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Dear Prime Minister, Premiers and Chief Ministers

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Dear Prime Minister, Premiers and Chief Ministers - 5 April 2017

Fix Fundraising – An Open Letter from 150 of Australia’s leading charities

5 April 2017

Dear Prime Minister, Premiers and Chief Ministers

Australia’s charity fundraising regulations are a mess. They’re out-of-date – they deal with wishing wells and the length of handles on collection boxes, but not with online fundraising, crowdfunding and websites.  Charities want to do the right thing, but it’s too complex, too confusing and it’s ineffective.

In economic terms alone this is a big issue: the charity sector employs over 1.1 million Australians generating over $134 billion in annual revenue, including more than $11 billion from individual giving.  The loss in productivity involved for the thousands of charities who try to meet the requirements of the seven different fundraising regimes amounts to tens of millions of dollars annually.

It is time to fix this.  It can be done, easily, at no cost.  Federal, State and Territory governments can provide charities with one nationally-consistent, modern and fit-for-purpose fundraising regime as part of the current review of the Australian Consumer Law. It can be clarified and amended to ensure charities (and those raising funds for them) are required to meet a clear set of donor-focused expectations and requirements in their fundraising activities.

For more than two decades, the sector has been asking governments to #fixfundraising.  There have been numerous independent inquiries all recommending change, yet still we are told this issue is not important enough.  It seems cutting red tape for business is essential, but cutting red tape for charities is not.

The charities of Australia support and enable so many aspects of our lives − education, the arts, health, housing, employment, recreation, social services, childcare, emergency services,  family support, justice systems, international development, the environment, religion and spirituality, animal welfare, and many other areas that are crucial to Australia’s productivity and well-being.  We need action now so our organisations, and the donors who support us, can operate under a 21st century, nationally-consistent and fit-for-purpose regulatory regime.

We call on your Governments to prioritise working together to fix this fundraising mess so we can get on with what we do best – building flourishing communities.

View Open Letter and Signatories.

View CCA Media Release.

Dear Prime Minister, Premiers and Chief Ministers Read More »

Victoria Takes a Lead in Fundraising Reform

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Victoria Takes a Lead in Fundraising Reform

In the coming months Australia’s charity sector has an opportunity to take a huge step forward in fundraising regulation reform, with Victoria leading the way, writes CCA CEO, David Crosbie in Pro Bono News.

Victoria Takes a Lead in Fundraising Reform, Pro Bono News, 16 March 2017

On Wednesday Victoria took a major step forward in supporting the #fixfundraising campaign. A court decision and an agenda-setting speech from a minister in the Victorian government have boosted the case for reform.

Most readers of Pro Bono News know that fundraising regulations in Australia are a classic example of ineffective regulation, duplication and red tape.The existing regime is grounded in an outmoded hangover of federalism requiring charities to comply with seven separate sets of administrative requirements. Perhaps just as importantly, fundraising regulations are rarely enforced and most of Australia’s 50,000-plus charities do not comply with all the requirements, even if they are engaged in fundraising.

For more than two decades charities have been seeking to make the system workable. Academics like Professor Myles McGregor Lowndes, not-for-profit law specialists and even the Productivity Commission have all pushed for reform.

Over the next month or so, the charity sector has an opportunity to take a huge step forward in fundraising regulation reform. The current review of Australian consumer law (ACL) is an important doorway to harmonisation. The ACL can easily be clarified and amended to ensure charities are required to meet a clear set of consumer-focused expectations and requirements in all their fundraising activities. We do not need seven sets of onerous and ineffective regulations.

CCA understands that the main barrier to achieving reform is not a lack of a policy solution or even state reluctance to let go of their regulatory role, the problem appears to be that key ministers and policy makers could not be bothered because it is not considered a significant issue.

It seems that while cutting red tape for business is essential, cutting red tape for charities is not.

When the Victorian Federal Court handed down a judgement on the fraudster Belle Gibson in a case brought by the Victorian Commissioner for Consumer Affairs, the decision highlighted how the existing consumer law can be applied to someone misleading people by saying they are providing money to a charitable purpose when they are not. This is an important judgement because it clearly demonstrates that the consumer law can be an effective way of addressing inappropriate fundraising practices. Breaching Victorian fundraising regulations was not at issue. Breaching consumer law was.

What made this action and decision in Victoria even more significant was the statement made by the Victorian Minister for Consumer Affairs Marlene Kairouz at an invitation only meeting of consumer affairs ministers and policy makers on the same day.

In part of her speech, she said: “The review of the Australian consumer law concludes next month when consumer affairs officials present their final report to all consumer affairs ministers for consideration.

“The review has drawn on a range of sources to build its evidence base and I know that many of you present today have contributed your knowledge and experience, whether that be in survey responses, face-to-face interviews, or formal submissions. Thank you for your input.

I’m also aware that among the issues you have championed is that of nationally consistent fundraising regulation – to both improve the clarity of the ACL’s application and to reduce regulatory burden.

“Research undertaken for the Australian Charities and Not-for-profits Commission in 2016 showed that state and territory regulation of charities (including fundraising regulation) imposed costs to registered charities of over $15 million per year.

“This is money wasted and just one reason why I support your calls to overhaul this aspect of the ACL. While I would hope that my colleagues in other jurisdictions are of a similar mind, the reality is that evolution for some looks akin to revolution for others and achieving a consistent view will be a challenge.

“Nonetheless, I will continue to advocate for national reform while taking appropriate action to remove red tape for charities and not for profits operating in Victoria.

“Legislation currently in the Parliament will enable me to exempt an incorporated association or a class of associations from annual financial reporting requirements where they are also registered with and reporting to another regulator.”

Clearly Victoria gets it. We know some other jurisdictions are now on the same page. But we still have quite a way to go to achieve the goal of harmonised fundraising grounded in the appropriate application of Australian consumer law combined with the registration role of the Australian

Charities and Not-for-profits Commission. The federal government is yet to offer support and at least two jurisdictions have adopted the “why bother” policy position.

CCA is a member of the #fixfundraising campaign and will be part of proposed activities over the coming months.

If we do not campaign and campaign hard on these issues, they will yet again slip off the policy agenda, and we in the charities sector will be left wringing our hands wondering why our concerns are not being taken seriously.

Well done Victoria and Minister Kairouz, for listening to the charities sector and responding.

I look forward to a vigorous campaign over the coming months to ensure the federal government and other jurisdictions get on board. I hope you will join us.

Victoria Takes a Lead in Fundraising Reform Read More »

Media Release: Please – get out of our way and let us do our work!

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Media Release: Please - get out of our way and let us do our work!

Charities across Australia are frustrated with governments not acting to remove red tape and duplication that is costing hundreds of millions of dollars a year in lost productivity. 

According to David Crosbie, CEO of the CCA, “Charities have had enough.  Governments talk about cutting red tape, but when it comes to freeing up charities to do their work, responsible Ministers fall into the arms of ill-informed bureaucratic advisers and wave more forms in our faces.

Fundraising regulations are a classic example of feral bureaucracy.  There is no point to the current dog’s breakfast of regulations.  They cost thousands of hours of staff time in wasted compliance activity.  There is an easy fix if all governments agreed to work with the information already collected by the Australian Charities and Not-for-profit Commission rather than duplicating and collecting their own.  For more than a decade governments have been saying they will fix it.  Time is up.”

Mr Crosbie indicated that CCA would be mounting a campaign to name and shame any Minister and senior bureaucrat that blocked the harmonization of fundraising regulations in Australia.

NB.  CCA is a signatory to the #fixfundraising campaign along with over 150 of Australia’s leading charities and professional bodies – see: http://www.justiceconnect.org.au/our-programs/not-for-profit-law/law-and-policy-reform/fundraising-reform/supporters-stories

This is a real case example of what a charity needs to do to become fundraising compliant:

 

ACT

NSW

SA

TAS

VIC

QLD

WA

Advertising requirements for a public notice

 

 

 

 

 

X

 

Amount intended to raise in jurisdiction

X

 

 

 

 

 

X

Appeal manager details

 

 

 

 

X

 

 

Auditors details

X

X

X

 

 

X

X

Bank account details

 

X

 

 

X

X

X

All Directors details (name, position and address)

 

 

X

 

X

X

 

All Directors signatures

 

 

 

 

X

 

 

Certified copies of supporting documents

 

 

 

 

 

X

X

Copies of supporting documents (not certified)

X

X

 

 

X

 

 

Covering letter

 

 

 

 

 

 

X

Dates required for the licence

 

 

 

X

 

 

 

Fundraising activities to be undertaken

X

 

X

 

 

 

X

Third party fundraising provider details

 

 

X

 

X

 

 

Police check

 

 

 

 

X

 

X

State address if fundraising in that state

 

X

 

 

X

 

 

Statement of purpose

 

 

X

X

X

X

X

Media Release: Please – get out of our way and let us do our work! Read More »

The Australia We Want for Christmas. December 2016

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The Australia We Want for Christmas. December 2016

On the first day of Christmas, my true love sent to me, the Australia we would like to see.

On the second day of Christmas, my true love sent to me, less kids in prison, in the Australia we would …  (just)

On the third day of Christmas, my true love sent to me, fairer income rates… (fair)

On the fourth day of Christmas, my true love sent to me, safer streets at night … (safe)

On the fifth day of Christmas, my true love sent to me, less suicides …  (inclusive)

On the sixth day of Christmas, my true love sent to me, housing for the poor … (equal opportunity)

On the seventh day of Christmas, my true love sent to me, more jobs for women ,,, (equal opportunity)

On the eighth day of Christmas, my true love sent to me, open government … (authentic)

On the ninth day of Christmas, my true love sent to me, increased arts all round … (creative)

On the tenth day of Christmas, my true love sent to me, less greenhouse gasses … (sustainable)

On the eleventh day of Christmas, my true love sent to me, new volunteers … (kind)

On the twelfth day of Christmas, my true love sent to me, more regular giving … (generous)

 

Time for a little fun and some serious reflections on our future with a CCA Christmas Carol for all Australians.

What happens when you bring more than 60 leaders from across the Australian charities and not-for-profit sector together to talk about their future, the future of their children and the future of their country?  Not only do they arrive at an agreed set of values and measures they believe are critical in achieving the kind of Australia they would like to live in (see report: https://www.communitycouncil.com.au/content/australia-we-want-first-report ), they also contribute to the writing and performing of a special Christmas carol!. 

In the words of CCA Chair, Rev Tim Costello, “Australians are much more than passengers in an economy.  We may be losing faith in our politicians, but that just makes our community, family and workplace connections, and the charities that support them, more important.  Christmas is a time of reflection for many of us, so we are offering a set of values and indicators we think are important for all of us in imagining and working towards the kind of Australia we would like to live in.”

David Crosbie, CEO of CCA, said “at the end of a very interesting year where public trust and personal values have assumed even more importance, reflecting on the kind of Australia we want to live in makes sense.  I am not so sure about the singing ability of staff within some CCA member organisations, but I would hope the attached Christmas Carol, sung by the digitally massed CCA choir, will provide a bit of fun (we had fun making it), and promote some discussion about how Australia is really doing beyond finances and budget measures.

CCA and our members wish all our communities a peaceful and fulfilling Christmas and New Year.

Sing along with the CCA massed choir singing the Australia we want version of the 12 days of Christmas. The original new words including indicators and values (in brackets) are below.

The Australia We Want for Christmas. December 2016 Read More »

Our Australia, Our Measures, Our Future

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Our Australia, Our Measures, Our Future

After the recent launch of the Australia We Want campaign the challenge now is to translate the national conversation into tangible actions to make Australia a better place, writes CEO of Community Council for Australia David Crosbie in Pro Bono Australia News.

Our Australia, Our Measures, Our Future, Pro Bono News, 7 November 2016

The launch of the first Australia We Want report last week attracted significant public attention and prompted many worthwhile discussions about where Australia is heading, including in Pro Bono Australia News.  

The concept of measuring our progress towards core community values clearly resonated with many. Tim Costello, Tabitha Lovett (Equity Trustees) and I conducted over 70 media interviews between us. The challenge now is to translate that interest into tangible actions to make Australia a better place.

One of the core principles that informed the AusWeWant approach is: what gets measured gets done.

The Community Council for Australia (CCA) has been concerned for some time that the most common forms of measurement around progress and success in Australia are grounded in an economic analysis. The implication is that if we are doing well economically, we will all be doing well in our own lives. The Australia We Want report provides a more inclusive set of measures that move beyond the economy to talk about the kinds of communities we are creating.

The tendency to focus on economic measures of progress is not restricted to business or government. It extends to many charities and not-for-profit organisations.  

While we may be charities and not for profits, this does not mean we are “for loss”. Most of us seek to generate strong income streams and make a surplus so we can not only do more, but also improve effectiveness through investment in organisational capacity – staff expertise, information systems, infrastructure etc.  

Building and maintaining capacity is important, particularly for medium and large charities and not-for-profit organisations. Boards, investors, staff and other stakeholders want to know the organisation is not losing money, is meeting good practice standards and is working towards having at least a small safety net of backup savings should income streams diminish significantly.

In most charities and not for profits, keeping the organisation sustainable is a significant pressure.  In practice, finding the money can easily become the primary focus. Sometimes we forget the other measures that matter such as how well we are achieving our purpose.

In many ways these organisations represent a microcosm of the broader national policy ecology.  Just as a cash strapped charity might not be in the position to make any investment in its future or to start up new programs and services that will better fulfill its purpose, a government committed to reducing the deficit faces similar challenges.

Whether you are a government or a charity it seems there are four core tasks:

  1. continue with policies, programs and services we know are effective and make a  difference
  2. let go of those activities that are ineffective or not making a difference
  3. innovate and respond to emerging challenges (digital, demographic, environmental etc.)
  4. have a vision for success and remain true to values and purpose.

Critical to each of these activities is knowledge about what is working and what is not. For most businesses the goals are clear – achieve better returns on the invested capital and provide good value to owners and investors. However, if your goal is not about financial performance, what is it about and how do you measure it?

Governments are increasingly asking themselves these questions about performance measures and reporting.They struggle to show how they make a difference, how they fulfill their purpose.  They have data to count outputs, measure compliance to contracts, model expenditure per activity, and in some cases, point to some economic outcomes. Governments are rich in evidence about activity, but poor in evidence about social outcomes.

Unfortunately, the same can be said about many charities. While evidence of activity abounds, evidence that organisations are achieving their purpose can be harder to find. And that is the challenge for the sector – how do we make a difference? What value do we bring to the table?  How do we contribute to building stronger communities? Beyond our economic indicators what are we measuring?

This is not just a question for impact investors, it is a question for all of us.

For me, this is the real strength of the Australia We Want’s first report. It provides some important touchstones, indicators of stronger communities reflecting the values that many of us in the community share.

Over the coming months CCA will be offering charities and not-for-profit organisations a chance to come together in leadership forums to share and plan for success around each of the measures in the Australia We Want first report.

A lot of the discussion around the Australia We Want last week was about the importance of moving beyond the economic prism and seeing Australia for what it is and where it is going.

As accelerating change steamrolls through an ever-larger charity and not-for-profit sector, it has never been more important to be able to demonstrate how the sector makes a positive difference – whether it be reducing crime, improving safety, reducing suicide or enabling kids to stay at school longer.

The Australia We Want is a report for all Australians. It is a reference point for a better Australia that is grounded in sector values. It speaks to the society we aspire to. CCA is working to ensure our next steps will progress a much-needed platform to promote the value of the sector and enhance our reputation for being at the heart of building stronger communities. Whether we can make that happen will be up to all of us.

Our Australia, Our Measures, Our Future Read More »

The Australia We Want – Launch at the National Press Club

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The Australia We Want - Launch at the National Press Club, 27 Oct 2016

The Australia We Want is the first ever benchmark of how Australia and each State and Territory is performing against values and goals prioritised by leaders from across the charities sector.

Launched at the National Press Club on 27 October 2016, The Australia We Want, First Report triggered high interest and discussion around Australia. 

Rev Tim Costello spoke to ‘Achieving the Australia We Want’ in the Press Club address, and the Report’s release and findings was covered by TV, major news, national and regional radio and online, including:

Guardian: Australia is no longer the home of the ‘fair go’ says report

Canberra Times: ACT ranked first in the Australia We Want report

News Limited:  Shocking statistics which reveal the truth about Australian life

Adelaide Advertiser: ‘We have to think about how we talk’

Pro Bono Australia: The Australia We Want is Going Backwards

Daily Telegraph: Where has all our kindness gone?

The Advertiser:  Where has all our kindness gone?

Sydney Morning Herald: Half of Australian women feel unsafe walking alone at night, report says

The Age: Half of Australian women feel unsafe walking alone at night, report says

The Australian: Welfare report card ‘wake up call for nation’

West Australian: Statistics paint a grim picture of WA life

The Saturday Paper: Fate of the nation

ABC News online: Australia falling behind in gender pay gap, women’s safety and incarceration rates, new report shows

SBS online: Tasmania, ACT best societies in Australia, report says

AMPAG News: Is this the Australia We Want?

ABC Radio National: Charity leaders describe ‘the Australia we want

Fran Kelly interviews Tim Costello

The Wire: A snapshot of the Australia we want

3AW: New report says Australians have become less generous when it comes to charity

6PR: We’re stingy and miserable?

Thoughts from leaders of today and tomorrow at the launch of the AusWeWant report:

Brett Williamson, CEO of Volunteering Australia

David Locke, Assistant Commissioner, ACNC

Members of the ACT Youth Coalition

Kate Seselja, Founder, The Hope Project

Michael Thorn, CEO, Foundation of Alcohol Education and Research (FARE)

Twitter reaction on the day:

The Australia We Want – Launch at the National Press Club Read More »

Australia – Beyond Imagining

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Australia - Beyond Imagining

The first Australia We Want report, to be released next week, will set some very import benchmarks towards measuring our progress, but with a challenge to move beyond imagining and start creating a better Australia, writes CEO of Community Council for Australia David Crosbie in Pro Bono News.

Australia – Beyond Imagining, Pro Bono News, 21 October 2016

“Imagine an Australia where incarceration rates are falling, where the suicide rate is less than the road toll, where women feel as safe as men?  Imagine an Australia where your postcode or cultural identity does not define your chance of getting an education or a job or living a long life? Imagine a humane and sustainable Australia, where people are more connected and engaged in the communities they live and work in, and where this involvement is reflected in the way we form policies and laws?  Imagine a generous and kind Australia where we take pride in supporting the less fortunate in our own communities, in our region and beyond?  Imagine the Australia we want?” -Rev Tim Costello speaking at the first AusWeWant roundtable held 18 months ago in Canberra.

Over a year ago the Community Council for Australia (CCA) brought together 60 leaders from across the charities sector, including many of the Pro Bono Australia Impact 25, in a roundtable to discuss the kind of Australia we want to achieve.

The ABC AM current affairs radio program introduced the news item about the AusWeWant roundtable in this way: “In Canberra today, a kind of council of war is being held as the charities sector lays out its claim for a greater voice in Australia’s future.”

Next week, on Thursday 27 October, CCA is launching the next step in moving beyond imagination to action. When Tim Costello speaks at the National Press Club, he will be issuing a challenge and an invitation for all of us to play our role in creating the kind of Australia we want our children to grow up in. 

Values like: just, fair, safe, inclusive, equality of opportunity, united, authentic, creative, confident, courageous, optimistic, generous, kind, and compassionate all need to be more than words we agree with. That is why CCA has worked hard, with the support of Equity Trustees and the Centre for Social Impact, to take the vision of Australia established in the AusWeWant roundtable and translate it into a report card of outcomes detailing how Australia and each state and territory is performing against these values we hold as important.  

The result is a fascinating snapshot of Australia today. Without wanting to reveal the content of the report, it clearly highlights how far we have to go in creating the Australia we want.

As an example of the report content and findings, it is interesting to consider the first indicator outlined in the report. At the AusWeWant roundtable, one of the priority goals was to achieve a “just” Australia. The agreed proxy measure for “just” was adult incarceration rates. In the AusWeWant report to be released next week, the incarceration rates reveal a divided Australia.

The rate at which we imprison members of our own community is a complex measure that reflects partially on levels of crime and enforcement, attitudes to punishment and rehabilitation, court and justice systems, and adequacy of support for those most vulnerable. Prison can be the last resort for drug users, those in extreme poverty, the homeless, those who cannot participate in community. Indigenous people, those with poor literacy, those from lower-socioeconomic families, people with disability and people with mental health issues all are grossly overrepresented in the Australian prison population (AIHW 2015). Men are 12 times more likely to be in prison. It is important to note that less than 25 per cent of our prison population are there because of acts of violence against others.            

The number of prisoners in Australia rose by 7 per cent in 2015. The rate of imprisonment grew by 6 per cent. Our rate of incarceration is 196 per 100,000, higher than any country in Western Europe, more than double Scandinavian countries, and significantly higher than comparable countries such as Canada. (The US is a real outlier amongst OECD countries with a staggering imprisonment rate of over 700 per 100,000).

Key issues of concern arising from our incarceration rates include:

  • the number of unsentenced prisoners in custody grew by over 20 per cent to 9,898, many waiting months to obtain their sentence
  • the incarceration rate of adult Indigenous people is now 2,253 per 100,000, which is more than 15 times the imprisonment rate of non-Indigenous Australians;
  • less than 20 per cent of adult prisoners have achieved year 12 education
  • one in three adult prisoners have a disability or long term chronic health condition.

The Northern Territory imprisons its adult population at a rate that is that is almost beyond comparison.Their current incarceration rate of 885 per 100,000 is more than quadruple the national average, higher than the United States. Adults are around 20 times more likely to be in prison in the Northern Territory than they are in Ireland.

Part of the explanation for this massive policy failure in the Northern Territory is the level of Indigenous incarceration. High levels of Indigenous imprisonment are further exacerbated by low levels of educational attainment, levels of drunkenness, untreated mental illness and chronic health conditions within some population groups.

Western Australia is the poorest performing state with an imprisonment rate double the national average. It seems despite being a rich state that has ridden its natural wealth through the mining boom, many people in Western Australia do not get to share in the spoils.

Incarceration rates are not part of some pre-ordained natural order.They reflect decisions we have all made. 

The AusWeWant report outlines indicators for each of the 14 values. They include distribution of income, suicide rates, greenhouse gas emissions, access to housing and employment, perceptions of feeling safe, levels of giving and volunteering, government transparency. All the findings are interesting but, more importantly, all make the case for our sector to play a greater role.

The first AusWeWant report has set some very import benchmarks, starting points from where we can measure our progress towards achieving the Australia we want. Our challenge is to move beyond imagining and start creating a better Australia.

Imagine a “just” Australia where incarceration rates are falling. What is your role?

Tickets are available to the National Press Club launch of AusWeWant with Tim Costello and David Crosbie here.

 
 

Australia – Beyond Imagining Read More »

The politics of competition

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The politics of competition

The recent Productivity Commission preliminary findings report into Competition in the Human Services makes for very interesting reading for the Not for Profit sector writes, David Crosbie, CEO of Community Council for Australia in Pro Bono News

The politics of competition, Pro Bono News, 6 October 2016

The release of the recent Productivity Commission Preliminary Findings Report into Competition in the Human Services makes for very interesting reading.  It raises fundamental questions about what competition, contestability and user choice actually mean in Human Services.  Perhaps just as importantly, it highlights the role of politics in these discussions.

To clarify the three terms:

Competition involves government and/or non‑government providers of a service (or substitute services) striving against one another to attract service users. If competition is effective, service providers will attempt to attract users by reducing the price they charge, improving the quality of their service, offering new and innovative services, or otherwise tailoring their services to better meet the needs of users.

Contestable markets are those where there are no substantial barriers preventing a provider that is not currently supplying services to users from doing so now or in the future. Contestability in human services refers to a provider of human services, or the management team of that provider, facing a credible threat of replacement if they underperform. This could include the threat of replacing the management of a public provider with another public management team

Informed user choice models empower consumers of human services to be actively involved in decisions about the services they use. There are many types of user choice. Users can directly make decisions about the services that they receive …. The user’s choice may be assisted or facilitated through an agent or intermediary who is tasked with implementing the user’s preferences.

(Productivity Commission Preliminary Findings Report: Human Services – Identifying Sectors For Reform Pg. 36)

I am not an economist and I struggle with the notion of applying the concepts of competition, contestability and user choice in what I see as distorted markets.  Most commercial markets operate on the principle of competing to provide what the customer wants to buy.  The prize is profit.  I can choose which car I buy and where I buy it, and they get my money/investment.  This kind of open commercial market seems a long way from the typical human service provision.

In areas like health, it seems to me the provider has a much greater say in what options are available.  Providers often compete in service provision, but their competition is to attract the main customer, the government.  Providers compete to have governments fund their services or (in the case of many professional groups) to obtain higher fees for their programs and services. 

The Productivity Commission suggests:

Competition and user choice are already common across a range of human services including general practitioners (GPs) and private dental services, and childcare centres.

(Productivity Commission Preliminary Findings Report: Human Services – Identifying Sectors For Reform Pg. 7)

I am a male, over 50 years of age.  I try not to go to the doctor because I know if I see a doctor, I will be asked to make several more appointments for various tests and screens.  None of these additional appointments will be done on the doctor’s premises or at the same time.  Most of the additional appointments will require me to make another doctor’s appointment to get my results, which may then lead to further specialist appointments and trips to the pharmacy, all again in other locations.

Like many of you reading this article, I am very time poor.  My health is passable, my fitness OK, so I wait for either a health breakdown (touch wood I stay healthy) or a break in my schedule to enable me to devote a few days of appointments to my preventative health, which never quite seems to happen.

The primary health care product or service I want and need is not available, and I am a well-informed consumer who can afford to pay.  I cannot go to a primary care service and in one day see a doctor, have my tests and screens, buy whatever prescriptions are needed, all at the one premise or in just one or two visits.  My one visit to the doctor will almost certainly require at least three new appointments at different premises for different purposes (tests, screening, medications, results, etc.).

The lack of an effective primary health care service is not a reflection of low demand.  The reason primary health care is not responsive to the needs of many consumers is because it does not suit the providers who fight to maintain their income by separating out their specialist service into a sub-market, restrict its supply, and operate what could only be described as mini cartels to exploit governments and consumers.  How else do you describe the $4 billion a year payment the government gives a select group of pharmacy owners (on top of Medicare etc.) in a secret agreement (even the government cannot identify what owners receive what payments) that also restricts who can own or operate a pharmacy and where they can operate?

When you look through the almost 300 submissions to the Productivity Commission Inquiry into Human Services (see: http://www.pc.gov.au/inquiries/current/human-services/identifying-reform/submissions ), there are more from health professionals and their unions than any other groups.  What most of these submissions seek to do is maintain the status quo – protect their exclusivity and relatively high incomes.

The Royal Australian College of General Practitioners provided a submission arguing in part that:

Further, change to funding approaches have the potential to disrupt effective service models and systems to the community’s detriment….  It is important to note that it is difficult for consumers to make a genuinely informed choice regarding healthcare services beyond the measures of out-of-pocket cost and access.

Not all GPs are focused on consumer health, well-being, or choice.  There is no clear data about the effectiveness of GP services, let alone outcome data about how much more or less healthy we are for receiving a service.

The RACGP submission is arguing that GPs must continue to be allowed to charge the government to see whoever they like for whatever they like from their ‘stand and deliver‘, ‘take it or leave it’ service model. 

Most importantly, we should never ask a consumer what their health needs might be because that is a very difficult area and they wouldn’t know except for prices (and even then …).

The reality is that very powerful anti-competitive cartels operate across our health system.  They have one real purpose – protect and increase incomes.  It is not just GPs or specialists. 

Pharmacies make significant profits selling completely useless snake oil products that cash in on poor health literacy and high marketing budgets (how many ‘fat blaster’ type products do you need on one shelf?). They also have the audacity to continually seek to extend their role as primary health care providers while maintaining their monopoly and secrecy.  If the provision of pharmacy services is really important to our health and well-being why can’t we have fully trained and licensed pharmacists in our major supermarkets (as in New Zealand where the cost of medicines is considerably lower and access much better) or in our doctor’s surgeries?

So why are pharmacies not on the list of human services the Productivity Commission believes would benefit from competition?

The simple answer is politics.  The Pharmacy Guild is one of the most powerful political lobby groups in Australia.  The AMA is not that far behind.    

Like the Pharmacy Guild, the various colleges of medical specialists operate some of the most effective business cartels in the world – restricting how many places and controlling who can enter (tough for women or overseas trained specialists) while inflating their fees and charges to ensure massive incomes.

As reported in ProBono Australia News two weeks ago (https://probonoaustralia.com.au/news/2016/09/report-points-six-areas-competition-reform-human-services/ ), the Productivity Commission has decided we could do with more competition in six areas:

·        social housing

·        public hospital services

·        specialist palliative care

·        public dental services

·        human services in remote Indigenous communities

·        grant-based family and community services.

Contrary to some reports, CCA is not opposed to all competition or consumer choice and will be seeking guidance from its members in relation to these recommendations. 

The CCA submission in response to the PC preliminary report will also be asking for a more detailed rationale as to why the most obvious cases where competition has been shown to deliver better outcomes, like pharmacy services, do not even rate a mention in this report.

 
 

The politics of competition Read More »

Disruptor or disrupted?

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Disruptor or disrupted?

Not for Profits that invest in the quality of their interactions within both their existing communities and their potential communities, have little to fear from disruption, CEO of Community Council for Australia, David Crosbie writes in Pro Bono News.

Disruptor or disrupted? Pro Bono News, 13 September 2016

Most of the charities and not-for-profits I have spent time with commenced their lives as disruptors.  They were driven by a need to change the current state of things, to offer support where none existed, to create opportunity, extend and innovate beyond what was possible.

For this reason, I am always interested when I read or hear about the not-for-profit sector being disrupted.  What does that mean?

When I use the term disruption, I am talking about what I think is seen as the classic form of innovative disruption.  This definition is fundamentally about cheaper and sometimes inferior products coming into a market, or in the case of charities and not-for-profits, into communities.  The disruptors capture a small part of the market and then build both quality and market share over a period of time.  There are also emerging theories about almost instant disruption occurring overnight when cheaper and superior alternatives to existing products or services explode onto the market.

Most financially significant charities and not-for-profits started small, offering something different, pushing for change that would benefit the community.  Over time, they developed specialist knowledge and skills which enabled a growth in the organisation.  Their share of their market grew from a small base to a larger base as the range and extent of activities and services increased.  They disrupted what existed and grew as a consequence.

For many of these successful organisations, there are new challenge.  Their specialist activities are being replicated by other organisations, sometimes cheaper and more efficiently, not always with the same quality.  There are new technologies that appear to offer cheaper solutions to some of their activities and competitors with scale and efficiencies.  They are increasingly at risk of being disrupted.

The bad news is that the level of disruption is not only increasing, but the rate of disruption is speeding up with digital innovation, scale, globalisation and other factors all driving accelerating change.

It seems that in the not too distant future, many of our call-centers may be replaced by avatars who can not only be customized to our needs (language, appearance, tone, etc.), but also have a complete knowledge of our transactional history, what options are available to us, and the capacity to listen, process and empathise without judging us.

Experiences in the US, China and other countries with prototypes like ‘IBM Watson’ are highlighting the scope for artificial intelligence to improve effectiveness in areas like medical diagnosis.  Watson is able to almost instantly cognitively process massive amounts of individual and collective information.  Diagnostic accuracy is greater than with human doctors for some diseases.  Marry this information processing ability with the more futuristic gaming and computer created characters that interact with you as a unique user, and the disruptive potential is enormous.  IBM is just one of the big players in this space – Google, Microsoft and others have artificial intelligence prototypes being tested.

The good news is that while this seems like scary stuff, it has the potential to improve human interaction and create new ways of relating across our communities.  IBM Watson cannot replace a doctor, but it can work with a doctor to improve their practice.  It can also learn from every interaction, operate in a cloud, 24 hours a day, across any almost any distance, making some health and diagnostic services much more accessible.

The challenge for the not-for-profit sector is to consider what role we will play as technological and other disruptors enter our areas of activity.  Striving to keep things the same is probably not going to work, but what do we offer?  Very few, if any, not-for-profits have the capacity or the resources to develop and refine cutting edge technological solutions to the issues they address.  Some organisations have tried to invest in this space, but it is almost impossible to stay ahead of the technological innovation curve if that is not the core focus.

What is now emerging as one of the most critical elements to successful implementation of artificial intelligence is not just the technological capacity, but the quality of the relationships it enables, or the user experience.  This sounds very familiar to me.  For some time, leaders in the not-for-profit sector have been saying how important it is to be able to demonstrate the quality of engagement with their communities, the capacity to establish and maintain trust building interactions.  These critical interactions enable change to occur, even when they are framed within transactional activities.  In other words, values and relationships are critical to success.  

Not-for-profits that invest in the quality of their interactions within both their existing communities, and their potential communities, have little to fear from disruption.  They are the advocates and the enablers of change.  As organisations, they will be able to use emerging technologies to show how they can and do make a difference.  While the methods for communicating and interacting may constantly evolve along with changing roles of governments and varying income streams, it is strong and meaningful community engagement that is most valued.

When I talk with Boards and CEOs, I usually ask about their vision, their measures of success.  Sometimes the first response is about success being measured by income levels, or size, or continuing the services they run.  More often the response I get is about making things better for a particular community and a commitment that only when the community they serve is stronger and has greater opportunities, will they be successful.  What makes an organisation strong is being able to show how they establish and maintain relationships that enable real and sustainable change to occur.

The not-for-profit sector are disruptors, at least to the extent that they are focused on their role in building flourishing communities.  For as long as this is the primary driving focus, they will continue to change and evolve as disruptors rather than being the disrupted, regardless of their size and the diversity of their activities.

 
 

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Media Release: Charities Commission will continue – a welcome announcement for all Australians

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Media Release: Charities Commission will continue – a welcome announcement for all Australians

Tim Costello (CCA Chair) and David Crosbie (CCA CEO) have joined many across the charities sector in welcoming today’s announcement from Ministers Porter and O’Dwyer that the government will support the continuation of the Australian Charities and Not-for-profit Commission (ACNC).  Previously the government has said it would disband the ACNC.

Tim Costello, Chair of CCA and CEO of World Vision said, ‘this is a very pleasing announcement.  The lack of certainty about the future of the ACNC has been a major issue within the sector and across governments.  The ACNC and the charities sector will now be able to better plan for their future and devote more time and energy to doing what they do well, serving our communities.’

Cassandra Goldie, ACOSS CEO said, ‘community sector organisations have been asking for this announcement now for several years.  It is encouraging that the Turnbull government is listening and have reacted to what the sector has been saying.  This decision will benefit all Australian communities through a better regulated and supported charities sector.’

CEO of Philanthropy Australia, Sarah Davies, said that this is a fantastic decision, ‘we commend the Australian Government for the way it has listened to sector voices on this issue, and also acknowledge the important role that the Prime Minister’s Community Business Partnership played in securing this outcome.  A well-regulated charities sector is important for funders as well as the wider community, and the ACNC has been working hard to deliver on that objective. We also need better data about philanthropy as well as charities more broadly, and the ACNC is the way were going to get that so it’s great that it’s here to stay.’

David Crosbie said ‘this announcement is about the voice of the charities sector growing louder in recent years, and the government is starting to listen.  Ministers Porter, Morrison and O’Dwyer are to be commended for responding to sector concerns and supporting this change in government policy.  The ACNC can now get on with better serving the charities sector and the community through its invaluable work; registering and maintaining a national listing of Australian charities, cutting red tape, investigating rogue charities, and ensuring charities can fulfill their purpose.’

Marc Purcell, CEO of the Australian Council for International Development, the peak body for Australia’s international aid agencies said; ‘we welcome the Government’s announcement. It is in the public interest to have a national regulator oversighting the integrity of charities. Secondly it is in the interests of charities to have a dedicated authority supporting the effectiveness of their work to benefit communities.’

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