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Wednesday, 14 February 2007
Page: 112


Mr HATTON (5:17 PM) —The Aged Care Amendment (Security and Protection) Bill 2007 is a sad bill to come before the House because it deals with very difficult areas. Questions of sexual or physical assault in aged-care premises send a shudder throughout the community because people in those areas of residential care are by their very nature relatively more vulnerable than people outside them. The reason for that, of course, is that 96 per cent of the Australian population still maintain themselves outside this kind of residential care. That figure has probably gone down in the last few years, since 1995 or so, but we are still looking at that order of magnitude. Most people can maintain themselves at home. Most people still have a close family relationship. They live either with a sibling at home or with their spouse until the spouse dies, or they have other connected family close to them. They have what we would see as a normal environment in which to operate and one in which the same occasions for the commission of sins are not there. It is not the same cloistered environment that you would find in this kind of residential place or in any of those other places where these kinds of things have been a problem over time—the boarding school environment and other closed environments, whether in the armed forces or closed academies, where you get congregations of people outside the normal family environment.

We know that physical and sexual assault can happen within the family context in the family home, but the measures here in this bill deal with a particular and different context. We have a different structure now to the one we had in the seventies, eighties or nineties and since the member for Mackellar was the minister. The structure then has been described as ‘ageing in place’ and it was based on the model where you would have one place that a person went into—they might go into a self-care unit. We now have a series of places where there are self-care units and, by and large, people just live the way they did in their original homes. It is a smaller area to take care of and there is a commonality in terms of dealing with all of the needs of the people. The common grounds are looked after, there is an on-site medical service and a nursing service if people get into trouble and there is also a range of other services available.

That facility is often combined with a hostel so that if people get to the point where they are no longer capable of looking after themselves in their own self-care places they can move into a hostel. It is a much smaller room—usually just one room with en suite—and there are common meal facilities. It is a much closer arrangement where more of the difficulties outlined in this bill in terms of sexual and physical assault can occur and, indeed, have occurred.

Where such assaults are less likely—but there is still the potential for them to occur—is at the very end of the process when people have been put into full nursing home care. Prior to the changes we made when we were last in government it used to be that people were inappropriately placed in full nursing home care when their condition was such that they should have been in a hostel or in their own self-care unit. So it is a question of time and place and of being put into an environment that people are not used to and one with the potential for sexual or physical assault to happen and for those assaults to be relatively concealed.

There are particular notations in the bill with regard to people who have dementia because there need to be exceptions to the reporting requirements where they are concerned. There has been a debate about whether there should be compulsory or mandatory reporting. This bill says that there should be compulsory rather than mandatory reporting. One of the reasons for it not being mandatory is people suffering from dementia. We know that those who do suffer from dementia can have a string of different responses over time and, in some people, there is a progression where they become very physically aggressive as they lose their sense of themselves and their normal control mechanisms in interactions with their family. They can become extremely aggressive and, although they are affected mentally, they do not have a loss of physical power.

I know from people in Bankstown who are in those circumstances, who have relatives who need that kind of care, just how difficult it is when a person develops that kind of response. A person who was a normal, loving husband throughout his life who develops into something else can be extremely confronting. That can happen in situ, at home. I am aware of cases where that has happened and where there has been relatively no protection for the spouse from the husband affected by dementia who becomes physically aggressive—except for taking out an AVO or taking other measures to address it. It also happens in residential care situations, but there it should be dealt with more easily and in a more orderly way because they have specific dementia care units. But people are so physically strong in these circumstances, the adrenalin runs so high, that it can be very difficult to deal with them.

I have considerable concern about the manner in which this bill has come before us, with very little time for us—certainly for me—and particularly the shadow minister to consider these matters. The government can say: ‘Well, we’ve made a quick response. We’ve come through with a bill that is substantial, small and narrow in focus, but that substantially meets the complaints that have been made. We’re putting this into place and we’re going to get it through the parliament as quickly as possible.’ What is the driver behind this? Media reports of physical and sexual abuse. Those media reports have been recent. The action taken here has already been underlined in arguments on the other side as a speedy reaction. The government have come forward; they have reacted.

Normally, the proper thing to do here would be, first, to have had full consultation with the industry to see how widespread and deep these problems are, and then to take speedy action—action that is based on extensive consultation, to ensure that what you are putting into place will really work and work effectively. Second, you would expect that the opposition in this place and in the other place would deal with this in an appropriate manner—well, for that to happen, it is often good to give people a brief on the legislation and allow them to look at it! But here we have a situation where the bill was referred for inquiry by the government on Wednesday, 7 February, and tabled in the House on Thursday, 8 February, and we are debating it today, Wednesday, 14 February. The Senate inquiry is not due to report for a full month, not until 14 March, and then the expectation is that the measures will be implemented on 1 April of this year.

What that means, as the shadow minister has argued, is that, firstly, the bill has been rushed in. The shadow minister was not able to see the bill before the government recommended it to the Senate legislation inquiry. Secondly, the principles that support the bill are still in draft form and have not yet been sighted. Thirdly, the bill only came after media reports of sexual abuse in residential aged-care facilities. This last point is telling, given the alacrity with which the government has put the bill forward, because what has happened is exactly the opposite. The provisions of this bill are being implemented two years after the Senate committee inquiry into aged care, with its report entitled Quality and equity in aged care, found deficiencies in the operation of the current complaints resolution scheme and made recommendations to improve the system that go to these very matters. The impetus behind this bill was getting the media coverage: if the coverage is embarrassing enough then the government will move—without adequate consultation.

The aged-care providers who are tagged in this bill with requirements for compulsory reporting of suspected physical or sexual assault, by and large, as far as we understand, are willing to take part in the Senate inquiry and are willing to take the measures in the bill forward and put them into place, but they think that they really do need to be part of this process. And a whole series of technical amendments may arise that we will have to look at later, after this has been through the Senate process.

Fundamental parts of this bill deal with the new compulsory reporting arrangements, which require aged-care providers to report suspected or alleged sexual abuse and serious physical assault of residents, and, further, require them to have internal processes within the organisation for staff to report all incidents of suspected or alleged sexual abuse or serious physical assault. The identity of staff who report incidents will be protected; there is protected disclosure. There are a number of measures in the bill that go to this situation.

As I said at the outset, this is a difficult area. It is difficult sometimes to know, unless it is blatantly in front of you, whether an assault is a direct assault on a person, particularly when it is of a sexual nature. It is particularly difficult when people who have dementia or who suffer from a range of other problems are the ones doing the assaulting. These assaults do not always occur in the way that people think and they need to be looked at closely.

There is a sensible proposal in this bill to appoint an Aged Care Commissioner to look at complaints and deal with them. This means not only that there is a greater capacity to investigate the complaints but also that the investigation will be done by someone outside the process.

We know that all of the aged-care facilities in my electorate have improved over time, but a number of them which were mentioned in dispatches some years ago have had to significantly improve the way in which they do things. This relates to what they are tasked with, the normal tasks that they have. The majority of those providers which are part of the network have always carried out those tasks. The Uniting Church has provided a significant number of places in Blaxland. Also our Bankstown aged-care organisation provided four basic hostels and now has a magnificent complex up at Georges Hall.

People know how difficult it is to adequately provide for not only people’s needs but also the particular areas addressed in this legislation. This is very much the case in the dementia care units. In these units you are looking at potential physical and sexual assaults almost from unguided missiles—from people who have lost the restraints and constraints that they used to have prior to being affected by dementia. So it is important that these measures are put into place. The dementia aspect is extremely significant.

I want to make the debate a little broader. There are significant language problems that demand a great deal not only of service providers but also of the staff in nursing homes in an electorate like Blaxland. This is the case in not only the existing electorate but also the new, redistributed Blaxland. Those language problems are significant and deep. This concerns all of those people who came here postwar. A lot of people who came from Europe who were from peasant backgrounds left school at primary school age, like most Aussies did before World War II. They were adequate in their own local dialect but they had difficulty with the broader language, be it Italian or Greek—the demotic language of the country. To come here at the age they did meant it was difficult to then go and learn English.

As those groups have aged, one of the fundamental problems they have had to deal with is the fact that they cease to have the capacity that they had when they were in the workforce—as good, bad or medium as it was—to deal with other people more readily. They retreat to their original language. If you do not have adequate services to help them then they can be imprisoned in that original language and go back to their original mode of going about things. It is only the family that can help to sort it out, as the young kids used to do when they were at school. The schoolkids used to sort out the problems their parents had.

There are specific cases just outside my electorate. St Basil’s Nursing Home is a wonderful facility run by the Greek community. It was set up specifically to address the problems in the Greek community. It is open to the rest of the community but is able to address that particularly significant problem of language. It is not just about food or cultural requirements; it is about the problem of people not being able to communicate their needs. In this area they also need to communicate problems of physical or sexual assault on them.

How do you deal with this? More than one person in five in my redistributed electorate of Blaxland is Vietnamese. Among that vast community of people who are Vietnamese are those who went through a brutal civil war that the communists finally won. There are people who ended up in camps or in prison and who were part of the refugee efflux in the seventies and eighties. They have been here for more than 30 years and have carried enough crosses in their lives. They have established themselves, worked hard and built strong communities based on their fundamental family and community values. They are the backbone, with their children and grandchildren, of our professional class—the doctors, dentists and lawyers—because they work so hard. There is not a single nursing home in my electorate with a dedicated language facility for people of Vietnamese background.

I went just a week or so ago, in the break, to a Vietnamese and Indochinese elderly group to speak to them and see what their concerns were. I had heard before what they were, but this is the first time that this area has come into my electorate since I have been the member. In 1984 we had part of it. It includes Cabramatta, Canley Vale, Lansvale and Lansdowne. In that area there is a very high concentration of Vietnamese. There are 1,000 people within this aged-care group. Most of them live in their own homes and come to this group for support once a week. There is a part-time employee five days a week, for four hours a day, doing excellent work, together with four volunteers who roll in every day in order to help the people who have problems, to refer them to federal or state members or to council to sort out their problems with departments.

Those kinds of facilities are available to people, but they do not have a dedicated aged-care facility where they can seek to help those people who are language dependent. The group have just initiated a process to look at setting up a hostel and to work within the community to get the money together to do that. I have committed myself in the next term to doing everything I can to support them in setting up a hostel program or an aged-care facility with federal, state and community support, not only from the Vietnamese community but from the community generally.

These are the particular results of living in a society based on migration. We did not do enough previously, and there were a series of decades in which not enough was done to help people settle. This is still part of the settlement process, 30 and 40 years on. It is inevitable that when people go into residential care there is a shutdown in their capacity to deal with people who are not from the same linguistic background. To assist them with all of their needs, but in particular the ones that are dealt with in this legislation, we need trained staff who are capable of translating the problems that these people come up with, translating the allegations. So the reporting mechanisms need to take that into account.

In so many of our facilities, not only in the dementia units but in hostel care and other areas, we have people from a whole variety of language backgrounds. You have the same problem but it is multiplied because there are multiple language problems. That is something else that is not looked at here but that I think needs to be looked at very closely in the Senate inquiry. The providers and the staff, along with the government, need to take account of this and put more resources where they are needed not only for the one in five people in my new electorate who are Vietnamese, where there is nothing at all that is specific—it is very difficult for them to get access—but for the plurality of people. (Time expired)