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Wednesday, 17 October 1984
Page: 1826

Senator REID(10.44) —Perhaps we need to remind ourselves that we are discussing cognately the Health Legislation Amendment Bill 1984 and the Social Security and Repatriation Legislation Amendment Bill (No. 2) 1984. It is in relation to those matters that I wish to speak. In particular, I wish to review some aspects of these relevant matters that relate to the Australian Capital Territory. I think most people are well aware at the moment of the run-down of hospital services in the Australian Capital Territory. For example, there have been many instances of very late cancellation of elective surgery. Also clearly there is inadequate nursing staff to give patient care and there seems to be an inability to attract and keep nursing staff in the hospitals in the Australian Capital Territory, at least in the government hospitals. There are also allegations of degenerating ante-natal and post-natal care.

I could speak more on these issues but I wish specifically to deal with the problems of the aging population in Canberra because they are most relevant to the matters before us this morning. I think we could sum up the rest of the health system at present by saying that it is in a mess and that it needs the attention of the Minister for Health (Dr Blewett) in the way that I suggested in a notice of motion that I placed on the Notice Paper earlier this week. There are quite serious problems for many families who have as one of their members a person who is presently classified as frail aged. There are many groups of aged people, and the people in those groups vary considerably. I remind listeners that the office of aged care has not yet been set up, and that too is relevant to the matters that we are discussing. During the last election campaign the Liberal Government promised to establish an office of aged care upon being returned to government, and the Australian Labor Party also said that it would establish an office of aged care. Many of the matters raised in this debate over the last two days may well have been looked at quite differently if in fact the office of aged care had been established some 18 months ago and had been able to get on with the job of analysing the needs of the aged, because there are such varied groups-from the people who retire between 60 and 65 years of age to the very frail aged who are quite elderly. Of course some fall into the frail aged category at a much earlier stage. To look at the aged as just a group of people who have retired is quite wrong.

We need to be sure that resources are spent wisely and actually service needs. I personally think that it is wrong to have the office of aged care under the Minister for Health because the implication of that would be that all the aged are in poor health. It is also wrong for it to be within the Department of Social Security because the implication of that would be that they are all welfare cases. There is a wide range of people with a wide variety of needs, and perhaps the office ought to be established within the Department of the Prime Minister and Cabinet which would indicate that it is a broadly based office. Two Budgets have passed since the promise to establish an office of aged care and, as I see it, it appears to be no nearer than in March of 1983. That is a matter of great regret and there is a risk that ad hoc decisions will be made as problems for the aged arise but no real solution will be found.

Let us look at some of the problems in the Australian Capital Territory. Recently the dilemma of one of my constituents was brought to my notice by the grandson of an elderly woman. This woman, who was then 99 and has since turned 100 years of age, was living with her daughter, I think aged 71. She needed pretty constant care and for a long time the daughter was able to give it. But the daughter became ill-I think it was influenza or something like that; certainly it was debilitating-and it was necessary for the mother to get care on a 24-hour basis. She was put in hospital and, of course, told that she would be able to stay for only 35 days. What happens to this woman at the end of the 35 days? It is clear that the 71-year-old daughter is no longer physically able to give the care that her mother needs. Her mother is not sick; she is merely in the category of being frail aged and in need of assistance. The older woman was approved for urgent nursing home care. That approval was given by a doctor at the Woden Valley Hospital. Of course the family was told that that care would not be available until someone died and a bed became available.

That is the situation that exists in Canberra at present. I do not deny the benefit of the domiciliary services that enable people to stay in their own homes for as long as possible. I totally support them as the first line of assistance, but there seems in this debate to be a complete lack of concern for the fact that there are people who are frail aged and who will eventually need care beyond what their families can give them, if they have families, or beyond what can be given by the domiciliary services which are so valuable to those who are able to stay in their own homes. The case I mentioned is not exaggerated; we have had many such cases and I believe the Minister has totally neglected his responsibilities to the Australian Capital Territory in this area of his portfolio.

At present in the Australian Capital Territory 102 people are assessed as in need of 24-hour care, but they are unable to obtain it and live in other circumstances. Some 35 of these people are now accommodated in acute care hospital beds. We need to look at the charade that surrounds Morling Lodge, a nursing home in Canberra, a very pleasant place that looks after its patients well and is well-managed and well-run. It is an absolutely incredible situation. Morling Lodge built some extensions as a result of which, and following a change in plan, the Lodge finished up with 107 nursing home beds. But there were many technical and red-tape problems and there was a saga of correspondence. Only 106 beds can be occupied because only that number of beds has been licensed for Morling Lodge. As honourable senators can imagine, a great deal of correspondence has been written on this matter and the Minister in one of his more recent contributions to the subject said that the Lodge could not be used even for emergency purposes because such a situation could be open to abuse.

One needs to go back a little into the history of the matter. In January this year Morling Lodge was issued with a certificate stating that it was licensed for 107 beds. As one would imagine, in view of the crisis of nursing home care in the Australian Capital Territory, the extra bed was filled. However, by 1 March the Lodge had received a letter saying that the certificate was incorrect, and that the figure should have been not 107 but 106 beds. It was said that the bed had been filled illegally and should be vacated forthwith. The problem was that the patient in it had nowhere to go until there was a death at Morling Lodge and the patient was able to be put into one of the Lodge's other beds. That has occurred, of course; and to this day the 107th bed remains empty. Another 23 beds are empty in the Australian Capital Territory because of the adverse nursing salaries that exist and continue to exist. There are 12 empty beds at the Allambee Nursing Home and 11 empty beds at the Jindalee Nursing Home . Those beds are empty because of inadequate nursing staff. In the meantime, this pathetic situation continues as to the remainder of the 102 aged people needing 24-hour care, many of whom are presently housed outside the Australian Capital Territory. This is traumatic for the families concerned, and particularly so for the elderly people who have had to be placed outside the Territory.

Some 16 of the people who need 24-hour care and who are awaiting nursing home beds in the Australian Capital Territory are in hospital beds interstate. Ten are in nursing homes outside the Australian Capital Territory-in Young, Yass and Goulburn. They have been moved from here out to those places and I suggest that that is very distressing for them and their families. Twenty-seven are being cared for at home in the Australian Capital Territory. One can imagine the stress to the families and to the old people knowing that they need the sort of 24-hour care that is provided in a nursing home, but also knowing that they are forced to stay in their present home simply because such care is not available. There are a further eight elderly people who are at home outside the Australian Capital Territory, in Queanbeyan, who are in a similar situation to the other 27 to whom I have already referred. By now, it will be realised that there are six more people to be dealt with of the 102, three of whom are housed in hostels in the Australian Capital Territory and three of whom are in hostels outside the Territory. Although the hostels are adequate for many elderly people, they do not have the facilities or staff to deal with the frail aged who may well be incontinent and need special attention and care. The hostels provide a valuable service for people at a particular stage as do the many other types of old folks homes, but there comes a time when the frail aged need special nursing home care . In the Australian Capital Territory, 102 frail aged persons are not able to get that care and have to stay where they are and wait. I remind the Senate that at Morling Lodge one bed remains empty because, according to the Minister for Health, it might be subject to abuse. I suggest that those who are being abused are the families of an aged person in the distressing situation of not being able to get the care he needs and the frail aged person who might be able to use that bed if the Minister took a somewhat more sympathetic approach.

Some steps are now being taken to correct the nurse shortage in the Australian Capital Territory, and not before time. It is well known that 23 nursing home beds are available and could be used if nurses were available to look after the people. We are told constantly that this is a Government which looks after people and puts the care of the needy, the sick and the disadvantaged first. As far as the frail aged are concerned, I suggest to the Government that it do something about the situation and show that it cares, because the facts rather speak for themselves. At present in our community 430 nursing home beds are available and are being fully utilised for a population of 9,480 people over the age of 65 years. It is well known that this community is aging rapidly; a number of aged people have come to Canberra to live with their children at a time when they can no longer fully look after themselves in their own homes in other States. That is perfectly reasonable, because people have moved to Canberra in the course of their employment in the Public Service. It is inevitable that their aged parents will come here and eventually may need the nursing home care that is necessary for the frail aged. Because of the shortage of nursing home beds, no beds are available for respite care for those who are looked after by their families but who need some time away from them now and again either for a holiday, because of sickness, or for all the other reasons for which respite care is reasonable and necessary. It is another area that needs development.

Who really cares for the carers? The Council on the Ageing in the Australian Capital Territory has set up a careers group so that those who provide virtually 24-hour care for people living with them are able to meet and discuss their problems and perhaps help each other with advice. It is a very valuable group the Council has established. There are 4.7 acute beds per thousand population in the Australian Capital Territory and 6.2 for the rest of Australia. Thus it can be seen that more beds for the frail aged need to be provided in this community.

The Office of Aged Care perhaps could have sorted out a number of these matters and given the sort of advice that would have enabled the problems to be solved and decisions to be made to provide services actually needed for all those involved. We should look at other ways of funding nursing home beds. It may well be that it could be made attractive for superannuation funds and others to provide the capital to build nursing homes and subsidise those who are in them on a different basis which I believe would cost less than the capital cost involved at present. The Office of Aged Care could look into this sort of thing and find out what money would be available. It seems quite absurd that the licensing system of nursing home beds is not related to the needs of the community which would use them. At present the statistics show that it is likely to get worse in the Australian Capital Territory and put more stress on more people, many of whom are not really qualified to look after people on a 24-hour basis. With the best will in the world, and trying as hard as they might, they cannot give the same type of care as properly trained staff who know exactly how to cope.

My contribution to this debate today is to highlight the problem with which we are faced. I ask the Government to take steps to find the right solutions and to establish the Office of Aged Care as a matter of urgency on the basis that I suggested-to make decisions for all those who fall into the category of retirement onwards, and not to look at the problem as something that relates merely to those who are in ill health or without financial resources, because that leaves out a lot of people and tackles the problem quite wrongly.