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Thursday, 15 February 2007
Page: 9

Ms HOARE (9:29 AM) —I rise to speak on the Aged Care Amendment (Security and Protection) Bill 2007. This bill proposes to introduce new compulsory reporting arrangements with requirements for aged-care providers to report suspected and alleged sexual abuse and serious physical assault of residents. It will require providers to ensure there are internal processes in place for the reporting, by staff, of all incidents of suspected or alleged sexual or serious physical assault and that the identity of staff who report is protected and that staff who report are not unfairly treated as a result of making a report. It will give the Department of Health and Ageing greater capacity to investigate complaints and to require aged-care providers to correct failures to meet their responsibilities. A new Office of Aged Care Quality and Compliance within the department will be responsible for this.

The bill also proposes to replace the current Commissioner for Complaints with a new Aged Care Commissioner to provide an independent mechanism to hear complaints about how the department has responded to complaints and about the conduct of the Aged Care Standards and Accreditation Agency and its assessors. The Aged Care Commissioner will also have the capacity to initiate its own reviews.

Labor will be supporting this bill. This bill highlights the need for better protection of older Australians who are placed in aged-care facilities. In the last couple of weeks I have been contacted by two constituents who have raised serious concerns in relation to two aged-care facilities in my electorate. I know that many members will have been touched by similar examples of poor treatment of vulnerable people in aged-care facilities.

In the first instance a constituent has, quite rightly, expressed anger and frustration at the treatment her elderly father has received. This gentleman has moderate to severe Alzheimer’s disease and requires total care. He cannot communicate and is restricted to a wheelchair. His condition requires that he be restrained by a seatbelt so he does not slip from his wheelchair. On Sunday, 28 January this year his family received a telephone call stating that this elderly man had fallen from his commode chair. The injuries sustained to his face were severe and required stitches. After being transported by ambulance to Belmont Hospital, the man and his distressed wife were forced to endure a nine-hour wait before he received medical treatment. For the duration of his time at the hospital his incontinence pad was not changed. He became dehydrated. He was not treated with the due concern and respect all elderly Australians should receive as a matter of course.

Unfortunately for this particular family, other concerns for this older Australian remain a matter of daily concern. The wife of this gentleman is obliged to visit her husband at the aged-care facility twice a day to ensure he is fed and receives an appropriate level of fluids. The stress and burden of this daily routine are untenable. The family reports that staff shortages at this aged-care facility are such that patients, including my constituent’s father, are not out of their beds before 11 am. Often patients are still in their beds at lunchtime and sometimes they are returned to their beds in the early afternoon.

My constituent is also devastated to visit her father only to find him frequently unshaven and unwashed. She reports that on occasion she has found him still seated in his wheelchair with pools of urine under his chair. My constituent feels that, unless a family member is present, it is ‘in the lap of the gods’ as to whether her father gets fed or not. She expresses outrage that she has seen many other patients being totally ignored at meal times.

Another constituent has contacted me this week in relation to similar concerns involving a different aged-care facility. Again the concerns relate to her father, an 81-year-old man who has encountered an indifferent and struggling aged-care system. This gentleman took up residence in a facility in August 2006. On 5 October 2006 he was admitted to the Newcastle Mater Misericordiae Hospital suffering from bedsores, which were so severe he remained hospitalised for approximately 15 weeks. My constituent claims that her father was clearly an at-risk patient, susceptible to bedsores. She claims that the severity of his lesions is indicative of poor patient management. Three weeks ago this elderly man was discharged from the Mater and returned to the aged-care facility. Incredibly, staff were unable to catheterise him and the procedure had to be undertaken at John Hunter Hospital.

On 5 February 2007, my constituent was contacted by the director of nursing and informed that her father was unwell. She was assured her father was being cared for and told not to worry. My constituent felt uncomfortable with this and immediately visited her father. She found him alone and in a weakened state. On insisting her father receive immediate medical attention, she was told a doctor had been called. Ultimately an ambulance was required and her father was taken, under lights and sirens, to John Hunter Hospital, where a severe urinary and blood infection was diagnosed. My constituent is refusing to return her father to this aged-care facility and will instead be placing him at another facility, probably some distance away from her home. My constituent is gravely concerned that staff shortages, staff inexperience and poor quality care combined to place her father at risk during his time in residence at this aged-care facility.

Access to quality aged-care services should be an inalienable right of all elderly Australians. The failure of the system to provide appropriate services can be resolved if we commit ourselves to demanding the very best for older Australians. We need to set a benchmark of accessibility and excellence that is not corrupted by income or postcode. We need to ensure that once in an aged-care facility each and every older Australian is accorded respect and the right to personal safety, appropriate medical intervention and the right to protest if their treatment is anything less than satisfactory.

The Health Services Union has detailed horror stories in relation to substandard aged care. HSU National Secretary Craig Thomson has reported that one facility was found by government inspectors to be so short of care staff that there had been no time to document or analyse problems among residents, including incontinence, skin tears, pressure sores and scabies outbreaks. In 2004, the Health Services Union reported almost 1,000 complaints had been made about aged-care facilities in the previous financial year, which were an indicator of the scale of the problems in the industry.

Training staff is imperative to securing quality care. Stakeholders in the aged-care sector consistently affirm that staffing numbers and the level of training afforded to staff are sound indicators as to the quality of a service. To attract committed and competent aged-care staff it is essential to provide them with sufficient training and remuneration. By training staff in the knowledge and awareness of elder abuse, we are empowering not only them but their patients. By recognising the special skills needed to manage and develop rapport with elderly clients, we also empower staff to report any issues that may negatively affect clients. The HSU reports:

Widespread staff shortages are severely affecting the care of elderly residents in aged care with clear evidence they do not get adequate treatment or therapy and face a much greater risk of violence and assault.

The HSU outlined details and examples of serious issues and concerns relating to employment in the aged-care sector in a submission to the 2004 Senate inquiry into aged care. The issues canvassed included: employers escaping proper scrutiny by making major changes to staff numbers, care plans and records in the days before an inspection takes place by the Aged Care Standards and Accreditation Agency; inadequate care in facilities without sufficient staff, with residents more likely to be injured or assaulted, not given the proper care or therapy, left in bed until after lunch or showered at 5 am; increasing assaults, with staff regularly left alone with little or no training to care for more than 50 residents; care staff forced to spend most of their shifts cleaning and doing laundry; nurses and care staff avoiding the industry because of the terrible pay and conditions; and employers taking advantage of a lack of regulation of the industry to cut spending on staffing and care levels.

While Labor welcomes the government’s announcement of $1.5 billion in funding for aged care over five years, there is no denying that this sector has been in crisis for many years. The government’s failure to resolve critical and longstanding problems in the sector is reprehensible. Its ability to ignore the pleas of stakeholders over an extended period of time underscores its absolute lack of compassion and foresight at a time when Australia faces an ageing population base. Let us make this very clear: the current aged-care funding mess was created by the Howard government in 1997. When then Minister Bronwyn Bishop planned to introduce a bond for all residents in aged care, the voter backlash saw the government back down. As a result we have a system filled with problems and shortfalls that have never been properly resolved.

In 10 years the Howard government has failed to cultivate a reputable and proficient aged-care sector. Instead we have witnessed a serious decline in the numbers of aged-care beds available. We have heard horror stories outlining the degradation and humiliation of sundry elderly Australians in the very environments that are supposed to nurture and support them. When Labor left office in 1996 there was a surplus of 800 aged-care beds. Today we face a shortage of 5,000. That represents 5,000 men and women whose needs are not being met. It also represents many more families who are struggling to care for people they love and respect. While the measures announced in the government’s package will go some way to alleviating the distress and frustration that surrounds aged care in Australia, it will not resolve all the issues and will not alleviate all the concerns that abound in the community.

I would also like to briefly raise the distressing situation of placing young people in nursing homes. The Young People in Nursing Homes National Alliance reports:

... over 6,500 young people across Australia are forced to live in nursing homes because they have nowhere else to go ...

We need to recognise that the placement of young Australians with acquired disabilities and high or complex support needs is inappropriate and further compromises the service delivery within an aged-care facility. The vision of the national alliance is to see:

A well resourced long term care and support system that enables young disabled Australians with high or complex support needs to have age appropriate accommodation and support service options, including access to their communities, where and when required.

Finally, without addressing the issues of minimum staffing levels and minimum training levels and without ensuring the rigorous scrutiny of aged-care facilities, the problems I have addressed today will only continue.