Social services

• This inquiry is about finding ways to put the people who use human services at the heart of service provision. This matters because everyone will use human services in their lifetime and change is needed to enable people to have a stronger voice in shaping the services they receive, and who provides them.
• In the study report for this inquiry, the Commission identified six services for which the introduction of greater user choice, competition and contestability would improve outcomes for the people who receive them. These services are: end-of-life care services; social housing; family and community services; services in remote Indigenous communities; patient choice over referred health services; and public dental services. This final inquiry report sets out tailored reforms for those six services. There is no one-size-fits-all competition solution.
• Users should have choice over the human services they access and who provides them, unless there are sound reasons otherwise. Choice empowers users of human services to have greater control over their lives and generates incentives for providers to be more responsive to their needs.
  • Competition and contestability are means to this end and should only be pursued when they improve the effectiveness of service provision.
• A stronger focus on users, better service planning and improved coordination across services and levels of government is needed. Governments should focus on the capabilities and attributes of service providers when designing service arrangements and selecting providers — not simply the form of an organisation.
• Each year, tens of thousands of people who are approaching the end of life are cared for and die in a place that does not fully reflect their choices or meet their needs. Reforms are needed to significantly expand community-based palliative care services and to improve the standard of end-of-life care in residential aged care facilities.
• The social housing system is broken. A single system of financial assistance that is portable across rental markets for private and social housing should be established. This would provide people with more choice over the home they live in and improve equity. Tenancy support services should also be portable across private and social housing.
• Family and community services are not effective at meeting the needs of people experiencing hardship. Practical changes to system planning, provider selection, and contract management would sharpen focus on improving outcomes for people who use these services.
• Current approaches to commissioning human services in remote Indigenous communities are not working. Governments should improve commissioning arrangements and should be more responsive to local needs. This would make services more effective and would lay the foundation for more place-based approaches in the future.
• Patients should have greater choice over which healthcare provider they go to when given a referral or diagnostic request by their general practitioner. A simple legislative change would help. More patient choice would empower patients to choose options that better match their preferences. Public information is needed to support choice and encourage self-improvement by providers.
• Public dental patients have little choice in who provides their care and most services are focused on urgent needs. Long-term reform is needed to introduce a consumer-directed care scheme. This would enhance patient choice and promote a greater focus on preventive care.

• Greater competition, contestability and informed user choice could improve outcomes in many, but not all, human services.
• The Commission has prioritised six areas where outcomes could be improved both for people who use human services, and the community as a whole. Reform could offer the greatest improvements in outcomes for people who use:
  • social housing
  • public hospitals
  • end-of-life care services
  • public dental services
  • services in remote Indigenous communities
  • government-commissioned family and community services.
• Well-designed reform, underpinned by strong government stewardship, could improve the quality of services, increase access to services, and help people have a greater say over the services they use and who provides them.
• Introducing greater competition, contestability and informed user choice can improve the effectiveness of human services.
  • Informed user choice puts users at the heart of service delivery and recognises that, in general, the service user is best placed to make decisions about the services that meet their needs and preferences.
  • Competition between service providers can drive innovation and create incentives for providers to be more responsive to the needs and preferences of users. Creating contestable arrangements amongst providers can achieve many of the benefits of effective competition.
  • For some services, and in some settings, direct government provision of services will be the best way to improve the wellbeing of individuals and families. The introduction of greater competition, contestability and choice does not preclude government provision of services.
• Access to high-quality human services, such as health and housing, underpins economic and social participation.
  • The enhanced equity and social cohesion this delivers improves community welfare.
• Government stewardship — the range of functions governments undertake that help to ensure service provision is effective at meeting its objectives — is critical.
  • Stewardship includes ensuring human services meet standards of quality, suitability and accessibility, giving people the support they need to make choices, ensuring that appropriate consumer safeguards are in place, and encouraging and adopting ongoing improvements to service provision.
• High-quality data are central to improving the effectiveness of human services.
  • User-oriented information allows people to make choices about the services they want and for providers to tailor their service offering to better meet users' needs.
  • Transparent use of data drives improvements in the performance of the system for the provision of human services and increases accountability to those who fund the services.

Developing social workers’ capacity and engagement in collaborative community-based innovations to climate-driven and other environmental hazards better ensures progress on the Grand Challenges. Such inclusive solutions value community leadership and are culturally responsive and justice-centered. Multisolving, pioneered by Dr. Elizabeth Sawin, offers a framework to pair social work goals from the Grand Challenges with climate-responsive interdisciplinary solutions by tackling multiple problems simultaneously with a single investment of resources. Exploring multisolving case studies that align closely with the Grand Challenge to create social responses to a changing environment, the authors consider collaborations and share experiences teaching courses and workshops that integrate multisolving into the social work curriculum and align with professional ethics to achieve these goals.