MLPs – What’s all the fuss?

Medical-Legal Partnerships or Advocacy-Health Alliances are an innovative and distinctive form of legal service delivery. But some of you are no doubt wondering what all the fuss is about.

I must admit this is a question I have sat with over the last few weeks when comparing MLPs to some of our own services in Central Victoria.

For example, since 2006 we’ve managed a referral program with Bendigo Health (the main Bendigo Hospital), fielding requests from social staff for legal assistance for patients who are receiving palliative care treatment. These referrals are usually referred to a panel of local volunteer lawyers, but may also be handled in-house by one of our lawyers. Isn’t this an MLP / AHA? We’ve outreached to Maryborugh Community Health (what might be described in the States as a Federally Qualified Health Center) for years, isn’t this an MLP? We’ve just been funded by the Legal Services Board of Victoria to educate doctors and other health workers on the legalities surrounding domestic / family violence and how they can make better referrals to our service. How about that? A regional arm of Senior’s Rights Victoria is embedded within Loddon Campaspe CLC , where lawyers and social workers work collaboratively – does that cut it?

The fact is, that many activities by our service and other community legal services across Australia feature some level of interaction between health and legal service providers. There are examples of such programs (in Australia and the States) that have been around for many decades, so are MLPs / AHAs all that new and amazing?

Having seen MLPs first hand over the last month and dwelled on their applicability in the Australian context, I think that these alliances / partnerships are both innovative and distinctive, if not “new” in all contexts. To sum it up, I think that MLPs / AHAs put it all together, in a way that we have not seen to any great extent in Australia. What do I mean?

At their best, they:

  • Feature on-site, integrated, multi-disciplinary teams. They are far more than referral systems or siloed services under a single roof-top.
  • Seek to improve the health outcomes of patients / clients through advocacy, not only seek to deliver legal services within the health context (which is simply an accessibility issue).
  • Have a strong educative component, often training law and medical students and delivering on-site professional education to health staff.
  • Attempt to consciously track their impact by evaluating outcomes, not just measuring outputs.
  • Are diverse, inhabiting many and varied fields and contexts of health service delivery, from children to the elderly, cancer patients, dialysis patients, people with mental health issues, asthmatics, the list goes on.
  • Seek to undertake individual case work but also organisational and systemic improvements in health service delivery.
  • Provide primary intervention, not crisis driven assistance.
  • Have developed a common language between disciplines that is accessible to politicians and the general public about the purpose of MLPs and the process for their delivery. People “get” medical-legal partnership in a way that they resist (consciously or otherwise) or just don’t “get” legal assistance services rooted in a  language of civil or human rights.  Not that MLP cuts across civil/human rights. It’s just a very accessible and complimentary language.

Many of these practices aren’t new. Many of them have been practiced by services and pro-bono providers for years. But, MLP puts them together. This is the really exciting thing.

Peter Noble

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