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Thursday, 21 June 2007
Page: 175


Senator CAROL BROWN (6:28 PM) —The incorporated speech read as follows

As the Shadow Minister pointed out in her second reading speech, the Aged Care Amendment (Residential Care) Bill 2007 seeks to amend the Aged Care Act 1997 by introducing a new arrangement for the allocation of subsidies in residential aged care called the Aged Care Funding Instrument or ACFI.

This Bill also removes the current requirement for classifications to expire after 12 months and instead gives providers the option to reappraise residents after 12 months.

The proposed amendments also make it easier for residents to move between aged care homes, by removing the requirement that providers submit a new appraisal.

These amendments are part of broader reforms due to take place in the Aged Care sector in Australia.

They come in the wake of the recommendations resulting from reviews conducted into the pricing arrangements in residential aged care and the resident classification scale.

They are designed to reduce the administrative burden on staff in Aged Care facilities.

The Aged Care Act 1997 saw the introduction of the complex resident classification scale, and increased regulation of the aged care sector.

Aged care providers were required to complete excessive amounts of paperwork for each resident to justify their funding classification.

Generally, these requirements significantly increased the workload of registered nurses working in aged care facilities across Australia, who were responsible for completing all the requisite paperwork.

And of course, with Government funding contingent on the completion of such paperwork, administration became a necessary priority and, sadly, reduced the amount of time available to them to actually care for the aged.

The introduction of the ACFI, which will POTENTIALLY reduce the amount of required paperwork, is a positive step forward for alleviating some of the pressure on staff in aged care facilities around the country.

Any measure that is aimed at providing staff with more time to focus on the needs of residents is, of course, most welcome.

The Bill was referred to the Community Affairs Committee on 29 March this year for review. The Committee tabled its report on the 16 May, and recommended three possible amendments to the bill.

They included:

Recommendation 1.41

“That the bill be amended to omit item 27 repealing the subsection 42-1(4) of the Aged Care Act 1997 and the Department of Health and Ageing monitor the use of this subsection by aged care facilities to ensure that it is used appropriately.”

The bill repeals a provision entitled “High Dependency Care Leave” that allowed more than one residential care subsidy when a resident had to move to another service temporarily, usually a high care facility.

However for a few smaller, often rural facilities, the removal of this provision may have a significant financial impact.

Such facilities should not be forced to unduly suffer simply because other facilities have attempted use this provision inappropriately.

The Government has adopted this recommendation of the Committee, and is moving an amendment which Labor will support. If the Government hadn’t made this amendment, Labor would have done so.

Recommendation 1.44

“That the bill be amended to ensure that determinations made by the Minister under items 28,29 and 31 of the bill are reasonable and a safeguard similar to that in section 44-4, which item 32 repeals, be implemented under the new ACFI to determine the minimum subsidy level.”

The bill proposes that the Minister will be able to determine the lower basic subsidy when a resident is receiving extended care in hospital.

As with any areas that rely on ministerial discretion, providers are nervous that the determination could possibly result in the significant loss of funds.

The Government has also adopted this recommendation of the Committee, and is moving an amendment which Labor will support.

And Finally, Recommendation 1.48

“That a review of the ACFI be undertaken eighteen months after its implementation to assess the implications to all aged care providers and ensure that the stated benefits are achieved”

Labor will amend the bill to require a formal review 18 months after implementation.

This review will be essential in determining the effectiveness or otherwise of the ACFI and its real impact on aged care providers around Australia.

If the Government is serious about getting aged care services right such a review is vital.

Securing the Future

In February this year the Prime Minister launched the Government’s revised aged care package, Securing the Future of Aged Care.

Getting it right in terms of the provision of Aged Care services in Australia has never been so vital.

The Prime Minister himself has acknowledged that the number of people relying on such services is set to rapidly increase.

The number of Australians aged 70 and over will double in the next twenty years.

My home state of Tasmania will most likely become the ‘oldest’ in terms of the population ageing from around the end of the decade onwards.

Indeed, the challenge of ensuring the effective provision of care for our rapidly ageing population is most likely to continue to grow over the next decade and into the future.

As lifestyle changes, and improved health care treatments, and their availability see Australians living well into their 70’s and even 80s more and more Australians will require access to aged care services and in many cases enter into an aged care facilities.

Community expectation is that a wide range of quality services will be available across the country in urban and rural and regional areas, and that our older Australians needs are met—which is only right

After all older Australians have worked hard, paid their taxes and made valuable contributions to their communities and our way of life.

While the Governments new funding package was initially welcomed by aged care service providers, many in the sector became increasingly sceptical as the details of the package emerged.

Indeed many providers became increasingly concerned about the potential to lose funding under the proposed package and the impact it would have particularly on the low-care facilities

Despite a funding “patch” of $92 million over four years in the Budget to fix “unintended consequences” in the Securing the Future package, providers remain concerned about sustainability into the future.

These concerns have been voiced with increasing urgency in my home state of Tasmania, where insufficiencies in the Government’s funding model have already forced the closure of two aged care facilities in southern Tasmania in the last few months.

The funding provided to these facilities by the Federal government barely covered the cost of wages, and ever increasing cost of providing quality care let alone the services that are provided.

These closures come despite the fact that there is a significant waiting list for residential care places in the region.

Many more aged care providers around the state may too face the threat of closure.

And from all accounts things are only likely to get worse for providers in Tasmania under the Governments Securing the Future of Aged Care package.

The President of Aged and Community Services Tasmania (ACST), Ms Susan Parr has said that while the increases in funding under the new package are welcome, she believes that it is still inadequate to deal with the emerging pressures on the aged care system, especially in low-care.

In particular, Ms Parr is most concerned that the Federal Government’s funding levels are “not keeping pace with the cost of care and providers are continually being asked by the Government to do more with less and it’s falling to families and care providers to make up the shortfall.”

There is more and more pressure on aged care providers. You only have to talk to some of the people who work in the industry to understand the level of pressure they are under. Not being able to provide residents with the level of care and attention that they deserve causes considerable stress to nurses, families and others

The nature of the Federal Government funding model for low-care facilities, simply does not makes it harder for smaller facilities with fewer residents financially viable.

Sadly, this proposed package does nothing to address this problem.

Tasmania at around 17% has a comparatively large proportion of small services with 20 or fewer places.

Until this is addressed properly, smaller homes in Tasmania may continue to close, forcing residents to relocate to bigger facilities away from their families, support networks and local communities.

It simply does not make any sense. How can this ensure, as the Prime Minister claims ‘that the increasing number of older Australians now and in the future will be able to access the right level of care, when they need it?’

A recent survey conducted by Taspoll on behalf of the Aged and Community Services Tasmania found that 76.4% of those surveyed in Tasmania did not think that services for the aged were adequately funded.

This finding demonstrates the level of community concern about Aged care services and the significant level of discontent with the Federal Government’s current approach to aged care.

The Government may well say, as it did when announcing in February that it will allocate an additional $1.5 billion in to the aged care sector over the next five years. What really matters though is how that money is going to be spent.

If homes such as the two I have referred to in Tasmania must close their doors, the question must be asked whether the Government has its priorities right or whether it is simply focused on the almighty dollar.

I completely understand the need for efficiencies in the provision of sustainable aged care services in Australia. Like any other business, the continuation of such services depends, in part, on them running efficiently.

But aged care services have many unique features which must also be factored into the Government’s funding model and broader policy on aged care

We must not simply aim to provide an efficient service; we must also ensure that we are providing high quality, caring services that provide for the diverse and complex needs of older Australians.

Part of providing adequate services is taking into account factors such as whether a resident will be forced to move a considerable distance away from their local community and family

If the Government views residents needs and value simply in terms of their funding classification it is likely that that is all that they will become.

Our lives today have become so busy that few of us can care for our aged relatives on a full time basis

This is why many of us are forced to put our trust in residential aged care providers to take care of our family member’s day to day needs.

The Government must play its part in ensuring that older Australians are not only part of an efficient-running sector but that they continue to receive top quality care.

I recommend that the bill with the amendments I outlined earlier be passed but the chamber take note that much more needs to be done by the federal government to ensure the provision of adequate aged care services into the future.

The federal government needs to address the concerns of the aged and community care sector.

Particularly the concerns expressed, by the ACST and the Tasmanian division of the Aged Care Association of Tasmania who together represent over 95% of the sector, in their current campaign.

The ACST, President Ms Susan Parr has noted that, “a system under strain [as our aged care system is] will become a system in collapse”.

We must do more to ensure the provision of quality care for our aged, and go further than the government is willing to with this bill.