Friday, August 19, 2011

Here is what happens when the profit motive drives the delivery of human services

photo courtesy of Sydney Morning Herald

The dangers involved in allowing the the for-profit private and corporate sector to deliver human services to vulnerable people are once again evident in a report More than board and lodging: the need for boarding house reform by the NSW Ombudsman into licensed for- profit boarding houses in NSW.  The Report documents what happens when the profit motive becomes the main driver of the delivery of human services and Governments and the not for profit sector hand over responsibility for service delivery to the private sector..

In NSW boarding houses are run as for- profit private businesses to provide accommodation to people with disabilities, people with alcohol and drug problems. and mental illness. Residents are usually reliant on income support and pay between 75-100% of their benefits to the boarding house for accommodation and consumables

 The Report documents shocking levels of abuse, sexual assault and mistreatment of residents by staff and other residents. The Report demonstrates the complete failure of the Government's licensing and regulation of for- profit and corporate providers.

The Ombudsman's investigation  found that residents have been physically and sexually assaulted by staff and other residents, have died in appalling circumstances, and been denied basic rights, including contact with their families. This is the fourth report in less than 10 years on the failure of the state and the for profit providers to protect boarding house residents, in particular those with psychological and intellectual disabilities.

 Adele Horin's report in the Sydney Morning Herald  describes the conditions:
An estimated 455 private boarding houses operate in NSW with more than 5000 residents, most of them poor and vulnerable. They pay the proprietor 75 per cent to 100 per cent of their pension. Thirty-one of the boarding houses are licensed by the government to accommodate 687 residents with mental illness and/or intellectual disabilities. They must comply with conditions set out in legislation.
The report, More than board and lodging: the need for boarding house reform, shows the level of care for boarding house residents is inferior to that received by people with similar conditions in housing run or funded by the government.
For example, in 2008, a resident was found 12 hours after he had died in a room strewn with faeces and toilet paper. Three months earlier, hospital staff had raised concerns about his hygiene and nutrition. Around the time of his death, the department had assured the Ombudsman of its initiatives to improve monitoring and compliance at the boarding house. The boarding house eventually closed due to ''unrelated factors''.
Another case involved two residents aged over 80 with schizophrenia, who lived in a licensed boarding house despite having been assessed as needing nursing home care.
Jan Daisley, president of People with Disability Australia, said: "It is abhorrent that people with disability are left to deteriorate and die in these places while all along paying up to 100 per cent of their income to live in this form of housing''.
The Ombudsman, Bruce Barbour, noted the good work of some proprietors but said resident welfare should not depend on the ''goodwill and favour of individual proprietors.''

 Dr Gabrielle Drake, a researcher and lecturer from the UWS School of Social Sciences who completed a PhD study in 2010 on the deinstitutionalisation of boarding houses for people with mental illness and disability. has long called for the closure of the boarding houses.
Dr Drake says many of the current licensed boarding houses came about as a part of the poorly resourced and poorly coordinated deinstitutionalisation process.
"The result of this process is that people use the majority of their pension to live in boarding houses which are located in the community, yet they still have restricted access to that community and are still denied their right to self-determination," says Dr Drake.
"These homes are effectively still institutions, where the residents must conform to structured meal times, closed kitchens, and a lack of coordinated health care and planning. Too many also experience abuse, sexual assault, fear and intimidation."
Dr Drake says licensed boarding houses are an archaic approach to service provision for people with a mental illness and disability.
"The Ombudsman's Report clearly indicates that the NSW Department of Ageing, Disability and Home Care's (ADHC) procedure for monitoring the conditions in boarding houses has been unacceptable," she says.
"While I support legislative reform and the need for a cross-agency and partnership approach, at the heart of this debate needs to be the realisation that people with disability have the right to live and participate in the community in non-congregate accommodation."

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