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17 Dec

Regional areas must insist on high quality careOpinion

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I read with dismay last week an opinion piece on these pages headed ‘Childcare policy failing regional ’.It was written by Eugenie Joseph from the Centre for Independent Studies. The article attacked the regulation of child care in regional areas. Ms Joseph argued that professional qualifications and pay rates make child care businesses in non-metropolitan areas non-viable, leaving working parents without access to these basic services. Better, said Ms Joseph, to deregulate the child care industry and allow the market to decide.

In other words, allow non-qualified people to deliver child care for lower wages. It’s the sort of free-market mantra that the CIS propagates from one sector to another. It’s snake oil stuff.

It is worth noting that the broader care industry is booming in the Hunter, with over 40,000 health and personal services workers, easily the region’s largest employment sector. The education and training sector, where child care is a part, employs a further 20,000 workers.

A worrying trend is emerging, however. Where these services’ workers are employed by a formal institution, like a school, a preschool, a hospital or a health clinic, it is highly likely they are professionally qualified. For example, teachers in the Hunter’s schools have university qualifications, just like teachers in schools in Parramatta and Bourke. Credentialling standards are the same whether the school is in Sydney or in regional NSW. The pattern for nurses is similar, with those employed in hospitals, city or country, more likely to hold higher education qualifications than those employed outside the hospital system.

The presence of quality trained staff is central to quality services irrespective of where you live. This is why training standards and staffing ratios are insisted on by trade unions and professional associations alike.Qualified staff with mandated staffing ratios guarantee high-quality services wherever you live. It’s sad the CIS opposes regulated standards. It’s ridiculous it sees no merit in country kids having access to qualified carers. Yet it is not just the ideological agenda of the CIS which threatens standards in human services. A new practice called personalisation is upon us and we need to be careful how it evolves.

Personalisation involves handing government money directly to individuals and households and letting them purchase the services they need. Personalisation is central to the National Disability Insurance Scheme. The NDIS moves control over disability services from managers in state-regulated institutions into the hands of disabled individuals and their carers. The ambition for the shift is to give the individual and the carer the main say in the delivery of services.

There are similar shifts to the personalisation of services in the My Aged Care program and in various health assistance packages.

Giving individuals and their carers control over spending on services has merit in the best of worlds. The personalisation of services means individuals and carers can tailor services to their needs, choose one provider over another, and maintain the dignity that comes from control over their lives.

The risk, however, is the threat to quality and safety standards especially in non-metropolitan areas where there is a limited pool of qualified carers to choose between. Moreover, away from the big smoke where trade unions, professional associations and the media are on the lookout for malpractice, there is a danger that corners will be cut and quality eroded, the wages of staff pared back by mean employers, and credentialling standards ignored.

A further complication with the personalisation of services in non-metropolitan areas is finding someone to intervene if there is a quality or safety issue. What do you do, ring a government call centre?

The CIS sees professional standards as impediments to free markets and is happy to see profit-making as the primary driver of human services provision. The rest of us see professional standards as the best way to ensure vulnerable people get the best care possible.

The quality of human services has always been central to regional prosperity in . Non-metropolitan regions need to insist on access to human services of the highest quality. We need to capture the best from the personalisation trend, but ward off the evils.

Phillip O’Neill is professor of economic geography at Western Sydney University.

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