System failure

I was always taught not to raise the topics of politics, sex or money unless you wanted to start an argument.  Todays policy announcement about free long term contraceptives for beneficiaries from National raises all three.

But why are people so concerned?  John Key seems keen to reassure us it is all optional:

“Mr Key said he did not believe Work and Income case managers would put undue pressure on beneficiaries to take up the long-term contraceptive options, saying they would simply be made aware of the options they had.” http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10804304

I think the question we need to ask is what can happen when people who have been disempowered, victimized by trauma, and suffering mental health difficulties engage with these policies in the real world?

Firstly I agree with Mr Shearer, quoted in the same article, that it is inappropriate for non-health professionals to be discussing health matters such as contraceptive choices with women or teenage girls in their role as a case manager.

With all due respect to WINZ case mangers, this is a health decision, and best left to the people who are actually trained and registered to help people make such a decision, namely doctors and health specialists.  And given recent events do I even need to point out the potential privacy issues?

Secondly policies are implemented by people.  And therein lies the core of the problem.  I have heard too many horror stories of how people with complex histories and difficulties can be mis-treated and outright abused by “systems.”

This is what therapists would call “enactments” where people with a history of being abused and mistreated find themselves being further bullied or mistreated by systems, be it WINZ, the ACC, CYFS or the health system.  John Key’s “belief” that this won’t happen does very  little to reassure me on this point.

People with little power, few skills, and a BIG incentive to be “compliant”,(namely their only source of income) can easily be gently coerced or outright forced into decisions they feel uncomfortable about.  The idea that even one woman could find herself in a position of having to accept a health procedure, which comes with considerable risks and side effects to keep their income, deeply troubles me.

Think about this for a moment.  Imagine an eighteen year old woman who is single, unemployed and is actively trying to get pregnant. Her morally conservative and enthusiastic WINZ case manager attempts to convince her to access free long term contraception.  She refuses this offer which results in conflict between her and her case manager and she comes to be seen by staff as “problematic” and “difficult.”

As a result this young person, anxious and frightened of the “system” starts to receive less entitlements and poor service.  She becomes pregnant and as a result receives disapproving comments, snide remarks and less offers of help and support to which she is entitled.  Believing she is unable to complain she simply tolerates it as “more of the same” from a world she has already learnt to mis-trust.  She becomes less and less willing to engage with services that may be able to help her, and her quality of life deteriorates.

Far fetched?  I don’t think so.  And while you may have a moral position on her decision, she has broken no laws and is entitled to the choice she has made.  And as soon as the state starts to have influence over maters of reproductive choices, we are on very, very dangerous ethical and moral ground.

National would not hesitate when in opposition to yell “nanny state” when Labour announced social policy they disagreed with.  But given the choice I’d rather have a nanny state than a strict and disapproving “daddy” state any day.

Leave a Comment

  • Geoff May 8, 2012, 4:08 pm

    I’m with you Kyle – Words and Actions for some unknown reason are seldom linked when it comes to care of those who are vulnerable. I think there is a phrase – “Lip Service” which seems to win out, when expediancy is the favoured course of action, and these days, expediancy is on the first page of the Politicians “How to Succeed” manual.

    Reply
    • Wendy Moore May 8, 2012, 4:26 pm

      Nice work, Kyle! Thank you for being such an articulate voice for the vulnerable members of our society – I hope Mr. Key and his cronnies get a copy of this blog. Would it make any difference – I don’t think so, but it would be good to try.

      Reply
  • Elaine May 8, 2012, 4:22 pm

    Your own comments sound rather patronising and disempowering. Many young woman I have had contact with in the course of my work over the years are more than capable of making their own decisions.

    Reply
    • Off the Couch: Kyle MacDonald May 8, 2012, 4:27 pm

      I have no doubt the majority of women are, but if only one isn’t, this is bad policy. The dynamics of the welfare system in particular will tend to conspire against those who struggle to speak up on their own behalf.

      Reply
  • Bob Stevens May 8, 2012, 4:58 pm

    Kyle my agreeing with your comments will go down like a lead balloon to many especially those who have never been at the bottom of humanities heap and who object to paying taxes for those ` bludgers’ . There is a real need to examine all ways of making the benifit system do what it was originally set up to provide i.e. short term help for those really in need but political will to do so by successive Governments has not materialised because they all have their eyes on the ballot boxes and not on the taxpayers money.

    I am of an age where I remember there being no welfare system and that was not pretty so I am an advocate of help for those who require it. I am not an advocate for being party to providing certain individuals and families in society with a free ride from birth to death with no requirement to work in between or of mother’s having numerous children sometimes to different fathers’ and then raising them totally at the cost to taxpayers. Some hard calls have to be made and I do not pretend to have anything more than suggestions rather than answers.

    If the current proposal of long term contraceptive options for benificiaries is implemented then those people are in effect being treated as a social experiment because this proposal is little more than that. How about those on higher incomes with Student Loans being given similar treatment and payment demands made more realistic. That analogy fails however when you consider the possible consequences for the first group and when did a WINZ officer qualify however well meaning or decent that person may be to offer contraceptive advice. Talk about Government grabbing the Tiger by the tail? I suspect the Tiger will bite back and that may well be in the ballot box because fair minded people will smell more than a Rat in this proposal. It is simply dangerous tinkering and please excuse the male analogy, trying to tune the engine on a motor vehicle that has a blown cylinder head gasket.

    Reply
  • Robyn May 8, 2012, 5:20 pm

    So what’s wrong with going to the dentist to get your car fixed???

    Reply
  • Matt May 8, 2012, 5:23 pm

    I can see it all now the threats from a power crazy WINZ case manager to a beneficiary….

    “unless you take the contraceptive pill you won’t be getting a WiNZ benefit”

    Reply
  • Lesley May 8, 2012, 5:30 pm

    Right on Kyle! I have yet to meet a beneficiary who has the deep relationship with her/his case manager John Key claims will make this policy work. Does he live in a parallel universe? This will be one more reason so many put off visiting their case manager when they really need to.
    Is it far fetched to think it also is one step closer to selective breeding?

    Reply
  • Heather May 8, 2012, 5:43 pm

    Labour leader David Shearer said access to contraception should be freely accessible to all people.
    “There should be easier access for all women whether they are on a benefit or not.”
    He said welfare changes also unfairly put the burden onto women and did not factor men into the equation.

    “The fathers of these children are not being called to account,” he said.

    He also questioned whether it was appropriate for contraceptive advice to be given by front line staff at Work and Income rather than medical professionals.

    I totally agree with all he said, especially about the fathers of the children being made to take responsibility.
    It is obvious to all who the mother of the children is, but who the father is, is not always known.
    Also often nobody knows how many children he has with how many different mothers. It can easily be established now by DNA testing, and it should be.
    If all was publicly known it might make them think twice, and lead to a few less births to solo mothers.
    Sending a mother out to work when a baby is one year old is all wrong. The father should be paying for her to stay home with the baby regardless of how many other children he has.
    He might just have to work a bit harder to support them all, but that is his fault.

    Reply
  • Lisa May 8, 2012, 10:09 pm

    Totally agree!! How will WINZ case managers know who is or isn’t on long-term contraceptives anyway, unless they are going to make a benefit subject to THEIR own contracted doctors approval (much like ACC)? I am personally more concerned about that, as we know ACC contracted doctors work for the ‘state’ rather than the client in the majority of cases. Something which I thought I would never see happen again after the Nuremberg Doctor Trials. The reason why ‘medicine’ and ‘the state’ are meant to remain separate. National seem to want to turn back time. I really hope the doctors that do still have morals and ethics start speaking out against these practises sooner, than later.

    Reply
  • K May 11, 2012, 9:50 pm

    Hi Kyle,

    I have to admit I paid more attention to your post than I did the actual story in the media. This is mainly because
    I had no idea that WINZ staff would be directly involved (why would I when they aren’t health professionals?).

    I would like to let you know that my health information that I provide WINZ is also passed along to someone called a Regional Health Advisor. This appears to be a new initiative by WINZ.

    They (RHA’s) are employed by WINZ to give advice on clients needs to Case Managers. So far they don’t appear to have a good understanding of the health information (I could explain but it is off topic) that is passed to them, but more disturbingly I can’t see who they are held accountable to. Who would the Case Managers be accountable to?

    As a women I would find it deeply uncomfortable, indeed traumatic due to past sexual violation to discuss my contraceptive needs in an open plan office with others walking around even if the Case Manager only mentions it in passing. My last three CM’s have been male. This is a third world idea. No, I don’t want it by mail either in fact I don’t want ANY assistance from WINZ in this regard. Can we at least opt out? Will they corral my daughter, 14yr?

    Is anyone else creeped out about standing in a long line with a bunch of dodgy looking guys (are they out of prison or just gang mates from the same HNZ development?) with contraceptive brochures scattered about the place? Will they give out condoms too?

    In any case if I so desire I can get contraceptives prescribed for $3 for a three month supply. If I can’t afford a doctor Family Planning has $5 appointments for Community Services Card holders. Where exactly is the “problem” they are trying to solve with this policy??

    Reply
  • K May 11, 2012, 10:00 pm

    Oops, sorry it’s $3 for a six month supply. Btw other long term contraceptives such as IUD’s are heavily subsidised already so they are free or close to free.

    Reply
  • Unicorn May 17, 2012, 8:57 pm

    Its just a Nazi-like joke…..SURELY!!

    Anyone can forget to take their contraceptive pill…
    Condoms break…
    Women get raped….
    Husbands leave home when the wife gets pregnant…..
    Women leave their husbands when they bash them or their children….
    Idiots run the country….
    The list goes on and on and on and on….

    Reply

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