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Tuesday, 2 December 2003
Page: 23440


Ms JANN McFARLANE (3:39 PM) —I am pleased to engage in this matter of public importance with the government on their failure to provide adequate aged care services. What I would like to talk about is how Labor is synonymous with the development of the aged care services that we currently have in this country. I want to talk about what Labor has done, what it will do and what is happening now. But I mainly want to talk about how Labor has been visionary, innovative and consultative, which is something that the government have failed to be.

Mr Deputy Speaker, as you are aware, I went into community work in 1972. What aged care was there? There was not much at all. There were nursing homes, some hostels, very little in the way of self-care units and some small not-for-profit community groups delivering some services. There was no program. It was ad hoc and there were differences from state to state. Very little was put into this very important area by the state governments. What came out of the Whitlam government's innovative Australian Assistance Plan was the need to develop a whole new strategy to deal with the issue of what people do when they become aged. I might add that, when we are talking about aged care services, we are talking about the full range of services.

As we all know, only about six to seven per cent of people go into an aged care facility, which means that 92 to 93 per cent live at home. Labor heard the call from the community back in the 1970s; Labor were out of government and not much happened for the next couple of years. However, when Labor came back into government in the mid-1980s, what did we do? We again became visionary, innovative and consultative. What we had from 1985 was the development of the Home and Community Care program. This is the program which enabled people to live at home with independence, in dignity, supported by their networks—their families and their communities—in the way they wanted, funded by the government and helped and supported by a whole community program.

Labor were aware of how this government can come and go on programs. So when Labor invented and developed the Home and Community Care program, we ensured that we backed it up with legislation so that, in the event that we lost government, the program would stay. This was very clever and intelligent of Labor because, when we eventually lost government in the early 1990s, the Home and Community Care program not only stayed but became the centrepiece of this government's policy. Again, they were acknowledging that Labor were innovative, visionary, consultative and in tune with the community.

Mr Deputy Speaker, let me tell you what the Commonwealth responsibilities are, as some people are not very tuned-in to the finer points of aged care. When it comes to residential aged care—when people have to go into some kind of facility—the Commonwealth has responsibility in two areas. The Commonwealth is responsible for high-care places, which most people generally call `nursing home places', and low-care places, which the community generally calls `hostel beds'. Again, we developed an innovative framework, good funding formulas and a capital grants program so that, in the event that the five or six per cent of people who needed residential aged care had to take up that care, it would invariably be in a place that was built through a contribution from the government—a dollar-for-dollar program—and supported by a funding program from the Commonwealth.

What has happened in the intervening years? I agree with the Minister for Ageing that Labor were not very keen on accreditation. There were flaws with accreditation, and it was not just Labor saying that we were not keen on accreditation; the sector—the people who worked in the facilities—and the community also said that it was a wee bit hasty, that it was flawed, and there were no evaluation strategies. They asked whether it was a little too much too soon and whether it would give the desired outcome: a quality supported framework for people living in a residential care facility. Accreditation has now come and the community do not really like it, and some of the facilities do not like it, because it has not delivered. What has been the major flaw in it? It has been that the funding formula has not kept pace.

The capital grants program was disbanded by this government in 1997. What we have in its place now is, I think, a limited hostel capital grants program. But, generally, without an adequate funding formula, what do we have? As the member for Lyons tells me—and he is one of my mentors and I much admire him for his life's work and for his Labor experience—the staff in an aged care facility in a rural area in Tasmania are paid 17 to 20 per cent less than city staff. This creates enormous pressure on those facilities to keep functioning. Why? It is because this government has failed to keep pace with the capital grants funding formula as well as with the staffing and other funding formulae.

What is happening now? I agree with the Minister for Ageing that this government does fund bed licences. But there is no point in funding bed licences when you have a situation such as exists in my electorate of Stirling—and I have spoken about it before in this place—where, in 11 facilities in the electorate, not one new bed has been built in the five years that I have been the member. This is because of a number of factors: (1) the lack of a capital grants program and (2) the funding formula. The private sector are not developing facilities because, as the private sector people tell me when they come to meet with me, there is only about a one per cent profit margin in developing a facility. They might as well put their money in an ordinary bank account where they can get three or four per cent and make more profit without all the work of running an aged care facility.

What has happened with home and community care in this scenario? It is the major form of aged care in this country—92 to 93 per cent of people live at home when they are ageing. We are an ageing population. We have an ageing healthier population and so by the time people need the Home and Community Care program they are usually 75, and often much older. And what do they have? They have waiting lists. Even though Labor developed a range of programs to help people live independently at home—Home and Community Care, as well as the hostel care package, the Community Aged Care Package and some other programs—the programs have not moved on from that. This government have not moved on from that. They have increased funding, but there is still insufficient funding in these programs to help the number of people who need support to live at home.

In Western Australia, in one of the major hospitals in my electorate, they are running a program—using some pilot money from the Commonwealth—to help people to come out of a hostel or an aged care facility where they have been placed early or inappropriately. People get placed in a hostel or a nursing home facility because of the lack of a Home and Community Care program. Whether it is on the aged care residential side or the home care support side, this government have failed to keep pace and they have mainly failed to keep pace with the funding formulas.

I have friends who are nurses. A lot of my generation became nurses. What do I find? I find they are exiting the industry, and a lot of them work in the aged care industry. Why are they leaving? The wages are poor and they can get a lot more being paid as an agency nurse or in the Western Australian hospital system, where the good Gallop government have increased wages and given them a career path. The Gallop government have attracted an extra 700 nurses back into the Western Australian health system. What have they done that on? They have done it on the back of the residential aged care sector. Nurses are leaving the aged care sector to go and work back in the mainstream hospital system, because they are better paid, they have better hours, they do not have to work the excessive overtime when the staff are inadequate and insufficient, and they have a career structure. On two levels the government are failing to provide adequate aged care services: they are failing to provide sufficient numbers on the home and community care side for support, and they are failing to provide on the residential care side.

There is another issue that keeps coming up, and that is the issue of carers. People come to my electorate office all the time. They want respite care: in-home respite care, drop-in respite care and centre respite care—it varies. There is insufficient money being provided by this government, and in Western Australia a lot of it is now being provided or backed up by the state government. Labor stand on our record. When we are back in government we will continue to consult with the community and say: `What are your needs? How do you want it done?' We will go along the path that we followed in the mid-eighties. We will expand the programs and develop new ones, but we will put a lot of extra money into it. I am proud of Labor's record in this regard. I am sad that the government do not value aged people to the same extent that Labor did and will not put the money in. (Time expired)