21 years of the Workers Health Centre
By Ben Bartlett
[The following is excerpted from a speech delivered at the 21st anniversary celebration of the Workers Health Centre.]
The '70s was an exciting time. The Whitlam Labor government had been elected on a wave of mass activism, and had introduced major reforms in the health sector — Medibank, community health programs and the like.
However, community groups had already set the pace. The Redfern Aboriginal Medical Service, and the many other AMSs which followed, was a product, not of government reform, but of government neglect.
A few years later the Leichhardt and Liverpool Women's Health Centres were established, again independently from government.
Some of us at that time were involved with the Health Workers Collective, which was a group of hospital-based workers who produced a newsletter called, imaginatively, The Health Worker.
It analysed the changes occurring in the health care system, as well as the nature of ill health in a capitalist society. Inevitably, workplace hazards were recognised.
I was living in a collective house at that time in Balmain. It was a highly political house, the centre of political activities ranging from meetings of the Left Tendency of the Communist Party to academic study groups struggling with the works of Althusser and Polansis.
In this environment we discussed what could be done about workplace health and safety. The models (Aboriginal Medical Services and Women's Health Centres) were already there.
Strange as it may seem, I was employed part time at the Liverpool Women's Health Centre in 1976. The centre was already dealing with significant numbers of South American and other women workers in manufacturing industries, who were suffering from overuse injuries.
Working there gave me access to resources to build the idea of a Workers Health Centre. The collective at Liverpool was highly supportive. Meanwhile, back in the ghetto, a small steering group had developed to help make it happen.
We produced a leaflet about workers' health issues, and the need for a centre to assist injured and sick workers, but also to work with them in tackling the hazards in their workplaces.
We approached trade union officials regardless of political leaning. The response was mixed. Those controlled by the right tended to ignore us. A number gave donations, including $1000 from the metalworkers, and $100 from the miscos. The wharfies, BWIU and other SPA unions were cautious of us, and eventually set up their own trade union clinic in the city.
We also gained support from organisations such as the Doctors Reform Society. But it was those unions and workplaces which had rank and file organisation which really proved the most valuable supporters.
In early 1977, premises were found in the main street of Lidcombe. We knew we needed to operate out of the western suburbs because that is where much of Sydney's industry was concentrated and where most workers lived.
We initially saw anybody who walked through the doors. We made it known that we bulk-billed Medibank. It was not long before a delegation from the local GPs visited. They complained at our undermining their practices, and accused us of advertising. I guess the poster in the window asserting "Housewives are workers too" alongside the "We bulk bill" sign didn't help.
Non-English speaking peoples were a significant part of the centre's clientele. The first government grant received was from the Ethnic Affairs Office in the Premier's Department. We developed relationships with ethnic community groups such as FILEF and the Turkish Workers League. We produced a range of leaflets about workplace hazards in a number of languages.
One of the reasons for the success of the centre was that we didn't set it up just as a clinic. We allocated human and other resources to providing information to workers and, more importantly, to groups of workers in workplaces.
We were seen by the occupational health and safety establishment as a threat. The state apparatus based at Lidcombe Hospital thought we had purposely set ourselves up there to confuse people — that people would think, because we were at Lidcombe, that we were the state authorities. They accused us of scaring workers, and being irresponsible.
I sometimes wonder at the emphasis we placed on information. In a world where we are so overwhelmed with information, people may well have difficulty deciphering what is useful information and what is not.
Further, there is a lot of evidence that people's knowledge changes behaviour only when people are fairly empowered already.
There is strong evidence that the health status of people of lower socioeconomic class remains poor, and that they do not respond to the mass media campaigns of the health promoters.
Maybe what is more important than just information is a change in societal power relationships that can come through people working and organising together on their shared problems.
Maybe the role of places like the Workers Health Centre is about forging relationships between those who have access to relevant information and those whose lives are caught in the contradictions between asserting one's right to a healthy work environment, and the possibility of facing the sack for being a troublemaker.
The centre helped shape a workers' health movement. Workers' health organisations developed in Brisbane, Newcastle, Wollongong, Melbourne, Adelaide and Fremantle. For a while, there was even a national coalition.
In NSW, the exposure of Alpha Chemicals and mercury poisoning was the straw that broke the system's back. The Williams Inquiry was set up by the state government, and out of that came new legislation replacing the old Shops and Factories Act.
It was not long before all state and territory governments had embraced this new style of legislation. The Victorian legislation was the most progressive: it not only saw the role of health and safety committees as integral to an improved and participative system, but also gave power to workers' delegates to stop work where danger was recognised. This is now being dismantled by the Kennett government.
At its Jakarta Conference earlier this year, the World Health Organisation had a Coca-Cola executive giving a keynote address, and representatives of the pharmaceutical industry on the drafting committee for the conference declaration.
Ilona Kickbush, director of the WHO's health promotion section, spoke in Sydney earlier this year about the strategy they were pursuing to engage multinational companies in their health promotion work. Is this the way the poor will get healthy: they do not have access to a clean water supply, but there is always Coke to drink?
Over the past decade or so we have been dominated by economic rationalist agendas run by both conservative and Labor governments. The rich have got richer and the poor poorer.
The nature of work has changed, with new insecurities and persistently high numbers of people unemployed. More people are working in narrow outcome-focused environments. Contract labour is seen as efficient. The economic rationalist environment has pushed health and safety issues further off the agenda.
ANU demographers John and Pat Caldwell have done some interesting work examining the factors required for better health at a population level. European countries took the high road to better health. Economic development in Europe, albeit at the expense of those places colonised by European powers, led to better living conditions, education, nutrition etc.
However, some poor countries also managed to achieve fairly good life expectancy rates. Sri Lanka is one such example. What characterised their success compared with similar countries that continue to have poor life expectancies was:
- high levels of literacy of women;
- relative autonomy of action of women;
- ready access to primary health care;
- a fervour or vision, usually socialist, which was capable of mobilising people.
In this country, Aborigines and Torres Strait Islanders, workers in certain industries and the unemployed, especially young men, experience worse health outcomes than the general Australian population. Education levels are relatively poor, and whilst they have access to health services, few such services are organised at the primary care level in ways which take into account their particular needs.
As for vision or fervour, orderly governance has tended to demand compliance rather than activism. Certainly workplace organisation, and indeed union membership, has declined dramatically.
What characterised the development of Aboriginal Medical Services, Women's Health Centres and Workers Health Centres included a fervour and vision of a better way of doing things.