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As a provider of health services, cohealth responded to this periodic review of the Victorian Charter of Human Rights by acknowledging the importance of promoting and protecting human rights as a key determinant of health and wellbeing.
cohealth is pleased to provide a submission to the 2015 Review of the Victorian Charter of Human Rights and Responsibilities Act 2006. Our submission focuses on “examples of effective ways to improve human rights outcomes in practice” (Charter Review Consultation Paper, page 4). More specifically, we provide information about how our organisation, an independent not-for-profit community health service, is working to implement and embed rights-based approaches.
3.1 We have established practices and processes that promote a human rights culture. cohealth’s commitment to human rights is evident in a range of strategies, mechanisms and policies, embedded within the organisation’s first 12 months, and forming the platform for further detailed planning and implementation over coming years. Some of these activities are described below, in relation to leadership, priority populations, education for service users and staff, and advocacy.
3.2.1 Senior staff within the organisation are committed to the realisation of rights-based principles and processes. This creates an authorising environment for rights-based decision making and practice.
3.2.2 cohealth’s mission is to strengthen community and make a difference to the lives and wellbeing of people, particularly of those who experience stigma and the risk of marginalisation. We create impact through a powerful combination of advocacy, innovation in service delivery, and partnership with consumers, communities and other stakeholders.
3.2.3 cohealth’s commitment to rights-based practice is made explicit in core strategic documents, including for example the forthcoming inaugural strategic plan, staff code of conduct, position descriptions and policy submissions.
3.2.4 The whole-of-organisation approach is best encapsulated within cohealth’s document management structures that include a forthcoming Human Rights and Advocacy Framework, to be endorsed by the cohealth Board in mid-2015.
3.2.5 All other organisational frameworks (our highest level, Board-endorsed policy statements) also explicitly reference cohealth’s commitment to human rights, rights-based practice and obligations under the Act. A human rights impact assessment is required as part of policy development and review process.
3.2.6 The organisation has resourced dedicated roles within the Advocacy and Partnerships Directorate which focus on rights-related issues. These roles include: the Director; Senior Manager of Community Partnerships, Programs, and Strategies; and Manager of Diversity Projects and Strategies.
3.2.7 There is an established formal process for ethical review of research and evaluation (a Human Ethics Advisory Group comprised of staff and consumer nominees), underpinned by a research and evaluation ethics policy.
3.3.1 A rights-based approach underpins our focus on structural causes of disadvantage and marginalisation, and their impacts on health.
3.3.2 We focus on groups who are likely to experience adverse health outcomes due to particular disadvantages, including Aboriginal and Torres Strait Islander people, refugees and asylum seekers, people at risk of harm associated with alcohol and drug use, families and young people at risk, people experiencing mental illness and people who are, or are at risk of being, homeless.
3.3.3 We do this through strategic, whole-of-organisation strategies and initiatives for inclusion and cultural competence (e.g. Reconciliation Action Plan, Aboriginal Employment Action Plan) as well as priority access and tailored responses at a service delivery level (e.g. assertive outreach programs, priority/drop in appointment systems etc.).
3.3.4 In addition to overseeing the RAP, the newly created Manager Diversity Projects and Strategies role is responsible for overseeing development of an integrated approach to diversity planning that will further incorporate strategies for other population groups, including refugees and asylum seekers, GLBTIQ communities, people with disabilities including psychiatric disabilities, and others.
3.4.1 cohealth is committed to informing and educating service users and community members about their rights and responsibilities outlined in the Victorian Charter and the Charter of Healthcare Rights.
3.4.2 We have developed easy English communication materials about rights and responsibilities (see Appendix 1), co-designed by service users with our communications, quality, client services and community partnerships teams. Our co-design approach to the development of resources is further supported through the establishment of a cross-organisation strategy to promote and develop improved health literacy.
3.4.3 We support service users to advocate for their rights by providing information about advocates, support people, advocacy groups, and complaints bodies; and by supporting self-advocacy. This is led in particular by our Community Partnerships, Programs and Strategies Team in the Advocacy & Partnerships Directorate; and our Consumer Leadership Team within the Mental Health, Alcohol and Other Drugs, and Homelessness Directorate.
3.4.4 A concrete example is assistance provided to clients of our mental health community support services to develop Advanced Care Directives, to support respect for their preferences and wishes during periods of acute ill health. This work evolved as a specific response to the review of the Victorian Mental Health Act, intended to bring it into line with human rights standards under the Charter.
3.4.5 In partnership with our community advisory committee, we have designed feedback systems which are simple to use and navigate. We maximize transparency and accountability by providing quality improvement data to our committee and to our broader community periodically through our Quality of Care Report to the Department of Health and Human Services. We provide information to clients about a range of internal and external feedback and complaints mechanisms.
We provide staff education and training to ensure understanding of and compliance with human rights obligations. A key target of this training has been management-level staff with responsibility for development, approval and implementation of organisational frameworks and policy. This is part of a multi-tiered approach to staff development, culture and organisational change which seeks to build rights culture, and more specifically a dialogue model as a common practice. This approach is designed to build and support staff capacity to balance competing rights, discuss complex issues using a common set of shared values, and bring to the fore countervailing interests and obligations.
3.6.1 Through co-design processes we actively involve people who use our services in the design, development and delivery of those services. Key among our co-design mechanisms is our community advisory governance structure which ensures that through myriad regional and special interest committee structures, local communities inform cohealth decision-making at every level.
3.6.2 We implement leadership development models aimed at increasing everyday people’s human rights literacy, engagement and advocacy capacity. These initiatives tackle pressing population health issues, such as prevention of family violence, through community-led engagement and activation that is both locally and culturally relevant and targeted. cohealth’s work in this area draws on the significant learnings from the Victorian Equal Opportunity and Human Rights Commission’s Everyday People, Everyday Rights project.[2]
3.7.1 The creation of a stronger platform for evidence-informed advocacy, underpinned by a commitment to consumer participation and co-design, was another key driver for the creation of cohealth from the merger of the three predecessor organisations.
3.7.2 In partnership with service users, community advisors and partners, we play an active role in policy dialogue. Our advocacy positions and policy submissions are informed by a human rights framework.
3.7.3 We are committed to contributing to the development of a human rights culture, particularly within the Victorian health sector. We champion and actively promote our commitment and approach and look forward to further opportunities to contribute to the review process.
cohealth views the protection and promotion of human rights as of intrinsic value for individuals and communities. As a health organisation, in line with our adoption of a social model of health, we further view the protection and promotion of human rights as a key determinant of health and wellbeing. As such, our adoption of human-rights based approaches is undertaken with the intention of improving health and wellbeing outcomes for the individuals and communities with whom we work. We anticipate that these benefits are realized through improved access to health care, empowerment to maintain one’s own health to the fullest extent possible, and enhanced self-determination and participation for individuals and communities.
We further anticipate that our rights-based approach contributes to cohealth being an employer of choice for people committed to social justice, and that it supports recruitment and retention of high quality staff.
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[1]http://www.parliament.vic.gov.au/images/stories/committees/sarc/charter_review/submissions/118_Group_West_Region_Health_Womens.pdf (accessed 30/5/15)
[2] http://www.humanrightscommission.vic.gov.au/index.php/our-projects-a-initiatives/past-projects/item/483-everyday-people-everyday-rights (accessed 2/6/15).
Collingwood