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Tuesday, 31 October 2006
Page: 77


Mr HAYES (6:14 PM) —Our ageing population necessarily dictates that policies aimed at delivering high quality outcomes to our aged will receive an increasing focus as the years roll by. This is an important area of public policy and should be driven by the notion that our elderly citizens require respect having regard to what they have developed and continue to develop in their own communities and what they have achieved through their contributions to the nation as a whole.

I am sure that in the coming years there will be many controversial decisions and much debate about the future policy programs to deal with the issue of an ageing population. I am sure that everyone in this place will have the desire to avoid the mistakes of the past which have led to the much-reported scandals that have taken place, some of which were mentioned only a moment ago by the member for Hindmarsh. Such scandals should not be allowed to occur and, quite frankly, these are matters that should be dealt with. I will make a contribution on what the Aged Care Amendment (Residential Care) Bill 2006 should have been looking at a little later.

All decisions on aged care both now and in the future should be based upon delivering a better quality of life for the residents of those facilities and providing a degree of security and surety to the families of residents and the loved ones who will benefit from aged care being provided in a proper manner. The bill, while largely technical in detail, deals with two important aspects of aged-care policy. These are important areas not only for those contemplating residency in an aged-care facility but also for families of those for whom care is considered to be essential to preserve quality of life.

Schedule 1 of the bill is aimed at amending the Aged Care Act 1997 to harmonise the aged-care and pension asset test in relation to income streams and gifted assets under the assets test for entry into permanent residential aged care. This was a budgetary announcement, supported by Labor. This measure is about equity in the treatment of assets and it was the product of recommendations by Professor Warren Hogan in his Review of pricing arrangements in residential aged care, which was handed down in 2004. Under current arrangements, the total amount of gifts—that is, assets that can be given away prior to entry to a permanent residential aged-care facility—are excluded from the calculation of the value of assets under the aged-care assessment.

Schedule 1 allows gifts of income streams to be treated in the same way that they are treated in the Social Security Act 1991 and the Veterans’ Entitlements Act 1986 for the pension assets test. Accordingly, it improves equity and is therefore being supported by Labor. The new arrangement will apply to persons who undergo an asset assessment for entry into permanent residential aged care on or after 1 January 2007; however, given that this was an announcement that was made in the last budget, any gifts made on or after 10 May of this year will be taken into consideration.

The second schedule of the bill amends the act to allow the Secretary of the Department of Health and Ageing to delegate to members of the aged-care assessment teams the ability to extend the maximum number of days of respite for families in need. Again, Labor supports this amendment. Currently people can access a maximum of 63 days respite care per financial year; however, the secretary or delegate of the secretary can increase the maximum number of days by a period of 21 days where there is considered to be a need to do so. Under the amendment proposed in this bill, the secretary will be able to delegate to members of the aged-care assessment teams the power to be able to formally approve an extension of respite care for families. Needless to say, this is a significant improvement in the process. It will cut down on red tape and certainly make it quicker for families to be able to access the additional and much-needed respite care when necessary.

I note from the outset that when considering all aspects of care for older Australians, both now and into the future, it is important that such considerations be made in light of respect for the aged in our community and that it is driven by the desire to improve the quality of life of those either in care or entering into care. Those are relatively straightforward objectives but, when considering the magnitude of the problem in the future, it is easy to see how these may translate into problematic areas of public policy.

Australia has an ageing population. There is no denying that. Like many other Western nations, due to the advances that we are seeing in various areas of life, including technology, the fact is—and fortunately so—that people will be living longer. The ageing population has significant public policy implications, particularly in the allocation of resources to service an ageing population.

The Productivity Commission projects that the share of population over 65 will rise from 13 per cent to 24.5 per cent of population between 2003-04 and 2044-45. Over the same period the proportion of the population aged 85 and over will undergo an increase from 1.5 per cent to five per cent. At the moment there is an age dependency ratio of around 19 per cent, and this is expected to rise to 41 per cent by 2044-45. What this means is that the number of potential workers for each person aged 65 and over will fall from 5.2 to 2.4. The implications of ageing under those circumstances are quite clear.

While the implications of growth in the number of people aged 65 and over are often considered through the prism of a budgetary bottom line and the resulting increases in health expenditure that future governments may be forced to face, I have to say that recently I had the opportunity to consider it in a completely different light. Recently, I had the good fortune to be invited to the Ingleburn pensioners club. I would like to thank the chair, Mrs Judy Payne, and the secretary, Mrs Freda Grant, for the invitation. What I found was a group of about 40 sprightly seniors. They get together on a reasonably regular basis. As I was speaking to them I gained some appreciation of how fiercely independent this group of seniors were. They did not want to be trapped in their age.

One thing they did emphasise to me is that they did not want to consider not living in their own homes. Part of this sprang from the concerns that I have in relation to my own ageing parents. It was probably actually good to have a number of other people clearly articulating their position to me and what their desires were, which they considered appropriate for their age. One of their desires was to make sure they were fit enough and independent enough to allow them to keep on living in the place that they have called home now for many years. It is too important an element of aged care to not reconsider aspects of this, particularly when we make considerations in the light of future investment and what sort of form it should take in community care to support our aged constituents.

As I noted at the outset, consideration of the impact of decisions of care for the aged should be borne out of considerations of respect and of improving their quality of life. In many cases the respect for and the quality of life of senior Australians, quite frankly, is premised on the fact that they want and should be able to stay, where they are able to, in their own homes. This is important to them, and it is something that we should all be mindful of when we consider the development of aged-care policy into the future, because it also has a significant impact on how we resource community care to facilitate that.

Increasing the proportion of senior Australians who continue largely to care for themselves in their own homes, with the possible assistance of community care, lends itself to an approach to health care supported by Labor—that is, considering health and aged care as part of our economic future, not simply assessing our approach to aged care on the impact it is likely to have on the budget bottom line.

There is clearly a role for expanded programs in community care. Maybe it is about time that this government started considering some health related policy solutions that do not simply result in the cutting back of expenditure and of services. Those who are already dealing with the impacts of the cuts in health by this government, whether they be through shortages in the health workforce or through what has occurred more recently in respect of cuts to the PBS, really know the sort of impact that short-term fixation on cuts and cost reductions is having on the budget bottom line—and what it is going to have, quite frankly, on the population of this country now and into the future.

Another area I would like to speak about while I have the opportunity is a concern that many Australians have when considering future care, particularly of their parents. It is related to this bill, because there were a number of amendments to this bill that were rejected when it was in the Senate. During the debate on the bill in the Senate an amendment was proposed that aimed at making sure that all aged-care facilities in Australia received at least one unannounced inspection, or spot check, each year, in which the facility would be assessed against all of the 44 quality outcomes that are prescribed by the Aged Care Standards and Accreditation Agency. This was an important amendment, and I am disappointed that the government has continued to resist the move to increase the number of unannounced inspections or at least meet the minimum that it promised on various occasions.

There have been many scandals in aged-care facilities in the last few years—and there have been many promises, but little has been delivered. To simply consider the facts, there are at the moment 3,000 residential aged-care facilities throughout Australia. In 2000-01 there were 350 spot checks, in 2001-02 there were 449, in 2002-03 there were 242, in 2003-04 there were 553 and in 2004-05 there were 563. I think the conclusion has to be pretty obvious: even after the promises to step up the program of random checks, and similar promises made by the minister earlier this year, clearly the checks are not taking place, as only about one in five facilities receives one of these spot checks.

There is a reasonable expectation on the part of seniors who are contemplating a future that may include residential aged care and on the part of families who are considering the future care of their parents and relatives that the quality and standards of care facilities will be checked regularly and be overseen by the government. It is not an unreasonable expectation that the government will do everything in its power to make sure that the standards it has set are being met by all possible providers of care, but I fear it is an expectation that is not presently being met, and will not be met, under this government.

I am very confident that you would not find in the aged-care facilities in my electorate the types of abuses that have occurred in the past, to which the member for Hindmarsh and others in this place have referred. I have been to each of the facilities. They are professionally run, and the care they afford to their residents is second to none. I have a number of facilities in my electorate, including Pembroke Lodge, Blue Hills, Frank Whiddon Masonic Home, Scalabrini Village and Maple Grove Retirement Village. These are all excellent facilities. I know that their operators have a deep commitment to providing high-quality care to their residents and a desire to provide the best possible care through their very professional and fantastic staff. Unfortunately, the reputation of aged-care facilities has been tarnished by some of the rogue operators in this industry who have captured the headlines.

I have every confidence that if any facility in my electorate had been subjected to a spot check throughout the year it would have met all 44 of the government’s quality requirements, as specified by the Aged Care Standards and Accreditation Agency. Despite the number of excellent facilities in my electorate in suburbs surrounding Liverpool and Campbelltown, there is certainly a bed shortage. Like many areas throughout the country, there is a shortage of residential aged-care beds and this is likely to increase over time. Currently in the south-west of Sydney there are more than 60,000 people over the age of 70. As at June this year, there were some 5,000 operational aged-care beds in the region but 5,423 beds were needed. So, even before the real pressure of our ageing population descends upon the aged-care sector in the south-west of Sydney, there is at the moment a shortage of 400 beds.

South-west Sydney has a relatively young population, so one can imagine that the shortage of aged-care beds will grow in the future. Imagine what will happen in the not too distant future when the proportion of the population aged over 65 reaches the projected 25 per cent and the proportion of those aged 80 and over reaches five per cent of the total population. The gap between the number of operational beds and the number of beds that are needed must be addressed, and we have to do that now.

While the provisions of this bill are sound, and supported by Labor, the government cannot simply move away from a further commitment to aged care and further support for community care in support of the aged. I welcome the provisions of the bill and I encourage all members to support them in the interests of quality—(Time expired)