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Thursday, 17 November 1983
Page: 2929


Mr IAN ROBINSON(10.07) —I feel it is necessary to make some further comments in respect of the Health Legislation Amendment Bill (No. 2) before the House because of the confusion brought about, in particular by the honourable member for Canning (Ms Fatin), who has just spoken. That confusion arises from a lack of understanding of what the Minister for Health (Dr Blewett) told the House in his second reading speech about the proposals embodied in the legislation for admission to nursing homes and his quite separate reference to a consideration of applications for permission to construct nursing homes, or, in former terminology, applications for bed allocations for the construction or provision of nursing homes. The Minister said:

Consideration of nursing home applications has been deferred while the new growth control guidelines are being settled and the arrangements proposed in this Bill are being put in place.

I remind the House that, in answer to a question asked in this House at the beginning of the first session of this new Parliament, the Minister said: ' Proposals in the pipeline will continue. The Government will ensure that there will be no cessation of projects that are in the pipeline'. He did not qualify that statement. But I am sure that many communities in this country-certainly communities in my electorate-assumed that he meant that those nursing homes that had either a bed allocation or were applicants for a bed allocation and had funds to substantiate their applications would be regarded as being in the pipeline.

I am very concerned-concern was also expressed by the honourable member for Lyne (Mr Cowan)-that there appears to be, on the part of the Government and certainly on the part of the Minister, a broken promise in sight. I hope that the words of the honourable member for Canning are not an attempt to back that up. Certainly members of my Party and other members on the Opposition side of the House have a very high regard for the principle that people should remain in their homes as long as possible and that every effort should be made to assist with the care of people in their homes. Home nursing services, Meals on Wheels and every other avenue should have the strongest support of the community. It must be recognised that the stage is reached when all that kind of help, no matter how it is delivered and in what circumstances it is given, can no longer meet the needs of aged people.

This confusion that we have at the moment is very worrying not only for aged people who are anticipating going into nursing homes but also for those communities which have worked so hard to try to ensure that this will be possible. I am not referring to overservicing or to people who just for the sake of it apply to the Government for a subsidy for a nursing home project. I am referring to those who have a real need. I hope there will not be too much confusion between the assessment proposals and the well intentioned expressions of need to assist to a greater extent with hostel accommodation notwithstanding the increased provision which allows people to be so accommodated. I hope that the nursing home requirement will not be placed in a secondary role or become the play thing of a bureaucratic system. I hope, as the honourable member for Lyne said, that some obscure committee will not make an assessment of a region which as yet has not been explained in this House by the Minister for Health or described in the legislation. One can only assume that some rather obscure proposal will be made to deal with assessing whether a community needs a nursing home.

I will give the Minister two examples of what is worrying me. In my electorate an application has been made for an additional nine beds in a nursing home to augment a project which is already under construction. Initially the project was given approval for 30 beds. In discussions with the Department of Health-the Minister's own Department-the project manager was advised that it was unwise to go ahead with the proposed 30 beds. There should be 40 beds. He was requested to put in an application straight away for an additional nine or 10 beds so, as the Department put it, that would be a more satisfactory proposition. This project is under construction. We have waited months for the Minister to respond to the application. I have had correspondence with him and he has replied to my representations. This is an abrogation of what was indicated in this House some months ago. I hope that the Minister will explain to the House tonight what his intentions are in the matter.

The second matter that is worrying me relates to Macksville, a town in my electorate on the north coast of New South Wales. A constituent is waiting for approval for a nursing home project which will augment an existing situation. The number of beds have been approved and the local community has the necessary funds. Tenders have been called and a very satisfactory tender has been submitted. If the project were delayed, costs would rise due to inflation. Obviously, the project should proceed. The people concerned want it so. However, under this legislation the project is obviously threatened, although approval was given some time ago. Can the local community be sure that under the bed allocation the Commonwealth share of funds will be forthcoming? I hope that that kind of circumstance will be cleared up by the Minister and not left swinging as it is at the moment on the face of what has been explained in the Minister's second reading speech.

If the system described by the Minister is introduced there will be little encouragement for communities to go ahead as they have in the past to raise funds. Sometimes it takes eight or nine years from the time it is suggested a home be built to its completion. It is known at the time that it will be in demand but this sort of work is not done overnight. I find it very clumsy and a very odd way to tackle the matter to advertise in the Commonwealth of Australia Gazette, the local newpaper and the metropolitan press as well as inviting applicants to submit a proposition for a nursing home and still have regard to the long established and successful system of building such homes with community support. I appeal to the Minister to consider some mechanism that would at least offer to the community in which there is a need, a preliminary opportunity to apply for the necessary permit to give the necessary lead time that the communities have experienced in the past. I refer to organisations such as the St Vincent de Paul Society which is in so many towns and Frank Whiddon Masonic Homes of New South Wales. These chains of homes for the aged did not come into existence a short time ago. They have been working in this field for 50 years. If they are to be confronted with the bureaucratic approach that we find in this legislation, obviously they will be able to contribute less to the community than other church organisations or community based groups that are formed for the purpose of sponsoring homes for the aged. Their work would virtually be put into mothballs becuase of the uncertainty, the doubts and the inability of people to respond to an adertisement in the Gazette. As I said a moment ago we need a mechanism that gives people a lead time in order to put up a proposition so that they can establish their viability by fund raising and all that is associated with it. Does this legislation mean that we would be handing over responsibility entirely to the other field as to private nursing homes? I have every respect for those who have invested capital in private nursing homes and who continue to do so. In some respects that saves the Government finding part of the capital required. For many years we have had private nursing homes and those sponsored by community groups. I hope that this Government will not cast aside the community group approach. I refer particularly to charitable work. Of course, that has been very much a part of the work of churches. I refer not only to the Roman Catholic Church but also to the Anglicans, Methodists, Presbyterians and the Baptists. They have all worked exceedingly hard in this field in my electorate. Are we going to say to them: 'We are not interested in the way you have done things in the past. Your reward is to put in an application if you see an advertisement in the Government Gazette or local newspaper'? If honourable members opposite suggest that that is a sensible way of tackling this important charity work, this Government has gone as socialist as we expected it to. This Government has been so cornered by bureaucratic do- gooders that it has lost its way in this field. I appeal to the Minister to clear up this matter tonight in a manner that will be in the best interests of those who do the kind of community work that has been so successful assisting homes for the aged over so many years since the introduction of the scheme by the Menzies Government in about 1949.