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Wednesday, 27 August 1997
Page: 7144


Mr ROCHER(7.40 p.m.) —The owners and operators of private nursing homes and hostels for the aged frequently have to put up with a great deal of nonsense in their dealings with standards monitoring team personnel. It seems that sometimes, but nevertheless all too often, individuals from the teams have to justify the time spent looking into the operations of a nursing home or hostel by finding fault where none really exists. We have become almost inured to Australian Taxation Office audit inspectors behaving in this way, but the thinking seems to have permeated at least some of those in the Department of Health and Family Services.

Take one case related to me recently. A new patient was admitted to a private nursing home and, on admission from a general hospital, was found to have scabies. We can only guess why her condition was not picked up and treatment for the condition commenced while she was still in hospital. As it turned out, the admitting nurse did not know about the scabies, and it was discovered immediately as a consequence of the home's routine procedures when any new resident is committed to its care.

After discussion with the new resident, treatment for scabies was administered, as might reasonably have been expected—a matter of course, we might think. But it is not. There is no way that trained nursing staff can just go ahead and treat a case of highly infectious scabies before it spreads to other residents or staff. There are bureaucratic procedures that must be observed.

All this comes to light as a result of a standards monitoring team having been told that the case of scabies had been found in the nursing home concerned. An anonymous tip-off, no less, had brought it to the department's attention. Telephone contact with the nursing home ensued and a visit by an inspector arranged. Part of the interview by the inspector with the senior nursing sister in the presence of the proprietor was concerned with the infected resident's right to freely choose treatment for the disease—`Was the resident cum patient consulted?' Yes, apparently she was. Sister told the inspector that, after discussion, the patient was—in the vernacular—`talked into it'.

It seems that the antennae of the inspector activated automatically. To be talked into something must have involved denial of the resident's right to freely choose to have or not have treatment. On it being explained that, in every day conversation, `to be talked into' something more often than not means to be persuaded by sweet reason to accept good advice, the inspector was still relatively unmoved.

Remember that this episode did not arise because of any complaint before or after treatment by the resident or her family. There had been a tip-off to the department by a person or persons unknown to the nursing home management. The potential for idle mischief-making should be apparent. But more important is that the nursing home nevertheless received a black mark on its record, plus all the time- and cost-consuming inconvenience, because of some bureaucratically perceived violation of an infected person's right to choose not to be treated.

It seems the rights of other residents and staff to remain uninfected were of only secondary importance. Least important from this example is a need for commonsense. Let it also be understood that, only a couple of months earlier, the nursing home had been audited by a standards monitoring team and been scored 31 out of a possible 31 for its entire operations—a rare mark indeed.