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Thursday, 21 June 2007
Page: 168


Senator STEPHENS (Parliamentary Secretary to the Leader of the Opposition) (6:28 PM) —The incorporated speech read as follows—

I rise to speak on the Aged Care Amendment (Residential Care) Bill 2007. The bill will amend the Aged Care Act 1997 to introduce a new arrangement for allocating subsidies in residential aged care. The aged-care funding instrument is designed to reduce the amount of documentation generated in aged-care facilities which is used to justify the funding classification for each resident.

Aged care is an important issue that needs to be addressed, of course. A reduction in paperwork for aged-care staff is welcome, as it will allow for the already stretched resources in aged-care facilities to be concentrated on looking after residents. At many of the aged-care facilities that I have had the privilege to visit, one thing that I have heard time and time again from the providers of aged care is that too much time is spent on paperwork and not enough time on the actual care of the aged. So this bill is welcome in that it will ensure that providers can spend more resources and time on looking after the people in those aged-care premises and will relieve providers of the mountains of paperwork.

Despite this bill’s attempts to address a more flexible funding regime, there are big problems in the aged-care sector in my home state of New South Wales, and this bill gives me an opportunity to speak more broadly on the issues that the bill is attempting to address. We have many aged and frail patients inappropriately languishing in public hospital beds, causing blockages in the public health system. Funding for the aged-care facilities continues to fall, leaving many families with few, if any, appropriate options for the care of an elderly relative and, therefore, restricting access to nursing homes that would normally be glad to take them.

Some 3,000 nursing homes across Australia are at this time catering for over 160,000 people, with the demand for care increasing dramatically. It has been estimated that by 2019 there will be a need to provide care for some 970,000 people. This is a factor that the Howard government continues to refuse to recognise. Where do they think these people will be placed? They cannot stay at home, as the funding for home based care is insufficient to allow that to continue safely. Home based care programs and services are continually suffering from a severe lack of funding and an inability to get quality staff to carry out the care—though many people would rather stay at home under that sort of care.

In many cases, families cannot care for their elderly parents or relatives because of other commitments on their time—for example, work and caring for children or a partner. In 1997, the Howard government made some pretty significant changes to the aged-care system which it predicted would guarantee positive outcomes for elderly Australians.

Those changes have never happened. The reforms never actually came into being, leaving a very large sector of the community still waiting to hear how their loved ones could be cared for.

Provision of adequate funding of aged care is high on the agenda for all providers. Maybe it is time to move to a funding model based on an accommodation component and a care component. It is suggested that there should be separation of these two cost drivers in residential aged care. This could possibly offer the public more flexibility, transparency and community understanding in this service delivery area.

There are myths and incorrect assumptions about working in aged care. The allocation of additional undergraduate nursing places in the budget is of course welcome, but it is now our responsibility to ensure the recruitment of more nurses for the aged-care sector. There needs to be more encouragement of personal carers to adopt careers in aged care.

The involvement of the medical and allied health professions in aged care is a goal that we all seem to want to achieve, but the barriers remain. There are access, funding and availability questions that must be addressed. Pay equity is an issue relative to not only nurses but also all aged-care workers. This should be addressed immediately. The conditional adjustment payment to 2007 is not of itself a sustainable solution.

Community expectations are growing very quickly. Families of residents of aged-care facilities and receivers of community care increasingly want to understand the type of care being provided. There will increasingly be an expectation that the staffing level and mix be known and understood by families of people who receive care.

Workforce issues present a challenge that can only be achieved through government and sectoral collaboration around funding, consumer education, training and education, career path development and national leadership. Labor will continue to hold the Howard government accountable for its failure to plan ahead and provide the type of detailed policies that are needed in aged care in particular. Planning for our built communities needs to take into account the overall ageing of the population. This needs to be kept in mind, with clever design and innovative ideas. This brings challenges to the building industry, town planners and governments, particularly local government, in delivering homes and communities that are suitable for the needs of an ageing population.

The emergence of Australia’s ageing population is not a surprise. The Australian National University Research School of Social Sciences reports three principle causes for this occurring. Firstly that the fertility rate has fallen to unprecedentedly low levels with no indication that it will increase again in the future. The fertility rate for population replacement is 2.1 births on average per woman since the mid 1970’s and is currently at 1.75 and declining. The second reason is that mortality rates of older Australians has fallen and the third cause is that from 2010 the large post war baby boom cohort begin to turn 65. These baby boomers will continue to exert significant influence on the size of Australia’s aged population—and its proportion of the total population—until around 2050.

Policy makers, aged care providers, designers and planners are required to take a proactive approach to promote innovative ideas to help older residents to age in their local community in a productive, healthy and active way. Every individual, family, community, business and each level of government is aware of, and will feel the impact of Australia’s ageing population.

Growing numbers of older Australians are demanding—and are entitled to—more choice in when, where and how services are delivered to enable them to enjoy quality of life throughout their whole life. We need to create positive environments for healthy ageing, including ones that can cater for transitional care, rehabilitation and ageing-in-place from low to high-level care.

Some people are likely to choose lifestyle villages, whereas others may choose to stay in their own homes that have been modified with, for example, wider doorways and ramps, and some may need greater care. We know that the best solution for people when they reach those twilight years is to remain in their own homes, with adequate care, if they are able to. For those who choose to stay in their homes, there is the significant issue of social isolation. It is here that policy needs to be developed to prevent this isolation from becoming an epidemic in Australia. This isolation often develops because the person may have a disability or may have lost a partner or may have few transport options.

Planning must take all of these circumstances into consideration in order to achieve cohesive communities. The importance of older Australians remaining involved in community life and remaining socially connected cannot be underestimated in their maintaining good health, both physically and mentally.