I would have more concerns if we could draw it out because it might be difficult. I am not sure that we would be able to because of the confidentiality of the tenders.
Senator TROETH --So the number of centres that took part in the final questionnaire was 2,700?
Mr Wight --Yes, all registered centres at the time.
Senator HERRON --Mr Lindenmayer, you spoke about the outcome of the accreditation process. What outcome do you hope to achieve by accreditation?
Mr Lindenmayer --I suppose the short answer is improved quality of service for clients.
Senator HERRON --We hear that magic word again.
Mr Lindenmayer --The long answer is all of the objectives underlying the pursuit of the 52 principles.
Senator HERRON --What mechanisms have you set in place to evaluate the outcome?
Mr Lindenmayer --The accreditation process itself implicitly does that up to a point. I would need to consult my colleagues about a more rigorous later evaluation of outcomes.
Senator HERRON --With respect, all that does is see whether you achieve your own accreditation guidelines.
Mr Lindenmayer --The first of the two things does, that is true.
Senator HERRON --Could you consult with your colleagues?
Mr Wight --At this point in time, while it is acknowledged that it will have to happen, the benefits of the program are better development opportunities for children, and they are clearly long term. They will have to be evaluated over a long term. An evaluation process has not been put in place about whether or not the children are better equipped, perform better at school or achieve better in their lives. That is uncertain, but it is intended that there be an evaluation over time of the improvement in outcomes for children in terms of their development.
Senator HERRON --Do you not think that is fundamental to the whole program?
Mr Wight --Yes.
Senator HERRON --Why have you not put mechanisms in place to evaluate it? Now is the time to put your mechanisms in place, and you have not done that.
Mr Wight --That is true in specific details, but academics in the industry are studying child development and the documentation collected in the first set of developmental programs very closely. We have assisted a research student at Macquarie University to do exactly what you are talking about; that is, to set down the development standards or status of children at present so that we have some sort of baseline. But the effort in the short term has been to get the process running, so it has been given secondary priority at the moment in identifying the data that we will need for a long-term trend. Everybody is acknowledging that that is a critical part of the process.
Senator HERRON --What happens if you do not achieve your objectives? What happens if we get little boys running around in frilly dresses singing anti-Christmas carols, as Senator McGauran has mentioned? You have no mechanisms in place, as I understand it, to evaluate the outcome of the accreditation process except your own concept of what quality is, which may not be the concept of the general public.
Senator Crowley --There are a number of presumptions in there that are not all correct.
Senator HERRON --I am not saying that they are all correct.
Senator Crowley --The outcome measurement of whether little boys are wearing dresses at kindergarten and whether little girls are playing with trains is something that can be evaluated from the accreditation process itself. Certainly the first stage of accreditation is a self-assessment carried out by the centre staff and/or parents. Then that self-assessment is reviewed or examined by a reviewer so that there is some kind of objective look at the self-assessment. There is a further stage where that review assessment of the self-assessment is put to a monitor. The whole accreditation process already has a built-in evaluation. The short-term goals that you have mentioned are currently able to be evaluated from that process itself.
The longer term goals about the development of kids or academic research about the development of children are in some ways incorporated in some of the principles. It is not as though the department made up these principles. They have been established after extensive consultation with both the child-care industry and the child-care professionals. People have been involved in early childhood education for nearly a century in this country, and many of those people have contributed a whole lot to assist the department in establishing the accreditation systems.
Senator HERRON --Are your baselines established before the accreditation guidelines so that you know what the outcome will be in relation to the baseline studies? Do you have baseline studies as to what the problems were? There must have been problems; otherwise you would not have introduced all these accreditation guidelines. Do we have baseline studies on which accreditation guidelines were established?
Senator Crowley --The accreditation process has a self-assessment which draws a baseline for the accreditation process. It is against that self-assessment by the centre of its standards that over time it is able to look at whether it improves. In regard to the points made by Mr Wight about the longer term evaluation of children's development, baselines are being looked at too.
Mr Wight --The consultant at Macquarie University is making a start on that. I sympathise with what you are saying. We do not have very good baselines on where children go, what sorts of circumstances affect their background and development. The problem that we have--and what I argue the accreditation system will rectify--is that we had absolutely no measure on what was going on in thousands of child-care situations around the country. At least now this system will have some measure on the quality that is currently going into those services.
This first set of self-assessments by the centres themselves will talk about the practice that is going on in those centres. We have no idea what is going on in many of them, or in all of them in a consistent sense. We will have some measure of whether they are actually running appropriate developmental programs for children and then, on the basis of those programs, the academics and the educators in our community that are involved in the child-care industry will identify and modify those developmental programs to achieve the outcomes that you and we are all seeking. I understand your question, but what are those outcomes and what are we seeking I guess is the uncertainty, but we have no measure of what is happening at the moment.
Senator HERRON --I have no further questions, but I hear a strong echo of the practice enhancement program of the department of health regarding general practice because I got the same answers in relation to that. I have no more questions in relation to accreditation.
CHAIR --Further questions on 3.1?
Senator TROETH --Yes, I have some more questions. On the child-care rebate, I had an inquiry from a constituent whose child attends a child-care centre two days a week. She had paid her fees prior to that week but she had to keep her son home because he was sick. As required on her claim form, she noted that her son had been absent for two days but she was told by a Medicare officer that the child-care rebate would not be payable for those two days when the child was absent. Now as far as the centre is concerned, you would think it made no difference whether her son was physically in the building or not, and she did not get a refund for the money that she had paid. Why was she not permitted to claim for moneys that were paid, irrespective of whether the service was used or not?
Mr Wight --Could I ask Mr Johnson to take that question? We may need some assistance from the Health Insurance Commission people who are here who actually administer the scheme as well.
Mr Johnson --Could I just clarify this: was the child there for part of the period or was the child away for the entire period?
Senator TROETH --No, he was absent for the two days that she had put him in for.
Mr Johnson --Can I just check with the--
Senator TROETH --Yes.
Mr Mynott --The interpretation of the legislation is that where a period of care has been claimed by a parent, by family, and the child is absent for the entire period of that care claimed, there is no rebate payable. They have to attend for some of the time claimed.
Senator Crowley --Senator Troeth, can I cut across what might be a lot of questions here and say that, as worded, the legislation allows that interpretation, that a child must attend to be eligible for the cash rebate. In the child-care assistance area we allow certain absences, including for a child to be sick. They still have to pay their child-care fee or at least some part of it. In the child-care assistance area those allowable absences are presumed effectively to be that the child would have been at the child-care centre except that he was sick and unable to attend. I think that the same rules need to be applied to the child-care cash rebate area and I am looking at ways in which that can be done. The parent has to pay the child-care fees even though the child is absent due to sickness, so I think we will have to introduce consistent definitions of things like allowable absences where fees are paid but when the rebate can be drawn. It is something that is under examination.
Senator TROETH --So you would hope that that anomaly would be--
Senator Crowley --It is certainly something that I am looking at at the moment, and I would hope that it could be removed.
Senator TROETH --Could I ask what training is given to Medicare officers in relation to the administration of and dealing with child-care rebate clients? Do they have any specific training in that area, as well as general office?
Mr Hazell --In terms of the content of the program and the policy behind it?
Senator TROETH --Yes.
Mr Hazell --Yes. Before the program was introduced extensive training was carried out within the states, and there has been further follow-up training on specific issues with which difficulties have been experienced since the program was introduced.
Senator TROETH --Are there any written guidelines or written instructions to staff on those lines?
Mr Hazell --In terms of procedures and in terms of interpretation of policy, yes.
Senator TROETH --Would I be able to get a copy of those?
Mr Hazell --Yes.
Senator Crowley --Are there any more questions on the cash rebate area?
Senator TROETH --No, not on that particular area.
Senator Crowley --I think the health insurance officers may be about to withdraw from the table, and they may never return--at least in the lifetime of these estimates. I would simply like to say that the message coming to my office from any number of places is that people have found the child-care cash rebate to be very user-friendly, and the Health Insurance Commission has been commended for the kind of way in which it has dealt with the problems. I would like to put that on record.
CHAIR --Thank you. Further questions, Senator Troeth?
Senator TROETH --I have a question drawn from page 191 of the human services and health annual report re the job education and training program. It says there that over 96 per cent of JET clients who sought assistance with child care in 1993-94 were found a child-care place. Given that most of these clients would actively need child care, and that it would be of a fairly urgent priority, I wondered what sort of guidance or help was given to the other 4 per cent who did not find a child-care place?
Ms Kerr --Some of these sole parent pensioners decide not to actually use formal child care. They approach the staff to have child care organised. In some cases perhaps there might not be a place that can be found for them, but in the great majority of situations they are found a place. But they, for one reason or another, may decide that they will use the informal sector or some other arrangements.
Senator TROETH --I realise it is probably difficult to comment on this, but do they normally have a fall back position that they can use if they cannot obtain formal child care?
Ms Kerr --Yes. A great number of the clients of the JET program choose to use informal arrangements. It is often because of the type of need they have for child care. They are often people who are going on short courses, or who are going into short-term jobs. For one reason or another it suits them better to make informal arrangements.
Mr Wight --I was just suggesting that Sue might also add that in some instances, in that 4 per cent where we are not able to provide the child-care needs and when they do not have a fall back, many of them may well then go into the next training course so that any further training that has been offered to them until the next training course may be six or eight weeks later, or something like that, and we can then satisfy them and they then get picked up in the 96 per cent.
Senator TROETH --But they need to put their plans on hold for the moment?
Mr Wight --They may be deferred for a short time.
Senator Crowley --May I make it clear that something like 80 per cent of JET clients find their own child care through the child-care provisions that are there. What we are talking about is the percentage left over.
Senator TROETH --So it is a fairly small percentage.
Senator Crowley --It is around 20 per cent, as I understand it, around about 80, so it is about 20 per cent that the department assists.
Senator TROETH --I would also like to ask about the mobile children's services quoted on page 192 of the human services and health annual report referring to the conference held in Alice Springs in April 1994. I would like to ask what is the purpose of the mobile children's service?
Ms Kerr --Perhaps I could answer that. They have been funded by the department to assist families whose access to general community resources and facilities is restricted because of remoteness or other locational disadvantage. They provide a range of services for those families in those areas. They provide playgroups, occasional care, vacation care, activities for older children and information and support networks for parents, which I think is something that is very important and is something that came through at that conference that you just referred to. Many of these services also include a toy library component.
Senator TROETH --How many people use the service?
Ms Kerr --I do not have that information with me. We can probably make an estimate, but I think that is all it would be. There would be a variety of families at different times accessing the services. We may need to go back to the services and ask them on average how many families they think they would see.
Senator TROETH --How long has that service been in operation?
Ms Kerr --I do not know exactly when it started, but it has been operational for quite some time.
Senator TROETH --Could I have the figures for the number of users over the last three years? How many people would you estimate who ask for access to this service are not able to use it? I imagine distance would be a restriction.
Ms Kerr --I think that would be very much just an opinion of the people who run the services because we just do not collect that sort of information. It would be fairly anecdotal, I would think. In the main those people drive incredibly long distances and do the best they can to look after all the families who require their services.
Senator TROETH --Apart from that particular service, what other child-care services are provided for children in rural and remote areas?
Mr Wight --All of the services that we described as the mainstream services are available in--and, again, it depends on your definition and my definition of rural and remote--many of the rural towns. In many of the rural towns they would have a child care service, a preschool service and family day care services. In most of the smaller rural towns, the main service that we would fund would be family day care. We might have in a particular area a family day care scheme coordinated from, say, Orange, that might have family day carers in several towns around Orange all coordinated from the one family day care scheme. That would be the predominant service.
Senator TROETH --I have been thinking particularly of children on farms and outlying properties when often the parents are needed to work on the properties and cannot spend time taking their children to a child-care centre in the nearest town, going back to work on the farm and going in to collect the child from child care when a great distance is involved. Has there been any thought of coordinating services in places away from towns, say, more on a community basis, so that the level of cooperation could be established?
Mr Wight --I would hasten to say that all of the family day care services are on a community non-profit basis, so they are all run by community groups and outreached into these various locations. Certainly, we have had the type of examples and problems that you have mentioned identified to us by the farming community. It is an extremely difficult problem to resolve. We have started piloting--and I am not sure of the detail--a program around Albury-Wodonga to try and address the needs of the farming community.
Senator TROETH --I am aware of that.
Mr Wight --That is our first attempt to try and address the problems of those people. The other one is through the mobile services and, as Sue Kerr has already said, there are a number of occasions when mobiles will go into an area to provide opportunities for farming communities, very small groups. They will go into communities where they might just get together four and five families from adjacent farms. That is the only service that those communities are getting at the moment.
Senator TROETH --I am aware of the program at Albury-Wodonga, but if you could keep me updated on it I would be happy to know more. I notice there was a budget blow-out of $36 million for child-care fee relief in 1993-94. I would like you to account for the gap in the estimated and actual budget allocation.
Mr Wight --The major reason for that--and Mr Johnson might be able to add to this--was that there were a significantly higher number of private child-care places established in 1993-94. This was linked with our estimate of 13,500 private places that would be created in the year and the actual outcome was 19,000. So there was significantly greater growth in the private sector than estimated. Those extra places involved additional child-care assistance for the clients of those services.
Senator TROETH --How many places were promised under the government's 1988 child-care strategy and how many of those places have been filled?
Mr Johnson --Some 30,000 were promised. There are still 948 outstanding, so that means that just over 29,000 have been delivered. Of the 950 that are outstanding, 780 are in New South Wales. That state provides all the capital funding for the places.
Senator TROETH --I would like to the move on to comments made in the Law Reform Commission report. What is the department's priority of access guidelines with regard to child care?
Mr Wight --I can provide you with a copy of the priority of access guidelines. In short, they give the first priority to children of working parents. The second priority is children with special needs like Aboriginal children, children with a physical disability and children from non-English speaking backgrounds. The third priority is children at risk. There is a much broader definition of that. The fourth priority is children from families with one parent at home who is not in the paid work force.
Senator TROETH --Families with one parent at home?
Mr Wight --Yes.
Senator TROETH --Does that provide for occasional day care and respite care?
Mr Wight --Yes.
Senator TROETH --Given that a lot of the upsurge in employment, at least over the last 12 months, has been in part-time, casual employment and shift work, has any thought been given to perhaps expanding the priority of access guidelines to cater for those parents who are in that type of employment but who obviously would not qualify for full-time child care?
Senator Crowley --Child care assistance now goes to that sort of child-care service.
Senator TROETH --Does the working category cover all of those people?
Mr Wight --Yes, that is a very broad definition of working. It includes people that are in full-time or part-time work, training, studying or preparing for work or looking for work.
Senator Crowley --There is not a priority for full-time work. If you are working part time you have got a legitimate claim for child care because you are a working parent.
Senator TROETH --Do you have the same access as someone who works, let us say, 40 hours a week? The Law Reform Commission report questioned the implementation of the priority of access guidelines on the grounds that they can lead to unnecessary invasion into the private lives of families and may leave services providers to `make policy decisions based on subjective analysis of social issues specific to each family.' Are their standard questions asked of families when priority of access is being considered?
Mr Wight --The priority of access guidelines have some requirements accorded to those four priorities. However, they also provide some discretion--and there are some words in the guidelines which you will see when we provide you a copy--for directors to take into account other special circumstances of the family. That wording is designed to be positive and helpful to take into account those who have most difficulty rather than the person who is next on the top of the list.
So there is some assessment made by the directors, I guess, if there are competing claims about the alternative or the options that each of those have for the one that misses out, and that gets taken into account. I can see why the Law Reform Commission, when one of its major terms of reference is equity, has some problems with that. I believe that the government will have to look at its recommendations when we are next looking at our priority of access guidelines as to whether or not there are better ways of doing it. I think the reality is that the special circumstances are a secondary consideration of the people who meet priority one categories.
Senator TROETH --When would you imagine that you would be looking at the guidelines again with a view to making those changes?
Mr Wight --I am not necessarily suggesting that there will be changes. I guess over the next year or more the government will need to respond to the range of recommendations that have been put forward by the Law Reform Commission, the department and the various other reviews that have been done. That will be done progressively, depending on the urgency. So it not easy to answer the specific question about priority of access guidelines. I am not sure that that has the highest priority of concerns that the government might want to address.
Senator TROETH --Over the next year or more?
Mr Wight --I do not know. I am not making government decisions.
Senator Crowley --That is really a question for me. At the moment we are in the process of the COAG examination of child care. That is a Commonwealth-state series of meetings about child care. As many of the recommendations go to the allocation between Commonwealth and state, there is a fair amount of sense in letting the COAG process at least take its course or advance further before we can see how best to start addressing some of these recommendations. We do not want to do that until the COAG process is over, especially as that is its main feature.
Senator TROETH --How long do you estimate that will take, minister?
Senator Crowley --I cannot really say. This current round of COAG process, looking at child care, is over a year old. There is a meeting planned for February. I could not predict what might be the outcome of that February meeting, but I would be very surprised if that were the last one. So the COAG process could run well into next year. As that process goes to a number of the recommendations of the Law Reform Commission, that would put a qualifier on the timing about when we would be addressing those recommendations.
Senator TROETH --Many submissions to the Law Reform Commission report noted that child care for babies and toddlers under three is in incredibly short supply. Is the department doing anything to increase the number of baby and toddler places?
Mr Wight --There are a number of reports that have identified some concerns and supply is the main issue that is coming through consistently. I guess government policy, by encouraging the private sector and having these national child care strategies agreed with the states, is generally addressing the overall supply question. At this point in time there is no specific initiative that would direct a higher proportion than is currently going into places for babies. Certainly, I believe that is something that needs to be addressed.
The current statistics show that the government is having much more success with the community based sector that it can fund through the national child care strategy. That sector has currently close to 20 per cent of babies under two and the private sector has only approximately eight per cent. So I think we probably ought to be conveying some messages to the community based sector to do better, because that is where the major shortfall is, and to the private sector to do better. I think in a market situation one would hope that they would respond as they become more aware of this shortfall.
Senator TROETH --Similarly, the report indicated that children from non-English speaking backgrounds are not getting access to child care and that services may not be culturally appropriate. Does the department keep records of the numbers of children from non-English speaking backgrounds in care or who require care?
Mr Wight --We certainly have statistics on the number of children from the various special needs groups, including non-English speaking backgrounds, from our annual census of services. We have got very good data on that. We do not have any data at all on those who are not in the system.
Senator TROETH --No. Could I have a copy of those figures?
Mr Wight --We could provide the last two or three census reports highlighting the relevant pages.
Senator TROETH --Yes. That would be helpful, thank you.
Mr Wight --There is also a program to encourage more children from non-English speaking backgrounds into what we loosely refer to as mainstream services. We have a special services program that expends of the order of $20 million a year, not all on non-English speaking backgrounds. That covers a range of special needs. That program is to assist children into mainstream services, in some instances, by providing support for those children when they first move into the centres.
Senator TROETH --Are there any guidelines for the centres themselves for the integration of children from different ethnic backgrounds?
Mr Wight --I suppose I could only say yes, via the new accreditation system.
Senator Crowley --Thank you very much for leading so generously with your chin. You do not mind at all if we very gently biff it and say yes, the principles do address this question, and we will not talk about Christmas.
Senator TROETH --No, we will not talk about Christmas.
Senator Crowley --But the point you make is actually very well made. One of the things that we were concerned about was that those needs for a whole variety of opportunities for children including the specific needs of children from non-English speaking backgrounds have those met in a child-care centre.
Senator TROETH --Yes, I have heard anecdotal evidence about children from those backgrounds having difficulty making their way into the mainstream culture. I do wish to ascertain what sort of help is provided to them. I would be happy if you could provide me with that literature.
Senator Crowley --It is a very important point.
Mr Wight --One extra thing that was brought to my attention was that we have produced what is referred to as a multi-cultural resource kit from one of the multi-cultural resource centres that helps centres to assist children from multi-cultural backgrounds. That has been circulated to every centre. As well as that, in the last budget, the government extended the supplementary services program called SUPS that assists integration of children in services. It is the first time that has been established as an on-going program to assist the private sector services integrate children not only from multi-cultural backgrounds but also who have a broad range of special needs.
Senator TROETH --Yes. For instance, my electorate office is in an area where the local primary school has children who speak 31 languages in the playground. I am interested to know that there is an effort being made to provide literature and information for those sorts of parents. Similarly, the report indicated that children from Aboriginal and Torres Strait Islander families are not getting access to child care. Do you have any records of the number of Aboriginal and Torres Strait Islander children in formal child-care services?
Mr Wight --I am fairly sure that that is also identified in that census document. We will highlight that for you in the last three census reports.
Senator TROETH --Yes, and also if there is any literature that goes out to centres to help centres in their integration of those children.
Mr Wight --Would you want that returned through the committee or to you direct?
Senator TROETH --I think it usually comes through the committee secretariat. What sort of planning system do you have in place regarding the collection of data and the targeting of child-care services?
Mr Wight --The planning system that we have at the moment only covers the community based non-profit sector, services funded by the government. That system--it depends what detail you want--is broadly based on identification of the number of children in the appropriate age group--if the children are under four or between five and 12--if you are planning for outside school hours child-care services. It identifies the number of children in that target group. It also uses the ABS survey indicating the number of parents who are at home that are satisfied with their child-care arrangements and are not seeking care. So we exclude that number of children from the analysis.
We then rank all local government areas in the state by shortfall against that assessment of demand and the supply. So there is the rank of what we call high needs areas. We then have in each state a consultation or an advisory group that includes representatives from the various sectors, needs based and from non-English speaking backgrounds--the committee varies. What I am saying is general, but not necessarily all these are represented in each state. But there are Aboriginal representatives, representatives from non-English speaking backgrounds and state government officials, and they then look at qualitative factors which they superimpose and maybe change some of the rankings based purely on statistics.
Then the government funded community based places are allocated to sponsors in those zones. At the moment there is no planning process at all for the private sector. They can locate anywhere in the country. Providing they meet other conditions set down in the legislation, they become an approved service or they have to be approved by the minister.
Senator TROETH --How up to date is the data? At this stage in time, what would be the most recent data that you have?
Mr Wight --The statistical information is 91 census, and the qualitative data is as recent as the people who are on the advisory council can provide.
Senator TROETH --I would like some copies of the literature that you put out for parents regarding child-care services and fee relief that is normally provided in child-care centres. Is there a formalised mechanism for complaints about the industry by carers and parents?
Mr Wight --No, there is not. In fact, that is one of the issues identified by the Law Reform Commission that needs to be addressed--that there is not a formal complaints mechanism in the program. There are appeals mechanisms for decisions that are taken by the minister under the Child Care Act. But one of the reasons why the reference went to the Law Reform Commission is that the Child Care Act covers only centres and it does not cover family day care and outside school hours care. They are at the moment outside the legislation. So the Law Reform Commission exercise was to bring all of child care into one piece of legislation and to have a complaints mechanism that covered all sectors.
It also highlighted in that Law Reform Commission report that there should not be duplication of state governments' complaints mechanisms. There is an exercise there when we go back with legislation of preparing a complaints mechanism and somehow or other linking that in with the state mechanisms.
Senator TROETH --So that may be looked at or will be looked at?
Mr Wight --It will certainly be looked at, but it does not exist at the moment, which I thought was your question.
Senator TROETH --Thank you. I refer to the $7 million allocated to the care for sick children program in the 1994-95 budget. I gather there has been a hold-up in the distribution of that money, that so far no money has been allocated to anyone?
Senator Crowley --Near enough no money.
Senator TROETH --Is there any reason for that?
Senator Crowley --Yes, there is, Senator. The question of how best to provide sick child care is a taxing and vexing one. While when asked a lot of consumers would say, `Oh, yes, assistance with child care would be a very good thing', when it actually comes to the crunch families have made it very clear that their preferred place to look after a sick child is in the child's own home with one or other parent or ongoing familiar carer. It might be a loved relative or something of that sort. That is clearly the preference.
When we came to looking at designing child care, that was one very important point. The second one was the concerns from a number of areas, including the NHMRC, about the spread of illness in child-care centres and family day care if you have a sick child. So we have not been able to advance quickly in trying to design what might be our preferred way of implementing sick child care.
What we are doing at this stage is continuing to examine ways in which it might be possible to provide a backup support for child care for families, with the care of children when they are sick. The examination of what we might do in long day care centres is--I suppose you would have to say--almost defeated by the requirements of controlling contagious diseases or spread of infection and so on.
The other thing that has happened at the same time has been the application for a family leave test case to the full bench of the Industrial Relations Commission. As that is something that exactly goes to the care of sick children, we want to pace our provision of care for sick children along behind what might be the outcome of that family leave test case.
Senator TROETH --Was there a pilot program for this project?
Senator Crowley --Yes, there was.
Mr Wight --That is what identified the issues of concern for the provision of the sick children that the minister mentioned--the transmission of diseases and things like that.
Senator TROETH --Does the government plan to go on with this at all, or is it just something that it said would happen and it will not happen? Can you see any way of resolving the difficulties?
Senator Crowley --At this stage, we are looking at ways in which we might be able to resolve those difficulties. We are not marking time, so much, but we have been very aware of the importance of the family leave test case. For example, if something like that were provided to all workers, or most workers had access to it, then the demands for the provision of sick child care could be very dramatically reduced. What we would want to look at, by way of providing child care, would then be very different. We would have a whole rethink to do. If you were looking at sick child-care provisions across the country, the sum, the equation, the way to deliver it would be a very different equation. There might be a small amount of sick child-care demand because most people can manage. So it is a question of letting those things sort themselves out before we proceed with it.
Senator TROETH --So the whole thing is on hold for the moment until that test case is resolved?
Senator Crowley --Fairly much so, yes.