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Thursday, 29 May 1997
Page: 4038


Senator DENMAN(6.00 p.m.) —Because we have run out of time, I seek leave to have my speech incorporated in Hansard .

Leave granted.

The speech read as follows

I wish to rise to speak on the notice of motion, moved by my colleague, Senator Carr, regarding the important announcement in a press release on Monday by the Minister for Family Services, Ms Moylan—that there will be at least a three month delay in the introduction of nursing home entry fees.

This indicates, that the effort, to allegedly build a secure future for all older Australians, in partnership with the aged care industry, remains fraught with problems, not the least of which is the Government's failure to guarantee to us, on this side of the Chamber, that a two tier system will not develop because of the introduction of the Aged Care Bill.

I read the response of the Prime Minister to a question without notice by the Shadow Minister, Ms Macklin on Monday about the delay on the Aged Care Bill.

There is a bit of a smoke screen, being perpetuated by the Prime Minister and the Minister for Family Services, that the central opposition to the Bill is the compelling of people who can afford to do so, to make a contribution towards their care.

That is not the paramount issue that concerns us on this side of the Chamber. What is of concern to us, is what is concerning groups all over the country, and that is, the implications for those older, sick poorer people. If the Federal Liberal Government continues with its current policies where are these people going to fit in under a market model of nursing home care?

I recall that the Minister for Family Services, earlier this year circulated a statement entitled `Steps to Better Care' about the dawning of a new era in the provision of residential aged care. Well at the moment the Minister appears to be doing a bit of a two step shuffle, that is one step forward two steps back.

As the Shadow Minister, Jenny Macklin stated the actions of the Minister of adopting a piecemeal or ad hoc approach to aged care is creating further concern in the elderly community.

It is no good for Senators on the other side to claim that we on this side of the Chamber are initiating this uproar of concern. The Minister herself is creating this environment of instability sweeping across the elderly community.

The Minister, unfortunately is compelled to dance this jig, moving to and fro, because the Howard Government's true motivation is to save money not to ensure that all residents are funded properly, according to their care needs, no matter where they are residing.

One has only to read the Commission of Audit Report, a blue print that has been relied upon by the Federal Liberal Government for policy direction, to realise what is the true motivation.

Many sections of the Australian populace are petrified about Australia's ageing population and its contingent pressure on expenditure. That is all well and good, but the crisis that is still some way off, has been recognised, and good solid government policy should be able to confront it down the track. Unfortunately this concern in the community, about our ageing society, has been utilised by the Liberal party, by becoming apparent, probably in polling and has been cunningly utilised to justify the measure of cutting over $500 million from aged care in the next four years.

In my own home state of Tasmania in another 50 years the median age will be close to 50 with a population likely to be less than it was in 1987. It is no surprise to know that on the current trend with so many of our young leaving the Island that our population will go into negative growth. Tasmania's position is a lot worse than the remainder of Australia.

The Tasmanian Liberal Minister for Community and Health Services, recognises that the crisis con, is only an excuse for arbitrary budget cuts and has pledged to prohibit new cost burdens on Tasmania by the Commonwealth in relation to aged care. No doubt the State Minister is very concerned about the matter of entry fees, especially when there is no upper limit on the size of the entry fee.

There is no doubt that the ageing of our population warrants good strong long term policies, to ensure we never reach a crisis in the future. The Federal Liberal Government con, has been to use the concern in the community on ageing, to argue the case for a massive cut when in fact these cuts are unwarranted.

That aside, as I said what has been of real concern on this side of the Chamber from the outset, when the Aged Care Bill in the other place was introduced, has been the failure by the Minister to ensure that an equitable service will be delivered under a market model. I mentioned earlier about the likelihood of a two tiered system resulting.

Apart from the fact that currently the majority of individuals entering a nursing home have suffered a serious illness, and are not in a position, I would envisage to be on an equal footing to negotiate, a contract with an individual who is in business to make a profit.

There is also the difficulty of ensuring, under the market model that if you are wealthy the, `I'm all right Jack' scenario, will end up being the rule of thumb, with those better off, as the Shadow Minister said obtaining the ensuite rooms with the river views. While concessional residents who are equally frail and ill, if they are admitted to such a home in the first place, they will be accommodated in rooms with four walls wash basin and prison bed. Obviously, that statement may be a little over the top, but I make it to illustrate the point that the Minister needs to guarantee people will get access on basis of need.

The Gregory Report stated on the matter of entry fees, and I quote: `The sheer size of entry contributions and the impact on a client's life, of having to agree to sell assets to receive care, would be a considerable barrier to entry'.

It might be all right for the Prime Minister to speak about his personal experiences in visiting new nursing home complexes, but what about the lack of swisho or elite nursing homes in the poorer socio economic regions.

We all know that certain large nursing home chains in the blue ribbon regions will prosper under the new legislation.

Aged, Health and Community Groups fear that in the poorer socio economic regions in Australia by moving to the market model and with the withdrawing of capital grants that there will be a gradual running down of nursing homes in such regions as operators will be forced to reduce capital expenditure.

There would be no compulsion on homes to make them spend the entry fees on capital improvements. For a nursing home that down the track, supplies care to a particular concessional resident market niche, more by necessity than choice, they could find difficulty in remaining operational if they are unable to pay for capital upgrades. There is the risk they could fall below the minimum standard of buildings and services required, and lose their certification to charge. It will be interesting to see how the bureaucracy deals with closing down a nursing home because of poor capital stock under the proposed system.

I would have thought, that the whole issue of the monitoring of the quality of care, should have been one of the first things settled under the reforms. I understand that the matter of auditing procedures has not been settled and I find this situation deplorable.

It has been stated that we cannot assume that the sick older generations are going to be cashed up or asset rich.

The failure by the Government, to provide adequate supplementary funding for concessional residents, who are unable to pay the entrance fee also is a worrying matter. If any one organisation could be responsible for creating doubt in the mind of the Minister and cause her to postpone commencement, it was the concerns of the Australian Nursing Homes and Extended Care Association Limited and the Council on the Ageing.

The Council for the Ageing stated publicly in February that the problems that have been exposed in recent weeks and especially in the last few days needed to be rectified. Why wasn't it sorted out prior to drafting the Bill.

An issue also, that has been raised, is the danger of the Aged Reforms creating an environment whereby poorer residents in a home become institutionalised, because they become economically dependent on that home. It must be assured that there must remain a particular level of disposable income for those concessional residents.

The Opposition has never said that improvements in the development of government policy on aged care, cannot be initiated to build upon what remains, in my view, a period of solid policy development of reconstruction and reform when Labor was in Government.

What the Opposition believe, as many groups across the nation believe, is that the Federal Liberal Government and the Minister concerned, need to reconsider how their aged care program will affect those poorer aged people in our community.


The ACTING DEPUTY PRESIDENT (Senator Chapman) —Order! The time for the debate has expired.