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Wednesday, 20 March 1985
Page: 490

Senator MESSNER —My question is addressed to the Minister for Community Services. In a rare but welcome moment of candour, when discussing in the South Australian Parliament the home and community care program, did the South Australian Labor Minister for Health, Dr John Cornwall, admit that the scheme had been significantly oversold in a pre-election climate, had unduly raised expectations, had suffered from bureaucratic wrangling and, finally, certainly will not be the answer to all our problems? Does the Minister agree with this incisive analysis by his colleague? Additionally, given the excitement surrounding the Prime Minister's announcement of his new $300m scheme, will the Minister state clearly how much of this $300m is new funds? When will the cost-sharing arrangements with the States be finalised? What assurances can he give to welfare groups which feel that they have been hoodwinked into believing that there will be a new scheme with a massive injection of new funds to assist the aged, the frail and the disabled?

Senator GRIMES —I am not aware that my State colleague, Dr Cornwall, made the statement he is alleged to have made in the State Parliament. I certainly will check to see whether he did so. It certainly does not surprise me that he said that sort of thing. I certainly agree with Dr Cornwall if he said that the home and community care program will not be the answer to all our prayers. If he said that there has been bureaucratic wrangling about it, if that is his shorthand for saying that there has been some disputation between State and Federal public servants in negotiating the program both during the election campaign and since then. I agree. Of course there have been differences of opinion between State and Federal bureaucrats during those negotiations, as there have been with every negotiation that has ever taken place between State and Federal bureaucrats on any subject, particularly on any subject involving money, since Federation.

Senator Messner said that Dr Cornwall said that the home and community care program had been oversold. I suppose that is a matter for judgment. If Senator Messner is suggesting that we said that there would be $330m-worth of new funds for this program, or if he interpreted it as being that, it was certainly oversold to Senator Messner. I certainly have not said that.

The state of play with the home and community care program is simply what I have stated here before. We have had negotiations between State and Federal public servants. I have had two lots of discussions, I think, with State Ministers involved. I have been to three seminars attended by large numbers of people in three States about the development of the home and community care program. There have been more seminars involving non-government organisations to which public servants representing the Commonwealth have been.

Of course, there are difficulties in negotiating any sort of agreement such as this. If, as I suspect, the Minister for Health in my own State intends merely to transfer existing State programs on to Federal funding and not introduce anything new himself, therefore cutting down State expenditure, there will be no home and community care program agreement between the Federal Government and Tasmania. That will apply to any other State.

I believe that most States, in fact, are taking the potential program seriously and are negotiating in good faith. They are not using the home and community care program negotiations to score political points. I believe that in the long term they will not use the program just to reduce their own Budgets.

In 1984-85 the Commonwealth allocated $10m to the States and Territories on an unmatched basis for newly expanded programs. On a 2:1 basis $25m has been provided for 1985-86, and $30m for 1986-87. Thereafter, we hope that there will be a dollar-for-dollar matching of eligible State outlays. That was the proposition we put to the States. The overall Commonwealth contribution is expected to be considerable in those first three years. The exact amount will depend on the results of negotiations.

Neither I, nor the Prime Minister, nor anyone here has suggested that the home and community care program that we have put forward will solve all the enormous problems which face this country. Australia has a higher number of nursing home beds per capita than any other country in the world. It has an appalling lack of home and community care services for elderly and disabled people who would prefer to live in their own homes. It has an imbalance between the various sorts of accommodation for the aged and disabled, there being far too many nursing homes, as compared with the number of hostels and the number of people who have independent living arrangements or who live in their own homes with some assistance. Those problems are very large and will loom even larger with an aging population.

The home and community care program was one proposition put forward to provide a co-operative effort between the States, the Federal Government, local government and non-government organisations as a first step in taking the emphasis away from providing institutional care for those who would be better off in their own homes and communities, with those they grew up with and their relatives. That is what the home and community care program is about. I hope we get a successful agreement with most of the States. If we cannot get agreement with individual States, so be it. If we do not make a step in this direction, if we do not change the direction we have had in the post-war years, the burden on the community in providing inappropriate institutional care will continue to rise and be considerable and the lives of the people receiving inappropriate institutional care will be less than satisfactory. That is the sort of situation we wish to correct.

Senator MESSNER —Mr President, I ask a supplementary question. As the Minister would know, the Opposition supported this program from its announcement in the Budget last year. We have no worries about supporting it now. What concerns us is that there does not appear to be the same commitment on the part of the Government to introducing new funds into the program as people were originally promised.

The PRESIDENT —Order! I ask the honourable senator to ask his supplementary question.

Senator MESSNER —Does the Minister agree that the money now introduced into the program is peanuts?

Senator GRIMES —I thank Senator Messner for saying that he supported the home and community care program which was first announced and put forward in the last Budget. The figures that I have quoted and which Senator Messner and his colleagues had to look at were in that last Budget. If Senator Messner is suggesting that the amount was peanuts then, he should have said so at that time. If he is saying that the amount of money we are able to put up in the present economic circumstances will not solve all the problems we see, I agree with him. But if he is suggesting at the same time that we should blow out the Federal Budget or transfer funds from other worthy causes in the community to provide, in one big hit, an expanded expenditure in this area, he is wrong and he knows he is wrong. Neither the States nor the Federal Government could in one fell swoop reverse the situation to which I referred earlier. We have proceeded cautiously because we do not want to proceed down the path that the previous Government proceeded down when it introduced programs like the program of aids for disabled people which crashed down around our ears in the first couple of years.