Hague Kevin: Home and Community Support (Payment for Travel Between Clients) Settlement Bill — First ReadingText is incorporated into the Bound VolumeHague Kevin: Home and Community Support (Payment for Travel Between Clients) Settlement Bill — First Reading[Sitting date: 13 October 2015. Volume:709;Page:7153. Text is incorporated into the Bound Volume.]KEVIN HAGUE (Green): It does sound as if all parties will be supporting this bill so I thought I may make some reflections on the problem that we are trying to solve here. My reflection is that the straitened financial circumstances that the health sector so often finds itself in sometimes leads to very poor strategic decision-making.When we look at mental health we have moved from an era when the approach to people with mental illness was to institutionalise. We all recognise that actually that is not the correct approach for most people so we closed down the big psychiatric hospitals but then we did not invest properly in creating the community-based support services that were required to replace them with the consequence that now we have both community-based services and acute units that are struggling to cope and chaos for people with mental illness.We know that the need for secondary care and the cost of secondary care could be saved by a much better investment in public health services and in primary care services yet do we make that investment? We do not. In fact in the last several years under this Government it is those precise services that have borne the brunt of funding cuts. So rather than taking us closer to a situation where we make the smart strategic choice to invest in keeping people well in the community and thereby saving costs in secondary care in actual fact we exacerbate the need for secondary care. We exacerbate the problem because our thinking is constrained by short-term considerations. That is how this problem has arisen.We have had a strategy now for at least the past 15 years I would say called Ageing in Place where we say: “We actually do not want to consign all of our older people to require rest home and hospital-level care as soon as they start to struggle to cope in their own homes so let’s instead bring services to them because that is the best thing for them and it is also the best thing in the long run for our services.” But what has happened is that we have made that our strategy and yet have failed to put in place the appropriate level of community-based services that older people need to be able to remain in their own homes. This bill addresses one of the facets of that issue.Several speakers have mentioned Judy McGregor’s report. Judy McGregor’s report Caring Counts addressed this as one of the most significant issues because she said that it was an injustice. She said that it added to the precarious nature of the work by community-based support workers.I put the case to the House—and I have heard other speakers in this debate do so—that we have got away with failing to appropriately reimburse for travel costs principally because this work has been carried out mainly by women. That is I think a pretty sad reflection on decision makers in the health sector over a significant period of time.I want to reflect too on the fact—and Judy McGregor makes this point in her report—that this has had a differential geographic impact. For community-based support workers in an urban environment the failure to be adequately reimbursed for travel costs may be a relatively small consideration but for those workers in an area like the one I live in the travel time and distance between clients may be vast and it may actually mean that it is completely non-viable to do that as a job. That certainly has been the case with costs both to the workers and also to the clients.I am a member of the Health Committee. I look forward to those submissions and I just want to conclude by saying thanks—thanks to those workers for the work they do for the perseverance and courage they showed in taking the cases that led to this situation and for their generosity in the settlement that this bill legislates for. Thank you.