CW: This article contains references to sexual abuse and domestic violence, which may be distressing to some readers.
Privatisation in Australia sounded an ominous death knell this week as 110 trauma counselling specialists from Rape and Domestic Violence Services Australia (R&DVSA) packed up their desks.
The counsellors work for 1800 RESPECT, a trauma counselling hotline for victims of sexual and domestic abuse. In August, the Federal Government announced that it would provide the contract for the vital service to Medibank Health Solutions (MHS), an offshoot of private health insurer Medibank Private.
Medibank heralded the takeover as a win for victims of rape and domestic violence across the country. The introduction of three new non-for-profit service providers – DVConnent (Queensland), Women’s Safety Services (South Australia), safe steps Family Violence Response Centre (Victoria) – would join their New South Wales counterpart, R&DVSA, to broaden the reach of 1800 RESPECT.
“The approach provides the right infrastructure and a broader base of 1800 RESPECT… to ensure trauma specialist counsellors are available when callers need them,” said Medibank’s Chief Medical Officer Dr Linda Swan.
*Medibank’s Chief Medical Officer Dr Linda Swan
But in an attempt to form this new federation, MHS stumbled at the first hurdle. Negotiations with R&DVSA broke down irretrievably after MHS insisted that R&DVSA hand over all existing client files to them.
“We couldn’t put our signature on a contract that would allow our client notes and calls to be retained and recorded, to be used god knows where,” said R&DVSA Chair Jane Gold. “That was the biggest stumbling block – ethically and morally we couldn’t sign. We had the backing of our workers too. They knew they couldn’t work that way without the trust of clients who use the service.”
Indeed, it has emerged since August that the for-profit insurance provider hasn’t been sensitive to the standards of service owed to victims of sexual and domestic abuse. While Medibank’s media release did boast a “significantly improved answer rate from 33 per cent… to 93 per cent” as a result of its “nationally consistent approach,” it made no mention of the triage system introduced to 1800 RESPECT’s service, a system which affords callers little more ceremony than sheep at the dipping pond.
Nina Funnell recounted her experience with triage phone operators to Richard Dennis on his podcast, The Lucky Country. “You’re being forced to audition in front of a non-trauma specialist phone operator who plays gatekeeper, deciding whether or not you get patched through to an actual trauma specialist counsellor.”
Nina, a survivor of a vicious sexual assault, now works as a freelance journalist reporting primarily on incidents involving domestic and sexual violence. “When I hear really horrific disclosures, I often call the hotline to debrief. Last year I received a disclosure of a gang rape, the details of which were unbelievably brutal.” Suffering from residual PTSD, Nina spent an agonising fifty minutes pleading her case to triage workers who, after directing her to a FAQ sheet and website, did not deem her case worthy of specialist counselling.
“I found that humiliating,” said Ms Funnell, her voice trembling, “to effectively be forced to audition for specialist care and not being offered that.”
As well as introducing ‘efficient’ triage schemes, MHS now outsource 1800 RESPECT’s services at the lowest possible tender price – that is, to service-providers able to source workers at competitive market rates. Perfectly normal behaviour for a private enterprise used to scrambling for profits and market share, but Natalie Lang of the Australian Services Union believes such practices are inappropriate for a life-saving service like 1800 RESPECT.
“Victims who’ve experienced the trauma of sexual and family violence deserve the best possible services, not the cheapest. Almost all the funding these services receive is spent on the wages of counsellors. So, for a provider to do it at the lowest possible tender price, yes, they are absolutely cutting the wages of those staff,” Natalie Lang told Richard Dennis.
It’s likely that Medibank will get what they pay for. Even after performing the emotional gymnastics necessary to pass the stone wall of triage workers, callers to 1800 RESPECT ought not get their hopes up about the quality of guidance they might receive. “New providers who are coming in [this month], their background is not in specialist sexual assault and family violence counselling,” said Lang.
“We know that they [MHS] are seeking to employ people to try to do that work, but I am concerned about whether they’ll be able to get workers of the high calibre such as the ones working at the R&DVSA.”
R&DVSA was formed as The Rape Crisis Centre over forty years ago by 500 feminists in the Redfern Town Hall. “They employ over 110 specialist staff and they’re facing closure at the end of this month,” said Lang.