USER CHARGES FOR COMMUNITY SERVICES

User charges have been suggested as a means of limiting demand for subsidised community services, yet the practicalities and effectiveness of this strategy remain largely unknown. Discussion of user charges has also been stimulated recently with the development of Regional Geriatric Assessment Teams and the restructuring of community services under the Home and Community Care Program. The first part of this paper presents an empirical analysis of user charges practices and policies in twelve Local Government Areas in metropolitan Melbourne that are served by the same Regional Geriatric Assessment Team. The significance of user charges in the financing of community services relative to subsidies from Commonwealth and State Governments and contributions from Local Government are also examined, and relationships between levels of funding and provision are analysed. The second part of the paper discusses a number of implications of the findings from the perspectives of users, providers and Commonwealth and State Governments. User charges appear to have limited effectiveness in containing demand for services, and the considerable variation found in all aspects of user charges creates both vertical and horizontal inequities. These problems compound the uneven access to services arising from variability in levels of central government subsidies, with resultant constraints on the operation of Regional Geriatric Assessment Teams.