| Aged Care | Violence | Rail Service | Bank Service | Employment | Depression | Schools | Vandalism | Apathy |
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Aged Care
A little over a year ago in the middle of a stormy night, I found myself at the emergency ward of a major public hospital. My father was in a coma and needed urgent brain surgery He survived the operation, but there was no intensive care bed for him. We were told a retrieval team would transport him to another public hospital in northern Sydney I thought about the wild night, about my father's chances of surviving the journey after such traumatic surgery and said no.
There was no option, I was told.
There was, of course. Our choices widened dramatically when my mother mentioned private hospital cover. Suddenly my father, still comatose, was being wheeled over an enclosed bridge to an adjacent, sparkling, private hospital with an impressive new intensive care facility.
A week later Dad opened one eye, then a few days later another. We rejoiced when he said a few words and again when the head of the neurosurgical team told us he could be in rehabilitation within weeks.
It was not to be. My father was moved to yet another hospital, where he had a tracheotomy performed. It saved his life temporarily but prevented him talking. He could not swallow, so he was fed by a tube into his stomach. He could move his head and hands a little, but could not walk or move his body. He could not press an alarm bell and his lungs had to be cleared every hour. A voracious reader with an extensive library a lover of ideas and conversation, he seemed mentally alert, but could not hold a book or focus to read.
The hospital setting provided a veneer of hope, but this vanished when the hospital's specialist in the field declared Dad was not a candidate for rehabilitation. No longer classified as needing acute care, we were told he should move to a nursing home. Impatient now to be rid of him, the hospital began to pressure my emotionally and physically exhausted mother to find him a bed elsewhere.
I joined her on the most miserable journey of our lives - trying to find him a "suitable" bed. We were shown through nursing homes that stank of urine overlaid with the cloying scent of lavender or antiseptic. We were shown dank rooms that resembled dungeons and taken down corridors where screaming could be heard in the distance.
Some of these were reasonably priced public facilities. Others were private for-profit ones that charged accommodation bonds of as much as $120,000. My mother wanted to find a decent nursing home relatively close to her own home so she could spend her days at her dying husband's bedside. But where? The few acceptable facilities we saw had long waiting lists, offered few beds for men and anyway in nearly all cases, lacked the training and equipment to sustain my father's extremely high medical needs.
The hospital increased its pressure when my mother rejected a bed offered by one of the worst and most expensive homes we had visited. She opted for the next bed that came up. The home was expensive, distant and sterile in atmosphere, but at least it did not smell. From that moment my father deteriorated at about the same rate as my alarm at the situation increased.
With staff cut back to an inexplicable bare minimum at the nursing home, care for Dad could not be adequate. The nurses said they adored him, but had no time to spare. Through the night there was one registered nurse on duty for around 30 residents. We were shocked one day to find a large gash on his leg inflicted through careless lifting by assistants. Helpless and with no voice, he had no way to complain.
In what became a familiar message, area health service therapists who visited my father complained that the health system was stretched to its absolute limit. If one of them was sick there would be no-one to fill in. If a car broke down there was not a replacement. I was reminded of this recently when the community speech pathologist my son sees told me she would be leaving soon on maternity leave and would not be replaced in the short term.
Dad developed pressure sores. Every couple of hours he was turned and his sheets were changed, but if he needed further assistance before the next scheduled move we discovered he at times had to lie in his own waste. Overwhelmed with sorrow, I sobbed that I wanted Dad to come home. If that was not possible -and it wasn't - I did not want him to die where he was. I could hardly bear to go there myself.
Sharing my many concerns, my mother moved Dad to another nursing home for the last month of his life. The management was helpful and the home had a friendlier, hospital-style bustle about it. We had visited and liked this institution months earlier, but regarded it as financially out of our reach. Now my mother felt that she could afford the higher fees, because my father's was clearly going to be a short-term stay. In this apparently caring environment she was surprised one afternoon to witness an assistant throw an elderly patient onto her bed.
Appalled, shattered, by what I observed during the six months of my father's dying, I have grown more and more uneasy about the way the success of our nation is measured increasingly in economic terms. Nine years of GDP growth and a budget surplus might be a triumph in Treasury parlance, but its darker flipside is a nation that in many ways is suffering under the tyranny of the bottom line.
Whether you're talking about family relationships, the impact of longer working hours and downsizing, epidemics in stress and depression, the state of health, faltering community responsibility, teen suicide, aged care and public schooling, or our unwillingness to commit to voluntary public service, I'm regularly confronted with evidence that a boom economy does not always equate with better quality of life. I know now, for instance, that my father's nursing home experience was certainly not atypical, and that many other very high-care patients among the 137,000 residents of the nation's several thousand aged care facilities are suffering in a similar, scandalous way I also now know that an important reason for this is the federal government's abandonment of rules regarding accountability for spending on patient care, a decision that has allowed unscrupulous operators to minimise the number of registered nurses and therapists employed in aged care.
"There are places where there is one registered nurse at night for 80 to 100 patients. I don't believe it is safe," says Kate Hurrell, a consultant and educator to the nursing home industry and a former director of nursing in an aged home. Last year, a survey of aged care nurses by the NSW Nurses Association found that a third believe current staffing levels put residents at significant risk. More than 40 per cent of respondents said they lacked the resources to provide an acceptable level of nursing care.
The lack of mandated staffing levels is an issue that must be remedied, according to Australian Nursing Federation secretary Jill Illiffe, but she says, "We can't get the federal government to take any notice. Stuffed if I know why they are putting billions into aged care and they don't know how it is spent. It's unbelievable."
According to Treasurer Peter Costello, the "reform" process must be pursued relentlessly if our economy is to maintain its upward track. Seemingly forgotten in his political equation is the cost on the way we live.
Violence
CONAL O'NEILL, A year 12 student from Sydney's lower north shore and the son of friends, celebrated his 17th birthday on October 7 last year at a party with other teenagers. Just before midnight he left the party with his girlfriend and walked to Turramurra station to catch a train home. Eight other friends, two of them girls, accompanied them. Turramurra is one of a number of Sydney stations unattended by rail staff after 9pm. The teenagers walked onto the platform and were confronted by a gang of seven youths aged around 16, wearing athletic gear and, according to O'Neill, "pretty drunk".
"We'd never seen them before. They started saying abusive things to us and one of them spat. Then a guy smashed a bottle and held it up against my chin. Two of my friends were pushed onto the tracks and I got a punch in the face. They were asking for wallets at one stage, then they got more interested just in hurting us. One big guy and a little one were out of control. They were both brandishing broken bottles. Another one had picked up a metal sign," recalls O'Neill.
"My girlfriend and her friends ran away onto the highway and called the cops on a mobile. It was pretty impressive — they were there in about two minutes, but the guys had nicked off by the time they arrived. An ambulance came and patched some of us up. We were all pretty shaken up. It's not a localised thing. [Gangs] ride the trains and hop on and off. There are guards on the trains, but not on the station."
Rail Service
More recently I walked into a CityRail station in Sydney's CBD and found it unattended. The machine on duty swallowed my money without issuing a ticket. Nothing happened when I pressed the coin return button and I had no more change. Hearing a train approach I attempted to pass the barrier gates, but without a ticket they would not open. There was no-one from whom I could seek assistance. As the train left I walked out of the station filled with frustration and rage.
I mentioned these incidents to a State Rail Authority spokesman. He denied the CBD station could have been unattended and insisted I submit a Freedom of Information request if I wanted a list of metropolitan stations unstaffed late at night. State Bureau of Crime Statistics figures show a doubling of robberies and assaults at NSW rail stations in the past five years. Could he give me information about how often these crimes occurred at unattended stations? Of course not.
Aggressive cost-cutting throughout all Australia's railways has resulted in a halving of rail employees nationally since 1980. In NSW 25,000 fewer employees than 20 years ago operate the state's rail system. Long queues at ticket machines, abuse of remaining station staff, a personal risk factor especially late at night, passenger frustration at trains cancelled because of poor maintenance, derailments, and what the national office of the Rail, Tram and Bus Union describes as an unprecedented number of deaths among track workers in 1998-99, are some of the cracks that have emerged in the "reformed" rail system in NSW.
Bank Service
Caught up in a similar cost-cutting frenzy, Australian banks have cut their collective staff by 40,000 since 1993 and closed the doors on nearly 2000 branch offices, two-thirds of them in cities and suburbia. The profits of Australia's four major banks — Westpac, Commonwealth, ANZ and National - soared between 1997-99, but the cuts continue. Nationally 300 branch offices have closed since July.
"Our customers are saying big banks don't care about little people anymore," says a teller at an outer suburban Melbourne Westpac branch. "Westpac has decided to close this branch at the end of the month, and the community is very upset and united. They have a petition with 2000 signatures and have called a meeting in protest. It's a half-hour bus trip to the nearest Westpac and trains go only once every hour. Quite a few come in here with wheelchairs — there's no way they'll be able to travel to another branch."
Customer rage at the slimmed-down delivery of financial services broke out in a suburban branch of the Commonwealth Bank I visited recently over an excessive wait for service at the customer assistance desk. In a cri de coeur the woman behind me exclaimed loudly
"The banks don't care about anyone but their shareholders. The banks' profits keep rising, but they have forgotten ordinary people. Politicians just stand by doing nothing. I just want to get my money and leave the country"
Red-faced, the elderly man ahead of me exploded in anger. A retired branch manager of the bank, he said he was disgusted with the current level of service.
"Please write and complain," said the besieged, solo employee at the counter. "We need more staff."
I asked Commonwealth Bank spokesman Brian Fitzgerald whether the organisation was aiming to make bank visits as frustrating for customers as possible.
"Not at all," he replied, suggesting that the bank's adoption of central queueing in branches might be responsible for customer perception of understaffing. "Twenty years ago, banks were open between 10am and 3pm and customers could not access their funds outside those hours. Now customers can do their banking over the telephone or the Internet, through a mobile lender service and at ATMs. We have 400,000 on-line users. Four out of every five Commonwealth Bank transactions are processed electronically You can go to a supermarket at midnight and have face-to-face contact [at the check-out] and withdraw funds."
"Bank staff are caught between a rock and a hard place," says George Wright of the Financial Sector Union. "There's a huge fault line between banks and their customers. It's a very stressful situation. Bank staff see themselves primarily in a customer service role and they are frustrated because they can't deliver. There's been a lot of angst about the rural situation, but there is a group of forgotten people in suburban and city areas who are also suffering."
Kathy Simmonds (not her real name) is an ANZ bank teller employed in suburban Brisbane. A year ago, staff numbers at her branch were cut from 18 to 12 full-time equivalent positions.
"It can be pretty chaotic," she told me. "Business hasn't decreased, but we are all expected to work harder. If people are away sick they are not replaced. On some days there's a queue of up to 25 people stretching out the door. You get stressed when you see a big queue; I've made errors where I never used to. I used to have time to explain things like how to avoid bank charges, but I don't have time for that now. You feel really sorry for the elderly in the queue. Some of them can hardly stand. You really see people heating up when they have been in a queue for half an hour and then we cop it.
At our branch they now want to cut another eight hours a week from our telling staff. It will put a lot of pressure on the girls who are there. It gets to some of the girls; it affects their health. I just feel the bank is trying to increase profits for shareholders. They want us all to cut our hours, but they are not offering redundancy packages. I don't know where it's going to end."
Schools
Every Monday night in February and March I attended an evening class at a local high school. The first evening I walked into the school I recoiled in shock. Corridors were covered in graffiti, the toilets filthy carpets spotted with stains, metal locker doors hung off their hinges and ancient, dog-eared textbooks were piled in corners. Currently required to spend no more than nine minutes cleaning a classroom, government school cleaners are engaged in action in part because private contractors want to reduce this to six minutes. A couple of kilometres west is the primary school where both our boys have thrived under remarkable teachers. Like many state schools, its facilities don't match its ethos of achievement. Its 19th century classrooms are too confined for large classes of 21st century-sized kids, its grounds way too small for the 500 to 600 children who burst from its doors at breaks.
Pressure on class sizes, an increasing resort to composite classes and greater strains on teachers have resulted in a less than ideal learning environment. With insufficient specialist staff available, teachers at the school say they can find themselves in the position of having to integrate children with autism and other learning difficulties without adequate support. The needs of children left at the school from 7.30 am until 6pm are a major concern to one teacher. "It's basically an in loco parentis situation, but nobody wants the responsibility" she says.
Add the issues of long-running pay disputes, ever-increasing demands on teachers to deal with social issues, insufficient training in new technologies, diminishing counselling services, falling standards required to enter teacher training, and the embattled image of public education and the result is a staffroom where morale is so low that, I'm told, outside the school gates some teachers rarely reveal their profession.
Research by the NSW Teachers' Federation in 1995 found that nearly one in five teachers had a medically diagnosed stress disorder due to excessive workload. The greater range of tasks expected of teachers and the lack of time to carry them out were major problems, according to the research.
"No other group in the community has been given so much extra responsibility," says Associate Professor Steve Dinham of the University of Western Sydney who has surveyed teachers in four nations. "It's a paradox that while the community has never been so critical of teachers as now, they have also never expected as much. Every time there is a problem, schools are given it to solve. They have to teach [kids] not to take drugs or be sexist, about multiculturalism, how to ride their bikes safely they have to counsel them if they are suicidal and handle their sex education.
"Teachers are suffering from change fatigue and their dissatisfaction is feeding directly into stress," Dinham adds "Training and development funding has been cut to the bone in NSW. There's no doubt there is a crying need for some more specialist support staff, but you are starting from so far behind you could put 5000 additional specialist teachers into Australia schools and they would be sucked up like ink on blotting paper. Schools are running on the goodwill of committed teachers, but the well is drying up."
"Just appalling" is the way primary school principal Brian Chudleigh describes the funding stringencies at his school in Sydney's sprawling south-west.
"The allocation for teacher training and development is $25.30 a head per year, but it costs the school $600 to provide substitutes to allow three teachers to do one day's training. The government provides computer hardware, but the $30,000 bill we face to cable every classroom for Internet access is prohibitive. There's a shortfall in fundamental counselling services. No additional counsellors have been appointed in NSW in the past five years. At this school the ratio is one full-time counsellor for 1600 students, and it gets worse every year.
"It's not all depressing," adds Chudleigh, who chairs the Public Schools Principals Forum. "Teacher morale is high at this school. If teachers did only what they are paid for, the system would have collapsed years ago.
Like many parents, I spend hours each week driving my children to and from tightly scheduled activities and at times find myself enraged by the combined strain of coping with heavy traffic, aggressive drivers and an urgency to be on time. Turning left from a main road recently on a local errand, I braked to allow an elderly pedestrian to cross the street. Horns and abuse blared jarringly from the cars behind me, urging me, I can only suppose, to run him down.
Employment
Behavioural scientist Bruce Parry says:
"I recall when everyone was saying the '90s would be the era of leisure because computers would free us up. In fact, technology has made life more stressful. Instead of job-sharing, computers have meant we can do the work of two."
Road rage, he says, is just one symptom of the pace of life getting quicker.
Parry is the national manager of IPS Employee Assistance, an Australia-wide workplace counselling service that caters to more than 600 private and public organisations and their million-strong workforce. He predicts that within two years, work-related stress will account for half his firm's usage.
"People are working longer with more demands. The bottom line is being shoved down their throats all the time."
To deal with stress he says people need to replenish their "emotional energy" by relaxing after hours. The only way many can fulfil the extra demands, however, is by taking work home. Professionals and managers make up most of the labour force working excessive hours but, with a move towards 12-hour shifts, blue-collar workers are also feeling the impact.
"Sleeping patterns are being affected because people are waking up thinking about what they forgot to do yesterday and what they have to do tomorrow. The next day they are not rested and are running on empty. It's doubly difficult for women. They still do two jobs. They get to work and they are already exhausted.
Depression
"In the past people could cope with stress because they knew it would come to an end. Now they are aware that the only constant is change and they feel overwhelmed. For some people this is translated into depression and anxiety. With more than 700,000 Australian adults affected, depression is being touted as the next major health issue- Managers can't keep expecting people to work longer and longer hours," says Parry.
In my own family circle, relatives downsized out of their jobs have suffered severe so-called reactive depressions that have taken years to recover from. I thought this was unusual until a male friend, also suffering depression, said his therapy group is full of retrenched middle-aged men.
"We see an increasing number of people with [reactive] depression," says Robin Ellis, head of clinical services at Sydney's Northside Clinic. "It's not just people losing jobs. It can also be a response to greater expectations at work. Some people respond quickly to therapy but we do see a number of people where it has developed into clinical depression. For a person whose whole self-esteem is wrapped up in work, when that is removed it leaves a major vacuum. It's a grief reaction — people are suffering a major loss. Then there is the strain it puts on family and other relationships."
I sat down at a kitchen table one afternoon recently for a cup of tea with another mother, a school counsellor. She was deeply concerned at news she had received earlier in the day that two teenagers in their final years of school, one at a selective high school, the other a student at a private college, had hanged themselves.
In the two years to 1998 nearly 450 Australian teenagers committed suicide, three in four of them boys.
"There were 11 suicides by students in [Sydney's] eastern suburbs last year," she says. "I know of 12 in the last six months. And what you don't see are the attempts — there wouldn't be a school which didn't see a couple of attempts a year. Everyone wants to understand why it's multi-factorial. Everything seems too hard, they feel alienated, there are high expectations from parents and a rising incidence of clinical depression as well as a rising incidence in drug and alcohol abuse.
"In the past families bonded together to solve problems. I feel kids of a decade ago had better problem-solving skills. Now they are so sheltered they don't see a way out or a light at the end of the tunnel. All parents have to say to teenagers that they are proud of them and will support them no matter what they do."
"We are flying by the seat of our pants," says Dr Michael Dudley a lecturer in psychiatry at the University of NSW, on understanding the reasons why school students suicide. "Young people haven't got a point of reference for what it all means. We've got a postmodern youth culture in a world that is increasingly about individualism and going our own way The rate of change in society is enormous. There's very little sense of continuity Australia has put lots of money into fabulous programs in youth suicide prevention, but not enough into looking at what works. Social capital and community connectedness need to be on the agenda."
Riding the wave of the revved up economy Sydney real estate prices continue to soar. With median house prices just short of $300,000, the average home loan in NSW has risen to an unprecedented $173,765 with the cost of repayments chewing up nearly a third of family income.
Vandalism
Last month I went for a walk around a small public waterfront reserve enjoyed by my local community I was looking for three 20-year-old native trees ringbarked a few months previously by a property owner looking for better water views and even higher market values. When I found them I was taken aback by the savagery of the deep gouges circling the trees' trunks.
"Wealthy individuals thumb their noses at council," says an officer from Mosman municipality. The difficulty of catching tree killers and the minimal penalties available mean there is little to deter vandals. The council secured a rare conviction two years ago in a case involving a property owner hiring a contractor to cut down trees outside his boundary. The fine? $100.
From nearby Balmoral beach I can look across Middle Harbour to North Head, location of Sydney's 180-year-old Quarantine Station and part of Sydney Harbour National Park. I headed there recently keen to inspect this part of our history before, as seems almost certain, it is handed over to private interests.
Apathy
At the south end of Balmoral our sons' sea scout hall and boatshed come into view Just over a year ago the group was on the verge of collapse —while there were plenty of youngsters looking for outdoor adventure, much more voluntary support was needed. As the organisation's secretary at the time, I sent out dozens of pleading letters to parents who dropped their boys at the scout hall each week. And then I sent out dozens more. The result? One reply.
Volunteering has been declining nationally since the early 1980s and has recently fallen below 20 per cent. When it comes to community service, Sydney performs worst of all Australia's cities with just 12 per cent of its population undertaking volunteer work.
Longer and less predictable work hours, greater self-absorption, fear of commitment among baby boomers and younger generations, and less need and time to carve out an identity outside work and family are among the reasons behind the decline in giving back to the community For our sea scout group this means the same adults carry out the work of the organisation year after year, with little support from the parents of recent recruits. When those volunteers leave, there may be no-one left with the knowledge to prevent the group, the oldest in NSW, from folding.
In his book Australia's Third Sector: The Dual Challenge, to be published by Allen & Unwin later this year, the University of Technology's Mark Lyons argues that strong civil society is under challenge in the current environment of profit-driven economics and consumer culture. Demutualisations, falling membership of many non-profit organisations and their replacement by for-profit organisations, and lack of government recognition are all signs that our civil society is sick. If it is to survive, Lyons argues, Australians need to see themselves less as consumers and more as active citizens.
Walking back along the beach, I pause for coffee. A mother and her preschooler are enjoying some quality time in the stylish cafe I select. The smartly groomed parent is sipping a macchiato and chatting on her mobile phone, the signature of the new prosperity. She is still chatting when I leave the cafe half an hour later. The bored child sips a shake and twiddles a serviette. "Aren't we having a lovely time, darling?"