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Within the contemporary child protection and family welfare environment most jurisdictions are striving to move beyond reactive investigative responses toward more needs-based interventions and services that will support the interests of vulnerable children and their families. This is so internationally and across Australian state jurisdictions:. As the close relationship between problems such as poverty, mental illness, homelessness, substance misuse, unemployment, crime, antisocial behaviour, poor health, low literacy and child abuse and neglect is increasingly understood, new ways of thinking and responding to this challenge are emerging.

Scott 1. The links between family hardship and other dimensions of child wellbeing—physical health, housing, safety and psychological wellbeing—are well established 2. Within a family support policy and practice context, notions of more ed up community-based responses that take into broader family circumstances, built on strengths and tailored to need, are seen as critical to the prevention efforts of both government and non-government services.

Increasingly, therefore, it is recognised that creating a responsive child, young person and family support system requires the development of a continuum of services that support diverse family need. The service continuum seeks to support those families identify and reduce situations of current harm and support strong, capable families.

Service systems across Australia strive to develop a strong continuum of services, consistent with the expectations of the National Framework for Protecting Australia's Children. Within this review we have examined Norfolk Island service framework across this continuum, considering both the broad and specific needs of children, young people and their families. Figure 1: a continuum of services to support children, young people and families.

Our experience of meeting with Norfolk Island children, young people and their families highlighted for us the considerable strength and resilience demonstrated by Norfolk Island families and communities. We observed and heard about the valuing of family including extended family and community life; the strong work ethic; the child-friendly physical environment; the high level of self-reliance and resilience in the face of adversity; and the valuing of history, culture and environment.

These strengths are important. They create a unique set of community expectations that reinforce a proud culture that has withstood many challenges over the decades. In the many meetings we had we also heard that Norfolk Island life is inevitably changing.

Whilst children and families have been supported by a strong extended kin network, this is now not the case for everyone. Vulnerable people who lack a supportive extended family find themselves without a safety net to support them in times of trouble.

There are also times when self-reliance creates a reluctance to seek help, resulting in vulnerable people falling through the net of family and community concern. The privileging of history, culture and environment is another important aspect of Norfolk Island identity. In the past, that sense of independence and history of self-governance contributed to the prosperity of Norfolk Island. Nevertheless, when we talked with people we found that many are concerned about the way in which Norfolk Island self-governance has impacted upon their rights as Australian residents. It is clear that many of the services and provisions available to people on mainland Australia are not accessible to people on Norfolk Island.

It is also clear that financial constraints and economic limitations prevent the Norfolk Island Government from providing the universal safety net that is taken for granted on mainland Australia. Many people expressed the view that the value and benefits of fully entering Australian Government systems outweigh the perceived lessening of aspects of the island's autonomy and management of its own affairs. Disagreement over this within the Island community and between the Norfolk Island Government and successive Australian Governments has restricted the development of a strong service sector supporting Norfolk Island children, young people and families, despite successive reviews and recommendations for change.

The findings of earlier reviews 5 and the extent of the distress and concern expressed by people within the Norfolk Island community suggests that the Norfolk Island Government alone is not able to close the gaps of disadvantage and promote lifelong wellbeing for children, young people and families living in Norfolk Island. Solutions depend upon the combined support of the Australian Government and Norfolk Island Government. Identify barriers and issues associated with the provision of effective children and family support services. Consider practices, procedures and resources within the Norfolk Island Government with direct responsibilities in this area, and also consider how the government and non-government organisation agencies might contribute to a more effective protection and support network.

Consider how the Norfolk Island Government can help to support children and young people to reach their potential and assist individuals and families who are at risk or in crisis. To maximise the participation of young people and their families we arranged for an item to be placed in The Norfolk ISLANDER explaining the purpose of the review and the importance of wide consultation. We were also interviewed on Norfolk Island radio, and received a volume of s from community stakeholders expressing their views and perspectives relating to the availability and quality of services on the island.

Hence the review has taken into consideration empirical data, professional reports, and the reported experiences of families, professionals, decision-makers and community leaders. The lack of reliable data has frustrated our efforts to assess in depth the wellbeing of Norfolk Island children, young people and families, both now and across time. Consequently self report and report by professional's form a bigger role in this report than might otherwise be the case.

It also makes planning more difficult as trends cannot be identified and tracked, nor can the impacts of interventions be assessed. The findings and recommendations of the review are organised within a systemic framework addressing levels across the continuum of services. This is consistent with the direction for service delivery that has been set by the National Framework 8 :. More intensive secondary prevention interventions are provided to those families that need additional assistance with a focus on early intervention. Tertiary child protection services are a last resort, and the least desirable option for families and governments.

The challenges facing Norfolk Island in providing a continuum of services have implications for children, young people and families, for professionals, and for the community more broadly. As such we have framed the sections of the report to address these three domains. Economic hardship ran through almost all our conversations with families on Norfolk Island. Families reported their experiences of "doing it tough" in a harsh economic environment. These personal experiences were validated by community members who provided help through their church or their club and by professionals across the service sector.

In their survey of community wellbeing, Deloitte Access Economics, found that 51 per cent of Norfolk Islanders reported they were "just getting by" compared with 28 per cent of mainland Australians 9. If things were tough for families, however, then there were even more difficult for families with additional needs; families that had with a disability or mental illness, families where one of the children had been ill and required time off island, or sole parents with no financial support from the other parent.

It would seem this personal experience is borne out by the sharp increase in more objective measures such as the recovery of unpaid debts to the Norfolk Island Government as Table 1 demonstrates. While there has been more effort to recover debts it is unlikely such dramatic increases would result solely from a more vigorous approach to recovering bad debts. It was not unusual for people to talk about needing to work at three or four jobs in order to make ends meet.

They found that over 25 per cent of the population indicated they had missed an electricity, gas or telephone bill in the past 12 months due to a shortage of money compared to 12 per cent in mainland Australia. They conclude that "the levels of financial stress on Norfolk Island are higher than elsewhere in Australia" Family economic stability is exacerbated by Norfolk Island's concentrated wage structure 12 , and high cost of living for essentials such as food, utilities and transport When combined with increasing job insecurity from the downturn in tourism 14 , this is creating ificant financial and emotional stressors.

The economic downturn on Norfolk Island has been relatively severe, and can be described as an economic depression. There is relatively strong evidence that the economic downturn is impacting the quality of life on Norfolk Island and resulting in the depreciation of social capital. Many costs on Norfolk Island are greater than on the mainland, and the cost of living on Norfolk Island has been increasing faster than on the mainland. Even allowing for the absence of income tax, incomes on Norfolk Island are relatively low. As such, increases in the cost of living have a relatively strong impact on welfare.

Having a parent work is positive for children because it provides family economic stability, one of the preconditions for wellbeing. Many adults spoke about feeling tired and stressed, and how they struggled to fulfil their parenting role. Stress and exhaustion not only impacts on the health of the parent, it also impacts on the quality of the child's experience of being parented. Families where someone had a disability or a mental illness, or where they were parenting alone, faced an even greater challenge.

It is interesting to note that unpublished data from the health survey undertaken by Professor Lyn Griffiths from Griffith University, shows an increase in self reported mental health concerns by Norfolk Island residents from 8. Women spoke to us of returning to work within 3—4 weeks of their baby's birth, some returned to work as soon as one week after giving birth.

Women reported that this return to work was usually by economic necessity. This return to work pattern in children entering child care very early, something that is particularly worrying as it impacts on the immediate and longer term wellbeing of infants. Any measure of women's health and child development policy would suggest this to be unacceptable. It allows no time for the woman to recover after the physical tasks of pregnancy and birthing, it complicates breastfeeding, and has the potential to interfere with critical processes of bonding and attachment between the baby and the important adults in their lives.

All said they would have wanted to stay with their babies. The research supports their concern. 's early environment plays a large role in shaping their later outcomes. Thus policies such as paid parental leave and programs that impact on the quality of early childhood education and care services and maternal health services have ificant impacts on human resource development and future Island prosperity. Nobel Laureate economist James Heckman has powerfully demonstrated this and argues that directing additional funds toward the early years, before the start of traditional schooling, is a sound investment in the productivity and safety of our society.

Programs impacting on the quality of early childhood education and care are especially ificant for Norfolk Island as it has a 25 per cent higher participation in preschool than mainland Australia Yet despite this higher participation rate, Norfolk Island has no standards covering these services. In contrast the development and implementation of a quality framework in early childhood has been an important focus for mainland Australian policy and investment.

We also were concerned about the perverse effects of the health insurance scheme operating on Norfolk Island. It has been shown across time and across countries that health is directly related to income; people on low incomes have poorer health whereas those on high incomes have much better health. Families with high incomes can carry this cost whereas poorer families are unable to and as a consequence will avoid seeking health care, a response that is deleterious to their health.

For example, they may neglect the management of chronic illnesses, or they may fail to take preventative measures to avoid hospitalisation and so on. As such the health insurance scheme creates perverse incentives—those who are better off generally enjoy better health and are able to access health care, whilst those with poorer health are discouraged from seeking health care because of cost.

This inverse incentive that discourages and disadvantages poorer people informs mainland Australia's commitment to Medicare as it enables those most in need i. Secure housing is another essential in meeting children's basic needs. On mainland Australia, family stress is ificantly relieved by the combination of and interaction between; an income support system e. Further, it is a progressive system which means that those with more wealth contribute more to the taxation base than those with less capacity to do so.

It is transparent and not arbitrary. To a large extent the mainland population sees these costs and benefits as part of the mutual obligation between a government and its citizens. We have found the breadth, de and operation of the safety net and mutual obligation expressed through Norfolk Island's income support, taxation, health, and employment legislation and systems to be extremely limited by comparison to mainland Australia.

It is in our view, inadequate to support the very real disadvantage facing some individuals and families in Norfolk Island. This inadequate safety net is critically ificant when seen in combination with the island's concentrated wage structure, high cost of living, increasing job insecurity, the absence of any social housing and the notably older age profile of Norfolk Island than that of the rest of Australia.

Indeed the median age on Norfolk Island is 46, as compared to 37 in the rest of Australia. It is also clear that economic hardship is forcing individuals and families to leave the island, or consider separation as the breadwinner seeks employment in mainland Australia or elsewhere internationally.

We are aware from our discussions with people on Norfolk Island that there is a real concern, expressed by a few, that introducing a stronger safety net for families could undermine the strengths of self-reliance and the strong work ethic that underpins many of the values of Norfolk Island life. We appreciate these concerns.

At the same time, the majority of people expressed to us the need to protect more vulnerable members of the Norfolk Island community in ways that are respectful of diverse need, for example, ensuring humane responses when people lose their jobs, when they are affected by mental illness, or when they require specialist care. Many suggested that building the preconditions for wellbeing and strengthening the safety net for its vulnerable members is a measure of a fair and supportive society. As highlighted earlier, the lack of reliable data has frustrated our efforts to assess in depth the wellbeing of Norfolk Island children and families, both now and across time.

It also compromises planning efforts when there is limited data upon which to measure progress or the impact of interventions. Mainland Australia has a of useful data collections that contribute importantly to planning for children, young people and families.

Based on teacher's assessment of every child in kindergarten, data are collected every three years and the provide a snapshot of how children in mainland Australia are developing. It is important that consideration is given to the gathering of similar data for Norfolk Island children.

In the first section of the report we considered the needs of children, young people and families and the ways in which economic hardship increases vulnerability and negatively impacts upon the capacity of individuals and the family to withstand disadvantage. As we reviewed the service framework for children, young people and families within Norfolk Island it was also clear that as a priority some local service systems need to be strengthened.

It is also clear that the professionals within these systems need greater support to provide improved service delivery. The offshore model of service delivery and ability has worked well for policing and schooling. Teachers at the school, provided by from the NSW Department of Education and Training, provide a strong and lively learning community for students, the majority of whom go on to achieve well academically. Island police provided by from the Australian Federal Police AFP with support from other AFP areas in law enforcement, corporate services and management provide community policing approaches on the Island.

It is notable that both the school and the police service are institutions with offshore support and ability. Our review of the services for children, young people and families has identified many of the same issues impacting on the delivery of services on the ground. Health services play a key role in building and maintaining the wellbeing of children, young people and families. Generally these cover a range of health services including healthy living programs, early intervention through screening programs and medical care for those who are seriously ill.

Further they are generally delivered from a range of sites including community centres, in home visits, schools, General Practice surgeries and hospitals. Health services on Norfolk Island were essentially hospital based and clustered at the tertiary end which in turn impacts on the planning, delivery and range of child, youth and family support services available on Norfolk Island. Missing from Norfolk Island for example, are some primary health services such as population health education and awareness programs.

Primary health services form part of the suite of services generally used to improve outcomes for children and youth wellbeing. Preparation for birth, breastfeeding education and support, childhood nutrition and activity campaigns for example, all contribute to positive outcomes for children. These services improve children's quality of life and reduce future health care costs to Norfolk Island families by avoiding hospital admissions, visits to the doctor and pharmaceutical costs. As the sole provider of health care, the Hospital occupies a critical place in Island life.

When trust in health service provision is diminished it generates considerable stress and anxiety for parents requiring health care for their children and family. It can also generate stress and anxiety in health providers resulting in high turnover. This in turn can result in service gaps, reduced service effectiveness and a lack of a service improvement approach. We heard from a of people regarding their concerns about health care on Norfolk Island.

For example despite a long-acknowledged lack of facilities for seriously unwell mental health patients, psychotic people continue to be restrained in police cells rather than in a suitable and appropriately staffed area within the hospital. The recent Norfolk Island Public Service Review found that as services become more complex the small workforce with its current levels of capability cannot deliver the range of services to standards commensurate with the mainland and that Norfolk Island will struggle to deliver even state type services.

The breadth of skills and knowledge required to support the full range of health care needs is too broad to be met solely within and by Norfolk Island. Based on the experience of the offshore model of service delivery and ability, which has worked well for policing and schooling, outsourcing and contracting out services would provide an effective and efficient option for meeting the health care needs of the Island. Outsourcing to a larger health provider enables Norfolk Island to take advantage of well established mainland systems that could provide greater support in terms of professional development, service standards, quality assurance, ability, financial and other administrative activities.

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