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Wednesday, 22 August 2001
Page: 30071


Mrs BRONWYN BISHOP (Minister for Aged Care) (12:34 PM) —I had intended to say a few words of thanks to the people who contributed to the work on the Criminal Code and the harmonisation of offence creating and related provisions in health and aged care, but, in light of the speech I have just heard, I will preface those thanks with a few other remarks. I understand that the member for Newcastle, as well as the member for Paterson, made some remarks concerning St Catherine's of Siena, which is in the Hunter region, and St Joseph's at Lochinvar.

St Catherine's of Sienna is one of 10 homes which are managed by Catholic Care of the Aged in the Hunter region. They have received for the management of those homes some 82 per cent increase in funding as a group since this government came to office. The expenditure in 1995-96 was something in the vicinity of $4 million and the income that those homes only have received in this last financial year was in excess of $7 million.

I make this point because there has been a business decision by Catholic Care of the Aged, which manage those homes on behalf of the Roman Catholic Diocese of Maitland and Newcastle, to close St Catherine's. It is housed in an old heritage building, which has three floors. They have made a business decision that they wish to close that facility. It has 67 beds and they will not be lost to the region. They will stay in the Hunter region and I understand that Catholic Care of the Aged, although they have not made a final decision, will probably want to redistribute those beds around the other homes that they already operate.

With regard to St Joseph's at Lochinvar, this is a home owned by the Sisters of St Joseph and they have also had Catholic Care of the Aged manage that home for them at Lochinvar. They are intending to move those new beds to Swansea, still within the region, where they believe they will have a better operational group once those beds are transferred there. They will also be able to bring on in a quite speedy manner 10 new beds that were allocated to them fairly recently. That is a good outcome for that. They are also in discussions about changing the group that manages their home for them from Catholic Care of the Aged to another group. I understand that has not been finalised, only discussions are occurring.

In the Hunter region, between 1 November 1998 and 31 December 2001, 461 new beds will become fully operational. It will include five brand new aged care homes and seven which have had large and considerable extensions. They are five new homes, seven extended homes and 461 brand new operational beds, which will come into effect in the Hunter region. Among those will be a very significant facility called the Warabrook Centre for Aged Care, which is operated by Baptist Community Services. This is the first teaching aged care home in the country. It is about absolute excellence in every way. I add that Baptist Community Services were the winners of my award for excellence in development of staff for the delivery of aged care services.

In replying to those remarks of the member for Paterson, allocation of places is made in accordance with aged care planning regions, not electorates or postcodes or any other definition. They are done in accordance with aged care planning regions of which the Hunter region covers, as its name would suggest, the Hunter. He also mentioned the need for high care and I would say that, in those lists of places—and they are all beds in homes that are being opened—a number of them are high care places.

In addition to that, we also have now Ageing in Place and that means that as people move from low care to having high care needs—what we used to call nursing home need—those people can remain in that place so long as the management brings in the right staff mix, including registered nurses as required under the act to ensure that proper care is given. I think Mr Morris said there were no requirements to have nurses in nursing homes. First, they are all called aged care homes now because we have united hostels and nursing homes and 85 per cent of all our homes have a mixture of high and low care. Second, the act specifies when registered nurses must be present and so his statement is quite wrong.

It was also mentioned that the John Hunter Hospital had people who were waiting in hospital beds simply to be moved out into aged care beds. I would point out the very important fact that older Australians have the right to go to hospital just as much as anybody else. Because older people will often have a multiple number of co-morbidities and will have complex needs, their need to remain in hospital will very often be much longer than the 5.6 days that state hospitals like to keep people over the age of 70, or 3.6 days if you are under the age of 70.

It may well be that the gentleman whom the member for Paterson cited as being in hospital for 20 weeks required to be there. He may have needed rehabilitation or he may have needed a whole range of services which are actually provided for in the health agreements with the states. Those health agreements provide money from the Commonwealth—the $6 billion that we provide, which is 43 per cent of all their funding. They are obliged to provide proper rehabilitation and discharge policies, and yet if you look at the statistics, as published by the Australian Institute of Health and Welfare, you will see that it is only a minute percentage of patients who are receiving that required rehabilitation treatment. That is why I have put on the table my proposal for having some transitional arrangements for people going from hospital to home or to their correct level of care if it is in a residential setting, but the states must pay for the rehabilitation treatment that they are entitled to have.

I might say in the Hunter, at the John Hunter Hospital, we indeed have in situ in that hospital a transitional unit where people who are chosen as suitable are given rehabilitation to get them to go home, or at least to a level of care that would be less than they otherwise would have been seeking, and that again is conducted by Baptist Community Services. It is a pilot program and is already up and working, but there is a most worrying attitude from hospitals to older people: they just want to get them out. They will mark their files `acopia', cannot cope at home.

I said yesterday there were 2,056 people who were identified across all Australian hospitals, and I might say that all public hospitals right across Australia have been reducing the number of beds they have. Indeed, in the last 12 months right across Australia, state and territory governments have reduced the number of beds in public hospitals by a further thousand. So we have gone from something like 77,000 beds in the mid-1980s or, say, 1987 across Australia in public hospitals down to 52,000. They have been closing them at the most disgraceful rate, and I am appalled to say that last year New South Wales underspent its health budget. Can you believe that? It underspent its health budget.

Quite clearly, there is a need to be looking at, from my point of view, whether older Australians are getting correct treatment and the respect and proper attention that they deserve. I have established a committee, headed by Dr Michael Murray from St Vincent's in Melbourne, of consumers, including, for instance, the president of the Council on the Ageing, which is looking at this question and at the horrendous stories of the way that older people are treated in hospital and thrown out of hospital. They have pressure put upon them. They are discharged in the middle of the night, with no underwear on, just one of those dreadful nighties tied up at the neck, without proper contact with GPs, families, carers or anything. There are horrendous stories and they have got to stop. We fund these hospitals to carry out proper discharge policies and it is not being done. So we have to have the data. We have to look at these things so that something can be done about it.

Looking at the question of aged care means looking at so many aspects of the way in which older people are cared for. I said that whereas in public hospitals state governments have been shutting hospital beds at a rate of 23 per cent over the last dozen years, in the same period in aged care we have opened an additional 24 per cent of beds. The statistics are these: we have 3,000 aged care homes in Australia; we have 143,000 beds in those homes, in which we have a 96 per cent average occupancy.

On the other hand, there are now only 748 public hospitals in Australia, with 52,000 beds. The really interesting statistic is that in the last 12 months the number of patients treated in public hospitals—there were 3.8 million episodes—increased by only 0.3 per cent. In other words, in a year they only took another 12,000 patients, whereas private hospitals, because of our reforms to private health insurance, had an eight per cent increase, treating an additional 150,000 patients. I think that says something about whether or not the states are meeting their obligations.

I would like to sum up debate on the bill, on behalf of Dr Wooldridge, and say that the Health and Aged Care Legislation Amendment (Application of Criminal Code) Bill 2001 advances the government's program to harmonise offence creating and related provisions in Commonwealth legislation with the Criminal Code. The Criminal Code will codify the most serious offences against Commonwealth law and establish a cohesive set of general principles of criminal responsibility. This harmonisation of offence creating and related offences in health and aged care legislation with the Criminal Code is an important step in the government's program of legislative reform that will achieve greater consistency with Commonwealth criminal law. I thank the honourable members for their contribution to this debate and their support for this bill. I commend the bill.

Question resolved in the affirmative.

Bill read a second time.

Ordered that the bill be reported to the House without amendment.