A race to the bottom
Australians are increasingly concerned by the impact of privatisation on our most vulnerable citizens.
People with a profound disability, and those requiring hospitalisation, aged care, child care, and child protection, have suffered “significant harm” as a result of privatisation of public services, a national inquiry has found.
The report of the People’s Inquiry into Privatisation says communities across Australia “are feeling let down by privatisations that deliver worse and often more expensive services”.
Initiated by public sector unions including the NSWNMA, the inquiry heard from hundreds of affected people, including nurses, at public hearings in capital cities and regional centres.
The inquiry was held to determine the extent and effects of privatisation and to put forward alternatives that protect public services.
The report described the privatisation of public health care services as “a story of policy failure that successive governments seem keen to repeat, despite the evidence.”
“The intrusion of the profit motive inevitably produces a race to the bottom in service quality that is totally inappropriate to the provision of public health care,” it found.
It said submissions to the inquiry raised concerns about the potential damage to the nursing profession of continuing hospital privatisation.
Inquiry chairman David Hetherington, executive director of the progressive think-tank, Per Capita, said the inquiry broadly aimed to “begin a conversation about the issue of privatisation in all its forms … and build consensus around an alternative vision for our public services”.
The report said the inquiry’s three-member independent panel “was overwhelmed by the thoughtful and passionate response to the inquiry from the community. We received detailed analysis, based on extensive research and evidence, from individuals and organisations who gave us a clear – and alarming – picture of the impact of privatisation”.
“We also heard, in written contributions and in person, powerful and moving personal stories of the pain that privatisation has caused people in this country.”
Privatisation hurts people
It said community response showed that “privatisation is not an abstract policy issue – it is deeply personal to the families and communities who brought us stories of damage that privatisation has done”.
“The evidence that we received showed that privatisation has overall had a damaging effect on services and that these effects make a real difference to people’s lives.
“When privatisation goes wrong, it is not a mere matter of inconvenience – it hurts people in very specific ways.
“Despite the very direct and personal impact that privatisation has on people’s lives, decisions about privatisation have been taken out of the democratic realm, and the discussion about privatisation has become technocratic, inaccessible and opaque.
“There is a lack of democracy in the way decisions are made: there is a lack of meaningful consultation with stakeholders, decisions are made with reference to the financial impacts of privatisation more than the impact of the actual services that are delivered, and vital information about privatisation is unavailable to citizens because of ‘commercial in confidence’ provisions and other mechanisms that prevent scrutiny.”
The report said it was increasingly difficult for communities to hold someone accountable for the delivery of privatised services.
“There is a very basic need for people to know who to call when things go wrong, to get answers from someone in authority, to know what level of service they can expect and who to blame if services fail.
“All these things are harder when services are at arm’s length from government, when corporations are not held to the same standards of transparency as government bodies, and when government is vacating the regulatory and oversight space.”
The report said evidence presented to the inquiry clearly showed that privatisation did not lead to greater consumer choice and claimed financial benefits were often “mythical” too.
“There is therefore a clear demand to reverse or somehow address failed privatisations – to improve oversight, to restore services to public hands, to right the wrongs that these policies have inflicted.”
Failure across the board
NSWNMA General Secretary Brett Holmes said the union supported the privatisation inquiry because it believed public services and especially health services should be run for public good not private profit.
He said the inquiry was needed to start a campaign that would build consensus for a positive vision for improved health care and other public services.
The inquiry found that privatisation has failed in three areas of major concern to nurses and patients:
- limited government control over quality
- poor contracting management
- increased risk for the state following contract difficulties
- cost blow-outs
- decline in quality of services to the public
- reduction in care hours
- reduction of staffing and skill mix
- profit motive outweighing delivery of quality care
- erosion of pay and conditions for staff
- Loss of the right to choose services
- Loss of a public disability safety net for people with complex needs
- Fears of service cutbacks and deterioration of quality care
- Lack of accountability and ability for non-government providers to turn away high-needs clients
- Reduced pay and conditions for workers
- Privatisations are rushed and distressing for client.