Betty has one kidney and a gastric ulcer. She is in chronic pain and says she can now only manage to eat sandwiches. She is 86. The stress of her case exacerbates her condition, but she can’t get to the hospital for her treatment and the surveyor can’t go in to report on the damage to her home – which is extensive. So, she has to wait. Her life on pause.

Betty sends long emails. Often. But she is the exception. As lockdown hit, with possession cases stayed, welfare benefit determinations on hold and our physical office closed, our usual clients all but disappeared. They normally find us because something has happened – usually something bad: a possession summons, an eviction notice or a refusal of benefit. They find us when they are in crisis, often on possession days. But what if we could find them instead? And much earlier.

In Katherine, Australia, Dr Simon Quilty decided to trial a multi-disciplinary approach to treating his patients.1See Simon Quilty et al, ‘Addressing profound disadvantages to improve indigenous health and reduce hospitalisation: a collaborative community program in remote Northern Territory’, International Journal of Environmental Research and Public Health, vol 16 no 22, November 2019, page 4306. See also ‘How a rethink of emergency care is closing the gap, one person at a time’, The Conversation, 19 December 2019. He hoped to reduce the number of local emergency admissions because they were costly to both patient and hospital. The idea was to address the profound disadvantages suffered by Katherine’s large Aboriginal population, including longstanding issues of homelessness and health and social inequalities.

Huge amounts of money were being spent on treating patients in the hospital, but when discharged, patients returned to accommodation that would often have 30 people in three bedrooms, no air conditioning and 30-degree heat. It made no sense.

Dr Quilty wanted to resolve the underlying drivers of hospitalisation such as homelessness or inadequate housing, so he invited a lawyer onto the team. Relationships were made with the other partners and trust was built with the patients. At the first team meeting, the lawyer identified 15 cases where legal action (or the threat of it) could make change for the patient. In the first year of the project, the findings showed a 50 per cent reduction in emergency hospital admissions.

The law is often viewed through a criminal lens and so people with social welfare issues don’t know they have a legal problem. Or one that can be resolved. They are much more likely to speak with their GP or their community about their poor housing, problems at work and family issues. The doctor treats the symptoms, but the causes of the problem remain unresolved.

When Peter Kandler set up the first Law Centre in 1970, he wanted to bring law to the people. Staff working in the Law Centre had to live in the area and be a part of the community. That is harder to do now, but the idea behind it is still as important. As lawyers, we have to begin to take our services out from behind our shop fronts and into places where people are already seeking help. The health justice movement started with the most professional setting of trust – the doctors’ surgery – but it could be anywhere. At Hammersmith Law Centre, we deliver advice in the Foodbank, sitting alongside people, building trust and resolving legal issues that have led clients into food poverty. Well, we were until lockdown.

Ten years of austerity and punishing welfare reform have created the perfect storm. The pandemic hasn’t helped. Structural inequality pervades our communities. With support services cut, there is no safety net and any statutory duties have to be hard fought. Lawyers are needed – we have the tools for change. Collaboration and co-location are key, but this means more than just being in the same place. It’s about building relationships and trust within a multi-disciplinary team with a person-centred approach. To be successful, this change will involve a fundamental switch in how lawyers value their time and the financial investment to support it. But it has the potential to make lasting change.

We can’t just sit in our offices anymore waiting for Betty to come in. The pandemic has pushed our services even more remote. Let’s find our clients before they have to make the torturous route, across great deserts, to find us. Let’s create a social justice network of lawyers, campaigners, community activists – all working together. Maybe then we can shake off the image of the wealthy privileged lawyer and reveal what we really are as legal aid lawyers: state-funded public servants (without a pay rise for 24 years).