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Wednesday, 20 June 2007
Page: 139


Mr SNOWDON (6:00 PM) —As we know, the Aged Care Amendment (Residential Care) Bill 2007 seeks to amend the Aged Care Act 1997 to introduce a new arrangement for allocating subsidies in residential aged care, the Aged Care Funding Instrument. The bill also alters current arrangements under which classifications expire after 12 months and removes the requirements for providers to submit reappraisals, but it gives providers the option to reappraise residents after 12 months. Another area of amendment allows a provider to accept a resident’s current classification when a resident moves from one home to another, rather than being required to submit a new appraisal. To me that is an eminently sensible suggestion.

The bill, in essence, is designed to reduce the amount of documentation generated in aged-care facilities which is required to justify the funding classifications for each resident. We welcome the stated objective of reducing paperwork for aged-care staff and hence liberating them for essential tasks in actually caring for residents.

The fact that our country has a progressively ageing population is well known, and in this it is similar to other Western nations. There are 2.5 million Australians, approximately 13 per cent of the total population, who are currently aged over 65. By 2051, the proportion of the population aged over 65 will represent one-quarter of the nation’s population, barring any major changes in immigration intake. Currently, across Australia there are some 3,000 nursing homes, which cater for 160,000 people. The demand for care is, as we know, increasing dramatically. It has been estimated that by 2019 there will be a need to provide care for some 970,000 people.

While the population as a whole is ageing quite rapidly, the situation is even more pronounced among Indigenous Australians, particularly in my own electorate. Earlier this year, Charles Darwin University put out some research findings on the projected rate of increase of the Northern Territory’s Indigenous population. You would know, Madam Deputy Speaker, that almost 40 per cent of the voters in my electorate of Lingiari are Indigenous Australians. According to that report released by Charles Darwin University, there are currently 62,669 Aboriginal Territorians, with 40,000 of those living in regional areas. By 2031, this number is expected to have increased to about 98,052, representing a 56 per cent jump. The research also found that the number of Aboriginal people in the Territory aged over 65 is set to increase from 1,576 in 2001 to 4,375 three decades in the future, representing a 177 per cent increase.

Whether or not we will see that increase and what factors have been assumed in getting to that figure is of interest, I think, because we know of the appalling mortality rates in Indigenous communities—the low life expectancy of Aboriginal Territorians. To see that the number of people over the age of 65 will increase by 177 per cent is a strong indication to me of an expectation that we will achieve much more than we have in terms of improving the health status of Aboriginal Territorians so that they do actually have a life expectancy beyond the age of 65, because currently that is not the case for the average Aboriginal Australian.

The Department of Health and Ageing annual report of 2005-06 provides figures on the ratio of aged-care places, allocated and operational, per 1,000 persons aged 70 and over. The figures cited for the Territory are quite high relative to the rest of Australia, partly because, recognising the demographic of the Northern Territory, they incorporate any Aboriginal Australians aged 50 years and over. In the case of Alice Springs there are 368.6 allocated places per 1,000 persons aged 70 or over if they are non-Indigenous and 50 or over if they are Indigenous. In the Barkly region—and, as you would know, Madam Deputy Speaker, the major centre for the Barkly is of course Tennant Creek—the number of allocated places per 1,000 persons is 516.9. In East Arnhem Land there are 532.1 allocated places per 1,000 persons, and that reflects the significantly high proportion of that population who are Aboriginal Territorians. Again it goes to the point that these places are allocated for Aboriginal Australians aged 50 and over, and the number of allocated places rises dramatically as a direct result. For the Territory as a total, there are 244.8 allocated places per 1,000 persons, again reflecting the demography of the place, whilst the average across Australia is 117.9 allocated places per 1,000 persons.

I have had difficulties with census data in the past and I still question the accuracy of some of the data that is used to calculate some of these figures; I do wonder whether or not they give an accurate picture of the situation in remote communities. It raises a significant question about whether elderly Australians—in this case, primarily Aboriginal Australians—living in isolated areas are getting the proper level of care that they require. I think that is very open to question, and a little later I will talk about some of the facilities that exist in the Northern Territory through which services are being provided in remote communities. But, significantly, in many major Aboriginal communities across the Top End of Australia, aged-care services are extremely limited.

The aged-care funding package Securing the Future of Aged Care for Australians was launched by the Prime Minister in February this year. On face value, at the time it did seem that the government had finally dealt with the underfunding of residential aged care. However, it was quickly ascertained by the aged-care sector that the proposals were seriously flawed. Mr Wayne Belcher, the Chief Executive of Churches of Christ Homes and Community Services Inc. in Western Australia, said that the package ‘lacked clarity, substance and equity for residential aged-care providers’. He continued:

The level of funding can no longer support the development of accommodation required to provide appropriate residential care. It fails the test of reasonableness.

He went on to say:

The Australian government has failed to meet its reasonable commitments to residential aged-care funding through these recent announcements ...

Even the former minister came out and admitted that some facilities could be worse off because of unintended consequences. The recent budget did patch up this flawed securing the future package to some extent. However, it is does not provide an answer for aged care into the future, least of all for aged care in the bush. It does little to reverse the slow and steady decline of aged care under this government. In 11 years the Howard government has turned a surplus of 800 aged-care beds in 1996 into a shortfall of 2,735 beds in 2006. In 1995, there were 92 aged-care beds for every 1,000 persons aged 70 years and over. In December 2006, there were only 86.6 beds for every 1,000 persons aged 70 years and over.

In the Northern Territory, it is true that there are issues to deal with the provision of aged care. It could be argued that there is a question of the concentration of population and the lack of critical mass, which make it difficult for the provision of aged-care places, particularly being spread across the region in small communities. But that raises a serious question of a danger of an ‘out of sight, out of mind’ mentality developing—because you cannot see people, because you do not visit them, you do not understand they are there and you do not provide them with the services that they require. There is a need for places in communities, because people have a right to live in those communities and be close to their country and loved ones.

I had a recent visit to Docker River, a small community in my electorate with an aged-care facility that has been there for at least a decade or so. It is not an accredited aged-care facility; however, it is funded and provides a socially and culturally sensitive aged-care service for people who live within that region. The community and the staff are highly motivated towards providing an appropriate service which meets the needs of clients, provides some respite facility for people who live in adjacent communities, who might be some hundreds of kilometres distance from this particular place, and, at the same time, provides the possibility of high-care service for particular clients.

If you looked at the standards in this place in the context of what might be provided in aged-care facilities in some of our metropolitan areas, you would say, having visited this particular facility, ‘This is a bit rough.’ While it is true that the buildings could do with some additional resourcing, the fact is that the service which is supplied by the people who are responsible for doing it appears to suit the needs of the client group and is most sensitive to their cultural needs. That to me is a very major test for any service which is provided to remote Aboriginal communities.

I am most concerned that there are probably many individuals who would qualify for aged-care services in the bush who have not been identified. I do know that aged care in Lingiari has not been considered as an area of priority by government because there are many non-Indigenous Territorians who on reaching retirement have historically left the Territory—although I am pleased to say that that trend is changing. Many have left the Territory at the end of their full-time working life. This leads to a catch-22 situation because many of those people leave the Territory or have left in the past because of their concern about the level of aged care and medical services for seniors. On the other hand, because they leave, governments often apparently do not see the need for services because most working Territorians may factor into their retirement plans that they will not be permanently living in the Territory once they retire.

In my electorate, mainstream services are provided in Alice Springs, Tennant Creek and Katherine. In Alice Springs, the two major providers of aged-care services are the Old Timers Homes and the Hetti Perkins Home for the Aged. The Old Timers Homes are operated by the Uniting Church Frontier Services and have been in operation since the late 1940s. I recently visited the opening of a new wing. It currently has 68 nursing home places plus a number of cottages. One of those cottages is currently occupied by a 94-year-old good friend of mine whose name is Peg Nelson. Peg is a significant Territorian in her own right but she is also the wife of a former member of this place, Jock Nelson, who served in this parliament between 1949 and 1966 and was later to become the Administrator of the Northern Territory. Peg is a wonderful woman. She lives in pretty well idyllic surroundings. She is a woman of great capacity and has as her neighbour another great friend of mine, Frances McKechnie.

Frances was a member of the Uniting Church and operated in a ministry in the Uniting Church for many years. She is someone who has chosen to come to live in Alice Springs in this aged-care facility. They live independently but within the facility. I know that they are very comfortable where they are. It is a great tribute to Frontier Services that they are able to provide the level of support and care required not only to Mrs Nelson and Ms McKechnie but also to those people who are their clients in the nursing home and the hostel.

The other facility in Alice Springs is provided by Aboriginal Hospitals. Hetti Perkins is a hostel which has over 30 places and largely provides services for people from the bush. Up the track in Tennant Creek, there is the Pulkapulla Kari Hostel, which is also operated by the Uniting Church’s Frontier Services. Further north in Katherine there are two aged-care facilities. There is the Katherine Red Cross Centre operated by the Red Cross NT Division and the Rocky Ridge Hostel operated by the Uniting Church’s Frontier Services. All of these places provide an excellent level of service with limited resources. Often the demand for places outstrips supply, but I have to give great credit to those people who work in these places for the care they give to their clients and to the organisations for taking on what is a very difficult task. It is a high-cost exercise delivering these services in the bush and they do it very well.

There are other services which are provided in remote communities. There is one at Yuendumu which is—as you would know, Madam Deputy Speaker Bishop, with your extensive knowledge of the Northern Territory—some four or five hours drive north-west of Alice Springs up the Tanami Road. It is a pretty corrugated road, I have to say. But again it is a service which is supplied as a result of funding from this government, one which was most needed and which provides support and care for a great group of people. Again the carers need to be recognised. There is another facility in Nguiu on Bathurst Island and it too provides an excellent standard of services. But these facilities are too rare.

The problem we have is that, with a very large population dispersed over a very great area, the resources for looking after the aged are extremely limited. As the demographers tell us, an increasing proportion of the population is reaching the age of 70. In the Aboriginal community, hopefully we will see a far greater proportion of their population age so that they can die gracefully in their 80s and 90s, as we would like to do. Hopefully we will be able to provide them with the standard of service that they require. We need to know that for Aboriginal Territorians, unlike some of those I referred to earlier who, once they finish their working life in the Territory, relocate to the coast to another community, the Northern Territory is their home and they will not be leaving. We have to make sure that we provide them with the services that they need as they get into their latter years. Again I make the point that it is extremely important that aged-care workers are sensitive to their cultural values.

I want to acknowledge the work of the Northern Territory Aged Care Planning Advisory Committee, the chair of which is Lee Oliver, in providing information and advice to the Department of Health and Ageing on the appropriate distribution of aged-care places across the Territory. I do want to commend all of those people who are involved in the aged-care industry across the electorate, but I say that they do so with a great deal of goodwill. I forgot to add that there is also a very good aged-care facility at Maningrida.

Labor’s policy development process is well underway in the lead-up to the federal election. The policies which we will take to the election will encompass the views of older Australians, service providers and representatives of the aged-care workers. A Rudd Labor government will ensure that older Australians enjoy the prosperity which they helped create for all of us. I am pleased to support this legislation.