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Family is culture legislative review discussion paper

Health justice partnerships as a non-legislative measure to improve early support to children and their families

This submission focuses on the question in the Discussion Paper about how the NSW Government can improve early support services to children and their families, as part of the broader context of the
legislative reforms arising from the Family is Culture review.

Health Justice Australia welcomes the NSW Government’s interest in improving early support as part of responding to children’s care and protection issues. As a centre of excellence supporting the effectiveness and expansion of health justice partnership, Health Justice Australia encourages the NSW Government to explore the practice and potential of health justice partnership as part of the early support service system.

Health justice partnership is an integrated service response bringing legal assistance into the healthcare teams and settings that people know and trust. Health justice partnerships provide multi-disciplinary responses to the multiple, intersecting health legal and social needs that are experienced by families. These partnerships demonstrate how health, legal and community services can work better together around the needs of children and families coming into contact with the child protection system.

While the question in the Discussion Paper, and the work of health justice partnership, extends beyond the original focus on Aboriginal and Torres Strait Islander children in the Family is Culture review, health justice partnerships can play an important role in improving early support for Aboriginal and Torres Strait Islander children and their families. Currently, 20 of the 109 health justice partnerships in Australia involve Aboriginal Community Controlled Health Organisations, and other health justice partnerships also serve many Aboriginal and Torres Strait Islander people (as evidenced in the case examples below). The role of health justice partnerships in addressing the complex needs of Aboriginal and Torres Strait Islander children and families is also reflected in our submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, which was based on consultations with Aboriginal and Torres Strait Islander-led health justice partnerships.(1)

Health justice partnerships are already responding to care and protection issues, but are not funded for this work

Our 2019 census of the health justice partnership landscape showed that care and protection was one of the most common legal issues for 31% of health justice partnerships surveyed. (2) This was especially common in health justice partnerships targeting family and domestic violence, which make up nearly half (48%) of the 109 health justice services in Australia. Another 26% of services target those experiencing mental ill-health or those dealing with alcohol or addiction, another context in which children’s care and protection issues are likely to arise.3 Yet, to our knowledge, these partnerships are not being specifically funded for their work in care and protection work. (4)

The benefits of health justice partnership as a form of early support In October 2021, we convened a roundtable of health, legal assistance and other practitioners that explored frontline perspectives on how children’s care and protection work occurs in health justice partnership and invited perspectives on the gaps and the opportunities for health justice partnership as a strategy to improve child care and protection outcomes. Participants included practitioners from specialist and generalist community legal centres, social services and Aboriginal community-controlled organisations.

Practitioners in that roundtable highlighted the following benefits of health justice partnership:

  • Alternative pathways: health justice partnerships can support alternative pathways for children and families seeking long term solutions towards care and wellbeing outcomes
  • Voice of the child: health justice partnership offers an opportunity to consider multiple pathways and multiple perspectives, including specialised child focussed support, that can help bring the best interests of the child into focus
  • Timeliness of intervention: health justice partnerships can address concerns from or about families in a more timely way, when they are easier to address
  • Shifting mindsets: practitioners in health justice partnerships bring their different lenses to a shared objective in terms of keeping children safe and addressing someone’s multiple and intersecting health and legal needs
  • Responding in holistic and integrated ways: health justice partnerships can work to improve the
    accessibility of services and systems like crisis or long-term housing, alcohol and other drug treatments or mental health support, but there are challenges in the availability and resourcing of such services
  • Trust and safety: Health justice partnerships can provide alternative pathways to legal help for people who may be unwilling to directly engage with a healthcare or legal assistance service, especially where people (including First Nations people) have experienced barriers to receiving help, such as institutional racism in service settings, or they have had previous interaction with the child care and protection system.

There is evidence that health justice partnerships can and have changed outcomes for children and their families

Evaluations of health justice partnerships indicate they provide early support by:

  • preparing clients for interactions with child protection
  • providing appropriate and timely information to clients
  • providing information that helped clients participate in planning and decision-making and helped them to navigate the options available to them
  • advocating with other services and systems
  • holding services accountable for their decisions
  • helping them secure housing or other services that improves their ability to protect their children

The evaluations include case studies demonstrating how health justice partnerships can and have changed the outcomes of children and families interacting with the child care and protection system. For example, Redfern Legal Centre, which operates a partnership with the Royal Prince Alfred Hospital that commonly addresses children’s care and protection, has provided us with examples such as:

  • The solicitor doggedly advocating for months of an appropriate public housing transfer to enable the return home of the daughter of a young Aboriginal woman and her partner who had both courageously addressed their personal issues, including a long-history of drug misuse
  • The solicitor representing an Aboriginal grandmother in care proceedings that restored her authorisation to care for her two young grandchildren from a non-Aboriginal family on a short-term basis
  • Aiding an Aboriginal first-time mum, before the birth of her baby, to negotiate and agree temporary care arrangements and ensuring wraparound support to enable her to return home with her baby
  • Assisting a client with lodging a successful complaint with the NSW Ombudsman about a case in which children were immediately removed from the client because of a mark on the child’s leg, even though police intervention formed the view that the mark was likely to have been caused by another child in the child care centre

We invite the NSW Government to discuss further with us the practice and potential of health justice partnerships as part of the early supports available to children and families, and how these can be strengthened through policy and funding support.

1 Health Justice Australia, Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (4 November 2020) .

2 Health Justice Australia, Joining the Dots: 2018 Census of the Australian Health Justice Landscape (Report, 29 October 2019) 23 .

3 Health Justice Australia, Health Justice Landscape: July 2021 Snapshot (10 September 2021) .

4 There is one exception, where funding for dedicated caseworkers was applied for during the partnership when it had identified the extent of the referrals involving child protection: L Curran, A Research and Evaluation Report for the Bendigo Health–Justice Partnership: A Partnership between Loddon Campaspe Community Legal Centre and Bendigo Community Health Services (Australian National University, 2016) 101 .

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