Unified approach best way to support families, says expert

Whanau Ora will fund agencies to work with whole families, not separate services for individuals. Photo / Brett Phibbs

A British expert says benefit-paying and housing agencies may need to be brought into any new scheme such as "Whanau Ora" which aims to reach disadvantaged families.

Naomi Eisenstadt, who founded a similar scheme in Britain called "Sure Start", says the key to reaching families in need is that there should be "no wrong door" when they approach any agency for help.

"We've had years of 'one-stop shops'. It's hopeless if you don't get to that shop," she said in Auckland yesterday at the start of a three-week tour organised by the Werry Centre, the Children's Commissioner and academic groups.

"'No wrong door' is saying every family is in touch with some public service. The chances are they will be in touch with the benefit system, they are usually in touch with housing agencies, but they are not likely to be involved with mental health services or children's services.

"There should be no wrong door - any door takes you to the whole range of services."

Whanau Ora, due to start in October, also aims to join up a range of social and health services for disadvantaged families so that agencies can help families deal with all their problems together, rather than parcelling out separate problems for individuals to separate agencies.

Work and Income, which pays welfare benefits, and Housing NZ, which provides rental housing, are not expected to hand over their budgets to Whanau Ora agencies.

Children's Commissioner's Office senior adviser Louisa Wall told Ms Eisenstadt at an Auckland University meeting yesterday that agencies such as Housing NZ were "retracting to their core business" in the recession.

But Auckland District Health Board "healthy housing" nurses Lynne McCarthy and Tania Lauese-Mulitalo said they and six other healthy housing nurses in Glen Innes, South Auckland and the Hutt Valley were offering the kind of open-ended help to Housing NZ tenants that Ms Eisenstadt advocated.

"We go in with a Housing NZ co-ordinator. We look at the house - insulation, ventilation, heating, overcrowding," Ms McCarthy said.

"Then the Housing NZ person leaves and we do a family-based health assessment for up to two hours. We say to the family: 'What worries you?' Often the families say no one has actually bothered to sit and listen to us."

She said these assessments often threw up issues such as domestic violence or immigration matters that had to be dealt with before any more narrowly health-related issues could be tackled. The nurses refer to other agencies and follow up if necessary.

Britain's Sure Start programme, which Ms Eisenstadt led for its first seven years from 1999, aimed to integrate healthcare, early childhood education, parenting education and other social services, initially for preschool children and now for all children.

There are now 3500 integrated children's centres across Britain providing a range of services for children, usually based at primary schools.

But Ms Eisenstadt said officials now realised that adult services needed to be connected up too because most of the risk factors for children were actually to do with their parents.

"The three biggest issues that make a difference are housing, employment and maternal mental health," she said.

She said they were all expensive to deal with and in the aftermath of the recession no governments had any extra money.

"So it's kind of how do you position yourself for when there is money," she said. "How do you [sustain the important visions] so that when we come out of the recession we are ready?"

Whanau Ora

* Will fund agencies to work with whole families, not separate services for individuals.

* Starts in October with 20 providers.

* Budget $30 million a year.

Sure Start

* Funds local authorities to provide integrated services at 3500 children's centres.

* Started in 1999 in 250 low-income communities.

* Budget now more than £1 billion ($2.1 billion) a year.