Removing the barriers of disadvantage – education and health partnerships

Transcript

Introduction:

You’re listening to the Victorian Academy of Teaching and Leadership podcast where we showcase conversations with some of the world’s biggest thought leaders in education. We also bring you the thoughts and reflections of teachers and school leaders from across Victoria.

Greg Lacey:

Learning and wellbeing, they're both essential for our children to thrive. Today, we'll hear from a principal from a community where the learning and wellbeing of children and their community come together in a creative place-based solution. We also talk to pediatrician involved in this innovative but vital program about the barriers to quality healthcare resulting from living in a disadvantaged community and how those barriers are being overcome through community partnerships. Hi, everyone. My name's Greg Lacey. I'm a principal in residence at the Victorian Academy of Teaching and Leadership. Today, I'm joined by Andrew Schneider, principal of Mahogany Rise Primary School, and Vanessa Gabriel, a pediatrician. Andrew and Vanessa work in the Frankston North community and are here today to talk about a unique and highly successful program that's having a positive impact on thousands of students in disadvantaged communities. Welcome, Andrew and Vanessa. Can I start with you, Andrew? Can you tell us a little bit about you and your school community?

Andrew Schneider:

Thanks, Greg. I'm really excited to be here. It's my first podcast, so a little bit nervous, but we'll work into it. I come from a long family history of school teachers and leaders. I have three children myself. I married my primary school sweetheart, believe it or not. I know, it's crazy. I throw that in whenever I can. It keeps Katie happy. And my youngest is about to go into grade six. So working in a school, being a school principal and having three of my own kids go through the state government education is fabulous. I'm really enjoying the ride as a parent and as a school leader.

Greg Lacey:

And you've got some family history with the Frankston North area too, haven't you? Can you tell us about that?

Andrew Schneider:

Yeah, I do. I do. I'm born and bred in Frankston and my grandfather... I can talk about the Pines in a little bit, but my grandfather was the assistant principal of the school that I'm currently at at Mahogany Rise Primary School, and there's a photo on my desk at school that's photo of my grandfather, Ron Schneider in 1978, standing at the steps that are no longer there since the renovation. In the late '80s, my dad started teaching at Aldercourt Primary School, which is the other school in Frankston North. My mom did the same when she went on maternity leave and went back into the classroom not long after that, mom became the principal at Aldercourt Primary School. My brother Nick, he's the principal at Baxter Primary School in Frankston or in Baxter rather, and he's worked in Frankston North. So I'm a third generation Schneider in Frankston North as a school leader. It's quite fascinating, isn't it?

Greg Lacey:

It's a great story. A great story. Tell us a little bit about Frankston North and your community that you serve.

Andrew Schneider:

Yeah, look, so Frankston North was part of the old Pines Forest and back in, I think it was... In the late '50s, there was a big fire that went through the Pines Forest. Rather than leaving it, they built a whole heap of housing, which became some housing commission in the late '50s. Second lot of houses were built in the mid '60s, and at one point, there were seven schools in Frankston North and Frankston North's only 5.2 square kilometers. So it's a tiny little community just on the outskirts of Frankston. And back in the day, when there were seven schools, it was really thriving, lots of kids because it was housing commission, not just because it was housing commission, but there was obviously lots of other issues that people needed to be aware of, and there was some crime and level of disadvantage. The Housing Commission, it was essential housing for families that needed it, and that's categorized with generational poverty. I've become really been involved in footy netball clubs. I'm so passionate and proud of Frankston North and I jump onto anybody that isn't.

Greg Lacey:

It takes me back, Andrew because I know that some of those schools were probably 1,000 students, and it's always really a very close-knit community. Can you talk to us about that?

Andrew Schneider:

It's a fabulous community. It really is. Occasionally, Frankston can get a bad rap, but when you work there, when you live and breathe and you meet the families and the children that go through our schools, you fall in love with it. I'm into my fifth year here, or nearly into my fifth year as a principal, and I can't see myself moving on because I've got such a strong relationship with everybody in the community.

Greg Lacey:

Yeah, great. And Vanessa, you've been working at Mahogany Rise as a pediatrician for quite some time. What are your reminiscences about the community and Frankston North in particular?

Vanessa Gabriel:

Yeah, I think I'd have to agree with Andrew that it's an amazing community, and although as Andrew says, we sometimes focus on the disadvantage in these communities, they're actually incredibly strong,

5 Supportive communities, and it's been an absolute joy to work with the families and the children and the school as part of this Frankston North project. It's been amazing.

Greg Lacey:

I think it's part of this project to be able to piggyback off that strong relationship with the school in terms of the work that you do is really important as well, isn't it?

Vanessa Gabriel:

Yeah. My work couldn't exist without the school being really supportive of what we do as pediatricians. And I think as you said, it's a unique program. Doesn't happen anywhere else or not in many other places, certainly in Victoria. So to have the backing of the school, its admin staff, all the staff and the families of the area is vital.

Greg Lacey:

Terrific. Thank you. Andrew, I know that you and your school community are in the midst of a major community project called the Frankston North Education Plan. And tell us a little bit about that project and what you expect that to provide for your Frankston North community.

Andrew Schneider:

Yeah, look, the Frankston North Education Plan was, I guess there were two parts to it. One of them was the major redevelopment of the three schools, Aldercourt, Mahogany Rise, and Monterey Secondary College. And our goal there is to have all of the local kids go to the local primary schools and then funnel them up into the secondary school and keep them in Frankston North schools. There are nine other education plans across the state, and we're a unique one because we're across three sites, even though we're one education plan. And I think we're in year five of the education plan and the results we're starting to get are really fabulous and life-changing for a lot of families.

Greg Lacey:

Terrific. And the other schools involved in that are?

Andrew Schneider:

Yep, Aldercourt primary school and Monterey Secondary College.

Greg Lacey:

Great. Terrific. So alongside the Frankston North project, you're both part of a really exciting and innovative program, really impactful on children. It's been running for more than five years now. It's the pediatric outreach program. Vanessa, perhaps tell us about the work that you do currently in that program, and then we might talk a little bit about the history of it as well.

Vanessa Gabriel:

Yeah, sure. So yes, I'm the pediatrician that's involved with the three schools that Andrew mentioned, but also Kananook Primary have come on board as well. So we run a school pediatric clinic, really. One of the reasons it was set up was to assist those families who have massive barriers to accessing really good healthcare in general. I rotate myself around the schools now, and I run a clinic once a week with a pediatric fellow who's a senior trainee. And we would see, I don't know, maybe between 12 to 14 patients each week with their families. I think one of the beauties of it is that the children stay in their classrooms while we meet the parents first, and then we just grab the kids out of the class and they come and sit in on the latter part of the consult. So we have this great space where families feel safe.

Greg Lacey:

So this project is spread across the peninsula, and we'll talk about that a little bit further later on. Tell us about how it works in your school, Andrew, and how did it all begin?

Andrew Schneider:

Well, I sort of started in the school in 2019, and there was a lot going on from the environmental works that were happening as well as some of the cultural things that were happening within our school in particular. And one of the longer serving staff members says, "Oh, we've got a pediatrician that comes to school. And I go, oh yeah. Okay. What? Once a month? Once a term?" "No, no. Every week." I went, "That is unbelievable. If I tried to get a pediatrician appointment for one of my kids..." How long were you waiting, Vanessa, these days?

Vanessa Gabriel:

Oh, it's maybe eight to nine months.

Andrew Schneider:

Eight to nine months. So it's crazy. And so the previous principal was instrumental in setting up the program. He connected with Menzies, and Menzies has funded the program for... Well, my five years, probably longer, Vanessa.

Greg Lacey:

The whole way through. I think it's been about seven or eight years now.

Vanessa Gabriel:

Yeah, maybe close to nine even, yeah.

Andrew Schneider:

Yeah. And it's just the access is unbelievable and it's one of, it's probably the most important thing that we have going at our school because it gives us that instant support when we need it. And we're not waiting eight or nine months for a pediatrician appointment for some of our most needy kids.

Greg Lacey:

Just for those who are listening, Menzies that Andrew's talking about is Menzies: Caring for Kids. It's a philanthropic organization. Menzies' history goes back about 120 something years and we're in out of home care for a long time. They're now funding this program across several sites across the Mornington Peninsula. We'll talk about that at other sites, but it's an amazing partnership between a local health authority, the local schools, and a local philanthropic organization, isn't it?

Andrew Schneider:

Mm-hmm.

Greg Lacey:

The benefits for kids, we'll talk about a little bit later, but I'm sure you can talk about that a lot, Vanessa. So the project started nine years ago in Frankston North, and I know it's been transplanted elsewhere in the Peninsula. Vanessa, can you tell us a little bit about your daily work in the program?

Vanessa Gabriel:

Yeah, I think it was around nine years ago, we started originally at Mahogany Rise and Aldercourt mainly, I think. And then we sort of expanded and the program's changed a little bit over those nine years. As I said, I work with a pediatric trainee, a senior trainee, and we would see around four new patients each week. And the rest are all reviews of which we have many now. And we see anyone that the school or the school have suggested would benefit from a pediatrician or the parents have come to the school and with concerns around their child. We're open to seeing everyone that needs assistance.

Greg Lacey:

Sure. We know that quality healthcare is disproportionately distributed across areas of advantage as compared to areas of disadvantage. So in your community, Andrew, and the people that you meet Vanessa face lots of barriers to getting quality healthcare. What are some of those barriers that this program helps to overcome?

Vanessa Gabriel:

I think you're right. So good healthcare is particularly set in advantageous settings, and that's the wrong way around, really. These families face so many barriers. They face cultural barriers, they face financial barriers of getting to a pediatrician. They have to get to a GP and get a referral. A lot of them catch public transport to get into Frankston or Hastings, where we're based normally through Peninsula Health for patient clinics. I think there's also, for a lot of families, there's fear involved in going and seeing professionals and feeling like they might be able to ask the right questions or not sure where to go to get that assistance.

So I think those barriers are really taken away with this project because they're in a place of safety for them. The parents know the schools really well, they trust their teachers and their school community. So if someone like me is working in that environment, there's already this level of trust that I think sometimes doesn't exist in a big hospital. Lots of outpatient clinics, it's busy, it's chaotic. So yeah, I think definitely transport financial is a huge one, and pediatric clinics don't exist in those areas a lot of the time.

Greg Lacey:

Yeah. And Andrew, piggybacking off your relationship with the community, I know we've talked to a lot of politicians about this program, and the key to part of this is that principle in that community has just a unique connection with the community. Can you talk to us a little bit about that?

Andrew Schneider:

Yeah. Look, one of the goals or the overarching vision for the Frankston North education plan is that every child and family is successful in learning and life. And having all of the services at family's fingertips onsite and having a wraparound approach for our families is really crucial. Vanessa talked about the barriers of transport and trust in the school, and I think that's really important because we'll have maternal and child health nurse onsite. We'll have, obviously, Vanessa and the pediatrician, and we want to make sure that our students and our children in Frankston North are supported from birth to adulthood. And to remove those barriers such as transport and those sorts of things is absolutely critical. Sure, there are some families that miss the odd appointment, but the school backs it. We value it so much that we make sure we ring the families the day before. Our teachers are fabulous in giving feedback to Vanessa. We call it paid back.

Greg Lacey:

You like that?

Andrew Schneider:

Because they value it so much because it has a really significant impact on the children's learning and also on the family's health and wellbeing too.

Greg Lacey:

And I know that in some cases, when the eight-year-old from the school is up there having an appointment, sometimes there's a three-year-old who might get a look at as well.

Vanessa Gabriel:

Yeah, and that's really common, I think, that we... Often, the little kids are with them, mom or dad during the appointment. And I remember when I first started pediatrics, one of the most important things was observation was where you started your history taking. It was when people walked in the door before you'd said anything. And so you're always looking at whoever's in the room and checking those little ones. And if they're not quite talking like you think they should be or they haven't developed their language or motor skills, then we'll suggest to the mother that we'd be happy to see them as well.

So it's not limited to the children that are attending school, it's the whole family. And I would see anyone from birth up to when they finish Year 12. Obviously, I cut off then. And I think just to add to what Andrew was saying before as well, that this is a two-way learning thing for me as well. So the teachers really find it supportive to have a pediatrician there. But I learn a massive amount from the teaching staff and allied health staff and the admin staff actually at the school who have this incredible knowledge of these children and their families. And it's really important for me as a pediatrician to have learnt a whole lot of stuff from staff of the schools.

Greg Lacey:

So I know in the second half of each day, you have case meetings. Can you talk to us about those case meetings? Because I feel like they're a really critical part of the program's success.

Vanessa Gabriel:

Yeah, they are. So we spend the morning seeing the patients and then from the afternoon for a couple of hours, we case conference with the teaching staff or lead teachers in the junior and senior areas of the primary school, plus any allied health staff that are on site. And at Mahogany, we have the psychologist and the OT, which is fantastic. And we talk about each patient with the permission of the families, obviously. And I've never had a family not give me permission to do that because they see the value in that as well. So we discuss each child and their needs and what I'm seeing as a pediatrician, but also what the teachers are seeing in class and any of the allied health professionals that are involved with them. So we can come out with a shared understanding of this child and where we need to head in terms of how we support them with their learning journey, their mental health, their behavior, their physical needs.

Greg Lacey:

I feel like that time when everyone hears the same message at the same time, it's not what normally happens. How is that a benefit?

Vanessa Gabriel:

No. So I mean, I try in my other practice, which is all public outpatients, to contact schools as much as I can. It's just always been part of my practice, but it's incredibly difficult because I'm with patients, they're with children in class, so you end up playing telephone tag. And so this is unique in that we can all get together at the same time. And sometimes that message changes. What I understand is that family's issues or that child's issues can change significantly when I'm listening to what's happening in the class or in the yard or what the teachers are experiencing. And then that allows us all to develop a plan for that child that's, as you say, is all on the same page with the family.

Greg Lacey:

So by the end of the day, you've got an appointment, a diagnosis, a behavior management plan, a mental health plan in what normally might've taken 12 months if it happened at all?

Vanessa Gabriel:

Yeah. I mean, sometimes it's not that much streamlined. But yeah, we definitely try to have a plan by the end of the day, and sometimes that takes three or four appointments to get to that point where we've all got a really good understanding of these families because families are complex and children are complex. But we definitely get there together. And I think for me, that is the biggest benefit I see for these families. And I've always thought in my pediatric career how crazy it was that we didn't have clinics in school because that is where children spend the majority of their time, and I think we underestimate the information and the value we get from schools in terms of how well they know their students and the families. So it was always a bit crazy to me that we weren't having pediatric clinics in schools. But anyway.

Greg Lacey:

You've been in the program for quite some time. You must've seen some patterns in terms of the common ailments and issues you're facing or finding in children and families. What are some of the things that really stand out for you that you've noticed?

Vanessa Gabriel:

Yeah, so I was the first pediatrician in the program. It was started just with me. It's obviously expanded since then. I mean, we see a lot of behavioral, developmental, mental health issues in young children, and I think probably what I've noticed particularly over the last three to four years is that we're seeing them in younger children than we had previously, particularly mental health issues. And obviously, that's an impact of a whole lot of things that are going on, have gone on, including COVID. So yeah, I think the mainstay of a lot of what we see is neurodevelopmental issues, ADHD, autism, developmental delays. And we know that families that are living in areas with significant stressors have higher rates of children with neurodevelopmental issues and particularly developmental delay.

Greg Lacey:

Great. Andrew, the Department of Education in Victoria has for some time now recognized wellbeing as a really significant part of what schools do to care for students, not only their learning, but their wellbeing particularly. What sort of improvements do you see in your kids in your school as a result of having this pediatric process available?

Andrew Schneider:

That's a fabulous question. I'm just so pleased that the department have tweaked FISO. That's a pretty new... You understand what FISO is? It says don't use acronyms, but it's the Framework for Improving Student Outcomes, and wellbeing and teaching and learning sit side by side, not one on top of the other. They are just as important as each other, which is just fabulous to see. So from the department side of things, we're getting that right, which is awesome. The other bit is that in our particular setting, we've got a kinder or an early learning center attached, and Vanessa talked about potentially seeing some of the younger siblings.

What we're able to do at school, and at Aldercourt as well in a similar way, is we can start tracking two and three and four-year-old kids at our local kinder that are going to come across to us before they even start prep, to put in place the processes and the programs and the supports that these children need before they even start, which is game-changing. It's game-changing for the classroom teacher, for the school, for the family, and for the student. And to be able to do that and understand where the children are coming from before they even start prep, it sets them up. It sets them up in a really, really positive way. And if we do need to go down the path of seeking additional funds through the department, we can do that quicker because of all of the history that we have there.

Greg Lacey:

What sort of things are your teachers noticing in the classroom once these kids have been on this program for a while and when finding out some of the issues and dealing with them?

Andrew Schneider:

Yeah. Well, there's a couple of things to it. The fact that they're coming in on site, the younger students are starting to see what school's all about straight away, and some of those stresses are being alleviated throughout their time, sort of attending on site. A lot of our children come in with low vocab, and then if they can't explain how they're feeling, you're going to see it and you can see it and you can hear it. To be able to unpack that early and put the supports in place, it brings the level of their behaviors and intensity of it and the stress for staff down significantly. And every decision we make is with that child in the center of it. And just having as many facts as we possibly can just sets us up for success very early.

Vanessa Gabriel:

And I think communication between the teachers and myself is really easy. So we're able to... I mean, obviously, with the case conferences, but even outside of the time that I'm at the school, we're in email contact. So when something's happening for a child, they'll be able to email me and we'll try and work it out even before the next appointment. So I think that really helps me and I think helps the school, Andrew.

Andrew Schneider:

I've got a fabulous example. I don't know whether it's your next question, Greg, but [inaudible 00:22:29] happy to share that we'd come out of one of our lockdowns, I think, and school had started again, and at the end of the day, we had a really upset foundation student. It's a couple of years ago now, a really upset, distraught parent in my office and a really distraught principal at the time, which was me. The child was showing signs of, really, self-harm, suicidal ideation, me throwing scissors that narrowly missing the assistant principal's face. And we didn't know what to do. We were really at crisis point. And I picked up the phone, Vanessa answered it on the other end, everyone took a big, deep breath, we explained what the symptoms were and what was going on. Within the end of the conversation, there was a medication review, a script emailed to the local chemist, the dad went and picked it up before it closed by the end of the day, and it set the child on a new path. And that's how quickly it happened, and it was just immeasurable how amazing that was.

Greg Lacey:

You must have so many of those amazing success stories.

Vanessa Gabriel:

Yeah, I think, yeah, we do. I'm really proud of where we've got to with the program. And to see children thrive in an environment where they're well-supported for me as well, to be able to offer that to children that maybe would've taken years to get to a pediatrician. And I've certainly seen many children who have had big delays in their diagnoses, very clear diagnoses, purely because they just didn't have access to a pediatrician. Children now, for instance, children with autism where we're hoping we can diagnose them in their early years so that they can get early intervention. But in my first years of this program, we certainly... I saw children that were 10 and 11 who clearly had autism and had not been diagnosed and missed out on a whole lot of early interventions. So yeah, it's great to be able to put that in place much, much earlier.

Greg Lacey:

In terms of learning and attendance and those sorts of things, are you seeing... It's really hard to measure that sort of stuff, but anecdotally, what are you seeing as a result of this program?

Andrew Schneider:

I think from the school setting, and I know this is happening across the Frankston North Education plan and the other two schools, is that we're seeing our normal data sets, we're seeing decreased staff turnover. So people are staying for longer, less burnout, less sick days. We're seeing teachers feeling that they're well-supported. It's not there yet, but it is a calmer and more orderly environment across all of the schools. We're seeing academic growth, we're seeing NAPLAN results improve the trust in families, and the parent carer surveys are all increasing. I think we've got the individual stories, but as a whole, all of the measurables are heading in the right way, and we're really, really proud of it. And I think it's underpinned by the support that we get and that support that can happen in a click of a finger to support the students.

Greg Lacey:

Vanessa, you work for Peninsula Health, and we really need to acknowledge what Peninsula Health have done in terms of supporting this program, that real social justice approach to pediatric health has been a linchpin in this. They're also running a research project. Can you tell us a little bit about the research and what we're finding out at this stage?

Vanessa Gabriel:

Yeah, so I think we do have to thank Peninsula Health as they pay my wage and Menzies obviously support the pediatric fellow and allied health teams. But yeah, it's incredible that they had the foresight to support the program When the previous principal had sort of started it up at Mahogany. The initial research project was really just trying to gather the figures around what work we're doing and to ensure that was viable, really. And I think one of our previous fellows or trainees did the initial research, and between 2017 and 2022 across all the outreach programs, which isn't just the Frankston North one, we saw just over seven and half thousand appointments. And just to give you some context of that, Peninsula Health, in all its pediatric developmental clinics, or I've had 11,000 appointments in that same amount of time. So we've done a lot of heavy lifting in terms of seeing children and their families. And the majority of those would be neurodevelopmental issues.

Greg Lacey:

Andrew, this runs as a HUB program, so children from other schools come to your school for those appointments. How does that work?

Andrew Schneider:

Yeah, they do. Michael Block and the team down at Kananook have been involved from the start, and there'll be... You might be able to provide a little bit more context around this, Vanessa. But yeah, we do have occasional students from other schools come in and get support. The waiting lists are getting longer still just for our schools, so it's a little tighter now, but just for another principal who's having a difficult time with a particular student or a family to be able to say, "Hey, let me contact Vanessa, it helps them relax a little bit as well and know that there is some support out there and quick support."

Vanessa Gabriel:

Yeah, I think initially, the program started and we were based at Mahogany Rise and all the students came to Mahogany Rise, and that's been one of the changes, is now, because there's four schools involved now, I actually rotate myself. So I do two weeks a month at Mahogany, one week at Aldercourt, and one week at Kananook. So the children are actually on site at their own schools.

Greg Lacey:

Terrific. Yeah. This pediatric outreach program has hub schools in Karingal, Rosebud, Hastings, and Mornington Park all running on a similar schedule, meaning the services reach some 40 schools, I think in early childhood centers over its history. The program's funded by the local philanthropic organization, Menzies: Caring for Kids. Menzies provides nearly $400,000 a year to maintain the program that we know that funding is not limitless, Andrew. Do you have a call-out?

Andrew Schneider:

Do you know what? I just think about I'm so grateful that our students are able to see the pediatrician if they need it, but it worries me, the amount of children that aren't or that don't have access to a ped like we do. It then makes me think how many students are missing out, how many young people are missing out on the support and the early intervention that they need to become really successful in education, in learning, and in life. Vanessa mentioned, why isn't it in all... I agree it should be in all schools. It is that important and that life-changing for families, that it seems crazy that we don't have more of this opportunity for more families and more children.

Vanessa Gabriel:

And I'll put a call-out to anyone who... You're right, Greg. Funding is not limitless, and these programs cannot run without some element of funding. So I'll make a plea to anyone out there listening who would love to become involved. It is an incredible program that does change children and families' lives.

Greg Lacey:

I know I'd love to have it at my school, but even being on the committee of management at Menzies doesn't allow me to stretch their resources out past the peninsula. So my teachers are always saying, "Can't you get that program at our school?" Unfortunately, that's not going to happen at the moment. So today, we've been talking to Andrew Schneider and Vanessa Gabriel about an amazing program that's running in the Frankston North schools, but in other disadvantaged areas around the peninsula. If you want more information about this program, you just need to go to menzies.org.au or email Menzies at admin@menzies.org.au. Any final words, Vanessa?

Vanessa Gabriel:

I'd just like to say thank you to Menzies in particular for starting this program, but also to all the schools and their staff, as it wouldn't work without them. And it's a big commitment. It's not just having the kids there, it's making appointments. It's a huge commitment, and I wouldn't be able to do it without all of them. So shout out to them.

Greg Lacey:

Andrew, final word?

Andrew Schneider:

I think about what my grandfather would say if I spoke to him now. He said, "I've got a pediatrician twice a month at my school." He'd say, "Absolutely unbelievable. That's fabulous." And my mom says the same thing, just keep it going. It's so important.

Greg Lacey:

Terrific. Thank you. Well, we hope you've enjoyed this podcast episode and learned something new about the important work of principals in their communities and the power of local partnerships to support the wellbeing and the learning of children. Principals and teachers all over Victoria bring their expertise, their time, and their leadership to schools across our state. This is just one example of the incredibly valuable and impactful work of government school principals and teachers working alongside local organizations like Menzies and Peninsula Health to give Victorian children a better future. Thank you so much, Andrew. Thank you so much, Vanessa, for your time today. 

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