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Finance and Public Administration References Committee
08/11/2017
Delivery of national outcome 4 of the National Plan to Reduce Violence Against Women and Their Children 2010-2022

BAXTER, Dr Roslyn, Group Manager, Families Group, Department of Social Services

CRANFIELD, Ms Melissa, Assistant Secretary, Office for Women, Department of the Prime Minister and Cabinet

MANDLA, Ms Kathryn, Principal Adviser, Department of Social Services

STRATFORD, Ms Chantelle, Branch Manager, Family Safety, Department of Social Services

[14:07]

CHAIR: I now welcome representatives from the Department of Social Services and the Department of the Prime Minister and Cabinet. Information on parliamentary privilege and the protection of witnesses has been provided to you. I remind senators that the Senate has resolved that an officer of a department of the Commonwealth or of a state should not be asked to give opinions on matters of policy and shall be given reasonable opportunity to refer questions asked of the officer to superior officers or to a minister. This resolution prohibits only questions asking for opinions on matters of policy and does not preclude questions asking for explanations of policies or factual questions about when and how policies were adopted. Officers of the departments are also reminded that any claim that it would be contrary to the public interest to answer a question must be made by a minister and should be accompanied by a statement setting out the basis for the claim.

DSS lodged submission 31 with the committee. Would you like to make any amendments or additions to that submission?

Dr Baxter : No.

CHAIR: I invite you to make a short opening statement. At the conclusion of your remarks, the senators will have questions for you.

Dr Baxter : I'd like to begin by saying that the department takes its role in funding and contract managing the 1800RESPECT service very seriously. We believe that women who reach out for help must get good support and they must get it quickly. Our submission, which you have, sets out how the department has reviewed and improved this important service. However, we are deeply concerned about the damaging inaccuracies that have been reported and repeated without evidence in the media and also in this room today. These inaccuracies only serve to dissuade women from seeking help, and we are very concerned about that. I'd like to take the opportunity to place a few corrections on the public record.

Firstly, it has been reported that the new panel arrangements are about cost savings. Funding for this service will increase from $14 million in 2016-17 to over $19 million in 2017-18. Almost all of this $5 million increase is for the trauma specialist arm of this service. This funding will provide an extra 17 full-time trauma specialist counsellors, bringing it to 48 in total. It will also buy ongoing training for not-for-profit organisations that join the new panel from established industry trauma leaders Blue Knot Foundation. I can also place unequivocally on the record that there are no hidden call targets in this service, in either arm of the service, just a commitment to answering all calls.

Secondly, it has been alleged that the new panel arrangements will prioritise quantity over quality. This is wrong. A high-quality service begins with answering a woman's call. No woman who has waited for hours in a queue or has had to hang up would report that she has received a high-quality service. When RDVSA was responsible for answering all calls too many calls went unanswered. In 2013-14, six out of every 10 people who attempted to access the service were not able to receive support in the moment that they needed it. RDVSA answered 38 per cent of calls. In 2014-15, performance deteriorated further—seven out of every 10 people who attempted to access the service were not able to receive support when they need it. RDVSA answered 28 per cent of calls.

We have heard today in this room that this is simply an issue of requiring more funding. However, in May 2015 the Australian government responded by providing an additional $4 million over two years to 1800RESPECT. Of this, the vast bulk—$3.6 million—was provided to RDVSA and increased their counsellors from 21 to 31.65 full-time equivalents. It didn't help. We have seen very clearly that this is not a simple matter of tracking demand, funding and response, as has been suggested today. In the first six months after extra funding, only 19 per cent of contacts were answered—6,765 contacts. This was a 32 per cent reduction on the rate from the previous year, despite the extra funding. To respond to the issue of the graph that tracked funding demand and responses, what we did see in that time it was that between 2011-12 and 2015-16 funding to RDVSA increased from $2.58 million to $7.59 million—a 194 per cent increase. However, the number of calls did not increase commensurately. The service went from answering 11,983 calls to 20,713 calls across those years, a 73 per cent increase pitched against a 194 per cent funding increase.

Much has been made in the submissions that we have heard today about occasions of service as a measure of performance. Let us be very clear that DSS funds MHS and MHS funds RDVSA for answering calls that come into the line. This was the intent of the national plan in setting up the 1800RESPECT service. We already had trauma counselling services. We already had state based domestic violence services. What 1800RESPECT was set up to be was a 24-our service where women could get their calls answered when they made the calls. Occasions of service are a distraction. They include voicemail responses that are responded to and they include emails. This means that seven occasions of service could represent support for just one client. We believe they are an inaccurate way of tracking how a service has responded to the needs of women calling in. The 234 per cent demand increase that was quoted this morning by RDVSA includes occasions of service as both a measure of demand and a way of meeting that demand. The department does not measure it in that way, nor do we believe it is an appropriate way to measure responses to women's calls for a service such as this.

It was evident to us that the operational model for 1800RESPECT needed review, and in November 2015 the department engaged KPMG to undertake that review. They conducted extensive consultations with industry experts, including RDVSA, and they found that the operating model was not fit for purpose. That operating model was based on the idea, which we have heard repeated often today, that 98 per cent of calls require trauma specialist counselling. We have heard that suggestion called into question by the people who have just provided evidence. What I would say is that that 98 per cent, even if it were accurate, was based on a sample of 30 per cent of calls which were being answered at that point in time. In that context, we can firstly assume that those people who desperately needed trauma specialist counselling would have perhaps been in the 30 per cent who would have hung on to have their calls answered. We also know that the way data was being collected by RDVSA at that time was not consistent and replicable. From the department's point of view, we are much more confident that we have robust, repeatable data now, and we are confident that 70 per cent of the calls that come into the service require other types of support, such as information and referrals. This is also consistent with the broader role that we play under the national plan where we know that the 1800 number is promoted for a range of purposes. We know that other services use the number to get information. We know that it's provided to schools—to school teachers who are for providing information—and to a range of other service providers, as well. We also know that it's provided to the media when they are seeking information about how to pitch a particular story or where they should go. So to us, also, the data we are now seeing seems a far more accurate representation of calls that are coming into the service.

KPMG identified at that time that adding a first response triage model would mean more women could get more help more quickly. This improvement was made on 16 August last year. Almost immediately, it led to a 172 per cent increase in the number of telephone and online contacts that were answered. It allowed an additional 40,500 people to receive support in the moment that they needed it and it dramatically decreased the length of average call wait times from 10 minutes to 37 seconds. However, the department absolutely acknowledges that simply picking up the call is not enough. We know that quality is every bit as important as quantity. Despite more calls getting answered immediately after the introduction of the first response model, more than two in every 10 warm transfers that were made to RDVSA at that time still went unanswered, despite the funding to RDVSA remaining the same.

The new panel arrangements provide immediate additional surge capacity to support those women who need to talk to a trauma specialist. Panel organisations are all highly qualified industry leaders. Collectively, they have over five decades of experience in the field. On the quality issue, we have heard consistently the allegation that women will have to retell their stories. They will not. Warm transfer means that the first responder tells the story to the trauma specialist and the woman caller can hear the conversation. We've heard that there is no clinical supervision, but DSS has been briefed on the clinical supervision arrangements and has been very satisfied with that briefing. We have heard that complaints for first responders are very high. However, we have examined the data in great detail. In actual fact, the complaint rate for trauma specialist counsellors under the previous model was higher than that for first responders. On every measure of quality, DSS has been satisfied.

Thirdly, we have seen damaging accusations that first responders are unqualified. This is wrong. We know, personally, that accusation has been very distressing for first responders. Everyone who calls 1800RESPECT will speak with a qualified counsellor and can get counselling, should they require it. These qualified counsellors have a minimum three-year tertiary degree in social work, social services, welfare studies and psychology, and a minimum of two years' full-time counselling experience. You have also heard about the intensive training they undergo before they respond to calls. It is very similar to that provided to the trauma specialist arm of the service.

Fourthly and finally—I promise I am getting there—we have heard that women's privacy will diminish because of the new panel arrangements. This is incorrect. There have been no changes to the privacy provisions as a result of the new panel arrangements. The same provisions will continue to apply that have been in existence since the establishment of the service in 2010. MHS is required under our contract with them to meet privacy standards as stringent as those that apply to an Australian government department. No caller is ever required to have their call recorded or to identify themselves if they choose to have it recorded. Further, at any point callers can advise that they no longer wish to have their call recorded. This will not affect the service they receive in any way. RDVSA have said that only they will commit to resist subpoenas. However, MHS are on the public record saying that they would use all powers and privileges to refuse sharing information, including in the case of subpoena.

We have also heard concerns about RDVSA supplying client files to MHS. It is important to remember why these files, which are files of the 1800RESPECT service, not of RDVSA, matter. They ensure that people who call the service again do not have to retell their story. When the department have heard time and time again that this is an issue that is absolutely critical for callers, it is reasonable for callers to expect their information will be available to counsellors employed by the service at any time that they call. It's reasonable to expect that they wouldn't have to repeat information they've already provided. These files will have the highest degree of privacy protection. They belong to the 1800RESPECT service.

I correct these matters because it is very important to us that women and others experiencing, or are at risk of, domestic and family violence and sexual assault have confidence in 1800RESPECT. They must know that they can get good, fast help when they need it, and that that will continue under the new arrangements.

DSS does not stand with a single organisation or provider in the provision of these services. We perform the role of government in examining the evidence and taking the necessary steps to ensure the best service possible. We hold MHS very strongly to account at each step because of that and we do this for the vulnerable women and others who need this service.

CHAIR: Ms Cranfield, did you wish to make an opening statement?

Ms Cranfield : The Office for Women thanks the committee for the opportunity to address the hearing today. The role of the Office for Women is to provide advice to the Minister for Women, Senator the Honourable Michaela Cash, and the Prime Minister on gender equality in Australia. We have a particular focus on equitable representation in decision making, economic agency and improving the safety of women and girls. As different ministers have responsibility for many of the areas relevant of women's safety, the Office for Women works collaboratively with departments, particularly the Department of Social Services, which has responsibility for the National Plan to Reduce Violence Against Women and their Children 2010 to 2022.

Responsibility for funding, procurement, implementation and operational decisions for specific programs under the national plan, including 1800 RESPECT, lies with portfolio agencies. Office for Women has an open and constructive working relationship with DSS. We have full confidence in DSS's management of the 1800 RESPECT service, and the recent changes to the service delivery model are helping to ensure that 1800 RESPECT remains a responsive and high-quality service.

Please be assured that we sought and received information from DSS in relation to 1800 RESPECT on matters in which the Office for Women and the minister were interested. We were satisfied in the information we received from DSS and the assurances we were provided.

CHAIR: Dr Baxter, can I ask you about the relationship with MHS? We've had differing accounts that you may be able to clear up. Just on what basis is funding provided to MHS? I want to know particularly whether it is grant or a contract. What is the actual administrative agreement?

Dr Baxter : It is a funding agreement. You will hear it colloquially referred to as a contract but it is a funding agreement. It is the basis on which we fund all of our service providers.

Ms Mandla : If I could just clarify, I understand that, for legal purposes, it is pretty much the same as a contract.

CHAIR: That has been in place since 2010. Is that correct?

Dr Baxter : It is not the same funding agreement.

CHAIR: Can you to talk me through the occasions on which that document or those arrangements have been altered or changed.

Dr Baxter : I will make sure I have got the dates right for you. There were two establishment agreements in 2210—an initial one and then a provision of service contract. There was a variation in 2016 for the development of the first response triage model and there was an additional variation in 2017 for additional funding up to December 2019 to cover the extra funding for the trauma specialist counsellors.

Ms Mandla : If I could just clarify, these were the key contractual milestone changes with the service model changing. I do understand there have been some variations in between for minor services.

Dr Baxter : So they are the new agreements but there will have been variations along the way as well, minor variations.

CHAIR: Is it possible to have a copy of that grant agreement provided to the committee?

Dr Baxter : We have received your request to those questions on notice. We have been actioning them as quickly as we can. They go through our legal area and absolutely we will get those to you.

CHAIR: Does your answer suggest that you are going to answer the question on notice or that you are going to provide the grant agreements?

Dr Baxter : Today?

CHAIR: No, at any point in time.

Dr Baxter : No, we are going to provide the grant agreement. I should clarify, we are in the process of checking with our legal area that we can provide all of them and checking whether there are any commercial-in-confidence clauses we need to be concerned about. But our intention is to review those with the aim of providing them. There's a bureaucratic answer for you.

CHAIR: That is a perfectly good answer. I want to understand what the KPIs are under that agreement. You said in your opening statement that, on every measure of quality, DSS has been satisfied.

Dr Baxter : That's correct.

CHAIR: I'm just wondering what those measures of quality are in a very specific way.

Dr Baxter : There are measures that go to calls being answered, which, as I've identified in my opening statement, we very much consider a measure of quality. They go to amount of calls answered and speed of calls being answered, and there are KPIs which go to ensuring that call wait times are not too long. Then there are measures of quality which go to how both the first-responding element of the service and the trauma element of the service work. They relate to the qualifications that are required for counsellors who are meeting each of those elements of the service and they go to measuring the process for the delivery of the counselling around engaging with the client; the development of a toolkit that is sensitive to client needs; the development of therapeutic plans; how clients are referred to services; and the number of calls that are transferred to trauma specialist counselling.

We also have processes to ensure that, if any of those KPIs are not met initially monthly and then a period over three months that we have the ability to institute escalating remedies under that funding agreement. We have a number of mechanisms through which we check that those KPIs are being met from both a service responsiveness and a quality point of view.

We have weekly meetings between my 1800RESPECT team and MHS's clinical implementation team. I convene a monthly meeting with senior executives from MHS where we run through a range of clinical and service responsiveness issues, including consideration of complaints. We know that one per cent of calls which are made to the service are sampled and reviewed by a trauma specialist and first-responding staff. This is specifically to ensure the quality of the service as well as to ensure that calls which are coming into the first-response service are being appropriately transferred to trauma counselling. We understand there were some concerns expressed early on by RDVSA that calls were not being appropriately transferred, and so we seek to reassure ourselves, through those clinical governance processes, that those calls are being appropriately transferred.

We also seek advice from the independent clinical advisory group that helps go to each of these KPIs so we can ensure that we are confident in the quality of the service that is being delivered. I'm happy to go to how we've assured ourselves about any of individual processes, if that would help.

Ms Mandla : We also collect statistics that go to performance—in addition to the KPIs, close to about 20 different statistics—and we also have the option to ask MHS for any other data that we need to understand how the service is running.

CHAIR: It may be that I have asked you this already as a question on notice—I'd actually hoped to get some of these answers before we spoke so that we'd be able to have a more informed discussion. It would be helpful if you could provide the framework that is in place between you and MHS to manage the contract and monitor contract performance—or grant performance. Do any of those measures that you just outlined go to the performance of the subcontractors who are providing the trauma counselling?

Dr Baxter : All of our levers are with MHS, but they do specify the requirements that we have for the service as a whole and they specify that all of those requirements must flow through to the subcontractor.

CHAIR: I'm trying to understand what levers you have to ensure that the trauma counselling, which is ultimately to be provided to people seeking to use the service, is today, next week and next year of a quality that is acceptable or meets the government standard; and what is the standard that government has established?

Dr Baxter : I've gone to what those KPIs are that are in the contract that are expected on both a service responsiveness side and the quality side—

CHAIR: The quality side I'm interested in.

Dr Baxter : Our contract requires that those standards will be met by MHS in delivering the service and that those standards will flow through to any agreements with the subcontractors. Our levers for reporting are that we have the monthly and quarterly reporting from—

CHAIR: Can we just pause there? I understand the structure of a head contractor and subcontracts, and that these obligations flow through. However, I am interested to understand what specific descriptor of quality in the trauma counselling have you provided to MHS as their standard for delivery in their subcontracting terms?

Dr Baxter : We can give that to you. I couldn't read all of it out now. There's quite a lot of detail in the contract about the quality markers that are required of the service, both the trauma specialist arm of the service and the first responding arm of the service. Through our monthly and quarterly reporting from MHS, we ask them to report on that. They provide us with qualitative information through from the subcontractors, as well as quantitative information in respect of calls answered. We review that material. We meet with them weekly and monthly. Where we are dissatisfied, we communicate formally to them that we would like to see rectifications. As I said, the new contract also gives us levers to withhold funding if we are not satisfied.

CHAIR: I think the problem that we're all having is that we're having this extended discussion over the course of today about this very question of quality, and it is difficult for us to hear you list a range of bureaucratic terms without having the capacity to dig into them, which is why I did ask the question some weeks ago—so that we wouldn't be in this position today.

Dr Baxter : We did receive the request for the questions on notice including the material late last week. We have been actioning that as quickly as we can and we will get that back to you as soon as possible, but, as I've said, there are—they're certainly not bureaucratically expressed in the funding agreement—a range of quality measures. We hold MHS to account for those measures. We require qualitative and quantitative information to respond to those measures. Where they are not met, we ask for rectification and we follow up very quickly with MHS.

Ms Mandla : One of those measures is complaints, and we also look at the number, the percentage and the type of complaint, and we look at trends in complaints. That gives us an indication as to quality.

Senator PATERSON: Dr Baxter, I think you largely addressed this in your opening statement, but I just want to return briefly to this issue of the metrics and performance of the RDVSA, because there's been a dispute about the data today. The RDVSA I don't think accepted the 33 per cent rate of answering calls, nor the 42,000 people who were unable to have their call answered. Just briefly again: how confident is the department on those views?

Dr Baxter : The department is interested in the figure that relates to calls which come into the service which get answered at the time the caller makes the call. That's very clear in our contract and we understand it's very clear as well in the contract between MHS and RDVSA. My understanding of the discrepancy between the two sets of numbers—and it's very hard for us to understand them, because they're not our numbers; they're RDVSA's numbers—is that it arises because RDVSA counts occasions of service, and occasions of service counts things like emails being sent on behalf of somebody who rings the service or a voicemail that may have been left being returned. Because of the nature of this service, because of what this service was set up to do, we do not accept them as valid measures of performance, when you're talking about the number of calls that are being answered, particularly with respect to what's set out in our contract. Our understanding of the discrepancy is that, both in terms of the increased demand and in terms of the increased rates of service that are asserted by RDVSA, they include those occasions of service. That means that, for one caller, they could include six or seven counts—if an email is sent, if a referral is made to a child psychologist, if a call is made to police, if a call is made to local services. Each of those would count as an occasion of service, whereas what we are interested in is, when women ring in the moment, can they get their calls answered?

Senator PATERSON: So the evidence we had from the ASU this morning, that the increase in funding resulted in a commensurate increase in performance in answering calls, is not correct?

Dr Baxter : The key metric in terms of calls answered is that, in the five years between 2011-12 and 2015-16, funding increased by 194 per cent and calls answered increased by 73 per cent.

Senator PATERSON: That is clearly not commensurate. The other figure that there has been some dispute about today is the figure of 98 per cent of people calling requiring trauma counselling. Do you have any comment on the validity of that? It's been pointed out to us that the decline from 98 per cent to, I think, 25 per cent with the new service, in their view indicates that there's a problem, that there's an unmet need for trauma counselling that is not being provided.

Dr Baxter : That's right. We've heard an assertion today that 75 per cent of people don't get counselling when they need it. The first thing that I would say is that everybody who rings the service can get counselling, and they can in fact get counselling from a qualified professional. What we are talking about is what percentage of people require trauma specialist counselling, so how many people are ready to sit down and have a trauma specialist counselling conversation. That's not something that can be dictated by the service; that is something that has to be led by the person. We've heard from safe steps and DVConnect today that their assessment is that it is around 25 to 30 per cent. That certainly accords with the more robust data that the department has felt more confident in since the introduction of the first responder model, and we have had far more accurate and replicable data from this service.

We would say that we do know, from that latest data, that eight per cent of callers who are accessing the service are in crisis, which obviously makes us especially concerned if we have a high number of calls not being answered. We believe that around 70 per cent of calls require other kinds of support, such as information and referrals, and we believe that's borne out by the one per cent sampling of calls that I mentioned earlier, which are listened to by both trauma specialist staff and first-responder staff, as well as clinical management, to make sure that the right calls are going through to the trauma specialists.

Senator KAKOSCHKE-MOORE: You said that one per cent of calls are sampled. Why is it one per cent? How did one per cent get landed at as the figure?

Dr Baxter : I'd probably have to take the exactitudes of that on notice, but there are a lot of calls that go to this service, so one per cent, when you're looking at upwards of 70,000 calls a year, is a very robust sample in any given year. And it is a figure that I understand was agreed when the first-response service was being introduced, through the independent clinical advisory group that was looking specifically at this question of how we assure ourselves that the right calls are getting through to the trauma specialist counsellors. It was an issue that DSS was very interested in. We had representations from RDVSA that they were concerned that the right calls would not go through. And we sought advice from MHS about how we could have some way of guaranteeing that everyone was satisfied that those correct calls were going through.

Senator KAKOSCHKE-MOORE: There's been some discussion about the KPMG report, and I believe a portion of the report is public but the bigger report itself hasn't been made public. Is my understanding about that right?

Dr Baxter : That's right. In fact, I don't think any of the report has been made public, but I know there were some versions of a PowerPoint presentation that KPMG used to consult with some of the organisations, which people still have and are in circulation. But the report wasn't made public.

Senator KAKOSCHKE-MOORE: Is it possible for the committee to get a copy of that report?

Dr Baxter : We think there's a limited value in releasing the report now. It was commissioned two years ago, and the data, funding and considerations reflect a point in time. But that's certainly something we can take on notice.

Senator KAKOSCHKE-MOORE: There's $5 million in additional funding that has been provided under the new model. How will that be divided between the new panellists?

Dr Baxter : Exactly how that will be divided is probably a question more accurately directed to MHS. But I understand that it is just a direct split. Sorry—I should also say that some of that money is also for Blue Knot Foundation, the training organisation that's been retained to provide support to the trauma specialist counsellors. They're a New South Wales based industry leader in trauma support.

Senator KAKOSCHKE-MOORE: What exactly will Blue Knot's role be? Will they be required to provide training to every single counsellor employed to answer calls to 1800RESPECT? Can you give us some more information?

Dr Baxter : My understanding—and, again, I think for the most accurate and up-to-date advice you should refer to MHS—is that they are not to be available on the end of the phone for every counsellor, but they are providing packages that are being developed in consultation with the three panel providers and MHS about where they see the training needs as being. They are providing some one-to-one clinical training with people who are answering phones, and they are also supporting those organisations as they develop training packages for their workforce going forward.

Senator KAKOSCHKE-MOORE: And how long will Blue Knot's services be available for, under this arrangement? Is it for the length of the—

Dr Baxter : At the moment they're funded in an ongoing way.

Senator KAKOSCHKE-MOORE: Thank you. That's all for me for now.

Senator RICE: We've received a range of evidence today about the model of having a triage system—a first-response system. And probably the bulk of that evidence says that if it's done well then it can provide a high-quality service. But we have received evidence of people's concerns that it's not being done well at the moment, and their particular criticisms of the model that MHS has got underway. One is what happens when there are too many calls coming in, and what MHS's processes are. We were told that in fact the overflow was going over to other services, so it wasn't qualified counsellors who were being provided as first response. So, perhaps you could respond to that, to begin with—whether that could have occurred. The example that was given was that the Quitline people were answering these calls, for example.

Dr Baxter : I would say that we at DSS hear a lot of anecdotal evidence, and we heard some today, about things that do or do not happen on this line. Where we have concerns about those, we always follow them up, and we seek data and concrete information from MHS about it. This is a concern we've heard before, and we have on a number of occasions sought assurance and been assured, in writing, by MHS that only counsellors who are trained and qualified for the 1800RESPECT line answer 1800RESPECT calls.

Senator RICE: So you're confident that's the case.

Dr Baxter : Yes, very confident.

Senator RICE: And your sampling of calls: they are obviously sampling only the calls from those counsellors who are designated to the 1800RESPECT line, so that sampling wouldn't pick up whether that was occurring or not, would it?

Dr Baxter : No, and I will just clarify that that's not our sampling. DSS has nothing to do with listening into calls. That sampling is done at the level of the service, and the listening and the quality checking is done by trauma specialist counsellors and first-responder counsellors to ensure that everybody is satisfied with how those calls are being allocated.

Senator RICE: And, again, that sampling would only be of the calls that are being allocated to the 1800RESPECT counsellors. So, if there was overflow to other services, it wouldn't pick that up, would it?

Dr Baxter : Every call that comes in to the 1800RESPECT line would be subject to that one per cent sampling. So, regardless of whether it was coming in to that line and, under your concern, was being diverted somewhere else, it would still potentially be caught up by that one per cent sampling process. But we have sought, as I said, and received assurance that that does not occur for the 1800RESPECT line.

Senator RICE: Okay. One of the other criticisms: in fact DVConnect and safe steps gave us evidence today about having services being provided from home, and particularly the issues of vicarious trauma and people not being well-enough supported to work at home, and problems with family members potentially also being impacted. Do you have concerns about that model of service that MHS is undertaking?

Dr Baxter : We aren't concerned, and in a moment I'll explain to you the assurances we've sought and the assurances we've been given about what protections are in place for those home based workers. But I will say that I noted with interest those comments today and also the comments that the new providers were seeking to work with MHS on some of those concerns. So, we will follow those up. However, I can assure you that to date this is an issue that we have discussed at some length with MHS, and, again, concerns that have been raised through the estimates process and through other channels. We have been following this up with MHS. So, we are assured that in terms of privacy the technological and support systems that are set up for home based workers are robust. We have had people check out those processes and ensure that they are able to maintain the privacy and confidentiality of callers. We have also sought and received assurance in relation to the support available to home based workers, all of whom have access to a 24/7 helpline to get counselling themselves for their own vicarious trauma, and also access to clinical supervision in the moment that they may require it—at any given point in time that they may need it.

MHS has walked us through how those clinical protocols work for home based workers, and we have been satisfied that they are appropriate. We also note that they are very similar to the protocols that are used for the beyondblue mental health line and for other lines that are operated, and on that basis we have ben satisfied with the assurances we've received. But, as I said, I noted with interest the comments that were made today that there were some ongoing conversations, and the department will certainly follow those up.

Senator RICE: Another issue that has been raised is about the conditions of the workers, that the new services are employing people on lower rates of pay and not on permanent contracts—so greater casualisation. Is that an issue that the department has considered as being a concern?

Dr Baxter : We're very confident that the rates of funding that are being provided to the services are sufficient to provide a very high degree of remuneration for these workers. In fact, that has always been the case for this service and it will continue to be the case. I recognise that there is some discrepancy—and I've seen that the material that has been provided and in some of the submissions—but, even at the rates that are being provided, there is absolutely sufficient funding being provided for appropriate levels of remuneration for these workers. I would also highlight that there are extra packages that these workers will be receiving around training—extra training through the Blue Knot trauma specialist provider—which will add to that which they had previously. We're confident that there has been no cut to funding which would mean that workers should have to receive lower rates of pay.

While there has been some discussion about the amount per head per counsellor that's provided now as opposed to under the previous model, we do know that there is a much more limited range of services that are being provided under this model that are purely around trauma specialist counselling rather than those other additional on-services that were being provided previously, such as around workforce planning and some of those data and measurement services.

We have very, very closely looked at the funding for this model. We also heard today from safe steps and from DV Connect that the funding rate compares very generously with how they are funded under their other lines, including their state-based lines. We have looked at that as well and satisfied ourselves that it's appropriate.

Senator RICE: How about the casualisation of staff?

Dr Baxter : The funding that's provided to each of the panel providers is for full-time equivalent positions. How those services elect to retain staff is a matter for those services. I would note that we have an end date to a contract across all of our funded services in the Commonwealth. There is some need to look at short- or medium-term contracts, depending on the length of the service. Where you don't, unfortunately we end up in some of the conversations and in the position that we've been over the last few months, with suggestions that you have full-time permanent workers who have been employed underneath these contracts and who now, unfortunately, don't seem to have redundancy payments available for them. So it would be a standard practice that, where an organisation has a contract going to a certain period of time, that they will retain a worker for that period of time.

In the department we try to manage that through things like, when we know that a contract round is coming due at the end of a financial year, we endeavour to ensure that we can provide that funded organisation with notice no later than six months prior, so that people have time to advise staff if there is not going to be ongoing funding and that people do have time to look at winding up their affairs.

Senator RICE: So basically you're saying that, for people working in these services, there is no permanency then?

Dr Baxter : No, I'm not saying that at all. In fact, what you often find in these services is that they are funded from a number of different funding sources—state government, federal government and, in some cases, commercial arrangements—and that, where they are confident that they have a range of contracts that cover time, they are often able to offer a certain number of full-time contracts. So, no, I'm not suggesting that it necessarily has to be a—

Senator RICE: There's full-time and there's permanency.

Dr Baxter : Sorry, permanent contracts.

Senator RICE: So essentially you are saying that, on the basis of federal funding, these services shouldn't offer permanent contracts; that, if they are only relying on federal funding and it's only fixed term funding, you are saying that they should only offer fixed-term contracts?

Dr Baxter : No, I'm not saying that at all. I'm saying that our expectation is that we fund for a particular period of time. Clearly, governments would be very reluctant to offer any funding agreements if it created obligations to employees beyond the length of time of that funding. That would be a very difficult situation for any level or type of Australian government. That would be a very difficult situation that we have limited appropriated funding and we have that funding appropriated for particular periods of time. I'm not sure how else governments could deal with that.

Senator RICE: We'll have to differ on that. RDVSA tabled their practice manual today. What's your understanding of the status of this manual and the processes outlined in this manual compared with what other services across the country are using?

Dr Baxter : My understanding, being someone who comes from a social work practitioner background myself, is that individual services have individual practice models, and that is the RDVSA practice model. I have absolutely no doubt it's a very good one. I think there was a very unfortunate conversation with MHS this morning about the status of their model—their practice manual—because we have been briefed on their clinical governance framework at DSS. We have sought briefing on that. I think they were talking about the fact that they plan for that practice manual to evolve, and they want to continue to take input from the three new panel services to ensure it can do so. We have certainly been briefed on a number of occasions and have asked many questions and sought many assurances about how the clinical governance framework looks, how the practice will operate, what are some of the protections that are in place, how workers will be supported and how individual clients will be supported when they call. We've ensured that not only we but also practice experts that we have in the department have been available to ask those questions. So we have been very confident that there is a set of practice guidance in place, albeit evolving, and we've assured ourselves that we're comfortable with the advice as it stands.

Senator SINGH: Firstly, we heard that there has been a cut to counsellors' wages. Your answer to Senator Rice in relation to that was that there hasn't been a drop in the level of funding. If there hasn't been a drop in the level of funding but there have been cuts to counsellors' wages, doesn't that show an element of corporate greed on the side of MHS?

Dr Baxter : It would be the not-for-profits who are determining the wages of the trauma specialist counsellors, rather than MHS.

Senator SINGH: Are you aware of cuts to counselling wages?

Dr Baxter : I'm aware—only through submissions that have been made to this service—that there have been a number of different rates of pay offered under the various different panel partners. That is a matter for the panels to decide. But, no, I'm certainly not aware of any attempts to cut the wages. I would imagine that would relate to the more general wage levels that are offered by that service generally—for example, what the DVConnect service might offer to its other workers in Queensland. I would imagine that they're seeking to match that service level.

Senator SINGH: I want to take you back to the department's decision—I think it was late last year—to change the model.

Dr Baxter : To introduce the first-response model?

Senator SINGH: No, late last year, when there was obviously a change of model from what was in place—from the first-response model to the triage model—and subsequently changes of funding and delivery of service, to what we now have. Could you just take us back to what was the main decision around that change.

Dr Baxter : Can I just clarify that you are talking about the decision of MHS to put the subcontract out to tender for when it expired in June 2017? I don't think you're talking about the introduction of the first response. I'm just trying to clarify exactly which decision you're talking about.

Senator SINGH: The tender, I understand, happened in February, didn't it?

Dr Baxter : Yes, that's correct.

Senator SINGH: So I'm talking about the decision that led up to that, which I think was late in 2016.

CHAIR: In a similar way to the questions I asked MHS—and they were unable to provide any information about it at all—our understanding is that there'd been a negotiation between MHS and RDVSA about a continuing contractual arrangement, which would have looked quite similar to the previous arrangements that were in place between RDVSA and MHS for service delivery, and that those conversations were ongoing up until around November-December 2016, and then there was a period of little communication and then, in February, RDVSA were approached to participate in an expression of interest. If you dispute that timetable, you should tell us, but I'm interested in understanding—we all are—the department's role in that series of decisions.

Dr Baxter : We were aware that MHS had a contract with the subcontractor, RDVSA, through until June 2017 and that, after the introduction of the first-response model, we then had a new contract with MHS that provided for the provision of the first-response service within the 1800RESPECT service. I was not privy to the conversations that were going on between MHS and RDVSA at the time, but my understanding is that they were not what I would call contractual negotiations but a set of conversations, ongoing, between MHS and RDVSA about how that first-response model would be implemented for the remainder of their contract—the period from August 2016, when the first-response model was implemented, to June 2017, which would be the end of the RDVSA contract.

Our understanding of the conversations between MHS and RDVSA—and this is absolutely second-hand; I will put that rider on it—is that there were a number of conversations about how to implement the first-responder model. Some of those, we were involved in, because there was quite a bit of consternation at the time between MHS and RDVSA, and we did attempt to provide a departmental perspective. I think there were conversations about how to do that. They were proceeding in a particular way which I don't think was, from our understanding, very productive. I think there was then a change of management. It's been very hard for us to understand some of the management changes at RDVSA. There was a board; the CEO left, and there was a change in the board. I understand there were sweeping changes in the membership. The old board then came back again.

So our understanding of what happened during that period is that there were conversations going on that were not particularly receptive to the implementation of the first-response model. The then and again now CEO left, and there were more-productive conversations about how the implementation of that first response model would go. I understand that that board was then swept out. A new board came in, and, from what we were given to understand, the implementation of the first-response model again hit a bit of a slow patch, and we were seeking information at that time about how the implementation was going.

I can only give you our perspective, which is that there was a period where it seemed to take a while to implement, a period where that seemed to speed up for a while and a period where it again slowed down. Then in—let me give you the exact dates—

CHAIR: Dr Baxter, before you move on to this next description, I think what you are describing here is the period in 2016?

Dr Baxter : Post August 2016.

CHAIR: So from August 2016 to December 2016. What is the department's role in the negotiations that were taking place?

Dr Baxter : There were no contract negotiations at that time.

CHAIR: Okay. You've described them as a series of conversations.

Dr Baxter : Yes, that's right. So I would call it—

CHAIR: What is the department's role in that process?

Dr Baxter : Sure. I would call them 'implementation conversations'. MHS had a contract with RDVSA. They were required to deliver the first-response service, and there were ongoing conversations with RDVSA about how they could deliver that service, recognising that RDVSA delivered the trauma specialist back-end. As for our role, we tried to play a brokering role in helping to bring some of those conversations together. We had understood there was a stalemate on some issues, and so we were involved in those conversations. I would have to take on notice dates and exactly how many times we were involved in those conversations, but we did get involved in conversations around why the government had elected to implement a first-responder service and what it was seeking from it. Again, as I've described it all along, it was seeking to assure ourselves that the first-responder service would be able to be implemented in a way that increased service responsiveness and also ensured an ongoing degree of quality. That is how I would describe the role that we played.

CHAIR: And your evidence is that, in that window of time, a future contract was not under discussion, simply execution of the remaining obligations under the contract that expired in 2017?

Dr Baxter : I don't know. My view would be that there were not contract negotiations going on at that time, but I could not answer that. I wasn't privy to the discussions between MHS and RDVSA at that time. The discussions I was involved—

CHAIR: But someone in your organisation was.

Dr Baxter : No. The discussions that I was involved in were around the implementation of the first-response model, not contract negotiations. The contract negotiation piece that you initially asked me about, as you said, then happened in January-February, where the Commonwealth did have a role. Under our contract with MHS, should MHS elect to make any changes to the subcontracting arrangements, they are required to approach the department and seek the department's consent. That's when we became actively involved in that process.

Senator SINGH: Just going back to your activity before that contractual change, you said you played a brokering role and you outlined the stalemate, and I think you said proceedings were going in a certain way that was unproductive. So in that brokering role and in the decision to implement this new model, the first responder model, did you indicate to MHS or RDVSA that that implementation would be contingent on certain personnel staying or leaving?

Dr Baxter : No.

Senator SINGH: In any of your conversations?

Dr Baxter : No.

CHAIR: And you're speaking on behalf of the department?

Dr Baxter : Yes.

Senator SINGH: What form did this brokering role take—in person, by email, on the phone?

Dr Baxter : As I said, I would have to take on notice the exact form—when we had meetings, when we had telephone calls. Our interest in the service is exactly as it has always been, which is to ensure implementation proceeds in a way where they can get calls answered and a high-quality service delivered. That was the period when the first responder service was being implement. Our interest was in providing what support we could to ensure the first responder service was implemented well. You've asked me what I knew about any discussions between MHS and RDVSA at the time and I've tried to give you an impression of what we saw from our point of view. There did seem to be some bumps in the road with the implementation of the first responder service. There seemed to be periods where that engagement was more frequent and more free flowing, and there seemed to be periods where that was more difficult. At no point did we make any requirements in regard to your suggestion about personnel and how that should occur. But we did get involved in meetings where we talked about why the first responder service was being implemented and seeking to assure ourselves that those processes that were in place—particularly, as I have said before, about making sure that when a call gets answered it is appropriately directed to trauma specialist counselling—were robust and appropriate. That is the role we played.

Senator SINGH: Since there has been this new contractual arrangement has the department, in requesting information or various detail from MHS, been faced with a situation where MHS said they couldn't provide the department with something because it is commercial in confidence?

Dr Baxter : Not that I'm aware of. I would have to take that on notice.

Senator SINGH: Obviously we're talking about 1800RESPECT.

Dr Baxter : When you say 'the new contractual arrangements', are you talking about the implementation of the first response or are you talking about the much more recent new panel arrangements?

Senator SINGH: Either/or, to be honest. I'm interested in the fact that MHS is a privatised organisation today. We've been given some responses from MHS earlier today that they would have to check with certain things being potentially commercial in confidence—because they are obviously a private organisation. I'm interested to see whether the department has been hit with that same response.

Dr Baxter : I will take it on notice because I wouldn't want to mislead you if there have been times. I am not aware of any times that has happened—and I'm very closely involved in the direct implementation of the service. We receive very frequent information from MHS; we require a lot of information from them. I review it all personally. If I feel that it doesn't have enough of the information we need about a particular element of the service, we demand more. I think they would easily see us as their most demanding clients in terms of what we require and how often. At no point have I been told that I couldn't have that information. And it goes to both responsiveness—calls answered—and quality on a regular basis.

CHAIR: Thank you very much for appearing before the committee today. There may be some additional questions that senators have for you, and we look forward to receiving the information you can provide on the questions I asked on notice. The secretariat will be in touch about those questions. Thank you everybody for participating. Thank you to broadcasting and the secretariat.

Committee adjourned at 15:04