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Thursday, 21 June 2007
Page: 23


Mr PYNE (Minister for Ageing) (10:34 AM) —in reply—Madam Deputy Speaker Bishop, may I say how appropriate it is to have you, a former Minister for Ageing, in the chair for the summing up of the Aged Care Amendment (Residential Care) Bill 2007. You were in fact a trailblazer in many of the areas in which we now find ourselves continuing to bring about reform to improve the lives of residents, the comfort of families with loved ones in aged-care facilities and the regulatory environment in which providers operate. As one of the former distinguished ministers for ageing, I hope that you have found this bill to be to your liking.

In summing up, I would like to thank the members for McMillan, Wakefield, Cook, Moreton, Cowper, Hasluck, Riverina and Hinkler from the government for their contributions to the debate about the aged-care funding instrument. I also thank the members for Gellibrand, Reid, Lyons, Hindmarsh, Gorton, Banks, Swan, Canberra, Lingiari, Shortland, Chisholm and Scullin from the opposition for their contributions. This debate is about the aged-care funding instrument bill, which is the new funding instrument to be used by aged-care providers to determine the appropriate level of support for their residents, in close contact with the Department of Health and Ageing, and the funding that those residents will attract.

However, the debate has ranged across a very wide number of issues in aged care, and the opposition has used it as an opportunity to comment generally about aged-care issues. In summing up the bill I would like to deal with a few of the calumnies they have dropped in the House over the last few days of this debate on the aged-care bill, even though they do not bear directly on the aged-care funding instrument. The opposition have tried to paint a picture of an aged-care system in some crisis. They have left out most of the facts about how the aged-care system operates, which you, Madam Deputy Speaker, would be well aware of. But, sadly, the opposition side have either deliberately or ignorantly tried to paint a quite false picture of how the aged-care system works and the situation that the aged-care system finds itself in.

By way of background, when this government took office in 1996 the federal government was spending $3.15 billion on aged care. Eleven years later, in the current forward estimates we will be spending $10.1 billion by 2010-11. We have trebled the spending on aged care. A lot of work has been done to try and get the aged-care system into a state where we as a nation can be proud of it. In many areas Australia is at the cutting edge in the provision of care to sometimes the most frail and vulnerable people in our community who are in residential aged care. This stands in stark contrast to the way we found aged care in 1996. It was underfunded, there were no consistent accreditation guidelines across the country and there were no spot checks by an accreditation agency. We established the accreditation agency and we insisted on spot checks. In fact, Madam Deputy Speaker Bishop, I believe you were the minister at the time spot checks were initiated for aged-care facilities. Every home has at least one spot check and unannounced visit every year. That is not to mention the many other visits to aged-care facilities, support visits and review audits. Some homes have numerous unannounced visits by the Aged Care Standards and Accreditation Agency.

In 1996 there were 4,500 Community Aged Care Packages for the entire country. Today there are 39,000. By 2010-11 there will be close to 50,000 Community Aged Care Packages. When we were elected in 1996 there were 93 places available for 1,000 Australians aged 70 and over. Today that ratio is 108 and the aim is to get to 113 by 2010-11. It will be made up of 44 high-care residential aged-care places, 44 low-care places and 25 Community Aged Care Packages. In this debate the Labor Party has quite wilfully ignored Community Aged Care Packages, which suggests to me that yet again the Labor Party is indulging in the trickery with which we have become accustomed with the current Leader of the Opposition—leaving out salient facts and quite misleading the Australian people, in this case on aged care.

Community aged-care places must be included in the places available to older Australians primarily because they are the same, in all material respects, as residential aged-care places. More importantly, they are the preferred option for older Australians. Madam Deputy Speaker, as you would know, the vast majority of Australians want to stay in their own home for as long as they possibly can and in as healthy a state as they can. The combination of HACC funding, which the states and the Commonwealth run together, and which we have doubled, and the Community Aged Care and Extended Aged Care at Home packages, which are particularly sought after, means that people can stay in their homes for longer and be healthier and, if necessary, go into an aged-care facility probably later in life when they really need to do so.

The Labor Party wilfully ignores the role of Community Aged Care Packages. In the Main Committee during the appropriations debate the shadow minister for health completely ignored the role of Community Aged Care Packages. The member for Shortland is particularly egregious in this respect with her misrepresentation of the number of places that are available for older people in Australia. Quite frankly, she frightens older Australians and their families into believing that the government has reduced the number of places available when, in fact, we will have increased the number of places by 48 per cent. That is our estimate of where we will be—that we will have increased the number of places that are available for older people in residential care and through the Community Aged Care and the Extended Aged Care at Home packages.

In addition, when Labor was in office $18 million was being spent on respite care. Today the figure is closer to $190 million. In the budget handed down recently we established funding for respite demonstration centres to the tune of $41 million. We are continuing to put our money where our mouth is when it comes to support for respite. The Prime Minister in particular—but I think all members on this side of the House—believes that those people who care for loved ones play a critically important role in society, not to mention the economy, and deserve the support and the respect of government. For those people, respite care is a critical element in their being able to care for their loved ones for longer periods. Without that respite care they would not be able to get by.

In this debate the Labor Party has wilfully ignored the role of the states in the provision of acute care places. Time and again I have heard Labor speakers talking about the shortage of places in the community and the fact that older people in hospital are supposedly taking up the places of others. I was not aware that when an older person went into hospital that meant they were going to end up in an aged-care residential facility. Many older people who go into hospital—in fact the vast majority—do not end up in residential aged care but return to their home and get on with their life. Yet the Labor Party would have us believe that almost every older person in an acute bed in hospital is somehow taking up a place that somebody else could have and that they should really be in an aged-care facility. Quite frankly, I think it would come as a shock to many older people going into hospital to think that the Labor Party would say, ‘You’re in hospital and the next step is an aged-care facility.’ The government recognises that often older people have longer stays in hospital because they may need extra care. For that reason we have the $150 million program Improving Care for Older Patients in Public Hospitals. We do not agree with the Labor Party that all older people in hospital will end up in an aged-care facility. I find it insulting to older Australians. I think the Labor Party should change its rhetoric and think carefully about the messages it sends when it says these things.

The Labor Party and the states are yet again hoisted on their own petard in attacking the government over supposed shortages of aged care places. The number of acute care beds in public hospitals around the country increased from 1996-97 to 2004-05. The percentage variation in total acute hospital beds across Australia has been 0.1 per cent. The states have managed to increase the number of acute care hospital beds by 0.1 per cent. The state that seems to make the most noise about acute hospital beds versus aged-care places is Queensland and yet, extraordinarily, the number of acute hospital beds in Queensland fell by 4.5 per cent between 1996-97 and 2004-05. The total number of those beds in Queensland in 1996-97 was 10,023 and in 2004-05 it was 9,569. It has gone down by 454 beds. They have the gall to criticise the federal government about a so-called shortage of aged-care places when in the same period of time the number of aged-care places in Queensland increased by 25.2 per cent. Overall, in the period June 1996 to June 2005 the number of aged-care places increased across Australia by 33.9 per cent. That does not take into account our estimate that, by the end of this year, it will be closer to a 47.7 per cent increase.

On the most recently available statistics, we have increased the number of places by 33.9 per cent across the country, while the Labor states—which are all the states and territories, unfortunately—have managed to increase the number of beds across Australia by 0.1 per cent. In New South Wales they increased them by 2.6 per cent, in Victoria 0.5 per cent, in Western Australia 3.1 per cent, and in Tasmania 2.1 per cent. In Queensland the number of beds has dropped by 4.5 per cent, in South Australia it has dropped by 3.2 per cent, in the ACT it has dropped by an extraordinary 18.8 per cent, and in the Northern Territory by 1.2 per cent. So if there are not beds available in acute care in public hospitals in Queensland, it is not the fault of the federal government, and it certainly is not the fault of older Australians who need to be in hospital. It is clearly the fault of the Queensland Labor government. One of the people who have been intrinsically involved in Queensland is the Leader of the Opposition, who is trying to use the same trickery that he brings to all these debates to suggest that somehow the government is failing to provide the number of beds that should be provided to older people in aged-care facilities. I notice that recently the Leader of the Opposition and the shadow minister for ageing—and the shadow minister for health as well—put out press statements about aged care in which yet again they repeated the line that there is a ratio of 88 beds for 88 places for every 1,000 people aged 70 or over in Australia, when that number is much greater than that because they again refuse to include community aged care packages. The ratio is 108 now and by 2010-11 it will be 113. When we came to office, the ratio was 93.


Ms Plibersek interjecting


Ms Roxon interjecting


Mr PYNE —You were a complete disgrace with respect to aged care. You were spending $3.1 billion on aged care, $18 million on respite care, and there were 4,500 community aged care packages. You have the gall to come into the House on this bill, the Aged Care Amendment (Residential Care) Bill 2007, and again trawl through these tricky lines about ratios and places, which are completely false, causing me to have to come in here and put the record straight yet again. I have to try to fix the situation so that older people are not led to believe the calumnies that are visited upon the government yet again by the opposition.

It is unfair that the Labor Party has not used the opportunities they have had to put together a policy on aged care that talks to the people in aged care about workforce issues, IT issues, or capital raising for infrastructure issues. Instead, they keep running these scare lines against the government, upsetting older people and leading them down the garden path of disbelief, even when the facts are finally pointed out to them, which I have been doing in this debate and continue to do in the press. It is not like the Labor Party have not had opportunities to put their record to the Australian people and to talk about their policies for the future. The shadow minister, at an aged care and community care conference in Victoria, which I also attended, spoke for half and hour and at no point in that speech did she talk about what the Labor Party was proposing to do about aged care. Apparently, aged care is in crisis, according to the shadow ministers who cover this area, the member for Gellibrand and Senator McLucas—


Mr John Cobb —They have no ideas.


Mr PYNE —They have no ideas, as the assistant minister says, to put to the Australian people about what they would do. Every time they are given the opportunity to do so, they squib it. The Leader of the Opposition had the chance on 18 May at a lunch in Queensland for the aged-care industry, which, amazingly, people paid $3,000 a head to attend. People paid $3,000 to hear the Leader of the Opposition at an aged care lunch talk about the Labor Party’s aged care policy! Yet he made no attempt to put to rest their concerns about Labor’s policy in aged care. He did not outline Labor’s agenda for the coming election in aged care. It was just the same lies about ratios and places and spending that we hear constantly from the shadow ministers who cover this area. If I were paying $3,000 to hear the Leader of the Opposition on aged care, I would have thought he would have said something to alleviate and allay my concerns. But no, yet again he squibbed it. The Australian public will have their opportunity at the end of the year to compare our excellent record on aged care with the Labor Party’s record on aged care.

I turn to workforce issues. The Labor Party are Johnny-come-latelies to this debate on the workforce. They think they are the first people to discover that there are workforce challenges in the area of aged care for a whole lot of reasons. It is not a unique issue in Australia that there is a shortage of nurses in aged care and across the health sector. There is a worldwide shortage of nurses, and that affects Australia. So the government has been taking action with respect to the workforce and aged care.

Since 2002, we have created almost 40,000 training places in aged care, 1,600 additional nursing scholarships, 3,200 medication management training places, 13,000 certificate level training places and 12,750 training places for personal care workers from rural and remote regions of Australia. In the budget’s Securing the Future of Aged Care initiative, we provided a further $32 million over five years for 6,000 training places for the community care workforce and 410 postgraduate scholarships. That is almost 40,000 places since 2002, at a cost of over $300 million. So we are definitely recognising the challenges that are there for workforce issues in aged care and we are meeting those challenges. We are not standing still like the Labor Party and wanting to return to the pre-1996 period when aged-care facilities in Australia were, quite frankly, a disgrace and an embarrassment to this country.

You took the necessary action, Madam Acting Deputy Speaker Bishop—if I can be so familiar—that was needed, as the Minister for Ageing. That has been followed up by subsequent ministers for ageing. I am quite proud to have had the opportunity to build on the record and the role that you and others have played in this area, because it is critically important. It is vitally important to the residents that they get the quality and standard of care that you would expect in Australia. We have initiated the processes and framework that have brought that about. It is critically important to the families of those residents that they feel comfortable that their loved ones are in a place where they would be happy to have them, and I think we are achieving that. We also need to maintain a viable industry for the not-for-profit, the for-profit and the government part of that industry, and we are doing that too. I look forward to this bill being passed and the ACFI being introduced in March 2008 because of the benefits that that will bring to the entire sector.

Question agreed to.

Bill read a second time.