At least 80,000 more Australians today would be in health and welfare institutions but for the 'deinstitutionalisation' policies of the 1980s and 90s, according to the Australian Institute of Health and Welfare.
The Institute's fifth biennial report on the nation's community services, Australia's Welfare 2001, reveals that in the fields of aged care, disability services, mental health and out-of-home care services for children, community-based services have grown as institutional services have reduced.
AIHW Director Dr Richard Madden said that the changes were 'part of an increasing national focus on families as the mainstay of support for people needing welfare services, and efforts on the part of governments to help families to support themselves'.
'Home-based carers are the mainstay of deinstitutionalisation, especially for younger people with a disability and frail or disabled older people.
'The welfare sector is significant in the nation's economy, with $13.7 billion being spent on paid services in 1999-00. But the value of unpaid services provided by carers and helpers in households was $27.2 billion.'
Dr Madden said that deinstitutionalisation was 'not just about moving people out of institutions and into the community'.
'The shift in thinking has been applied to institutions themselves through increased flexibility in how they operate, and innovations such as half-way houses and group homes'.
Dr Madden also warned that care was needed in assessing the quality and adequacy of expanded community-based services, as well as quality of life in residential services in institutions, because there are limitations on relevant information.
'One of the major reasons for the move to community-based care was acknowledgement of the importance of individual rights and needs, independence, and flexible services in providing truly appropriate services.
'In this light, concepts such as healthy living, autonomy and participation, and social cohesion are complex, and notoriously difficult to measure. But, as our report makes clear, we're working on it, together with many others.'
