In October 1996, on her 76th Birthday, a relative of mine was finally granted permission from the Queensland Health Department’s Aged Care Assessment Team (ACAT) to enter a nursing home.
Long suffering from dementia (presumed Alzheimer’s) and incontinence, she had earlier been ejected from an aged care hostel after two years, on the grounds that she was now in a high need category requiring nursing home care. In the absence of a nursing home entry permit from ACAT, or a vacancy, she was returned to the care of her family, who found the necessary 24-hour physical support care impossible to sustain after 4 long months of domestic hell. She was then placed in a public hospital mixed general ward to await a nursing home vacancy.
In 1996, the age pension was still administered by the Department of Social Security (DSS). Social workers were available to visit aged folk, especially those suffering from illness or disability, to ensure needs and records were properly attended to. My review of the relevant DSS correspondence between my relative and her carer during that initial period indicated a DSS helpfulness and factual recording accuracy, with a notable absence of threats about non-compliance with requirements, no threats of the stopping of her pension and so forth. There was even a caring and personalised letter expressing the department’s sympathy on the death of my relative’s husband in 1997. The husband was by then in the same nursing home.
It is a coincidence that my relative entered a nursing home at around this time in 1996 when John Howard became Prime Minister. It is no coincidence that on July 1, 1997 Centrelink commenced as the statutory authority charged with delivering the Commonwealth’s social security welfare payments. Mutual Obligation policy, requiring compulsory activity such as “work for the dole” and responding to communications was introduced through Centrelink in 1997, with severe breach penalties for non-compliance. Initially the breaches were mainly directed at young unemployed people. Howard justified the policy noting “it is the case that - to the extent that it is within their capacity to do so - those in receipt of such [welfare] assistance should give something back to society in return …” (Howard, 1999).
In recent years under Howard, this obligation concept, fuelled by Liberal economic fundamentalism, has spread throughout Centrelink’s two main categories of income support, pensions and benefits (allowances). Beyond penalising unemployed people excessively through breach penalties or allowance reductions (Schooneveldt, 2004), disability pensioners with an ability to work 15 hours a week are to be placed on Newstart allowance for obligatory job search or training at a reduced benefit rate. Single parent allowance recipients will be obliged to seek work under Newstart when their children reach specific ages and are at school.
Howard has begun exhorting the elderly to work beyond retirement age and accept casual work including demotion, in order to fulfil their obligation to boost the work force (Dennis Peters, The Courier-Mail, February 21, 2006). Once ready for the nursing home or hostel, most elderly people are now obliged to pay a significant entry bond (Residential Aged Care, 2006).This often requires the sale of their only major asset, the family home, to raise the money for the bond.
The advent of Centrelink has evidenced a new style bureaucracy, that refers to their clients as customers, but Centrelink’s customer service increasingly takes the form of a coercive, bullying and insensitive process that begrudges the rightful payment of entitlements to citizens (Schooneveldt, 2004).
I have kept a file of the nearly nine years of correspondence between Centrelink and my relative, who is now demented beyond communication, lying in a fetal position in her bed. I note the tone of the communications deteriorating in parallel with her deterioration and the heightened shrewish attitude of Centrelink.
Over time, Centrelink was persuaded to write to my relative’s official carer, at the carer’s home address, rather than to the demented relative. This eventuated, but the spelling of names, addresses, nursing home details and the “customer’s" details became more and more unintelligible. Written attempts by the carer in 2000, 2003 and 2005 to correct the misinformation was not acted upon by Centrelink, whose responses were becoming increasingly strident and coercive. A 2006 effort for correction has so far gone unanswered.
By 2003 the language had changed from “you should” to “you must” … “the authority to request this information is contained in social security law … return … within 21 days…” “If you do not reply to this letter within 21 days your payments may be stopped”. Payments were never stopped, but it was obvious that the people and the computers at Centrelink were not on top of this case.
By 2006, Centrelink had again inexplicably changed the name of my relative’s carer to a new and more unintelligible form with an incorrect address. Centrelink then wrote to my relative directly, but at a wrongly named nursing home. They informed my relative that “your correspondence nominee [very incorrect name] may have moved and not informed Centrelink.” The carer, of course, has had the same name and address for the whole nine years under discussion.
Given Centrelink is aware of the nursing home, the dementia, and that my relative’s file has a fully documented Enduring Power of Attorney for her carer, it is extraordinary that Centrelink’s letter of February 15, 2006 would continue: