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Monday, 3 March 2014
Page: 1353


Mr BUTLER (Port Adelaide) (16:32): It is a pleasure to participate in the address-in-reply debate. I congratulate so many of the members on their addresses, particularly all of the new members who have experienced the privilege, first, of being elected to this place and then, usually in front of their family, friends and new colleagues, giving their first speech. It is a wonderful opportunity for all the new members on both sides of the House.

This address-in-reply is an opportunity for all members to reply to the new government's agenda, as was outlined in Her Excellency's speech in the other place. Usually members of the opposition, the government or the crossbench confront a detailed plan, from the new or re-elected government, of what it plans to do over the course of the ensuing three years to build the nation: to build the nation's prosperity, to build opportunity for its citizens, and to build social and physical infrastructure and the like.

The challenge we have in giving our addresses-in-reply is that the government has outlined precious little by way of a new plan. The limits of the plan outlined by this new government are really defined by what the new government intends to dismantle or to cut, rather than what it intends to build. In policy areas that are particularly close to my heart, the government has outlined very little by way of new plans. I want to address a few of those plans, contrast them with what we were able to achieve over the last few years in government and pose some questions about what this government might intend to do by way of dismantling that.

The first area I would like to address is the area of mental health. This is an area of very longstanding neglect, frankly, by governments of all political persuasions, at state and Commonwealth levels, over many years. All of us supported a process of deinstitutionalisation that would see people living with mental illness who, for many years, had been confined to hospitals for their entire lives often brought out into the community—taken out of the institutions and allowed to live their lives in the community in different Australian cities and regional areas. That was a fantastic policy.

The difficulty was that the quid pro quo, the follow-up from that policy, was supposed to be greater investment in community based mental health services so that those Australians would be able to receive good levels of support, find employment and stable housing, ensure they had strong peer and family relationships and take up all of the opportunities that Australian citizens have in front of them. As I said, governments of all political persuasions—particularly at state level, given that states have had responsibility for this policy area generally—

failed in delivering that quid pro quo. This led, firstly and most importantly, to very significant disability and profound disadvantage for hundreds of thousands of our fellow citizens and their families. It also eventually led to a very significant level of community unease about the degree to which we were letting down those fellow citizens.

This unease really found its shape in Patrick McGorry being made the Australian of the Year in 2010. That year, with a whole range of other supports, Professor McGorry was able to shine a spotlight onto those issues associated with mental health at a national level that they simply had not had shone on them before. It did not happen overnight. A whole range of great organisations and individuals had done extraordinary work in previous years—beyondblue, along with many individuals, had done fantastic work. But Professor McGorry was able, in an election year, to bring a spotlight to these community failures for which we all bore responsibility.

For the first time in Australian political history the two alternative Prime Ministers, the current Prime Minister and former Prime Minister Julia Gillard, actually talked about mental health in a federal political campaign. It was a wonderful thing. I commend the Liberal Party for bringing a very substantial mental health policy to that 2010 campaign. Ultimately, when we formed government, I was made the first ever mental health minister at a national level. I then undertook a range of direct consultations all around the country—in regional areas and in capital cities—with consumers, people living with mental illness, their family members and their carers about what it was they wanted from a mental health reform package.

In 2011 we were able to deliver the largest-ever mental health reform package in Commonwealth history. It covered a whole range of different age cohorts, a whole range of different needs—many of them medical and many of them non-medical—many of them related to housing and employment and other social supports. We brought in a whole range of reforms, building on previous years, to deliver youth-specific mental health services, through the headspace model in particular, that had been started under the previous Howard government. We built upon that over the past few years. There were also services to deal with the first episodes of psychosis, which are often experienced by young people in their late teens or their early twenties—a model particularly pioneered by Professor McGorry.

We were able to bring into place new services to support families with very young children experiencing mental health difficulties. It is not often understood that fully 25 per cent of all mental health disorders emerge before the age of 12, often even before the age of five. Early intervention to support those kids, and particularly to support their families, is critically important if those kids are to be able to get back on the rails and embrace all of the opportunities that Australia has to offer—schooling, post-school education and training, and then adult lives. So again those were very wonderful reforms we were able to bring into place.

We were also able to respond to the requests that carers and consumers gave to me, as I was travelling around the country, for much better integration between the different types of services that people living with severe and persistent mental illness need. Often they are not just medical services; they relate to their need to find stable housing, to find avenues into employment and to be able to build good peer and family relationships. Those sorts of living skills, as well, were all brought together into a program known as Partners in Recovery.

I hope that this new government will continue with a range of those reforms, as we did with the range of reforms that came under the Howard government—and I will talk soon about headspace—but we have heard very little from the Liberal Party since their 2010 election policy. I hope that we will hear more into the future.

Another area on which the new government has said precious little is the area of aged care. I know from talking to members across the chamber, whether it is in this chamber or outside, everyone understands how critical a policy area aged care is; both because of the growing demand that we are going to see in the system in the future as the population ages, but also because there are emerging differences in the preferences that older Australians have for their aged-care services. There are some new needs that are emerging, and I talk particularly about the growing prevalence of dementia.

We inherited, when we came to government in 2007, a position that had not changed much in the 11 years of the Howard government, not for want of trying. Prime Minister Howard had tried on two occasions to get substantial reform of the aged-care system through—in 1997 and in 2004—and he was not successful. So we inherited a system that was largely put in place, firstly, by the Hawke government in the mid-1980s, and then reformed by the Keating government in the early 1990s to bring in some Commonwealth funded home-care arrangements.

We had put in place a Productivity Commission inquiry that took place at the same time they were inquiring into a national disability insurance scheme, and we received a report from the Productivity Commission at about the same time they published the NDIS report as well. Both reports are excellent and pay great tribute to the social policy expertise of the Productivity Commission.

At the same time, it is important to recognise that the aged-care sector had become much better organised, in terms of dealing with its own internal differences and then presenting a united front to parliamentarians and the community about what they wanted from aged-care reform. A lot of the difficulty that Prime Minister Howard got into in 1997 and 2004 reflected the fact that the aged-care sector itself was not united about what it wanted from reform. I think people in the parliament and people in the community were entitled to say: 'Well, if the aged-care sector cannot say what they want, why should we take a leap of faith into that unknown?' They learnt from that; they formed the National Aged Care Alliance, and they were able to work through their differences and present two important documents—first the NACA blueprint and then the NACA vision—about what they wanted from aged-care reform. NACA covered aged-care providers; the big church and charitable providers; private sector for-profit providers; the big consumer groups, like the Council on the Ageing, Alzheimer's Australia, Legacy and many others; aged-care staff; clinicians; and pretty much anyone with an interest in the aged-care sector. These were very good reports and they certainly assisted me and other government members in responding to the Productivity Commission report.

After we received the report, I talked to literally thousands of older Australians in dozens of forums around the country, in capital cities and in many regional communities as well, to hear from them what they wanted from aged-care reform. Many of these were general forums where people came along. A number of them were specific forums for people living with dementia and their families, and they were incredibly powerful opportunities for me to hear from them about the failures of so many different elements of our health system—the hospital sector, the primary care sector and the aged-care sector—to respond to and support the particular needs of the tens and tens of thousands of Australians who are living with dementia now.

We came up with a comprehensive package to respond to the Productivity Commission report in the 2012 budget. It really does transform the nature of our aged-care system. It starts to bring to the centre of the system the need for people to live in their own home for as long as possible. If there was a single message I heard from older Australians during that period, it was that they did not want the aged-care system to be about nursing homes—although they wanted to know there was a good nursing home system there to fall back on if they needed it—they wanted aged care to be focused on supporting them to stay in their own home for as long as possible and, if at all possible, for the remainder of their lives. Our package significantly lifts the number of home-care packages and home support packages that older Australians are able to receive in their own home.

We also brought a new level of transparency and robustness to the way in which the residential care or nursing home sector works, particularly around the question of what accommodation charges some older Australians will have to pay to get into those nursing homes. We heard terrible stories about people being charged arbitrary figures that would run into the hundreds and hundreds of thousands of dollars as bonds to enter aged-care facilities, with no requirement on the provider at all to justify why a figure of $500,000 or $600,000 or $700,000 or even $800,000 needed to be paid to gain entry to an aged-care facility. We have brought much more robustness. I understand the government will keep in place the Aged Care Financing Authority, which puts providers to proof about what they are charging older Australians and why. I think that will very significantly lift the confidence that older Australians and their families have in the residential care sector.

I am particularly proud of the elements of the reform package that respond to the needs of people living with dementia. I want to pay particular tribute to Alzheimer's Australia. This is an organisation that has been providing wonderful support for many, many years to Australians affected by this condition. It lifted its game incredibly with a public campaign that caught people's attention in this parliament and across the Australian community—across the cities, across the regions. It really captured the imagination of so many Australians about the need to come to grips with what I think will be one of the two major epidemics for Australia in the 21st century, and that is dementia.

The numbers of people living with dementia, if we do not find a cure for this condition, will double every 20 years, reaching a million people by 2050 or so. As I said earlier in my address, neither our health system nor our aged-care system is well equipped to deal with those particular needs. To be frank, and without apology, the elements of the reform package that we adopted in this area largely come from the Fight Dementia Campaign that Alzheimer's Australia developed and talked about to parliamentarians across both sides of this chamber in the months leading up to the budget in 2012. I hope that the new government will support those elements of the aged-care reform package. I commend the new government for taking to the election campaign we just had a policy to provide additional funding for research into Alzheimer's. I think that is an important step in building on our reforms in this area, but again I cannot stress enough how important it is to shine a spotlight on the need of the health and aged-care sectors to respond to the needs of people living with Alzheimer's.

One element of the reform package where I think the government and the opposition part company is around issues associated with our workforce. The one change that we have seen to the reform package from the new government is to take $1.1 billion out of a program that was intended to start to lift the wages of aged-care workers. This is a very significant challenge, party politics aside. Aged-care providers are already having difficulty attracting and then retaining quality aged-care staff because of the low wages that they are paid. We currently have 350,000 workers in the aged-care sector. We are going to need about a million aged-care workers by 2050, to the point where one in 20 workers in Australia will be an aged-care worker. If we do not lift their wages, we simply will not get there. The position that we outlined in the reform package around wages reflected exactly the position that the aged-care sector had entirely signed up to in the National Aged Care Alliance blueprint. I am very disappointed that the new government has decided to turn its back on that element and particularly disappointed because I have not heard anything from the new government about what it intends to do to improve recruitment and retention of staff performing some of the most important work that our community has.

In the few minutes I have left, I want to say a few things about the wonderful community that I have the privilege of representing. This is my third election as the member for Port Adelaide. My two predecessors, Mick Young and Rod Sawford, both achieved seven elections, so I am a very long way short of those two very significant members for Port Adelaide. But it really is a privilege to serve the community. The community is made up of a number of different bits: the traditional port of Adelaide; the Lefevre Peninsula; the north-western suburbs, where I live; and then, beyond the salt pans, the northern suburbs, which have wonderful traditions and a wonderful culture. This is a community that is deeply tribal and has very high expectations—I know, from going to street corner meetings, shopping centres and footy clubs—of its members of parliament, whether they be members of this parliament or of the state parliament. I am acutely conscious every day I go to work of the high expectations that my community has of me.

They have achieved very big benefits from the last six years of the Rudd and Gillard governments. I have seen, from the time I started going to high schools in the area—because my kids are still at primary school I had not been to a high school since I was at high school—the capital upgrades that have been achieved over the last few years. When I started going to the high schools in my community, some of them only had one computer for every eight children. The changes that they have seen in the last several years have been extraordinary. There are trades training centres and community infrastructure. We saw part of the Rudd government's response to the global financial crisis bring new sporting and community facilities that are being used every day and every week. We have seen Water Proofing the West, which is a wonderful stormwater-recycling project. I know that those opposite do not see a role for the Commonwealth in urban stormwater, but this has been a wonderful project to do urban stormwater-recycling in that area.

In closing, I want to thank the vast number of supporters that we all need if we are going to get to this position and be a member of the federal parliament. Party members and party supporters again came out in force through the whole of the last three years, which were often very difficult years for members of the Labor Party, I can tell you. They came out time and time again, including in the election campaign, and supported me. For that, I am extremely grateful. They will now be working hard again, in the state election campaign over the next couple of weeks. There were so many other volunteers—not party members and not even people who would consider themselves ongoing party supporters—who also were willing to come out and give me support: well-wishers who would just say a good word to you in the shopping centre or at the footy club and make you lift your step when you might be feeling a bit exhausted. I had extraordinary officers, headed by Karen Grogan in the ministerial office and Julie Duncan in the electoral office, for whom again I am incredibly grateful. But without family and without friends—particularly without my wife, Suzanne, and my children, Ellie and Isaac—to come home to every now and then, when we have finally left and I can get back to Adelaide, this would not be worth doing. It is a wonderful privilege to be a member of this parliament. It is a wonderful privilege to represent Port Adelaide, and I am looking forward to the next three years.