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AGED CARE AMENDMENT (OMNIBUS) BILL 1999
- Parl No.
- Question No.
Gibbs, Sen Brenda
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- Start of Business
- PETROLEUM RETAIL MARKETING SITES AMENDMENT REGULATIONS
- MIGRATION LEGISLATION AMENDMENT (MIGRATION AGENTS) BILL 1999
- VOCATIONAL EDUCATION AND TRAINING FUNDING AMENDMENT LEGISLATION
- TAIWAN: EARTHQUAKE
- QUALIFICATION OF SENATORS
- PETROLEUM RETAIL MARKETING SITES AMENDMENT REGULATIONS
- AGED CARE AMENDMENT (OMNIBUS) BILL 1999
- NATIONAL HEALTH AMENDMENT (LIFETIME HEALTH COVER) BILL 1999
- CUSTOMS TARIFF AMENDMENT BILL (No. 2) 1999
- WAR CRIMES AMENDMENT BILL 1999
- CUSTOMS TARIFF AMENDMENT BILL (No. 2) 1999
- LAW AND JUSTICE LEGISLATION AMENDMENT BILL 1998
SUPERANNUATION (UNCLAIMED MONEY AND LOST MEMBERS) BILL 1999
SUPERANNUATION (UNCLAIMED MONEY AND LOST MEMBERS) CONSEQUENTIAL AND TRANSITIONAL BILL 1999
- CRIMES AMENDMENT (FINE ENFORCEMENT) BILL 1999
TELEVISION LICENCE FEES AMENDMENT BILL 1999
BROADCASTING SERVICES AMENDMENT BILL (NO. 2) 1999
- STATES GRANTS (GENERAL PURPOSES) AMENDMENT BILL 1999
- AUSTRALIAN TOURIST COMMISSION AMENDMENT BILL 1999
QUESTIONS WITHOUT NOTICE
East Timor: Peacekeeping
(Faulkner, Sen John, Hill, Sen Robert)
Business Tax Reform: Employment
(Chapman, Sen Grant, Hill, Sen Robert)
East Timor: Troop Rotation
(Collins, Sen Jacinta, Newman, Sen Jocelyn)
Business Tax Reform: Retirees
(Coonan, Sen Helen, Newman, Sen Jocelyn)
Business Tax Reform: Revenue Neutrality
(Cook, Sen Peter, Kemp, Sen Rod)
East Timor: Land Mines
(Bourne, Sen Vicki, Newman, Sen Jocelyn)
Business Tax Reform: Capital Gains
(Ludwig, Sen Joe, Kemp, Sen Rod)
Business Tax Reform: Input Tax Credits
(Harradine, Sen Brian, Kemp, Sen Rod)
(Schacht, Sen Chris, Minchin, Sen Nick)
Business Tax Reform: Rural and Regional Australia
(McGauran, Sen Julian, Macdonald, Sen Ian)
Business Tax Reform: Strategic Investment Coordination
(Conroy, Sen Stephen, Minchin, Sen Nick)
Civil Aviation Safety Authority: Airspace Trial
(Woodley, Sen John, Macdonald, Sen Ian)
Australian Federal Police: Funding
(Bolkus, Sen Nick, Vanstone, Sen Amanda)
- East Timor: Peacekeeping
- ANSWERS TO QUESTIONS WITHOUT NOTICE
- PARLIAMENTARY LANGUAGE
- ANSWERS TO QUESTIONS WITHOUT NOTICE
- MINISTERIAL STATEMENTS
- VICTORIA: QUALITY OF SERVICES
Thursday, 23 September 1999
Senator GIBBS (10:55 AM) —I rise to speak on the Aged Care Amendment (Omnibus) Bill 1999. Last night in this chamber Senator Allison delivered an extremely defensive speech. No doubt this was the signal that the Democrats will yet again sell out and vote with the government. They will cave in on this bill just like they caved in on the GST and industrial relations bills. This bill seeks to address the problems that this government, with the willing help of the likes of Senator Allison and her gang of 10, have foisted on the aged care sector. Even the minister could not hide the flaws from parliament. In her own speech she said:
This bill also addresses anomalies in the Aged Care Act 1997 . . .
I could not agree more with the minister when she said that they deserve better, but, after three years of this government, older Australians deserve a whole lot better.
Labor will be moving a number of amendments to this bill to address what we see as further problems in the aged care sector. However, Labor will support the broad concept of this bill, in particular the amendments designed to ensure that people in rural and remote areas who own houses worth less than $23,000 are not denied concessional resident status. As a Queensland senator, I find this of particular importance. As the Senate is aware, Queensland is the most decentralised state in Australia, so this amendment is very important to us.
The history of this government's aged care reforms have read like a circus program, backflip after backflip. Indeed, in March 1998, the government introduced the Aged Care Amendment Bill 1998, but let it lapse so as to minimise their exposure on the issue as the 1998 election approached. The government had been aware of the serious flaws in the Aged Care Act since at least March last year, and only now do they act to rectify this.
This bill also has provisions to ensure that nursing home patients before October 1997 will be refunded any accommodation fees they may have been charged, in contravention of the Prime Minister's promise to the contrary. And where did the Prime Minister announce this backflip? Not in parliament. No. He showed utter contempt for this institution by announcing the change on A Current Affair. Labor can quite proudly claim responsibility for this measure, as the Prime Minister only changed tack after almost 18 months of ALP pressure.
Nursing homes and aged care is an issue of particular importance to me and the people of Queensland. In my home of Ipswich and surroundings, we have some of the highest median ages in the country. In the electorate of Moreton, 16.5 per cent of the population is over 65 years old. In Coolangatta the median age is around 60 years. The Gold Coast has the highest median age in the country. My electorate office is constantly fielding questions from worried and scared older Australians and their families about the devastating effects of this government's relentless cuts to the aged care sector. Yet nursing home service in Queensland has been reduced to the worst in the country. We have the highest waiting lists, lowest funding and worst paid nurses in the country. Now we see the further deskilling of enrolled nurses and assistants in nursing. A 12-month report on the impact of aged care reform on nurses in Queensland compiled by the Queensland Nurses Union shows that staffing hours for all nurses have been cut in more than 50 per cent of nursing homes. Almost 30 per cent of providers directly attribute these cuts to the new resident classification scale introduced by this government. This all adds up to a reduction in the quality of care for nursing home residents, and an increase in stress and anxiety for residents and their families.
The report details changes occurring in the aged care sector in Queensland. The report says that staff have reported increasing work loads; problems with accessing leave; cuts in hours and accompanying changes to skills mix; inability to take meal breaks; an increase in the performance of unpaid overtime; lack of access to training and professional development; pressure on nurses to perform non-nursing duties; and pressure on non-nursing staff to undertake nursing duties. This can only do one thing to the care given to patients, and that is force it down.
The Queensland Nurses Union Secretary, Gay Hawkesworth, said:
There is a notion in some sections of the aged care industry that nursing homes are just homes for elderly people and that they don't need proper nursing staff levels. This idea defies reality. Nursing homes should not be confused with retirement villages. While people in nursing homes are usually referred to as residents for reasons of dignity, they are really patients requiring specialised geriatric health services.
. . . . . . . . .
Most people go into nursing homes as a last resort—when they are too sick to look after themselves or be cared for by relatives. Most go directly from hospital and all require nursing and medical care.
Queensland has the second-worst waiting list for nursing homes in the country—behind the Northern Territory. In Queensland in 1998-99, the average waiting period for a nursing home bed was 93 days, compared with 68 days nationally. In the past three years, waiting lists in Queensland have increased by almost 50 per cent, more than double the national increase. Queensland has also seen a nearly 60 per cent increase in waiting periods in remote areas, up to 93 days.
Evidence provided to the Queensland Nurses Union shows that, in many of the better nursing homes, waiting lists can be up to 18 months. This is a national disgrace. What a way to celebrate and recognise the International Year of Older Persons—making them wait up to 18 months for a nursing home bed. Rather than reduce waiting lists, this government's incompetence over the last three years has caused a national increase of 21 per cent. If this isn't bad enough, when older Australians do finally get a bed in a nursing home, thanks to this government they do not receive the high quality of medical and nursing care they so desperately need and deserve.
A story in the Courier-Mail on 27 July titled `Nursing home terror' claimed:
Some Queensland nursing home residents are living in a culture of terror in which they are subjected to gross degradations, including freezing showers on winter mornings [and] verbal and physical abuse, chemical restraint of patients and starvation.
This is most certainly not the way we expect our older Australians to be cared for. Senator Harradine's unforgettable line in his GST speech on 14 May 1999—`The true test of a civilised society is how it regards and treats its most vulnerable'—is, I think, very apt in the current debate on aged care. This government has well and truly failed this test.
The Aged Care Act removed any detailed regulations as to the ratio of nurses to patients. This has led to the deskilling of nursing staff, as some providers seek to make a quick buck. This has led to a further reduction in the quality of care provided to nursing home patients. This bill does nothing to rectify this situation. Qualified, dedicated and committed nurses will not continue to work under such appalling conditions, where their skills are not adequately recognised and, after five years of being an `aged care worker', they lose their practising licence. These qualified nurses will be replaced with underqualified aged care workers, thus further reducing the standard of care given to our older Australians.
In many nursing homes in Queensland, patients receive less than 1.8 hours of nursing care per day, with there often only being one registered nurse to care for between 30 and 60 patients. The Nurses Union says there should be one registered nurse for between 10 and 25 patients—not 60. Under the guise of deregulation, the government has removed the requirement that at nursing homes with more than eight high-care residents there be 24-hour registered nurse coverage. This further reduces the quality of care being provided for older Australians in nursing homes.
The last thing this side of the chamber wants is to return to the pre-1985 days, when lack of regulation allowed bad practices and low quality of care to flourish. We cannot let cost minimisation be the be-all and end-all of aged care. Nursing is a job where another person's life is at stake, requiring great training and responsibilities. We do not want second-rate aged carers; we need trained nurses.
Aged care reform, with its focus on the reduction of government funding, deregulation and user pays, has resulted in both staff and residents feeling insecure—insecure about whether high standards of care will continue to be maintained in Queensland. This government's only concern is to minimise costs, regardless of the effect on patient care.
In other nursing homes, nursing staff are required to do non-nursing domestic duties, like washing dishes and cleaning toilets. Queensland nursing homes have the highest qualified toilet cleaners and the lowest qualified aged care workers in the Western world. Nurses are caught in the dilemma of having to decide between washing the dishes and caring for their patients. This is bizarre, to say the least. Nurses should be doing what they do best—caring for their patients, not washing dishes.
Queensland also has the lowest funding for aged care in the country. The standard hourly rate determines the amount the government pays nursing homes. This rate is set at different levels in different states, with the rate paid in Queensland being the lowest of all the states. Why are older Australians in Queensland considered less worthy than nursing home patients in the other states? We know there are plans to rectify this situation. We welcome the government's move to increase nursing home funding in Queensland, but not the coalescence policy of slowly increasing funding. Funding needs to be increased now. The patients need it.
Queensland nurses are also the worst paid in the country. It does not take a rocket scientist or even a Liberal minister to work out what this means. Poor remuneration naturally means that highly qualified nurses either leave the sector or move to another state in order to improve their salaries. This is yet another attack on the quality of care in Queensland nursing homes.
This government has also removed key accountability measures which ensured that moneys given to nursing homes for wages or capital improvements were in fact spent on wages or capital improvements. The accommodation bond, the daily fee from nursing home residents or the subsidy from the government is supposed to be spent on capital improvement, yet there are no accountability measures to ensure that this money is in fact spent on capital improvement and not simply pocketed by shonky proprietors or spent in other areas.
Some disreputable operators are seeking to increase their profits by cutting services and skimming more money off the top, even though patient requirements have not changed. This means that the government will be inadvertently lining some proprietors' pockets to the tune of $142 million in 1999-2000, to the detriment of older Australians. I am sure this is not the intention of the government. It is this significant problem that our amendment seeks to address.
It is an issue that does urgently need to be addressed, and I will outline one scenario to prove the point. Queensland nursing home owners Kerry and Malcolm Bishop were recently sentenced to four years and three years imprisonment respectively for defrauding the Commonwealth government of over $130,000. The couple pleaded guilty to one count each of being knowingly concerned with the defrauding of the Commonwealth between 1987 and 1994. This involved claim ing that domestic staff were performing nursing duties.
In another instance, they claimed that clerical staff in Melbourne were performing nursing duties in Queensland and that gardeners performed occupational therapy. This case was picked up under our CAM and OCRE systems, which require proper auditing and accounting. But, under this government's system, there are no accountability mechanisms, no way of finding out if this sort of thing is going on all the time. Even the judge criticised the new system, stating:
. . . the Commonwealth had developed programs which depended very greatly on the honesty of nursing home proprietors.
Evidence provided to the Queensland Nurses Union shows that this is not an infrequent occurrence.
We all know that not all nursing home owners or proprietors are dishonest—and I am sure the main bulk of them are not—but you always get the few who will take advantage and will do the damage. I urge the government to support the ALP's amendment to stop this systematic rorting and fraud by a very small number of providers to ensure that money designed for capital improvement is spent on exactly that.
In conclusion, this government has presided over some of the worst reforms of the aged care sector in Australia's history. I am glad to see that it has recognised some of its errors, and this bill is a good first step in improving the aged care area. But there is still a long way to go. We should not and cannot accept waiting lists of up to 18 months for some nursing homes, putting the lives of older Australians at risk.
We should not and cannot accept the replacement of highly qualified and trained nurses with underqualified aged care workers. Nor should we accept the lack of accountability in this sector. We must ensure that money destined for capital works actually gets there. Queenslanders will not accept the fact that Queensland nursing homes are the worst funded and Queensland nurses are the worst paid in the country. Most importantly, the citizens of this country should not and cannot accept the government's slash and burn approach to aged care.