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Monday, 10 September 1984
Page: 754


Senator JESSOP(10.39) —I raise in the adjournment debate a subject that has created a lot of concern in South Australia which could well be reflected in other parts of Australia; namely, rest homes. The Adelaide News on Friday carried an article dealing with rest home patients. Eleven rest homes have threatened to shut their doors. The article stated:

Eleven of Adelaide's private rest homes today threatened to close their doors and 'unload' more than 300 patients on to the city's public hospitals.

They have told the Federal Government they need financial assistance within a fortnight or they will close permanently.

The ultimatum was not a bluff, the SA Rest Homes Association president, Mrs S. Stoppel, warned today.

Rest home proprietors will meet the SA Council of the Ageing on Monday to give notice of the decision.

This involves the accommodation which is provided for our older retired citizens who enjoy reasonable health and who seek rest home beds for one of two main reasons: Firstly, because they are unwilling to live alone or with their wives or husbands as they are unable to deal with the maintenance of house and garden, or cannot afford to have this done for them; and secondly, because their families are not prepared to look after them. In South Australia this type of accommodation has reached a crisis point, as I have indicated.

Should these 11 homes be forced to close it will create tremendous problems for the 300 inhabitants involved. These homes are experiencing financial stress because they are feeding and caring for their clients all day every day for about $13 a day. These rest homes perform a most valuable service to the community as they also show added interest in the welfare of their guests by ensuring that they have clean, comfortable beds and good meals and that they take medication, if it is required, at the times prescribed. In addition, the proprietors and their staff assist in personal shopping requirements and ensure that healthy exercise is taken by the elderly people who inhabit those institutions. They encourage the walks and outings that are necessary to provide a healthy environment and to make life as interesting as possible.

Unfortunately, a significant number of these people develop senile dementia, sometimes a year or so after their admission. Senile dementia is a very difficult thing to determine. It is an insidious disorder that involves elderly people. I have a paper here that describes senile dementia, and I seek leave for this document to be incorporated in Hansard. It is an extract from the McMillan Guide to Family Health, the Editor-in-Chief of which is Dr Tony Smith, MA, BM, BCH. The paper is very interesting because, among other things, it describes dementia as a disorder in which a formerly normal brain ceases to function normally and the sufferer becomes forgetful, confused and out of touch. Unfortunately, the first symptoms are not readily recognised. A patient who is admitted to a rest home can quite easily be in the early stages of dementia and develop this problem progressively over the year or so in which he or she is resident in the rest home. They get to a stage where they need to be admitted to a nursing home for proper, qualified nursing care or to the geriatric ward of a hospital such as the Royal Adelaide Hospital or other public hospital that is competent to treat them.

Patients sometimes become incontinent and require appropriate nursing care. Such care is quite frequently beyond the training and capabilities of rest home staff. Frequently problems have arisen whereby rest home proprietors have had to recommend that such people who are resident in their homes be transferred either to a public hospital institution such as the Royal Adelaide Hospital or other public hospitals in South Australia or to a private nursing home with qualified staff who can care adequately for them. However, when they are taken to the Royal Adelaide Hospital or to the appropriate nursing home equipped to deal with them, accommodation cannot be provided because sufficient beds are not available . From what I have been told by Mrs Stoppel, the President of the South Australian Rest Homes Association, it seems that some nursing homes have beds that are occupied by people who do not require nursing care but who could be accommodated in rest homes, or guest houses, as they could be termed. It has been suggested to me that up to 20 per cent of these nursing home beds are occupied by people in this category who could otherwise find accommodation in rest homes. It is a serious matter that ought to be recognised and investigated.

In addition, the South Australian Rest Homes Association claims that a subsidy of $4 a day per patient is required to enable them to carry on their business and provide these services. If these private institutions do not obtain Commonwealth assistance it could result in their closure. If patients had to be accommodated in public institutions it would cost the Commonwealth $200 a day in the Royal Adelaide Hospital, for example. In order to save time, I have an article that can be incorporated in Hansard, together with the document to which I referred dealing with senile dementia. I seek leave to have these documents incorporated in Hansard.

Leave granted.

The documents read as follows-

SENILE DEMENTIA

Dementia is a disorder in which a formerly normal brain ceases to function normally and the sufferer becomes forgetful, confused, and out of touch with the real world. The condition is very rare among people under 65 (see Pre-senile dementia, p.293). Senile dementia (dementia affecting the elderly), on the other hand is common. The deterioration of the mind is due sometimes to the progressive wasting of irreplaceable brain cells; sometimes-and when this happens, there is a greater possibility of any treatment being successful-to gradual narrowing and hardening of the arteries that carry blood to the brain ( see Arteriosclerosis, (p.404).)

Senile dementia, which may develop over several years, is by definition progressive and incurable. Do not assume, however, that signs of confusion or impaired intellectual capacity in someone over 65 are always due to senility. There may be an underlying-and treatable-cause. For example, chest or urinary tract infections, strokes, heart attacks, and hypothermia can result in mental confusion; and so can low blood-sugar level, hypoglycaemia, or the use of types of drug. The confusion, agitation, and drowsiness resulting from any such underlying condition are different from the symptoms of senile dementia in two respects: they tend to develop rapidly over the course of a day or two, and they are likely to clear up with appropriate treatment of the basic trouble. In some cases, when senile dementia is developing, the condition may seem worse than it is because of the problems with eyesight and hearing that already exist.

Moreover, actual dementia is sometimes caused by long-standing abuse of alcohol or drugs or by vitamin deficiency, hypothyroidism, syphilis, or brain trouble such as a tumor or subdural haemorrhage. And very often the mental signs of '' senility'' lessen when any such condition is treated. An additional common problem in the elderly is depressive illness (see Depression, p.297), which sometimes mimics the symptoms of dementia. These symptoms are unfortunately often attributed to dementia when they may be caused by treatable depression.

The following paragraphs deal exclusively with true senile dementia, which has a slow, insidious onset and which is not caused by an underlying, treatable disorder. Many elderly people in an early stage of the condition realize that they are beginning to lose their mental grip, but they can do little to arrest its progress. The advice in this article is therefore directed to close relatives and friends rather than to the sufferers themselves.

What are the symptoms

The first symptom is a gradual loss of memory, particularly of recent events. You will begin to notice that the elderly person cannot remember what has happened a few hours (or even minutes) earlier, although he or she can recall happenings of many years ago. This is a classic symptom of an old memory and does not necessarily mean that dementia will progress, though it can do. As weeks and months pass, powers of reasoning and understanding may dwindle, and there may also be a loss of interest to all familar pursuits, even in such simple activities as watching television or seeking news of friends. Eventually there may be a deterioration of personality.

Senile dementia often culminates in emotional and physical instability. Some sufferers tend to swing between moods of apathetic withdrawal and overactive aggressiveness, and they may behave in uninhibited and anti-social ways. Table manners deteriorate; personal cleanliness is neglected; and usual politeness disappears. Sometimes sufferers may even become violent if impulsive behaviour is frustrated. A few old people lose their sexual inhibitions, too, and this can lead to embarrassing physical approaches to young persons of either sex. Any or all such symptons lead slowly but progressively towards decay of intellect and emotion.

How common is the problem

The older the age group, the greater the likelihood of senile dementia. Probably about 1 person in 10 over the age of 65 has the condition, but the figures rise to 1 in 5 over the age of 80. This means that, in the population at large, about 1 family in every 10 includes at least one elderly member suffering from senile dementia.

What are the risks?

You are taking risks, whenever you leave demented old people alone or permit them to continue living alone after they have progressed beyond an early stage of senitity. Because of forgetfulness and inability to concentrate, there is a constant danger of accidental misuse of fire, gas, and kitchen tools. Combined with possible physical disabilities such as deafness or impaired vision, mental confusion makes it difficult for sufferers to take medicines as prescribed, to cross streets in safety, or even to use the bathroom. Without supervision they are apt to eat badly and to neglect personal hygiene. The results can be distressing, especially if-as often happens they begin to suffer from incontinence (p. 718), malnutrition, or a disease caused by lack of vitamins ( see vitamins, p. 494). If a relative of yours in the early stages of senility is still about without companionship, be sure that he or she always carries some mark of identification-for example, a bracelet inscribed with name and address or, at the very least, a piece of paper carrying your own address and telephone number.

What should be done?

If you suspect that an elderly relative or close friend is beginning to suffer from dementia, you should gently persuade (or take) him or her to see a doctor, preferably the family doctor, who will be familiar with the person's history and may already have suspected signs of the condition. The doctor may refer you to a geriatrician, if necessary. After making a physical examination and carrying out tests of memory and reasoning power, the doctor will probably search for the symptoms of a possible underlying disease-the pallor of vitamin B12 deficiency, for example-that might be causing mental deterioration. If loss of memory or confusion has developed with extreme rapidity, the doctor will be unwilling to make a firm diagnosis of senile dementia without further tests. If, however, you have noticed a slow deterioration, and if the sufferer is well past 65, and there seems to be no good reason for him or her to be suffering from depression, your suspicion is likely to be confirmed.

What is the treatment?

Although no medical cure is possible, you doctor will undoubtedly help you decide what to do next. Some practical help can be given to both the old person and those who care for him or her. In the early stages of senility, when many old people are still able to live alone their friends can help by organising memory aids such as lists and routines, and by making sure that adequate food and warmth are provided. There are risks to this procedure (see 'What are the risks?' above); but unless they have become very confused, most of the elderly do better in familiar-even if muddled-surroundings than in homes for the aged. Visits by an efficient, sympathetic health visitor or district nurse, along with regular attention from a service such as Home Help or Meals on Wheels, will help many people to maintain some degree of independence in spite of increasing senility.

If you feel responsible for the well-being of a senile relative, you should take as much advantage of community sevices as you can. In many places, for instance, there are day-care centres where old people are looked after for several hours, provided with lunch, and given some kind of occupational therapy (see Community health care, p. 743). Your doctor may also be able to arrange for your relative to be admitted to hospital or a home for the elderly (see the box below) for brief periods so that you can have an occasional holiday. And the doctor can advise you how to cope with such specific problems as incontinence. For information on home-nursing techniques see the section entitled Caring for the sick at home on p. 754.

What are the long-term prospects?

Eventually your aged relative may well require the skilled and constant care that are available only in long-stay hospitals or homes. If the doctor strongly recommends this form of care, you will be doing the old person the best possible service by accepting the recommendation.

Eleven rest homes threaten to shut

Eleven of Adelaide's private rest homes today threatened to close their doors and ''unload'' more than 30 patients on to the city's public hospitals.

They have told the Federal Government they need financial assistance within a fortnight or they will close permanently.

The ultimatum was not a bluff, the SA Rest Homes Association president, Mrs S. Stoppel, warned today.

Rest home proprietors will meet the SA Council of the Ageing on Monday to give notice of the decision.

If they go ahead with the plan, up to 100 staff will be retrenched.

Mrs Stoppel said homes no longer could operate without Federal or State aid.

Patients were being fed, clothed and cared for round-the-clock for only $13 a day.

Rest homes want the Commonwealth to provide $4 a day subsidy for each patient.

Mrs Stoppel said proprietors were prepared to ''shut for good'' if the Government refused.

Tragedy

She said each would shut simultaneously on the same date-yet to be made public.

''We cannot continue under the present conditions,'' she said.

State Liberal MLC, Dr Ritson, who has been lobbying for the association, said it would be a tragedy if the rest homes closed.

But they could not continue to function as de facto nursing homes without appropriate subsidies.

The Opposition Leader, Mr Olsen, said the homes were small businesses providing a service for a real need and their funding request deserved urgent attention.

The Premier, Mr Bannon, said he was ''seriously concerned.''

''I have referred the matter to the Health Commission to see what can be done,' ' he said.

Mrs Stoppel said: ''If the Commonwealth feels it can't help us with a subsidy of $4 a day, its going to have to find $200 a day to cope with these people in public institutions.''

Proprietors were angry that many of their patients qualified for nursing home care and a subsidy of $43 a day.

But because of an acute shortage of nursing beds, they could not transfer them and continued to care for them with no Government aid.

Mrs Stoppel warned the Government not to see the threat as bluff.

''The only thing worrying us is the trauma inflicted on residents and staff.''

The closure ultimatum has been made to the Health Minister, Dr Blewett, and the Social Security Minister, Senator Grimes.

These may close

Mrs Stoppel named the rest homes which would close as:

Hillview, Adelaide St, Magill.

St Bernard's, Penfold Rd, Magill.

Argyle, Charles St, Prospect.

Emerald, Prospect.

Catherine Love, Prospect Rd, Prospect.

Sunnydale, Military Rd, Semaphore.

Cobham, Gordon Tce, Morphettville.

Glenelg, Byron St, Glenelg.

Brougham, Brougham Place, North Adelaide.

Seacliff, Kauri Pde, Seacliff.

Sumeera, Salisbury Hwy, Parafield Gardens.


Senator JESSOP —I thank the Senate. I have raised the matter with the Government through the Minister for Health (Dr Blewett) and the Minister for Social Security (Senator Grimes). It seems that these Ministers should recognise the need to carry out an urgent inquiry into this most serious matter. The Premier of South Australia has recognised the problem and is prepared to co-operate. I have had a series of letters from the Minister for Social Security and his colleague the Minister for Health and I am grateful for their replies to my representations on behalf of the Rest Homes Association of South Australia. I seek leave to have those letters incorporated in Hansard, for the information of the Senate.


The PRESIDENT —I assume that the normal conditions in regard to incorporation have been met?


Senator JESSOP —The Minister has seen my letters and he knows the replies.

Leave granted.

The letters read as follows-

8th November, 1983

The Hon. Neal Blewett, M.P.

Minister for Health,

Parliament House,

CANBERRA A.C.T. 2600

My dear Minister,

My State colleague, Mr. J. Burdett, MLC, has brought to my attention the plight of Rest Homes in this State.

The Rest Homes Association, C/- Employers' Federation Inc., 46 Fullarton Road, Norwood, S.A.5069, had raised this matter with him, and as it concerns a Federal issue, I am taking it up on their behalf.

The Association feels it is being discriminated against in that funding is not available to Rest Homes which provide exactly the same service as community and church based organisations.

The Association receives payments out of the pensions of residents, and this does not go far enough to operate on a viable basis. They do provide a service for people who cannot get appropriate care through any other source. They have pointed out that some payment is available, in the form of subsidies, to such persons when cared for in their own homes, such as electricity reductions, etc. however, not even this small amount of assistance is provided to people because they choose to live in a private rest home.

The total number of persons cared for in rest homes is not available to me, and I believe there are about 26 rest homes in the State, half of which belong to the Rest Homes Association.

It will be necessary in the near future for hospitals, nursing homes and rest homes to provide adequate fire protection equipment to keep in line with the new requirements, and I am advised the rest homes will suffer severe financial difficulty in finding the capital outlay to comply with these requirements.

I know of one Matron at least who works for no wage at all, and has used her own savings to pay bills rather than tell her residents that she can't afford to maintain the home, and they must leave.

You can imagine the suffering which would be caused to these old people if they were told they must leave their rest homes because the owners could no longer afford to maintain them, yet the situation is rapidly threatening.

And, of course, there would be the potential loss of many nursing jobs if rest homes were forced to close. I am advised that staff are now working up to 16 hours a day, for a very minimal wage, as the homes cannot afford to employ any more staff, and this is causing intolerable strain on these dedicated people.

I therefore request your most sympathetic consideration to amending the provisons which preclude the payment of funds to private nursing homes in order to remove the discrimination which apparently exists.

Yours sincerely,

DONALD S. JESSOP

Senator for South Australia

December 1, 1983

Hon. Neal Blewett, MP,

Minister for Health,

Parliament House,

Canberra A.C.T. 2600

My dear Minister,

You will recall that I wrote to you on 8 November, 1983, on behalf of the Rest Homes Association of South Australia, concerning Government funding for Rest Homes.

I am enclosing a copy of further information I have received from Matron Shirley Stoppel in support of their submission for funding.

Matron Stoppel has detailed a number of instances for your consideration and I look forward to your further comments on this important matter.

Yours sincerely,

DONALD S. JESSOP

Senator for South Australia

Matron Shirley Stoppel, Hillview Rest Home, 4 Adelaide Street, LACIL S.A. 5072

19th November, 1983 Parliament House,

Canberra

To Whom it may Concern,

On behalf of the Rest Home Association of South Australia, it is with great concern and confusion I write this letter, there are many questions we need answered.

Firstly, why are the so called Non-Profit Organisations with back up Voluntary Assistance paid personal care subsidies on top ot the pension and expected only to break even whilst at the same time, Private Rest Homes with absolutely no assistance or concessions expected not only to maintain a standard of care with fees below the pension but be placed in the category of Profit Making Concern. Let me say we believe voluntary organisations need subsidy, but so do we. It is gross discrimination not only to Managers of Rest Homes but even more so to the residents who have equal rights to the same standards of care.

Rest Homes in S.A. deal with in general with many very difficult residents, many times rejected by society and would certainly not pass the test for entry into selective Voluntary Organisation, Hostels etc. Many times rejected for entry into Nursing Homes for behavioral problems.

A great number of people residing in Rest Homes are not quite little old ladies sitting and knitting but are Brain Damaged, Alcoholics, Senile Dementias, Epileptics, Diabetics, War Veterans with behavioral problems, Intellectually Retarted Geriatrics and also Nursing Home cases that we are unable to place simply because of my next point.

Criteria for Admission to Nursing Homes-For Extensive Care in Nursing Homes.

Example-Almost Blindman, periodically incontinent of bowel and bladder, able to walk with aid of a stick.

Answer-Unacceptable because able to walk, (must be chair or bedfast.)

Please tell me what we are supposed to do with these people. We are not registered for Nursing Home Patients. Do we break their legs to make them eligible.

Do we get up at night to nurse them for nothing or do we make them fend for themselves as best they can.

Some Private Nursing Homes request Extensive Care only, this reduces the amount of beds available for ordinary care subsidy. This is reduced even further when you take into consideration that many residents in Rest Homes can afford pension only, so many Nursing Homes are out of the question if asking higher than pension so we virtually really come back to Voluntary Organisation, who many times have Hostels attached, who have top priority on vacant Nursing Home beds.

Who will Care for these People?

Do we send them to Acute Hospital?

If sent back do we refuse to re-admit.

That would mean they would spend the rest of their lives in an ambulance.

Rest Homes are a very necessary link in the chain of Human Care for Aged and Disabled, they are and can be tuned to many areas of care and if granted some form of financial assistance would surely slow down the over increasing need for expensive Nursing Home beds and eventually save Government, thousands of dollars .

Members of our Association have been asked by Politicians why we bother to do this kind of work? So I will answer this on their behalf, the same as we answered these Politicians.

(A) We happen to think the Human Race is the most importance thing on this earth and there are still people who do care. However these politicians have been asked to back their statements with an alternative and of course have been unable to come up with an answer.

We request urgent consideration for Personal Care Subsidy, you cannot tell Private Rest Homes to maintain a standard of care and make a profit and at the same time give Subsidy to so called Non-Profit Organisations, with their back-up of voluntary assistance to only break even it is ridiculous.

We would welcome your visit to our Homes at any time.

Thank you

MATRON S. STOPPEL

on behalf of the Rest Homes Association of S.A.

MINISTER FOR HEALTH Parliament House, Canberra, A.C.T. 2600

Dear Senator Jessop,

I refer to your personal representations on behalf of the Rest Homes Association, c/- Employers' Federation Inc., 46 Fullarton Road, Norwood, S.A. 5069 referred to you by the Hon. J. Burdett, M.L.C., concerning funding for rest homes.

I would like to say initially that I recognise that rest homes can play an important role in the care of the frail aged.

Programs relating to residential care for aged people have been, over a number of years, administered by the Commonwealth Government both within my Department and within the Department of Social Security. My Department administers programs of financial assistance for nursing homes, while the Department of Social Security administers programs relating to hostels. State Government health and welfare agencies are also involved in these areas. This has resulted in gaps, inequities and a lack of co-ordination and integration in programs for the aged.

This Government's policies incorporate an integrated plan for the care of the aged, based on a community care program and a residential care program. In respect of residential care, our intention is to moderate growth in the nursing home sector, and to provide a more equitable geographic distribution of nursing home beds while increasing the availability of hostel accommodation.

This year the Government's main initiative in the health area has been to introduce Medicare, although it has also taken some initiatives in the aged care area which will assist in the development and the implementation of its aged care policies. I anticipate that in formulating future Budgets it will be giving consideration to taking further steps to introduce its aged care policies.

Under the current arrangements I see rest Homes as being more akin to hostels than to nursing homes. Consequently, consideration of any assistance that might be provided to them in the short term is a matter for my colleague Senator Grimes. Accordingly, I have forwarded a copy of your representations to him for his consideration.

Thank you for bringing this matter to my attention.

Yours sincerely,

NEAL BLEWETT

Minister for Health Senator D. S. Jessop,

Commonwealth Parliament Offices

4 January 1984

MINISTER FOR HEALTH Parliament House, Canberra, A.C.T. 2600

Dear Senator Jessop,

I refer to your personal representations on behalf of Matron Stoppel of the Rest Homes Association of South Australia, concering the funding for rest homes.

In my previous letter to you of 4 January 1984 on this subject I indicated that the Government had taken some initiatives in the aged care area and that in formulating future Budgets it will be giving consideration to taking further steps to initiate its aged care policies.

I also pointed out that because of their similarity to hostels, consideration of any assistance that might be provided to rest homes in the short term is a matter for my colleague, Senator the Hon. Don Grimes, Minister for Social Security.

Matron Stoppel has requested urgent consideration of matters related to the personal care subsidy. This subsidy is also adminisitered under the Social Security portfolio. Accordingly, I have also forwarded your further representations to Senator Grimes for his consideration.

Yours sincerely,

NEAL BLEWETT

Minister for Health Senator D. S. Jessop,

Parliament House,

Canberra, A.C.T. 2600

29 February 1984

COMMONWEALTH OF AUSTRALIA

Minister for Social Security Parliament House Canberra, A.C.T. 2600

Dear Senator Jessop

The Minister for Health, the Hon. Neal Blewett has forwarded to me your letter of 8 November 1983. In it, you expressed concern about the lack of financial assistance from the Commonwealth Government for rest home in South Australia.

You make reference to requirements such as fire protection equipment in rest homes. Regulations concerning operational standards in rest homes are not the responsibility of the Commonwealth Government, but are standards set up by the State Government under the State Health Act 1974 for implementation by the Central Board of Health.

The Commonwealth Government provides subsidy to eligible non-profit organisations to assist them to provide accommodation and care for the aged or disabled members of the community requiring these services. No subsidies are available for profit making enterprises under the existing legislation.

However, the Commonwealth Government is concerned about issues such as the financial viability of rest homes, and is currently undertaking a study into this and other aspects of rest home operations in South Australia. It is proposed to compare the information obtained from the survey with data on subsidised hostels. Further action will be considered after completion of the study and comparative analysis.

Yours Sincerely,

(DON GRIMES)

Senator the Hon. D. S. Jessop

Commonwealth Parliament Offices

1 King William Street,

Adelaide, S.A. 5000

COMMONWEALTH OF AUSTRALIA

Minister for Social Security Parliament House Canberra, A.C.T. 2600

Dear Senator Jessop

The Minister for Health, the Hon. Neal Blewett MP, has forwarded me your letter of 1 December 1983. With it, you enclosed a letter from Matron Shirley Stoppel providing information in suport of the request from the Rest Homes Associaion of South Australia for Commonwealth financial assistance.

My department has had extensive discussions with Matron Stoppel and the Association about the issues raised. The legislative basis for the recurrent funding of aged hostel accommodation is the Aged or Disabled Persons Homes Act ( 1954). Section 2 of that Act restricts the payment of either capital or recurrent subsidy to facilities operating on a not-for-profit basis. Hence, financial assistance in the form of Hostel or Personal Care subsidies is not available to private hostels operating for profit, such as rest homes.

Careful consideration needs to be given to both the cost and policy implications of extending subsidies to orginisations operating hostels for profit. The study of private hostels being undertaken by my department, to which I alluded in my letter to you of 24 January 1984, will assist in consideration of this issue.

Yours Sincerely,

(DON GRIMES)

Senator D. S. Jessop

Commonwealth Parliament Offices

1 King William Street

Adelaide 5000


Senator JESSOP —I know that the Minister is sympathetic and recognises that there is a problem. I know that the Government recognises that there is a problem. I appreciate the response I have had from the Minister. I put the proposition to the Minister that it would be very helpful in South Australia, particularly as the situation has reached crisis point, for the Federal Government to co-operate with the State Government and appoint a medical specialist trained in geriatric treatment, perhaps a senior matron experienced in geriatric nursing, a representative of the rest homes and the nursing homes association, representatives of the private nursing homes in South Australia, and the South Australian Health Comission, to inquire into this problem. I suggest as a starting point that it would perhaps be advisable to investigate the rest homes that are nominated in the article to which I referred and which I have had incorporated in Hansard. I suggest also that it would be helpful if the Commonwealth Government and the State Government in South Australia, as a pilot exercise, examined a cross-section of private nursing homes to establish the claims that up to 20 per cent of their patients could quite properly be accommodated in rest homes. This would alleviate the problem and make beds available so that patients who develop the conditions I have described, including senile dementia, could be accommodated and treated with expert nursing and medical care. I think it is a serious problem. I know that the Minister recognises this. I believe he would recognise the significance and importance of the inquiry that I have suggested. I hope that he will co-operate with the State Government in examining the problem as I have outlined it.