PARLIAMENT OF VICTORIA COMMUNITY DEVELOPMENT COMMITTEE FIRST REPORT upon the Needs of Families for Early Childhood Services in Health, Welfare and Education. General Services Required by Most Children and Their Families. MARCH 1995 Ordered to be printed MELBOURNE L. V. NORTH, GOVERNMENT PRINTER 1995 No.31 1817(1'1) National Library of Australia Victoria. Parliament. Community Development Committee Inquiry into the Needs of Families for Early Childhood Services ISBN 0 7306 7900 4 Cover Design: ColorBox Design Group Level 5, 582 St. Kilda Road Melbourne, 3004. ii Community Development Committee Chairman's Preface This Inquiry has provided the Community Development Committee with a unique opportunity to investigate early childhood services at a time of far reaching State Government reform. The Inquiry proceeded on the basis that the State Government has a fundamental role in ensuring that children are provided with world class health, welfare and educational services. Throughout the Inquiry the Committee gathered ample evidence of the opportunities available to Government to make a difference to the overall well-being and development of children. Effective, accessible services, provided at the right time, can result in long term benefits for the individual, the family and therefore the entire community. A concrete example of the value of proactive Government action can be seen in the Hib immunisation program implemented in 1993 which has seen the number of cases of the disease fall by over 50 per cent. Similarly hearing tests for pre-school children has resulted in the early detection of auditory difficulties and appropriate remedial action before long term negative effects are experienced. The Committee in this report has recognised that prevention and early intervention is possible and can make a critical difference to the long term development of children. To best address the needs of children requires that the family is resourced and empowered and thus able to provide a caring and nurturing environment for the child. Therefore in this report we have placed a particular emphasis on services that improve the ability and expertise of parents to care for their children. The Maternal and Child Health Service exemplified a model of best practice with this regard, particularly in its ability to form a partnership with families. Parents, particularly during the early periods of a child's development, need to feel comfortable and confident in their parenting role. Community Development Committee iii Background Information They need to be assured that seeking assistance and support at this time is not abnormal but is indeed a right. The Committee faced a number of difficulties in undertaking this Inquiry. Firstly, the terms of reference were extremely broad and to attempt to address them in their entirety would have been impossible in any meaningful way. The Committee made a unanimous decision to limit the dimensions of the Inquiry to the needs of generalist services for most children and their families. The Committee acknowledges that some children with special needs require specialist services and is disappointed that this area could not be covered in the Inquiry. However, it has been made explicit throughout this report that generalist services should be accessible for children with special needs. Indeed enhancing the current provision of generic services, we believe, will result in an overall improvement in the accessibility of mainstream services to all children including those with special needs. The Committee also had a. difficult task reviewing children's services at a time of immense change. The new State Government was introducing far reaching reform to the health, welfare and education sectors at the same time as the Committee was conducting its Inquiry. This presented a number of difficulties. The Committee was often left in the position where the evidence it had gathered within a particular area was quickly out of date because of the changed landscape. This ultimately led to the delay in the Inquiry's completion as the Committee was reluctant to make recommendations early on in the reform process as these had the potential to be irrelevant in the longer term context. The Committee therefore waited for the 'dust to settle' before formulating its recommendations. In considering recommendations, the Committee has attempted to capture the concerns, hopes and aspirations raised by service providers and families consulted during the Inquiry. However, instead of presenting a long wish list of proposals, the report provides a small number of feasible policy options, which if implemented will both safeguard and improve childhood services. iv Community Development Committee Background Information A proposal in the report which deserves particular mention is the development of an Office of the Family. This recommendation stems from the Committee's view that the impact of the wider environment on families requires a greater emphasis during the formation of policy and legislation. A central role for the Office of the Family would be to ensure informed decision making by Government. This would occur through the requirement that a family impact statement be developed for any new policy initiative - explicitly stating the consequences of new proposals for families. This Inquiry would not have been possible without the participation of the hundreds of organisations (both Government and non-Government} and individuals. This participation took the form of written submissions and attendance at public hearings. At various stages throughout the Inquiry, Committee members were also provided with the opportunity to visit different services, thus enabling them to develop a more comprehensive understanding of the areas under investigation. I would like to take this opportunity to thank all the contributors for their time and effort. I would also like to thank all my colleagues for their hard work and commitment to the Reference and particularly for the manner in which they put aside party politics in the interests of Victorian children and their parents. Finally this report would not have been possible without the hard work and dedication of the Committee staff. In particular I would like to thank Matthew Fisher, the Office Manager for his work during the Inquiry. Geoff. G. Leigh, M.P. Chairman Community Development Committee v Background Information vi Community Development Committee Table of Contents Chairman's Preface.................................................................................................. iii Table of Contents...................................................................................................... vii Membership.............................................................................................................. xi Recommendations................................................................................................... xiii Functions of the Community Development Committee............................... xx Terms of Reference.................................................................................................. xxi Chapter 1 Introduction 1.1 Scope of the Inquiry.......................................................................... 1 1.2 Premises and Principles................................................................... 3 1.3 Wider Environment........................................................................ 5 1.4 Background to the Inquiry.............................................................. 12 1.5 Conduct of the Inquiry..................................................................... 14 Chapter 2 Early Childhood Services in Health, Welfare and Education 2.1 Introduction....................................................................................... 17 2.2 What is a Need?................................................................................ 18 2.3 What is a Family?............................................................................. 20 2.4 What is Early Childhood?............................................................... 21 2.5 Submissions to the Inquiry............................................................. 22 2.6 Survey Commissioned by the Inquiry......................................... 24 2.7 Other sources of information......................................................... 25 2.8 The Cultural Backgrounds of Victorians..................................... 26 Chapter 3 Role, Relationship and Effectiveness of Services 3.1 Introduction....................................................................................... 29 3.2 Maternal and Child Health Services............................................ 32 Community Development Committee vii Table of Contents 3.3 Screening and Intervention Services........................................... 51 3.3.1 Immunisation................................................................... 51 3.3.2 Medical Services............................................................... 62 3.3.3 School Nursing................................................................. 73 3.3.4 School Dental.................................................................... 77 3.4 Family Support Services................................................................. 83 3.4.1 Post Natal Domiciliary Services.................................... 84 3.4.2 Early Parenting Centres................................................... 97 3.4.3 Family Support Program...............................................