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Thursday, 29 March 1973
Page: 947

Mr WILSON (Sturt) - I want to draw the attention of the House to the situation of a significant group of aged and invalid people living in nursing homes who, at the beginning of this year, were given a benefit and now appear to be having that benefit taken from them. Late last year the Repatriation Department by advertisement gave details of benefits to be conferred on repatriation pensioners in respect of nursing home care. The advertisement read:

The Repatriation Department will continue to provide nursing home care at no cost to the pensioner for chronic conditions accepted as related to war service.

It went on:

However, if you are a special rate pensioner, an Intermediate rate pensioner, a war widow, widowed mother or World War I nurse, you will from 1st January 1973 be eligible, subject to a personal contribution of $2.55 a day, for nursing home care for chronic conditions not accepted as related to war service where the need for such care has been established and you are admitted to a nursing home approved by the Department.

Following the announcement, no doubt many of the eligible pensioners made application. The standard form of reply when those applicants were accepted for benefit read as follows:

I am pleased to inform you that responsibility for the partial cost of your maintenance in-

The name of the nursing home would then be shown - as detailed below will be accepted by the Department. Your contribution is to be paid direct to the proprietor.

Nursing classification-

In this case it would be intensive care -

Commencing date 1st January 1973.

Approved daily fee SI 5.30 less your contribution of $2.55 - daily rate approved for payment by Repatriation Department $12.75.

In other words, the pensioner was notified that the benefit that was available was nursing home care in an approved home at a cost to him of $2.55 a day, the Repatriation Department undertaking the whole of the additional cost, having approved the home. No reference was made in the advertisement to whether the fee structure of the home had to be separately looked at.

The month of January concluded. The payment was made to the home. The patient paid $2.55 a day or $18 a week. Towards the end of February and into March, this letter was received by patients who had received the benefit:

The Repatriation Department has undertaken to pay your nursing home fees.

Here is the rub -

The maximum rate which they are able to pay is $9.50 a day for ordinary care and $12.50 a day for intensive care. Your hospital has a charge of $12.30 per day for ordinary care and $15.30 per day for intensive care. Are you willing to pay the excess of $2.80 per day?

Two months before, the Department had notified the patient that the patient would only have to pay $2.55 a day and the Department would meet the cost of $15.30. Now, two months later, patients are advised that the Department will only pay $12.50 a day in the case of an intensive care patient and that the balance must be paid by the patient. Later to that a further letter was sent out to the patients n this home to try to explain the situation. It read as follows:

My Department may accept responsibility for the payment of maintenance for certain eligible Repatriation patients accommodated in registered nursing homes subject to a personal patient contribution of $2.55 per day up to a maximum daily rate which is approved by the Repatriation Commission. The present maximum daily rates which have been approved by the Repatriation Commission are $9.50 per day for ordinary nursing care and $12.50 per day for intensive nursing care. (This means that where the nursing home fee is $9.50 a day the Repatriation Department will pay $6.95 and the patient $2.55 per day.) As the fees at present being charged for your maintenance are in excess of the rates approved by the Repatriation Commission, it will be your responsibility to pay the amount in excess, in addition to the mandatory contribution of $2.55 per day.

Patients who were informed 2 months ago that they would have to pay $2.55 a day and are being informed this month that in some instances they will have to pay double that amount daily are being seriously upset by the fact that here is the appearance and the fact of a benefit granted being taken from them.

I pay tribute to the work being done by the Deputy Commissioner of Repatriation in Adelaide in trying to unravel this situation. It appears that an announcement was made. The benefits to be granted were announced to the particular patients but now it is found that the Repatriation Department has a different scale of fees which it approved in relation to approved nursing homes to the scale of fees approved by the Department of Health. It also appears that the Government now has had a look at the question and has said that in some instances the patient should make a greater contribution towards the cost of his care. If that change of decision were to apply to a patient about to enter a nursing home and the circumstances could be outlined to the patient, the patient would be in the position of being able to make his or her own judgment as to whether he or she could afford the cost of $2.55 a day plus the extra that the nursing home wished to charge. However, the people being affected are, in many instances, patients who have been in nursing homes receiving long term care - patients who, whether of a light nursing care nature or of an intensive care nature, have come to regard the nursing homes where they are being properly accommodated as their homes.

In order to try to overcome the financial problem that apparently exists, the Department now is going to these patients and saying: 'If you want to be liable for only $2.55 a day we will try to find another nursing home where you can go and get accommodation for a charge which does not cost you more than $2.55 a day'. I think it creates an unfair situation for and is an inhumane attitude to people who, in the main, are elderly and sick to cause them this emotional upset by suggesting to them that they move from a home that was approved 2 months ago because the Government has now changed its attitude with regard to the costs being charged by that particular nursing home.

The original advertisement in the Press made no reference to the fact that once the nursing home was approved the eligibility for the benefit at $2.55 a day would be looked at in relation to the charges made by that nursing home. I urge the Government to reexamine the position so that existing patients do not have benefits granted to them 2 months ago taken away from them in circumstances that cause them a great deal of distress.

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