Radical reform for six human services


People on the social housing waiting list should get more say in where they end up living and patients needing an operation or dental work should be able to choose where they have it done and who performs it, says a Productivity Commission study backing an overhaul of a clutch of key human services.

The Commission is currently conducting a two-part inquiry looking at how to encourage greater competition and boost the involvement of private companies and not-for-profit organisations in the provision of some human services, while increasing choice for the people who use these services.

The first part of the inquiry is now complete with the release of the study report yesterday (Sunday), which outlines those services that the Commission believes would benefit most from the reforms while improving the outcomes for people who use them.

The service areas it has identified are: social housing; public hospitals; public dental services; end-of-life care; services to remote indigenous communities and family and community services commissioned by government.

The Commission is now moving into phase two of what it hopes will be the large-scale renewal of six major human services where it will make recommendations about reform in each of these service areas.

Notable highlights of the study include a summary of the state of social housing in Australia and some ideas about how to fix it.

The Commission says that about one-fifth of Australia’s social housing stock is in disrepair, many places are under-occupied with spare bedrooms, there are long waiting lists for properties and tenants have little choice about which house they take.

Government bodies manage four out of five social housing properties, not-for-profit community housing organisations manage the remainder. Limited data available also means the performance of service providers often goes unchecked.

The Commission suggests opening up the management of social housing to the non-government sector.

“Four out of five social housing properties are managed by government entities, yet there are a large number of housing providers — both not-for-profit and for-profit — that could perform this service.

“Community housing providers outperform public providers on some indicators, including tenant satisfaction and property maintenance.”

It said social housing tenants in other countries had more say in the kind of home they were allocated, difficult in Australia since a prospective tenant has two chances to accept a property before they are moved to the back of the queue.

Public hospitals is another area where patients should be given more flexibility and choice, says the study.

The Commission holds up the example of England, where patients referred to a specialist by their GP have a legal right to choose the hospital or clinic and consultant-led team that treats them. They can also access data, such as mortality rates by hospital or surgeon, to help guide their choice.

The study also suggests making service provision more contestable – where private providers compete to drive innovation and more responsive user outcomes – by inviting bids from non‑government providers to operate public dental clinics.

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