How lawyers improve health care
An ANU researcher is creating opportunities for lawyers to work in medical clinics to help patients with health problems that are linked to their legal issues. KIM LESTER reports.
They’re starting to pop up like mushrooms.
A legal clinic in a Copenhagen cancer ward; a regional community service that combines law, health and education resources for pregnant Aboriginal teenagers; and a UK university-run clinic for nursing and law students who serve the public.
These are just three examples of Health Justice Partnerships (HJP) that are being launched with advice – most of it pro bono – from ANU College of Law researcher Dr Liz Curran.
The partnerships are vital services that place lawyers in the same location as doctors and other healthcare professionals, giving patients whose health problems are intertwined with their legal issues access to affordable justice.
While still on the fringe of Australia’s healthcare services, and barely on the agenda of government coffers, the number of HJPs across the country – and now the world – is growing, thanks largely to Curran’s extensive research into outcomes reported by existing organisations.
But how are legal and health issues connected? The former can easily lead to the latter; however, most people are more likely to seek out a doctor than a lawyer.
“Client problems might be spiralling out of control, for instance, with a mental health issue because they have a whole lot of documents from debt collectors,” Curran says.
“The lawyer is quickly able to have a look at them and have a chat to the professional and confirm the letters aren’t court documents, they’re unlawful and illegal and the client is ok.
“That advice, given within a very short period of time, can calm the client down – they know their rights, they know they’re safe, they know they’re ok.”
For 10 years, Curran worked as a lawyer in Banyule Community Health – Australia’s first HJP – in Melbourne’s public housing area of West Heidelberg. Stories of her experiences at the centre and the outcomes for clients are often moving.
“One of the doctors in the health service rang me and said he had a young boy with him who had been wetting his pants,” she says.
“He was highly stressed and anxious, he was being bullied at school for wetting his pants and he confided in the doctor that he had a huge mobile phone debt that he’d been hiding from his parents. He was running to the letterbox each day to hide letters of demand for almost $6,000.
“The doctor brought the client straight to me and by the end of the day, I had spoken to the mobile phone provider and got them to write off the debt on the basis that it was illegal contracting with a minor.
“The boy didn’t know his rights, the doctor didn’t know how to help him and immediately I solved his health problems.
“By the end of the day he was calmer and he’d stopped wetting his pants, I gave him a few tips about what not to do in future and he could get on with his life.”
Curran saw similar outcomes “time in, time out” working within the partnership and knew the model worked.
Since then she has conducted a number of studies on the impact this style of partnership can have on clients, professional staff, the community and the legal system.
She is building an evidence base to see if the model works and is effective more broadly.
She is analysing a three-year longitudinal study of a partnership at the Loddon Campaspe Community Legal Centre JP in Bendigo and an evaluation of a similar partnership run by Redfern Legal Service in the busy Royal Prince Alfred hospital.
She is also working with eight Health Justice Partnerships funded through a 2014 Victorian Legal Services Board grant to develop measures of the effectiveness of the model.
Her results show positive outcomes for both the clients and the communities in which they live – and this evidence is allowing the model to spread.
“There’s a number of HJPs in Australia now and they’re starting to pop up like mushrooms,” she says.
“I’ve published the draft release of my results from the Bendigo study online and now a whole lot of services are using the material as evidence to support the funding of other Health Justice Partnerships.”
This is commonplace for Curran who generously publishes her findings on the Social Science Research Network as soon as they’re available, to share the results and grow the program.
Her research and expertise in the area has captured the attention of health and legal organisations in several countries, including Canada and the United Kingdom, as well as China and Denmark where HJPs either didn’t exist or were in their fledgling stage.
The recommendations of the British 2014 Low Commission of Inquiry on the Future of Advice and Legal Support aligned with the HJP model, resulting in British service providers being keen to engage with Curran. More invitations arrived and she presented workshops for legal, education, health and social service groups across the UK and at the University of Copenhagen.
Her advice was sought on two unique HJPs being established in Europe – one is a pilot interdisciplinary clinic at Portsmouth University that will place law and nursing students together.
“They can learn how to collaborate more effectively because the research shows that when people work together holistically to solve the client’s problems, they lose their professional differences and they work together more effectively because the focus is on the client and the outcome,” Curran says.
“I’m really excited as an educator about changing the way our lawyers are taught and getting different professions to break down the barriers.”
And in Copenhagen the Law School is in the process of setting up Denmark’s first student law clinic which will be based in a cancer ward to assist patients with debt issues, wills, superannuation, insurance, poor health and employment rights.
This year Curran will continue as a pro bono adviser on many projects she is most passionate about, one being the Portsmouth University clinic.
ANU has been contracted for the Invisible Hurdles Youth Family Violence Project in Wodonga which helps pregnant young Aboriginal women because they’re most at risk of family violence.
“One site is in an alternative school setting for kids who fall out of school and other sites are at an Aboriginal health agency and youth homelessness, mental health and drug addiction service,” Curran says.
She is working on this project with ANU College of Law colleague Pamela Taylor Barnett.
Curran hopes that, by making her findings freely available online, more organisations around the world will take the initiative to establish their own HJPs without her.
Her long-term aim is to see Health Justice Partnerships rolled out in developing countries where they can effect social change, and Asia is beginning to show an interest.
“My ANU Law colleague Professor Simon Rice presented the research on my behalf in China last year,” Curran says.
“The next steps would be to use this model to provide social justice outcomes for countries with limited resources.
“My view is I’ve started the conversation, I’ve shared the evidence and variations on the model with everybody – now it’s out there for other people to take up.”