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Monday, 18 June 2007
Page: 112

Mr FAWCETT (8:07 PM) —I rise tonight to speak to the Aged Care Amendment (Residential Care) Bill 2007. The purpose of this bill is to amend the Aged Care Act 1997 to introduce a new arrangement for allocating subsidy in residential aged care. Specifically it is to replace the resident classification scale with the Aged Care Funding Instrument as a means of allocating subsidy to providers of residential aged care.

The key point about this is trying to make the system more efficient. It is going to reduce the number of funding levels in residential aged care and provide subsidies for the care of residents with complex health and nursing needs, including palliative care and care for residents who have mental or behavioural conditions, such as dementia. It is designed to reduce the amount of documentation and record keeping which staff have to generate in order to justify the funding classification for each of their residents.

The bill also changes current arrangements in which classifications expire after 12 months. It allows the option for managers and operators of residential facilities to renew a classification at 12 months if they want to, but, by removing the requirement to reclassify at the end of 12 months, there will be some 60,000 classifications a year that will be not required, and that in itself will provide a substantial saving to the sector. The bill also allows the secretary to define the types and forms of records that an approved provider must maintain. This will reduce the amount of documentation and record keeping needed to justify the funding. It will also streamline the audit process so that single questions or specific groups of questions can be targeted by the review officers, rather than every single aspect of the appraisal.

The last significant point is that the amendments allow an approved provider to choose to accept a resident’s current classification if a resident moves from one home to another, rather than being required to submit a new appraisal. This has come not so much out of this place but out of a two-year consultation throughout the sector, with providers and, importantly, with their staff—both nursing care staff and administrative staff—to work out the most efficient way to manage the governance surrounding the funding that the Australian government provides, along with practical and effective record keeping and care for residents.

In 2005 there was a trial in which nearly a quarter of all residential facilities in Australia participated, and they found some significant developments through that. This does not come for free, though. There are costs that will be involved with this. These costs will ensure that the level of funding for existing residents will not decrease when they are reassessed under the new Aged Care Funding Instrument. It will provide additional funding for the top levels of the two new supplements, and it will establish a panel of advisers to assist homes to manage the transition—in all, some $393.6 million.

Why is the government making that investment in the system? I think most people in Australia now are aware of the fact that, with the ageing of our population, the number of Australians aged 70 or older is expected to double in the next 20 years. That is going to place a huge demand on our aged-care system, both the residential system and the provisions we make for people to stay at home. That means that we need to invest now, to commit funds now, to make running the system by which we manage aged care as efficient as we possibly can and providing that care for the people who need it as effective as we possibly can.

It is worth pointing out that the reason this government has been able to make this investment, as well as the significant investment of $1.7 billion in aged care in the budget this year, is its good economic management. Having paid down the $96 billion of Labor debt that we inherited in 1996, we now have some $8½ billion of saved interest payments that is providing a dividend to a range of areas, such as education, defence and aged care.

The budget measures this year include the extensive package of reforms called ‘Securing the future of aged care for Australians’. The budget allocated some $1.1 billion to increase government payments for residents of aged care. Overall funding will increase by some $1.3 billion over the next four years, on top of increases for indexation. That includes some $92.2 million in the form of a transitional accommodation subsidy to offset the changes that we are discussing in this bill.

As I have said, the number of people over 70 is going to double in the next 20 years. That means we also need to be looking for innovative ways to care for people who are ageing and need assistance. That does not mean that we need to be building more homes necessarily, because, increasingly, people are indicating that, where possible, they would rather stay in their own home—or perhaps downsize to a smaller home, but certainly stay in their own community and have that support from family and friends and a familiar environment. So the government, as part of this budget, has increased the availability of aged care in people’s own homes, at the cost of some $411 million.

An additional 7,200 community care places are going to be funded over the next four years, and these places will take our aged-care ratio from the current target of 108 places per thousand people who are aged 70 and over to a record 113 places per thousand people by 2011. This compares with around 93 places per thousand when the government was elected in 1996. In 1996 there were fewer than 5,000 Community Aged Care Packages, and now there are over 40,000. Community care has extended to the provision of high-level care at home. This is significant, particularly for people who are living in regional areas, where the cost of maintaining a residential facility, without the benefits of the economies of scale, is a significant issue for communities.

In South Australia, a range of packages have been made available in this current round and out to 2009-10, and they are going to a fair range of places. Within Wakefield, there are facilities ranging from the very large, such as Domus Operosa, at Burton—which is run by the Italian village and is a magnificent facility—and Resthaven, through to country homes such as Wheatfields, in Freeling, and Indigenous specific homes such as the Aboriginal Elders Village. There is also Mill Court, in Balaclava; the Gilbert Valley Senior Citizens Home, in Riverton; Hamley Bridge, in the Memorial Hospital; and the community hospital in Mallala provides an aged-care facility. A number of these are very small facilities and at least a few are run by the community.

One of the challenges that Australia faces into the future is how we support these communities. I am thinking particularly of the communities in Riverton, Mallala and Hamley Bridge, with whom I have had extensive discussions around the viability of the aged-care homes. In Mallala, for example, the aged-care facility there—Butlers View—is the largest employer in the town. It is also the facility where many people in the community choose to live when they can no longer live in their own home. But the facility is up against it in terms of actually making ends meet. I think that one of the next phases that Australia needs to look at in terms of how we fund aged care is not only how we work with the mainstream in metropolitan areas or large regional areas but also, when it comes to smaller rural communities, how we get alongside these facilities, how we have a funding model that meets their needs so that these facilities can maintain not only the employment but also the focus of families.

One of the options that we have been exploring in Wakefield is how communities can optimise the facilities they have in terms of the building and particularly the staffing to expand the provision of in-home care. I welcome the fact that there are a number of Community Aged Care Packages and the Extended Aged Care at Home packages that have been allocated to South Australia. That is one avenue that I believe we need to explore more assertively in our rural and regional areas, along with appropriate levels of training, so that we can provide care for people who choose to remain in their homes in our regional towns. I welcome the initiative that the budget brings, and I welcome the efficiencies that this new funding formula and method of funding brings to the aged-care sector. I certainly think we owe it to our communities, and we owe it to those who have gone before us to provide appropriate care for them. I commend this bill to the House.