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Thursday, 22 March 2007
Page: 38


Senator POLLEY (12:02 PM) —I want to acknowledge in the chamber today the contribution to this debate of our shadow minister for ageing, disabilities and carers, and her ongoing commitment to this area. I congratulate her. The hearing that took place was very important. But I also rise today to speak on the Aged Care Amendment (Security and Protection) Bill 2007. Firstly, I wish to commend the government’s allocation of $90.2 million from next month towards further safeguarding residents in aged-care homes from sexual and serious physical assault. This is a welcome move but tragically late in its delivery and sadly limited in its impact.

I remind honourable senators that this bill was only introduced in February this year. For six long months after the minister promised those funds to safeguard aged-care residents the $90.2 million has just been sitting there waiting for this legislation. It is also now a long time—two years—since the Senate inquiry on quality and equity in aged care. And it is one full year since the shocking revelations on the ABC’s Lateline, when distressed relatives told of the sexual abuse of their grandmother in a residential aged-care home. Sadly, that shameful story is not an isolated case.

Nor is the abuse of the elderly limited to criminal assault. It extends to negligence, psychological mistreatment, bullying and neglect. Our aged citizens—our parents and our grandparents—deserve our protection and care. It is a minimalist approach to limit that protection to alleged criminal behaviour. The government should be proactive in compelling providers of aged care to provide care which complies not merely with the criminal law but with standards of decency.

Many of our aged-care institutions do provide that quality of care, particularly in my home state of Tasmania. Most aged-care workers look after the aged and infirm inmates of those institutions with professionalism and dedication that go well beyond the call of duty.

It was extremely helpful for the members of the Senate inquiry into this legislation to hear from associations representing the interests of the ageing community and of the people caring for them. Their knowledge and concern were evident in their submissions and are indicative of the care and commitment of those who look after our aged and infirm. It is just a pity that more use was not made of their valuable expertise when the bill was being drafted. For several of the key stakeholder organisations not to have been involved at all, or to have been involved in only an incidental manner, in the consultations leading up to this legislation is very damning of this government—but that, I would have to say, is proving since I have been in this place to be fairly typical of this arrogant government.

Labor supports the provisions of this bill to the extent that they address the pressing problems faced in aged-care institutions. Compulsory reporting of suspected sexual and physical abuse is as necessary for our aged persons in care as it is for our young people in our schools, but this is overdue. And protection of those who report suspected abuse is essential if the legislation is to be fair for those reporting, as well as effective for those abused. A greater capacity for the Department of Health and Ageing to investigate complaints, and an ombudsman-like Aged Care Commissioner, independent of the department, to scrutinise the department’s investigations are also essential to the effectiveness of this legislation.

However, it is not enough to limit the scope of the legislation to criminal abuse and its prevention. All forms of abuse of the aged should have to be reported. The vast majority of abuses are not a matter of breaking the law but of breaking the hearts of the aged and their relatives. Poor nutrition, neglect—leaving residents unattended in wet and dirty beds—emotional abuse and financial abuse are among the examples of abuse and degradation submitted to the Senate inquiry. Labor, in response to this large, if largely hidden, range of abuses of the elderly, is proposing an amendment so that all forms of abuse must be reported. Deficiencies in nutrition, hydration, hygiene, verbal and emotional or financial abuse, as well as other instances of inadequate care, must be required to be investigated.

The so-called whistleblowers—those who report on these abuses—must also be protected. Labor is also proposing an amendment to widen the categories of people who should report abuses and to extend the same protection to them as is currently proposed only for aged-care providers. There are many people in a position to assess whether or not elderly residents of our aged-care facilities have been abused. Indeed, family members are often the ones best placed to discern the effects of abuse on a loved one. Others who are well placed to observe the abuse itself are other aged-care residents and aged-care advocates. These people, too, should be protected by law from victimisation inflicted on them as a result of their reporting.

Only by widening the network of protectors can we be certain that the aged and frail in our community do not suffer the pain, suffering and indignity that too many of them have been subjected to up to now. It is not only Labor that recommends an amendment of this kind. The Senate committee to which this legislation was referred recommended on 9 March, among other things:

That the Bill be amended to extend the whistleblower protections to aged care residents, the families of residents and aged care advocates where they have reasonable grounds to suspect that the information indicates that a reportable assault has occurred and the disclosure is made in good faith.

It was not only the Labor members of the committee who heard what witnesses had to say. The entire committee recognised that it was a significant oversight to exclude loved ones, as well as experienced, independent professionals, from reporting on abuse of the aged.

How arrogant of this government to ignore the advice it got from the very community that it invited to give advice. These are citizens who know firsthand about the care of the vulnerable in our community. These people took the time to write to the Senate committee and to appear before it. Their experience was taken on board by the Senate inquiry but not, apparently, by this arrogant government. This government will not even listen to its own coalition-dominated committee. As we all know, the committee structure was changed very recently to ensure that the government had control. The government is not even listening to its own committees.

This legislation gives all the signs of a botched job being rushed through by a confused and forgetful minister who himself has now moved on. Only a rattled, tired government would make such a mess of spending the promised $90.2 million. It has skimmed over the surface of the depth and detail of a complex problem. I do acknowledge the amendment being proposed to the impossible commencement date of 1 April—although it was pretty appropriate, being April Fools’ Day.

The changes mean that all staff must be informed. That date, 1 April, was going to make things almost impossible, because there is an onus on institutions to ensure that all staff are properly and correctly prepared for the changes. Anyone who has any idea of the enormous time it has taken to inform teachers, carers, counsellors and medical practitioners about the mandatory reporting of sexual harassment of young people would have some idea of the demands for training in new procedures. So I reiterate that I support the amendment to change the date.

The Senate inquiry was told by stakeholders just what pressures institutions will be under if they have to meet the deadlines of this legislation. With all the will in the world, it will be virtually impossible to set up the systems needed to report, sensitively, accurately and fairly, suspected and alleged instances of sexual abuse. We want to make sure that we get this right. As Catholic Health Australia submitted:

This Bill ... imposes extra administrative, training and legal responsibilities on approved providers without any additional funding flowing to enable the process to be as effective as possible.

Not only funding but clear guidelines are missing. Who will ensure that policies and practices are in place that will truly enable staff to report neglect and abuse without any fear of reprisal? A set of investigation principles has been foreshadowed by the government, but they will not be available until after this bill has become law. So there will be no scrutiny by parliament and no input from the stakeholders best qualified to say what will work and what will not.

Guidelines are essential if the legislation is actually to take effect. Staff will need to know which matters they must report. Management will need to know which matters it must investigate. Institutions will need to know how investigations are to be conducted, and they must exercise care to protect the aged residents and the carers. Procedures may have to be modified, especially where any element of dementia might be involved, and guidelines are crucial in an area of such sensitivity.

Our aged-care system faces a number of long-term challenges. Two years ago the Senate’s inquiry into quality and equity in aged care found deficiencies with the operation of the Aged Care Complaints Resolution Scheme and made recommendations to improve the system. It has taken media reports to shake this government’s complacency. Yet still it has reacted with one bandaid solution, poorly constructed, to a long-term social challenge.

It is estimated that the number of Australians aged 70 or over will double over the next 20 years. We must act now to prepare for the future. The sector has suffered for far too long, and this is evident in the problems which are emerging now. Labor’s stance on this issue is clear: our elderly deserve the right to live in a safe and caring environment. Labor believes that healthy and positive ageing must be an achievable goal. Older Australians deserve the best our nation can provide.

Just one of the many important areas absent from this legislation is the critical issue of staff-resident ratios. Staffing levels have dropped since the introduction of the Commonwealth Aged Care Act 1997, which took away the connection between funding and the level of care provided in aged-care facilities. Various independent surveys have confirmed this. Currently there are no minimum levels of staffing required by Commonwealth legislation for aged-care facilities. The Commonwealth accreditation process only requires a facility to have ‘adequate’ staffing numbers. Residents who have specialised nursing care needs must have them met by ‘appropriately qualified nursing staff’. Opinions will inevitably vary as to what levels are adequate or whether staff are appropriately qualified. These terms must be clarified to end uncertainty.

There is now significant evidence that patient care and safety can be adversely affected by inadequate staff numbers. A well-trained, adequate and valued workforce is ultimately the best protection against elder abuse. The Aged Care Crisis Team has highlighted the importance of all levels of staff working in aged-care services, including management, to have an understanding of the issues of caring for frail older Australians. These issues include dementia and cognitive impairment, troublesome areas that have not adequately been accounted for in this legislation. Additionally, there are no requirements for registered nurses to have undergone specialist training. It is unacceptable for frail and ill elderly people to be cared for largely by untrained staff.

I recognise the inherent difficulties in the education and training of staff working in residential aged-care facilities, in particular assistants in nursing and personal-care staff. There is a critical shortage of aged-care nurses and a major wage disparity between nurses and personal-care staff in the aged-care sector and the acute-care sector. Labor will develop strategies to improve the recruitment and retention of aged-care nurses with a focus on addressing the wage disparity, improving working conditions, reducing the paperwork burden, and improving opportunities for further education and training.

To ensure high-quality service standards are adopted and maintained, Labor supports a rigorous accreditation process. We need to tighten the monitoring of aged-care facilities, especially for those that do not provide an appropriate level of care, to ensure that all aged-care facilities provide high-quality care and services to older Australians. In 1996 there were 800 surplus beds in aged care. We are now facing a massive shortage of beds for the elderly. Waiting time for a bed doubled between 2000 and 2005. Frail and elderly people were taking up acute-care beds in hospital as a direct result of this.

We should be providing aged-care services of the highest quality possible. I believe that older Australians who need residential care should be provided with the highest quality nursing and personal care in safe and comfortable surroundings. I support an effective complaints resolution process to ensure that residents of aged-care facilities and their families are able to resolve their concerns satisfactorily. I commend to the Senate the amendments proposed by the Labor Party.