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Monday, 10 September 1984
Page: 761

Senator GRIMES (Minister for Social Security)(10.50) —First of all, I am sorry that I was unable to be here to listen to what Senator Reid said tonight but I can assure her I will have a look at Hansard tomorrow and will get replies to all the matters she raised.

I am more familiar, as Senator Jessop has said, with the problems that he has raised and with those that the South Australian Rest Homes Association has raised with him and through the Press. Let me say first of all, and I think it is fair for me to say, that no Commonwealth government of any persuasion has ever had a role in subsidising rest homes of this type. It is not clear to me or to my colleague the Minister for Health (Dr Blewett) why these homes now find themselves in financial difficulties to the extent that they claim they will have to close down in a fortnight. In fact they have never received Commonwealth subsidies in the past and Commonwealth legislation does not provide for us to fund profit-making rest homes in the way that Senator Jessop and the rest homes would like.

There may be, as Senator Jessop has said, something in what they say about the level of dependence of their patients having changed in recent years, but at the moment we have no evidence of this, although a Senate inquiry into this sort of thing is under way at the moment. It is also worth pointing out that to the extent that there are any controls over rest homes, those controls are imposed by State governments, not the Commonwealth Government. If we funded these rest homes to the extent that some people seem to claim they should be funded, as have the articles in the Adelaide News, the cost in South Australia would be something like $3m a year. We do not know the cost Australia-wide because we do not know the extent to which these institutions exist.

It is worth while pointing out that funding by the Commonwealth for nursing homes, which is the most expensive form of care for the aged, and funding for hostels, carries with it the provision of certain services and conditions. The staffing costs at the moment are about 75 per cent to 80 per cent of nursing home expenditure. Where nursing home benefits are paid, in South Australia, for instance, such homes are expected to employ staff of the order of one nurse for each six patients during the day, one nurse for each eight patients in the afternoon and one nurse for each 15 patients at night. Those provisions vary throughout the States but they are roughly the same as that.

If the rest homes that Senator Jessop mentioned were to be funded, they would have to look at their staffing ratios. They would also have to look at the minimum accommodation standards which are provided and which are regulated by State governments. Heaven knows what the capital cost of those changes would be.

Senator Jessop —That is quite right, but I hope you will address the other point .

Senator GRIMES —I am coming to that. Senator Jessop pointed out that it is believed by the rest home proprietors that something like 20 per cent, I think he said, of nursing home patients should not be nursing home patients and should be in other forms of accommodation. I certainly would accept that figure. In fact I think it is a very conservative figure. It is estimated in some States that some 25 per cent to 30 per cent or even more of the people in nursing homes should not be there. That is why the present Government has introduced the new age care package. We want to introduce geriatric assessment. We want greater control over the people who are going into nursing homes. We want to introduce a system whereby we encourage people to stay in their own homes. When they cannot do that we hope to encourage them to go into hostels or independent type accommodation. Only when necessary should they go into nursing homes. We accept that. We have moved to do something about it. That is what the package in the present Budget is all about.

Quite suddenly we find that the profit-making rest homes in South Australia are coming along and saying: 'Look, we want to be in this. If we are not in this we will have to close down in a fortnight'. I suggest that is not the way we or any government could proceed. An inquiry is already under way into the problems of the rest homes. The Department of Health, with the assistance of the South Australian Government, is looking at this problem. It has been looking at it in recent times. As I said, one of the Senate committees is looking at it. We have to analyse the results of those inquiries.

At the moment South Australia has a higher than average number of nursing home beds and a higher number of hostel beds available per thousand aged people in the community. To expect us suddenly to produce the sort of moneys that Senator Jessop is talking about is a bit much.

Senator Jessop —I want the Minister, if he does not mind, to clear my concern about what happens to the people that these rest homes cannot deal with because they are incapable of doing so. That is the crux of my argument. What will we do with them?

Senator GRIMES —That is the crux of the problem and the crux of geriatric care throughout the community. If the honourable senator were to look at the approvals we have granted in recent times and at the package which is in the Budget which is going through Parliament at the moment he would find that they are problems we are addressing at the moment. I do not believe that we should suddenly, for the first time-the honourable senator should remember that the Commonwealth has been involved in aged persons' accommodation for a long time- move in a big way at a fortnight's notice into funding profit-making rest homes in this way. Of course we are concerned about the matter. It is the result of accumulated problems we have had over the years in the area of geriatric care in this country. However, I will look at the documents that he has had incorporated in Hansard tonight, apart from the letters I wrote to the honourable senator, and I will get a more detailed answer after consultation with my colleague the Minister for Health.

Question resolved in the affirmative.

Senate adjourned at 10.57 p.m.