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Alston, M. (2009). Rural Australia and rural human service practice in context. In Innovative

human services practice : Australia’s changing landscape (pp. 1-22). South Yarra, Vic. : Palgrave Macmillan.

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Rural Australia and rural human service practice

in context

This book begins with an overview of the rural context, the parameters that define

rural Australia, the people who live there and the types of challenges they face.

Chapter 1 presents essential definitions of 'rural' and of 'human services' and outlines the

dimensions of these concepts. Human service practice is broadly discussed, as is the way

the rural setting shapes and challenges workers.

Chapter 2 sets rural Australia in an international context. How does the rural expe

rience reflect or differ from the rural experience of others across the globe? More

importantly, this chapter notes different approaches adopted in other countries to address

rural disadvantage, advice from which Australia might draw insight.

Chapter 3 outlines new challenges facing all Australians, but especially those which

are fundamentally based in the rural context-climate change events, food and water

security and people movements. The way we address these issues in the twenty-first

century is fundamentally important to our ongoing quality of life, making the rural

context a critical focus for ongoing national attention. Human service practitioners have

a critical role to play in ensuring that all voices are heard in debates about these issues

and in ensuring that policy development is socially just and based on attending to the

human rights of all Australians.

1

Alistralian rural human • • •

servtce practtce tn context Before beginning a detailed discussion of the contextual issues that shape rural human

service practice, it is important to establish some quite basic definitions. For example,

what exactly is 'rural'? Where are rural areas located? Who lives there? What are the

critical features of rural and remote areas? Where do they begin and end? What are the

characteristics of the people who live there? These are not simple questions to answer

and, indeed, there is much debate on what constitutes 'rural' and 'rural people', not only

in Australia but also across the world. Change, decline and depopulation are features

of rural society in most Western countries, but defining what constitutes the rural. and

making attempts to preserve it (whatever 'it' may be), remains problematic.

Once a broad dimension of 'rural' and 'rural people' is outlined, this chapter also sets

out a definition of human services and human service practitioners. What exactly do we

mean by human services? Who are human service practitioners and what do they do?

What does human service practice constitute in the context of rural Australia? How does

this differ from urban practice? How does it differ from rural practice in other countries?

There are lots of questions to ponder, but first an overview of the Australian population

and where 'rural' fits in the larger national context.

1.1 Rural in the context of Australia

In December 2003 Australia's population officially passed the 20 million mark,

significant to Australia but small by world standards. Despite our low population, we

have the sixth largest country in the world in terms of land mass, after Russia, Canada,

China, USA and Brazil. By comparison with the rest of the world, our population

ranges over a very large geographical area. If we compare our land mass with that

of other countries, we find that Australia's area is nearly the same as the USA (83%)

for example, but our population is only 7% of theirs. By contrast, we have 24 times

the land mass of the United Kingdom but only one-third of their population base

(Geoscience Australia 2006).

Consequently when we are thinking about human services in a rural context,

it is useful to note that Australia is a very large country with a very small population

2

AUSTRALIAN RURAL HUMAN SERVICE PRACTICE IN CONTEXT 3

b.tsc:. We therefore have quite different issues around service delivery in these vast,

diverse areas than other countries across the globe. What makes us even more unique

is that approximately 84% of Australians live within 50 kilometres of the coast, making

us one of the most urbanised, coastal-hugging countries in the world. Our massive

mland food-growing areas are home to only 16% of our people. The vast majority

of Australia's land mass is sparsely populated indeed, and it is these areas we tend to

identifY as 'rural'.

1.2 What is 'rural Australia'?

Of note in defining 'rural' is the bold pronouncement by the United Nations

Populations Fund (UNFPA 2007) that during 2008 the world would move into a

remarkable new era where, for the first time in history, more than half the world's

population, or 3.3 billion people, will be living in urban areas. Previous to this, a

majority of the world's population has been 'rural' . However UN definitions of rural

and urban are remarkably fuzzy and, in this global context, urban and rural definitions

are left to nation states, meaning they may differ between countries.

As elsewhere, Australians have considerable difficulty defining 'rural' and these

definitions vary from spatial (how sparsely populated an area is, for example) to how

one feels about one's self ('do I feel rural or not?'). As Black (2005: 22) notes, most

definitions rest on:

• aspects of population density or size of communities-the spatial difznition

• economic activity of the area (agriculture or mining, for example)-the economic

difznition

• socio-cultural aspects of the area such as relationships or common values-the

socio-cultural difznition.

Before we go through these definitions of rural to assess their usefulness, it is

noteworthy that all are problematic in some way (Black 2005). For example, if the

definition is by population base, then where is the dividing line between rural and

urban? If we don't move straight from one area (rural) to another (urban), then how

do we define the gradations in between? Is rural-urban then a continuum with rural!

remote at one end and urban at the other and various combinations in between?

These complexities in spatial definitions remain problematic.

Critics of the second type of definition-that based on the economic activity of

an area-argue that no area is exclusively based on one industry alone. For example,

no one area is entirely based on agriculture or mining-there is usually some level of

diversity in even the most sparsely populated areas. Equating the rural with farming,

for example, is significantly flawed.

The third type of definitional assumption-the socio-cultural one--is criticised

for suggesting a romanticised, folksy view of rural people, one where everyone has

the same values and believes in the same things-and this is as unlikely in rural areas

4 INNOVATIVE HUMAN SERVICES PRACTICE: AUSTRALIA'S CHANGING LANDSCAPE

as it is in the cities. As a result of the problems associated with defining 'rural', most

definitions end up de�cribing what rural Australia is not, rather than what it actually

is! That is, most tend to report that 'rural' is everything that is not 'urban' or 'metro

politan'. It is, therefore, not uncommon to see rural defined as 'non-metropolitan' .

But a brief exploration of the three types of definitions will give some indication at

least of the areas that are most readily identified as 'rural' .

Spatial definitions

Official sources, such as Australian government departments, continue their quest to

define rurality-and these definitions, while constantly being refined, vary according

to what is being measured. The Australian Standard Geographical Classification

(AS GC) Rural, Remote and Metropolitan Areas (RRMA) classification is a measure

developed in 1994 to identifY and classifY rural areas using a spatial definition, based

on population density. The m� or categories in this classification are:

111 Major Urban-areas with populations of 100 000 or more

• Other Urban-urban areas with a population of 1000-99 999

• Bounded Rural Locality-rural areas with a population of 200-999

• Rural Balance-the remainder

IS Migratory-areas offshore (Hugo 2005: 57).

This classification is two-dimensional and does not address the nuances of isolation

or levels of remoteness. For example, it is quite possible to have a solid population base

but still to be remote from services.Therefore ASGC has also developed a classification

of remoteness-the Accessibility /Remoteness Index of Australia (ARIA). ARIA

determines a category for each area based on road distance to the nearest service

centre (scores vary from 0 to12, with 0 being highly urbanised with excellent access

to services and 12 being significantly remote from services). Under the ARIA scheme

there are five classifications for areas outside the major cities and these vary by level

of remoteness. They are:

IS Highly Accessible-locations with relatively unrestricted accessibility to a wide

range of goods, services and opportunities for social interaction

• Accessible-locations with some restrictions in terms of accessibility to some

goods, services and opportunities for social interaction

IS Moderately Accessible-locations with significantly restricted accessibility to

goods, services and opportunities for social interaction

IS Remote--locations with very restricted accessibility to goods, serviCes and

opportunities for social interaction

IS Very Remote-locationally disadvantaged, with very little accessibility to goods,

services and opportunities for social interaction (Hugo 2005: 58).

ASGC introduced a Remoteness Area Structure (RA) in 2001 to classifY census

districts according to levels of remoteness-thereby combining the spatial definition

AUSTRALIAN RURAL HUMAN SERVICE PRACTICE IN CONTEXT S

with a remoteness factor. The classification system combines both the population

base definition and the remoteness from services and includes:

• Major Cities of Australia-ARIA score between 0 and 0.2

• Inner Regional Australia-ARIA score between 0.2 and 2.4

• Outer Regional Australia-ARIA score between 2.4 and 5. 92

• Remote Australia-ARIA score between 5.92 and 10.53

• Very Remote Australia-ARIA score greater than 10.53.

The 2006 Australian Census figures show that more than two-thirds of Australians

(68%) live in Major Cities, approximately 20% in Inner Regional, 9.5% in Outer

Regional, 1.5% in Remote areas and 0.8% in Very Remote areas. By contrast, only

32% ofindigenous Australians live in Major Cities, 43% in Inner and Outer Regional

areas, 10% in Remote areas and 16% in Very Remote areas. Hence the proportion

of Indigenous Australians in Very Remote areas is 48% and in Remote areas 16%

(ABS 2008b).

Under these fairly static definitions there are discernable trends in areas that are

outside major urban centres and centres that have highly accessible services. Since

the previous census the population of the Major Cities grew (1.6%) more than the

national average (1.4%), Outer Regionals remained steady. Remote (-0.4%) and; Very

Remote areas (-0.3%) experienced population decline (ABS 2008a). Perhaps more

alarming is that there are discernible sex ratio differences opening up in remoter areas

of the country. For example, in Very Remote areas, there are 113 males for every 100

females (ABS 2008a).

Table 1.1 Demographic data on rural Australia

�

Total ppputation

Major Cities 68%

Inner and Outer Regional 29.5%

Remote areas 1.5%

Very Remote areas 0.8%

lildigenous ppputiltlon

32%

43%

16%

48%

Information from Australian Bureau of Statistics (ABS) reports emerging from Census 2006

Gtowtfl rate

1.6%

0

-0.4%

-0.3%

Along the vast coastlines of our country, particularly along the eastern seaboard,

there is significant growth in populations, even in what might be termed 'rural'

locations-coastal villages, for example. Because of the 'baby boomer' generation

moving into retirement age, there is a growth in the number of people seeking to

retire in places with high aesthetic value, such as these coastal regions (Salt 2001).

There is also a movement of working-age people fleeing the cities, seeking less stress

ful circumstances and a 'sea change'. Coastal 'rural' places are often highly dependent

6 INNOVATIV E HUMAN SERVICES PRACTICE: AUSTRALIA'S CHANGING LANDSCAPE

on tourism and retirees, but also have a solid base of working-age groups and are

therefore experiencing quite different population changes. In these regions there

is often extraordinary pressure on human services, natural resources and essential

services such as water.

By contrast, many inland regions are experiencing ageing populations and signif

icant out-migration of young people. The population loss is greatest in wheat/ sheep

growing areas (because of the volatility of the agricultural industries and drought

conditions) and the further one gets from major or regional cities (Hugo 2005).

Meanwhile the percentage of Indigenous people as a proportion of the population

increases the more remote the town, and it is often these towns that have the most

significant erosion of services and infrastructure.

While the 'sea change' phenomenon is well understood along the coastal

regions, there is some evidence of a 'tree change' in inland areas as people move into

communities as a lifestyle choice (Salt 2007). However tree changers tend to look for

areas of high amenity and aesthetic value and are often located in peri-urban areas of

regional communities (Inner and Outer Regional), rather than in Remote or Very

Remote communities.

In inland communities with low amenity value that are highly dependent on agri

culture, there have been quite radical population changes. The drought has escalated

already well-established trends of out-migration and depopulation. In these areas there

are further losses of farm families and workers, and amalgamation of properties into

larger holdings, leading to further depopulation of communities, significant impacts

on small businesses in these areas, significant declines in the number of children in

the local schools, closures of small schools and bus runs, loss of other services and a

marked depopulation of remoter areas (Alston and Kent 2004).

Spatial definitions of 'rural' therefore give us strong indications of the trends in

areas of lower populations. What they do not give us are a sense of the activities

within those communities, the diversity (or lack of it) of the population and an

understanding of the community itself, its people and its values. Some of this is

addressed by the economic activity definitions.

Economic activity definition

The second definition of 'rural' engages with the type of economic activity in rural

and remote areas. If we discount the rural coastal areas which are highly dependent on

tourism, the most significant industries of the vast inland areas are agriculture, mining

and, to some extent, tourism. However assessing the numbers of people engaged in

these industries remains problematic. It is possible to gain an understanding of the

number of people directly engaged in agriculture, for example, but this does not

represent the number of people who are indirectly dependent on the industry-the


1nachmery distributors, the mechanics, stock and station agents, etc. who live and work

111 rural communities.

Nevertheless agriculture remains the most significant of the inland industries and

the Australian Bureau of Statistics (ABS) provides some dimensions to the number

of people directly engaged in this industry. There are approximately 140 000 farming

enterprises in Australia and the vast majority (over 90%) of these are run by families

(Carnaut and Lim-Applegate 1998). The farming population is ageing markedly as

young people turn their backs on the industry as it struggles through tough times.

Approximately18% of people identifYing as farmers are over 65 years and only 10%

are under 35 years (ABS 2006a). Yet over half the farming population reports that

they work more than 49 hours a week, compared with 18% of the rest of the popula

tion who work these hours. Women are taking a more prominent role in agriculture,

with one-third of identified farmers being female and approximately half of the farms

run by families being reliant on the income produced by women employed off-farm

(Alston 2000). Consequently women are far less likely to report fitting the traditional

'farmer's wife' model, and it is not too extreme to suggest that food production in

Australia is being subsidised by women who work off the farm to allow their families

to remain in farming (Kubik and Moore 2005).

While not indicative of the total population who are dependent on these indus

tries, the 2006 census reveals that 3.2% of Australians work in agriculture and 1.2%

are engaged in mining industries. In the 2000s Australia has been riding a wave

of prosperity due largely to the resources boom. Mining occurs mostly in rural

and remote areas, particularly in Queensland in communities like Emerald, Mount

Morgan and Clermont and in Western Australian areas like Kalgoorlie, Karatha and

Meekatharra, among many others. These areas draw large numbers of workers to

remote and very remote areas and, in many of these communities, because wages are

so high and housing stock so limited, the cost of housing has skyrocketed. Many also

have a skewed gender profile, with men over-represented because the type of work

available has traditionally been done by men. However, in a new age of flexible work

ing conditions, many workers operate on 'fly-in fly-out' employment arrangements

from capital cities and regional centres, resulting in large numbers of workers not

being readily identified in rural statistics. Thus the economic definition gives some

sense of the activities within the vast inland regions, but does not tell us much about

the people who live there.

Socio-cultural definitions

Perhaps greater depth has been given to the third type of population definition

the socio-cultural explanation of what it is to be 'rural'. This definition rests on

understanding what it is like to feel 'rural' or to identifY as 'rural' , regardless of the


spatial or economic dimensions of one's living arrangements.As Rios (1988: 1) notes

people know when they are rural!

Much has been written about the 'rural idyll'-the notion that life is more peace

ful, harmonious and community-minded in rural areas (Little and Austin 1996; Cloke

2006; Smailes 2006). In fact the 'rural idyll' owes much to Tonnies' (1887) original

concept of Gemeinschajt-the notion of a strong sense of community-as opposed

to his idea of Gesselschajt-the more formal and less personal society-perhaps more

typical of urban areas. This conceptualisation of the 'rural idyll' as thickly bound up

with a harmonious and supportive community lent a certain air of moral authority

to rural people who tend to laud the value of place, connection and sense of belong

ing. There is much evidence to support the community-mindedness so evident in

rural communities-dense interactions between family, friends and neighbours, the

shared facing of adversity and the strong networks of trust. However more recent

events such as the long years of drought, the gradual loss of people and insidious and

ongoing change have eroded the social capital that once typified rural areas. The rural

idyll looks out of place in communities where social capital, networks and trust have

been dissipated over decades.

The concept of a rural idyll also disguises the more sinister forces at play in relation

to the rural-the power and gender imbalances, racism and conflicts, and the powerful

ideological forces that support inequalities and prejudices (see, for example, Little and

Austin 1996). These are evident when one assesses who holds political power in small

communities, who owns the resources such as farm land and who dominates areas of

public space. In many rural and remote communities there is an over-representation

of older white males who dominate power and gender relations (Alston 2000; Shortall

1999; Pini 2002, 2004 and 2005).

Thus many researchers refer to the rural as highly 'masculinised' territory. This is

perhaps best typified by inheritance patterns in agriculture, where research suggests

that women inherit only about 5% of family farms in their own right (Dempsey

1992; Alston 2000) resulting in much of the resources on which our rural industries

are based being owned by white men. This masculinisation of resources and power

in rural areas is also represented in historical notions of taming, conquering and

dominating the rural landscape and the linking of these values with male strength

and aggressiveness (Little and ]ones 2000; Coldwell 2006). Thus what it is to be

rural is bound up with one's place in family and community, and gender and race

are highly visible markers of rural power and prestige (see, for example, Little and

Panelli 2003).

Leipins (2000: 606) argues that the rural is a socio-cultural field with its own

social relations and institutions, with meanings and social practices identified as 'social

truths'. Thus she argues that men (and presumably women) are 'made' or socially

constructed around certain recognised customs and practices and these are often

highly conservative (Leipins 2000;Alston 1995b).While these values and customs can


lead to a rich depth of networks within communities, stepping outside long-estab

lished boundaries may result in ostracism and social exclusion. Thus the rural idyll has

its dark underside, an underside that can disempower and render invisible those with

more limited resources and those who do not conform with normative behaviour.

More tellingly for the purposes of this book, Little and ]ones (2000) argue that

these dominant rural values are reflected in rural policy, thereby ensuring that policy

is often framed from a white male reference point, ensuring the protection of certain

interests over others. As we move through the material in this book, there is much

to support this notion that policy undervalues the needs and worth of women and

other disempowered groups in rural areas-and this is one of the significant points of

which human service practitioners should be cognisant. Accepting these views, values

and customs at face value and uncritically accepting policy parameters can further

disempower those whose positions are not represented.

Nonetheless socio-cultural definitions give a stronger sense of the 'rural' because

they outline more fully what people describe when they note their rural back

ground. However, over the last 30 years, times have changed. Rural people now face

unprecedented challenges; their strong sense of certainty in their 'rurality' and its

moral superiority, its enduring nature and values base has been unsettled by events

out of their control. As a result, those in rural areas are much more likely to suffet

socio-economic disadvantage by comparison with urban Australians and the notion

of a morally superior existence in rural areas is a quaint historical notion.

For the purposes of this book then, 'rural' is defined as:

Those areas outside major metropolitan areas that are more commonly in the Outer

Regional, Remote and Very Remote classifications, where accessibility to services is

moderate to remote, where the main industries are agriculture, mining and to a lesser

extent tourism, and where people generally relate to the notion of a shared set of values

loosely defined as rural.

Who then are the people who live in these regions-the vast inland areas of

Australia, and what are their circumstances?

1.3 Indicators of rural

Even though populations are more sparse in rural and remote areas, families tend to

be larger, with women more likely to have children and more of them. While nearly

a quarter of Australia's population (24%) were born overseas, most tend to settle in

capital cities (ABS 2008a). Thus rural and remote areas tend to exhibit less diversity

in their population base and it is more likely that people have been born in Australia.

Nonetheless the out-migration of young people has led to an ageing profile across

rural and remote areas and these communities are ageing at faster rates than urban

areas (Birrell 2000). Further, the more remote the area, the greater the likelihood


that there will be more men and a greater proportion of Indigenous people in the

population. To see how rural and remote people are faring it is useful to analyse the

socio-economic data for these sparse regions of Australia.

1.4 Socio-economic indicators of rural

What we consider to be disadvantaged in Australia may appear to be quite affiuent

in other countries. Thus when we talk about the socio-economic status of an area

we tend to be referring to it in relation to other areas-in other words such status

is relative (Townsend 1979) and, in this discussion, this means relative to other areas

within Australia. Thus if we describe an area as disadvantaged, we mean that it is

disadvantaged in relation to other areas within the country.

In any discussion of the socio-economic status of rural areas, it is useful to note

that the ABS (2006b) has developed a measure to compare and contrast areas on

various parameters including income, education, employment, occupation and hous

ing. The Socio-Economic Indexes for Areas (SEIFA) are an amalgamation of four

indexes-the index of relative socio-economic disadvantage, the index of relative

socio-economic advantage and disadvantage, the index of education and occupation

and the index of economic resources (ABS 2006b). The SEIFA are locality based,

and as Pink (2008) notes, these scores define the broader area context rather than

being a score for all of the people living there. It would be ridiculous to assume

that everyone within an area with a low SEIFA score was disadvantaged. All areas,

including those in the remotest parts of the country, are diverse and include wealthy

as well as vulnerable populations.

Nonetheless, as with other measures of socio-economic status (for example, see

Kreiger et al. 2003), the SEIFA measures have proved to be accurate predictors of

certain social determinants of health status.As Adikari (2006: 28) notes:

Proportionately more people living in areas that are relatively more disadvantaged were

found to be in poor health, more likely to be smoking, more likely to have higher

mental distress and were also more likely to be obese.

This indicates that people in areas with low SEIFA scores have higher levels of

social disadvantage.Across the world, rural areas are over-represented in those defined

as relatively socio-economically disadvantaged (FAO 2007). Disturbingly this holds

true for Australia where rural and remote areas are also over-represented in the low

SEIFA bands. The high bands tend to cluster around the coastal, capital city and

mmmg areas.

Adding to this understanding of rural Australia as socio-economically

disadvantaged is the work of noted social work researcher, Tony Vinson, who has

undertaken two studies looking at the geographical distribution of social disadvantage

in Australia, one published in 1999 and another in 2004 (Vinson 1999 and 2004; see

AUSTRALIAN RURAL HUMAN SERVICE PRACTICE IN CONTEXT 1 1

.1lso Vinson 2007). These studies draw on the World Health Organisation's (WHO)

concept of Social Gradient-the view that poor social and economic circumstances

.1Hect health throughout life (WHO 1998). Using a complex set of factors including

unemployment, low birth weight, child maltreatment, childhood injuries, education,

psychiatric admissions, crime, income, mortality, sickness and disability support,

imprisonment, early school leaving and electricity disconnections,Vinson has come

up with a list of the most disadvantaged areas in New South Wales (NSW) and

Victoria by postcode. Not surprisingly, rural areas are over-represented in those listed

as most disadvantaged in both the 1999 and 2004 studies. In the 2004 study, 31 of the

top 40 most disadvantaged areas in NSW are rural and in Victoria, similarly, 31 of the

top 40 are classified as rural. The link between rurality and disadvantage in Australia

is firmly established by both SEIFA categories and Vinson's work.

Several additional studies assessing socio-economic factors associated with

rural living report that Australians living in these areas experience higher rates of

unemployment and poverty, lower income and poorer health status and outcomes

(see, for example, Hugo 2002). Poverty rates are also higher, more widespread and

chronic in rural areas (Bourke 2001: 98).

In relation to health, rural Australians have poorer health status, higher mortality

rates, lower life expectancy and suffer from more chronic conditions than those

in metropolitan areas (Foster 2007; AIHW 2005). Further, life expectancy tends

to decrease the further one moves from a regional centre (Ryan-Nichols 2004),

suggesting risks are higher, services are less accessible and it seems people have come

to expect a reduced level of support. People in rural and remote areas are more likely

to suffer from heart diseases, respiratory diseases, infectious diseases and injury and

death rates are five times higher than the general population (ABS 2003a: 4). They

also experience higher rates of disability (Brown 2002) and higher prevalence of

psychiatric disorders (Cheers and Taylor 2005). The Australian Institute of Health and

Welfare (AIHW 2008) notes that rural health is poorer in the following areas:

. . . coronary heart disease, other circulatory diseases, chronic obstructive pulmonary dis

ease (for example, emphysema), motor vehicle accidents, diabetes, suicide, other injuries,

and some cancers such as lung cancer. These higher death rates may relate to differences

in access to services, risk factors and the regional/remote environment.

The poorer health status of rural and remote Australians results from greater

exposure to environmental and risk factors (Foster 2007), and poor infrastructure

including bad roads and a lack of public transport. Rural people have lower rates of

medical consultations but higher rates of hospital admissions (AIHW 2008). With

the onset of drought and subsequent conditions of extreme stress in rural areas, the

number of people suffering mental health problems in rural areas is increasing at the

same time as services are critically lacking (Malo ne 2008). The mental health crisis in

rural and remote areas has resulted in significant campaigns emanating from agencies

1 2 INNOVATIV E HUMAN SERVICES PRACTICE: AUSTRALIA'S CHANGING LANDSCAPE

such as beyondblue, an organisation committed to raising awareness of depression. It is

also acknowledged by human service workers such as the Rural Doctors' Association

(2006) and by workers in the field (Malone 2008).Yet mental health services in rural

and remote areas, where they exist at all, are poor (Alston and Kent 2004).

Unemployment rates tend to be higher and employment is more precarious in

rural and remote communities. With new workplace relations legislation in Australia,

and because of a lack of choice in employment options, rural and remote people are

often forced to take whatever conditions are on offer. Many rural and remote workers

are on casual contracts and have few of the benefits of secure employment, such as

holiday pay and sick leave (Alston and Kent 2001).A decline in agricultural jobs has

left many workers unemployed and the ongoing drought has reduced employment

options for contractors and casual workers (Alston and Kent 2004). By contrast, in

mining communities employment options have boomed, wages are high and condi

tions good because of the need for workers.

In the area of education, people in rural and remote areas achieve less. Distance,

financial and associated factors result in lower levels of high school completion and

significantly lower numbers of people accessing tertiary study (Alston and Kent

2006). The ABS (2008a) Social Trends report notes that the proportion of people with

a post-school qualification declines as level of remoteness increases. While 57% of

people in major cities have a post-school qualification, only 36% of those in very

remote areas do. These lower rates of educational attainment are also reflected in

high schobl completion rates which decline markedly by level of remoteness. In all

areas women/ girls have higher completion rates and/ or post-school qualifications

and Indigenous Australians have significantly lower levels of achievement (Alston

and Kent 2006).

The Human Rights and Equal Opportunities Commission (HREOC) conducted

consultations across rural Australia in 1999 and noted that:

In almost every aspect of our work the Human Rights and Equal Opportunities

Commission (HREOC) has noticed that people in rural and remote Australia generally

come off second best. Distance, isolation, lower incomes and minority status all exacer

bate the experience of discrimination, harassment, and lack of services and participation.

(HREOC 1999: 1)

Their publication, Bush Talks, and their follow-up report on rural and remote

education (HREOC 2000) note that rural people are seriously discriminated against

and their human rights violated, in the areas of health, mental health services,

education, and broadly across all levels of service delivery. Making these issues more

difficult is an inability to attract and/ or retain health professionals, and the fact that

there are fewer services, a lack of public transport and higher prices for goods and

services (Bourke 2001:89).Very little has changed in the period since the HREOC

consultations were undertaken.


I kdining social interactions in rural communities have eroded the dense

l.1ycrs of social capital that typified rural communities in the past. While a sense of

ronnectedness and belonging is still vitally important to rural people (Byles-Drage

21 HI H), socio-economic factors that have shaped rural communities and the people

who live there have been significantly undermined by changed circumstances. There

1s no doubt that those living in rural and remote areas of Australia are more likely

to suffer socio-economic disadvantage. These issues are exacerbated by distance, lack

of transport and a lack of services. For rural people these factors combine to reduce

quality of life.

1.5 Ongoing processes of change

The indicators outlined above give a static understanding of rural and remote areas

as fixed in a state of ongoing and sometimes profound disadvantage. It is important

to note that it has not always been this way-nothing is fixed and everywhere there

is change. Even 50 years ago rural Australians would have been viewed as advantaged

by comparison with the rest of the population. Agricultural prices were high, there

were many employment opportunities, service infrastructure was extensive and well

staffed and most rural communities were vibrant places.

Over the intervening period much has changed. A downturn in agriculture,

reduced need for manual labourers, a decline in services and the jobs that go with

them, privatisation of many public services and a general movement of people, partic

ularly the young, to regional and capital cities, has changed the face of rural and remote

Australia. Over the past 100 years, Australia has become a highly urbanised society, far

less reliant on agricultural produce for our national wealth. At the same time, rural

influence in politics has declined-a process evident in the decline in the National

Party, the party traditionally set up to represent rural Australia (Alston 2000).

Yet one of the most significant factors creating change in Australia's rural and

remote areas is globalisation-a factor explored in more detail in the next chapter.

In the globalised world, multinational corporations have significant power and the

ability of national governments to regulate and control social impacts is reduced.

Additional features of globalisation are the growth of transnational regulating bodies

to monitor the new world production order; the growth of a 'world culture'; the

interconnectedness of various, particularly financial, centres around the world; the

increasing mobility of people across national boundaries; and the breakdown in work

conditions and national safety nets (Gray and Lawrence 2001). Many companies

have moved their operations offshore, taking jobs to third world countries. While

the effects of globalisation are felt everywhere, for rural people and communities

dependent on agriculture, globalisation has resulted in a shift of power from the local

to the global level and many rural communities are uncompetitive in the big world

of global politics, leading to job losses and an erosion of working conditions.


Yet it is important to note that not all rural and remote areas are in decline-many

have benefited from globalisation and the dominance of multinational corporations.

Mining, for example, has created new areas of prosperity and many small mining

communities have significant wealth and prosperity. So too do the bigger regional

centres in rural areas-cities that have grown at the same time as smaller commun

ities around them decline. These 'sponge cities' (Salt 1996) are soaking up people

and service infrastructure and are therefore providing a diverse range of jobs and

opportunities. There are many stories in rural and remote Australia, not all of them

discouraging and many of them indicating a vibrant cultural context.

Nonetheless, for human service practitioners trained in urban institutions, the

circumstances of some rural Australians, the paucity of service infrastructure and the

conservative views can surprise and shock. Gender, race, ethnicity and class are all

elements that shape rural society, not always in positive ways. It is best to be prepared

and to be aware of rural and remote contextual factors in the various and diverse

areas that constitute rural and remote Australia. Equally important is the need to

be creative in the way these factors shape practice. Each area is different and each

has its own unique strengths. But before we move into a discussion of rural human

service practice, it is important to define what constitutes 'human services' and what

constitutes human service practice.

1.6 What do we mean by human services?

As with the rural definition outlined above, there is no generally acknowledged

definition of human services, other than that people working in this area assist others

in the areas of health and welfare. Thus the field of human service practice represents a

wide range of professions and settings. Human service workers include social workers,

doctors, pharmacists, nurses, physiotherapists, occupational therapists, rural financial

counsellors and community workers. The range of human service practice then

encompasses a wide range of areas, including direct health and welfare service delivery,

community development, counselling, child protection, income support, disability

support, aged care, etc. In rural regions these areas include all of the above as well as

crisis counselling, community work, financial counselling and drought support.

1.7 Human services in a rural context

In the rural context it is not unusual for human service workers, particularly those

in areas like medical specialisations, or welfare areas like income support, disability

care and child protection, to be based in regional centres undertaking some outreach

to more isolated areas. In more remote areas this may take the form of fly-in fly-out

services, where service providers fly to an area for short periods of time, work long

hours and then fly out again. While this form of practice provides some level of


services, it does little to attend to ongoing and crisis care. Far more common is the

expectation that rural people will travel to regional centres for services. The lack

of specialist services in rural and remote communities is an ongoing and critical

problem that creates significant hardship.

In small rural communities there are some human service workers, most typically

a local medical practitioner, community nurse and pharmacist. There may be a

small community hospital specialising in aged and basic emergency care and a rural

financial counsellor. There may also be health social workers and drought support

workers. In most communities human service workers operate in a collaborative and

supportive manner providing interdisciplinary care and working together to improve

program delivery. These collaborations can provide rich professional rewards and

enable innovative and creative practice.

Because of the extensive distances involved and the dispersed population base,

workers cover large areas and there are fewer workers than there should be. This

is often made more difficult by the fact that many advertised positions go unfilled

and by the high turnover in staff and positions. Those who are working in these

areas report working extended hours to cover the demand and many services are

over-reliant on volunteers. Privatisation of some services like employment agencies

sometimes results in multiple service deliverers in one area and none in others (Alston

and Kent 2001).

Charities such as Red Cross, the Salvation Army and St Vincent de Paul, often

relying on volunteers, also perform critical service delivery in rural and remote

communities because of the high demand for services and the lower levels of pro

fessional service delivery. There is clear evidence that there is increased demand

for services in small rural communities at the same time as service infrastructure is

declining (NCOSS 2004).

Rural human service practice, like other professions in rural areas, such as teaching

and public service management, operates as a 'professional nursery' (Healy 2004)

employing new graduates and/ or more inexperienced workers, who gain valuable

experience and then leave after two to five years. This flight of workers may be in

part due to the closed nature of rural communities who may not readily incorporate

'newcomers' into their midst (Byles-Drage 2008). It may also be due to a lack of

supportive human service practice models. While the turnover is not entirely prob

lematic, as it sources good people who gain knowledge and sympathy for rural people

and communities, it provides problems associated with attracting and retaining good

staff and growing strong teams.

A summary of research conducted in the area of rural human service practice (Alston

and Kent 2001 and 2004; Stayner and Barclay 2002; Briskman, Lynn and La Neuze

1999) suggests that it differs from urban practice in several ways including that:

• communities may not readily accept workers

• workers may have fewer colleagues


111 supervision may be patchy or non-existent

11 resources may be more stretched

111 workers in small businesses ruch as medical practitioners and pharmacists may be

carrying lots of unpaid bills

11 telecommunications infrastructure such as mobile phone and broadband coverage . .

1s very poor m many areas

11 the geographical areas workers are expected to cover are much more extensive

• driving long distances is expected and can be hazardous as a result of kangaroos

and other wildlife on the roads

m because of distance, workers may not be able to see as many clients

• regional and city-based managers may not understand the difficulties associated

with rural practice

111 reliance on volunteers is essential

111 anonymity is impossible

• separating professional and personal space may be difficult.

On the positive side the same research also suggests that:

111 workers have far greater autonomy

@ workers are able to be more creative with their practice

11 interdisciplinary teams are a feature of rural practice and are usually strong and

supportive

• the work of human service practitioners is usually highly valued and appreciated.

Human service workers are often surprised by the dense networks and strong

social organisations in rural communities and many report there being lots of activ

ities to keep them involved in their community. Country people are very good at

creating their own social activities and young professionals usually report that they

have a ready social network waiting for them and that this network engages in a

surprising number of sporting, cultural and social activities.

There are also strong networks of volunteer organisations on which human serv

ice workers can draw. For example, there are several women's groups, including the

Country Women's Association (CWA), as well as male-dominated groups like Lions

and Rotary clubs. Sporting organisations, church groups and charities also draw in

many volunteers eager to make a difference to their communities. However, in many

communities over the last two decades, the membership of these groups has declined

as people leave or are too busy or time poor to participate. Many of these organis

ations are also highly dependent on very old people to survive (Alston and Kent 2001

and 2004) and many have very conservative views about vulnerable people. Thus

workers should be aware of these groups but also note their limitations.

These features of Australian rural human services are common to other countries

across the world: isolation, lack of anonymity and high levels of creativity. Where

Australia differs is in the distances that workers must cover and the sparse and

dispersed population base.


1.8 Three layers of government

In .1ttending to human services in the rural context, it is important also to note

t hl' multilayered government involvement. There are three layers of government

111 Australia-the Commonwealth or national government, the states and local

government. All have some level of responsibility for policy concerning services and

may be involved in front-line service delivery in rural and remote Australia. At the

national government level, Australia has a Department of Human Services (DHS)

which includes several agencies: Centrelink (the government income support agency),

( :hild Support Agency, CRS Australia (formerly the Commonwealth Rehabilitation

Service), Medicare and Australian Hearing. According to its website the Department

of Human Services:

. . . directs, coordinates and brokers improvements to policy on service delivery and

service delivery reform across Human Services agencies from a whole-of-government

perspective. (DHS 2009)

Thus the Department has wide-ranging responsibility for service infrastructure and

service delivery and is critical to policy development in rural and remote Australia.

There are also a number of other Commonwealth departments that have an impact

on rural and remote service delivery and policy. These include the Departments of:

• Health and Ageing

u Families, Housing, Community Services and Indigenous Affairs

• Education, Employment and Workplace Relations

• Agriculture, Fisheries and Forestry

• Infrastructure, Transport, Regional Development and Local Government.

In addition, the states and territories have departments and instrumentalities with

responsibility for health and welfare policy and services, but each state approaches

this differently. This results in states having contrasting configurations in their depart

mental structures. For some workers the issues between states can create service

anomalies in communities near state borders which can create a minefield of paper

work and obstructions.

Local government is the least involved in health and welfare areas but perhaps is the

layer of government most likely to be directly confronted by local needs. Increasing

stress on community members can place great pressure on small local governments

with low levels of resources. Local government representatives are constantly advocat

ing for their constituencies with their state and Commonwealt� governments.

These three layers often intersect at local community levels, creating overlap

and confusion. It can also lead to over-servicing in some areas and a lack of serv

ices in others. In addition Commonwealth-state relations have been fraught with

difficulty in the past, creating obstructions and lack of communication between

departments and leading to difficulties on the ground for workers. Human service


work can include dealing with these dense layers of bureaucracy and consequent

accountability measures for several departments. It may also include negotiating

state-Commonwealth and/ or state-state relations and inconsistencies. At times this

can lead to significant frustration for workers.

1.9 Government policy affecting human services

In addition to the complexity of government layers and structures, there have been

significant changes in the principles underpinning social policy in recent times.

This has occurred not just in Australia but across the Western world, and is driven

by the impact of globalisation and the desire by nation states to accommodate the

needs of global capital. A neo-liberal policy orientation over the last two decades

(variously called economic rationalism, Reaganomics (after a former US President),

and Thatcherism (after a former Prime Minister of Britain)) has resulted in a

reduced commitment to community, a favouring of individualism over collectivism

and greater expectations on families to support their own (Powell 2001).

Economic rationalism is 'the belief in the efficacy of free market forces as a

mechanism to determine the allocation of scarce resources among alternative users'

or, more succinctly, 'the market knows best' (O'Toole 1999: 65). Because of its

commitment to market forces being determinant, neo-liberalism enables maximum

profit generation opportunities for companies, at the same time as it reduces the

ability of disadvantaged groups to receive assistance. This widely held, cross-party

philosophy has resulted in governments at national and state levels withdrawing

from the front-line of service delivery and reducing government involvement in

the marketplace (including in health and welfare service delivery).

The Commonwealth government adopted a National Competition Policy in

the 1990s to make Australian industries more efficient and globally competitive.

This policy dictates that services are judged on quantitative performance outcomes,

a process that ultimately disadvantages rural businesses (Cheers and Taylor 2005).

One result of National Competition Policy has been a fostering of privatisation and

a gradual downsizing of government as services, including those run by govern

ments, have been put to competitive tender to ensure the most efficient operation.

A consequence has been a move away from rural economies through a process of

recentralisation. For rural communities lacking a strong basis for maximised profits,

this policy has inevitably led to service loss and a consequent loss of employment

opportunities for professional workers.

Mutual obligation between governments and citizens is also a fundamental

principle fostered by neo-liberals to address efficient use of resources, including

income support payments. This describes the expectation that people who receive

assistance must also give something back. However mutual obligation is rarely ever

AUSTRALIAN RURAL HUMAN SERVICE PRACTICE IN CONTEXT 1 9

' n tutual' and there is evidence that governments hold the upper hand in a decidedly

one-way process of obligation.

The introduction of these more market-based policy underpinnings has

t'oincided with a move away from a strong, rights-based and universal social

\l'rurity system to a more residualist and punitive approach. There is more pressure

on people to look after themselves or to be cared for within the family context.

The development of what has become known as the Third Way (Giddens 2001)-a

third option falling somewhere between the strong universalist post-War social

security system and the more punitive economic rationalist position-has softened

the more austere versions of neo-liberalism and mutual obligation. However social

policy is now developed and delivered with a much harsher face. For example,

in Australia there has been a significant focus on people who may be 'cheating'

the social security system or failing in their obligation to declare income. In a

study undertaken in 2001, the Australian Council of Social Services (ACOSS 2001)

noted that the government had 'breached' (that is, withdrawn benefits from) nearly

350 000 people in a one-year period for failing to comply with regulations. The

language adopted to address disadvantaged groups by politicians and commentators

indicates that the vulnerable are more likely to be viewed with suspicion than

with sympathy.

The result of these gradual but quite dramatic changes is that efficiencies and

economies have been introduced into service delivery. This has coincided also with

the adoption of a managerialist approach, aimed at improving these efficiencies.

For workers this ensures that accountability measures are high. Form filling has

become a fact of life and work practices must be justified, often through the use

of inappropriate quantitative measures. Workers now speak of managing up to

managers rather than down to clientele. While there is .no doubt that systems and

processes must be efficient and economically viable, many would argue that new

managerialist practices have overshadowed the benefits of services for clients.

1 .1 0 Effects of policy on rural human services

In understanding the impacts of these dramatic changes in social policy orientation

on rural and remote service delivery, it is useful to note the four '-isations'

centralisation, regionalisation, privatisation and marketisation.

New efficiencies have led to the centralisation into capital cities and larger

centres of administration of many services and the regionalisation (shifting

into regional centres) of many specialist services. Regionalisation of services has

had major impacts on the availability of services in rural and remote areas. One

particular example which gives some understanding of the way regionalisation

may be fine in theory but totally inappropriate at local levels is the provision of


birthing facilities in rural areas. Efficiency measures have resulted in the closure of

over 130 rural birthing centres in Australia from the late 1990s and the consolidation

of these into the larger regional centres (Australian College of Midwives 2007). The

result has been disastrous for women, with reports that babies are being born on the

side of the road because families are attempting to drive long distances to hospital,

and others are delivering their babies in unsafe circumstances (Dietsch et al. 2008).

There are similar reports of people having difficulties accessing specialist services,

such as cancer care and psychiatric care (Alston and Kent 2004). While the premise

of regionalisation is that more technologically advanced and superior services can be

provided in regional areas, this is unjustified if people cannot access them in a crisis.

The introduction of privatisation of services has also resulted in the retreat of

governments from the front-line of service provision in many service areas and the

introduction of private providers in the area of welfare and health service delivery

an area where market-based parameters had not previously been dominant. These

new private organisations are businesses and are therefore focused on bottom-line

profit motives over service delivery. Privatisation has also had significant impacts in

rural and remote areas, with reports of multiple providers in some service areas and

none in others (Alston and Kent 2001). Because it is difficult to make a 'profit', many

areas have lost services altogether. Privatisation has also had an impact on the levels

of collaboration between service providers in rural and remote areas, as some services

are now competitors in the 'marketplace' rather than collaborators. The tendering of

services by government to the lowest private provider bidder has resulted in the loss,

in some areas, of local providers with critical knowledge and networks, and the intro

duction of outside companies with little knowledge and community understanding.

Marketisation (Healy and Meagher 2000) is also a more prominent factor of

service delivery-this is the adoption of user-pays principles to health and welfare

services. Many services charge individuals using their services at least a portion of

the costs and this can result in services being inaccessible to people if they are unable

to pay. Marketisation-or user pays-has also undermined rural service users' access

to services. Increasing poverty has made it difficult for people in rural and remote

areas to pay for services. There are reports of people being unable to access the local

doctor because they do not bulk-bill, and others being unable to access medicines at

the pharmacy because of an inability to pay (Alston and Kent 2004).

These new ' -isations' in service delivery and the introduction of market principles

and efficiency measures have had major impacts in rural areas where the population

base is small. Many services now operate in an environment where demand is the

dominant factor, rather than need, and many rural and remote areas are highly unlikely

to have the population base to support a viable business. Hence many essential serv

ices have been withdrawn or are unable to meet local needs. The centralisation of

administration of many services, for example, means that these administrative hubs

AUSTRALIAN RU RAL HUMAN SERV ICE P RACTICE IN CONTEXT 2 1

are rarely in rural areas. Health administration is one example where the amalga

mation of health boards into large conglomerates, covering vast geographical areas,

may be administratively efficient, but results in the removal of these hubs from local

knowledge and expertise. This can result in a lack of understanding of the complexi

ties of service delivery in rural and remote areas.

The result of the gradual withdrawal or downsizing of services in rural and remote

areas has been significant anger with governments for their lack of concern for the

issues facing people and communities. In many interviews the writer has undertaken

over several years of drought conditions, people report strong feelings of alienation

from government and the nation as a whole. They feel let down and abandoned, and

question the basis on which policies relating to services are developed (Alston and

Kent 2001 , 2004 and 2006).

A neo-liberal approach to service delivery has been a consequence of globalisation,

and there is no doubt that efficiencies needed to be developed. However, policy

outcomes have been particularly brutal in their impacts on rural and remote areas.

Reshaped policy, together with globalisation and other forces such as out-migration,

has changed the face of rural and remote Australia. Human service workers find them

selves drawn to advocate on behalf of their communities. They also bear the brunt

of these policies because the result is a low level of services and infrastructure that

often does not meet the needs of the people they serve, at a time when services are

critically needed. The next chapter will examine how Australia's situation compares

to other countries and how rural and remote peoples fare in a globalised world.

SUMMARY

In this chapter several key concepts have been introduced including the nature of 'rural', the

circumstances of rural people, definitions of human services and the role of human service work

ers in rural and remote areas, and the impacts of changing policy on the delivery of services and

infrastructure in rural and remote areas. lt has also been noted that rural practice offers major

challenges. In the following chapters readers will also come to understand the exciting possibilities

inherent in rural and remote practice.

QUESTIONS

1 What are the three types of definitions of 'rural'?

2 Describe the comparative socio-economic circumstances of rural people.

3 What professions work in the human services?

4 What issues affect human service workers in rural and remote areas?

5 How has government policy affected human services delivery in rural and remote areas?

22 INNOVATIVE H UMAN SERVICES P RACTICE: AUSTRALIA'S CHANGING LANDSCAPE

Go to the ABS website <www.abs.gov.au > and download the community profile of a small rural

community. Assess the population demographics, noting the age profile, employment base,

education levels, diversity characteristics, etc. Assess what services are likely to be needed in the

community for optimal support of the population. Locate information on the services available

in this community-this may be through a commu nity services directory or telephone interview

with a local service provider. Assess whether the service infrastructure might meet local needs.

rural australia and rural human service practice in context · out a definition of human services...

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