Mr WILKIE (4:46 PM) —Before beginning I might mention a question I asked the Minister for Aged Care, and I know that I raised this yesterday after question time. But I see that it is taking quite a long time to get responses to questions from ministers. Back on 15 February I asked a question which was particularly relevant to this bill introduced by the Minister for Aged Care. Although I think we have 60 days in which we could normally expect to receive a response, after 128 days I am still waiting for a response from the minister. As I have said, the answer to that question would have been particularly relevant to this bill we are discussing today. Hopefully I will get a response to that particular question before I need to go into a nursing home myself.

It needs to be said at the outset that the government has tried to play the double-headed penny with this piece of legislation, the Aged Care Amendment (Omnibus) Bill 1999 . Members of the public should be in no doubt that the government suffered a resounding defeat when it tried to introduce its previous Aged Care Bill. It was a defeat based certainly on the community's views about what should be appropriate for those in our community who have contributed to the nation. It was perceived as manifestly unfair—and, of course, it was. I will not have to remind members of this House that it also contributed to the demise of at least one minister and perhaps to the defeat of another at the polls.

The Labor Party will not have to suffer that same fate because of a simple premise: we believe in equity measures in aged care. This means equity for the 3,500 private and 2,500 non-profit provider beds in Western Australia, for example, as well as all the public nursing agencies. This is of added importance in my seat of Swan. In my electorate there are over 15,000 members of the community who would be classified as aged. Swan has one of the highest proportions of this demographic in Australia. We have a number of notable institutions that cater for and assist the aged in nursing homes and carer facilities.

Life for these institutions and their residents has been particularly difficult since this government tried to enact the Aged Care Bill 1997. The government must have twigged to the fact that there was insufficient support for its plans because this current legislation makes a number of amendments that have arisen as a result of the previous legislation—and it is for that reason that Labor supports some of the strategies undertaken by this bill. These measures address problems that have arisen under the Aged Care Act. Indeed, we have been raising these matters with the government for a considerable period of time.

I can say, however, that Labor will be voting against the bill in the House. This is necessary because the opposition has not had time to examine the bill and its ramifications. In the event of there being any degree of bipartisanship, I would not think of this as the way to introduce legislation that affects so many. It would not be responsible for us to do otherwise than vote against this legislation. The aged community, carers and providers need to be given a firm undertaking that all the impacts of this legislation are thought through by decision makers. It is natural, given the time frame, that we shall be responding to the bill in detail in the Senate, armed with all the necessary information.

We believe, for example, that residents in nursing homes prior to October 1997 should be refunded any accommodation charges they have been required to pay. In fact, over the last six months my electoral office has received a number of complaints over this issue. Justifiably, these people are angry at compliance with a piece of unfair legislation. I am also happy to report that matters will finally conclude, at least in regard to this matter.

I have also indicated to the members of the Swan cottage homes, Collier village and the TPI village that the government only gave a commitment to stop this practice after pressure being applied from Labor. Well and good. But it is an outrage that these residents have been paying these tariffs for the better part of 18 months.

What is disturbing is that for a year and a half residents have been forking out this money, and in one day the government has sought to thump this legislation through the House without any care for ethics or cursory examination. Many would say that the government is not very keen on any review of the act in this House, lest some painful memories return. Heaven knows, the government must be eager to avoid scrutiny of the bill as it demonstrates this government's bungle of the aged care sector since coming into office in 1996.

As an amendment bill to the 1997 act, this legislation serves to remind many in this chamber of the failings of the Aged Care Act. It should serve as a lesson in the public policy problems that will always occur when policy is carelessly implemented—all, of course, under the guise of `reform'. Nor would many in the community be blamed for scratching their heads in disbelief about evaluation mechanisms that have taken over a year and a half to change.

The government announced its aged care reforms in the 1996-97 budget without having had adequate discussion with the aged care sector, and proceeded to implement many of those measures in October 1997 through the Aged Care Act. I can indicate to members of this House that I have received correspondence from and had meetings with a number of management groups in the industry about problems they have encountered.

I can inform the House of one critical element of the act that has had, and will continue to have, an impact particularly in Western Australia: the wage differential for nurses. As members will understand, the rate of salary is different for each state. Notably, in Western Australia that rate is so low as to create an inequity between the wage paid in public hospitals and the wage paid to nursing home workers.

The government is always highlighting its supposed superiority in the field of economics. I wonder then why it does not have a grasp of labour economics 101 which is taught to first-year undergraduates as follows: if a wage is paid at a lower rate in one sector there will be a commensurate flight of staff if a higher wage is paid in another sector, given that all is held equal. Here is the reality of that lesson. Staff cannot be kept in the aged care sector in Western Australia because they are unsatisfactorily remunerated. The government has been aware of the problem for two years and has not acted to rectify the problem by increasing funding to compensate the nursing homes or by increasing the wages of nursing staff.

Yesterday my office spoke with George Van Lawick of the Western Australian branch of the Nurses Federation. George illustrated the point by noting, `We are looking at $100 per week minimum, it can be averaged out to almost $7,000 per year.' George went on to illustrate that point further when he explained how the problem was compounded:

The trouble is our nurses are increasingly being taken off patient duty and being asked to fill in doing clerical duties to process clients for the business. In this way the agency gets paid. The problem is that maybe 8-10% of time is now dedicated to other tasks without an increase in staff to compensate for the work not done.

In other words, the level of care suffers. Experienced staff must be offered an incentive to stay in the sector and new staff must be given the opportunity of career development, including training and suitable terms and conditions of employment. As they say about the current government, `Don't hold your breath.'

Is it any wonder that the place is in crisis. We should not forget, because members of the aged care community have not forgotten, that $500 million was ripped out of the sector in 1996. I guess this is what reform is to this government. One of my colleagues has already mentioned that, within a month of the Aged Care Act coming into force, we had the Prime Minister appearing on A Current Affair to announce a change in policy, abandoning the proposed accommodation bonds in the face of widespread concern.

In March 1998 the government tabled the Aged Care Amendment Bill 1998. The Aged Care Amendment (Omnibus) Bill 1999 currently before the House closely resembles many sections of the earlier bill. Both list a number of problems that have arisen in the aged care sector because of the Aged Care Act. Within four months of the Aged Care Act coming into effect the government had already discovered a large number of problems in the system, problems that were a direct result of the government's rush to make changes in the aged care sector.

I am led to believe that the minister has received representations from the Western Australian health care industry on a range of issues, including the funding models used for the calculations regarding nursing homes and the breakdown of these models. In discussions I have had with the industry, a few very salient points have been made that highlight the problems faced on a daily basis by these carers. Mr Deputy Speaker, did you know that simple but elementary things such as incontinence pads are not included in funding formulas, nor are dressings, bandaids, sanitary pads or even Dettol?

It gets worse. I am also led to believe that many deficiencies have been illustrated by the industry due to reimbursement no longer being available for infrastructure costs. Put simply, the system is starting to crack. It needs money but, according to the funding formula, non-salary costs are not relative to the funding structure, which means that the industry has to trim around the edges. The result is that the aged and their carers are getting it in the neck. These issues affect the majority of all private institutions in the state and also impact heavily on my electorate of Swan.

One thing that was particularly evident was that this minister had done nothing to address these issues. I put it to members of this House that the reason for this is one of two scenarios: first, that the minister was not aware of the perilous state of the finances in Western Australia and that when informed of the situation she did nothing—in which case, the minister has blatantly ignored the warnings of the industry; or, second, the minister was aware of the problems in the nursing home industry and has simply chosen to ignore the problem.

I find it strange in the extreme for there to be differences in the models used to assist nursing homes due to different funding models in different states. When these can be highlighted as problematic and when alternatives can be discussed, costed and explained and yet still ignored, is it any wonder that the industry is in a total state of disarray and disillusionment with the minister? It will take more than this legislation to fix these problems. It will require a listening minister who can help the industry, not bludgeon it to death.

In discussing these and other issues with other members of the opposition, I am led to believe there are other problems. Firstly, our understanding is that a ridiculous situation can actually occur that makes it possible for providers to charge people fees before the person has formally agreed to take up a place. This is lunacy. It is an act of insanity. Secondly, even if an aged care provider has committed serious breaches of the act in that fraudulent practices are evident, the department is unable to remove the provider's status. Because the government repealed the previous legislation, the department now cannot impose a penalty where a provider transgressed the act before October 1997. In effect, the government has let offenders off the hook, offenders who have behaved like parasites on those who can least defend themselves.

My colleagues who have examined the act have also found that where the department would normally have shut down an entire facility which had offended, which would require the immediate relocation of all residents, where there are not sufficient alternative places available the department has no choice under the act but to allow the provider to continue to operate. The act also does not recognise residents in aged care that were financially responsible for children who were not actually living with them, nor does it recognise grandchildren who lived in the same house as `close relatives' of the resident.

We also have a number of concerns about the accommodation charge and its effectiveness in funding the capital requirements of the aged care sector. This has already been highlighted in Western Australia by the industry and needs immediate attention. In the end, many older Australians might have to sell their homes in order to pay any charge. Given the circumstances in which a person enters a nursing home, how reasonable is it of us in a mature society to expect this?

Furthermore, in highlighting the plight of the industry, I understand from conversations this morning with aged care representatives in Western Australia that providers are now having to do battle because they must meet certification standards by the first months of 2001. Whilst certification sounds wonderful, the accommodation charge does not deliver the principal capital requirements they need to meet the deadline. The government has offered no funding to assist in this process.

In conclusion, we are happy to discuss these and other aged care issues with the government but we need to sit down and structure long-term planning with the industry. This will ensure the health and viability of the aged care sector. In the end, the government has to realise that funding is a necessary component of aged care. Standards have to be maintained and the quality of care has to be made the highest priority. Likewise, staff working in the industry must receive proper wages, and the providers themselves who have had to bear the brunt of the reductions in the sector must be properly funded. The saga of those awaiting refunds after the first wave of aged care reductions must also be resolved. Once these issues have been addressed, then and only then can we begin to solve the growing dilemma facing aged care.