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Wednesday, 20 June 2007
Page: 146


Ms BURKE (6:39 PM) —I also rise to speak on the Aged Care Amendment (Residential Care) Bill 2007. The Aged Care Funding Instrument will clearly reduce the amount of documentation generated in aged-care facilities that is needed to justify the funding classification for each resident. The reduction of paperwork for aged-care staff is welcome and long overdue, and will allow staff to get back to doing what they are actually employed for and wish to do: caring for the residents in their nursing homes. However, there are a number of problems with the bill as it stands and that is why Labor has proposed amendments.

We all have a duty and a responsibility to get the provision of aged care right in this country not only to respect the dignity of older Australians and the contribution they have made to our nation—indeed, through wars and through depression—but also to make sure that current and future generations of older Australians are able to be supported. Australia has an ageing population; and while the aged sector—citizens who are 65 and over—currently makes up 12 per cent of the Australian population, this figure will rise to 18 per cent by 2021 and to 26 per cent by 2051. By 2020, the number of people aged over 65 will have doubled to four million. Aged care is therefore a vitally important issue and that is why we need to start planning and investing for the future now.

My electorate of Chisholm has a significant aged population and aged care is an important issue. The percentage of people aged 65 years and over in Chisholm is 17.8 per cent. This figure has increased by three per cent in just the last four years and is higher than the national average, which is 13.1 per cent. I receive many phone calls and letters from people who are dealing with aged-care services for themselves or for their loved ones. Deciding to move into an aged-care facility or helping a loved one to find a place at a facility can be difficult for many people. It is often a very stressful process and often people do not know where to begin or are not aware of the choices that are available to them. Many people are also not aware of how to access support services which may help them to remain in their own homes. Due to these numerous inquiries, my office produced a guide to aged-care options for my constituents because the aged-care sector is complex and not easy to understand. We have 14 terrific aged-care facilities in Chisholm and they do a great job with the limited resources that some of them have. But I am very concerned that the Howard government’s reform package, Securing the Future of Aged Care for Australians, falls well short of the mark in terms of providing enough high-care beds and securing the future of aged care in this country.

In the immediate future, we know that the rapid growth of the population aged 80 years and over will put enormous pressure on aged-care programs and facilities. Most of us see people come through the doors of our electorate offices who have to face this problem every day and know how desperate the situation is. We know what the situation will be for the population in the immediate and long-term future. There are no surprises. The policy challenge is to prepare for these changes. The Treasurer released his much vaunted Intergenerational report some time ago, but we still have not seen great action on this front. The government has conducted numerous reviews into aged care, but we still have not seen a great deal happen over the last 10 years. While I welcome the government’s announcement of $1.5 billion in funding for aged care over five years, we have had to wait 10 years or until the sector is at crisis point—indeed, beyond crisis point—for it to happen. It has taken the government far too long to act, and it is a burden for the community and for those people who are sitting in acute care hospital beds, and for the families who are trying to care for them.

I have recently had this experience, having to move my father from hospital into respite care. Indeed, I have now had to place him into a nursing home. I can speak from firsthand experience about the traumas of trying to achieve this. I am currently in the process of selling my father’s flat so that I can raise the bond for the low-care bed that he needs. This needs to be put into perspective: my father is only 70, so it is a rather daunting task for him and for all concerned. Even though I understand and can deal with bureaucracy, I found this a very trying and fraught experience. It got to the stage where I had to explain to the social worker at the hospital, ‘Indeed he is my father, but he is your patient,’ and that at some stage somebody had to try and give us all a hand in relieving this situation because he certainly could not go home. Indeed, the medical advice is that he cannot, unfortunately, return to his own home on his own. This is a very stressful time, and many people have to cope with this very complex environment.

What the Securing the Future of Aged Care for Australians package did not provide was the impetus for the aged-care sector to address key capital-raising issues. It has also meant some aged-care facilities will lose funding from March next year. This is because two key supplements—the $6.32 pensioner supplement and the $7.40 non-pensioner daily-care fee rate—are being withdrawn. This will impact significantly on some aged-care facilities. Some aged-care facilities will lose money, and the industry considers this to be counterproductive when the nation needs to encourage investment in aged care.

On top of this, the Howard government has ignored the needs of the sector and just has not done enough planning or investment in facilities. In fact, you could say the sector is crying out for attention from the Howard government because it is facing a looming crisis. In 10 years the Howard government has presided over a serious decline in the number of aged-care beds available. When Labor left government in 1996 there were 92 beds for every thousand people aged 70 and over, compared with only 85.6 now. In 1996 there was a surplus of 800 beds, compared with a shortage of nearly 5,000 now.

For the last 10 years the aged-care industry has been waiting for a decision to be made by government on funding arrangements. Since 1987 there has been a deep concern in the sector about whether they will be able to continue to provide aged-care services with the government funding arrangements that they have been receiving. Three years ago Professor Warren Hogan, in his review of pricing arrangements in residential aged care, said that funding increases had to happen. The government has only just acted now. The Howard government has created this aged-care funding mess.

Bronwyn Bishop, who was minister for the portfolio in 1997, planned to introduce bonds for all aged-care residents, but, faced with a backlash from voters, who did not want to sell the family home for this purpose, the government retreated. Since that time we have had review after review, but no action has been taken to fix the problem. We have ended up with a patchwork funding system that does not work, and we are still waiting for a response to the Hogan review in respect of pricing.

While I welcome additional community aged care, because most people want to stay in their own home and services in homes are greatly needed, the truth is that when people need a residential aged-care bed they need it straightaway and generally cannot wait. The government has consistently failed to provide sufficient residential aged care for frail and elderly Australians, and this continues with the latest measures announced by the government. While government members can wax lyrical about the progress that has been made in this area over the last few years, I can safely say that it has been too long coming and it is just not good enough.

There are still huge problems in the sector. The 2005-06 Productivity Commission report on government services, released in January, shows that waiting times to get into residential aged-care beds have increased significantly over time. Over 28 per cent of people who have been assessed as requiring a bed wait three months or more to actually receive one, compared with 15 per cent in 2000. So, even though the Howard government continually claim that they have provided more aged-care places, they have failed to keep residential beds in proportion to the increased number of frail elderly in Australia. Many government reports have indicated that there is a crisis and a shortfall in places.

We have also seen the lack of provision of funding and skills within the area. We have seen numerous reports of exploitation of care workers who have been brought from overseas to work in nursing homes because we simply have not provided enough aged-care nurses within the sector. Nor is there pay parity for those individuals. Attracting and retaining staff in aged care is one of the biggest issues facing the aged-care providers. Under the Howard government, aged-care workforce planning is non-existent and aged care is being compromised by the lack of trained aged-care workers. Consider this statistic: over the next 10 years, the Australian workforce will grow by eight per cent, but the aged-care workforce will have to grow by 35 per cent to meet demand. That gives you an idea of the aged-care crisis we are facing.

The outbreak of gastritis at Broughton Hall nursing home earlier this year represented a failure of federal government policy. Five elderly residents died because the facility had inadequate infection controls, a fact established too late after the event by an audit by the federal government authorities. In the six-day audit, it turned out that the home failed key standards, including clinical care, nutrition and hydration, continence management, infection control, staff training and regulatory compliance. Instead of accepting responsibility for the crisis, the Minister for Ageing tried to blame the state government, when it is clear that the operation and standards of Australian aged-care facilities are a federal responsibility—his responsibility. It is the Minister for Ageing’s responsibility to ensure there are proper standards in federally funded and regulated aged-care facilities in Australia. In fact, it took the Commonwealth agencies a staggering 10 days to investigate the circumstances around the outbreak, which is completely unacceptable. The minister should have accepted responsibility and given an assurance that the systems were now in place so that the situation could not be repeated. Indeed, the systems should have been in place so that the situation never happened in the first place. But instead all we got from the minister was a cowardly attempt to pass the buck to the Victorian Minister for Health.

The Broughton Hall crisis also showed the inconsistencies in the aged-care accreditation process—another Howard government policy failure. It emerged that an audit of Broughton Hall’s standards by the Aged Care Standards and Accreditation Agency following the crisis showed the facility was noncompliant on 12 out of 44 accreditation outcomes, even though it had passed all 44 accreditation outcomes a year earlier. ‘How could standards at Broughton Hall have deteriorated so rapidly within a year?’ you may ask. It was because there is inconsistency in the way the standards are applied, which is a view shared by the aged-care sector.

The minister needs to assure the public that systems are in place to ensure standards are consistent and reliable. But a big part of the problem is that the Minister for Ageing does not really have his heart in the job—he is not really interested in his portfolio. In fact, according to the Age, at a Liberal Party fundraising breakfast attended by aged-care providers in May he described caring for the aged as an ‘unenviable industry’ and went on to tell the audience that he preferred to avoid aged-care events because he was ‘young’. Unbelievably, the minister told the Menzies 200 Club that he would rather not open aged-care facilities or attend meetings about them. ‘I’m young and have a young family, and it’s an election year,’ he said. He also cited his marginal seat and big workload as a reason to cut down travel to attend industry forums. ‘I have waited a long time for promotion,’ Mr Pyne is reported to have said. He then admitted he was less interested in aged care than in his ‘passion’ for foreign affairs. What he is saying is that aged care is not ‘sexy’ enough—that it is a portfolio that he does not welcome. It is a very serious portfolio. These comments show the minister is not really interested in his portfolio or the welfare of the 2.6 million-plus Australians over the age of 65 that he represents. This is a disgrace.

If the Minister for Ageing is not interested in doing the right thing by the senior citizens of this country, Labor certainly are. We want to fix the residential aged-care mess that the Howard government has presided over for the last 11 years. The Howard government is still not providing enough high-care residential care beds, despite the figures showing that this is exactly what is needed in Australia. A report on residential aged care released last week by the Australian Institute of Health and Welfare shows the frail elderly are still getting a poor deal from the Howard government. According to the report, 69 per cent of residents as at 30 June last year required high care; however, the government’s own provision ratio was 48 low-care and 40 high-care beds for every 1,000 people aged 70 years or older. This was recently amended to 44 low-care and 44 high-care beds—but it still does not reflect the needs in our community. In fact, the number of aged-care residents needing high-level care has jumped by almost 19 per cent in less than a decade.

Over the same period, the number of people requiring low levels of aged-care supervision has dropped from 38 per cent to 31 per cent, which coincided with a significant expansion in the aged-care package designed for the same group. There is a trend for our elderly to stay in their own homes for as long as they can before they enter residential care—something we welcome and something the community wants. As our population is ageing our elderly are also living longer, so when they finally go into residential care they are older, frailer and generally need higher levels of care. By not providing enough high-care beds, the Howard government is failing to provide for their needs. The recent budget failed to look at the bed allocation system and failed to introduce new measures for capital raising to build new facilities and keep others up to standard. This is a big issue in my electorate of Chisholm, where land is very expensive and is very built out. People want to go into nursing homes within their area so they are still accessible to their community and so their families can visit them easily.

The recent situation in the Blackburn Nursing Home, where we saw the oldest Australian having to be driven away in an ambulance because of the bungle of the previous minister for aged care, highlighted most significantly for me and my community that the aged-care industry is in crisis. Blackburn Nursing Home ended up in an absolutely disastrous situation where the owner of the building was refusing to let the licensee continue. Indeed, the minister granted to the owner of the building an aged-care licence provider number even though the man who owned the building had never ever been involved in the aged-care industry and had some dubious business dealings in the past. The licensee—who was in the nursing home providing service, who had been in the aged-care industry for many years and whose wife was the nurse in charge—had to leave the residence. By virtue of that, all the residents had to leave. It was an absolutely shocking day when the oldest living Australia, a woman of 113 years of age, was bundled into an ambulance and taken away to another nursing home. It was scandalous, and demonstrated that the various ministers who have filled this portfolio do not care about this very important issue.

If we want to properly provide for the aged-care needs of our ageing society, the allocation of bed licences needs to be backed up by rigorous analysis of care needs. A Rudd Labor government will ensure there is equitable access to aged-care beds, using thorough research and analysis of the needs of our elderly. We should be providing the greatest benefit to our elderly Australians, who have looked after us in our greatest times of crisis. The elderly within my community are Australia’s great backbone, and we should respect them. The measure of society, it is often said, is judged by how you care for the young and the elderly. On both counts under this current government we should hang our heads in shame.